hospital_name,last_updated_on,version,,,hospital_location,hospital_address,license_number|ct,financial_aid_policy," To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated. ",,,,,,,,,,,,
Connecticut Children's,1/1/2025,2.0.0,,,Connecticut Children's Medical Center,"282 Washington Street, Hartford, CT  06106",2CH|CT,,TRUE,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,setting,drug_unit_of_measurement,drug_type_of_measurement, standard_charge|gross , standard_charge|discounted_cash ,payer_name,plan_name,modifiers,standard_charge|negotiated_dollar,standard_charge|negotiated_percentage,standard_charge|negotiated_algorithm,estimated_amount, standard_charge|min , standard_charge|max ,standard_charge|methodology,additional_generic_notes,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,78.16,,,78.16,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT ,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,70.34,,,70.34,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,55.94,86.57,percent of total billed charges,,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,55.94,,,55.94,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,68.3,,,68.3,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,55.94,86.57,percent of total billed charges,,
HC FNA BX W/O IMAGE EA ADDL LESION,10004,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,70.29,,,70.29,55.94,86.57,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX ULSND GUIDE FIRST LESION,10005,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX ULSND GUIDE EA ADDL LESION,10006,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX FLUORO GUIDE FIRST LESION,10007,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX FLUORO GUIDE EA ADDL LESION,10008,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX CT GUIDE FIRST LESION,10009,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX CT GUIDE EA ADDL LESION,10010,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX MRI GUIDE FIRST LESION,10011,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT  ,,,both,,,1285.34,771.2,Aetna,Commerical,,929.69,,,929.69,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT ,,,both,,,1285.34,771.2,Aetna,Middlesex Employees,,836.73,,,836.73,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Anthem,Commerical,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Anthem,Indemnity,,,934.8,,934.8,665.49,1029.82,percent of total billed charges,,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Anthem,State Preferred,,831.87,,,831.87,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Anthem,Individual Exchange,,665.49,,,665.49,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Cigna,Cigna,,812.41,,,812.41,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Connecticare,Commerical,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Connecticare,Exchange,,868.95,,,868.95,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,Multiplan,Multiplan,,,1029.82,,1029.82,665.49,1029.82,percent of total billed charges,,
HC FNA BX MRI GUIDE EA ADDL LESION,10012,CPT,,,both,,,1285.34,771.2,United Healthcare/Oxford,United Healthcare/Oxford,,836.09,,,836.09,665.49,1029.82,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC FNA W/O IMAGE,10021,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT  ,,,both,,,948.63,569.18,Aetna,Commerical,,686.28,,,686.28,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT ,,,both,,,948.63,569.18,Aetna,Middlesex Employees,,617.66,,,617.66,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Anthem,Commerical,,614.07,,,614.07,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Anthem,Indemnity,,,690.05,,690.05,491.25,760.19,percent of total billed charges,,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Anthem,State Preferred,,614.07,,,614.07,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Anthem,Individual Exchange,,491.25,,,491.25,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Cigna,Cigna,,599.71,,,599.71,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Connecticare,Commerical,,641.44,,,641.44,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Connecticare,Exchange,,641.44,,,641.44,491.25,760.19,other,Could be inpatient or outpatient,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,Multiplan,Multiplan,,,760.19,,760.19,491.25,760.19,percent of total billed charges,,
HC FNA W/IMAGING,10022,CPT,,,both,,,948.63,569.18,United Healthcare/Oxford,United Healthcare/Oxford,,617.19,,,617.19,491.25,760.19,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT  ,,,both,,,2042.49,1225.49,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT ,,,both,,,2042.49,1225.49,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC US FNA WITH IMAGE,10022,CPT,,,both,,,2042.49,1225.49,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT  ,,,both,,,428.48,257.09,Aetna,Commerical,,310.17,,,310.17,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT ,,,both,,,428.48,257.09,Aetna,Middlesex Employees,,279.16,,,279.16,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Anthem,Commerical,,277.54,,,277.54,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Anthem,Indemnity,,,311.87,,311.87,222.03,343.57,percent of total billed charges,,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Anthem,State Preferred,,277.54,,,277.54,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Anthem,Individual Exchange,,222.03,,,222.03,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Cigna,Cigna,,271.04,,,271.04,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Connecticare,Commerical,,289.9,,,289.9,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Connecticare,Exchange,,289.9,,,289.9,222.03,343.57,other,Could be inpatient or outpatient,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,Multiplan,Multiplan,,,343.57,,343.57,222.03,343.57,percent of total billed charges,,
HC IMAGE GUIDE CATH FLUID DRAINAGE SOFT TISSUE,10030,CPT,,,both,,,428.48,257.09,United Healthcare/Oxford,United Healthcare/Oxford,,278.94,,,278.94,222.03,343.57,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Aetna,Commerical,50,825.48,,,825.48,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Aetna,Middlesex Employees,50,742.935,,,742.935,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Anthem,Commerical,50,738.63,,,738.63,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Anthem,Indemnity,50,,857.690112,,857.690112,590.91,914.385,percent of total billed charges,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Anthem,State Preferred,50,738.63,,,738.63,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Anthem,Individual Exchange,50,590.91,,,590.91,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Cigna,Cigna,50,721.365,,,721.365,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Connecticare,Commerical,50,771.555,,,771.555,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Connecticare,Exchange,50,771.555,,,771.555,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,Multiplan,Multiplan,50,,970.496,,970.496,590.91,970.496,percent of total billed charges,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC I&D ABSC; SMPL OR SGL,10060,CPT  ,,,both,,,1141.76,685.05,United Healthcare/Oxford,United Healthcare/Oxford,50,742.38,,,742.38,590.91,914.385,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC I&D ABSC; COMPL OR MULTI,10061,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT  ,,,both,,,2577.41,1546.45,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT ,,,both,,,2577.41,1546.45,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC I&D PILONIDAL CYST SIMPLE,10080,CPT,,,both,,,2577.41,1546.45,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT ,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC I&D PILONIDAL CYST COMPLEX,10081,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INC & REM FB SQ; SMPL,10120,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT ,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC INC & REM FB SQ; COMPL,10121,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT ,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC I&D HEMATOMA/FLUID,10140,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT  ,,,both,,,390.37,234.22,Aetna,Commerical,,282.48,,,282.48,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT ,,,both,,,390.37,234.22,Aetna,Middlesex Employees,,254.24,,,254.24,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Anthem,Commerical,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Anthem,Indemnity,,,284.04,,284.04,202.22,312.91,percent of total billed charges,,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Anthem,State Preferred,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Anthem,Individual Exchange,,202.22,,,202.22,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Cigna,Cigna,,246.85,,,246.85,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Connecticare,Commerical,,264.03,,,264.03,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Connecticare,Exchange,,264.03,,,264.03,202.22,312.91,other,Could be inpatient or outpatient,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,Multiplan,Multiplan,,,312.91,,312.91,202.22,312.91,percent of total billed charges,,
HC I&D PUCT ASPIRTN,10160,CPT,,,both,,,390.37,234.22,United Healthcare/Oxford,United Healthcare/Oxford,,254.05,,,254.05,202.22,312.91,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT  ,,,both,,,401.7,241.02,Aetna,Commerical,,290.64,,,290.64,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT ,,,both,,,401.7,241.02,Aetna,Middlesex Employees,,261.58,,,261.58,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Anthem,Commerical,,260.05,,,260.05,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Anthem,Indemnity,,,292.23,,292.23,208.05,321.93,percent of total billed charges,,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Anthem,State Preferred,,260.05,,,260.05,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Anthem,Individual Exchange,,208.05,,,208.05,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Cigna,Cigna,,253.97,,,253.97,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Connecticare,Commerical,,271.64,,,271.64,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Connecticare,Exchange,,271.64,,,271.64,208.05,321.93,other,Could be inpatient or outpatient,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,Multiplan,Multiplan,,,321.93,,321.93,208.05,321.93,percent of total billed charges,,
HC PUNCT ASP - ABSC HEMAT CYST,10160,CPT,,,both,,,401.7,241.02,United Healthcare/Oxford,United Healthcare/Oxford,,261.37,,,261.37,208.05,321.93,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT  ,,,both,,,5035.67,3021.4,Aetna,Commerical,,3643.06,,,3643.06,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT ,,,both,,,5035.67,3021.4,Aetna,Middlesex Employees,,3278.75,,,3278.75,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Anthem,Commerical,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Anthem,Indemnity,,,3663.07,,3663.07,2607.78,4035.4,percent of total billed charges,,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Anthem,State Preferred,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Anthem,Individual Exchange,,2607.78,,,2607.78,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Cigna,Cigna,,3183.48,,,3183.48,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Connecticare,Commerical,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Connecticare,Exchange,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,Multiplan,Multiplan,,,4035.4,,4035.4,2607.78,4035.4,percent of total billed charges,,
HC I&D CPLX POSTOP WND INFECTION,10180,CPT,,,both,,,5035.67,3021.4,United Healthcare/Oxford,United Healthcare/Oxford,,3276.27,,,3276.27,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,504.74,,,504.74,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT ,,,both,,,698.34,419,Aetna,Middlesex Employees,,454.26,,,454.26,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Anthem,Commerical,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,361.3,559.1,percent of total billed charges,,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Anthem,State Preferred,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,361.3,,,361.3,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Cigna,Cigna,,441.06,,,441.06,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Connecticare,Commerical,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Connecticare,Exchange,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,361.3,559.1,percent of total billed charges,,
HC DEBR EXZ/INF SKIN; <=10% BS,11000,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,453.92,,,453.92,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT  ,,,both,,,302.82,181.69,Aetna,Commerical,,218.99,,,218.99,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT ,,,both,,,302.82,181.69,Aetna,Middlesex Employees,,197.09,,,197.09,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Anthem,Commerical,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Anthem,Indemnity,,,220.19,,220.19,156.76,242.57,percent of total billed charges,,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Anthem,State Preferred,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Anthem,Individual Exchange,,156.76,,,156.76,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Cigna,Cigna,,191.36,,,191.36,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Connecticare,Commerical,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Connecticare,Exchange,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,Multiplan,Multiplan,,,242.57,,242.57,156.76,242.57,percent of total billed charges,,
HC DEBRIDE INFECTED SKIN ADD-ON =<10% BS,11001,CPT,,,both,,,302.82,181.69,United Healthcare/Oxford,United Healthcare/Oxford,,196.95,,,196.95,156.76,242.57,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT  ,,,both,,,1097.98,658.79,Aetna,Commerical,,794.55,,,794.55,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT ,,,both,,,1097.98,658.79,Aetna,Middlesex Employees,,715.1,,,715.1,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Anthem,Commerical,,710.95,,,710.95,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Anthem,Indemnity,,,798.92,,798.92,568.76,880.12,percent of total billed charges,,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Anthem,State Preferred,,710.95,,,710.95,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Anthem,Individual Exchange,,568.76,,,568.76,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Cigna,Cigna,,694.31,,,694.31,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Connecticare,Commerical,,742.64,,,742.64,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Connecticare,Exchange,,742.64,,,742.64,568.76,880.12,other,Could be inpatient or outpatient,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,Multiplan,Multiplan,,,880.12,,880.12,568.76,880.12,percent of total billed charges,,
HC DEBRIDE SKIN MUSC AT FX SITE,11011,CPT,,,both,,,1097.98,658.79,United Healthcare/Oxford,United Healthcare/Oxford,,714.55,,,714.55,568.76,880.12,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT  ,,,both,,,519.99,311.99,Aetna,Commerical,,376.11,,,376.11,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT ,,,both,,,519.99,311.99,Aetna,Middlesex Employees,,338.5,,,338.5,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Anthem,Commerical,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Anthem,Indemnity,,,378.18,,378.18,269.22,416.62,percent of total billed charges,,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Anthem,State Preferred,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Anthem,Individual Exchange,,269.22,,,269.22,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Cigna,Cigna,,328.66,,,328.66,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Connecticare,Commerical,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Connecticare,Exchange,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,Multiplan,Multiplan,,,416.62,,416.62,269.22,416.62,percent of total billed charges,,
HC ABRASIONS DEBRID,11040,CPT,,,both,,,519.99,311.99,United Healthcare/Oxford,United Healthcare/Oxford,,338.24,,,338.24,269.22,416.62,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,504.74,,,504.74,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT ,,,both,,,698.34,419,Aetna,Middlesex Employees,,454.26,,,454.26,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Anthem,Commerical,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,361.3,559.1,percent of total billed charges,,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Anthem,State Preferred,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,361.3,,,361.3,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Cigna,Cigna,,441.06,,,441.06,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Connecticare,Commerical,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Connecticare,Exchange,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,361.3,559.1,percent of total billed charges,,
HC DEBR FULL TH SKIN,11041,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,453.92,,,453.92,361.3,559.1,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC DEB SUBQ TISSUE 20 SQ CM/<,11042,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT  ,,,both,,,1145.36,687.22,Aetna,Commerical,,828.75,,,828.75,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT ,,,both,,,1145.36,687.22,Aetna,Middlesex Employees,,745.87,,,745.87,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Anthem,Commerical,,741.55,,,741.55,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Anthem,Indemnity,,,833.3,,833.3,593.24,918,percent of total billed charges,,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Anthem,State Preferred,,741.55,,,741.55,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Anthem,Individual Exchange,,593.24,,,593.24,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Cigna,Cigna,,724.19,,,724.19,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Connecticare,Commerical,,774.59,,,774.59,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Connecticare,Exchange,,774.59,,,774.59,593.24,918,other,Could be inpatient or outpatient,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,Multiplan,Multiplan,,,918,,918,593.24,918,percent of total billed charges,,
HC DEB MUSC/FASCIA 20 SQ CM/<,11043,CPT,,,both,,,1145.36,687.22,United Healthcare/Oxford,United Healthcare/Oxford,,745.31,,,745.31,593.24,918,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT  ,,,both,,,3080.73,1848.44,Aetna,Commerical,,2228.17,,,2228.17,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT ,,,both,,,3080.73,1848.44,Aetna,Middlesex Employees,,2005.36,,,2005.36,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Anthem,Commerical,,1993.71,,,1993.71,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Anthem,Indemnity,,,2240.4,,2240.4,1594.97,2468.13,percent of total billed charges,,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Anthem,State Preferred,,1993.71,,,1993.71,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Anthem,Individual Exchange,,1594.97,,,1594.97,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Cigna,Cigna,,1947.08,,,1947.08,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Connecticare,Commerical,,2082.57,,,2082.57,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Connecticare,Exchange,,2082.57,,,2082.57,1594.97,2468.13,other,Could be inpatient or outpatient,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,Multiplan,Multiplan,,,2468.13,,2468.13,1594.97,2468.13,percent of total billed charges,,
HC DEB BONE 20 SQ CM/<,11044,CPT,,,both,,,3080.73,1848.44,United Healthcare/Oxford,United Healthcare/Oxford,,2003.83,,,2003.83,1594.97,2468.13,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT  ,,,both,,,677.55,406.53,Aetna,Commerical,,490.08,,,490.08,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT ,,,both,,,677.55,406.53,Aetna,Middlesex Employees,,441.08,,,441.08,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Anthem,Commerical,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Anthem,Indemnity,,,492.77,,492.77,350.81,542.86,percent of total billed charges,,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Anthem,State Preferred,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Anthem,Individual Exchange,,350.81,,,350.81,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Cigna,Cigna,,428.26,,,428.26,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Connecticare,Commerical,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Connecticare,Exchange,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,Multiplan,Multiplan,,,542.86,,542.86,350.81,542.86,percent of total billed charges,,
HC TANGENTIAL BX OF SKIN SINGLE LESION,11102,CPT,,,both,,,677.55,406.53,United Healthcare/Oxford,United Healthcare/Oxford,,440.74,,,440.74,350.81,542.86,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT  ,,,both,,,293.76,176.25,Aetna,Commerical,,212.48,,,212.48,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT ,,,both,,,293.76,176.25,Aetna,Middlesex Employees,,191.24,,,191.24,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Anthem,Commerical,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Anthem,Indemnity,,,213.64,,213.64,152.09,235.36,percent of total billed charges,,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Anthem,State Preferred,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Anthem,Individual Exchange,,152.09,,,152.09,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Cigna,Cigna,,185.67,,,185.67,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Connecticare,Commerical,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Connecticare,Exchange,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,Multiplan,Multiplan,,,235.36,,235.36,152.09,235.36,percent of total billed charges,,
HC TANGENTIAL BX OF SKIN EA ADDL LESION,11103,CPT,,,both,,,293.76,176.25,United Healthcare/Oxford,United Healthcare/Oxford,,191.09,,,191.09,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT  ,,,both,,,677.55,406.53,Aetna,Commerical,,490.08,,,490.08,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT ,,,both,,,677.55,406.53,Aetna,Middlesex Employees,,441.08,,,441.08,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Anthem,Commerical,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Anthem,Indemnity,,,492.77,,492.77,350.81,542.86,percent of total billed charges,,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Anthem,State Preferred,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Anthem,Individual Exchange,,350.81,,,350.81,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Cigna,Cigna,,428.26,,,428.26,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Connecticare,Commerical,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Connecticare,Exchange,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,Multiplan,Multiplan,,,542.86,,542.86,350.81,542.86,percent of total billed charges,,
HCPUNCH BX OF SKIN SINGLE LESION,11104,CPT,,,both,,,677.55,406.53,United Healthcare/Oxford,United Healthcare/Oxford,,440.74,,,440.74,350.81,542.86,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT  ,,,both,,,293.76,176.25,Aetna,Commerical,,212.48,,,212.48,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT ,,,both,,,293.76,176.25,Aetna,Middlesex Employees,,191.24,,,191.24,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Anthem,Commerical,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Anthem,Indemnity,,,213.64,,213.64,152.09,235.36,percent of total billed charges,,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Anthem,State Preferred,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Anthem,Individual Exchange,,152.09,,,152.09,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Cigna,Cigna,,185.67,,,185.67,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Connecticare,Commerical,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Connecticare,Exchange,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,Multiplan,Multiplan,,,235.36,,235.36,152.09,235.36,percent of total billed charges,,
HCPUNCH BX OF SKIN EA ADDL LESION,11105,CPT,,,both,,,293.76,176.25,United Healthcare/Oxford,United Healthcare/Oxford,,191.09,,,191.09,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT  ,,,both,,,677.55,406.53,Aetna,Commerical,,490.08,,,490.08,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT ,,,both,,,677.55,406.53,Aetna,Middlesex Employees,,441.08,,,441.08,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Anthem,Commerical,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Anthem,Indemnity,,,492.77,,492.77,350.81,542.86,percent of total billed charges,,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Anthem,State Preferred,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Anthem,Individual Exchange,,350.81,,,350.81,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Cigna,Cigna,,428.26,,,428.26,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Connecticare,Commerical,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Connecticare,Exchange,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,Multiplan,Multiplan,,,542.86,,542.86,350.81,542.86,percent of total billed charges,,
HC INCISIONAL BX OF SKIN SINGLE LESION,11106,CPT,,,both,,,677.55,406.53,United Healthcare/Oxford,United Healthcare/Oxford,,440.74,,,440.74,350.81,542.86,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT  ,,,both,,,293.76,176.25,Aetna,Commerical,,212.48,,,212.48,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT ,,,both,,,293.76,176.25,Aetna,Middlesex Employees,,191.24,,,191.24,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Anthem,Commerical,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Anthem,Indemnity,,,213.64,,213.64,152.09,235.36,percent of total billed charges,,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Anthem,State Preferred,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Anthem,Individual Exchange,,152.09,,,152.09,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Cigna,Cigna,,185.67,,,185.67,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Connecticare,Commerical,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Connecticare,Exchange,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,Multiplan,Multiplan,,,235.36,,235.36,152.09,235.36,percent of total billed charges,,
HC INCISIONAL BX OF SKIN EA ADDL LESION,11107,CPT,,,both,,,293.76,176.25,United Healthcare/Oxford,United Healthcare/Oxford,,191.09,,,191.09,152.09,235.36,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,332.96,,,332.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT ,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,299.67,,,299.67,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,238.34,368.82,percent of total billed charges,,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,238.34,,,238.34,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,290.96,,,290.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,238.34,368.82,percent of total billed charges,,
HC REM SKIN TAGS; <=15 LESIONS,11200,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,299.44,,,299.44,238.34,368.82,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,504.74,,,504.74,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT ,,,both,,,698.34,419,Aetna,Middlesex Employees,,454.26,,,454.26,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Anthem,Commerical,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,361.3,559.1,percent of total billed charges,,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Anthem,State Preferred,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,361.3,,,361.3,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Cigna,Cigna,,441.06,,,441.06,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Connecticare,Commerical,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Connecticare,Exchange,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,361.3,559.1,percent of total billed charges,,
HC REMOVE SKIN TAGS ADD-ON =<10 LESIONS,11201,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,453.92,,,453.92,361.3,559.1,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC EXC TR-EXT B9+MARG 0.5CM/<,11400,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 0.6-1.0CM,11401,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 1.1-2.0CM,11402,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 2.1-3.0CM,11403,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT  ,,,both,,,6024.47,3614.68,Aetna,Commerical,,4357.83,,,4357.83,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT ,,,both,,,6024.47,3614.68,Aetna,Middlesex Employees,,3922.05,,,3922.05,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Anthem,Commerical,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Anthem,Indemnity,,,4381.76,,4381.76,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Anthem,State Preferred,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Anthem,Individual Exchange,,3119.43,,,3119.43,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Cigna,Cigna,,3808.08,,,3808.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Connecticare,Commerical,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Connecticare,Exchange,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,Multiplan,Multiplan,,,4827.15,,4827.15,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; 3.1-4.0CM,11404,CPT,,,both,,,6024.47,3614.68,United Healthcare/Oxford,United Healthcare/Oxford,,3919.08,,,3919.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT  ,,,both,,,6024.47,3614.68,Aetna,Commerical,,4357.83,,,4357.83,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT ,,,both,,,6024.47,3614.68,Aetna,Middlesex Employees,,3922.05,,,3922.05,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Anthem,Commerical,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Anthem,Indemnity,,,4381.76,,4381.76,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Anthem,State Preferred,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Anthem,Individual Exchange,,3119.43,,,3119.43,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Cigna,Cigna,,3808.08,,,3808.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Connecticare,Commerical,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Connecticare,Exchange,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,Multiplan,Multiplan,,,4827.15,,4827.15,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES T/A/L; > 4.0CM,11406,CPT,,,both,,,6024.47,3614.68,United Healthcare/Oxford,United Healthcare/Oxford,,3919.08,,,3919.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 0.5CM/<,11420,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 0.6-1.0CM,11421,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 1.1-2.0CM,11422,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 2.1-3.0CM,11423,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT  ,,,both,,,6024.47,3614.68,Aetna,Commerical,,4357.83,,,4357.83,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT ,,,both,,,6024.47,3614.68,Aetna,Middlesex Employees,,3922.05,,,3922.05,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Anthem,Commerical,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Anthem,Indemnity,,,4381.76,,4381.76,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Anthem,State Preferred,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Anthem,Individual Exchange,,3119.43,,,3119.43,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Cigna,Cigna,,3808.08,,,3808.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Connecticare,Commerical,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Connecticare,Exchange,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,Multiplan,Multiplan,,,4827.15,,4827.15,3119.43,4827.15,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; 3.1-4.0CM,11424,CPT,,,both,,,6024.47,3614.68,United Healthcare/Oxford,United Healthcare/Oxford,,3919.08,,,3919.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT  ,,,both,,,7839.33,4703.6,Aetna,Commerical,,5670.15,,,5670.15,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT ,,,both,,,7839.33,4703.6,Aetna,Middlesex Employees,,5103.14,,,5103.14,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Anthem,Commerical,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Anthem,Indemnity,,,5701.28,,5701.28,4058.81,6280.79,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Anthem,State Preferred,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Anthem,Individual Exchange,,4058.81,,,4058.81,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Cigna,Cigna,,4954.85,,,4954.85,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Connecticare,Commerical,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Connecticare,Exchange,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,Multiplan,Multiplan,,,6280.79,,6280.79,4058.81,6280.79,percent of total billed charges,,
HC EXC BENIGN LES S/N/EX G; > 4.0CM,11426,CPT,,,both,,,7839.33,4703.6,United Healthcare/Oxford,United Healthcare/Oxford,,5099.26,,,5099.26,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 0.5CM/<,11440,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 0.6-1 CM,11441,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 1.1-2 CM,11442,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 2.1-3 CM,11443,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT ,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC EXC FACE-MM B9+MARG 3.1-4 CM,11444,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT  ,,,both,,,7839.33,4703.6,Aetna,Commerical,,5670.15,,,5670.15,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT ,,,both,,,7839.33,4703.6,Aetna,Middlesex Employees,,5103.14,,,5103.14,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Anthem,Commerical,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Anthem,Indemnity,,,5701.28,,5701.28,4058.81,6280.79,percent of total billed charges,,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Anthem,State Preferred,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Anthem,Individual Exchange,,4058.81,,,4058.81,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Cigna,Cigna,,4954.85,,,4954.85,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Connecticare,Commerical,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Connecticare,Exchange,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,Multiplan,Multiplan,,,6280.79,,6280.79,4058.81,6280.79,percent of total billed charges,,
HC EXC FACE-MM B9+MARG > 4 CM,11446,CPT,,,both,,,7839.33,4703.6,United Healthcare/Oxford,United Healthcare/Oxford,,5099.26,,,5099.26,4058.81,6280.79,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT  ,,,both,,,276.04,165.62,Aetna,Commerical,,199.45,,,199.45,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT ,,,both,,,276.04,165.62,Aetna,Middlesex Employees,,179.5,,,179.5,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Anthem,Commerical,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Anthem,Indemnity,,,200.55,,200.55,142.77,220.93,percent of total billed charges,,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Anthem,State Preferred,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Anthem,Individual Exchange,,142.77,,,142.77,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Cigna,Cigna,,174.29,,,174.29,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Connecticare,Commerical,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Connecticare,Exchange,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,Multiplan,Multiplan,,,220.93,,220.93,142.77,220.93,percent of total billed charges,,
HC TRIM NAILS,11719,CPT,,,both,,,276.04,165.62,United Healthcare/Oxford,United Healthcare/Oxford,,179.37,,,179.37,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT  ,,,both,,,276.04,165.62,Aetna,Commerical,,199.45,,,199.45,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT ,,,both,,,276.04,165.62,Aetna,Middlesex Employees,,179.5,,,179.5,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Anthem,Commerical,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Anthem,Indemnity,,,200.55,,200.55,142.77,220.93,percent of total billed charges,,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Anthem,State Preferred,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Anthem,Individual Exchange,,142.77,,,142.77,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Cigna,Cigna,,174.29,,,174.29,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Connecticare,Commerical,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Connecticare,Exchange,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,Multiplan,Multiplan,,,220.93,,220.93,142.77,220.93,percent of total billed charges,,
HC DEBR OF NAIL 1-5,11720,CPT,,,both,,,276.04,165.62,United Healthcare/Oxford,United Healthcare/Oxford,,179.37,,,179.37,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT  ,,,both,,,276.04,165.62,Aetna,Commerical,,199.45,,,199.45,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT ,,,both,,,276.04,165.62,Aetna,Middlesex Employees,,179.5,,,179.5,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Anthem,Commerical,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Anthem,Indemnity,,,200.55,,200.55,142.77,220.93,percent of total billed charges,,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Anthem,State Preferred,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Anthem,Individual Exchange,,142.77,,,142.77,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Cigna,Cigna,,174.29,,,174.29,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Connecticare,Commerical,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Connecticare,Exchange,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,Multiplan,Multiplan,,,220.93,,220.93,142.77,220.93,percent of total billed charges,,
HC DEBR OF >6  NAILS,11721,CPT,,,both,,,276.04,165.62,United Healthcare/Oxford,United Healthcare/Oxford,,179.37,,,179.37,142.77,220.93,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC AVUL SGL NAIL PL,11730,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT  ,,,both,,,302.82,181.69,Aetna,Commerical,,218.99,,,218.99,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT ,,,both,,,302.82,181.69,Aetna,Middlesex Employees,,197.09,,,197.09,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Anthem,Commerical,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Anthem,Indemnity,,,220.19,,220.19,156.76,242.57,percent of total billed charges,,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Anthem,State Preferred,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Anthem,Individual Exchange,,156.76,,,156.76,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Cigna,Cigna,,191.36,,,191.36,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Connecticare,Commerical,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Connecticare,Exchange,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,Multiplan,Multiplan,,,242.57,,242.57,156.76,242.57,percent of total billed charges,,
HC AVUL ADD NAIL PL,11732,CPT,,,both,,,302.82,181.69,United Healthcare/Oxford,United Healthcare/Oxford,,196.95,,,196.95,156.76,242.57,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT ,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,344.84,244.17,377.84,percent of total billed charges,,
HC EVAC SUBNGAL HEM,11740,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC REM NAILBD &MATR,11750,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT  ,,,both,,,7609.64,4565.78,Aetna,Commerical,,5504.07,,,5504.07,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT ,,,both,,,7609.64,4565.78,Aetna,Middlesex Employees,,4953.67,,,4953.67,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Anthem,Commerical,,4924.91,,,4924.91,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Anthem,Indemnity,,,5534.29,,5534.29,3939.93,6096.83,percent of total billed charges,,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Anthem,State Preferred,,4924.91,,,4924.91,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Anthem,Individual Exchange,,3939.93,,,3939.93,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Cigna,Cigna,,4809.73,,,4809.73,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Connecticare,Commerical,,5144.42,,,5144.42,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Connecticare,Exchange,,5144.42,,,5144.42,3939.93,6096.83,other,Could be inpatient or outpatient,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,Multiplan,Multiplan,,,6096.83,,6096.83,3939.93,6096.83,percent of total billed charges,,
HC RE NAILBD PHALX,11752,CPT,,,both,,,7609.64,4565.78,United Healthcare/Oxford,United Healthcare/Oxford,,4949.91,,,4949.91,3939.93,6096.83,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT  ,,,both,,,2195.96,1317.58,Aetna,Commerical,,1588.29,,,1588.29,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT ,,,both,,,2195.96,1317.58,Aetna,Middlesex Employees,,1429.47,,,1429.47,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Anthem,Commerical,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Anthem,Indemnity,,,1597.02,,1597.02,1136.94,1759.35,percent of total billed charges,,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Anthem,State Preferred,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Anthem,Individual Exchange,,1136.94,,,1136.94,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Cigna,Cigna,,1387.93,,,1387.93,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Connecticare,Commerical,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Connecticare,Exchange,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,Multiplan,Multiplan,,,1759.35,,1759.35,1136.94,1759.35,percent of total billed charges,,
HC REPAIR NAILBED,11760,CPT,,,both,,,2195.96,1317.58,United Healthcare/Oxford,United Healthcare/Oxford,,1428.38,,,1428.38,1136.94,1759.35,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,504.74,,,504.74,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT ,,,both,,,698.34,419,Aetna,Middlesex Employees,,454.26,,,454.26,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Anthem,Commerical,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,361.3,559.1,percent of total billed charges,,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Anthem,State Preferred,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,361.3,,,361.3,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Cigna,Cigna,,441.06,,,441.06,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Connecticare,Commerical,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Connecticare,Exchange,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,361.3,559.1,percent of total billed charges,,
HC WEDGE EXC NAIL FOLD,11765,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,453.92,,,453.92,361.3,559.1,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT  ,,,both,,,523.24,313.94,Aetna,Commerical,,378.55,,,378.55,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT ,,,both,,,523.24,313.94,Aetna,Middlesex Employees,,340.69,,,340.69,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Anthem,Commerical,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Anthem,Indemnity,,,380.63,,380.63,270.98,419.32,percent of total billed charges,,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Anthem,State Preferred,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Anthem,Individual Exchange,,270.98,,,270.98,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Cigna,Cigna,,330.79,,,330.79,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Connecticare,Commerical,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Connecticare,Exchange,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,Multiplan,Multiplan,,,419.32,,419.32,270.98,419.32,percent of total billed charges,,
HC INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11981,CPT,,,both,,,523.24,313.94,United Healthcare/Oxford,United Healthcare/Oxford,,340.44,,,340.44,270.98,419.32,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT  ,,,both,,,1710.83,1026.5,Aetna,Commerical,,1237.42,,,1237.42,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT ,,,both,,,1710.83,1026.5,Aetna,Middlesex Employees,,1113.68,,,1113.68,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Anthem,Commerical,,1107.21,,,1107.21,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Anthem,Indemnity,,,1244.22,,1244.22,885.77,1370.68,percent of total billed charges,,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Anthem,State Preferred,,1107.21,,,1107.21,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Anthem,Individual Exchange,,885.77,,,885.77,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Cigna,Cigna,,1081.32,,,1081.32,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Connecticare,Commerical,,1156.56,,,1156.56,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Connecticare,Exchange,,1156.56,,,1156.56,885.77,1370.68,other,Could be inpatient or outpatient,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,Multiplan,Multiplan,,,1370.68,,1370.68,885.77,1370.68,percent of total billed charges,,
HC RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,11983,CPT,,,both,,,1710.83,1026.5,United Healthcare/Oxford,United Healthcare/Oxford,,1112.83,,,1112.83,885.77,1370.68,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 2.5CM/<,12001,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 2.6-7.5CM,12002,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 7.6-12.5CM,12004,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 12.6-20.0CM,12005,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; 20.1-30.0CM,12006,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP S/N/A/G/TR/E; > 30CM,12007,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 2.5CM/<,12011,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 2.6-5.0CM,12013,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 5.1-7.5CM,12014,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 7.6-12.5CM,12015,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 12.6-20.0CM,12016,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; 20.1-30.0CM,12017,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.64,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC SMPL REP F/E/N/L/MM; > 30.0CM,12018,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC TX S WND DEHISC; SMPL,12020,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC TX S WND DEHIS; W PACKING,12021,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Aetna,Commerical,50,1516.65,,,1516.65,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Aetna,Middlesex Employees,50,1364.99,,,1364.99,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Anthem,Commerical,50,1357.07,,,1357.07,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Anthem,Indemnity,50,,1574.943384,,1574.943384,1085.67,1679.99,percent of total billed charges,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Anthem,State Preferred,50,1357.07,,,1357.07,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Anthem,Individual Exchange,50,1085.67,,,1085.67,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Cigna,Cigna,50,1325.33,,,1325.33,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Connecticare,Commerical,50,1417.55,,,1417.55,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Connecticare,Exchange,50,1417.55,,,1417.55,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,Multiplan,Multiplan,50,,1782.0845,,1782.0845,1085.67,1782.0845,percent of total billed charges,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT <=2.5CM,12031,CPT  ,,,both,,,2096.57,1257.94,United Healthcare/Oxford,United Healthcare/Oxford,50,1363.95,,,1363.95,1085.67,1679.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 2.6-7.5CM,12032,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/TR/EXT 7.6-12.5 CM,12034,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 12.6-20.0CM,12035,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR S/A/T/EXT 20.1-30.0CM,12036,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC INT RP S/T/E>30CM,12037,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT =< 2.5 CM,12041,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 2.6-7.5CM,12042,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5CM,12044,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 12.6-20.0CM,12045,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 20.1-30.0CM,12046,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC INTMD WND REPAIR N-HF/GENIT 30.0+CM,12047,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM =< 2.5 CM,12051,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 5.1-7.5 CM,12053,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 12.6-20.0 CM,12055,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 20.1-30.0 CM,12056,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC INTMD WND REPAIR FACE/MM 30.0+ CM,12057,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP TRUNK; 1.1-2.5CM,13100,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP TRUNK; 2.6-7.5CM,13101,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC CMPLX REP TRUNK; EA ADDTL 5 CM/<,13102,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT  ,,,both,,,2195.96,1317.58,Aetna,Commerical,,1588.29,,,1588.29,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT ,,,both,,,2195.96,1317.58,Aetna,Middlesex Employees,,1429.47,,,1429.47,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Anthem,Commerical,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Anthem,Indemnity,,,1597.02,,1597.02,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Anthem,State Preferred,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Anthem,Individual Exchange,,1136.94,,,1136.94,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Cigna,Cigna,,1387.93,,,1387.93,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Connecticare,Commerical,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Connecticare,Exchange,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,Multiplan,Multiplan,,,1759.35,,1759.35,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP S/A/L; 1.1-2.5CM,13120,CPT,,,both,,,2195.96,1317.58,United Healthcare/Oxford,United Healthcare/Oxford,,1428.38,,,1428.38,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT  ,,,both,,,2195.96,1317.58,Aetna,Commerical,,1588.29,,,1588.29,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT ,,,both,,,2195.96,1317.58,Aetna,Middlesex Employees,,1429.47,,,1429.47,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Anthem,Commerical,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Anthem,Indemnity,,,1597.02,,1597.02,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Anthem,State Preferred,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Anthem,Individual Exchange,,1136.94,,,1136.94,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Cigna,Cigna,,1387.93,,,1387.93,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Connecticare,Commerical,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Connecticare,Exchange,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,Multiplan,Multiplan,,,1759.35,,1759.35,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP S/A/L; 2.6-7.5CM,13121,CPT,,,both,,,2195.96,1317.58,United Healthcare/Oxford,United Healthcare/Oxford,,1428.38,,,1428.38,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT ,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC CMPLX REP S/A/L; EA ADD 5 CM/<,13122,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT ,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC COM FA 1.1-2.5CM,13131,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT  ,,,both,,,2195.96,1317.58,Aetna,Commerical,,1588.29,,,1588.29,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT ,,,both,,,2195.96,1317.58,Aetna,Middlesex Employees,,1429.47,,,1429.47,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Anthem,Commerical,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Anthem,Indemnity,,,1597.02,,1597.02,1136.94,1759.35,percent of total billed charges,,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Anthem,State Preferred,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Anthem,Individual Exchange,,1136.94,,,1136.94,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Cigna,Cigna,,1387.93,,,1387.93,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Connecticare,Commerical,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Connecticare,Exchange,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,Multiplan,Multiplan,,,1759.35,,1759.35,1136.94,1759.35,percent of total billed charges,,
HC COM FA 2.6-7.5CM,13132,CPT,,,both,,,2195.96,1317.58,United Healthcare/Oxford,United Healthcare/Oxford,,1428.38,,,1428.38,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC CMPLX REP H/A/G/EXTR; EA ADD 5 CM/<,13133,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC CO E/N/E/L <= 1.0,13150,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT  ,,,both,,,2195.96,1317.58,Aetna,Commerical,,1588.29,,,1588.29,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT ,,,both,,,2195.96,1317.58,Aetna,Middlesex Employees,,1429.47,,,1429.47,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Anthem,Commerical,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Anthem,Indemnity,,,1597.02,,1597.02,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Anthem,State Preferred,,1421.17,,,1421.17,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Anthem,Individual Exchange,,1136.94,,,1136.94,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Cigna,Cigna,,1387.93,,,1387.93,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Connecticare,Commerical,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Connecticare,Exchange,,1484.51,,,1484.51,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,Multiplan,Multiplan,,,1759.35,,1759.35,1136.94,1759.35,percent of total billed charges,,
HC CMPLX REP E/N/E/L; 1.1-2.5CM,13151,CPT,,,both,,,2195.96,1317.58,United Healthcare/Oxford,United Healthcare/Oxford,,1428.38,,,1428.38,1136.94,1759.35,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1385.59,,,1385.59,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT ,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,1247.03,,,1247.03,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1239.79,,,1239.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,991.83,,,991.83,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1210.79,,,1210.79,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1295.05,,,1295.05,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,991.83,1534.8,percent of total billed charges,,
HC CMPLX REP E/N/E/L; 2.6-7.5CM,13152,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1246.08,,,1246.08,991.83,1534.8,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT ,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC CMPLX REP E/N/E/L; EA ADDTL 5 CM/<,13153,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT  ,,,both,,,6813.45,4088.07,Aetna,Commerical,,4927.69,,,4927.69,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT ,,,both,,,6813.45,4088.07,Aetna,Middlesex Employees,,4434.92,,,4434.92,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Anthem,Commerical,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Anthem,Indemnity,,,4954.76,,4954.76,3527.34,5458.39,percent of total billed charges,,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Anthem,State Preferred,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Anthem,Individual Exchange,,3527.34,,,3527.34,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Cigna,Cigna,,4306.06,,,4306.06,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Connecticare,Commerical,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Connecticare,Exchange,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,Multiplan,Multiplan,,,5458.39,,5458.39,3527.34,5458.39,percent of total billed charges,,
HC 2NDARY CL SURG WND/DEH EXTENS/COMPL,13160,CPT,,,both,,,6813.45,4088.07,United Healthcare/Oxford,United Healthcare/Oxford,,4431.56,,,4431.56,3527.34,5458.39,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT  ,,,both,,,2057.94,1234.76,Aetna,Commerical,,1519.36,,,1519.36,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT ,,,both,,,2057.94,1234.76,Aetna,Middlesex Employees,,1456.94,,,1456.94,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Anthem,Commerical,,1538.05,,,1538.05,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Anthem,Indemnity,,,1496.85,,1496.85,1230.44,1678.49,percent of total billed charges,,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Anthem,State Preferred,,1538.05,,,1538.05,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Anthem,Individual Exchange,,1230.44,,,1230.44,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Cigna,Cigna,,1419.99,,,1419.99,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Connecticare,Commerical,,1619.44,,,1619.44,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Connecticare,Exchange,,1619.44,,,1619.44,1230.44,1678.49,other,Could be inpatient or outpatient,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,Multiplan,Multiplan,,,1649,,1649,1230.44,1678.49,percent of total billed charges,,
HC DRESSING CHANGE NOT FOR BURN,15852,CPT,,,both,,,2057.94,1234.76,United Healthcare/Oxford,United Healthcare/Oxford,,1678.49,,,1678.49,1230.44,1678.49,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT  ,,,both,,,302.82,181.69,Aetna,Commerical,,218.99,,,218.99,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT ,,,both,,,302.82,181.69,Aetna,Middlesex Employees,,197.09,,,197.09,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Anthem,Commerical,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Anthem,Indemnity,,,220.19,,220.19,156.76,242.57,percent of total billed charges,,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Anthem,State Preferred,,195.95,,,195.95,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Anthem,Individual Exchange,,156.76,,,156.76,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Cigna,Cigna,,191.36,,,191.36,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Connecticare,Commerical,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Connecticare,Exchange,,204.69,,,204.69,156.76,242.57,other,Could be inpatient or outpatient,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,Multiplan,Multiplan,,,242.57,,242.57,156.76,242.57,percent of total billed charges,,
HC INIT TX 1ST DEGR BURN,16000,CPT,,,both,,,302.82,181.69,United Healthcare/Oxford,United Healthcare/Oxford,,196.95,,,196.95,156.76,242.57,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT ,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN S,16020,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,332.96,,,332.96,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT ,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,299.67,,,299.67,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,238.34,368.82,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,238.34,,,238.34,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,290.96,,,290.96,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,238.34,368.82,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN MED,16025,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,299.44,,,299.44,238.34,368.82,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,504.74,,,504.74,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT ,,,both,,,698.34,419,Aetna,Middlesex Employees,,454.26,,,454.26,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Anthem,Commerical,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,361.3,559.1,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Anthem,State Preferred,,451.62,,,451.62,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,361.3,,,361.3,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Cigna,Cigna,,441.06,,,441.06,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Connecticare,Commerical,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Connecticare,Exchange,,471.75,,,471.75,361.3,559.1,other,Could be inpatient or outpatient,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,361.3,559.1,percent of total billed charges,,
HC DRESS/DEBRID P-THICK BURN LG,16030,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,453.92,,,453.92,361.3,559.1,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT ,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC ESCHAROTOMY; INIT INCISION,16035,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT ,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC ESCHAROTOMY; EA ADDL INCISION,16036,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT  ,,,both,,,287.37,172.42,Aetna,Commerical,,207.6,,,207.6,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT ,,,both,,,287.37,172.42,Aetna,Middlesex Employees,,186.84,,,186.84,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Anthem,Commerical,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Anthem,Indemnity,,,208.73,,208.73,148.61,229.95,percent of total billed charges,,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Anthem,State Preferred,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Anthem,Individual Exchange,,148.61,,,148.61,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Cigna,Cigna,,181.41,,,181.41,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Connecticare,Commerical,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Connecticare,Exchange,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,Multiplan,Multiplan,,,229.95,,229.95,148.61,229.95,percent of total billed charges,,
HC CHEM CAUT GRANULATION TISS,17250,CPT,,,both,,,287.37,172.42,United Healthcare/Oxford,United Healthcare/Oxford,,186.69,,,186.69,148.61,229.95,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT  ,,,both,,,949.66,569.8,Aetna,Commerical,,687.09,,,687.09,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT ,,,both,,,949.66,569.8,Aetna,Middlesex Employees,,618.39,,,618.39,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Anthem,Commerical,,614.79,,,614.79,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Anthem,Indemnity,,,690.87,,690.87,491.83,761.09,percent of total billed charges,,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Anthem,State Preferred,,614.79,,,614.79,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Anthem,Individual Exchange,,491.83,,,491.83,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Cigna,Cigna,,600.41,,,600.41,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Connecticare,Commerical,,642.19,,,642.19,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Connecticare,Exchange,,642.19,,,642.19,491.83,761.09,other,Could be inpatient or outpatient,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,Multiplan,Multiplan,,,761.09,,761.09,491.83,761.09,percent of total billed charges,,
HC UNLISTED PROC SKIN MM & SQ TISS,17999,CPT,,,both,,,949.66,569.8,United Healthcare/Oxford,United Healthcare/Oxford,,617.92,,,617.92,491.83,761.09,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT  ,,,both,,,1224.67,734.8,Aetna,Commerical,,884.92,,,884.92,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT ,,,both,,,1224.67,734.8,Aetna,Middlesex Employees,,796.43,,,796.43,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Anthem,Commerical,,791.81,,,791.81,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Anthem,Indemnity,,,889.78,,889.78,633.44,980.22,percent of total billed charges,,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Anthem,State Preferred,,791.81,,,791.81,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Anthem,Individual Exchange,,633.44,,,633.44,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Cigna,Cigna,,773.28,,,773.28,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Connecticare,Commerical,,827.09,,,827.09,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Connecticare,Exchange,,827.09,,,827.09,633.44,980.22,other,Could be inpatient or outpatient,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,Multiplan,Multiplan,,,980.22,,980.22,633.44,980.22,percent of total billed charges,,
HC PUNCT ASP BRST CYST - INITIAL,19000,CPT,,,both,,,1224.67,734.8,United Healthcare/Oxford,United Healthcare/Oxford,,795.82,,,795.82,633.44,980.22,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT  ,,,both,,,738.51,443.11,Aetna,Commerical,,534.04,,,534.04,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT ,,,both,,,738.51,443.11,Aetna,Middlesex Employees,,480.64,,,480.64,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Anthem,Commerical,,477.85,,,477.85,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Anthem,Indemnity,,,536.98,,536.98,382.28,591.56,percent of total billed charges,,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Anthem,State Preferred,,477.85,,,477.85,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Anthem,Individual Exchange,,382.28,,,382.28,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Cigna,Cigna,,466.67,,,466.67,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Connecticare,Commerical,,499.14,,,499.14,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Connecticare,Exchange,,499.14,,,499.14,382.28,591.56,other,Could be inpatient or outpatient,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,Multiplan,Multiplan,,,591.56,,591.56,382.28,591.56,percent of total billed charges,,
HC US PUNC ASP BREAST CYST - EA ADDL CYST,19001,CPT,,,both,,,738.51,443.11,United Healthcare/Oxford,United Healthcare/Oxford,,480.28,,,480.28,382.28,591.56,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT  ,,,both,,,8776.32,5265.79,Aetna,Commerical,,6540.69,,,6540.69,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT ,,,both,,,8776.32,5265.79,Aetna,Middlesex Employees,,5886.62,,,5886.62,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Anthem,Commerical,,5302.06,,,5302.06,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Anthem,Indemnity,,,6382.85,,6382.85,4241.65,7031.64,percent of total billed charges,,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Anthem,State Preferred,,5302.06,,,5302.06,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Anthem,Individual Exchange,,4241.65,,,4241.65,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Cigna,Cigna,,5448.56,,,5448.56,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Connecticare,Commerical,,5254.66,,,5254.66,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Connecticare,Exchange,,5254.66,,,5254.66,4241.65,7031.64,other,Could be inpatient or outpatient,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,Multiplan,Multiplan,,,7031.64,,7031.64,4241.65,7031.64,percent of total billed charges,,
REMOVAL OF 1 OR MORE BREAST GROWTH OPEN PROCEDURE,19120,CPT,,,both,,,8776.32,5265.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4241.65,7031.64,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT  ,,,both,,,8176.14,4905.68,Aetna,Commerical,,5914.37,,,5914.37,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT ,,,both,,,8176.14,4905.68,Aetna,Middlesex Employees,,5322.93,,,5322.93,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Anthem,Commerical,,5292.04,,,5292.04,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Anthem,Indemnity,,,5946.85,,5946.85,4233.63,6551.32,percent of total billed charges,,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Anthem,State Preferred,,5292.04,,,5292.04,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Anthem,Individual Exchange,,4233.63,,,4233.63,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Cigna,Cigna,,5168.27,,,5168.27,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Connecticare,Commerical,,5527.91,,,5527.91,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Connecticare,Exchange,,5527.91,,,5527.91,4233.63,6551.32,other,Could be inpatient or outpatient,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,Multiplan,Multiplan,,,6551.32,,6551.32,4233.63,6551.32,percent of total billed charges,,
HC DEEP TISSUE ABS,20005,CPT,,,both,,,8176.14,4905.68,United Healthcare/Oxford,United Healthcare/Oxford,,5318.9,,,5318.9,4233.63,6551.32,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT  ,,,both,,,1306.04,783.62,Aetna,Commerical,,944.35,,,944.35,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT ,,,both,,,1306.04,783.62,Aetna,Middlesex Employees,,849.91,,,849.91,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Anthem,Commerical,,844.97,,,844.97,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Anthem,Indemnity,,,949.53,,949.53,675.98,1046.04,percent of total billed charges,,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Anthem,State Preferred,,844.97,,,844.97,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Anthem,Individual Exchange,,675.98,,,675.98,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Cigna,Cigna,,825.22,,,825.22,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Connecticare,Commerical,,882.64,,,882.64,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Connecticare,Exchange,,882.64,,,882.64,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,Multiplan,Multiplan,,,1046.04,,1046.04,675.98,1046.04,percent of total billed charges,,
HC WOUND EXPLOR NECK,20100,CPT,,,both,,,1306.04,783.62,United Healthcare/Oxford,United Healthcare/Oxford,,849.27,,,849.27,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT  ,,,both,,,6813.45,4088.07,Aetna,Commerical,,4927.69,,,4927.69,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT ,,,both,,,6813.45,4088.07,Aetna,Middlesex Employees,,4434.92,,,4434.92,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Anthem,Commerical,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Anthem,Indemnity,,,4954.76,,4954.76,3527.34,5458.39,percent of total billed charges,,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Anthem,State Preferred,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Anthem,Individual Exchange,,3527.34,,,3527.34,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Cigna,Cigna,,4306.06,,,4306.06,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Connecticare,Commerical,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Connecticare,Exchange,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,Multiplan,Multiplan,,,5458.39,,5458.39,3527.34,5458.39,percent of total billed charges,,
HC WOUND EXPLOR CHST,20101,CPT,,,both,,,6813.45,4088.07,United Healthcare/Oxford,United Healthcare/Oxford,,4431.56,,,4431.56,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT  ,,,both,,,6813.45,4088.07,Aetna,Commerical,,4927.69,,,4927.69,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT ,,,both,,,6813.45,4088.07,Aetna,Middlesex Employees,,4434.92,,,4434.92,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Anthem,Commerical,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Anthem,Indemnity,,,4954.76,,4954.76,3527.34,5458.39,percent of total billed charges,,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Anthem,State Preferred,,4409.18,,,4409.18,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Anthem,Individual Exchange,,3527.34,,,3527.34,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Cigna,Cigna,,4306.06,,,4306.06,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Connecticare,Commerical,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Connecticare,Exchange,,4605.7,,,4605.7,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,Multiplan,Multiplan,,,5458.39,,5458.39,3527.34,5458.39,percent of total billed charges,,
HC WOUND EXPLOR TRNK,20102,CPT,,,both,,,6813.45,4088.07,United Healthcare/Oxford,United Healthcare/Oxford,,4431.56,,,4431.56,3527.34,5458.39,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT  ,,,both,,,1306.04,783.62,Aetna,Commerical,,944.35,,,944.35,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT ,,,both,,,1306.04,783.62,Aetna,Middlesex Employees,,849.91,,,849.91,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Anthem,Commerical,,844.97,,,844.97,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Anthem,Indemnity,,,949.53,,949.53,675.98,1046.04,percent of total billed charges,,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Anthem,State Preferred,,844.97,,,844.97,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Anthem,Individual Exchange,,675.98,,,675.98,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Cigna,Cigna,,825.22,,,825.22,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Connecticare,Commerical,,882.64,,,882.64,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Connecticare,Exchange,,882.64,,,882.64,675.98,1046.04,other,Could be inpatient or outpatient,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,Multiplan,Multiplan,,,1046.04,,1046.04,675.98,1046.04,percent of total billed charges,,
HC WOUND EXPLOR EXTR,20103,CPT,,,both,,,1306.04,783.62,United Healthcare/Oxford,United Healthcare/Oxford,,849.27,,,849.27,675.98,1046.04,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT  ,,,both,,,1424.49,854.69,Aetna,Commerical,,952.82,,,952.82,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT ,,,both,,,1424.49,854.69,Aetna,Middlesex Employees,,857.54,,,857.54,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Anthem,Commerical,,929.7,,,929.7,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Anthem,Indemnity,,,1036.3,,1036.3,743.76,1141.64,percent of total billed charges,,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Anthem,State Preferred,,929.7,,,929.7,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Anthem,Individual Exchange,,743.76,,,743.76,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Cigna,Cigna,,1068.83,,,1068.83,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Connecticare,Commerical,,995.04,,,995.04,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Connecticare,Exchange,,995.04,,,995.04,743.76,1141.64,other,Could be inpatient or outpatient,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,Multiplan,Multiplan,,,1141.64,,114.64,743.76,1141.64,percent of total billed charges,,
HC CT GUIDE SOFT TISSUE BX,20206,CPT,,,both,,,1424.49,854.69,United Healthcare/Oxford,United Healthcare/Oxford,,868.05,,,868.05,743.76,1141.64,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT ,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC MUSCLE BX; PERC NDL,20206,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT  ,,,both,,,1935.37,1161.22,Aetna,Commerical,,1399.42,,,1399.42,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT ,,,both,,,1935.37,1161.22,Aetna,Middlesex Employees,,1259.48,,,1259.48,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Anthem,Commerical,,1252.17,,,1252.17,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Anthem,Indemnity,,,1407.11,,1407.11,1001.74,1550.14,percent of total billed charges,,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Anthem,State Preferred,,1252.17,,,1252.17,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Anthem,Individual Exchange,,1001.74,,,1001.74,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Cigna,Cigna,,1222.88,,,1222.88,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Connecticare,Commerical,,1307.98,,,1307.98,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Connecticare,Exchange,,1307.98,,,1307.98,1001.74,1550.14,other,Could be inpatient or outpatient,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,Multiplan,Multiplan,,,1550.14,,1550.14,1001.74,1550.14,percent of total billed charges,,
HC BONE BX TR/NDL; SUPERF,20220,CPT,,,both,,,1935.37,1161.22,United Healthcare/Oxford,United Healthcare/Oxford,,1258.53,,,1258.53,1001.74,1550.14,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT  ,,,both,,,1489.38,893.63,Aetna,Commerical,,818.26,,,818.26,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT ,,,both,,,1489.38,893.63,Aetna,Middlesex Employees,,736.43,,,736.43,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Anthem,Commerical,,971.56,,,971.56,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Anthem,Indemnity,,,1082.96,,1082.96,736.43,1193.03,percent of total billed charges,,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Anthem,State Preferred,,971.56,,,971.56,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Anthem,Individual Exchange,,777.25,,,777.25,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Cigna,Cigna,,1116.95,,,1116.95,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Connecticare,Commerical,,1039.84,,,1039.84,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Connecticare,Exchange,,1039.84,,,1039.84,736.43,1193.03,other,Could be inpatient or outpatient,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,Multiplan,Multiplan,,,1193.03,,1193.03,736.43,1193.03,percent of total billed charges,,
HC CT GUIDE SUP BONE BX,20220,CPT,,,both,,,1489.38,893.63,United Healthcare/Oxford,United Healthcare/Oxford,,907.13,,,907.13,736.43,1193.03,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT ,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC DEEP BONE BX TRCR/NDL,20225,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT  ,,,both,,,646.84,388.1,Aetna,Commerical,,468.1,,,468.1,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT ,,,both,,,646.84,388.1,Aetna,Middlesex Employees,,421.29,,,421.29,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Anthem,Commerical,,418.84,,,418.84,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Anthem,Indemnity,,,470.67,,470.67,335.07,518.52,percent of total billed charges,,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Anthem,State Preferred,,418.84,,,418.84,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Anthem,Individual Exchange,,335.07,,,335.07,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Cigna,Cigna,,409.05,,,409.05,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Connecticare,Commerical,,437.52,,,437.52,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Connecticare,Exchange,,437.52,,,437.52,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,Multiplan,Multiplan,,,518.52,,518.52,335.07,518.52,percent of total billed charges,,
HC SINUS TRACT INJ; THERAPEUTIC,20500,CPT,,,both,,,646.84,388.1,United Healthcare/Oxford,United Healthcare/Oxford,,420.97,,,420.97,335.07,518.52,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT  ,,,both,,,867.26,520.36,Aetna,Commerical,,626.85,,,626.85,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT ,,,both,,,867.26,520.36,Aetna,Middlesex Employees,,564.17,,,564.17,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Anthem,Commerical,,560.89,,,560.89,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Anthem,Indemnity,,,630.29,,630.29,448.71,694.36,percent of total billed charges,,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Anthem,State Preferred,,560.89,,,560.89,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Anthem,Individual Exchange,,448.71,,,448.71,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Cigna,Cigna,,547.77,,,547.77,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Connecticare,Commerical,,585.89,,,585.89,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Connecticare,Exchange,,585.89,,,585.89,448.71,694.36,other,Could be inpatient or outpatient,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,Multiplan,Multiplan,,,694.36,,694.35,448.71,694.36,percent of total billed charges,,
HC SINUS TRACT INJ; DX,20501,CPT,,,both,,,867.26,520.36,United Healthcare/Oxford,United Healthcare/Oxford,,563.74,,,563.74,448.71,694.36,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT ,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC REM FB MUSCLE; SMPL,20520,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT  ,,,both,,,7839.33,4703.6,Aetna,Commerical,,5670.15,,,5670.15,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT ,,,both,,,7839.33,4703.6,Aetna,Middlesex Employees,,5103.14,,,5103.14,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Anthem,Commerical,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Anthem,Indemnity,,,5701.28,,5701.28,4058.81,6280.79,percent of total billed charges,,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Anthem,State Preferred,,5073.52,,,5073.52,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Anthem,Individual Exchange,,4058.81,,,4058.81,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Cigna,Cigna,,4954.85,,,4954.85,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Connecticare,Commerical,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Connecticare,Exchange,,5299.64,,,5299.64,4058.81,6280.79,other,Could be inpatient or outpatient,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,Multiplan,Multiplan,,,6280.79,,6280.79,4058.81,6280.79,percent of total billed charges,,
HC REM FB MUSCLE; DEEP,20525,CPT,,,both,,,7839.33,4703.6,United Healthcare/Oxford,United Healthcare/Oxford,,5099.26,,,5099.26,4058.81,6280.79,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT  ,,,both,,,882.71,529.63,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT ,,,both,,,882.71,529.63,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Anthem,Indemnity,,,641.76,,641.76,456.87,706.99,percent of total billed charges,,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC INJ SGL TENDON SHTH OR LIGAMENT,20550,CPT,,,both,,,882.71,529.63,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT  ,,,both,,,882.71,529.63,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT ,,,both,,,882.71,529.63,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Anthem,Indemnity,,,641.76,,641.76,456.87,706.99,percent of total billed charges,,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC INJ SNGL TENDON ORIGIN/INSERT,20551,CPT,,,both,,,882.71,529.63,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT  ,,,both,,,882.4,529.44,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT ,,,both,,,882.4,529.44,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Anthem,Indemnity,,,641.76,,641.76,456.87,706.99,percent of total billed charges,,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC INJ TRIGGER POINT 1/2 MUSCL,20552,CPT,,,both,,,882.4,529.44,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT  ,,,both,,,882.71,529.63,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT ,,,both,,,882.71,529.63,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Anthem,Indemnity,,,641.76,,641.76,456.87,706.99,percent of total billed charges,,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC INJECT TRIGGER POINTS >=3 MUSCLES,20553,CPT,,,both,,,882.71,529.63,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,70.49,,,70.49,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT ,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,67.59,,,67.59,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,68.08,,,68.08,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,69.44,,69.44,54.47,487.19,percent of total billed charges,,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,68.08,,,68.08,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,54.47,,,54.47,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,79.2,,,79.2,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,75.13,,,75.13,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,75.13,,,75.13,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,76.5,,76.5,54.47,487.19,percent of total billed charges,,
HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,20560,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,487.19,,,487.19,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,70.49,,,70.49,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT ,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,67.59,,,67.59,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,68.08,,,68.08,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,69.44,,69.44,54.47,487.19,percent of total billed charges,,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,68.08,,,68.08,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,54.47,,,54.47,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,79.2,,,79.2,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,75.13,,,75.13,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,75.13,,,75.13,54.47,487.19,other,Could be inpatient or outpatient,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,76.5,,76.5,54.47,487.19,percent of total billed charges,,
HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,20561,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,487.19,,,487.19,54.47,487.19,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT  ,,,both,,,1101.87,661.12,Aetna,Commerical,,797,,,797,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT ,,,both,,,1101.87,661.12,Aetna,Middlesex Employees,,717.3,,,717.3,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Anthem,Commerical,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Anthem,Indemnity,,,801.37,,801.37,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Anthem,State Preferred,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Anthem,Individual Exchange,,570.51,,,570.51,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Cigna,Cigna,,696.46,,,696.46,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Connecticare,Commerical,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Connecticare,Exchange,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,Multiplan,Multiplan,,,882.83,,882.83,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,CPT,,,both,,,1101.87,661.12,United Healthcare/Oxford,United Healthcare/Oxford,,716.76,,,716.76,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT ,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC DRAIN/INJ SMALL JOINT/BURSA W/US,20604,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT  ,,,both,,,873.44,524.06,Aetna,Commerical,,479.94,,,479.94,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Aetna,Middlesex Employees,,431.95,,,431.95,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Anthem,Commerical,,569.86,,,569.86,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Anthem,Indemnity,,,635.21,,635.21,431.95,699.77,percent of total billed charges,,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Anthem,State Preferred,,569.86,,,569.86,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Anthem,Individual Exchange,,455.89,,,455.89,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Cigna,Cigna,,655.14,,,655.14,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Connecticare,Commerical,,609.91,,,609.91,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Connecticare,Exchange,,609.91,,,609.91,431.95,699.77,other,Could be inpatient or outpatient,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,Multiplan,Multiplan,,,699.77,,699.77,431.95,699.77,percent of total billed charges,,
HC ASP/INJ MED JNT,20605,CPT,,,both,,,873.44,524.06,United Healthcare/Oxford,United Healthcare/Oxford,,532.08,,,532.08,431.95,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT  ,,,both,,,883.52,530.11,Aetna,Commerical,,639.06,,,639.06,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Aetna,Middlesex Employees,,575.16,,,575.16,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Anthem,Commerical,,571.82,,,571.82,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Anthem,Indemnity,,,642.57,,642.57,457.45,707.89,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Anthem,State Preferred,,571.82,,,571.82,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Anthem,Individual Exchange,,457.45,,,457.45,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Cigna,Cigna,,558.44,,,558.44,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Connecticare,Commerical,,597.31,,,597.31,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Connecticare,Exchange,,597.31,,,597.31,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,Multiplan,Multiplan,,,707.89,,707.89,457.45,707.89,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/O US,20605,CPT,,,both,,,883.52,530.11,United Healthcare/Oxford,United Healthcare/Oxford,,574.72,,,574.72,457.45,707.89,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT  ,,,both,,,1101.07,660.64,Aetna,Commerical,,797,,,797,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Aetna,Middlesex Employees,,717.3,,,717.3,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Anthem,Commerical,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Anthem,Indemnity,,,801.37,,801.37,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Anthem,State Preferred,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Anthem,Individual Exchange,,570.51,,,570.51,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Cigna,Cigna,,696.46,,,696.46,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Connecticare,Commerical,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Connecticare,Exchange,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,Multiplan,Multiplan,,,882.83,,882.83,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/O US - MED,20605,CPT,,,both,,,1101.07,660.64,United Healthcare/Oxford,United Healthcare/Oxford,,716.76,,,716.76,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC DRAIN/INJ INTER JOINT/BURSA W/US,20606,CPT,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT  ,,,both,,,1101.87,661.12,Aetna,Commerical,,797,,,797,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT  ,,,both,,,873.4,524.04,Aetna,Commerical,,631.74,,,631.74,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Aetna,Middlesex Employees,,717.3,,,717.3,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Aetna,Middlesex Employees,,568.56,,,568.56,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Anthem,Commerical,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Anthem,Commerical,,565.27,,,565.27,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Anthem,Indemnity,,,801.37,,801.37,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Anthem,Indemnity,,,635.21,,635.21,452.21,699.77,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Anthem,State Preferred,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Anthem,State Preferred,,565.27,,,565.27,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Anthem,Individual Exchange,,570.51,,,570.51,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Anthem,Individual Exchange,,452.21,,,452.21,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Cigna,Cigna,,696.46,,,696.46,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Cigna,Cigna,,552.04,,,552.04,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Connecticare,Commerical,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Connecticare,Commerical,,590.45,,,590.45,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Connecticare,Exchange,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Connecticare,Exchange,,590.45,,,590.45,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,Multiplan,Multiplan,,,882.83,,882.83,570.51,882.83,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,Multiplan,Multiplan,,,699.77,,699.77,452.21,699.77,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,CPT,,,both,,,1101.87,661.12,United Healthcare/Oxford,United Healthcare/Oxford,,716.76,,,716.76,570.51,882.83,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/O US-SPECIALTY SERVICES,20610,CPT,,,both,,,873.4,524.04,United Healthcare/Oxford,United Healthcare/Oxford,,568.13,,,568.13,452.21,699.77,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC DRAIN/INJ MAJOR JOINT/BURSA W/US,20611,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC ASP & INJ TX OF BONE CYST,20615,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT  ,,,both,,,2040.43,1224.26,Aetna,Commerical,,1475.95,,,1475.95,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Aetna,Middlesex Employees,,1328.36,,,1328.36,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Anthem,Commerical,,1320.64,,,1320.64,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Anthem,Indemnity,,,1484.05,,1484.05,1056.51,1634.9,percent of total billed charges,,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Anthem,State Preferred,,1320.64,,,1320.64,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Anthem,Individual Exchange,,1056.51,,,1056.51,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Cigna,Cigna,,1289.76,,,1289.76,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Connecticare,Commerical,,1379.5,,,1379.5,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Connecticare,Exchange,,1379.5,,,1379.5,1056.51,1634.9,other,Could be inpatient or outpatient,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,Multiplan,Multiplan,,,1634.9,,1634.9,1056.51,1634.9,percent of total billed charges,,
HC REMOVAL SUPERFICIAL SUPPORT IMPLANT,20670,CPT,,,both,,,2040.43,1224.26,United Healthcare/Oxford,United Healthcare/Oxford,,1327.35,,,1327.35,1056.51,1634.9,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT  ,,,both,,,13948.35,8369.01,Aetna,Commerical,,10519.22,,,10519.22,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Aetna,Middlesex Employees,,9467.29,,,9467.29,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Anthem,Commerical,,9717.92,,,9717.92,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Anthem,Indemnity,,,10144.38,,10144.38,7599.73,11175.51,percent of total billed charges,,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Anthem,State Preferred,,9717.92,,,9717.92,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Anthem,Individual Exchange,,7774.33,,,7774.33,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Cigna,Cigna,,9073.12,,,9073.12,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Connecticare,Commerical,,,,,,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Connecticare,Exchange,,,,,,7599.73,11175.51,other,Could be inpatient or outpatient,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,Multiplan,Multiplan,,,11175.51,,11175.51,7599.73,11175.51,percent of total billed charges,,
PR REMOVAL DEEP IMPLANT,20680,CPT,,,both,,,13948.35,8369.01,United Healthcare/Oxford,United Healthcare/Oxford,,7599.73,,,7599.73,7599.73,11175.51,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT  ,,,both,,,4839.97,2903.98,Aetna,Commerical,,3500.59,,,3500.59,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Aetna,Middlesex Employees,,3150.53,,,3150.53,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Anthem,Commerical,,3132.25,,,3132.25,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Anthem,Indemnity,,,3519.82,,3519.82,2505.8,3877.59,percent of total billed charges,,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Anthem,State Preferred,,3132.25,,,3132.25,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Anthem,Individual Exchange,,2505.8,,,2505.8,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Cigna,Cigna,,3058.98,,,3058.98,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Connecticare,Commerical,,3271.85,,,3271.85,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Connecticare,Exchange,,3271.85,,,3271.85,2505.8,3877.59,other,Could be inpatient or outpatient,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,Multiplan,Multiplan,,,3877.59,,3877.59,2505.8,3877.59,percent of total billed charges,,
HC ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,4839.97,2903.98,United Healthcare/Oxford,United Healthcare/Oxford,,3148.14,,,3148.14,2505.8,3877.59,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT  ,,,both,,,7343.9,4406.34,Aetna,Commerical,,5311.13,,,5311.13,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Aetna,Middlesex Employees,,4780.02,,,4780.02,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Anthem,Commerical,,4752.27,,,4752.27,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Anthem,Indemnity,,,5340.3,,5340.3,3801.82,5883.11,percent of total billed charges,,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Anthem,State Preferred,,4752.27,,,4752.27,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Anthem,Individual Exchange,,3801.82,,,3801.82,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Cigna,Cigna,,4641.12,,,4641.12,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Connecticare,Commerical,,4964.08,,,4964.08,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Connecticare,Exchange,,4964.08,,,4964.08,3801.82,5883.11,other,Could be inpatient or outpatient,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,Multiplan,Multiplan,,,5883.11,,5883.11,3801.82,5883.11,percent of total billed charges,,
HC CT ABLATE BONE TUMOR(S) PERQ,20982,CPT,,,both,,,7343.9,4406.34,United Healthcare/Oxford,United Healthcare/Oxford,,4776.4,,,4776.4,3801.82,5883.11,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT  ,,,both,,,2070.3,1242.18,Aetna,Commerical,,1497.11,,,1497.11,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Aetna,Middlesex Employees,,1347.4,,,1347.4,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Anthem,Commerical,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Anthem,Indemnity,,,1505.34,,1505.34,1071.66,1658.35,percent of total billed charges,,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Anthem,State Preferred,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Anthem,Individual Exchange,,1071.66,,,1071.66,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Cigna,Cigna,,1308.25,,,1308.25,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Connecticare,Commerical,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Connecticare,Exchange,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,Multiplan,Multiplan,,,1658.35,,1658.35,1071.66,1658.35,percent of total billed charges,,
HC IMPRESSION & PREP ORAL SURG SPLINT,21085,CPT,,,both,,,2070.3,1242.18,United Healthcare/Oxford,United Healthcare/Oxford,,1346.39,,,1346.39,1071.66,1658.35,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT  ,,,both,,,216.09,129.66,Aetna,Commerical,,156.31,,,156.31,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT  ,,,both,,,202.59,121.55,Aetna,Commerical,,146.54,,,146.54,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Aetna,Middlesex Employees,,140.68,,,140.68,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Aetna,Middlesex Employees,,131.88,,,131.88,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Anthem,Commerical,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Anthem,Commerical,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Anthem,Indemnity,,,157.16,,157.16,111.88,173.14,percent of total billed charges,,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Anthem,Indemnity,,,147.34,,147.34,104.89,162.32,percent of total billed charges,,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Anthem,State Preferred,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Anthem,State Preferred,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Anthem,Individual Exchange,,111.88,,,111.88,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Anthem,Individual Exchange,,104.89,,,104.89,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Cigna,Cigna,,136.58,,,136.58,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Cigna,Cigna,,128.06,,,128.06,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Connecticare,Commerical,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Connecticare,Commerical,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Connecticare,Exchange,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Connecticare,Exchange,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,Multiplan,Multiplan,,,173.14,,173.15,111.88,173.14,percent of total billed charges,,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,Multiplan,Multiplan,,,162.32,,162.32,104.89,162.32,percent of total billed charges,,
HC UNLST MAXILLOFACL PROS PROC-2,21089,CPT,,,both,,,216.09,129.66,United Healthcare/Oxford,United Healthcare/Oxford,,140.56,,,140.56,111.88,173.14,other,Could be inpatient or outpatient,
HC UNLST MAXILLOFACL PROS PROC,21089,CPT,,,both,,,202.59,121.55,United Healthcare/Oxford,United Healthcare/Oxford,,131.78,,,131.78,104.89,162.32,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT  ,,,both,,,2694.48,1616.69,Aetna,Commerical,,1800.8,,,1800.8,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Aetna,Middlesex Employees,,1620.72,,,1620.72,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Anthem,Commerical,,1494.53,,,1494.53,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Anthem,Indemnity,,,1959.8,,1959.8,1195.62,2159,percent of total billed charges,,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Anthem,State Preferred,,1494.53,,,1494.53,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Anthem,Individual Exchange,,1195.62,,,1195.62,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Cigna,Cigna,,1586.28,,,1586.28,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Connecticare,Commerical,,1627.19,,,1627.19,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Connecticare,Exchange,,1627.19,,,1627.19,1195.62,2159,other,Could be inpatient or outpatient,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,Multiplan,Multiplan,,,2159,,2159,1195.62,2159,percent of total billed charges,,
HC APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,21110,CPT,,,both,,,2694.48,1616.69,United Healthcare/Oxford,United Healthcare/Oxford,,1668.09,,,1668.09,1195.62,2159,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT  ,,,both,,,5625.86,3375.52,Aetna,Commerical,,4069.64,,,4069.64,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Aetna,Middlesex Employees,,3662.68,,,3662.68,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Anthem,Commerical,,3641.42,,,3641.42,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Anthem,Indemnity,,,4091.99,,4091.99,2913.13,4507.92,percent of total billed charges,,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Anthem,State Preferred,,3641.42,,,3641.42,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Anthem,Individual Exchange,,2913.13,,,2913.13,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Cigna,Cigna,,3556.25,,,3556.25,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Connecticare,Commerical,,3803.72,,,3803.72,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Connecticare,Exchange,,3803.72,,,3803.72,2913.13,4507.92,other,Could be inpatient or outpatient,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,Multiplan,Multiplan,,,4507.92,,4507.92,2913.13,4507.92,percent of total billed charges,,
HC SKULL FX TRMT,21300,CPT,,,both,,,5625.86,3375.52,United Healthcare/Oxford,United Healthcare/Oxford,,3659.9,,,3659.9,2913.13,4507.92,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT  ,,,both,,,783.83,470.3,Aetna,Commerical,,566.6,,,566.6,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Aetna,Middlesex Employees,,509.95,,,509.95,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Anthem,Commerical,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Anthem,Indemnity,,,569.72,,569.72,405.59,627.63,percent of total billed charges,,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Anthem,State Preferred,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Anthem,Individual Exchange,,405.59,,,405.59,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Cigna,Cigna,,495.13,,,495.13,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Connecticare,Commerical,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Connecticare,Exchange,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,Multiplan,Multiplan,,,627.63,,627.63,405.59,627.63,percent of total billed charges,,
HC CL TXT OF NASAL BONE FX WO MANIP,21310,CPT,,,both,,,783.83,470.3,United Healthcare/Oxford,United Healthcare/Oxford,,509.56,,,509.56,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC CL TX OF NASAL BONE FX; W STABILIZ,21320,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT  ,,,both,,,9895.21,5937.13,Aetna,Commerical,,7156.67,,,7156.67,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Aetna,Middlesex Employees,,6441.01,,,6441.01,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Anthem,Commerical,,6403.63,,,6403.63,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Anthem,Indemnity,,,7195.98,,7195.98,5122.9,7927.41,percent of total billed charges,,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Anthem,State Preferred,,6403.63,,,6403.63,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Anthem,Individual Exchange,,5122.9,,,5122.9,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Cigna,Cigna,,6253.85,,,6253.85,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Connecticare,Commerical,,6689.03,,,6689.03,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Connecticare,Exchange,,6689.03,,,6689.03,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,Multiplan,Multiplan,,,7927.41,,7327.41,5122.9,7927.41,percent of total billed charges,,
HC CL TX LEFORT I  FX; W ID W FIX,21421,CPT,,,both,,,9895.21,5937.13,United Healthcare/Oxford,United Healthcare/Oxford,,6436.13,,,6436.13,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT  ,,,both,,,9895.21,5937.13,Aetna,Commerical,,7156.67,,,7156.67,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Aetna,Middlesex Employees,,6441.01,,,6441.01,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Anthem,Commerical,,6403.63,,,6403.63,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Anthem,Indemnity,,,7195.98,,7195.98,5122.9,7927.41,percent of total billed charges,,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Anthem,State Preferred,,6403.63,,,6403.63,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Anthem,Individual Exchange,,5122.9,,,5122.9,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Cigna,Cigna,,6253.85,,,6253.85,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Connecticare,Commerical,,6689.03,,,6689.03,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Connecticare,Exchange,,6689.03,,,6689.03,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,Multiplan,Multiplan,,,7927.41,,7927.41,5122.9,7927.41,percent of total billed charges,,
HC CL TX MAND/MAXILL ALVEOLAR RIDGE FX,21440,CPT,,,both,,,9895.21,5937.13,United Healthcare/Oxford,United Healthcare/Oxford,,6436.13,,,6436.13,5122.9,7927.41,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT  ,,,both,,,783.83,470.3,Aetna,Commerical,,566.6,,,566.6,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Aetna,Middlesex Employees,,509.95,,,509.95,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Anthem,Commerical,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Anthem,Indemnity,,,569.72,,569.72,405.59,627.63,percent of total billed charges,,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Anthem,State Preferred,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Anthem,Individual Exchange,,405.59,,,405.59,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Cigna,Cigna,,495.13,,,495.13,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Connecticare,Commerical,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Connecticare,Exchange,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,Multiplan,Multiplan,,,627.63,,627.63,405.59,627.63,percent of total billed charges,,
HC CL TX MANDIBULAR FX; WO MANIP,21450,CPT,,,both,,,783.83,470.3,United Healthcare/Oxford,United Healthcare/Oxford,,509.56,,,509.56,405.59,627.63,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC CL TX MANDIBULAR FX; W MANIP,21451,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT  ,,,both,,,13090.27,7854.16,Aetna,Commerical,,9468.69,,,9468.69,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Aetna,Middlesex Employees,,8521.82,,,8521.82,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Anthem,Commerical,,8472.37,,,8472.37,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Anthem,Indemnity,,,9520.69,,9520.69,6777.89,10488.43,percent of total billed charges,,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Anthem,State Preferred,,8472.37,,,8472.37,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Anthem,Individual Exchange,,6777.89,,,6777.89,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Cigna,Cigna,,8274.21,,,8274.21,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Connecticare,Commerical,,8849.98,,,8849.98,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Connecticare,Exchange,,8849.98,,,8849.98,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,Multiplan,Multiplan,,,10488.43,,10488.43,6777.89,10488.43,percent of total billed charges,,
HC CL TX OF MAND FX W ID FIX,21453,CPT,,,both,,,13090.27,7854.16,United Healthcare/Oxford,United Healthcare/Oxford,,8515.37,,,8515.37,6777.89,10488.43,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX TMJ DISLOCATION; INIT/SUBS,21480,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT  ,,,both,,,5361.15,3216.69,Aetna,Commerical,,3877.51,,,3877.51,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Aetna,Middlesex Employees,,3489.76,,,3489.76,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Anthem,Commerical,,3469.51,,,3469.51,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Anthem,Indemnity,,,3898.81,,3898.81,2775.6,4295.11,percent of total billed charges,,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Anthem,State Preferred,,3469.51,,,3469.51,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Anthem,Individual Exchange,,2775.6,,,2775.6,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Cigna,Cigna,,3388.36,,,3388.36,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Connecticare,Commerical,,3624.15,,,3624.15,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Connecticare,Exchange,,3624.15,,,3624.15,2775.6,4295.11,other,Could be inpatient or outpatient,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,Multiplan,Multiplan,,,4295.11,,4295.11,2775.6,4295.11,percent of total billed charges,,
HC INTERDENTAL WIRING NON FRACTURE,21497,CPT,,,both,,,5361.15,3216.69,United Healthcare/Oxford,United Healthcare/Oxford,,3487.12,,,3487.12,2775.6,4295.11,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT  ,,,both,,,5214.89,3128.93,Aetna,Commerical,,3772.5,,,3772.5,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Aetna,Middlesex Employees,,3395.26,,,3395.26,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Anthem,Commerical,,3375.55,,,3375.55,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Anthem,Indemnity,,,3793.21,,3793.21,2700.44,4178.78,percent of total billed charges,,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Anthem,State Preferred,,3375.55,,,3375.55,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Anthem,Individual Exchange,,2700.44,,,2700.44,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Cigna,Cigna,,3296.59,,,3296.59,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Connecticare,Commerical,,3525.99,,,3525.99,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Connecticare,Exchange,,3525.99,,,3525.99,2700.44,4178.78,other,Could be inpatient or outpatient,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,Multiplan,Multiplan,,,4178.78,,4178.78,2700.44,4178.78,percent of total billed charges,,
HC BX SOFT TISS NECK OR THORAX,21550,CPT,,,both,,,5214.89,3128.93,United Healthcare/Oxford,United Healthcare/Oxford,,3392.68,,,3392.68,2700.44,4178.78,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLS TX RIB FX,21800,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,533.34,387.52,599.68,percent of total billed charges,,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX STERNUM FX,21820,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT  ,,,both,,,728.21,436.93,Aetna,Commerical,,526.71,,,526.71,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Aetna,Middlesex Employees,,474.05,,,474.05,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Anthem,Commerical,,471.3,,,471.3,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Anthem,Indemnity,,,529.61,,529.61,377.04,583.44,percent of total billed charges,,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Anthem,State Preferred,,471.3,,,471.3,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Anthem,Individual Exchange,,377.04,,,377.04,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Cigna,Cigna,,460.27,,,460.27,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Connecticare,Commerical,,492.3,,,492.3,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Connecticare,Exchange,,492.3,,,492.3,377.04,583.44,other,Could be inpatient or outpatient,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,Multiplan,Multiplan,,,583.44,,583.44,377.04,583.44,percent of total billed charges,,
HC CLS VERTR PROC,22305,CPT,,,both,,,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,473.69,,,473.69,377.04,583.44,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT  ,,,both,,,7834.18,4700.51,Aetna,Commerical,,5666.08,,,5666.08,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Aetna,Middlesex Employees,,5099.47,,,5099.47,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Anthem,Commerical,,5069.88,,,5069.88,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Anthem,Indemnity,,,5697.19,,5697.19,4055.9,6276.28,percent of total billed charges,,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Anthem,State Preferred,,5069.88,,,5069.88,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Anthem,Individual Exchange,,4055.9,,,4055.9,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Cigna,Cigna,,4951.29,,,4951.29,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Connecticare,Commerical,,5295.83,,,5295.83,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Connecticare,Exchange,,5295.83,,,5295.83,4055.9,6276.28,other,Could be inpatient or outpatient,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,Multiplan,Multiplan,,,6276.28,,6276.28,4055.9,6276.28,percent of total billed charges,,
HC I & D SHLDR; DEEP ABSC,23030,CPT,,,both,,,7834.18,4700.51,United Healthcare/Oxford,United Healthcare/Oxford,,5095.61,,,5095.61,4055.9,6276.28,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC REM FB SHOULDER; SQ,23330,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT  ,,,both,,,230.72,138.43,Aetna,Commerical,,166.89,,,166.89,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Aetna,Middlesex Employees,,150.2,,,150.2,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Anthem,Commerical,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Anthem,Indemnity,,,167.8,,167.8,119.46,184.86,percent of total billed charges,,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Anthem,State Preferred,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Anthem,Individual Exchange,,119.46,,,119.46,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Cigna,Cigna,,145.84,,,145.84,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Connecticare,Commerical,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Connecticare,Exchange,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,Multiplan,Multiplan,,,184.86,,184.86,119.46,184.86,percent of total billed charges,,
HC INJ SHOULDER ARTHROGRAPHY,23350,CPT,,,both,,,230.72,138.43,United Healthcare/Oxford,United Healthcare/Oxford,,150.08,,,150.08,119.46,184.86,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CLAVICULAR FX; WO MANIP,23500,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CLAVICULAR FX; W MANIP,23505,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX SCAPULAR FX; WO MANIP,23570,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX SCAPULAR FX; W MANIP,23575,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX PROX HUMERAL FX; WO MANIP,23600,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX PROX HUMERAL  FX; W MANIP,23605,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX GR TUBEROSITY FX; WO MANIP,23620,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX GR TUBEROSITY FX; W MANIP,23625,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX SHLDR DISL W MANI; WO ANESTH,23650,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX SHLDR DISL W MANIP; W ANESTH,23655,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX SHLDR DISLOC & FX GT; W MAN,23665,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT  ,,,both,,,1686.11,1011.67,Aetna,Commerical,,1219.51,,,1219.51,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Aetna,Middlesex Employees,,1097.56,,,1097.56,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Anthem,Commerical,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Anthem,Indemnity,,,1226.21,,1226.21,872.95,1350.85,percent of total billed charges,,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Anthem,State Preferred,,1091.19,,,1091.19,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Anthem,Individual Exchange,,872.95,,,872.95,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Cigna,Cigna,,1065.67,,,1065.67,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Connecticare,Commerical,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Connecticare,Exchange,,1139.82,,,1139.82,872.95,1350.85,other,Could be inpatient or outpatient,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,Multiplan,Multiplan,,,1350.85,,1350.85,872.95,1350.85,percent of total billed charges,,
HC REM FB UP ARM OR ELBOW; SQ,24200,CPT,,,both,,,1686.11,1011.67,United Healthcare/Oxford,United Healthcare/Oxford,,1096.72,,,1096.72,872.95,1350.85,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT  ,,,both,,,6024.47,3614.68,Aetna,Commerical,,4357.83,,,4357.83,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Aetna,Middlesex Employees,,3922.05,,,3922.05,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Anthem,Commerical,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Anthem,Indemnity,,,4381.76,,4381.76,3119.43,4827.15,percent of total billed charges,,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Anthem,State Preferred,,3899.29,,,3899.29,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Anthem,Individual Exchange,,3119.43,,,3119.43,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Cigna,Cigna,,3808.08,,,3808.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Connecticare,Commerical,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Connecticare,Exchange,,4073.07,,,4073.07,3119.43,4827.15,other,Could be inpatient or outpatient,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,Multiplan,Multiplan,,,4827.15,,4827.15,3119.43,4827.15,percent of total billed charges,,
HC DEEP REM FB FROM UA/ELBOW,24201,CPT,,,both,,,6024.47,3614.68,United Healthcare/Oxford,United Healthcare/Oxford,,3919.08,,,3919.08,3119.43,4827.15,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT  ,,,both,,,510.88,306.53,Aetna,Commerical,,369.6,,,369.6,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Aetna,Middlesex Employees,,332.65,,,332.65,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Anthem,Commerical,,330.7,,,330.7,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Anthem,Indemnity,,,371.63,,371.63,264.57,409.4,percent of total billed charges,,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Anthem,State Preferred,,330.7,,,330.7,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Anthem,Individual Exchange,,264.57,,,264.57,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Cigna,Cigna,,322.97,,,322.97,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Connecticare,Commerical,,345.44,,,345.44,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Connecticare,Exchange,,345.44,,,345.44,264.57,409.4,other,Could be inpatient or outpatient,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,Multiplan,Multiplan,,,409.4,,409.4,264.57,409.4,percent of total billed charges,,
HC INJ ELBOW ARTHRO,24220,CPT,,,both,,,510.88,306.53,United Healthcare/Oxford,United Healthcare/Oxford,,332.38,,,332.38,264.57,409.4,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX HUMERUS FX WO MANIP,24500,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX HUMERUS FX W MANIP,24505,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX SC/TC HUMERUS FX WO MANIPL,24530,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX SC/TX HUMERUS SHFT FX W MANIP,24535,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT  ,,,both,,,2980.82,1788.49,Aetna,Commerical,,2156.53,,,2156.53,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Aetna,Middlesex Employees,,1940.87,,,1940.87,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Anthem,Commerical,,1929.61,,,1929.61,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Anthem,Indemnity,,,2168.37,,2168.37,1543.69,2388.77,percent of total billed charges,,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Anthem,State Preferred,,1929.61,,,1929.61,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Anthem,Individual Exchange,,1543.69,,,1543.69,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Cigna,Cigna,,1884.48,,,1884.48,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Connecticare,Commerical,,2015.61,,,2015.61,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Connecticare,Exchange,,2015.61,,,2015.61,1543.69,2388.77,other,Could be inpatient or outpatient,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,Multiplan,Multiplan,,,2388.77,,2388.77,1543.69,2388.77,percent of total billed charges,,
HC PERC FIX SC/TC HUMERUS FX,24538,CPT,,,both,,,2980.82,1788.49,United Healthcare/Oxford,United Healthcare/Oxford,,1939.41,,,1939.41,1543.69,2388.77,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT  ,,,both,,,10105.71,6063.43,Aetna,Commerical,,7616.13,,,7616.13,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Aetna,Middlesex Employees,,6854.52,,,6854.52,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Anthem,Commerical,,10055.84,,,10055.84,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Anthem,Indemnity,,,7349.7,,7349.7,4550.9,10055.84,percent of total billed charges,,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Anthem,State Preferred,,10055.84,,,10055.84,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Anthem,Individual Exchange,,8044.67,,,8044.67,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Cigna,Cigna,,6613.63,,,6613.63,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Connecticare,Commerical,,5969.15,,,5969.15,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Connecticare,Exchange,,5969.15,,,5969.15,4550.9,10055.84,other,Could be inpatient or outpatient,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,Multiplan,Multiplan,,,8096.76,,8096.76,4550.9,10055.84,percent of total billed charges,,
PR PERCUT FIX HUM SUPRACONDYLAR FX,24538,CPT,,,both,,,10105.71,6063.43,United Healthcare/Oxford,United Healthcare/Oxford,,4550.9,,,4550.9,4550.9,10055.84,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT  ,,,both,,,265.74,159.44,Aetna,Commerical,,177.25,,,177.25,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Aetna,Middlesex Employees,,159.53,,,159.53,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Anthem,Commerical,,147.1,,,147.1,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Anthem,Indemnity,,,192.89,,192.89,117.68,212.5,percent of total billed charges,,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Anthem,State Preferred,,147.1,,,147.1,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Anthem,Individual Exchange,,117.68,,,117.68,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Cigna,Cigna,,156.14,,,156.14,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Connecticare,Commerical,,160.16,,,160.16,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Connecticare,Exchange,,160.16,,,160.16,117.68,212.5,other,Could be inpatient or outpatient,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,Multiplan,Multiplan,,,212.5,,212.5,117.68,212.5,percent of total billed charges,,
HC CLOSED TX HUMERUS FRACTURE,24560,CPT,,,both,,,265.74,159.44,United Healthcare/Oxford,United Healthcare/Oxford,,164.18,,,164.18,117.68,212.5,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX EC HUMERUS FX W MANIP,24565,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT  ,,,both,,,465.56,279.34,Aetna,Commerical,,337.03,,,337.03,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Aetna,Middlesex Employees,,303.33,,,303.33,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Anthem,Commerical,,301.57,,,301.57,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Anthem,Indemnity,,,338.88,,338.88,241.26,373.33,percent of total billed charges,,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Anthem,State Preferred,,301.57,,,301.57,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Anthem,Individual Exchange,,241.26,,,241.26,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Cigna,Cigna,,294.52,,,294.52,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Connecticare,Commerical,,315.01,,,315.01,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Connecticare,Exchange,,315.01,,,315.01,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,Multiplan,Multiplan,,,373.33,,373.33,241.26,373.33,percent of total billed charges,,
HC CL TX C HUMERUS FX WO MANIP,24576,CPT,,,both,,,465.56,279.34,United Healthcare/Oxford,United Healthcare/Oxford,,303.1,,,303.1,241.26,373.33,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX C HUMERUS FX W MANIP,24577,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC TX CL ELBOW DISLOC WO ANESTH,24600,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC TX CL ELBOW DISLOC W ANESTH,24605,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX MONTEGGIA ELB FX W MANIP,24620,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX NURSEMAID ELBOW W MANIP,24640,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL  TX RADIAL HD/NECK FX; WO MANIP,24650,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX RADIAL HD/NECK FX; W MANIP,24655,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END WO MNP,24670,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CLOSED TX ULNAR FRACTURE PROXIMAL END W MNP,24675,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT  ,,,both,,,10070.31,6042.19,Aetna,Commerical,,7284.49,,,7284.49,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Aetna,Middlesex Employees,,6556.05,,,6556.05,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Anthem,Commerical,,6518,,,6518,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Anthem,Indemnity,,,7324.49,,7324.49,5214.39,8068.99,percent of total billed charges,,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Anthem,State Preferred,,6518,,,6518,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Anthem,Individual Exchange,,5214.39,,,5214.39,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Cigna,Cigna,,6365.54,,,6365.54,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Connecticare,Commerical,,6808.5,,,6808.5,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Connecticare,Exchange,,6808.5,,,6808.5,5214.39,8068.99,other,Could be inpatient or outpatient,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,Multiplan,Multiplan,,,8068.99,,8068.99,5214.39,8068.99,percent of total billed charges,,
HC OPEN TX ULNAR FRACTURE PROXIMAL END,24685,CPT,,,both,,,10070.31,6042.19,United Healthcare/Oxford,United Healthcare/Oxford,,6551.08,,,6551.08,5214.39,8068.99,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT  ,,,both,,,361.53,216.92,Aetna,Commerical,,261.32,,,261.32,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Aetna,Middlesex Employees,,235.19,,,235.19,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Anthem,Commerical,,233.83,,,233.83,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Anthem,Indemnity,,,262.76,,262.76,187.07,289.47,percent of total billed charges,,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Anthem,State Preferred,,233.83,,,233.83,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Anthem,Individual Exchange,,187.07,,,187.07,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Cigna,Cigna,,228.35,,,228.35,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Connecticare,Commerical,,244.25,,,244.25,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Connecticare,Exchange,,244.25,,,244.25,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,Multiplan,Multiplan,,,289.47,,289.47,187.07,289.47,percent of total billed charges,,
HC INJ WRIST ARTHRO,25246,CPT,,,both,,,361.53,216.92,United Healthcare/Oxford,United Healthcare/Oxford,,235.02,,,235.02,187.07,289.47,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX OF RADIAL SHAFT FX; WO MANIP,25500,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX RADIAL SHFT FX W MANIP,25505,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT  ,,,both,,,1868.42,1121.05,Aetna,Commerical,,1351.39,,,1351.39,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Aetna,Middlesex Employees,,1216.25,,,1216.25,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Anthem,Commerical,,1209.19,,,1209.19,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Anthem,Indemnity,,,1358.81,,1358.81,967.35,1496.93,percent of total billed charges,,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Anthem,State Preferred,,1209.19,,,1209.19,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Anthem,Individual Exchange,,967.35,,,967.35,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Cigna,Cigna,,1180.91,,,1180.91,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Connecticare,Commerical,,1263.08,,,1263.08,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Connecticare,Exchange,,1263.08,,,1263.08,967.35,1496.93,other,Could be inpatient or outpatient,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,Multiplan,Multiplan,,,1496.93,,1496.93,967.35,1496.93,percent of total billed charges,,
HC CLS TX RADIAL SHAFT FX AND CLS TX DISLOCATN OF DIS RAD JNT,25520,CPT,,,both,,,1868.42,1121.05,United Healthcare/Oxford,United Healthcare/Oxford,,1215.33,,,1215.33,967.35,1496.93,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX ULNAR SHAFT FX; WO MANIP,25530,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX ULNAR SHFT FX W MANIP,25535,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP,25560,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Aetna,Commerical,50,6590.48,,,6590.48,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Aetna,Middlesex Employees,50,5931.44,,,5931.44,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Anthem,Commerical,50,5897,,,5897,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Anthem,Indemnity,50,,6845.242392,,6845.242392,4717.59,7300.25,percent of total billed charges,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Anthem,State Preferred,50,5897,,,5897,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Anthem,Individual Exchange,50,4717.59,,,4717.59,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Cigna,Cigna,50,5759.09,,,5759.09,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Connecticare,Commerical,50,6159.83,,,6159.83,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Connecticare,Exchange,50,6159.83,,,6159.83,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,Multiplan,Multiplan,50,,7745.5485,,7745.5485,4717.59,7745.5485,percent of total billed charges,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX RADIAL & ULNA FX W MANIP,25565,CPT  ,,,both,,,9112.41,5467.45,United Healthcare/Oxford,United Healthcare/Oxford,50,5926.94,,,5926.94,4717.59,7300.25,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP,25600,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Aetna,Commerical,50,6590.48,,,6590.48,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Aetna,Middlesex Employees,50,5931.44,,,5931.44,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Anthem,Commerical,50,5897,,,4897,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Anthem,Indemnity,50,,6845.242392,,6845.242392,4717.59,8890.4,percent of total billed charges,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Anthem,State Preferred,50,5897,,,5897,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Anthem,Individual Exchange,50,4717.59,,,4717.59,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Cigna,Cigna,50,5759.09,,,5759.09,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Connecticare,Commerical,50,6159.83,,,6159.83,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Connecticare,Exchange,50,6159.83,,,6159.83,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,Multiplan,Multiplan,50,,7745.5485,,7745.5485,4717.59,8890.4,percent of total billed charges,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP,25605,CPT  ,,,both,,,9112.41,5467.45,United Healthcare/Oxford,United Healthcare/Oxford,50,8890.4,,,8890.4,4717.59,8890.4,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CARPAL SCAPHOID FX; WO MANIP,25622,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CARPL SCAPHOID FX W MANIP,25624,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLTX CARPL BONE FX WO MNP EA BONE,25630,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLTX CARPL BONE FX W MNP EA BONE,25635,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT  ,,,both,,,836.36,501.82,Aetna,Commerical,,558.68,,,558.68,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Aetna,Middlesex Employees,,502.81,,,502.81,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Anthem,Commerical,,463.66,,,463.66,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Anthem,Indemnity,,,608,,608,370.92,669.8,percent of total billed charges,,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Anthem,State Preferred,,463.66,,,463.66,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Anthem,Individual Exchange,,370.92,,,370.92,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Cigna,Cigna,,492.12,,,492.12,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Connecticare,Commerical,,504.81,,,504.81,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Connecticare,Exchange,,504.81,,,504.81,370.92,669.8,other,Could be inpatient or outpatient,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,Multiplan,Multiplan,,,669.8,,669.8,370.92,669.8,percent of total billed charges,,
HC CLOSE TREATMENT OF ULNAR STYLOID FACTURE,25650,CPT,,,both,,,836.36,501.82,United Healthcare/Oxford,United Healthcare/Oxford,,517.5,,,517.5,370.92,669.8,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLTX RDCRPL/INTERCARPL DISLC 1+ BONES W MNP,25660,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT  ,,,both,,,523.24,313.94,Aetna,Commerical,,378.55,,,378.55,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Aetna,Middlesex Employees,,340.69,,,340.69,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Anthem,Commerical,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Anthem,Indemnity,,,380.63,,380.63,270.98,419.32,percent of total billed charges,,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Anthem,State Preferred,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Anthem,Individual Exchange,,270.98,,,270.98,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Cigna,Cigna,,330.79,,,330.79,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Connecticare,Commerical,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Connecticare,Exchange,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,Multiplan,Multiplan,,,419.32,,419.32,270.98,419.32,percent of total billed charges,,
HC CL TX DSTL RADIOULNAR DISLOC W MANIP,25675,CPT,,,both,,,523.24,313.94,United Healthcare/Oxford,United Healthcare/Oxford,,340.44,,,340.44,270.98,419.32,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX TRANS-SPL FX DISL; W MANIP,25680,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT  ,,,both,,,761.17,456.7,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Anthem,Indemnity,,,553.35,,553.35,393.94,609.59,percent of total billed charges,,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC DRAIN FINGER ABSC; SIMPLE,26010,CPT,,,both,,,761.17,456.7,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT  ,,,both,,,5035.67,3021.4,Aetna,Commerical,,3643.06,,,3643.06,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Aetna,Middlesex Employees,,3278.75,,,3278.75,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Anthem,Commerical,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Anthem,Indemnity,,,3663.07,,3663.07,2607.78,4035.4,percent of total billed charges,,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Anthem,State Preferred,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Anthem,Individual Exchange,,2607.78,,,2607.78,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Cigna,Cigna,,3183.48,,,3183.48,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Connecticare,Commerical,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Connecticare,Exchange,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,Multiplan,Multiplan,,,4035.4,,4035.4,2607.78,4035.4,percent of total billed charges,,
HC DRAIN FINGER ABSC; COMPLICATED,26011,CPT,,,both,,,5035.67,3021.4,United Healthcare/Oxford,United Healthcare/Oxford,,3276.27,,,3276.27,2607.78,4035.4,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT  ,,,both,,,3910.02,2346.01,Aetna,Commerical,,2828.16,,,2828.16,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Aetna,Middlesex Employees,,2545.34,,,2545.34,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Anthem,Commerical,,2530.56,,,2530.56,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Anthem,Indemnity,,,2843.69,,2843.69,2024.45,3132.73,percent of total billed charges,,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Anthem,State Preferred,,2530.56,,,2530.56,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Anthem,Individual Exchange,,2024.45,,,2024.45,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Cigna,Cigna,,2471.37,,,2471.37,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Connecticare,Commerical,,2643.35,,,2643.35,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Connecticare,Exchange,,2643.35,,,2643.35,2024.45,3132.73,other,Could be inpatient or outpatient,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,Multiplan,Multiplan,,,3132.73,,3132.73,2024.45,3132.73,percent of total billed charges,,
HC ARTHROTOMY W EXPL DRAINAGE OR REMV LOOSE FB FINGER JNT,26080,CPT,,,both,,,3910.02,2346.01,United Healthcare/Oxford,United Healthcare/Oxford,,2543.41,,,2543.41,2024.45,3132.73,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT  ,,,both,,,4399.13,2639.48,Aetna,Commerical,,3182.28,,,3182.28,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Aetna,Middlesex Employees,,2864.06,,,2864.06,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Anthem,Commerical,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Anthem,Indemnity,,,3199.76,,3199.76,2277.94,3525,percent of total billed charges,,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Anthem,State Preferred,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Anthem,Individual Exchange,,2277.94,,,2277.94,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Cigna,Cigna,,2780.84,,,2780.84,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Connecticare,Commerical,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Connecticare,Exchange,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,Multiplan,Multiplan,,,3525,,3525,2277.94,3525,percent of total billed charges,,
HC PART EXC BONE; DISTAL PHALANX,26236,CPT,,,both,,,4399.13,2639.48,United Healthcare/Oxford,United Healthcare/Oxford,,2861.89,,,2861.89,2277.94,3525,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT  ,,,both,,,10064.13,6038.48,Aetna,Commerical,,7279.6,,,7279.6,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Aetna,Middlesex Employees,,6551.64,,,6551.64,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Anthem,Commerical,,6513.62,,,6513.62,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Anthem,Indemnity,,,7319.58,,7319.58,5210.89,8063.58,percent of total billed charges,,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Anthem,State Preferred,,6513.62,,,6513.62,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Anthem,Individual Exchange,,5210.89,,,5210.89,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Cigna,Cigna,,6361.27,,,6361.27,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Connecticare,Commerical,,6803.93,,,6803.93,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Connecticare,Exchange,,6803.93,,,6803.93,5210.89,8063.58,other,Could be inpatient or outpatient,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,Multiplan,Multiplan,,,8063.58,,8063.58,5210.89,8063.58,percent of total billed charges,,
HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA,26350,CPT,,,both,,,10064.13,6038.48,United Healthcare/Oxford,United Healthcare/Oxford,,6546.68,,,6546.68,5210.89,8063.58,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT  ,,,both,,,6274.76,3764.86,Aetna,Commerical,,4539.37,,,4539.37,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Aetna,Middlesex Employees,,4085.44,,,4085.44,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Anthem,Commerical,,4061.72,,,4061.72,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Anthem,Indemnity,,,4564.3,,4564.3,3249.38,5028.24,percent of total billed charges,,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Anthem,State Preferred,,4061.72,,,4061.72,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Anthem,Individual Exchange,,3249.38,,,3249.38,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Cigna,Cigna,,3966.73,,,3966.73,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Connecticare,Commerical,,4242.76,,,4242.76,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Connecticare,Exchange,,4242.76,,,4242.76,3249.38,5028.24,other,Could be inpatient or outpatient,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,Multiplan,Multiplan,,,5028.24,,5028.24,3249.38,5028.24,percent of total billed charges,,
HC EXTENSOR TENDON REPAIR EACH,26418,CPT,,,both,,,6274.76,3764.86,United Healthcare/Oxford,United Healthcare/Oxford,,4082.34,,,4082.34,3249.38,5028.24,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX MC FX SGL; W  MANIP EACH,26605,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX CMC DISLOC THUMB W MANIP,26641,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CMC FX DISLOC THUMB W MANIP,26645,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX CMC DISL W M EA,26670,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX MCP DISLOC SGL W MANIP,26700,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX PHAL SHAFT FX; WO MANIP EA,26720,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX PHALANG SHFT FX; W MANIP,26725,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX ART FX MCP/IP JNT; WO MAN,26740,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX ARTFX MCP/IP JNT; W MANIP,26742,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT  ,,,both,,,1662.42,997.45,Aetna,Commerical,,1202.41,,,1202.41,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Aetna,Middlesex Employees,,1082.17,,,1082.17,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Anthem,Commerical,,1075.89,,,1075.89,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Anthem,Indemnity,,,1209.02,,1209.02,860.72,1331.91,percent of total billed charges,,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Anthem,State Preferred,,1075.89,,,1075.89,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Anthem,Individual Exchange,,860.72,,,860.72,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Cigna,Cigna,,1050.72,,,1050.72,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Connecticare,Commerical,,1123.84,,,1123.84,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Connecticare,Exchange,,1123.84,,,1123.84,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,Multiplan,Multiplan,,,1331.91,,1331.91,860.72,1331.91,percent of total billed charges,,
HC CL TX D PHAL FX FGR/THMB; WO MANIP,26750,CPT,,,both,,,1662.42,997.45,United Healthcare/Oxford,United Healthcare/Oxford,,1081.36,,,1081.36,860.72,1331.91,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX D PHAL FX FGRR/THMB; W MANIP,26755,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX IP JNT D W MANIP ; WO ANESTH,26770,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC CL TX IP JT D W MANIP; W ANESTH,26775,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT  ,,,both,,,5922.5,3553.5,Aetna,Commerical,,4283.75,,,4283.75,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Aetna,Middlesex Employees,,3855.38,,,3855.38,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Anthem,Commerical,,3833,,,3833,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Anthem,Indemnity,,,4307.28,,4307.28,3066.39,4745.09,percent of total billed charges,,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Anthem,State Preferred,,3833,,,3833,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Anthem,Individual Exchange,,3066.39,,,3066.39,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Cigna,Cigna,,3743.34,,,3743.34,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Connecticare,Commerical,,4003.84,,,4003.84,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Connecticare,Exchange,,4003.84,,,4003.84,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,Multiplan,Multiplan,,,4745.09,,4745.09,3066.39,4745.09,percent of total billed charges,,
HC AMPUTATION MC W FING/THUMB,26910,CPT,,,both,,,5922.5,3553.5,United Healthcare/Oxford,United Healthcare/Oxford,,3852.46,,,3852.46,3066.39,4745.09,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT  ,,,both,,,11901.65,7140.99,Aetna,Commerical,,8608.2,,,8608.2,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Aetna,Middlesex Employees,,7747.38,,,7747.38,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Anthem,Commerical,,7702.42,,,7702.42,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Anthem,Indemnity,,,8655.48,,8655.48,6161.93,9535.27,percent of total billed charges,,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Anthem,State Preferred,,7702.42,,,7702.42,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Anthem,Individual Exchange,,6161.93,,,6161.93,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Cigna,Cigna,,7522.27,,,7522.27,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Connecticare,Commerical,,8045.71,,,8045.71,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Connecticare,Exchange,,8045.71,,,8045.71,6161.93,9535.27,other,Could be inpatient or outpatient,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,Multiplan,Multiplan,,,9535.27,,9535.27,6161.93,9535.27,percent of total billed charges,,
HC AMPUTATE FING/TH SGL; W DIR CLOSE,26951,CPT,,,both,,,11901.65,7140.99,United Healthcare/Oxford,United Healthcare/Oxford,,7741.51,,,7741.51,6161.93,9535.27,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT  ,,,both,,,3085.88,1851.53,Aetna,Commerical,,2232.24,,,2232.24,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Aetna,Middlesex Employees,,2009.02,,,2009.02,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Anthem,Commerical,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Anthem,Indemnity,,,2244.5,,2244.5,1597.88,2472.64,percent of total billed charges,,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Anthem,State Preferred,,1997.35,,,1997.35,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Anthem,Individual Exchange,,1597.88,,,1597.88,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Cigna,Cigna,,1950.63,,,1950.63,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Connecticare,Commerical,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Connecticare,Exchange,,2086.38,,,2086.38,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,Multiplan,Multiplan,,,2472.64,,2472.64,1597.88,2472.64,percent of total billed charges,,
HC REM FB PELVIS OR HIP; SQ,27086,CPT,,,both,,,3085.88,1851.53,United Healthcare/Oxford,United Healthcare/Oxford,,2007.49,,,2007.49,1597.88,2472.64,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT  ,,,both,,,8176.14,4905.68,Aetna,Commerical,,5914.37,,,5914.37,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Aetna,Middlesex Employees,,5322.93,,,5322.93,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Anthem,Commerical,,5292.04,,,5292.04,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Anthem,Indemnity,,,5946.85,,5946.85,4233.63,6551.32,percent of total billed charges,,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Anthem,State Preferred,,5292.04,,,5292.04,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Anthem,Individual Exchange,,4233.63,,,4233.63,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Cigna,Cigna,,5168.27,,,5168.27,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Connecticare,Commerical,,5527.91,,,5527.91,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Connecticare,Exchange,,5527.91,,,5527.91,4233.63,6551.32,other,Could be inpatient or outpatient,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,Multiplan,Multiplan,,,6551.32,,6551.32,4233.63,6551.32,percent of total billed charges,,
HC REM FB PELVIS OR HIP; DEEP,27087,CPT,,,both,,,8176.14,4905.68,United Healthcare/Oxford,United Healthcare/Oxford,,5318.9,,,5318.9,4233.63,6551.32,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT  ,,,both,,,317.24,190.34,Aetna,Commerical,,229.57,,,229.57,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Aetna,Middlesex Employees,,206.61,,,206.61,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Anthem,Commerical,,205.42,,,205.42,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Anthem,Indemnity,,,230.83,,230.83,164.34,254.29,percent of total billed charges,,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Anthem,State Preferred,,205.42,,,205.42,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Anthem,Individual Exchange,,164.34,,,164.34,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Cigna,Cigna,,200.62,,,200.62,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Connecticare,Commerical,,214.57,,,214.57,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Connecticare,Exchange,,214.57,,,214.57,164.34,254.29,other,Could be inpatient or outpatient,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,Multiplan,Multiplan,,,254.29,,254.29,164.34,254.29,percent of total billed charges,,
HC INJ FOR HIP ARTHROGRAPHY W/O ANESTHESIA,27093,CPT,,,both,,,317.24,190.34,United Healthcare/Oxford,United Healthcare/Oxford,,206.46,,,206.46,164.34,254.29,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Aetna,Commerical,,367.16,,,367.16,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Aetna,Commerical,50,550.74,,,550.74,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Aetna,Middlesex Employees,,330.44,,,330.44,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Aetna,Middlesex Employees,50,495.66,,,495.66,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Anthem,Commerical,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Anthem,Commerical,50,492.78,,,492.78,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Anthem,Indemnity,,,369.17,,369.17,262.82,406.7,percent of total billed charges,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Anthem,Indemnity,50,,572.181528,,572.181528,394.23,610.05,percent of total billed charges,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Anthem,State Preferred,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Anthem,State Preferred,50,492.78,,,492.78,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Anthem,Individual Exchange,,262.82,,,262.82,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Anthem,Individual Exchange,50,394.23,,,394.23,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Cigna,Cigna,,320.84,,,320.84,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Cigna,Cigna,50,481.26,,,481.26,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Connecticare,Commerical,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Connecticare,Commerical,50,514.74,,,514.74,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Connecticare,Exchange,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Connecticare,Exchange,50,514.74,,,514.74,394.23,610.05,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,Multiplan,Multiplan,,,406.7,,406.7,262.82,406.7,percent of total billed charges,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,Multiplan,Multiplan,50,,647.4365,,647.4365,394.23,647.4365,percent of total billed charges,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,507.79,304.67,United Healthcare/Oxford,United Healthcare/Oxford,,330.19,,,330.19,262.82,406.7,other,Could be inpatient or outpatient,
HC HIP ARTHROGRAPHY INJ W ANESTH,27095,CPT  ,,,both,,,761.69,457.01,United Healthcare/Oxford,United Healthcare/Oxford,50,495.29,,,495.29,394.23,610.05,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT  ,,,both,,,249.26,149.56,Aetna,Commerical,,179.92,,,179.92,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Aetna,Middlesex Employees,,161.92,,,161.92,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Anthem,Commerical,,160.98,,,160.98,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Anthem,Indemnity,,,180.9,,180.9,128.79,199.29,percent of total billed charges,,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Anthem,State Preferred,,160.98,,,160.98,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Anthem,Individual Exchange,,128.79,,,128.79,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Cigna,Cigna,,157.22,,,157.22,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Connecticare,Commerical,,168.16,,,168.16,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Connecticare,Exchange,,168.16,,,168.16,128.79,199.29,other,Could be inpatient or outpatient,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,Multiplan,Multiplan,,,199.29,,199.29,128.79,199.29,percent of total billed charges,,
HC INJECT SACROILIAC JOINT,27096,CPT,,,both,,,249.26,149.56,United Healthcare/Oxford,United Healthcare/Oxford,,161.8,,,161.8,128.79,199.29,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX TRAUMA HIP DICLOC WO ANESTH,27250,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT  ,,,both,,,4909.47,2945.68,Aetna,Commerical,,3551.07,,,3551.07,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT  ,,,both,,,8289.38,4973.63,Aetna,Commerical,,5995.79,,,5995.79,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Aetna,Middlesex Employees,,3195.96,,,3195.96,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Aetna,Middlesex Employees,,5396.21,,,5396.21,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Anthem,Commerical,,3177.41,,,3177.41,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Anthem,Commerical,,5364.88,,,5364.88,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Anthem,Indemnity,,,3570.57,,3570.57,2541.93,3933.5,percent of total billed charges,,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Anthem,Indemnity,,,6028.71,,6028.71,4291.91,6641.5,percent of total billed charges,,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Anthem,State Preferred,,3177.41,,,3177.41,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Anthem,State Preferred,,5364.88,,,5364.88,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Anthem,Individual Exchange,,2541.93,,,2541.93,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Anthem,Individual Exchange,,4291.91,,,4291.91,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Cigna,Cigna,,3103.09,,,3103.09,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Cigna,Cigna,,5239.41,,,5239.41,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Connecticare,Commerical,,3319.03,,,3319.03,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Connecticare,Commerical,,5603.99,,,5603.99,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Connecticare,Exchange,,3319.03,,,3319.03,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Connecticare,Exchange,,5603.99,,,5603.99,4291.91,6641.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,Multiplan,Multiplan,,,3933.5,,3933.5,2541.93,3933.5,percent of total billed charges,,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,Multiplan,Multiplan,,,6641.5,,6641.5,4291.91,6641.5,percent of total billed charges,,
HC DEEP I&D THIGH/KNEE - OR,27301,CPT,,,both,,,4909.47,2945.68,United Healthcare/Oxford,United Healthcare/Oxford,,3193.54,,,3193.54,2541.93,3933.5,other,Could be inpatient or outpatient,
HC DEEP I&D THIGH/KNEE,27301,CPT,,,both,,,8289.38,4973.63,United Healthcare/Oxford,United Healthcare/Oxford,,5392.11,,,5392.11,4291.91,6641.5,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT  ,,,both,,,301.79,181.07,Aetna,Commerical,,201.35,,,201.35,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Aetna,Middlesex Employees,,181.21,,,181.21,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Anthem,Commerical,,167.1,,,167.1,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Anthem,Indemnity,,,219.13,,219.13,133.68,241.4,percent of total billed charges,,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Anthem,State Preferred,,167.1,,,167.1,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Anthem,Individual Exchange,,133.68,,,133.68,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Cigna,Cigna,,177.36,,,177.36,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Connecticare,Commerical,,181.94,,,181.94,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Connecticare,Exchange,,181.94,,,181.94,133.68,241.4,other,Could be inpatient or outpatient,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,Multiplan,Multiplan,,,241.4,,241.4,133.68,241.4,percent of total billed charges,,
HC INJ CONTRAST KNEE ARTHROGRAPHY,27369,CPT,,,both,,,301.79,181.07,United Healthcare/Oxford,United Healthcare/Oxford,,186.51,,,186.51,133.68,241.4,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT  ,,,both,,,301.79,181.07,Aetna,Commerical,,165.76,,,165.76,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Aetna,Middlesex Employees,,149.18,,,149.18,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Anthem,Commerical,,196.81,,,196.81,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Anthem,Indemnity,,,219.37,,219.37,149.18,241.67,percent of total billed charges,,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Anthem,State Preferred,,196.81,,,196.81,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Anthem,Individual Exchange,,157.44,,,157.44,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Cigna,Cigna,,226.26,,,226.26,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Connecticare,Commerical,,210.64,,,210.64,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Connecticare,Exchange,,210.64,,,210.64,149.18,241.67,other,Could be inpatient or outpatient,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,Multiplan,Multiplan,,,241.67,,241.67,149.18,241.67,percent of total billed charges,,
HC INJECTION FOR KNEE X-RAY,27370,CPT,,,both,,,301.79,181.07,United Healthcare/Oxford,United Healthcare/Oxford,,183.76,,,183.76,149.18,241.67,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT  ,,,both,,,6988.55,4193.13,Aetna,Commerical,,5054.69,,,5054.69,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Aetna,Middlesex Employees,,4549.22,,,4549.22,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Anthem,Commerical,,4522.83,,,4522.83,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Anthem,Indemnity,,,5082.45,,5082.45,3618.26,5599.06,percent of total billed charges,,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Anthem,State Preferred,,4522.83,,,4522.83,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Anthem,Individual Exchange,,3618.26,,,3618.26,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Cigna,Cigna,,4417.04,,,4417.04,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Connecticare,Commerical,,4724.4,,,4724.4,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Connecticare,Exchange,,4724.4,,,4724.4,3618.26,5599.06,other,Could be inpatient or outpatient,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,Multiplan,Multiplan,,,5599.06,,5599.06,3618.26,5599.06,percent of total billed charges,,
HC REM DEEP FB THIGH OR KNEE,27372,CPT,,,both,,,6988.55,4193.13,United Healthcare/Oxford,United Healthcare/Oxford,,4545.78,,,4545.78,3618.26,5599.06,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT  ,,,both,,,32774.69,19664.82,Aetna,Commerical,,24717.53,,,24717.53,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Aetna,Middlesex Employees,,22245.79,,,22245.79,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Anthem,Commerical,,15737.48,,,15737.48,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Anthem,Indemnity,,,23836.43,,23836.43,12589.98,26259.3,percent of total billed charges,,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Anthem,State Preferred,,15737.48,,,15737.48,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Anthem,Individual Exchange,,12589.98,,,12589.98,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Cigna,Cigna,,21445.2,,,21445.2,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Connecticare,Commerical,,16165.62,,,16165.62,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Connecticare,Exchange,,16165.62,,,16165.62,12589.98,26259.3,other,Could be inpatient or outpatient,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,Multiplan,Multiplan,,,26259.3,,26259.3,12589.98,26259.3,percent of total billed charges,,
PR LIGMT REVISION KNEE EXTRA-ARTIC,27427,CPT,,,both,,,32774.69,19664.82,United Healthcare/Oxford,United Healthcare/Oxford,,14163.13,,,14163.13,12589.98,26259.3,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX FEMORAL SHAFT FX WO MANIP,27500,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX FEMORAL SHAFT FX W MANIP,27502,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX D FEM FX WO MANIP,27508,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX FEMUR FX OR EPIPHYS SEP,27510,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT  ,,,both,,,898.16,538.9,Aetna,Commerical,,649.64,,,649.64,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Aetna,Middlesex Employees,,584.68,,,584.68,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Anthem,Commerical,,581.29,,,581.29,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Anthem,Indemnity,,,653.21,,653.21,465.03,719.61,percent of total billed charges,,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Anthem,State Preferred,,581.29,,,581.29,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Anthem,Individual Exchange,,465.03,,,465.03,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Cigna,Cigna,,567.69,,,567.69,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Connecticare,Commerical,,607.19,,,607.19,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Connecticare,Exchange,,607.19,,,607.19,465.03,719.61,other,Could be inpatient or outpatient,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,Multiplan,Multiplan,,,719.61,,719.61,465.03,719.61,percent of total billed charges,,
HC CLD TX DISTAL FEMORAL EPIPHYSEAL SEP: WO MANIPULATION,27516,CPT,,,both,,,898.16,538.9,United Healthcare/Oxford,United Healthcare/Oxford,,584.24,,,584.24,465.03,719.61,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLOSED TX PATELLAR FX WO MANIP,27520,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX PROX TIBIAL FX  WO MANIP,27530,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT  ,,,both,,,11901.65,7140.99,Aetna,Commerical,,8608.2,,,8608.2,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Aetna,Middlesex Employees,,7747.38,,,7747.38,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Anthem,Commerical,,7702.42,,,7702.42,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Anthem,Indemnity,,,8655.48,,8655.48,6161.93,9535.27,percent of total billed charges,,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Anthem,State Preferred,,7702.42,,,7702.42,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Anthem,Individual Exchange,,6161.93,,,6161.93,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Cigna,Cigna,,7522.27,,,7522.27,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Connecticare,Commerical,,8045.71,,,8045.71,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Connecticare,Exchange,,8045.71,,,8045.71,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,Multiplan,Multiplan,,,9535.27,,9535.27,6161.93,9535.27,percent of total billed charges,,
HC CL TX PROX TIBIAL FX  W SK TRACTION,27532,CPT,,,both,,,11901.65,7140.99,United Healthcare/Oxford,United Healthcare/Oxford,,7741.51,,,7741.51,6161.93,9535.27,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX KNEE DISL; WO ANESTH,27550,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC C TX PATELLAR DISLOCATION; WO ANESTH,27560,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,744.61,500.58,774.61,percent of total billed charges,,
HC CL TX PATELLAR DISLOCATION; W ANESTH,27562,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT  ,,,both,,,6452.95,3871.77,Aetna,Commerical,,4668,,,4668,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Aetna,Middlesex Employees,,4201.2,,,4201.2,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Anthem,Commerical,,4176.81,,,4176.81,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Anthem,Indemnity,,,4693.63,,4693.63,3341.46,5170.72,percent of total billed charges,,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Anthem,State Preferred,,4176.81,,,4176.81,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Anthem,Individual Exchange,,3341.46,,,3341.46,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Cigna,Cigna,,4079.13,,,4079.13,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Connecticare,Commerical,,4362.98,,,4362.98,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Connecticare,Exchange,,4362.98,,,4362.98,3341.46,5170.72,other,Could be inpatient or outpatient,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,Multiplan,Multiplan,,,5170.72,,5170.72,3341.46,5170.72,percent of total billed charges,,
HC MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,27570,CPT,,,both,,,6452.95,3871.77,United Healthcare/Oxford,United Healthcare/Oxford,,4198.01,,,4198.01,3341.46,5170.72,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT  ,,,both,,,30602.11,18361.27,Aetna,Commerical,,23078.92,,,23078.92,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Aetna,Middlesex Employees,,20771.03,,,20771.03,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Anthem,Commerical,,14098.23,,,14098.23,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Anthem,Indemnity,,,22256.35,,22256.35,10397.42,24518.62,percent of total billed charges,,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Anthem,State Preferred,,14098.23,,,14098.23,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Anthem,Individual Exchange,,11278.58,,,11278.58,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Cigna,Cigna,,20033.47,,,20033.47,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Connecticare,Commerical,,15094.02,,,15094.02,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Connecticare,Exchange,,15094.02,,,15094.02,10397.42,24518.62,other,Could be inpatient or outpatient,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,Multiplan,Multiplan,,,24518.62,,24518.62,10397.42,24518.62,percent of total billed charges,,
PR FEMUR/KNEE SURG UNLISTED,27599,CPT,,,both,,,30602.11,18361.27,United Healthcare/Oxford,United Healthcare/Oxford,,10397.42,,,10397.42,10397.42,24518.62,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT  ,,,both,,,239.99,143.99,Aetna,Commerical,,173.4,,,173.4,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Aetna,Middlesex Employees,,156.07,,,156.07,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Anthem,Commerical,,155.16,,,155.16,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Anthem,Indemnity,,,174.35,,174.35,124.13,192.07,percent of total billed charges,,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Anthem,State Preferred,,155.16,,,155.16,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Anthem,Individual Exchange,,124.13,,,124.13,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Cigna,Cigna,,151.53,,,151.53,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Connecticare,Commerical,,162.07,,,162.07,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Connecticare,Exchange,,162.07,,,162.07,124.13,192.07,other,Could be inpatient or outpatient,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,Multiplan,Multiplan,,,192.07,,192.07,124.13,192.07,percent of total billed charges,,
HC INJ ANKLE ARTHRO,27648,CPT,,,both,,,239.99,143.99,United Healthcare/Oxford,United Healthcare/Oxford,,155.94,,,155.94,124.13,192.07,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX TIB SHFT FX WO MANIP,27750,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX TIB SHFT FX W MANIP,27752,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLTX MEDIAL ANKLE FX,27760,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CLTX MED ANKLE FX W/MNPJ,27762,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX PROX FIB/SHAFT FX WO MANIP,27780,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX PROX FIB/SHAFT FX W MANIP,27781,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX DSTL FIB FX WO MANIP,27786,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX DISTL FIB FX W MANIP,27788,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP,27808,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CLTX BIMALLEOLAR ANKLE FRACT W MNP,27810,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX TRIMALL ANKLE FX; WO MANIP,27816,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX TRIMALL ANKLE FX; W MANIP,27818,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX WB DSTL TIB WO MANIP,27824,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT  ,,,both,,,6074.94,3644.96,Aetna,Commerical,,4393.65,,,4393.65,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Aetna,Middlesex Employees,,3954.29,,,3954.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Anthem,Commerical,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Anthem,Indemnity,,,4417.78,,4417.78,3145.06,4866.83,percent of total billed charges,,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Anthem,State Preferred,,3931.33,,,3931.33,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Anthem,Individual Exchange,,3145.06,,,3145.06,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Cigna,Cigna,,3839.39,,,3839.39,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Connecticare,Commerical,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Connecticare,Exchange,,4106.55,,,4106.55,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,Multiplan,Multiplan,,,4866.83,,4866.83,3145.06,4866.83,percent of total billed charges,,
HC CL TX WB DSTL TIB FX W MANIP,27825,CPT,,,both,,,6074.94,3644.96,United Healthcare/Oxford,United Healthcare/Oxford,,3951.29,,,3951.29,3145.06,4866.83,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT  ,,,both,,,7889.82,4733.89,Aetna,Commerical,,5706.78,,,5706.78,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Aetna,Middlesex Employees,,5136.1,,,5136.1,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Anthem,Commerical,,5106.3,,,5106.3,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Anthem,Indemnity,,,5738.12,,5738.12,4085.04,6321.37,percent of total billed charges,,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Anthem,State Preferred,,5106.3,,,5106.3,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Anthem,Individual Exchange,,4085.04,,,4085.04,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Cigna,Cigna,,4986.86,,,4986.86,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Connecticare,Commerical,,5333.88,,,5333.88,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Connecticare,Exchange,,5333.88,,,5333.88,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,Multiplan,Multiplan,,,6321.37,,6321.37,4085.04,6321.37,percent of total billed charges,,
HC CLS TX OF PROX TIBIOFIBULAR JNT DISLOCTN REQ ANESTH,27831,CPT,,,both,,,7889.82,4733.89,United Healthcare/Oxford,United Healthcare/Oxford,,5132.21,,,5132.21,4085.04,6321.37,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX ANKLE DISLOCATION; WO ANESTH,27840,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC UNLISTED PROCEDURE LEG OR ANKLE,27899,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT  ,,,both,,,4399.13,2639.48,Aetna,Commerical,,3182.28,,,3182.28,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Aetna,Middlesex Employees,,2864.06,,,2864.06,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Anthem,Commerical,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Anthem,Indemnity,,,3199.76,,3199.76,2277.94,3525,percent of total billed charges,,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Anthem,State Preferred,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Anthem,Individual Exchange,,2277.94,,,2277.94,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Cigna,Cigna,,2780.84,,,2780.84,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Connecticare,Commerical,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Connecticare,Exchange,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,Multiplan,Multiplan,,,3525,,3525,2277.94,3525,percent of total billed charges,,
HC PARTIAL EXC PHALANX TOE BONE,28124,CPT,,,both,,,4399.13,2639.48,United Healthcare/Oxford,United Healthcare/Oxford,,2861.89,,,2861.89,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT  ,,,both,,,4399.13,2639.48,Aetna,Commerical,,3182.28,,,3182.28,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Aetna,Middlesex Employees,,2864.06,,,2864.06,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Anthem,Commerical,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Anthem,Indemnity,,,3199.76,,3199.76,2277.94,3525,percent of total billed charges,,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Anthem,State Preferred,,2847.43,,,2847.43,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Anthem,Individual Exchange,,2277.94,,,2277.94,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Cigna,Cigna,,2780.84,,,2780.84,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Connecticare,Commerical,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Connecticare,Exchange,,2974.34,,,2974.34,2277.94,3525,other,Could be inpatient or outpatient,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,Multiplan,Multiplan,,,3525,,3525,2277.94,3525,percent of total billed charges,,
HC INTERPHALANG TOE JNT EXC EA SGL,28160,CPT,,,both,,,4399.13,2639.48,United Healthcare/Oxford,United Healthcare/Oxford,,2861.89,,,2861.89,2277.94,3525,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC REM FB FOOT; SQ,28190,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT  ,,,both,,,5295.23,3177.14,Aetna,Commerical,,3830.3,,,3830.3,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Aetna,Middlesex Employees,,3447.26,,,3447.26,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Anthem,Commerical,,3427.26,,,3427.26,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Anthem,Indemnity,,,3851.33,,3851.33,2741.81,4242.8,percent of total billed charges,,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Anthem,State Preferred,,3427.26,,,3427.26,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Anthem,Individual Exchange,,2741.81,,,2741.81,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Cigna,Cigna,,3347.1,,,3347.1,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Connecticare,Commerical,,3580.01,,,3580.01,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Connecticare,Exchange,,3580.01,,,3580.01,2741.81,4242.8,other,Could be inpatient or outpatient,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,Multiplan,Multiplan,,,4242.8,,4242.8,2741.81,4242.8,percent of total billed charges,,
HC REM FB FOOT DEEP,28192,CPT,,,both,,,5295.23,3177.14,United Healthcare/Oxford,United Healthcare/Oxford,,3444.66,,,3444.66,2741.81,4242.8,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT  ,,,both,,,4011.85,2407.11,Aetna,Commerical,,2902.24,,,2902.24,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Aetna,Middlesex Employees,,2612.02,,,2612.02,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Anthem,Commerical,,2596.86,,,2596.86,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Anthem,Indemnity,,,2918.17,,2918.17,2077.48,3214.79,percent of total billed charges,,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Anthem,State Preferred,,2596.86,,,2596.86,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Anthem,Individual Exchange,,2077.48,,,2077.48,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Cigna,Cigna,,2536.11,,,2536.11,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Connecticare,Commerical,,2712.6,,,2712.6,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Connecticare,Exchange,,2712.6,,,2712.6,2077.48,3214.79,other,Could be inpatient or outpatient,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,Multiplan,Multiplan,,,3214.79,,3214.79,2077.48,3214.79,percent of total billed charges,,
HC COMPLIC REM FB FROM FOOT,28193,CPT,,,both,,,4011.85,2407.11,United Healthcare/Oxford,United Healthcare/Oxford,,2610.03,,,2610.03,2077.48,3214.79,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX CALCANEAL FX; WO MANIP,28400,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL  TX CALCANEAL FX; W MANIP,28405,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX TALUS FX; WO MANIP,28430,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX TALUS FX; W MANIP,28435,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC TX TARSAL BONE FX ; WO MANIPU,28450,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC TX TARSAL BONE FX; W MANIP,28455,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX METATARSAL FX; WO MANIP,28470,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX METATARSAL FX; W MANIP,28475,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT  ,,,both,,,5101.59,3060.95,Aetna,Commerical,,3690.28,,,3690.28,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Aetna,Middlesex Employees,,3321.25,,,3321.25,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Anthem,Commerical,,3301.97,,,3301.97,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Anthem,Indemnity,,,3710.54,,3710.54,2641.58,4087.7,percent of total billed charges,,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Anthem,State Preferred,,3301.97,,,3301.97,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Anthem,Individual Exchange,,2641.58,,,2641.58,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Cigna,Cigna,,3224.74,,,3224.74,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Connecticare,Commerical,,3449.14,,,3449.14,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Connecticare,Exchange,,3449.14,,,3449.14,2641.58,4087.7,other,Could be inpatient or outpatient,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,Multiplan,Multiplan,,,4087.7,,4087.7,2641.58,4087.7,percent of total billed charges,,
HC TREAT METATARSAL FRACTURE,28485,CPT,,,both,,,5101.59,3060.95,United Healthcare/Oxford,United Healthcare/Oxford,,3318.73,,,3318.73,2641.58,4087.7,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX FX GT PHALANX(S); WO MANIP,28490,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX FX GT PHALANX(S); W MANIP,28495,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT  ,,,both,,,355.35,213.21,Aetna,Commerical,,257.25,,,257.25,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Aetna,Middlesex Employees,,231.53,,,231.53,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Anthem,Commerical,,230.18,,,230.18,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Anthem,Indemnity,,,258.66,,258.66,184.15,284.95,percent of total billed charges,,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Anthem,State Preferred,,230.18,,,230.18,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Anthem,Individual Exchange,,184.15,,,184.15,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Cigna,Cigna,,224.8,,,224.8,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Connecticare,Commerical,,240.44,,,240.44,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Connecticare,Exchange,,240.44,,,240.44,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,Multiplan,Multiplan,,,284.95,,284.95,184.15,284.95,percent of total billed charges,,
HC CL TX FX PHALNX/PHALANG WO MANIP,28510,CPT,,,both,,,355.35,213.21,United Healthcare/Oxford,United Healthcare/Oxford,,231.35,,,231.35,184.15,284.95,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX FX PHALANX/PHALANG; W MANIP,28515,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT  ,,,both,,,748.81,449.29,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Anthem,Indemnity,,,544.34,,544.34,387.52,599.68,percent of total billed charges,,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC CL TX TARSAL BONE DISLO; WO ANESTH,28540,CPT,,,both,,,748.81,449.29,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX MTP JNT DISLOC; WO ANESTH,28630,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,,699.3,,,699.3,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Aetna,Middlesex Employees,,629.37,,,629.37,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Anthem,Commerical,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Anthem,Indemnity,,,703.14,,703.14,500.58,774.61,percent of total billed charges,,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Anthem,State Preferred,,625.72,,,625.72,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Anthem,Individual Exchange,,500.58,,,500.58,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Cigna,Cigna,,611.08,,,611.08,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Connecticare,Commerical,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Connecticare,Exchange,,653.61,,,653.61,500.58,774.61,other,Could be inpatient or outpatient,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,Multiplan,Multiplan,,,774.61,,774.61,500.58,774.61,percent of total billed charges,,
HC CL TX IP JOINT DISL; WO ANESTH,28660,CPT,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,,628.9,,,628.9,500.58,774.61,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT  ,,,both,,,809.58,485.75,Aetna,Commerical,,585.33,,,585.33,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Aetna,Middlesex Employees,,526.8,,,526.8,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Anthem,Commerical,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Anthem,Indemnity,,,588.55,,588.55,418.99,648.37,percent of total billed charges,,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Anthem,State Preferred,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Anthem,Individual Exchange,,418.99,,,418.99,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Cigna,Cigna,,511.49,,,511.49,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Connecticare,Commerical,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Connecticare,Exchange,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,Multiplan,Multiplan,,,648.37,,648.37,418.99,648.37,percent of total billed charges,,
HC APPLY SHOULDER SPICA,29055,CPT,,,both,,,809.58,485.75,United Healthcare/Oxford,United Healthcare/Oxford,,526.4,,,526.4,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC APPLY PLASTER VELPEAU,29058,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC APPLY LONG ARM CAST,29065,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC APPLY SHORT ARM CAST,29075,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT  ,,,both,,,608.73,365.24,Aetna,Commerical,,440.42,,,440.42,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Aetna,Middlesex Employees,,396.38,,,396.38,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Anthem,Commerical,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Anthem,Indemnity,,,442.84,,442.84,315.26,487.86,percent of total billed charges,,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Anthem,State Preferred,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Anthem,Individual Exchange,,315.26,,,315.26,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Cigna,Cigna,,384.86,,,384.86,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Connecticare,Commerical,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Connecticare,Exchange,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,Multiplan,Multiplan,,,487.86,,487.86,315.26,487.86,percent of total billed charges,,
HC APPLY GAUNTLET CAST,29085,CPT,,,both,,,608.73,365.24,United Healthcare/Oxford,United Healthcare/Oxford,,396.08,,,396.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT  ,,,both,,,318.27,190.96,Aetna,Commerical,,230.38,,,230.38,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Aetna,Middlesex Employees,,207.34,,,207.34,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Anthem,Commerical,,206.14,,,206.14,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Anthem,Indemnity,,,231.65,,231.65,164.92,255.2,percent of total billed charges,,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Anthem,State Preferred,,206.14,,,206.14,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Anthem,Individual Exchange,,164.92,,,164.92,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Cigna,Cigna,,201.32,,,201.32,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Connecticare,Commerical,,215.34,,,215.34,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Connecticare,Exchange,,215.34,,,215.34,164.92,255.2,other,Could be inpatient or outpatient,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,Multiplan,Multiplan,,,255.2,,255.2,164.92,255.2,percent of total billed charges,,
HC APPL CAST; FIGURE 8 FINGER,29086,CPT,,,both,,,318.27,190.96,United Healthcare/Oxford,United Healthcare/Oxford,,207.19,,,207.19,164.92,255.2,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT  ,,,both,,,608.73,365.24,Aetna,Commerical,,440.42,,,440.42,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Aetna,Middlesex Employees,,396.38,,,396.38,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Anthem,Commerical,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Anthem,Indemnity,,,442.84,,442.84,315.26,487.86,percent of total billed charges,,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Anthem,State Preferred,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Anthem,Individual Exchange,,315.26,,,315.26,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Cigna,Cigna,,384.86,,,384.86,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Connecticare,Commerical,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Connecticare,Exchange,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,Multiplan,Multiplan,,,487.86,,487.86,315.26,487.86,percent of total billed charges,,
HC APPLY LONG ARM SPLINT,29105,CPT,,,both,,,608.73,365.24,United Healthcare/Oxford,United Healthcare/Oxford,,396.08,,,396.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC APPLY SHORT ARM SPLINT; STATIC,29125,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT  ,,,both,,,252.35,151.41,Aetna,Commerical,,182.35,,,182.35,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Aetna,Middlesex Employees,,164.12,,,164.12,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Anthem,Commerical,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Anthem,Indemnity,,,183.36,,183.36,130.53,201.99,percent of total billed charges,,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Anthem,State Preferred,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Anthem,Individual Exchange,,130.53,,,130.53,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Cigna,Cigna,,159.35,,,159.35,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Connecticare,Commerical,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Connecticare,Exchange,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,Multiplan,Multiplan,,,201.99,,201.99,130.53,201.99,percent of total billed charges,,
HC APPLY FINGER SPLINT; STATIC,29130,CPT,,,both,,,252.35,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,164,,,164,130.53,201.99,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC APPLY FINGER SPLINT; DYNAMIC,29131,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC CHEST STRAPPING,29200,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT  ,,,both,,,445.99,267.59,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC SHOULDER STRAPPING (VELPEAU),29240,CPT,,,both,,,445.99,267.59,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC ELBOW / WRIST STRAPPING,29260,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC HAND / FINGER STRAPPING,29280,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT  ,,,both,,,507.79,304.67,Aetna,Commerical,,367.16,,,367.16,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Aetna,Middlesex Employees,,330.44,,,330.44,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Anthem,Commerical,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Anthem,Indemnity,,,369.17,,369.17,262.82,406.7,percent of total billed charges,,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Anthem,State Preferred,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Anthem,Individual Exchange,,262.82,,,262.82,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Cigna,Cigna,,320.84,,,320.84,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Connecticare,Commerical,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Connecticare,Exchange,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,Multiplan,Multiplan,,,406.7,,406.7,262.82,406.7,percent of total billed charges,,
HC APPLICATION OF HIP CAST 1 LEG,29305,CPT,,,both,,,507.79,304.67,United Healthcare/Oxford,United Healthcare/Oxford,,330.19,,,330.19,262.82,406.7,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT  ,,,both,,,717.91,430.75,Aetna,Commerical,,519.39,,,519.39,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Aetna,Middlesex Employees,,467.45,,,467.45,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Anthem,Commerical,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Anthem,Indemnity,,,522.24,,522.24,371.79,575.32,percent of total billed charges,,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Anthem,State Preferred,,464.74,,,464.74,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Anthem,Individual Exchange,,371.79,,,371.79,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Cigna,Cigna,,453.87,,,453.87,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Connecticare,Commerical,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Connecticare,Exchange,,485.45,,,485.45,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,Multiplan,Multiplan,,,575.32,,575.32,371.79,575.32,percent of total billed charges,,
HC APPLICATION OF HIP CASTS 1.5 SPICA/2 LEGS,29325,CPT,,,both,,,717.91,430.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.09,,,467.09,371.79,575.32,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC APPLY LONG LEG CAST,29345,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC APPLY WLKR LG LEG CAST,29355,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT  ,,,both,,,706.58,423.95,Aetna,Commerical,,511.25,,,511.25,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Aetna,Middlesex Employees,,460.12,,,460.12,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Anthem,Commerical,,457.45,,,457.45,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Anthem,Indemnity,,,514.06,,514.06,365.96,566.31,percent of total billed charges,,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Anthem,State Preferred,,457.45,,,457.45,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Anthem,Individual Exchange,,365.96,,,365.96,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Cigna,Cigna,,446.75,,,446.75,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Connecticare,Commerical,,477.84,,,477.84,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Connecticare,Exchange,,477.84,,,477.84,365.96,566.31,other,Could be inpatient or outpatient,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,Multiplan,Multiplan,,,566.31,,566.31,365.96,566.31,percent of total billed charges,,
HC LONG CAST APPLICATION,29365,CPT,,,both,,,706.58,423.95,United Healthcare/Oxford,United Healthcare/Oxford,,459.77,,,459.77,365.96,566.31,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC APPLY SHORT LEG CAST,29405,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Aetna,Commerical,50,1157.64,,,1157.64,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Aetna,Middlesex Employees,50,1041.87,,,1041.87,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Anthem,Commerical,50,1035.83,,,1035.83,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Anthem,Indemnity,50,,1201.228896,,1201.228896,742.93,1282.31,percent of total billed charges,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Anthem,State Preferred,50,1035.83,,,1035.83,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Anthem,Individual Exchange,50,828.66,,,828.66,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Cigna,Cigna,50,1011.6,,,1011.6,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Connecticare,Commerical,50,1081.98,,,1081.98,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Connecticare,Exchange,50,1081.98,,,1081.98,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,Multiplan,Multiplan,50,,1359.218,,1359.218,742.93,1359.218,percent of total billed charges,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC APPLY WLKR SH LEG CAST,29425,CPT  ,,,both,,,1599.08,959.45,United Healthcare/Oxford,United Healthcare/Oxford,50,742.93,,,742.93,742.93,1282.31,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT  ,,,both,,,809.58,485.75,Aetna,Commerical,,585.33,,,585.33,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Aetna,Middlesex Employees,,526.8,,,526.8,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Anthem,Commerical,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Anthem,Indemnity,,,588.55,,588.55,418.99,648.37,percent of total billed charges,,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Anthem,State Preferred,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Anthem,Individual Exchange,,418.99,,,418.99,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Cigna,Cigna,,511.49,,,511.49,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Connecticare,Commerical,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Connecticare,Exchange,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,Multiplan,Multiplan,,,648.37,,648.37,418.99,648.37,percent of total billed charges,,
HC APPY PATELLAR TENDON BEARING CAST,29435,CPT,,,both,,,809.58,485.75,United Healthcare/Oxford,United Healthcare/Oxford,,526.4,,,526.4,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT  ,,,both,,,809.58,485.75,Aetna,Commerical,,585.33,,,585.33,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Aetna,Middlesex Employees,,526.8,,,526.8,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Anthem,Commerical,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Anthem,Indemnity,,,588.55,,588.55,418.99,648.37,percent of total billed charges,,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Anthem,State Preferred,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Anthem,Individual Exchange,,418.99,,,418.99,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Cigna,Cigna,,511.49,,,511.49,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Connecticare,Commerical,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Connecticare,Exchange,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,Multiplan,Multiplan,,,648.37,,648.37,418.99,648.37,percent of total billed charges,,
HC ADD WALKER TO OLD CAST,29440,CPT,,,both,,,809.58,485.75,United Healthcare/Oxford,United Healthcare/Oxford,,526.4,,,526.4,418.99,648.37,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT  ,,,both,,,608.73,365.24,Aetna,Commerical,,440.42,,,440.42,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Aetna,Middlesex Employees,,396.38,,,396.38,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Anthem,Commerical,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Anthem,Indemnity,,,442.84,,442.84,315.26,487.86,percent of total billed charges,,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Anthem,State Preferred,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Anthem,Individual Exchange,,315.26,,,315.26,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Cigna,Cigna,,384.86,,,384.86,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Connecticare,Commerical,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Connecticare,Exchange,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,Multiplan,Multiplan,,,487.86,,487.86,315.26,487.86,percent of total billed charges,,
HC APPLY LONG LEG SPLINT,29505,CPT,,,both,,,608.73,365.24,United Healthcare/Oxford,United Healthcare/Oxford,,396.08,,,396.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT  ,,,both,,,608.73,365.24,Aetna,Commerical,,440.42,,,440.42,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Aetna,Middlesex Employees,,396.38,,,396.38,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Anthem,Commerical,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Anthem,Indemnity,,,442.84,,442.84,315.26,487.86,percent of total billed charges,,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Anthem,State Preferred,,394.08,,,394.08,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Anthem,Individual Exchange,,315.26,,,315.26,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Cigna,Cigna,,384.86,,,384.86,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Connecticare,Commerical,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Connecticare,Exchange,,411.64,,,411.64,315.26,487.86,other,Could be inpatient or outpatient,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,Multiplan,Multiplan,,,487.86,,487.86,315.26,487.86,percent of total billed charges,,
HC APPLY SHORT LEG SPLINT,29515,CPT,,,both,,,608.73,365.24,United Healthcare/Oxford,United Healthcare/Oxford,,396.08,,,396.08,315.26,487.86,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC HIP STRAPPING,29520,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT  ,,,both,,,445.99,267.59,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC KNEE STRAPPING,29530,CPT,,,both,,,445.99,267.59,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC ANKLE / FOOT STRAPPING,29540,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,231.93,358.9,percent of total billed charges,,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC TOES STRAPPING,29550,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC UNNA BOOT STRAPPING,29580,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC DENIS-BROWN STRPG,29590,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC REM GAUNTLET BOOT OR BODY CAST,29700,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT  ,,,both,,,1066.05,639.63,Aetna,Commerical,,771.76,,,771.76,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Aetna,Middlesex Employees,,694.58,,,694.58,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Anthem,Commerical,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Anthem,Indemnity,,,775.99,,775.99,552.44,854.87,percent of total billed charges,,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Anthem,State Preferred,,690.55,,,690.55,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Anthem,Individual Exchange,,552.44,,,552.44,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Cigna,Cigna,,674.4,,,674.4,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Connecticare,Commerical,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Connecticare,Exchange,,721.32,,,721.32,552.44,854.87,other,Could be inpatient or outpatient,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,Multiplan,Multiplan,,,854.87,,854.87,552.44,854.87,percent of total billed charges,,
HC REMOVE FULL ARM OR LEG CAST,29705,CPT,,,both,,,1066.05,639.63,United Healthcare/Oxford,United Healthcare/Oxford,,694.06,,,694.06,552.44,854.87,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT  ,,,both,,,809.58,485.75,Aetna,Commerical,,585.33,,,585.33,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Aetna,Middlesex Employees,,526.8,,,526.8,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Anthem,Commerical,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Anthem,Indemnity,,,588.55,,588.55,418.99,648.37,percent of total billed charges,,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Anthem,State Preferred,,523.74,,,523.74,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Anthem,Individual Exchange,,418.99,,,418.99,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Cigna,Cigna,,511.49,,,511.49,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Connecticare,Commerical,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Connecticare,Exchange,,547.09,,,547.09,418.99,648.37,other,Could be inpatient or outpatient,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,Multiplan,Multiplan,,,648.37,,648.37,418.99,648.37,percent of total billed charges,,
HC REM SHOULDER OR HIP SPICA,29710,CPT,,,both,,,809.58,485.75,United Healthcare/Oxford,United Healthcare/Oxford,,526.4,,,526.4,418.99,648.37,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC WINDOWING OF CAST,29730,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC WEDGING OF CAST NOT CLUBFOOT CAST,29740,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,325.63,,,325.63,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,293.07,,,293.07,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.42,,327.42,233.1,360.71,percent of total billed charges,,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,291.37,,,291.37,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,233.1,,,233.1,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,284.55,,,284.55,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,304.36,,,304.36,233.1,360.71,other,Could be inpatient or outpatient,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.71,,360.71,233.1,360.71,percent of total billed charges,,
HC LOW BACK STRAPING,29799,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,292.85,,,292.85,233.1,360.71,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT  ,,,both,,,10933.19,6559.92,Aetna,Commerical,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Aetna,Middlesex Employees,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Anthem,Commerical,,7561.85,,,7561.85,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Anthem,Indemnity,,,7951.51,,7951.51,6049.48,8759.74,percent of total billed charges,,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Anthem,State Preferred,,7561.85,,,7561.85,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Anthem,Individual Exchange,,6049.48,,,6049.48,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Cigna,Cigna,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Connecticare,Commerical,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Connecticare,Exchange,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,Multiplan,Multiplan,,,8759.74,,8759.74,6049.48,8759.74,percent of total billed charges,,
SHAVING OF SHOULDER BONE USING AN ENDOSCOPE,29826,CPT,,,both,,,10933.19,6559.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6049.48,8759.74,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT  ,,,both,,,18657.19,11194.32,Aetna,Commerical,,9138.63,,,9138.63,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Aetna,Middlesex Employees,,8224.77,,,8224.77,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Anthem,Commerical,,11649.75,,,11649.75,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Anthem,Indemnity,,,13569.03,,13569.03,6691.31,14948.26,percent of total billed charges,,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Anthem,State Preferred,,11649.75,,,11649.75,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Anthem,Individual Exchange,,9319.8,,,9319.8,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Cigna,Cigna,,12834.42,,,12834.42,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Connecticare,Commerical,,11055.37,,,11055.37,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Connecticare,Exchange,,11055.37,,,11055.37,6691.31,14948.26,other,Could be inpatient or outpatient,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,Multiplan,Multiplan,,,14948.26,,14948.26,6691.31,14948.26,percent of total billed charges,,
REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE,29881,CPT,,,both,,,18657.19,11194.32,United Healthcare/Oxford,United Healthcare/Oxford,,6691.31,,,6691.31,6691.31,14948.26,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT  ,,,both,,,28811.84,17287.1,Aetna,Commerical,,,,,,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Aetna,Middlesex Employees,,,,,,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Anthem,Commerical,,13180.09,,,13180.09,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Anthem,Indemnity,,,20954.32,,20954.32,10544.07,23084.23,percent of total billed charges,,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Anthem,State Preferred,,13180.09,,,13180.09,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Anthem,Individual Exchange,,10544.07,,,10544.07,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Cigna,Cigna,,18855.19,,,18855.19,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Connecticare,Commerical,,15843.28,,,15843.28,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Connecticare,Exchange,,15843.28,,,15843.28,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,Multiplan,Multiplan,,,23084.23,,23084.23,10544.07,23084.23,percent of total billed charges,,
PR KNEE SCOPE MED OR LAT MENIS REPAIR,29882,CPT,,,both,,,28811.84,17287.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10544.07,23084.23,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT  ,,,both,,,36994.46,22196.68,Aetna,Commerical,,27900.21,,,27900.21,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Aetna,Middlesex Employees,,25110.19,,,25110.19,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Anthem,Commerical,,14106.68,,,14106.68,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Anthem,Indemnity,,,26905.39,,26905.39,11285.34,29640.21,percent of total billed charges,,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Anthem,State Preferred,,14106.68,,,14106.68,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Anthem,Individual Exchange,,11285.34,,,11285.34,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Cigna,Cigna,,24222,,,24222,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Connecticare,Commerical,,,,,,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Connecticare,Exchange,,,,,,11285.34,29640.21,other,Could be inpatient or outpatient,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,Multiplan,Multiplan,,,29640.21,,29640.21,11285.34,29640.21,percent of total billed charges,,
PR KNEE SCOPE AID ANT CRUCIATE REPAIR,29888,CPT,,,both,,,36994.46,22196.68,United Healthcare/Oxford,United Healthcare/Oxford,,18893.06,,,18893.06,11285.34,29640.21,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Aetna,Commerical,50,511.65,,,511.65,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Aetna,Middlesex Employees,50,460.49,,,460.49,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Anthem,Commerical,50,457.82,,,457.82,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Anthem,Indemnity,50,,531.556632,,531.556632,366.26,566.76,percent of total billed charges,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Anthem,State Preferred,50,457.82,,,457.82,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Anthem,Individual Exchange,50,366.26,,,366.26,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Cigna,Cigna,50,447.11,,,447.11,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Connecticare,Commerical,50,478.23,,,478.23,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Connecticare,Exchange,50,478.23,,,478.23,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,Multiplan,Multiplan,50,,601.4685,,601.4685,366.26,601.4685,percent of total billed charges,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB INTRANASAL; OFFICE TYPE,30300,CPT  ,,,both,,,707.61,424.57,United Healthcare/Oxford,United Healthcare/Oxford,50,460.14,,,460.14,366.26,566.76,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT  ,,,both,,,557.23,334.34,Aetna,Commerical,,402.98,,,402.98,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Aetna,Middlesex Employees,,362.68,,,362.68,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Anthem,Commerical,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Anthem,Indemnity,,,405.19,,405.19,288.45,446.38,percent of total billed charges,,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Anthem,State Preferred,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Anthem,Individual Exchange,,288.45,,,288.45,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Cigna,Cigna,,352.14,,,352.14,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Connecticare,Commerical,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Connecticare,Exchange,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,Multiplan,Multiplan,,,446.38,,446.38,288.45,446.38,percent of total billed charges,,
HC CONTROL NASAL HEMORRH ANT SIMPLE,30901,CPT,,,both,,,557.23,334.34,United Healthcare/Oxford,United Healthcare/Oxford,,362.41,,,362.41,288.45,446.38,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC CONTROL NASAL HEMORRH ANT COMPLEX,30903,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Aetna,Commerical,,402.98,,,402.98,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Aetna,Commerical,50,604.47,,,604.47,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Aetna,Middlesex Employees,,362.68,,,362.68,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Aetna,Middlesex Employees,50,544.02,,,544.02,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Anthem,Commerical,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Anthem,Commerical,50,540.86,,,540.86,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Anthem,Indemnity,,,405.19,,405.19,288.45,446.38,percent of total billed charges,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Anthem,Indemnity,50,,627.89052,,627.89052,432.68,669.57,percent of total billed charges,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Anthem,State Preferred,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Anthem,State Preferred,50,540.86,,,540.86,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Anthem,Individual Exchange,,288.45,,,288.45,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Anthem,Individual Exchange,50,432.68,,,432.68,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Cigna,Cigna,,352.14,,,352.14,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Cigna,Cigna,50,528.21,,,528.21,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Connecticare,Commerical,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Connecticare,Commerical,50,564.96,,,564.96,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Connecticare,Exchange,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Connecticare,Exchange,50,564.96,,,564.96,432.68,669.57,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,Multiplan,Multiplan,,,446.38,,446.38,288.45,446.38,percent of total billed charges,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,Multiplan,Multiplan,50,,710.4725,,710.4725,432.68,710.4725,percent of total billed charges,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,557.23,334.34,United Healthcare/Oxford,United Healthcare/Oxford,,362.41,,,362.41,288.45,446.38,other,Could be inpatient or outpatient,
HC CNTRL POST EPISTAX INIT,30905,CPT  ,,,both,,,835.85,501.51,United Healthcare/Oxford,United Healthcare/Oxford,50,543.62,,,543.62,432.68,669.57,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT  ,,,both,,,557.23,334.34,Aetna,Commerical,,402.98,,,402.98,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Aetna,Middlesex Employees,,362.68,,,362.68,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Anthem,Commerical,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Anthem,Indemnity,,,405.19,,405.19,288.45,446.38,percent of total billed charges,,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Anthem,State Preferred,,360.57,,,360.57,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Anthem,Individual Exchange,,288.45,,,288.45,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Cigna,Cigna,,352.14,,,352.14,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Connecticare,Commerical,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Connecticare,Exchange,,376.64,,,376.64,288.45,446.38,other,Could be inpatient or outpatient,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,Multiplan,Multiplan,,,446.38,,446.38,288.45,446.38,percent of total billed charges,,
HC CTRL POST EPISTAX SQ,30906,CPT,,,both,,,557.23,334.34,United Healthcare/Oxford,United Healthcare/Oxford,,362.41,,,362.41,288.45,446.38,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT  ,,,both,,,705.55,423.33,Aetna,Commerical,,510.43,,,510.43,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Aetna,Middlesex Employees,,459.39,,,459.39,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Anthem,Commerical,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Anthem,Indemnity,,,513.23,,513.23,365.38,565.4,percent of total billed charges,,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Anthem,State Preferred,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Anthem,Individual Exchange,,365.38,,,365.38,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Cigna,Cigna,,446.05,,,446.05,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Connecticare,Commerical,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Connecticare,Exchange,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,Multiplan,Multiplan,,,565.4,,565.4,365.38,565.4,percent of total billed charges,,
HC NASAL ENDOSCPY DX,31231,CPT,,,both,,,705.55,423.33,United Healthcare/Oxford,United Healthcare/Oxford,,459.04,,,459.04,365.38,565.4,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT  ,,,both,,,758.08,454.85,Aetna,Commerical,,548.7,,,548.7,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Aetna,Middlesex Employees,,493.83,,,493.83,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Anthem,Commerical,,490.96,,,490.96,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Anthem,Indemnity,,,551.71,,551.71,392.77,607.79,percent of total billed charges,,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Anthem,State Preferred,,490.96,,,490.96,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Anthem,Individual Exchange,,392.77,,,392.77,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Cigna,Cigna,,479.48,,,479.48,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Connecticare,Commerical,,512.84,,,512.84,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Connecticare,Exchange,,512.84,,,512.84,392.77,607.79,other,Could be inpatient or outpatient,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,Multiplan,Multiplan,,,607.79,,607.79,392.77,607.79,percent of total billed charges,,
HC INTUBATION ET EMERGENT,31500,CPT,,,both,,,758.08,454.85,United Healthcare/Oxford,United Healthcare/Oxford,,493.45,,,493.45,392.77,607.79,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT  ,,,both,,,803.4,482.04,Aetna,Commerical,,581.26,,,581.26,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Aetna,Middlesex Employees,,523.13,,,523.13,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Anthem,Commerical,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Anthem,Indemnity,,,584.45,,584.45,416.08,643.86,percent of total billed charges,,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Anthem,State Preferred,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Anthem,Individual Exchange,,416.08,,,416.08,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Cigna,Cigna,,507.94,,,507.94,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Connecticare,Commerical,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Connecticare,Exchange,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,Multiplan,Multiplan,,,643.86,,643.86,416.08,643.86,percent of total billed charges,,
HC TRACH TUBE CHG BEFORE FISTULA TRACT,31502,CPT,,,both,,,803.4,482.04,United Healthcare/Oxford,United Healthcare/Oxford,,522.74,,,522.74,416.08,643.86,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT  ,,,both,,,562.38,337.43,Aetna,Commerical,,407.05,,,407.05,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Aetna,Middlesex Employees,,366.34,,,366.34,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Anthem,Commerical,,364.22,,,364.22,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Anthem,Indemnity,,,409.28,,409.28,291.37,450.88,percent of total billed charges,,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Anthem,State Preferred,,364.22,,,364.22,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Anthem,Individual Exchange,,291.37,,,291.37,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Cigna,Cigna,,355.7,,,355.7,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Connecticare,Commerical,,380.45,,,380.45,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Connecticare,Exchange,,380.45,,,380.45,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,Multiplan,Multiplan,,,450.88,,450.88,291.37,450.88,percent of total billed charges,,
HC LARYNGOSCOPY IND; W REM OF FB,31511,CPT,,,both,,,562.38,337.43,United Healthcare/Oxford,United Healthcare/Oxford,,366.06,,,366.06,291.37,450.88,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT  ,,,both,,,6728.29,4036.97,Aetna,Commerical,,4866.64,,,4866.64,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Aetna,Middlesex Employees,,4379.98,,,4379.98,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Anthem,Commerical,,4354.56,,,4354.56,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Anthem,Indemnity,,,4893.36,,4893.36,3483.64,5390.75,percent of total billed charges,,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Anthem,State Preferred,,4354.56,,,4354.56,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Anthem,Individual Exchange,,3483.64,,,3483.64,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Cigna,Cigna,,4252.71,,,4252.71,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Connecticare,Commerical,,4548.63,,,4548.63,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Connecticare,Exchange,,4548.63,,,4548.63,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,Multiplan,Multiplan,,,5390.75,,5390.75,3483.64,5390.75,percent of total billed charges,,
HC LARYNGSCOPY DIR W/WO TRACHOSCOPY DX,31525,CPT,,,both,,,6728.29,4036.97,United Healthcare/Oxford,United Healthcare/Oxford,,4376.66,,,4376.66,3483.64,5390.75,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT  ,,,both,,,6023.44,3614.06,Aetna,Commerical,,4357.02,,,4357.02,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Aetna,Middlesex Employees,,3921.32,,,3921.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Anthem,Commerical,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Anthem,Indemnity,,,4380.95,,4380.95,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Anthem,State Preferred,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Anthem,Individual Exchange,,3118.85,,,3118.85,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Cigna,Cigna,,3807.38,,,3807.38,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Connecticare,Commerical,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Connecticare,Exchange,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,Multiplan,Multiplan,,,4826.25,,4826.25,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE ABLAT/DEST/LESION(S) UNI,31572,CPT,,,both,,,6023.44,3614.06,United Healthcare/Oxford,United Healthcare/Oxford,,3918.35,,,3918.35,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT  ,,,both,,,6023.44,3614.06,Aetna,Commerical,,4357.02,,,4357.02,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Aetna,Middlesex Employees,,3921.32,,,3921.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Anthem,Commerical,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Anthem,Indemnity,,,4380.95,,4380.95,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Anthem,State Preferred,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Anthem,Individual Exchange,,3118.85,,,3118.85,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Cigna,Cigna,,3807.38,,,3807.38,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Connecticare,Commerical,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Connecticare,Exchange,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,Multiplan,Multiplan,,,4826.25,,4826.25,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,31573,CPT,,,both,,,6023.44,3614.06,United Healthcare/Oxford,United Healthcare/Oxford,,3918.35,,,3918.35,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT  ,,,both,,,6023.73,3614.24,Aetna,Commerical,,4357.02,,,4357.02,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Aetna,Middlesex Employees,,3921.32,,,3921.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Anthem,Commerical,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Anthem,Indemnity,,,4380.95,,4380.95,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Anthem,State Preferred,,3898.56,,,3898.56,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Anthem,Individual Exchange,,3118.85,,,3118.85,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Cigna,Cigna,,3807.38,,,3807.38,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Connecticare,Commerical,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Connecticare,Exchange,,4072.32,,,4072.32,3118.85,4826.25,other,Could be inpatient or outpatient,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,Multiplan,Multiplan,,,4826.25,,4826.25,3118.85,4826.25,percent of total billed charges,,
HC LARYNGOSCOPY FLEXIBLE W/ INJECTION AGMNT UNI,31574,CPT,,,both,,,6023.73,3614.24,United Healthcare/Oxford,United Healthcare/Oxford,,3918.35,,,3918.35,3118.85,4826.25,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT  ,,,both,,,705.55,423.33,Aetna,Commerical,,510.43,,,510.43,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Aetna,Middlesex Employees,,459.39,,,459.39,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Anthem,Commerical,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Anthem,Indemnity,,,513.23,,513.23,365.38,565.4,percent of total billed charges,,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Anthem,State Preferred,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Anthem,Individual Exchange,,365.38,,,365.38,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Cigna,Cigna,,446.05,,,446.05,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Connecticare,Commerical,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Connecticare,Exchange,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,Multiplan,Multiplan,,,565.4,,565.4,365.38,565.4,percent of total billed charges,,
HC DIAGNOSTIC FLEXIBLE LARYNGOSCOPY,31575,CPT,,,both,,,705.55,423.33,United Healthcare/Oxford,United Healthcare/Oxford,,459.04,,,459.04,365.38,565.4,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT  ,,,both,,,1690.23,1014.14,Aetna,Commerical,,1222.76,,,1222.76,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Aetna,Middlesex Employees,,1100.48,,,1100.48,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Anthem,Commerical,,1094.1,,,1094.1,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Anthem,Indemnity,,,1229.48,,1229.48,875.28,1354.45,percent of total billed charges,,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Anthem,State Preferred,,1094.1,,,1094.1,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Anthem,Individual Exchange,,875.28,,,875.28,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Cigna,Cigna,,1068.52,,,1068.52,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Connecticare,Commerical,,1142.86,,,1142.86,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Connecticare,Exchange,,1142.86,,,1142.86,875.28,1354.45,other,Could be inpatient or outpatient,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,Multiplan,Multiplan,,,1354.45,,1354.45,875.28,1354.45,percent of total billed charges,,
HC LARGSC W/RMVL FOREIGN BDY(S),31577,CPT,,,both,,,1690.23,1014.14,United Healthcare/Oxford,United Healthcare/Oxford,,1099.66,,,1099.66,875.28,1354.45,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC TRACHEOSTOMY EMERG; TRANSTRACHL,31603,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC TRACHEOSTOMY EMERG; CRICOTHYROID,31605,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT  ,,,both,,,2070.3,1242.18,Aetna,Commerical,,1497.11,,,1497.11,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Aetna,Middlesex Employees,,1347.4,,,1347.4,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Anthem,Commerical,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Anthem,Indemnity,,,1505.34,,1505.34,1071.66,1658.35,percent of total billed charges,,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Anthem,State Preferred,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Anthem,Individual Exchange,,1071.66,,,1071.66,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Cigna,Cigna,,1308.25,,,1308.25,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Connecticare,Commerical,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Connecticare,Exchange,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,Multiplan,Multiplan,,,1658.35,,1658.35,1071.66,1658.35,percent of total billed charges,,
HC TRACHEOBRONCH THRU OLD INCISION,31615,CPT,,,both,,,2070.3,1242.18,United Healthcare/Oxford,United Healthcare/Oxford,,1346.39,,,1346.39,1071.66,1658.35,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT  ,,,both,,,5617.62,3370.57,Aetna,Commerical,,4063.13,,,4063.13,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Aetna,Middlesex Employees,,3656.81,,,3656.81,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Anthem,Commerical,,3635.59,,,3635.59,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Anthem,Indemnity,,,4085.44,,4085.44,2908.47,4500.71,percent of total billed charges,,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Anthem,State Preferred,,3635.59,,,3635.59,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Anthem,Individual Exchange,,2908.47,,,2908.47,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Cigna,Cigna,,3550.56,,,3550.56,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Connecticare,Commerical,,3797.63,,,3797.63,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Connecticare,Exchange,,3797.63,,,3797.63,2908.47,4500.71,other,Could be inpatient or outpatient,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,Multiplan,Multiplan,,,4500.71,,4500.71,2908.47,4500.71,percent of total billed charges,,
HC DX BRONCHOSCOPE/WASH,31622,CPT,,,both,,,5617.62,3370.57,United Healthcare/Oxford,United Healthcare/Oxford,,3654.05,,,3654.05,2908.47,4500.71,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT  ,,,both,,,11674.56,7004.73,Aetna,Commerical,,8804.62,,,8804.62,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Aetna,Middlesex Employees,,7924.16,,,7924.16,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Anthem,Commerical,,6946.25,,,6946.25,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Anthem,Indemnity,,,8490.69,,8490.69,5557,9552.03,percent of total billed charges,,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Anthem,State Preferred,,6946.25,,,6946.25,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Anthem,Individual Exchange,,5557,,,5557,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Cigna,Cigna,,7519.37,,,7519.37,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Connecticare,Commerical,,,,,,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Connecticare,Exchange,,,,,,5557,9552.03,other,Could be inpatient or outpatient,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,Multiplan,Multiplan,,,9353.73,,9353.73,5557,9552.03,percent of total billed charges,,
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,31622,CPT,,,both,,,11674.56,7004.73,United Healthcare/Oxford,United Healthcare/Oxford,,9552.03,,,9552.03,5557,9552.03,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT  ,,,both,,,2013.65,1208.19,Aetna,Commerical,,1456.41,,,1456.41,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Aetna,Middlesex Employees,,1310.77,,,1310.77,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Anthem,Commerical,,1303.16,,,1303.16,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Anthem,Indemnity,,,1464.41,,1464.41,1042.52,1613.26,percent of total billed charges,,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Anthem,State Preferred,,1303.16,,,1303.16,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Anthem,Individual Exchange,,1042.52,,,1042.52,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Cigna,Cigna,,1272.68,,,1272.68,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Connecticare,Commerical,,1361.25,,,1361.25,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Connecticare,Exchange,,1361.25,,,1361.25,1042.52,1613.26,other,Could be inpatient or outpatient,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,Multiplan,Multiplan,,,1613.26,,1613.26,1042.52,1613.26,percent of total billed charges,,
HC BRONCHOSCOPY W/ ALVEOLAR LAVAGE,31624,CPT,,,both,,,2013.65,1208.19,United Healthcare/Oxford,United Healthcare/Oxford,,1309.78,,,1309.78,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC HEM/RP LUNG TEAR,32110,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC THOR CARDIAC MASS,32160,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT  ,,,both,,,1157.72,694.63,Aetna,Commerical,,635.81,,,635.81,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Aetna,Middlesex Employees,,572.23,,,572.23,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Anthem,Commerical,,754.92,,,754.92,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Anthem,Indemnity,,,841.49,,841.49,572.23,927.02,percent of total billed charges,,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Anthem,State Preferred,,754.92,,,754.92,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Anthem,Individual Exchange,,603.93,,,603.93,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Cigna,Cigna,,867.89,,,867.89,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Connecticare,Commerical,,807.98,,,807.98,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Connecticare,Exchange,,807.98,,,807.98,572.23,927.02,other,Could be inpatient or outpatient,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,Multiplan,Multiplan,,,927.02,,927.02,572.23,927.02,percent of total billed charges,,
HC ASCABSCESSDRNLUNG,32201,CPT,,,both,,,1157.72,694.63,United Healthcare/Oxford,United Healthcare/Oxford,,704.86,,,704.86,572.23,927.02,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT  ,,,both,,,6065.37,3639.22,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC BIOPSY PLEURA PERC NEEDLE,32400,CPT,,,both,,,6065.37,3639.22,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT  ,,,both,,,2001.16,1200.69,Aetna,Commerical,,1447.45,,,1447.45,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT  ,,,both,,,1539.7,923.82,Aetna,Commerical,,1113.68,,,1113.68,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Aetna,Middlesex Employees,,1302.7,,,1302.7,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Aetna,Middlesex Employees,,1002.31,,,1002.31,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Anthem,Commerical,,1295.15,,,1295.15,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Anthem,Commerical,,996.49,,,996.49,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Anthem,Indemnity,,,1455.4,,1455.4,1036.12,1603.34,percent of total billed charges,,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Anthem,Indemnity,,,1119.79,,1119.79,973.18,1233.61,percent of total billed charges,,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Anthem,State Preferred,,1295.15,,,1295.15,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Anthem,State Preferred,,996.49,,,996.49,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Anthem,Individual Exchange,,1036.12,,,1036.12,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Anthem,Individual Exchange,,797.19,,,797.19,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Cigna,Cigna,,1264.86,,,1264.86,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Cigna,Cigna,,973.18,,,973.18,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Connecticare,Commerical,,1352.88,,,1352.88,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Connecticare,Commerical,,1040.9,,,1040.9,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Connecticare,Exchange,,1352.88,,,1352.88,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Connecticare,Exchange,,1040.9,,,1040.9,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,Multiplan,Multiplan,,,1603.34,,1603.34,1036.12,1603.34,percent of total billed charges,,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,Multiplan,Multiplan,,,1233.61,,1233.61,973.18,1233.61,percent of total billed charges,,
HC PERCUT BX LUNG/MEDIASTINUM-OR,32405,CPT,,,both,,,2001.16,1200.69,United Healthcare/Oxford,United Healthcare/Oxford,,1301.72,,,1301.72,1036.12,1603.34,other,Could be inpatient or outpatient,
HC PERCUT BX LUNG/MEDIASTINUM,32405,CPT,,,both,,,1539.7,923.82,United Healthcare/Oxford,United Healthcare/Oxford,,1001.55,,,1001.55,973.18,1233.61,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT  ,,,both,,,5563.36,3338.02,Aetna,Commerical,,3717.87,,,3717.87,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Aetna,Middlesex Employees,,3346.09,,,3346.09,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Anthem,Commerical,,3085.55,,,3085.55,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Anthem,Indemnity,,,4046.13,,4046.13,2468.44,4457.4,percent of total billed charges,,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Anthem,State Preferred,,3085.55,,,3085.55,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Anthem,Individual Exchange,,2468.44,,,2468.44,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Cigna,Cigna,,3274.98,,,3274.98,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Connecticare,Commerical,,3359.43,,,3359.43,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Connecticare,Exchange,,3359.43,,,3359.43,2468.44,4457.4,other,Could be inpatient or outpatient,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,Multiplan,Multiplan,,,4457.4,,4457.4,2468.44,4457.4,percent of total billed charges,,
HC PERC CORE NDL BX LUNG OR MEDIASTM W I&G WHEN PERF,32408,CPT,,,both,,,5563.36,3338.02,United Healthcare/Oxford,United Healthcare/Oxford,,3443.88,,,3443.88,2468.44,4457.4,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT  ,,,both,,,8179.23,4907.54,Aetna,Commerical,,5916,,,5916,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Aetna,Middlesex Employees,,5324.4,,,5324.4,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Anthem,Commerical,,5293.5,,,5293.5,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Anthem,Indemnity,,,5948.49,,5948.49,4234.8,6553.13,percent of total billed charges,,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Anthem,State Preferred,,5293.5,,,5293.5,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Anthem,Individual Exchange,,4234.8,,,4234.8,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Cigna,Cigna,,5169.69,,,5169.69,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Connecticare,Commerical,,5529.42,,,5529.42,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Connecticare,Exchange,,5529.42,,,5529.42,4234.8,6553.13,other,Could be inpatient or outpatient,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,Multiplan,Multiplan,,,6553.13,,6553.13,4234.8,6553.13,percent of total billed charges,,
HC INSERT PLEURAL CATH,32550,CPT,,,both,,,8179.23,4907.54,United Healthcare/Oxford,United Healthcare/Oxford,,5320.37,,,5320.37,4234.8,6553.13,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT  ,,,both,,,1473.93,884.36,Aetna,Commerical,,1066.46,,,1066.46,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Aetna,Middlesex Employees,,959.81,,,959.81,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Anthem,Commerical,,954.24,,,954.24,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Anthem,Indemnity,,,1072.32,,1072.32,763.4,1181.31,percent of total billed charges,,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Anthem,State Preferred,,954.24,,,954.24,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Anthem,Individual Exchange,,763.4,,,763.4,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Cigna,Cigna,,931.92,,,931.92,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Connecticare,Commerical,,996.77,,,996.77,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Connecticare,Exchange,,996.77,,,996.77,763.4,1181.31,other,Could be inpatient or outpatient,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,Multiplan,Multiplan,,,1181.31,,1181.31,763.4,1181.31,percent of total billed charges,,
HC ASC CHEST TUBE PLCM,32551,CPT,,,both,,,1473.93,884.36,United Healthcare/Oxford,United Healthcare/Oxford,,959.08,,,959.08,763.4,1181.31,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT  ,,,both,,,985.71,591.43,Aetna,Commerical,,713.14,,,713.14,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Aetna,Middlesex Employees,,641.83,,,641.83,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Anthem,Commerical,,638.11,,,638.11,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Anthem,Indemnity,,,717.06,,717.06,510.48,789.95,percent of total billed charges,,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Anthem,State Preferred,,638.11,,,638.11,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Anthem,Individual Exchange,,510.48,,,510.48,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Cigna,Cigna,,623.18,,,623.18,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Connecticare,Commerical,,666.54,,,666.54,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Connecticare,Exchange,,666.54,,,666.54,510.48,789.95,other,Could be inpatient or outpatient,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,Multiplan,Multiplan,,,789.95,,789.95,510.48,789.95,percent of total billed charges,,
HC CT CHEST TUBE ABS,32551,CPT,,,both,,,985.71,591.43,United Healthcare/Oxford,United Healthcare/Oxford,,641.34,,,641.34,510.48,789.95,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT  ,,,both,,,2220.68,1332.41,Aetna,Commerical,,1606.21,,,1606.21,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Aetna,Middlesex Employees,,1445.58,,,1445.58,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Anthem,Commerical,,1437.19,,,1437.19,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Anthem,Indemnity,,,1615.03,,1615.03,1149.75,1779.19,percent of total billed charges,,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Anthem,State Preferred,,1437.19,,,1437.19,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Anthem,Individual Exchange,,1149.75,,,1149.75,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Cigna,Cigna,,1403.57,,,1403.57,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Connecticare,Commerical,,1501.25,,,1501.25,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Connecticare,Exchange,,1501.25,,,1501.25,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,Multiplan,Multiplan,,,1779.19,,1779.19,1149.75,1779.19,percent of total billed charges,,
HC ASPIRATE PLEURA W/O IMAGING,32554,CPT,,,both,,,2220.68,1332.41,United Healthcare/Oxford,United Healthcare/Oxford,,1444.48,,,1444.48,1149.75,1779.19,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT  ,,,both,,,2428.84,1457.31,Aetna,Commerical,,1756.81,,,1756.81,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT  ,,,both,,,1491.3,894.78,Aetna,Commerical,,1078.67,,,1078.67,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT  ,,,both,,,1969.65,1181.79,Aetna,Commerical,,1424.66,,,1424.66,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT  ,,,both,,,1725.4,1035.24,Aetna,Commerical,,1248,,,1248,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT  ,,,both,,,1724.28,1034.57,Aetna,Commerical,,1247.19,,,1247.19,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Aetna,Middlesex Employees,,1581.14,,,1581.14,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Aetna,Middlesex Employees,,970.81,,,970.81,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Aetna,Middlesex Employees,,1282.2,,,1282.2,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Aetna,Middlesex Employees,,1123.2,,,1123.2,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Aetna,Middlesex Employees,,1122.47,,,1122.47,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Anthem,Commerical,,1571.95,,,1571.95,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Anthem,Commerical,,965.17,,,965.17,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Anthem,Commerical,,1274.75,,,1274.75,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Anthem,Commerical,,1116.68,,,1116.68,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Anthem,Commerical,,1115.96,,,1115.96,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Anthem,Indemnity,,,1766.45,,1766.45,970.81,1946.01,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Anthem,Indemnity,,,1084.59,,1084.59,970.81,1194.84,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Anthem,Indemnity,,,1432.49,,1432.49,970.81,1578.09,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Anthem,Indemnity,,,1254.86,,1254.86,970.81,1382.41,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Anthem,Indemnity,,,1254.04,,1254.04,970.81,1381.51,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Anthem,State Preferred,,1571.95,,,1571.95,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Anthem,State Preferred,,965.17,,,965.17,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Anthem,State Preferred,,1274.75,,,1274.75,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Anthem,State Preferred,,1116.68,,,1116.68,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Anthem,State Preferred,,1115.96,,,1115.96,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Anthem,Individual Exchange,,1257.56,,,1257.56,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Anthem,Individual Exchange,,772.13,,,772.13,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Anthem,Individual Exchange,,1019.8,,,1019.8,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Anthem,Individual Exchange,,893.35,,,893.35,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Anthem,Individual Exchange,,892.77,,,892.77,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Cigna,Cigna,,1535.19,,,1535.19,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Cigna,Cigna,,942.59,,,942.59,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Cigna,Cigna,,1244.93,,,1244.93,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Cigna,Cigna,,1090.56,,,1090.56,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Cigna,Cigna,,1089.86,,,1089.86,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Connecticare,Commerical,,1642.01,,,1642.01,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Connecticare,Commerical,,1008.19,,,1008.19,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Connecticare,Commerical,,1331.56,,,1331.56,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Connecticare,Commerical,,1166.45,,,1166.45,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Connecticare,Commerical,,1165.7,,,1165.7,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Connecticare,Exchange,,1642.01,,,1642.01,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Connecticare,Exchange,,1008.19,,,1008.19,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Connecticare,Exchange,,1331.56,,,1331.56,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Connecticare,Exchange,,1166.45,,,1166.45,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Connecticare,Exchange,,1165.7,,,1165.7,970.81,1381.51,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,Multiplan,Multiplan,,,1946.01,,1946.01,970.81,1946.01,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,Multiplan,Multiplan,,,1194.84,,1194.84,970.81,1194.84,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,Multiplan,Multiplan,,,1578.09,,1579.09,970.81,1578.09,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,Multiplan,Multiplan,,,1382.41,,1382.41,970.81,1382.41,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,Multiplan,Multiplan,,,1381.51,,1381.51,970.81,1381.51,percent of total billed charges,,
HC ASPIRATE PLEURA W/ IMAGING RAD HH SVCS,32555,CPT,,,both,,,2428.84,1457.31,United Healthcare/Oxford,United Healthcare/Oxford,,1579.93,,,1579.93,970.81,1946.01,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ED,32555,CPT,,,both,,,1491.3,894.78,United Healthcare/Oxford,United Healthcare/Oxford,,970.06,,,970.06,970.81,1194.84,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD HTFD,32555,CPT,,,both,,,1969.65,1181.79,United Healthcare/Oxford,United Healthcare/Oxford,,1281.23,,,1281.23,970.81,1578.09,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING RAD CT HTFD,32555,CPT,,,both,,,1725.4,1035.24,United Healthcare/Oxford,United Healthcare/Oxford,,1122.35,,,1122.35,970.81,1382.41,other,Could be inpatient or outpatient,
HC ASPIRATE PLEURA W/ IMAGING ULTRSND HTFD,32555,CPT,,,both,,,1724.28,1034.57,United Healthcare/Oxford,United Healthcare/Oxford,,1121.62,,,1121.62,970.81,1381.51,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT  ,,,both,,,1499.68,899.81,Aetna,Commerical,,1085.19,,,1085.19,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Aetna,Middlesex Employees,,976.67,,,976.67,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Anthem,Commerical,,971,,,971,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Anthem,Indemnity,,,1091.14,,1091.14,776.8,1202.05,percent of total billed charges,,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Anthem,State Preferred,,971,,,971,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Anthem,Individual Exchange,,776.8,,,776.8,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Cigna,Cigna,,948.28,,,948.28,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Connecticare,Commerical,,1014.28,,,1014.28,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Connecticare,Exchange,,1014.28,,,1014.28,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,Multiplan,Multiplan,,,1202.05,,1202.05,776.8,1202.05,percent of total billed charges,,
HC INSERT CATH PLEURA W/O IMAGE,32556,CPT,,,both,,,1499.68,899.81,United Healthcare/Oxford,United Healthcare/Oxford,,975.93,,,975.93,776.8,1202.05,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT  ,,,both,,,3504.06,2102.44,Aetna,Commerical,,2535.08,,,2535.08,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Aetna,Middlesex Employees,,2281.58,,,2281.58,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Anthem,Commerical,,2268.33,,,2268.33,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Anthem,Indemnity,,,2549,,2549,1814.67,2808.09,percent of total billed charges,,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Anthem,State Preferred,,2268.33,,,2268.33,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Anthem,Individual Exchange,,1814.67,,,1814.67,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Cigna,Cigna,,2215.27,,,2215.27,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Connecticare,Commerical,,2369.43,,,2369.43,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Connecticare,Exchange,,2369.43,,,2369.43,1814.67,2808.09,other,Could be inpatient or outpatient,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,Multiplan,Multiplan,,,2808.09,,2808.09,1814.67,2808.09,percent of total billed charges,,
HC INSERT CATH PLEURA W/ IMAGE,32557,CPT,,,both,,,3504.06,2102.44,United Healthcare/Oxford,United Healthcare/Oxford,,2279.84,,,2279.84,1814.67,2808.09,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT  ,,,both,,,1460.54,876.32,Aetna,Commerical,,1056.69,,,1056.69,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Aetna,Middlesex Employees,,951.01,,,951.01,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Anthem,Commerical,,945.5,,,945.5,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Anthem,Indemnity,,,1062.49,,1062.49,756.4,1170.49,percent of total billed charges,,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Anthem,State Preferred,,945.5,,,945.5,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Anthem,Individual Exchange,,756.4,,,756.4,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Cigna,Cigna,,923.38,,,923.38,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Connecticare,Commerical,,987.65,,,987.65,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Connecticare,Exchange,,987.65,,,987.65,756.4,1170.49,other,Could be inpatient or outpatient,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,Multiplan,Multiplan,,,1170.49,,1170.49,756.4,1170.49,percent of total billed charges,,
HC US THORACENTESIS W CATH PLAC INC IMAGE,32557,CPT,,,both,,,1460.54,876.32,United Healthcare/Oxford,United Healthcare/Oxford,,950.3,,,950.3,756.4,1170.49,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT  ,,,both,,,1404.92,842.95,Aetna,Commerical,,1015.98,,,1015.98,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Aetna,Middlesex Employees,,914.38,,,914.38,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Anthem,Commerical,,909.08,,,909.08,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Anthem,Indemnity,,,1021.56,,1021.56,727.26,1125.4,percent of total billed charges,,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Anthem,State Preferred,,909.08,,,909.08,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Anthem,Individual Exchange,,727.26,,,727.26,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Cigna,Cigna,,887.82,,,887.82,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Connecticare,Commerical,,949.59,,,949.59,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Connecticare,Exchange,,949.59,,,949.59,727.26,1125.4,other,Could be inpatient or outpatient,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,Multiplan,Multiplan,,,1125.4,,1125.4,727.26,1125.4,percent of total billed charges,,
HC TREAT PLEURODESIS W/AGENT,32560,CPT,,,both,,,1404.92,842.95,United Healthcare/Oxford,United Healthcare/Oxford,,913.69,,,913.69,727.26,1125.4,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT  ,,,both,,,12450.64,7470.38,Aetna,Commerical,,9005.48,,,9005.48,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Aetna,Middlesex Employees,,8104.93,,,8104.93,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Anthem,Commerical,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Anthem,Indemnity,,,9054.93,,9054.93,6446.31,9975.33,percent of total billed charges,,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Anthem,State Preferred,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Anthem,Individual Exchange,,6446.31,,,6446.31,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Cigna,Cigna,,7869.42,,,7869.42,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Connecticare,Commerical,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Connecticare,Exchange,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,Multiplan,Multiplan,,,9975.33,,9975.33,6446.31,9975.33,percent of total billed charges,,
HC PERQ RF ABLATE TX PUL TUMOR(S),32998,CPT,,,both,,,12450.64,7470.38,United Healthcare/Oxford,United Healthcare/Oxford,,8098.79,,,8098.79,6446.31,9975.33,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT  ,,,both,,,1404.92,842.95,Aetna,Commerical,,1015.98,,,1015.98,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Aetna,Middlesex Employees,,914.38,,,914.38,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Anthem,Commerical,,909.08,,,909.08,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Anthem,Indemnity,,,1021.56,,1021.56,727.26,1125.4,percent of total billed charges,,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Anthem,State Preferred,,909.08,,,909.08,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Anthem,Individual Exchange,,727.26,,,727.26,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Cigna,Cigna,,887.82,,,887.82,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Connecticare,Commerical,,949.59,,,949.59,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Connecticare,Exchange,,949.59,,,949.59,727.26,1125.4,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,Multiplan,Multiplan,,,1125.4,,1125.4,727.26,1125.4,percent of total billed charges,,
HC UNLISTED PROCEDURE LUNGS AND PLEURA,32999,CPT,,,both,,,1404.92,842.95,United Healthcare/Oxford,United Healthcare/Oxford,,913.69,,,913.69,727.26,1125.4,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT  ,,,both,,,1342.09,805.25,Aetna,Commerical,,970.4,,,970.4,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Aetna,Middlesex Employees,,873.36,,,873.36,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Anthem,Commerical,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Anthem,Indemnity,,,975.72,,975.72,694.63,1074.9,percent of total billed charges,,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Anthem,State Preferred,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Anthem,Individual Exchange,,694.63,,,694.63,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Cigna,Cigna,,847.98,,,847.98,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Connecticare,Commerical,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Connecticare,Exchange,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,Multiplan,Multiplan,,,1074.9,,1074.9,694.63,1074.9,percent of total billed charges,,
HC PERICARDIO INIT,33010,CPT,,,both,,,1342.09,805.25,United Healthcare/Oxford,United Healthcare/Oxford,,872.7,,,872.7,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT  ,,,both,,,1342.09,805.25,Aetna,Commerical,,970.4,,,970.4,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Aetna,Middlesex Employees,,873.36,,,873.36,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Anthem,Commerical,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Anthem,Indemnity,,,975.72,,975.72,694.63,1074.9,percent of total billed charges,,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Anthem,State Preferred,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Anthem,Individual Exchange,,694.63,,,694.63,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Cigna,Cigna,,847.98,,,847.98,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Connecticare,Commerical,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Connecticare,Exchange,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,Multiplan,Multiplan,,,1074.9,,1074.9,694.63,1074.9,percent of total billed charges,,
HC PERICARDIO SUB,33011,CPT,,,both,,,1342.09,805.25,United Healthcare/Oxford,United Healthcare/Oxford,,872.7,,,872.7,694.63,1074.9,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT  ,,,both,,,6861.86,4117.12,Aetna,Commerical,,4963.51,,,4963.51,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Aetna,Middlesex Employees,,4467.16,,,4467.16,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Anthem,Commerical,,4441.24,,,4441.24,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Anthem,Indemnity,,,4990.77,,4990.77,3552.99,5498.06,percent of total billed charges,,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Anthem,State Preferred,,4441.24,,,4441.24,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Anthem,Individual Exchange,,3552.99,,,3552.99,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Cigna,Cigna,,4337.36,,,4337.36,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Connecticare,Commerical,,4639.18,,,4639.18,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Connecticare,Exchange,,4639.18,,,4639.18,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,Multiplan,Multiplan,,,5498.06,,5498.06,3552.99,5498.06,percent of total billed charges,,
HC PERICARDIOCENTESIS W/ IMAGING,33016,CPT,,,both,,,6861.86,4117.12,United Healthcare/Oxford,United Healthcare/Oxford,,4463.78,,,4463.78,3552.99,5498.06,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT  ,,,both,,,1266.9,760.14,Aetna,Commerical,,915.85,,,915.85,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Aetna,Middlesex Employees,,824.27,,,824.27,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Anthem,Commerical,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Anthem,Indemnity,,,920.88,,920.88,655.59,1014.48,percent of total billed charges,,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Anthem,State Preferred,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Anthem,Individual Exchange,,655.59,,,655.59,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Cigna,Cigna,,800.32,,,800.32,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Connecticare,Commerical,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Connecticare,Exchange,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,Multiplan,Multiplan,,,1014.48,,1014.48,655.59,1014.48,percent of total billed charges,,
HC PERICARDIAL DRAINAGE 6YR+ W/CONG CAR ANOMALY,33017,CPT,,,both,,,1266.9,760.14,United Healthcare/Oxford,United Healthcare/Oxford,,823.64,,,823.64,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT  ,,,both,,,1266.9,760.14,Aetna,Commerical,,915.85,,,915.85,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Aetna,Middlesex Employees,,824.27,,,824.27,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Anthem,Commerical,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Anthem,Indemnity,,,920.88,,920.88,655.59,1014.48,percent of total billed charges,,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Anthem,State Preferred,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Anthem,Individual Exchange,,655.59,,,655.59,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Cigna,Cigna,,800.32,,,800.32,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Connecticare,Commerical,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Connecticare,Exchange,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,Multiplan,Multiplan,,,1014.48,,1014.48,655.59,1014.48,percent of total billed charges,,
HC PERICARDIAL DRAINAGE 0-5YR W/ CAR ANOMALY,33018,CPT,,,both,,,1266.9,760.14,United Healthcare/Oxford,United Healthcare/Oxford,,823.64,,,823.64,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT  ,,,both,,,1266.9,760.14,Aetna,Commerical,,915.85,,,915.85,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Aetna,Middlesex Employees,,824.27,,,824.27,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Anthem,Commerical,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Anthem,Indemnity,,,920.88,,920.88,655.59,1014.48,percent of total billed charges,,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Anthem,State Preferred,,819.48,,,819.48,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Anthem,Individual Exchange,,655.59,,,655.59,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Cigna,Cigna,,800.32,,,800.32,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Connecticare,Commerical,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Connecticare,Exchange,,856,,,856,655.59,1014.48,other,Could be inpatient or outpatient,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,Multiplan,Multiplan,,,1014.48,,1014.48,655.59,1014.48,percent of total billed charges,,
HC PERQ PERICARDIAL DRAINAGE INSERT CATH CT,33019,CPT,,,both,,,1266.9,760.14,United Healthcare/Oxford,United Healthcare/Oxford,,823.64,,,823.64,655.59,1014.48,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT  ,,,both,,,22313.92,13388.35,Aetna,Commerical,,16139.36,,,16139.36,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Aetna,Middlesex Employees,,14525.43,,,14525.43,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Anthem,Commerical,,14441.12,,,14441.12,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Anthem,Indemnity,,,16227.99,,16227.99,11552.9,17877.49,percent of total billed charges,,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Anthem,State Preferred,,14441.12,,,14441.12,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Anthem,Individual Exchange,,11552.9,,,11552.9,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Cigna,Cigna,,14103.36,,,14103.36,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Connecticare,Commerical,,15084.75,,,15084.75,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Connecticare,Exchange,,15084.75,,,15084.75,11552.9,17877.49,other,Could be inpatient or outpatient,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,Multiplan,Multiplan,,,17877.49,,17877.49,11552.9,17877.49,percent of total billed charges,,
HC INSERT ELECTRD/PM CATH SNGL,33210,CPT,,,both,,,22313.92,13388.35,United Healthcare/Oxford,United Healthcare/Oxford,,14514.42,,,14514.42,11552.9,17877.49,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT  ,,,both,,,29152,17491.2,Aetna,Commerical,,23642.27,,,23642.27,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Aetna,Middlesex Employees,,21278.04,,,21278.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Anthem,Commerical,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Anthem,Indemnity,,,21898.98,,21898.98,6296.83,24779.2,percent of total billed charges,,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Anthem,State Preferred,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Anthem,Individual Exchange,,6296.83,,,6296.83,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Cigna,Cigna,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Connecticare,Commerical,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Connecticare,Exchange,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,Multiplan,Multiplan,,,24779.2,,24779.2,6296.83,24779.2,percent of total billed charges,,
HC ECMO INITIAL DAY VENO-VENOUS,33946,CPT,,,both,,,29152,17491.2,United Healthcare/Oxford,United Healthcare/Oxford,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT  ,,,both,,,29152,17491.2,Aetna,Commerical,,23642.27,,,23642.27,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Aetna,Middlesex Employees,,21278.04,,,21278.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Anthem,Commerical,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Anthem,Indemnity,,,21898.98,,21898.98,6296.83,24779.2,percent of total billed charges,,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Anthem,State Preferred,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Anthem,Individual Exchange,,6296.83,,,6296.83,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Cigna,Cigna,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Connecticare,Commerical,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Connecticare,Exchange,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,Multiplan,Multiplan,,,24779.2,,24779.2,6296.83,24779.2,percent of total billed charges,,
HC ECMO INITIAL DAY VENO-ARTERIAL,33947,CPT,,,both,,,29152,17491.2,United Healthcare/Oxford,United Healthcare/Oxford,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT  ,,,both,,,29152,17491.2,Aetna,Commerical,,23642.27,,,23642.27,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Aetna,Middlesex Employees,,21278.04,,,21278.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Anthem,Commerical,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Anthem,Indemnity,,,21898.98,,21898.98,6296.83,24779.2,percent of total billed charges,,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Anthem,State Preferred,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Anthem,Individual Exchange,,6296.83,,,6296.83,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Cigna,Cigna,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Connecticare,Commerical,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Connecticare,Exchange,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,Multiplan,Multiplan,,,24779.2,,24779.2,6296.83,24779.2,percent of total billed charges,,
HC ECMO ADDT'L 24HRS VENO-VENOUS,33948,CPT,,,both,,,29152,17491.2,United Healthcare/Oxford,United Healthcare/Oxford,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT  ,,,both,,,29152,17491.2,Aetna,Commerical,,23642.27,,,23642.27,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Aetna,Middlesex Employees,,21278.04,,,21278.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Anthem,Commerical,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Anthem,Indemnity,,,21898.98,,21898.98,6296.83,24779.2,percent of total billed charges,,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Anthem,State Preferred,,7871.04,,,7871.04,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Anthem,Individual Exchange,,6296.83,,,6296.83,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Cigna,Cigna,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Connecticare,Commerical,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Connecticare,Exchange,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,Multiplan,Multiplan,,,24779.2,,24779.2,6296.83,24779.2,percent of total billed charges,,
HC ECMO ADDT'L 24HRS VENO-ARTERIAL,33949,CPT,,,both,,,29152,17491.2,United Healthcare/Oxford,United Healthcare/Oxford,,11019.46,,,11019.46,6296.83,24779.2,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT  ,,,both,,,757.05,454.23,Aetna,Commerical,,547.89,,,547.89,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Aetna,Middlesex Employees,,493.1,,,493.1,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Anthem,Commerical,,490.24,,,490.24,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Anthem,Indemnity,,,550.9,,550.9,392.19,606.89,percent of total billed charges,,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Anthem,State Preferred,,490.24,,,490.24,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Anthem,Individual Exchange,,392.19,,,392.19,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Cigna,Cigna,,478.76,,,478.76,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Connecticare,Commerical,,512.09,,,512.09,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Connecticare,Exchange,,512.09,,,512.09,392.19,606.89,other,Could be inpatient or outpatient,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,Multiplan,Multiplan,,,606.89,,606.89,392.19,606.89,percent of total billed charges,,
HC AA REPAIR W AA PROSTHESIS,34800,CPT,,,both,,,757.05,454.23,United Healthcare/Oxford,United Healthcare/Oxford,,492.72,,,492.72,392.19,606.89,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT  ,,,both,,,6714.57,4028.74,Aetna,Commerical,,4856.87,,,4856.87,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Aetna,Middlesex Employees,,4371.18,,,4371.18,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Anthem,Commerical,,4345.81,,,4345.81,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Anthem,Indemnity,,,4883.54,,4883.54,3476.65,5379.93,percent of total billed charges,,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Anthem,State Preferred,,4345.81,,,4345.81,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Anthem,Individual Exchange,,3476.65,,,3476.65,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Cigna,Cigna,,4244.17,,,4244.17,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Connecticare,Commerical,,4539.51,,,4539.51,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Connecticare,Exchange,,4539.51,,,4539.51,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,Multiplan,Multiplan,,,5379.93,,5379.93,3476.65,5379.93,percent of total billed charges,,
HC REPAIR BLD VESSEL UPPER EXT,35206,CPT,,,both,,,6714.57,4028.74,United Healthcare/Oxford,United Healthcare/Oxford,,4367.87,,,4367.87,3476.65,5379.93,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT  ,,,both,,,5772.74,3463.64,Aetna,Commerical,,4175.48,,,4175.48,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Aetna,Middlesex Employees,,3757.93,,,3757.93,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Anthem,Commerical,,3736.11,,,3736.11,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Anthem,Indemnity,,,4198.41,,4198.41,2988.89,4625.16,percent of total billed charges,,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Anthem,State Preferred,,3736.11,,,3736.11,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Anthem,Individual Exchange,,2988.89,,,2988.89,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Cigna,Cigna,,3648.74,,,3648.74,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Connecticare,Commerical,,3902.64,,,3902.64,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Connecticare,Exchange,,3902.64,,,3902.64,2988.89,4625.16,other,Could be inpatient or outpatient,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,Multiplan,Multiplan,,,4625.16,,4625.16,2988.89,4625.16,percent of total billed charges,,
HC REPAIR BLD VESSL LESION UPPER EXT,35206,CPT,,,both,,,5772.74,3463.64,United Healthcare/Oxford,United Healthcare/Oxford,,3755.08,,,3755.08,2988.89,4625.16,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT  ,,,both,,,14837.15,8902.29,Aetna,Commerical,,10732.16,,,10732.16,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Aetna,Middlesex Employees,,9658.94,,,9658.94,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Anthem,Commerical,,9602.9,,,9602.9,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Anthem,Indemnity,,,10791.1,,10791.1,7682.32,11887.96,percent of total billed charges,,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Anthem,State Preferred,,9602.9,,,9602.9,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Anthem,Individual Exchange,,7682.32,,,7682.32,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Cigna,Cigna,,9378.28,,,9378.28,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Connecticare,Commerical,,10030.89,,,10030.89,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Connecticare,Exchange,,10030.89,,,10030.89,7682.32,11887.96,other,Could be inpatient or outpatient,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,Multiplan,Multiplan,,,11887.96,,11887.96,7682.32,11887.96,percent of total billed charges,,
HC HH ANGIORENAL,35471,CPT,,,both,,,14837.15,8902.29,United Healthcare/Oxford,United Healthcare/Oxford,,9651.64,,,9651.64,7682.32,11887.96,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT  ,,,both,,,3219.78,1931.87,Aetna,Commerical,,1769.49,,,1769.49,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Aetna,Middlesex Employees,,1592.55,,,1592.55,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Anthem,Commerical,,2101.01,,,2101.01,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Anthem,Indemnity,,,2341.9,,2341.9,1592.55,2579.95,percent of total billed charges,,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Anthem,State Preferred,,2101.01,,,2101.01,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Anthem,Individual Exchange,,1680.81,,,1680.81,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Cigna,Cigna,,2415.41,,,2415.41,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Connecticare,Commerical,,2248.66,,,2248.66,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Connecticare,Exchange,,2248.66,,,2248.66,1592.55,2579.95,other,Could be inpatient or outpatient,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,Multiplan,Multiplan,,,2579.95,,2579.95,1592.55,2579.95,percent of total billed charges,,
HC ANGPLSTAVFIST ART,35475,CPT,,,both,,,3219.78,1931.87,United Healthcare/Oxford,United Healthcare/Oxford,,1961.69,,,1961.69,1592.55,2579.95,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT  ,,,both,,,4064.38,2438.63,Aetna,Commerical,,2939.68,,,2939.68,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Aetna,Middlesex Employees,,2645.72,,,2645.72,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Anthem,Commerical,,2630.36,,,2630.36,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Anthem,Indemnity,,,2955.83,,2955.83,2104.29,3256.27,percent of total billed charges,,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Anthem,State Preferred,,2630.36,,,2630.36,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Anthem,Individual Exchange,,2104.29,,,2104.29,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Cigna,Cigna,,2568.84,,,2568.84,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Connecticare,Commerical,,2747.59,,,2747.59,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Connecticare,Exchange,,2747.59,,,2747.59,2104.29,3256.27,other,Could be inpatient or outpatient,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,Multiplan,Multiplan,,,3256.27,,3256.27,2104.29,3256.27,percent of total billed charges,,
HC HH ANGIOPLSTYVEIN,35476,CPT,,,both,,,4064.38,2438.63,United Healthcare/Oxford,United Healthcare/Oxford,,2643.71,,,2643.71,2104.29,3256.27,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT  ,,,both,,,422.07,253.24,Aetna,Commerical,,305.28,,,305.28,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Aetna,Middlesex Employees,,274.75,,,274.75,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Anthem,Commerical,,273.16,,,273.16,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Anthem,Indemnity,,,306.96,,306.96,218.53,338.16,percent of total billed charges,,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Anthem,State Preferred,,273.16,,,273.16,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Anthem,Individual Exchange,,218.53,,,218.53,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Cigna,Cigna,,266.77,,,266.77,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Connecticare,Commerical,,285.33,,,285.33,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Connecticare,Exchange,,285.33,,,285.33,218.53,338.16,other,Could be inpatient or outpatient,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,Multiplan,Multiplan,,,338.16,,338.16,218.53,338.16,percent of total billed charges,,
HC INTRO NDL/CATH VN,36000,CPT,,,both,,,422.07,253.24,United Healthcare/Oxford,United Healthcare/Oxford,,274.55,,,274.55,218.53,338.16,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT  ,,,both,,,1274.11,764.47,Aetna,Commerical,,921.55,,,921.55,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Aetna,Middlesex Employees,,829.4,,,829.4,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Anthem,Commerical,,824.58,,,824.58,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Anthem,Indemnity,,,926.61,,926.61,659.67,1020.8,percent of total billed charges,,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Anthem,State Preferred,,824.58,,,824.58,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Anthem,Individual Exchange,,659.67,,,659.67,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Cigna,Cigna,,805.29,,,805.29,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Connecticare,Commerical,,861.33,,,861.33,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Connecticare,Exchange,,861.33,,,861.33,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,Multiplan,Multiplan,,,1020.8,,1020.8,659.67,1020.8,percent of total billed charges,,
HC HH EXTREM VENOGRAM INJ,36005,CPT,,,both,,,1274.11,764.47,United Healthcare/Oxford,United Healthcare/Oxford,,828.77,,,828.77,659.67,1020.8,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT  ,,,both,,,3480.37,2088.22,Aetna,Commerical,,2517.17,,,2517.17,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Aetna,Middlesex Employees,,2265.45,,,2265.45,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Anthem,Commerical,,2252.3,,,2252.3,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Anthem,Indemnity,,,2530.99,,2530.99,1801.84,2788.26,percent of total billed charges,,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Anthem,State Preferred,,2252.3,,,2252.3,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Anthem,Individual Exchange,,1801.84,,,1801.84,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Cigna,Cigna,,2199.62,,,2199.62,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Connecticare,Commerical,,2352.69,,,2352.69,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Connecticare,Exchange,,2352.69,,,2352.69,1801.84,2788.26,other,Could be inpatient or outpatient,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,Multiplan,Multiplan,,,2788.26,,2788.26,1801.84,2788.26,percent of total billed charges,,
HC HH NONSELECTIVE CATH SUP/INF VENA CAVA,36010,CPT,,,both,,,3480.37,2088.22,United Healthcare/Oxford,United Healthcare/Oxford,,2263.73,,,2263.73,1801.84,2788.26,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT  ,,,both,,,718.94,431.36,Aetna,Commerical,,520.21,,,520.21,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Aetna,Middlesex Employees,,468.19,,,468.19,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Anthem,Commerical,,465.47,,,465.47,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Anthem,Indemnity,,,523.06,,523.06,372.37,576.23,percent of total billed charges,,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Anthem,State Preferred,,465.47,,,465.47,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Anthem,Individual Exchange,,372.37,,,372.37,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Cigna,Cigna,,454.58,,,454.58,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Connecticare,Commerical,,486.21,,,486.21,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Connecticare,Exchange,,486.21,,,486.21,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,Multiplan,Multiplan,,,576.23,,576.23,372.37,576.23,percent of total billed charges,,
HC SELECTIVE CATH VEIN; 1ST ORDER FAMILY,36011,CPT,,,both,,,718.94,431.36,United Healthcare/Oxford,United Healthcare/Oxford,,467.83,,,467.83,372.37,576.23,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT  ,,,both,,,376.98,226.19,Aetna,Commerical,,272.72,,,272.72,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Aetna,Middlesex Employees,,245.45,,,245.45,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Anthem,Commerical,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Anthem,Indemnity,,,274.22,,274.22,195.22,302.09,percent of total billed charges,,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Anthem,State Preferred,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Anthem,Individual Exchange,,195.22,,,195.22,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Cigna,Cigna,,238.32,,,238.32,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Connecticare,Commerical,,254.9,,,254.9,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Connecticare,Exchange,,254.9,,,254.9,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,Multiplan,Multiplan,,,302.09,,302.09,195.22,302.09,percent of total billed charges,,
HC SELECTIVE CATH VEIN; 2ND ORDER FAMILY,36012,CPT,,,both,,,376.98,226.19,United Healthcare/Oxford,United Healthcare/Oxford,,245.26,,,245.26,195.22,302.09,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT  ,,,both,,,3865.59,2319.35,Aetna,Commerical,,2796.41,,,2796.41,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Aetna,Middlesex Employees,,2516.76,,,2516.76,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Anthem,Commerical,,2502.15,,,2502.15,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Anthem,Indemnity,,,2811.76,,2811.76,2001.72,3097.56,percent of total billed charges,,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Anthem,State Preferred,,2502.15,,,2502.15,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Anthem,Individual Exchange,,2001.72,,,2001.72,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Cigna,Cigna,,2443.64,,,2443.64,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Connecticare,Commerical,,2613.68,,,2613.68,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Connecticare,Exchange,,2613.68,,,2613.68,2001.72,3097.56,other,Could be inpatient or outpatient,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,Multiplan,Multiplan,,,3097.56,,3097.56,2001.72,3097.56,percent of total billed charges,,
HC SELECTIVE CATH - LT/RT PULMONARY ARTERY,36014,CPT,,,both,,,3865.59,2319.35,United Healthcare/Oxford,United Healthcare/Oxford,,2514.86,,,2514.86,2001.72,3097.56,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT  ,,,both,,,3490.67,2094.4,Aetna,Commerical,,2524.5,,,2524.5,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Aetna,Middlesex Employees,,2272.05,,,2272.05,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Anthem,Commerical,,2258.86,,,2258.86,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Anthem,Indemnity,,,2538.36,,2538.36,1807.09,2796.37,percent of total billed charges,,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Anthem,State Preferred,,2258.86,,,2258.86,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Anthem,Individual Exchange,,1807.09,,,1807.09,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Cigna,Cigna,,2206.03,,,2206.03,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Connecticare,Commerical,,2359.54,,,2359.54,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Connecticare,Exchange,,2359.54,,,2359.54,1807.09,2796.37,other,Could be inpatient or outpatient,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,Multiplan,Multiplan,,,2796.37,,2796.37,1807.09,2796.37,percent of total billed charges,,
HC INTRACATH EXTRART,36140,CPT,,,both,,,3490.67,2094.4,United Healthcare/Oxford,United Healthcare/Oxford,,2270.33,,,2270.33,1807.09,2796.37,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT  ,,,both,,,3194.03,1916.42,Aetna,Commerical,,2310.39,,,2310.39,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Aetna,Middlesex Employees,,2079.36,,,2079.36,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Anthem,Commerical,,2067.29,,,2067.29,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Anthem,Indemnity,,,2323.08,,2323.08,1653.83,2559.21,percent of total billed charges,,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Anthem,State Preferred,,2067.29,,,2067.29,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Anthem,Individual Exchange,,1653.83,,,1653.83,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Cigna,Cigna,,2018.93,,,2018.93,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Connecticare,Commerical,,2159.42,,,2159.42,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Connecticare,Exchange,,2159.42,,,2159.42,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,Multiplan,Multiplan,,,2559.21,,2559.21,1653.83,2559.21,percent of total billed charges,,
HC HHAVDIALYGRAFTEVL,36147,CPT,,,both,,,3194.03,1916.42,United Healthcare/Oxford,United Healthcare/Oxford,,2077.78,,,2077.78,1653.83,2559.21,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT  ,,,both,,,904.34,542.6,Aetna,Commerical,,653.71,,,653.71,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Aetna,Middlesex Employees,,588.34,,,588.34,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Anthem,Commerical,,584.93,,,584.93,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Anthem,Indemnity,,,657.3,,657.3,467.94,724.12,percent of total billed charges,,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Anthem,State Preferred,,584.93,,,584.93,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Anthem,Individual Exchange,,467.94,,,467.94,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Cigna,Cigna,,571.25,,,571.25,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Connecticare,Commerical,,611,,,611,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Connecticare,Exchange,,611,,,611,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,Multiplan,Multiplan,,,724.12,,724.12,467.94,724.12,percent of total billed charges,,
HC HH ACC AVSHUNT RX,36148,CPT,,,both,,,904.34,542.6,United Healthcare/Oxford,United Healthcare/Oxford,,587.89,,,587.89,467.94,724.12,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT  ,,,both,,,6411.75,3847.05,Aetna,Commerical,,4637.88,,,4637.88,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Aetna,Middlesex Employees,,4174.1,,,4174.1,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Anthem,Commerical,,4149.86,,,4149.86,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Anthem,Indemnity,,,4663.35,,4663.35,3319.89,5137.36,percent of total billed charges,,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Anthem,State Preferred,,4149.86,,,4149.86,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Anthem,Individual Exchange,,3319.89,,,3319.89,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Cigna,Cigna,,4052.81,,,4052.81,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Connecticare,Commerical,,4334.82,,,4334.82,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Connecticare,Exchange,,4334.82,,,4334.82,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,Multiplan,Multiplan,,,5137.36,,5137.36,3319.89,5137.36,percent of total billed charges,,
HC HH ABD AORTA IRR,36160,CPT,,,both,,,6411.75,3847.05,United Healthcare/Oxford,United Healthcare/Oxford,,4170.92,,,4170.92,3319.89,5137.36,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT  ,,,both,,,4592.77,2755.66,Aetna,Commerical,,3322.31,,,3322.31,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Aetna,Middlesex Employees,,2990.08,,,2990.08,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Anthem,Commerical,,2972.73,,,2972.73,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Anthem,Indemnity,,,3340.55,,3340.55,2378.18,3680.1,percent of total billed charges,,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Anthem,State Preferred,,2972.73,,,2972.73,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Anthem,Individual Exchange,,2378.18,,,2378.18,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Cigna,Cigna,,2903.19,,,2903.19,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Connecticare,Commerical,,3105.22,,,3105.22,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Connecticare,Exchange,,3105.22,,,3105.22,2378.18,3680.1,other,Could be inpatient or outpatient,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,Multiplan,Multiplan,,,3680.1,,3680.1,2378.18,3680.1,percent of total billed charges,,
HC HH INTRO CATHAORTA,36200,CPT,,,both,,,4592.77,2755.66,United Healthcare/Oxford,United Healthcare/Oxford,,2987.81,,,2987.81,2378.18,3680.1,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT  ,,,both,,,4373.38,2624.03,Aetna,Commerical,,3162.74,,,3162.74,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Aetna,Middlesex Employees,,2846.47,,,2846.47,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Anthem,Commerical,,2829.95,,,2829.95,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Anthem,Indemnity,,,3180.12,,3180.12,2263.96,3503.36,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Anthem,State Preferred,,2829.95,,,2829.95,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Anthem,Individual Exchange,,2263.96,,,2263.96,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Cigna,Cigna,,2763.76,,,2763.76,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Connecticare,Commerical,,2956.08,,,2956.08,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Connecticare,Exchange,,2956.08,,,2956.08,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,Multiplan,Multiplan,,,3503.36,,3503.36,2263.96,3503.36,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 1ST ORDER,36215,CPT,,,both,,,4373.38,2624.03,United Healthcare/Oxford,United Healthcare/Oxford,,2844.31,,,2844.31,2263.96,3503.36,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT  ,,,both,,,1259.69,755.81,Aetna,Commerical,,910.15,,,910.15,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Aetna,Middlesex Employees,,819.14,,,819.14,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Anthem,Commerical,,814.38,,,814.38,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Anthem,Indemnity,,,915.16,,915.16,651.5,1008.18,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Anthem,State Preferred,,814.38,,,814.38,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Anthem,Individual Exchange,,651.5,,,651.5,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Cigna,Cigna,,795.34,,,795.34,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Connecticare,Commerical,,850.68,,,850.68,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Connecticare,Exchange,,850.68,,,850.68,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,Multiplan,Multiplan,,,1008.18,,1008.18,651.5,1008.18,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 2ND ORDER,36216,CPT,,,both,,,1259.69,755.81,United Healthcare/Oxford,United Healthcare/Oxford,,818.52,,,818.52,651.5,1008.18,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT  ,,,both,,,4103.52,2462.11,Aetna,Commerical,,2968.17,,,2968.17,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Aetna,Middlesex Employees,,2671.36,,,2671.36,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Anthem,Commerical,,2655.85,,,2655.85,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Anthem,Indemnity,,,2984.48,,2984.48,2124.68,3287.83,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Anthem,State Preferred,,2655.85,,,2655.85,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Anthem,Individual Exchange,,2124.68,,,2124.68,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Cigna,Cigna,,2593.74,,,2593.74,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Connecticare,Commerical,,2774.22,,,2774.22,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Connecticare,Exchange,,2774.22,,,2774.22,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,Multiplan,Multiplan,,,3287.83,,3287.83,2124.68,3287.83,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; 3RD ORDER,36217,CPT,,,both,,,4103.52,2462.11,United Healthcare/Oxford,United Healthcare/Oxford,,2669.34,,,2669.34,2124.68,3287.83,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT  ,,,both,,,1982.75,1189.65,Aetna,Commerical,,1434.43,,,1434.43,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Aetna,Middlesex Employees,,1290.99,,,1290.99,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Anthem,Commerical,,1283.49,,,1283.49,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Anthem,Indemnity,,,1442.31,,1442.31,1026.79,1588.91,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Anthem,State Preferred,,1283.49,,,1283.49,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Anthem,Individual Exchange,,1026.79,,,1026.79,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Cigna,Cigna,,1253.47,,,1253.47,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Connecticare,Commerical,,1340.7,,,1340.7,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Connecticare,Exchange,,1340.7,,,1340.7,1026.79,1588.91,other,Could be inpatient or outpatient,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,Multiplan,Multiplan,,,1588.91,,1588.91,1026.79,1588.91,percent of total billed charges,,
HC SELECT CATH ART - BRACH-CEPH; EA ADDTL,36218,CPT,,,both,,,1982.75,1189.65,United Healthcare/Oxford,United Healthcare/Oxford,,1290,,,1290,1026.79,1588.91,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT  ,,,both,,,8887.87,5332.72,Aetna,Commerical,,6428.88,,,6428.88,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Aetna,Middlesex Employees,,5785.99,,,5785.99,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Anthem,Commerical,,5752.41,,,5752.41,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Anthem,Indemnity,,,6464.18,,6464.18,4601.92,7121.24,percent of total billed charges,,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Anthem,State Preferred,,5752.41,,,5752.41,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Anthem,Individual Exchange,,4601.92,,,4601.92,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Cigna,Cigna,,5617.87,,,5617.87,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Connecticare,Commerical,,6008.79,,,6008.79,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Connecticare,Exchange,,6008.79,,,6008.79,4601.92,7121.24,other,Could be inpatient or outpatient,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,Multiplan,Multiplan,,,7121.24,,7121.24,4601.92,7121.24,percent of total billed charges,,
HC HH CAROTID CERIR,36222,CPT,,,both,,,8887.87,5332.72,United Healthcare/Oxford,United Healthcare/Oxford,,5781.61,,,5781.61,4601.92,7121.24,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT  ,,,both,,,17412.15,10447.29,Aetna,Commerical,,12594.81,,,12594.81,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Aetna,Middlesex Employees,,11335.33,,,11335.33,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Anthem,Commerical,,11269.54,,,11269.54,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Anthem,Indemnity,,,12663.97,,12663.97,9015.63,13951.2,percent of total billed charges,,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Anthem,State Preferred,,11269.54,,,11269.54,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Anthem,Individual Exchange,,9015.63,,,9015.63,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Cigna,Cigna,,11005.96,,,11005.96,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Connecticare,Commerical,,11771.81,,,11771.81,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Connecticare,Exchange,,11771.81,,,11771.81,9015.63,13951.2,other,Could be inpatient or outpatient,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,Multiplan,Multiplan,,,13951.2,,13951.2,9015.63,13951.2,percent of total billed charges,,
HC SL CM CART ICR SI,36223,CPT,,,both,,,17412.15,10447.29,United Healthcare/Oxford,United Healthcare/Oxford,,11326.73,,,11326.73,9015.63,13951.2,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT  ,,,both,,,15205.89,9123.53,Aetna,Commerical,,10999.19,,,10999.19,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Aetna,Middlesex Employees,,9899.27,,,9899.27,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Anthem,Commerical,,9841.82,,,9841.82,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Anthem,Indemnity,,,11059.59,,11059.59,7873.45,12183.75,percent of total billed charges,,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Anthem,State Preferred,,9841.82,,,9841.82,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Anthem,Individual Exchange,,7873.45,,,7873.45,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Cigna,Cigna,,9611.63,,,9611.63,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Connecticare,Commerical,,10280.46,,,10280.46,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Connecticare,Exchange,,10280.46,,,10280.46,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,Multiplan,Multiplan,,,12183.75,,12183.75,7873.45,12183.75,percent of total billed charges,,
HC PLACE CATH CAROTD ART,36224,CPT,,,both,,,15205.89,9123.53,United Healthcare/Oxford,United Healthcare/Oxford,,9891.77,,,9891.77,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT  ,,,both,,,4173.56,2504.14,Aetna,Commerical,,3018.65,,,3018.65,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Aetna,Middlesex Employees,,2716.79,,,2716.79,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Anthem,Commerical,,2701.02,,,2701.02,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Anthem,Indemnity,,,3035.23,,3035.23,2160.81,3343.75,percent of total billed charges,,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Anthem,State Preferred,,2701.02,,,2701.02,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Anthem,Individual Exchange,,2160.81,,,2160.81,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Cigna,Cigna,,2637.85,,,2637.85,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Connecticare,Commerical,,2821.4,,,2821.4,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Connecticare,Exchange,,2821.4,,,2821.4,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,Multiplan,Multiplan,,,3343.75,,3343.75,2160.81,3343.75,percent of total billed charges,,
HC PLACE CATH SUBCLAVIAN ART,36225,CPT,,,both,,,4173.56,2504.14,United Healthcare/Oxford,United Healthcare/Oxford,,2714.73,,,2714.73,2160.81,3343.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT  ,,,both,,,15205.89,9123.53,Aetna,Commerical,,10999.19,,,10999.19,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Aetna,Middlesex Employees,,9899.27,,,9899.27,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Anthem,Commerical,,9841.82,,,9841.82,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Anthem,Indemnity,,,11059.59,,11059.59,7873.45,12183.75,percent of total billed charges,,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Anthem,State Preferred,,9841.82,,,9841.82,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Anthem,Individual Exchange,,7873.45,,,7873.45,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Cigna,Cigna,,9611.63,,,9611.63,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Connecticare,Commerical,,10280.46,,,10280.46,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Connecticare,Exchange,,10280.46,,,10280.46,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,Multiplan,Multiplan,,,12183.75,,12183.75,7873.45,12183.75,percent of total billed charges,,
HC PLACE CATH VERTEBRAL ART,36226,CPT,,,both,,,15205.89,9123.53,United Healthcare/Oxford,United Healthcare/Oxford,,9891.77,,,9891.77,7873.45,12183.75,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT  ,,,both,,,427.45,256.47,Aetna,Commerical,,309.35,,,309.35,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Aetna,Middlesex Employees,,278.41,,,278.41,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Anthem,Commerical,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Anthem,Indemnity,,,311.05,,311.05,221.44,342.67,percent of total billed charges,,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Anthem,State Preferred,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Anthem,Individual Exchange,,221.44,,,221.44,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Cigna,Cigna,,270.33,,,270.33,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Connecticare,Commerical,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Connecticare,Exchange,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,Multiplan,Multiplan,,,342.67,,342.67,221.44,342.67,percent of total billed charges,,
HC PLACE CATH XTRNL CAROTID,36227,CPT,,,both,,,427.45,256.47,United Healthcare/Oxford,United Healthcare/Oxford,,278.21,,,278.21,221.44,342.67,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT  ,,,both,,,1118.58,671.15,Aetna,Commerical,,808.4,,,808.4,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Aetna,Middlesex Employees,,727.56,,,727.56,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Anthem,Commerical,,723.33,,,723.33,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Anthem,Indemnity,,,812.83,,812.83,578.67,895.45,percent of total billed charges,,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Anthem,State Preferred,,723.33,,,723.33,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Anthem,Individual Exchange,,578.67,,,578.67,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Cigna,Cigna,,706.41,,,706.41,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Connecticare,Commerical,,755.57,,,755.57,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Connecticare,Exchange,,755.57,,,755.57,578.67,895.45,other,Could be inpatient or outpatient,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,Multiplan,Multiplan,,,895.45,,895.45,578.67,895.45,percent of total billed charges,,
HC PLACE CATH INTRACRANIAL ART,36228,CPT,,,both,,,1118.58,671.15,United Healthcare/Oxford,United Healthcare/Oxford,,727,,,727,578.67,895.45,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT  ,,,both,,,3993.31,2395.99,Aetna,Commerical,,2888.4,,,2888.4,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Aetna,Middlesex Employees,,2599.56,,,2599.56,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Anthem,Commerical,,2584.47,,,2584.47,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Anthem,Indemnity,,,2904.25,,2904.25,2067.58,3199.46,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Anthem,State Preferred,,2584.47,,,2584.47,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Anthem,Individual Exchange,,2067.58,,,2067.58,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Cigna,Cigna,,2524.02,,,2524.02,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Connecticare,Commerical,,2699.65,,,2699.65,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Connecticare,Exchange,,2699.65,,,2699.65,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,Multiplan,Multiplan,,,3199.46,,3199.46,2067.58,3199.46,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 1ST,36245,CPT,,,both,,,3993.31,2395.99,United Healthcare/Oxford,United Healthcare/Oxford,,2597.59,,,2597.59,2067.58,3199.46,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT  ,,,both,,,4626.76,2776.06,Aetna,Commerical,,3346.73,,,3346.73,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Aetna,Middlesex Employees,,3012.05,,,3012.05,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Anthem,Commerical,,2994.58,,,2994.58,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Anthem,Indemnity,,,3365.11,,3365.11,2395.66,3707.16,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Anthem,State Preferred,,2994.58,,,2994.58,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Anthem,Individual Exchange,,2395.66,,,2395.66,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Cigna,Cigna,,2924.53,,,2924.53,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Connecticare,Commerical,,3128.04,,,3128.04,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Connecticare,Exchange,,3128.04,,,3128.04,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,Multiplan,Multiplan,,,3707.16,,3707.16,2395.66,3707.16,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 2ND,36246,CPT,,,both,,,4626.76,2776.06,United Healthcare/Oxford,United Healthcare/Oxford,,3009.77,,,3009.77,2395.66,3707.16,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT  ,,,both,,,4770.96,2862.58,Aetna,Commerical,,3450.93,,,3450.93,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Aetna,Middlesex Employees,,3105.84,,,3105.84,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Anthem,Commerical,,3087.82,,,3087.82,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Anthem,Indemnity,,,3469.89,,3469.89,2470.26,3822.59,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Anthem,State Preferred,,3087.82,,,3087.82,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Anthem,Individual Exchange,,2470.26,,,2470.26,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Cigna,Cigna,,3015.59,,,3015.59,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Connecticare,Commerical,,3225.44,,,3225.44,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Connecticare,Exchange,,3225.44,,,3225.44,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,Multiplan,Multiplan,,,3822.59,,3822.59,2470.26,3822.59,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART 3RD,36247,CPT,,,both,,,4770.96,2862.58,United Healthcare/Oxford,United Healthcare/Oxford,,3103.48,,,3103.48,2470.26,3822.59,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT  ,,,both,,,1062.96,637.78,Aetna,Commerical,,769.32,,,769.32,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Aetna,Middlesex Employees,,692.39,,,692.39,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Anthem,Commerical,,688.37,,,688.37,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Anthem,Indemnity,,,773.54,,773.54,550.69,852.17,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Anthem,State Preferred,,688.37,,,688.37,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Anthem,Individual Exchange,,550.69,,,550.69,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Cigna,Cigna,,672.27,,,672.27,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Connecticare,Commerical,,719.04,,,719.04,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Connecticare,Exchange,,719.04,,,719.04,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,Multiplan,Multiplan,,,852.17,,852.17,550.69,852.17,percent of total billed charges,,
HC INS CATH ABD/L-EXT ART ADDL,36248,CPT,,,both,,,1062.96,637.78,United Healthcare/Oxford,United Healthcare/Oxford,,691.86,,,691.86,550.69,852.17,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT  ,,,both,,,9694.01,5816.41,Aetna,Commerical,,7011.77,,,7011.77,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT  ,,,both,,,2910.56,1746.34,Aetna,Commerical,,2105.24,,,2105.24,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Aetna,Middlesex Employees,,6310.6,,,6310.6,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Aetna,Middlesex Employees,,1894.72,,,1894.72,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Anthem,Commerical,,6273.96,,,6273.96,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Anthem,Commerical,,1883.72,,,1883.72,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Anthem,Indemnity,,,7050.27,,7050.27,5019.17,7766.9,percent of total billed charges,,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Anthem,Indemnity,,,2116.8,,2116.8,1506.98,2331.97,percent of total billed charges,,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Anthem,State Preferred,,6273.96,,,6273.96,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Anthem,State Preferred,,1883.72,,,1883.72,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Anthem,Individual Exchange,,5019.17,,,5019.17,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Anthem,Individual Exchange,,1506.98,,,1506.98,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Cigna,Cigna,,6127.22,,,6127.22,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Cigna,Cigna,,1839.66,,,1839.66,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Connecticare,Commerical,,6553.6,,,6553.6,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Connecticare,Commerical,,1967.68,,,1967.68,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Connecticare,Exchange,,6553.6,,,6553.6,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Connecticare,Exchange,,1967.68,,,1967.68,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,Multiplan,Multiplan,,,7766.9,,7766.9,5019.17,7766.9,percent of total billed charges,,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,Multiplan,Multiplan,,,2331.97,,2331.97,1506.98,2331.97,percent of total billed charges,,
HC INS CATH REN ART 1ST UNILAT-OR,36251,CPT,,,both,,,9694.01,5816.41,United Healthcare/Oxford,United Healthcare/Oxford,,6305.81,,,6305.81,5019.17,7766.9,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST UNILAT,36251,CPT,,,both,,,2910.56,1746.34,United Healthcare/Oxford,United Healthcare/Oxford,,1893.28,,,1893.28,1506.98,2331.97,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT  ,,,both,,,10808.82,6485.29,Aetna,Commerical,,7817.72,,,7817.72,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Aetna,Middlesex Employees,,7035.95,,,7035.95,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Anthem,Commerical,,6995.11,,,6995.11,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Anthem,Indemnity,,,7860.65,,7860.65,5596.09,8659.65,percent of total billed charges,,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Anthem,State Preferred,,6995.11,,,6995.11,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Anthem,Individual Exchange,,5596.09,,,5596.09,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Cigna,Cigna,,6831.5,,,6831.5,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Connecticare,Commerical,,7306.88,,,7306.88,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Connecticare,Exchange,,7306.88,,,7306.88,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,Multiplan,Multiplan,,,8659.65,,8659.65,5596.09,8659.65,percent of total billed charges,,
HC INS CATH REN ART 1ST BILAT,36252,CPT,,,both,,,10808.82,6485.29,United Healthcare/Oxford,United Healthcare/Oxford,,7030.62,,,7030.62,5596.09,8659.65,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT  ,,,both,,,3136.35,1881.81,Aetna,Commerical,,2268.06,,,2268.06,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Aetna,Middlesex Employees,,2041.26,,,2041.26,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Anthem,Commerical,,2029.41,,,2029.41,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Anthem,Indemnity,,,2280.52,,2280.52,1623.52,2512.32,percent of total billed charges,,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Anthem,State Preferred,,2029.41,,,2029.41,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Anthem,Individual Exchange,,1623.52,,,1623.52,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Cigna,Cigna,,1981.94,,,1981.94,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Connecticare,Commerical,,2119.85,,,2119.85,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Connecticare,Exchange,,2119.85,,,2119.85,1623.52,2512.32,other,Could be inpatient or outpatient,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,Multiplan,Multiplan,,,2512.32,,2512.32,1623.52,2512.32,percent of total billed charges,,
HC INS CATH REN ART 2ND+ BILAT,36254,CPT,,,both,,,3136.35,1881.81,United Healthcare/Oxford,United Healthcare/Oxford,,2039.71,,,2039.71,1623.52,2512.32,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC BL DRAW <3 YRS OTHER VEIN MD SKILL,36406,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT  ,,,both,,,30.98,18.59,Aetna,Commerical,,22.4,,,22.4,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Aetna,Middlesex Employees,,20.16,,,20.16,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Anthem,Commerical,,20.05,,,20.05,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Anthem,Indemnity,,,22.53,,22.53,16.04,24.82,percent of total billed charges,,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Anthem,State Preferred,,20.05,,,20.05,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Anthem,Individual Exchange,,16.04,,,16.04,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Cigna,Cigna,,19.57,,,19.57,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Connecticare,Commerical,,20.94,,,20.94,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Connecticare,Exchange,,20.94,,,20.94,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,Multiplan,Multiplan,,,24.82,,24.82,16.04,24.82,percent of total billed charges,,
HC VENIPUNCTURE <3,36406,CPT,,,both,,,30.98,18.59,United Healthcare/Oxford,United Healthcare/Oxford,,20.15,,,20.15,16.04,24.82,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC NON-ROUTINE BL DRAW >=3YRS MD SKILL,36410,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT  ,,,both,,,287.37,172.42,Aetna,Commerical,,207.6,,,207.6,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Aetna,Middlesex Employees,,186.84,,,186.84,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Anthem,Commerical,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Anthem,Indemnity,,,208.73,,208.73,148.61,229.95,percent of total billed charges,,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Anthem,State Preferred,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Anthem,Individual Exchange,,148.61,,,148.61,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Cigna,Cigna,,181.41,,,181.41,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Connecticare,Commerical,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Connecticare,Exchange,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,Multiplan,Multiplan,,,229.95,,229.95,148.61,229.95,percent of total billed charges,,
HC NON-ROUTINE BL DRAW 3/> YRS,36410,CPT,,,both,,,287.37,172.42,United Healthcare/Oxford,United Healthcare/Oxford,,186.69,,,186.69,148.61,229.95,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT  ,,,both,,,30.98,18.59,Aetna,Commerical,,22.4,,,22.4,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Aetna,Middlesex Employees,,20.16,,,20.16,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Anthem,Commerical,,20.05,,,20.05,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Anthem,Indemnity,,,22.53,,22.53,16.04,24.82,percent of total billed charges,,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Anthem,State Preferred,,20.05,,,20.05,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Anthem,Individual Exchange,,16.04,,,16.04,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Cigna,Cigna,,19.57,,,19.57,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Connecticare,Commerical,,20.94,,,20.94,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Connecticare,Exchange,,20.94,,,20.94,16.04,24.82,other,Could be inpatient or outpatient,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,Multiplan,Multiplan,,,24.82,,24.82,16.04,24.82,percent of total billed charges,,
HC VENIPUNCTURE >3,36410,CPT,,,both,,,30.98,18.59,United Healthcare/Oxford,United Healthcare/Oxford,,20.15,,,20.15,16.04,24.82,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT  ,,,both,,,9.77,5.86,Aetna,Commerical,,3.56,,,3.56,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Aetna,Middlesex Employees,,3.21,,,3.21,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Anthem,Commerical,,6.14,,,6.14,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Anthem,Indemnity,,,7.11,,7.11,2.55,7.83,percent of total billed charges,,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Anthem,State Preferred,,2.55,,,2.55,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Anthem,Individual Exchange,,4.91,,,4.91,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Cigna,Cigna,,,,,,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Connecticare,Commerical,,,,,,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Connecticare,Exchange,,,,,,2.55,7.83,other,Could be inpatient or outpatient,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,Multiplan,Multiplan,,,7.83,,7.83,2.55,7.83,percent of total billed charges,,
HC ROUTINE VENIPUNCTURE,36415,CPT,,,both,,,9.77,5.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,7.83,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT  ,,,both,,,15.05,9.03,Aetna,Commerical,,,,,,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Aetna,Middlesex Employees,,,,,,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Anthem,Commerical,,9.46,,,9.46,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Anthem,Indemnity,,,10.94,,10.94,4.31,12.05,percent of total billed charges,,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Anthem,State Preferred,,9.46,,,9.46,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Anthem,Individual Exchange,,7.57,,,7.57,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Cigna,Cigna,,,,,,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Connecticare,Commerical,,4.31,,,4.31,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Connecticare,Exchange,,4.31,,,4.31,4.31,12.05,other,Could be inpatient or outpatient,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,Multiplan,Multiplan,,,12.05,,12.05,4.31,12.05,percent of total billed charges,,
HC COLLECTION CAPILLARY BLOOD SPECIMEN,36416,CPT,,,both,,,15.05,9.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.31,12.05,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN < 2HR,36430,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT  ,,,both,,,931.12,558.67,Aetna,Commerical,,673.25,,,673.25,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Aetna,Middlesex Employees,,605.92,,,605.92,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Anthem,Commerical,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Anthem,Indemnity,,,676.95,,676.95,481.93,745.76,percent of total billed charges,,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Anthem,State Preferred,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Anthem,Individual Exchange,,481.93,,,481.93,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Cigna,Cigna,,588.32,,,588.32,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Connecticare,Commerical,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Connecticare,Exchange,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,Multiplan,Multiplan,,,745.76,,745.76,481.93,745.76,percent of total billed charges,,
HC BLOOD ADMIN > 8HR,36430,CPT,,,both,,,931.12,558.67,United Healthcare/Oxford,United Healthcare/Oxford,,605.46,,,605.46,481.93,745.76,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 2-4HR,36430,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 4-6HR,36430,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC BLOOD ADMIN 6-8HR,36430,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT  ,,,both,,,1514.93,908.96,Aetna,Commerical,,1095.76,,,1095.76,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT  ,,,both,,,1457.54,874.53,Aetna,Commerical,,1054.25,,,1054.25,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Aetna,Middlesex Employees,,986.18,,,986.18,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Aetna,Middlesex Employees,,948.82,,,948.82,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Anthem,Commerical,,980.47,,,980.47,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Anthem,Commerical,,943.32,,,943.32,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Anthem,Indemnity,,,1101.78,,1101.78,784.37,1213.77,percent of total billed charges,,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Anthem,Indemnity,,,1060.04,,1060.04,754.66,1167.79,percent of total billed charges,,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Anthem,State Preferred,,980.47,,,980.47,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Anthem,State Preferred,,943.32,,,943.32,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Anthem,Individual Exchange,,784.37,,,784.37,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Anthem,Individual Exchange,,754.66,,,754.66,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Cigna,Cigna,,957.54,,,957.54,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Cigna,Cigna,,921.25,,,921.25,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Connecticare,Commerical,,1024.16,,,1024.16,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Connecticare,Commerical,,985.36,,,985.36,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Connecticare,Exchange,,1024.16,,,1024.16,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Connecticare,Exchange,,985.36,,,985.36,754.66,1167.79,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,Multiplan,Multiplan,,,1213.77,,1213.77,784.37,1213.77,percent of total billed charges,,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,Multiplan,Multiplan,,,1167.79,,1167.79,754.66,1167.79,percent of total billed charges,,
HC BLOOD TRANSFUSION HTC,36430,CPT,,,both,,,1514.93,908.96,United Healthcare/Oxford,United Healthcare/Oxford,,985.44,,,985.44,784.37,1213.77,other,Could be inpatient or outpatient,
HC BLOOD TRANSFUSION ED,36430,CPT,,,both,,,1457.54,874.53,United Healthcare/Oxford,United Healthcare/Oxford,,948.1,,,948.1,754.66,1167.79,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC TRANSFUSION BLOOD OR BLOOD COMPONENTS,36430,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT  ,,,both,,,1457.45,874.47,Aetna,Commerical,,1054.25,,,1054.25,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Aetna,Middlesex Employees,,948.82,,,948.82,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Anthem,Commerical,,943.32,,,943.32,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Anthem,Indemnity,,,1060.04,,1060.04,754.66,1167.79,percent of total billed charges,,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Anthem,State Preferred,,943.32,,,943.32,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Anthem,Individual Exchange,,754.66,,,754.66,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Cigna,Cigna,,921.25,,,921.25,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Connecticare,Commerical,,985.36,,,985.36,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Connecticare,Exchange,,985.36,,,985.36,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,Multiplan,Multiplan,,,1167.79,,1167.79,754.66,1167.79,percent of total billed charges,,
HC PUSH TRANSFUS <2,36440,CPT,,,both,,,1457.45,874.47,United Healthcare/Oxford,United Healthcare/Oxford,,948.1,,,948.1,754.66,1167.79,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT  ,,,both,,,1443.03,865.82,Aetna,Commerical,,1043.66,,,1043.66,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Aetna,Middlesex Employees,,939.3,,,939.3,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Anthem,Commerical,,933.85,,,933.85,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Anthem,Indemnity,,,1049.39,,1049.39,747.08,1156.06,percent of total billed charges,,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Anthem,State Preferred,,933.85,,,933.85,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Anthem,Individual Exchange,,747.08,,,747.08,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Cigna,Cigna,,912.01,,,912.01,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Connecticare,Commerical,,975.47,,,975.47,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Connecticare,Exchange,,975.47,,,975.47,747.08,1156.06,other,Could be inpatient or outpatient,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,Multiplan,Multiplan,,,1156.06,,1156.06,747.08,1156.06,percent of total billed charges,,
HC PUSH TRANSFUSION BLOOD <=2 YRS,36440,CPT,,,both,,,1443.03,865.82,United Healthcare/Oxford,United Healthcare/Oxford,,938.59,,,938.59,747.08,1156.06,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI < 2HR,36455,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT  ,,,both,,,931.12,558.67,Aetna,Commerical,,673.25,,,673.25,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Aetna,Middlesex Employees,,605.92,,,605.92,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Commerical,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Indemnity,,,676.95,,676.95,481.93,745.76,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,State Preferred,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Individual Exchange,,481.93,,,481.93,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Cigna,Cigna,,588.32,,,588.32,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Connecticare,Commerical,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Connecticare,Exchange,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,Multiplan,Multiplan,,,745.76,,745.76,481.93,745.76,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI > 8HR,36455,CPT,,,both,,,931.12,558.67,United Healthcare/Oxford,United Healthcare/Oxford,,605.46,,,605.46,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 2-4HR,36455,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT  ,,,both,,,1591.35,954.81,Aetna,Commerical,,1151.12,,,1151.12,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Aetna,Middlesex Employees,,1036.01,,,1036.01,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Commerical,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Indemnity,,,1157.44,,1157.44,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,State Preferred,,1030,,,1030,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Anthem,Individual Exchange,,824,,,824,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Cigna,Cigna,,1005.91,,,1005.91,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Commerical,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Connecticare,Exchange,,1075.9,,,1075.9,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,Multiplan,Multiplan,,,1275.09,,1275.09,824,1275.09,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 4-6HR,36455,CPT,,,both,,,1591.35,954.81,United Healthcare/Oxford,United Healthcare/Oxford,,1035.23,,,1035.23,824,1275.09,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT  ,,,both,,,931.12,558.67,Aetna,Commerical,,673.25,,,673.25,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Aetna,Middlesex Employees,,605.92,,,605.92,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Commerical,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Indemnity,,,676.95,,676.95,481.93,745.76,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,State Preferred,,602.41,,,602.41,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Anthem,Individual Exchange,,481.93,,,481.93,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Cigna,Cigna,,588.32,,,588.32,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Connecticare,Commerical,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Connecticare,Exchange,,629.26,,,629.26,481.93,745.76,other,Could be inpatient or outpatient,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,Multiplan,Multiplan,,,745.76,,745.76,481.93,745.76,percent of total billed charges,,
HC EXCHANGE TRANSFUSION BLOOD PEDI 6-8HR,36455,CPT,,,both,,,931.12,558.67,United Healthcare/Oxford,United Healthcare/Oxford,,605.46,,,605.46,481.93,745.76,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT  ,,,both,,,1397.71,838.63,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Anthem,Indemnity,,,1016.66,,1016.66,723.78,1119.99,percent of total billed charges,,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC INJ SCLEROSING SOLN - SGL VEIN,36470,CPT,,,both,,,1397.71,838.63,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT  ,,,both,,,493.37,296.02,Aetna,Commerical,,356.57,,,356.57,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Aetna,Middlesex Employees,,320.91,,,320.91,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Anthem,Commerical,,319.05,,,319.05,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Anthem,Indemnity,,,358.53,,358.53,255.24,394.97,percent of total billed charges,,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Anthem,State Preferred,,319.05,,,319.05,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Anthem,Individual Exchange,,255.24,,,255.24,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Cigna,Cigna,,311.59,,,311.59,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Connecticare,Commerical,,333.28,,,333.28,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Connecticare,Exchange,,333.28,,,333.28,255.24,394.97,other,Could be inpatient or outpatient,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,Multiplan,Multiplan,,,394.97,,394.97,255.24,394.97,percent of total billed charges,,
HC INJ SCLEROSING SOLUTION; MULTI SAME LEG,36471,CPT,,,both,,,493.37,296.02,United Healthcare/Oxford,United Healthcare/Oxford,,320.67,,,320.67,255.24,394.97,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT  ,,,both,,,986.74,592.04,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC VENOUS SELECTIVE ORGAN BLOOD SAMPLING,36500,CPT,,,both,,,986.74,592.04,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT  ,,,both,,,5185.02,3111.01,Aetna,Commerical,,3750.52,,,3750.52,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Aetna,Middlesex Employees,,3375.46,,,3375.46,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Anthem,Commerical,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Anthem,Indemnity,,,3771.12,,3771.12,2684.7,4154.43,percent of total billed charges,,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Anthem,State Preferred,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Anthem,Individual Exchange,,2684.7,,,2684.7,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Cigna,Cigna,,3277.38,,,3277.38,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Connecticare,Commerical,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Connecticare,Exchange,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,Multiplan,Multiplan,,,4154.43,,4154.43,2684.7,4154.43,percent of total billed charges,,
HC APHERESIS WHITE BLOOD CELLS,36511,CPT,,,both,,,5185.02,3111.01,United Healthcare/Oxford,United Healthcare/Oxford,,3372.91,,,3372.91,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT  ,,,both,,,5185.02,3111.01,Aetna,Commerical,,3750.52,,,3750.52,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Aetna,Middlesex Employees,,3375.46,,,3375.46,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Anthem,Commerical,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Anthem,Indemnity,,,3771.12,,3771.12,2684.7,4154.43,percent of total billed charges,,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Anthem,State Preferred,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Anthem,Individual Exchange,,2684.7,,,2684.7,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Cigna,Cigna,,3277.38,,,3277.38,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Connecticare,Commerical,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Connecticare,Exchange,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,Multiplan,Multiplan,,,4154.43,,4154.43,2684.7,4154.43,percent of total billed charges,,
HC APHERSIS RB CELLS,36512,CPT,,,both,,,5185.02,3111.01,United Healthcare/Oxford,United Healthcare/Oxford,,3372.91,,,3372.91,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT  ,,,both,,,1443.03,865.82,Aetna,Commerical,,1043.66,,,1043.66,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Aetna,Middlesex Employees,,939.3,,,939.3,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Anthem,Commerical,,933.85,,,933.85,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Anthem,Indemnity,,,1049.39,,1049.39,747.08,1156.06,percent of total billed charges,,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Anthem,State Preferred,,933.85,,,933.85,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Anthem,Individual Exchange,,747.08,,,747.08,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Cigna,Cigna,,912.01,,,912.01,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Connecticare,Commerical,,975.47,,,975.47,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Connecticare,Exchange,,975.47,,,975.47,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,Multiplan,Multiplan,,,1156.06,,1156.06,747.08,1156.06,percent of total billed charges,,
HC APHERESIS PLATELETS,36513,CPT,,,both,,,1443.03,865.82,United Healthcare/Oxford,United Healthcare/Oxford,,938.59,,,938.59,747.08,1156.06,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT  ,,,both,,,5185.02,3111.01,Aetna,Commerical,,3750.52,,,3750.52,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Aetna,Middlesex Employees,,3375.46,,,3375.46,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Anthem,Commerical,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Anthem,Indemnity,,,3771.12,,3771.12,2684.7,4154.43,percent of total billed charges,,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Anthem,State Preferred,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Anthem,Individual Exchange,,2684.7,,,2684.7,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Cigna,Cigna,,3277.38,,,3277.38,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Connecticare,Commerical,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Connecticare,Exchange,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,Multiplan,Multiplan,,,4154.43,,4154.43,2684.7,4154.43,percent of total billed charges,,
HC APHERESIS PLASMA PHERESIS,36514,CPT,,,both,,,5185.02,3111.01,United Healthcare/Oxford,United Healthcare/Oxford,,3372.91,,,3372.91,2684.7,4154.43,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT  ,,,both,,,13911.28,8346.77,Aetna,Commerical,,10062.17,,,10062.17,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Aetna,Middlesex Employees,,9055.95,,,9055.95,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Anthem,Commerical,,9003.39,,,9003.39,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Anthem,Indemnity,,,10117.42,,10117.42,7202.71,11145.81,percent of total billed charges,,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Anthem,State Preferred,,9003.39,,,9003.39,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Anthem,Individual Exchange,,7202.71,,,7202.71,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Cigna,Cigna,,8792.82,,,8792.82,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Connecticare,Commerical,,9404.67,,,9404.67,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Connecticare,Exchange,,9404.67,,,9404.67,7202.71,11145.81,other,Could be inpatient or outpatient,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,Multiplan,Multiplan,,,11145.81,,11145.81,7202.71,11145.81,percent of total billed charges,,
HC APHERESIS W/EXTRACOR IMMUNADS SLCTV ABSORB/FILT AND PLASMA REINF,36516,CPT,,,both,,,13911.28,8346.77,United Healthcare/Oxford,United Healthcare/Oxford,,9049.1,,,9049.1,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT  ,,,both,,,13911.28,8346.77,Aetna,Commerical,,10062.17,,,10062.17,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Aetna,Middlesex Employees,,9055.95,,,9055.95,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Anthem,Commerical,,9003.39,,,9003.39,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Anthem,Indemnity,,,10117.42,,10117.42,7202.71,11145.81,percent of total billed charges,,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Anthem,State Preferred,,9003.39,,,9003.39,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Anthem,Individual Exchange,,7202.71,,,7202.71,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Cigna,Cigna,,8792.82,,,8792.82,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Connecticare,Commerical,,9404.67,,,9404.67,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Connecticare,Exchange,,9404.67,,,9404.67,7202.71,11145.81,other,Could be inpatient or outpatient,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,Multiplan,Multiplan,,,11145.81,,11145.81,7202.71,11145.81,percent of total billed charges,,
HC PHOTOPHERESIS EXTRACORPOREAL,36522,CPT,,,both,,,13911.28,8346.77,United Healthcare/Oxford,United Healthcare/Oxford,,9049.1,,,9049.1,7202.71,11145.81,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT  ,,,both,,,1393.59,836.15,Aetna,Commerical,,1008.66,,,1008.66,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Aetna,Middlesex Employees,,907.8,,,907.8,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Anthem,Commerical,,902.52,,,902.52,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Anthem,Indemnity,,,1014.2,,1014.2,722.02,1117.29,percent of total billed charges,,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Anthem,State Preferred,,902.52,,,902.52,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Anthem,Individual Exchange,,722.02,,,722.02,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Cigna,Cigna,,881.41,,,881.41,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Connecticare,Commerical,,942.75,,,942.75,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Connecticare,Exchange,,942.75,,,942.75,722.02,1117.29,other,Could be inpatient or outpatient,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,Multiplan,Multiplan,,,1117.29,,1117.29,722.02,1117.29,percent of total billed charges,,
HC INSERT NON-TUNNEL CV CATH <5 YRS,36555,CPT,,,both,,,1393.59,836.15,United Healthcare/Oxford,United Healthcare/Oxford,,907.1,,,907.1,722.02,1117.29,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT  ,,,both,,,4421.79,2653.07,Aetna,Commerical,,3198.57,,,3198.57,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Aetna,Middlesex Employees,,2878.71,,,2878.71,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Anthem,Commerical,,2862,,,2862,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Anthem,Indemnity,,,3216.13,,3216.13,2289.61,3543.04,percent of total billed charges,,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Anthem,State Preferred,,2862,,,2862,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Anthem,Individual Exchange,,2289.61,,,2289.61,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Cigna,Cigna,,2795.06,,,2795.06,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Connecticare,Commerical,,2989.56,,,2989.56,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Connecticare,Exchange,,2989.56,,,2989.56,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,Multiplan,Multiplan,,,3543.04,,3543.04,2289.61,3543.04,percent of total billed charges,,
HC INS NON-TUNNEL CV CATH 5 YRS/>,36556,CPT,,,both,,,4421.79,2653.07,United Healthcare/Oxford,United Healthcare/Oxford,,2876.52,,,2876.52,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT  ,,,both,,,1665.75,999.45,Aetna,Commerical,,1204.86,,,1204.86,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT  ,,,both,,,1585.84,951.5,Aetna,Commerical,,1147.05,,,1147.05,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT  ,,,both,,,7215.63,4329.38,Aetna,Commerical,,5219.14,,,5219.14,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Aetna,Middlesex Employees,,1084.38,,,1084.38,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Aetna,Middlesex Employees,,1032.35,,,1032.35,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Aetna,Middlesex Employees,,4697.23,,,4697.23,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Anthem,Commerical,,1078.08,,,1078.08,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Anthem,Commerical,,1026.36,,,1026.36,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Anthem,Commerical,,4669.96,,,4669.96,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Anthem,Indemnity,,,1211.47,,1211.47,1026.36,1334.61,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Anthem,Indemnity,,,1153.36,,1153.36,1026.36,1270.59,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Anthem,Indemnity,,,5247.8,,5247.8,1026.36,5781.22,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Anthem,State Preferred,,1078.08,,,1078.08,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Anthem,State Preferred,,1026.36,,,1026.36,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Anthem,State Preferred,,4669.96,,,4669.96,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Anthem,Individual Exchange,,862.47,,,862.47,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Anthem,Individual Exchange,,821.09,,,821.09,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Anthem,Individual Exchange,,3735.97,,,3735.97,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Cigna,Cigna,,1052.86,,,1052.86,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Cigna,Cigna,,1002.35,,,1002.35,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Cigna,Cigna,,4560.73,,,4560.73,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Connecticare,Commerical,,1126.12,,,1126.12,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Connecticare,Commerical,,1072.1,,,1072.1,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Connecticare,Commerical,,4878.1,,,4878.1,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Connecticare,Exchange,,1126.12,,,1126.12,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Connecticare,Exchange,,1072.1,,,1072.1,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Connecticare,Exchange,,4878.1,,,4878.1,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,Multiplan,Multiplan,,,1334.61,,1334.61,1026.36,1334.61,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,Multiplan,Multiplan,,,1270.59,,1270.59,1026.36,1270.59,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,Multiplan,Multiplan,,,5781.22,,5781.22,1026.36,5781.22,percent of total billed charges,,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS MED SURG 6,36557,CPT,,,both,,,1665.75,999.45,United Healthcare/Oxford,United Healthcare/Oxford,,1083.55,,,1083.55,1026.36,1334.61,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH ,36557,CPT,,,both,,,1585.84,951.5,United Healthcare/Oxford,United Healthcare/Oxford,,1031.57,,,1031.57,1026.36,1270.59,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH WO SQ PORT <5 YRS RAD HH SVCS,36557,CPT,,,both,,,7215.63,4329.38,United Healthcare/Oxford,United Healthcare/Oxford,,4693.67,,,4693.67,1026.36,5781.22,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT  ,,,both,,,5393.43,3236.06,Aetna,Commerical,,3901.12,,,3901.12,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Aetna,Middlesex Employees,,3511.01,,,3511.01,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Anthem,Commerical,,3490.63,,,3490.63,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Anthem,Indemnity,,,3922.55,,3922.55,2792.5,4321.26,percent of total billed charges,,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Anthem,State Preferred,,3490.63,,,3490.63,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Anthem,Individual Exchange,,2792.5,,,2792.5,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Cigna,Cigna,,3409,,,3409,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Connecticare,Commerical,,3646.21,,,3646.21,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Connecticare,Exchange,,3646.21,,,3646.21,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,Multiplan,Multiplan,,,4321.26,,4321.26,2792.5,4321.26,percent of total billed charges,,
HC INS TUNNELED CV CATH AGE >= 5,36558,CPT,,,both,,,5393.43,3236.06,United Healthcare/Oxford,United Healthcare/Oxford,,3508.36,,,3508.36,2792.5,4321.26,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT  ,,,both,,,1676.84,1006.1,Aetna,Commerical,,1213,,,1213,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Aetna,Middlesex Employees,,1091.69,,,1091.69,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Anthem,Commerical,,1085.36,,,1085.36,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Anthem,Indemnity,,,1219.66,,1219.66,868.29,1343.63,percent of total billed charges,,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Anthem,State Preferred,,1085.36,,,1085.36,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Anthem,Individual Exchange,,868.29,,,868.29,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Cigna,Cigna,,1059.98,,,1059.98,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Connecticare,Commerical,,1133.73,,,1133.73,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Connecticare,Exchange,,1133.73,,,1133.73,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,Multiplan,Multiplan,,,1343.63,,1343.63,868.29,1343.63,percent of total billed charges,,
HC INS TUNNELED CV CATH AGE 5/>,36558,CPT,,,both,,,1676.84,1006.1,United Healthcare/Oxford,United Healthcare/Oxford,,1090.87,,,1090.87,868.29,1343.63,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT  ,,,both,,,1006.2,603.72,Aetna,Commerical,,727.8,,,727.8,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT  ,,,both,,,956.68,574.01,Aetna,Commerical,,691.98,,,691.98,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Aetna,Middlesex Employees,,655.02,,,655.02,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Aetna,Middlesex Employees,,622.78,,,622.78,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Anthem,Commerical,,651.21,,,651.21,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Anthem,Commerical,,619.17,,,619.17,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Anthem,Indemnity,,,731.79,,731.79,520.97,806.17,percent of total billed charges,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Anthem,Indemnity,,,695.78,,695.78,495.33,766.5,percent of total billed charges,,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Anthem,State Preferred,,651.21,,,651.21,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Anthem,State Preferred,,619.17,,,619.17,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Anthem,Individual Exchange,,520.97,,,520.97,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Anthem,Individual Exchange,,495.33,,,495.33,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Cigna,Cigna,,635.98,,,635.98,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Cigna,Cigna,,604.69,,,604.69,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Connecticare,Commerical,,680.24,,,680.24,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Connecticare,Commerical,,646.77,,,646.77,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Connecticare,Exchange,,680.24,,,680.24,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Connecticare,Exchange,,646.77,,,646.77,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,Multiplan,Multiplan,,,806.17,,806.17,520.97,806.17,percent of total billed charges,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,Multiplan,Multiplan,,,766.5,,766.5,495.33,766.5,percent of total billed charges,,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS-INPT,36560,CPT,,,both,,,1006.2,603.72,United Healthcare/Oxford,United Healthcare/Oxford,,654.52,,,654.52,520.97,806.17,other,Inpatient,
HC INS TUNNELED CV CATH W SQ PORT <5 YRS,36560,CPT,,,both,,,956.68,574.01,United Healthcare/Oxford,United Healthcare/Oxford,,622.31,,,622.31,495.33,766.5,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT  ,,,both,,,1015.21,609.13,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT  ,,,both,,,7691.73,4615.04,Aetna,Commerical,,5563.5,,,5563.5,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Aetna,Middlesex Employees,,5007.15,,,5007.15,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Anthem,Commerical,,4978.09,,,4978.09,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Anthem,Indemnity,,,738.34,,738.34,525.64,813.39,percent of total billed charges,,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Anthem,Indemnity,,,5594.05,,5594.05,3982.47,6162.66,percent of total billed charges,,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Anthem,State Preferred,,4978.09,,,4978.09,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Anthem,Individual Exchange,,3982.47,,,3982.47,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Cigna,Cigna,,4861.66,,,4861.66,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Connecticare,Commerical,,5199.96,,,5199.96,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Connecticare,Exchange,,5199.96,,,5199.96,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,Multiplan,Multiplan,,,6162.66,,6162.66,3982.47,6162.66,percent of total billed charges,,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>-INPATIENT,36561,CPT,,,both,,,1015.21,609.13,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC INS TUNNELED CVAD W PORT AGE 5 YRS/>,36561,CPT,,,both,,,7691.73,4615.04,United Healthcare/Oxford,United Healthcare/Oxford,,5003.36,,,5003.36,3982.47,6162.66,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT  ,,,both,,,6653.8,3992.28,Aetna,Commerical,,4812.91,,,4812.91,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Aetna,Middlesex Employees,,4331.61,,,4331.61,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Anthem,Commerical,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Anthem,Indemnity,,,4839.34,,4839.34,3445.18,5331.23,percent of total billed charges,,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Anthem,State Preferred,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Anthem,Individual Exchange,,3445.18,,,3445.18,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Cigna,Cigna,,4205.75,,,4205.75,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Connecticare,Commerical,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Connecticare,Exchange,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,Multiplan,Multiplan,,,5331.23,,5331.23,3445.18,5331.23,percent of total billed charges,,
HC INS TUNNEL CVAD W SQ PUMP,36563,CPT,,,both,,,6653.8,3992.28,United Healthcare/Oxford,United Healthcare/Oxford,,4328.34,,,4328.34,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT  ,,,both,,,6653.8,3992.28,Aetna,Commerical,,4812.91,,,4812.91,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Aetna,Middlesex Employees,,4331.61,,,4331.61,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Anthem,Commerical,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Anthem,Indemnity,,,4839.34,,4839.34,3445.18,5331.23,percent of total billed charges,,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Anthem,State Preferred,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Anthem,Individual Exchange,,3445.18,,,3445.18,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Cigna,Cigna,,4205.75,,,4205.75,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Connecticare,Commerical,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Connecticare,Exchange,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,Multiplan,Multiplan,,,5331.23,,5331.23,3445.18,5331.23,percent of total billed charges,,
HC INSERT TUNNELED CV 2X CATH WO SQ PORT,36565,CPT,,,both,,,6653.8,3992.28,United Healthcare/Oxford,United Healthcare/Oxford,,4328.34,,,4328.34,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT  ,,,both,,,6653.8,3992.28,Aetna,Commerical,,4812.91,,,4812.91,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Aetna,Middlesex Employees,,4331.61,,,4331.61,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Anthem,Commerical,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Anthem,Indemnity,,,4839.34,,4839.34,3445.18,5331.23,percent of total billed charges,,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Anthem,State Preferred,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Anthem,Individual Exchange,,3445.18,,,3445.18,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Cigna,Cigna,,4205.75,,,4205.75,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Connecticare,Commerical,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Connecticare,Exchange,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,Multiplan,Multiplan,,,5331.23,,5331.23,3445.18,5331.23,percent of total billed charges,,
HC INSERT TUNNELED CV 2X CATH W SQ PORT,36566,CPT,,,both,,,6653.8,3992.28,United Healthcare/Oxford,United Healthcare/Oxford,,4328.34,,,4328.34,3445.18,5331.23,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT  ,,,both,,,2756.28,1653.77,Aetna,Commerical,,1993.71,,,1993.71,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Aetna,Middlesex Employees,,1794.35,,,1794.35,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Anthem,Commerical,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Anthem,Indemnity,,,2004.65,,2004.65,1427.14,2208.42,percent of total billed charges,,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Anthem,State Preferred,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Anthem,Individual Exchange,,1427.14,,,1427.14,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Cigna,Cigna,,1742.2,,,1742.2,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Connecticare,Commerical,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Connecticare,Exchange,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,Multiplan,Multiplan,,,2208.42,,2208.42,1427.14,2208.42,percent of total billed charges,,
HC INSERT PICC CATH <5 YRS,36568,CPT,,,both,,,2756.28,1653.77,United Healthcare/Oxford,United Healthcare/Oxford,,1792.98,,,1792.98,1427.14,2208.42,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT  ,,,both,,,4421.79,2653.07,Aetna,Commerical,,3198.57,,,3198.57,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Aetna,Middlesex Employees,,2878.71,,,2878.71,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Anthem,Commerical,,2862,,,2862,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Anthem,Indemnity,,,3216.13,,3216.13,2289.61,3543.04,percent of total billed charges,,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Anthem,State Preferred,,2862,,,2862,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Anthem,Individual Exchange,,2289.61,,,2289.61,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Cigna,Cigna,,2795.06,,,2795.06,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Connecticare,Commerical,,2989.56,,,2989.56,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Connecticare,Exchange,,2989.56,,,2989.56,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,Multiplan,Multiplan,,,3543.04,,3543.04,2289.61,3543.04,percent of total billed charges,,
HC INS PICC AGE 5 YRS/>,36569,CPT,,,both,,,4421.79,2653.07,United Healthcare/Oxford,United Healthcare/Oxford,,2876.52,,,2876.52,2289.61,3543.04,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT  ,,,both,,,5548.61,3329.17,Aetna,Commerical,,4013.47,,,4013.47,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Aetna,Middlesex Employees,,3612.12,,,3612.12,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Anthem,Commerical,,3591.16,,,3591.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Anthem,Indemnity,,,4035.51,,4035.51,2872.93,4445.7,percent of total billed charges,,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Anthem,State Preferred,,3591.16,,,3591.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Anthem,Individual Exchange,,2872.93,,,2872.93,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Cigna,Cigna,,3507.16,,,3507.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Connecticare,Commerical,,3751.22,,,3751.22,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Connecticare,Exchange,,3751.22,,,3751.22,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,Multiplan,Multiplan,,,4445.7,,4445.7,2872.93,4445.7,percent of total billed charges,,
HC INSERT PICVAD CATH <5 YRS,36570,CPT,,,both,,,5548.61,3329.17,United Healthcare/Oxford,United Healthcare/Oxford,,3609.39,,,3609.39,2872.93,4445.7,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT  ,,,both,,,11214.64,6728.78,Aetna,Commerical,,8111.61,,,8111.61,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Aetna,Middlesex Employees,,7300.45,,,7300.45,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Anthem,Commerical,,7258.07,,,7258.07,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Anthem,Indemnity,,,8156.15,,8156.15,5806.45,8985.19,percent of total billed charges,,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Anthem,State Preferred,,7258.07,,,7258.07,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Anthem,Individual Exchange,,5806.45,,,5806.45,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Cigna,Cigna,,7088.32,,,7088.32,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Connecticare,Commerical,,7581.56,,,7581.56,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Connecticare,Exchange,,7581.56,,,7581.56,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,Multiplan,Multiplan,,,8985.19,,8985.19,5806.45,8985.19,percent of total billed charges,,
HC INS PICC DEVICE W PORT 5 YRS/>,36571,CPT,,,both,,,11214.64,6728.78,United Healthcare/Oxford,United Healthcare/Oxford,,7294.91,,,7294.91,5806.45,8985.19,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT  ,,,both,,,3451.53,2070.92,Aetna,Commerical,,2496.01,,,2496.01,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Aetna,Middlesex Employees,,2246.41,,,2246.41,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Anthem,Commerical,,2233.36,,,2233.36,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Anthem,Indemnity,,,2509.71,,2509.71,1786.69,2764.81,percent of total billed charges,,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Anthem,State Preferred,,2233.36,,,2233.36,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Anthem,Individual Exchange,,1786.69,,,1786.69,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Cigna,Cigna,,2181.13,,,2181.13,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Connecticare,Commerical,,2332.91,,,2332.91,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Connecticare,Exchange,,2332.91,,,2332.91,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,Multiplan,Multiplan,,,2764.81,,2764.81,1786.69,2764.81,percent of total billed charges,,
HC INS PICC WO SUBC PORT/PUMP W IMAGE < 5YO,36572,CPT,,,both,,,3451.53,2070.92,United Healthcare/Oxford,United Healthcare/Oxford,,2244.7,,,2244.7,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT  ,,,both,,,3451.53,2070.92,Aetna,Commerical,,2496.01,,,2496.01,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Aetna,Middlesex Employees,,2246.41,,,2246.41,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Anthem,Commerical,,2233.36,,,2233.36,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Anthem,Indemnity,,,2509.71,,2509.71,1786.69,2764.81,percent of total billed charges,,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Anthem,State Preferred,,2233.36,,,2233.36,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Anthem,Individual Exchange,,1786.69,,,1786.69,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Cigna,Cigna,,2181.13,,,2181.13,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Connecticare,Commerical,,2332.91,,,2332.91,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Connecticare,Exchange,,2332.91,,,2332.91,1786.69,2764.81,other,Could be inpatient or outpatient,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,Multiplan,Multiplan,,,2764.81,,2764.81,1786.69,2764.81,percent of total billed charges,,
HC INS PICC WO SUBC PORT/PUMP W IMAGE > 5YO,36573,CPT,,,both,,,3451.53,2070.92,United Healthcare/Oxford,United Healthcare/Oxford,,2244.7,,,2244.7,1786.69,2764.81,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT  ,,,both,,,2756.36,1653.82,Aetna,Commerical,,1993.71,,,1993.71,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT  ,,,both,,,658.43,395.06,Aetna,Commerical,,476.25,,,476.25,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Aetna,Middlesex Employees,,1794.35,,,1794.35,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Aetna,Middlesex Employees,,428.62,,,428.62,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Anthem,Commerical,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Anthem,Commerical,,426.13,,,426.13,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Anthem,Indemnity,,,2004.65,,2004.65,1427.14,2208.42,percent of total billed charges,,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Anthem,Indemnity,,,478.86,,478.86,340.91,527.54,percent of total billed charges,,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Anthem,State Preferred,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Anthem,State Preferred,,426.13,,,426.13,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Anthem,Individual Exchange,,1427.14,,,1427.14,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Anthem,Individual Exchange,,340.91,,,340.91,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Cigna,Cigna,,1742.2,,,1742.2,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Cigna,Cigna,,416.17,,,416.17,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Connecticare,Commerical,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Connecticare,Commerical,,445.12,,,445.12,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Connecticare,Exchange,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Connecticare,Exchange,,445.12,,,445.12,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,Multiplan,Multiplan,,,2208.42,,2208.42,1427.14,2208.42,percent of total billed charges,,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,Multiplan,Multiplan,,,527.54,,527.54,340.91,527.54,percent of total billed charges,,
HC REPAIR CVA CATHETER,36575,CPT,,,both,,,2756.36,1653.82,United Healthcare/Oxford,United Healthcare/Oxford,,1792.98,,,1792.98,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REPAIR CVA CATHETER-RAD HH SVCS,36575,CPT,,,both,,,658.43,395.06,United Healthcare/Oxford,United Healthcare/Oxford,,428.29,,,428.29,340.91,527.54,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT  ,,,both,,,1380.99,828.6,Aetna,Commerical,,998.89,,,998.89,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT  ,,,both,,,1314.59,788.75,Aetna,Commerical,,950.86,,,950.86,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Aetna,Middlesex Employees,,899.01,,,899.01,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Aetna,Middlesex Employees,,855.78,,,855.78,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Anthem,Commerical,,893.78,,,893.78,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Anthem,Commerical,,850.8,,,850.8,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Anthem,Indemnity,,,1004.37,,1004.37,715.03,1106.46,percent of total billed charges,,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Anthem,Indemnity,,,956.08,,956.08,680.64,1053.26,percent of total billed charges,,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Anthem,State Preferred,,893.78,,,893.78,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Anthem,State Preferred,,850.8,,,850.8,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Anthem,Individual Exchange,,715.03,,,715.03,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Anthem,Individual Exchange,,680.64,,,680.64,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Cigna,Cigna,,872.88,,,872.88,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Cigna,Cigna,,830.91,,,830.91,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Connecticare,Commerical,,933.62,,,933.62,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Connecticare,Commerical,,888.73,,,888.73,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Connecticare,Exchange,,933.62,,,933.62,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Connecticare,Exchange,,888.73,,,888.73,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,Multiplan,Multiplan,,,1106.46,,1106.46,715.03,1106.46,percent of total billed charges,,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,Multiplan,Multiplan,,,1053.26,,1053.26,680.64,1053.26,percent of total billed charges,,
HC REPAIR CVA DEVICE W PORT/PUMP,36576,CPT,,,both,,,1380.99,828.6,United Healthcare/Oxford,United Healthcare/Oxford,,898.32,,,898.32,715.03,1106.46,other,Could be inpatient or outpatient,
HC REPAIR CVA DEVICE W PORT/PUMP-RAD HH SVCS,36576,CPT,,,both,,,1314.59,788.75,United Healthcare/Oxford,United Healthcare/Oxford,,855.13,,,855.13,680.64,1053.26,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT  ,,,both,,,5548.61,3329.17,Aetna,Commerical,,4013.47,,,4013.47,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Aetna,Middlesex Employees,,3612.12,,,3612.12,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Anthem,Commerical,,3591.16,,,3591.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Anthem,Indemnity,,,4035.51,,4035.51,2872.93,4445.7,percent of total billed charges,,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Anthem,State Preferred,,3591.16,,,3591.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Anthem,Individual Exchange,,2872.93,,,2872.93,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Cigna,Cigna,,3507.16,,,3507.16,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Connecticare,Commerical,,3751.22,,,3751.22,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Connecticare,Exchange,,3751.22,,,3751.22,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,Multiplan,Multiplan,,,4445.7,,4445.7,2872.93,4445.7,percent of total billed charges,,
HC REPLACE CATH ONLY OF VAD,36578,CPT,,,both,,,5548.61,3329.17,United Healthcare/Oxford,United Healthcare/Oxford,,3609.39,,,3609.39,2872.93,4445.7,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT  ,,,both,,,2455.52,1473.31,Aetna,Commerical,,1777.16,,,1777.16,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Aetna,Middlesex Employees,,1599.45,,,1599.45,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Anthem,Commerical,,1590.16,,,1590.16,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Anthem,Indemnity,,,1786.92,,1786.92,1272.13,1968.55,percent of total billed charges,,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Anthem,State Preferred,,1590.16,,,1590.16,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Anthem,Individual Exchange,,1272.13,,,1272.13,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Cigna,Cigna,,1552.97,,,1552.97,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Connecticare,Commerical,,1661.03,,,1661.03,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Connecticare,Exchange,,1661.03,,,1661.03,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,Multiplan,Multiplan,,,1968.55,,1968.55,1272.13,1968.55,percent of total billed charges,,
HC REPLACE NON-TUNNELED CV CATH,36580,CPT,,,both,,,2455.52,1473.31,United Healthcare/Oxford,United Healthcare/Oxford,,1598.23,,,1598.23,1272.13,1968.55,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT  ,,,both,,,1430.52,858.31,Aetna,Commerical,,1034.71,,,1034.71,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT  ,,,both,,,1501.43,900.86,Aetna,Commerical,,1086,,,1086,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Aetna,Middlesex Employees,,931.24,,,931.24,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Aetna,Middlesex Employees,,977.4,,,977.4,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Anthem,Commerical,,925.84,,,925.84,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Anthem,Commerical,,971.73,,,971.73,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Anthem,Indemnity,,,1040.39,,1040.39,740.67,1146.14,percent of total billed charges,,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Anthem,Indemnity,,,1091.96,,1091.96,777.39,1202.95,percent of total billed charges,,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Anthem,State Preferred,,925.84,,,925.84,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Anthem,State Preferred,,971.73,,,971.73,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Anthem,Individual Exchange,,740.67,,,740.67,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Anthem,Individual Exchange,,777.39,,,777.39,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Cigna,Cigna,,904.18,,,904.18,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Cigna,Cigna,,949,,,949,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Connecticare,Commerical,,967.1,,,967.1,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Connecticare,Commerical,,1015.04,,,1015.04,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Connecticare,Exchange,,967.1,,,967.1,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Connecticare,Exchange,,1015.04,,,1015.04,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,Multiplan,Multiplan,,,1146.14,,1146.14,740.67,1146.14,percent of total billed charges,,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,Multiplan,Multiplan,,,1202.95,,1202.95,777.39,1202.95,percent of total billed charges,,
HC REPLACE TUNNELED CV CATH,36581,CPT,,,both,,,1430.52,858.31,United Healthcare/Oxford,United Healthcare/Oxford,,930.53,,,930.53,740.67,1146.14,other,Could be inpatient or outpatient,
HC REPLACE TUNNELED CV CATH-RAD HH SVCS,36581,CPT,,,both,,,1501.43,900.86,United Healthcare/Oxford,United Healthcare/Oxford,,976.66,,,976.66,777.39,1202.95,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT  ,,,both,,,6653.8,3992.28,Aetna,Commerical,,4812.91,,,4812.91,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Aetna,Middlesex Employees,,4331.61,,,4331.61,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Anthem,Commerical,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Anthem,Indemnity,,,4839.34,,4839.34,3445.18,5331.23,percent of total billed charges,,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Anthem,State Preferred,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Anthem,Individual Exchange,,3445.18,,,3445.18,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Cigna,Cigna,,4205.75,,,4205.75,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Connecticare,Commerical,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Connecticare,Exchange,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,Multiplan,Multiplan,,,5331.23,,5331.23,3445.18,5331.23,percent of total billed charges,,
HC REPL TUNNELED VAD W PORT,36582,CPT,,,both,,,6653.8,3992.28,United Healthcare/Oxford,United Healthcare/Oxford,,4328.34,,,4328.34,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT  ,,,both,,,6653.8,3992.28,Aetna,Commerical,,4812.91,,,4812.91,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Aetna,Middlesex Employees,,4331.61,,,4331.61,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Anthem,Commerical,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Anthem,Indemnity,,,4839.34,,4839.34,3445.18,5331.23,percent of total billed charges,,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Anthem,State Preferred,,4306.48,,,4306.48,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Anthem,Individual Exchange,,3445.18,,,3445.18,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Cigna,Cigna,,4205.75,,,4205.75,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Connecticare,Commerical,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Connecticare,Exchange,,4498.42,,,4498.42,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,Multiplan,Multiplan,,,5331.23,,5331.23,3445.18,5331.23,percent of total billed charges,,
HC REPL TNL CVAD W PUMP,36583,CPT,,,both,,,6653.8,3992.28,United Healthcare/Oxford,United Healthcare/Oxford,,4328.34,,,4328.34,3445.18,5331.23,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT  ,,,both,,,3082.77,1849.66,Aetna,Commerical,,2229.79,,,2229.79,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT  ,,,both,,,2934.2,1760.52,Aetna,Commerical,,2122.33,,,2122.33,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Aetna,Middlesex Employees,,2006.82,,,2006.82,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Aetna,Middlesex Employees,,1910.1,,,1910.1,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Anthem,Commerical,,1995.17,,,1995.17,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Anthem,Commerical,,1899.02,,,1899.02,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Anthem,Indemnity,,,2242.04,,2242.04,1596.14,2469.94,percent of total billed charges,,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Anthem,Indemnity,,,2133.99,,2133.99,1519.21,2350.9,percent of total billed charges,,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Anthem,State Preferred,,1995.17,,,1995.17,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Anthem,State Preferred,,1899.02,,,1899.02,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Anthem,Individual Exchange,,1596.14,,,1596.14,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Anthem,Individual Exchange,,1519.21,,,1519.21,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Cigna,Cigna,,1948.5,,,1948.5,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Cigna,Cigna,,1854.6,,,1854.6,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Connecticare,Commerical,,2084.09,,,2084.09,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Connecticare,Commerical,,1983.65,,,1983.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Connecticare,Exchange,,2084.09,,,2084.09,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Connecticare,Exchange,,1983.65,,,1983.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,Multiplan,Multiplan,,,2469.94,,2649.94,1596.14,2469.94,percent of total billed charges,,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,Multiplan,Multiplan,,,2350.9,,2350.9,1519.21,2350.9,percent of total billed charges,,
HC REPLACE PICC CATH,36584,CPT,,,both,,,3082.77,1849.66,United Healthcare/Oxford,United Healthcare/Oxford,,2005.3,,,2005.3,1596.14,2469.94,other,Could be inpatient or outpatient,
HC REPLACE PICC CATH-RAD HH SVCS,36584,CPT,,,both,,,2934.2,1760.52,United Healthcare/Oxford,United Healthcare/Oxford,,1908.65,,,1908.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT  ,,,both,,,2922.11,1753.27,Aetna,Commerical,,2113.38,,,2113.38,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Aetna,Middlesex Employees,,1902.05,,,1902.05,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Anthem,Commerical,,1891.01,,,1891.01,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Anthem,Indemnity,,,2124.99,,2124.99,1512.81,2340.99,percent of total billed charges,,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Anthem,State Preferred,,1891.01,,,1891.01,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Anthem,Individual Exchange,,1512.81,,,1512.81,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Cigna,Cigna,,1846.78,,,1846.78,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Connecticare,Commerical,,1975.28,,,1975.28,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Connecticare,Exchange,,1975.28,,,1975.28,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,Multiplan,Multiplan,,,2340.99,,2340.99,1512.81,2340.99,percent of total billed charges,,
HC REPL PERIPH VAD W PORT,36585,CPT,,,both,,,2922.11,1753.27,United Healthcare/Oxford,United Healthcare/Oxford,,1900.6,,,1900.6,1512.81,2340.99,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT  ,,,both,,,2756.28,1653.77,Aetna,Commerical,,1993.71,,,1993.71,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Aetna,Middlesex Employees,,1794.35,,,1794.35,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Anthem,Commerical,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Anthem,Indemnity,,,2004.65,,2004.65,1427.14,2208.42,percent of total billed charges,,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Anthem,State Preferred,,1783.93,,,1783.93,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Anthem,Individual Exchange,,1427.14,,,1427.14,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Cigna,Cigna,,1742.2,,,1742.2,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Connecticare,Commerical,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Connecticare,Exchange,,1863.44,,,1863.44,1427.14,2208.42,other,Could be inpatient or outpatient,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,Multiplan,Multiplan,,,2208.42,,2208.42,1427.14,2208.42,percent of total billed charges,,
HC REMOVE TNL CV CATH,36589,CPT,,,both,,,2756.28,1653.77,United Healthcare/Oxford,United Healthcare/Oxford,,1792.98,,,1792.98,1427.14,2208.42,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT  ,,,both,,,6998.92,4199.35,Aetna,Commerical,,5278.39,,,5278.39,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Aetna,Middlesex Employees,,4750.55,,,4750.55,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Anthem,Commerical,,5111.87,,,5111.87,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Anthem,Indemnity,,,5090.19,,5090.19,4089.49,5607.59,percent of total billed charges,,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Anthem,State Preferred,,5111.87,,,5111.87,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Anthem,Individual Exchange,,4089.49,,,4089.49,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Cigna,Cigna,,4575.46,,,4575.46,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Connecticare,Commerical,,,,,,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Connecticare,Exchange,,,,,,4089.49,5607.59,other,Could be inpatient or outpatient,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,Multiplan,Multiplan,,,5607.59,,5607.59,4089.49,5607.59,percent of total billed charges,,
 PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ ,36590,CPT,,,both,,,6998.92,4199.35,United Healthcare/Oxford,United Healthcare/Oxford,,5497.73,,,5497.73,4089.49,5607.59,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT  ,,,both,,,1941.55,1164.93,Aetna,Commerical,,1404.3,,,1404.3,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Aetna,Middlesex Employees,,1263.88,,,1263.88,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Commerical,,1256.54,,,1256.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Indemnity,,,1412.02,,1412.02,1005.23,1555.54,percent of total billed charges,,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Anthem,State Preferred,,1256.54,,,1256.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Individual Exchange,,1005.23,,,1005.23,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Cigna,Cigna,,1227.15,,,1227.15,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Connecticare,Commerical,,1312.54,,,1312.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Connecticare,Exchange,,1312.54,,,1312.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,Multiplan,Multiplan,,,1555.54,,1555.54,1005.23,1555.54,percent of total billed charges,,
HC REM TUNNELED CVAD W PORT/PUMP,36590,CPT,,,both,,,1941.55,1164.93,United Healthcare/Oxford,United Healthcare/Oxford,,1262.92,,,1262.92,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT  ,,,both,,,1941.55,1164.93,Aetna,Commerical,,1404.3,,,1404.3,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Aetna,Middlesex Employees,,1263.88,,,1263.88,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Commerical,,1256.54,,,1256.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Indemnity,,,1412.02,,1412.02,1005.23,1555.54,percent of total billed charges,,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Anthem,State Preferred,,1256.54,,,1256.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Anthem,Individual Exchange,,1005.23,,,1005.23,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Cigna,Cigna,,1227.15,,,1227.15,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Connecticare,Commerical,,1312.54,,,1312.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Connecticare,Exchange,,1312.54,,,1312.54,1005.23,1555.54,other,Could be inpatient or outpatient,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,Multiplan,Multiplan,,,1555.54,,1555.54,1005.23,1555.54,percent of total billed charges,,
HC REMOV TUNNEL CVA W P/P,36590,CPT,,,both,,,1941.55,1164.93,United Healthcare/Oxford,United Healthcare/Oxford,,1262.92,,,1262.92,1005.23,1555.54,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC BLD SPEC COLLECT VAD,36591,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC COLLECT BLOOD FROM PICC,36592,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT  ,,,both,,,707.61,424.57,Aetna,Commerical,,512.07,,,512.07,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Aetna,Middlesex Employees,,460.86,,,460.86,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Anthem,Commerical,,458.18,,,458.18,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Anthem,Indemnity,,,514.88,,514.88,366.55,567.21,percent of total billed charges,,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Anthem,State Preferred,,458.18,,,458.18,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Anthem,Individual Exchange,,366.55,,,366.55,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Cigna,Cigna,,447.47,,,447.47,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Connecticare,Commerical,,478.61,,,478.61,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Connecticare,Exchange,,478.61,,,478.61,366.55,567.21,other,Could be inpatient or outpatient,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,Multiplan,Multiplan,,,567.21,,567.21,366.55,567.21,percent of total billed charges,,
HC DECLOTTING VAD / CATH,36593,CPT,,,both,,,707.61,424.57,United Healthcare/Oxford,United Healthcare/Oxford,,460.51,,,460.51,366.55,567.21,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT  ,,,both,,,675.68,405.41,Aetna,Commerical,,488.46,,,488.46,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Aetna,Middlesex Employees,,439.62,,,439.62,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Anthem,Commerical,,437.06,,,437.06,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Anthem,Indemnity,,,491.14,,491.14,349.64,541.06,percent of total billed charges,,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Anthem,State Preferred,,437.06,,,437.06,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Anthem,Individual Exchange,,349.64,,,349.64,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Cigna,Cigna,,426.84,,,426.84,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Connecticare,Commerical,,456.54,,,456.54,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Connecticare,Exchange,,456.54,,,456.54,349.64,541.06,other,Could be inpatient or outpatient,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,Multiplan,Multiplan,,,541.06,,541.06,349.64,541.06,percent of total billed charges,,
HC HH DECLOT VAD/CAT,36593,CPT,,,both,,,675.68,405.41,United Healthcare/Oxford,United Healthcare/Oxford,,439.27,,,439.27,349.64,541.06,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT  ,,,both,,,5805.08,3483.05,Aetna,Commerical,,4199.09,,,4199.09,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Aetna,Middlesex Employees,,3779.18,,,3779.18,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Anthem,Commerical,,3757.24,,,3757.24,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Anthem,Indemnity,,,4222.14,,4222.14,3005.78,4651.3,percent of total billed charges,,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Anthem,State Preferred,,3757.24,,,3757.24,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Anthem,Individual Exchange,,3005.78,,,3005.78,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Cigna,Cigna,,3669.36,,,3669.36,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Connecticare,Commerical,,3924.69,,,3924.69,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Connecticare,Exchange,,3924.69,,,3924.69,3005.78,4651.3,other,Could be inpatient or outpatient,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,Multiplan,Multiplan,,,4651.3,,4651.3,3005.78,4651.3,percent of total billed charges,,
HC SA MECH REM OBSTR CVAD,36595,CPT,,,both,,,5805.08,3483.05,United Healthcare/Oxford,United Healthcare/Oxford,,3776.31,,,3776.31,3005.78,4651.3,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT  ,,,both,,,2473.03,1483.82,Aetna,Commerical,,1358.82,,,1358.82,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Aetna,Middlesex Employees,,1222.94,,,1222.94,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Anthem,Commerical,,1613.39,,,1613.39,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Anthem,Indemnity,,,1798.38,,1798.38,1222.94,1981.18,percent of total billed charges,,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Anthem,State Preferred,,1613.39,,,1613.39,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Anthem,Individual Exchange,,1290.71,,,1290.71,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Cigna,Cigna,,1854.83,,,1854.83,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Connecticare,Commerical,,1726.78,,,1726.78,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Connecticare,Exchange,,1726.78,,,1726.78,1222.94,1981.18,other,Could be inpatient or outpatient,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,Multiplan,Multiplan,,,1981.18,,1981.18,1222.94,1981.18,percent of total billed charges,,
HC REPOSIT CVC W FLUORO,36597,CPT,,,both,,,2473.03,1483.82,United Healthcare/Oxford,United Healthcare/Oxford,,1506.41,,,1506.41,1222.94,1981.18,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT  ,,,both,,,859.02,515.41,Aetna,Commerical,,621.15,,,621.15,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Aetna,Middlesex Employees,,559.03,,,559.03,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Anthem,Commerical,,555.8,,,555.8,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Anthem,Indemnity,,,624.57,,624.57,444.64,688.05,percent of total billed charges,,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Anthem,State Preferred,,555.8,,,555.8,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Anthem,Individual Exchange,,444.64,,,444.64,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Cigna,Cigna,,542.8,,,542.8,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Connecticare,Commerical,,580.57,,,580.57,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Connecticare,Exchange,,580.57,,,580.57,444.64,688.05,other,Could be inpatient or outpatient,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,Multiplan,Multiplan,,,688.05,,688.05,444.64,688.05,percent of total billed charges,,
HC INJ W/FLUOR EVAL CV DEVICE,36598,CPT,,,both,,,859.02,515.41,United Healthcare/Oxford,United Healthcare/Oxford,,558.61,,,558.61,444.64,688.05,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,40.59,,,40.59,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,36.53,,,36.53,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.82,,40.82,29.05,44.97,percent of total billed charges,,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.05,,,29.05,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,35.47,,,35.47,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.97,,44.97,29.05,44.97,percent of total billed charges,,
HC ARTERIAL ABG DRAW,36600,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,36.5,,,36.5,29.05,44.97,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC ART LINE INS PERC,36620,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC ART LINE INS CUT,36625,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT  ,,,both,,,794.13,476.48,Aetna,Commerical,,574.74,,,574.74,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Aetna,Middlesex Employees,,517.27,,,517.27,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Anthem,Commerical,,514.27,,,514.27,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Anthem,Indemnity,,,577.91,,577.91,411.41,636.65,percent of total billed charges,,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Anthem,State Preferred,,514.27,,,514.27,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Anthem,Individual Exchange,,411.41,,,411.41,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Cigna,Cigna,,502.25,,,502.25,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Connecticare,Commerical,,537.19,,,537.19,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Connecticare,Exchange,,537.19,,,537.19,411.41,636.65,other,Could be inpatient or outpatient,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,Multiplan,Multiplan,,,636.65,,636.65,411.41,636.65,percent of total billed charges,,
HC INTRAOSSEOUS INF NDL PLC,36680,CPT,,,both,,,794.13,476.48,United Healthcare/Oxford,United Healthcare/Oxford,,516.88,,,516.88,411.41,636.65,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT  ,,,both,,,4316.73,2590.04,Aetna,Commerical,,3122.04,,,3122.04,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Aetna,Middlesex Employees,,2809.83,,,2809.83,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Anthem,Commerical,,2793.53,,,2793.53,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Anthem,Indemnity,,,3139.18,,3139.18,2234.82,3458.27,percent of total billed charges,,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Anthem,State Preferred,,2793.53,,,2793.53,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Anthem,Individual Exchange,,2234.82,,,2234.82,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Cigna,Cigna,,2728.19,,,2728.19,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Connecticare,Commerical,,2918.04,,,2918.04,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Connecticare,Exchange,,2918.04,,,2918.04,2234.82,3458.27,other,Could be inpatient or outpatient,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,Multiplan,Multiplan,,,3458.27,,3458.27,2234.82,3458.27,percent of total billed charges,,
HC HH THROMB AV FIST,36870,CPT,,,both,,,4316.73,2590.04,United Healthcare/Oxford,United Healthcare/Oxford,,2807.71,,,2807.71,2234.82,3458.27,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT  ,,,both,,,3684.31,2210.59,Aetna,Commerical,,2665.34,,,2665.34,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Aetna,Middlesex Employees,,2398.81,,,2398.81,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Anthem,Commerical,,2384.88,,,2384.88,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Anthem,Indemnity,,,2679.97,,2679.97,1907.9,2952.38,percent of total billed charges,,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Anthem,State Preferred,,2384.88,,,2384.88,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Anthem,Individual Exchange,,1907.9,,,1907.9,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Cigna,Cigna,,2329.1,,,2329.1,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Connecticare,Commerical,,2491.17,,,2491.17,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Connecticare,Exchange,,2491.17,,,2491.17,1907.9,2952.38,other,Could be inpatient or outpatient,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,Multiplan,Multiplan,,,2952.38,,2952.38,1907.9,2952.38,percent of total billed charges,,
HC OPEN PORTACAV VEN ANASTAM,37140,CPT,,,both,,,3684.31,2210.59,United Healthcare/Oxford,United Healthcare/Oxford,,2396.99,,,2396.99,1907.9,2952.38,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT  ,,,both,,,8386.17,5031.7,Aetna,Commerical,,6065.79,,,6065.79,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT  ,,,both,,,10583.16,6349.89,Aetna,Commerical,,7654.9,,,7654.9,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Aetna,Middlesex Employees,,5459.22,,,5459.22,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Aetna,Middlesex Employees,,6889.4,,,6889.4,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Anthem,Commerical,,5427.53,,,5427.53,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Anthem,Commerical,,6849.42,,,6849.42,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Anthem,Indemnity,,,6099.11,,6099.11,4342.02,6719.05,percent of total billed charges,,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Anthem,Indemnity,,,7696.93,,7696.93,4342.02,8479.29,percent of total billed charges,,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Anthem,State Preferred,,5427.53,,,5427.53,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Anthem,State Preferred,,6849.42,,,6849.42,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Anthem,Individual Exchange,,4342.02,,,4342.02,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Anthem,Individual Exchange,,5479.54,,,5479.54,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Cigna,Cigna,,5300.59,,,5300.59,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Cigna,Cigna,,6689.23,,,6689.23,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Connecticare,Commerical,,5669.43,,,5669.43,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Connecticare,Commerical,,7154.7,,,7154.7,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Connecticare,Exchange,,5669.43,,,5669.43,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Connecticare,Exchange,,7154.7,,,7154.7,4342.02,8479.29,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,Multiplan,Multiplan,,,6719.05,,6719.05,4342.02,6719.05,percent of total billed charges,,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,Multiplan,Multiplan,,,8479.29,,8479.29,4342.02,8479.29,percent of total billed charges,,
HC INS ENDOVAS VENA CAVA FILTR,37191,CPT,,,both,,,8386.17,5031.7,United Healthcare/Oxford,United Healthcare/Oxford,,5455.08,,,5455.08,4342.02,6719.05,other,Could be inpatient or outpatient,
HC INS ENDOVAS VENA CAVA FILTR-2,37191,CPT,,,both,,,10583.16,6349.89,United Healthcare/Oxford,United Healthcare/Oxford,,6884.19,,,6884.19,4342.02,8479.29,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT  ,,,both,,,11214.64,6728.78,Aetna,Commerical,,8111.61,,,8111.61,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Aetna,Middlesex Employees,,7300.45,,,7300.45,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Anthem,Commerical,,7258.07,,,7258.07,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Anthem,Indemnity,,,8156.15,,8156.15,5806.45,8985.19,percent of total billed charges,,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Anthem,State Preferred,,7258.07,,,7258.07,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Anthem,Individual Exchange,,5806.45,,,5806.45,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Cigna,Cigna,,7088.32,,,7088.32,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Connecticare,Commerical,,7581.56,,,7581.56,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Connecticare,Exchange,,7581.56,,,7581.56,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,Multiplan,Multiplan,,,8985.19,,8985.19,5806.45,8985.19,percent of total billed charges,,
HC TRANSCATH RETRIEVAL FB,37197,CPT,,,both,,,11214.64,6728.78,United Healthcare/Oxford,United Healthcare/Oxford,,7294.91,,,7294.91,5806.45,8985.19,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT  ,,,both,,,1368.87,821.32,Aetna,Commerical,,989.94,,,989.94,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Aetna,Middlesex Employees,,890.95,,,890.95,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Anthem,Commerical,,885.77,,,885.77,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Anthem,Indemnity,,,995.37,,995.37,708.62,1096.54,percent of total billed charges,,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Anthem,State Preferred,,885.77,,,885.77,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Anthem,Individual Exchange,,708.62,,,708.62,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Cigna,Cigna,,865.05,,,865.05,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Connecticare,Commerical,,925.25,,,925.25,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Connecticare,Exchange,,925.25,,,925.25,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,Multiplan,Multiplan,,,1096.54,,1096.54,708.62,1096.54,percent of total billed charges,,
HC TRANSCATHETER BX,37200,CPT,,,both,,,1368.87,821.32,United Healthcare/Oxford,United Healthcare/Oxford,,890.27,,,890.27,708.62,1096.54,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT  ,,,both,,,1990.99,1194.59,Aetna,Commerical,,1440.12,,,1440.12,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Aetna,Middlesex Employees,,1296.11,,,1296.11,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Anthem,Commerical,,1288.6,,,1288.6,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Anthem,Indemnity,,,1448.03,,1448.03,1030.88,1595.22,percent of total billed charges,,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Anthem,State Preferred,,1288.6,,,1288.6,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Anthem,Individual Exchange,,1030.88,,,1030.88,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Cigna,Cigna,,1258.45,,,1258.45,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Connecticare,Commerical,,1346.02,,,1346.02,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Connecticare,Exchange,,1346.02,,,1346.02,1030.88,1595.22,other,Could be inpatient or outpatient,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,Multiplan,Multiplan,,,1595.22,,1595.22,1030.88,1595.22,percent of total billed charges,,
HC TRANSCATH RK37202,37202,CPT,,,both,,,1990.99,1194.59,United Healthcare/Oxford,United Healthcare/Oxford,,1295.13,,,1295.13,1030.88,1595.22,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT  ,,,both,,,14751.66,8851,Aetna,Commerical,,10670.3,,,10670.3,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Aetna,Middlesex Employees,,9603.27,,,9603.27,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Anthem,Commerical,,9547.53,,,9547.53,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Anthem,Indemnity,,,10728.89,,10728.89,7638.03,11819.44,percent of total billed charges,,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Anthem,State Preferred,,9547.53,,,9547.53,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Anthem,Individual Exchange,,7638.03,,,7638.03,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Cigna,Cigna,,9324.22,,,9324.22,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Connecticare,Commerical,,9973.06,,,9973.06,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Connecticare,Exchange,,9973.06,,,9973.06,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,Multiplan,Multiplan,,,11819.44,,11819.44,7638.03,11819.44,percent of total billed charges,,
HC HH EMBOLNONNEURO,37204,CPT,,,both,,,14751.66,8851,United Healthcare/Oxford,United Healthcare/Oxford,,9595.98,,,9595.98,7638.03,11819.44,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT  ,,,both,,,7432.48,4459.49,Aetna,Commerical,,5376.26,,,5376.26,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Aetna,Middlesex Employees,,4838.64,,,4838.64,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Anthem,Commerical,,4810.55,,,4810.55,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Anthem,Indemnity,,,5405.78,,5405.78,3848.44,5955.25,percent of total billed charges,,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Anthem,State Preferred,,4810.55,,,4810.55,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Anthem,Individual Exchange,,3848.44,,,3848.44,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Cigna,Cigna,,4698.03,,,4698.03,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Connecticare,Commerical,,5024.95,,,5024.95,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Connecticare,Exchange,,5024.95,,,5024.95,3848.44,5955.25,other,Could be inpatient or outpatient,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,Multiplan,Multiplan,,,5955.25,,5955.25,3848.44,5955.25,percent of total billed charges,,
HC HH VASC STENT IR,37205,CPT,,,both,,,7432.48,4459.49,United Healthcare/Oxford,United Healthcare/Oxford,,4834.96,,,4834.96,3848.44,5955.25,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT  ,,,both,,,4477.41,2686.45,Aetna,Commerical,,3238.46,,,3238.46,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Aetna,Middlesex Employees,,2914.61,,,2914.61,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Anthem,Commerical,,2897.69,,,2897.69,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Anthem,Indemnity,,,3256.24,,3256.24,2318.15,3587.22,percent of total billed charges,,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Anthem,State Preferred,,2897.69,,,2897.69,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Anthem,Individual Exchange,,2318.15,,,2318.15,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Cigna,Cigna,,2829.92,,,2829.92,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Connecticare,Commerical,,3026.84,,,3026.84,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Connecticare,Exchange,,3026.84,,,3026.84,2318.15,3587.22,other,Could be inpatient or outpatient,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,Multiplan,Multiplan,,,3587.22,,3587.22,2318.15,3587.22,percent of total billed charges,,
HC THROMBOLYTIC ART THERAPY,37211,CPT,,,both,,,4477.41,2686.45,United Healthcare/Oxford,United Healthcare/Oxford,,2912.4,,,2912.4,2318.15,3587.22,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT  ,,,both,,,47288.33,28373,Aetna,Commerical,,34204.86,,,34204.86,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Aetna,Middlesex Employees,,30784.37,,,30784.37,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Anthem,Commerical,,30605.71,,,30605.71,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Anthem,Indemnity,,,34392.69,,34392.69,24484.56,37888.55,percent of total billed charges,,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Anthem,State Preferred,,30605.71,,,30605.71,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Anthem,Individual Exchange,,24484.56,,,24484.56,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Cigna,Cigna,,29889.87,,,29889.87,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Connecticare,Commerical,,31969.79,,,31969.79,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Connecticare,Exchange,,31969.79,,,31969.79,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,Multiplan,Multiplan,,,37888.55,,37888.55,24484.56,37888.55,percent of total billed charges,,
HC  OPEN/PERQ PLACE STENT 1ST,37236,CPT,,,both,,,47288.33,28373,United Healthcare/Oxford,United Healthcare/Oxford,,30761.05,,,30761.05,24484.56,37888.55,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT  ,,,both,,,18625.49,11175.29,Aetna,Commerical,,13472.4,,,13472.4,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Aetna,Middlesex Employees,,12125.16,,,12125.16,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Anthem,Commerical,,12054.79,,,12054.79,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Anthem,Indemnity,,,13546.38,,13546.38,9643.83,14923.31,percent of total billed charges,,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Anthem,State Preferred,,12054.79,,,12054.79,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Anthem,Individual Exchange,,9643.83,,,9643.83,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Cigna,Cigna,,11772.83,,,11772.83,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Connecticare,Commerical,,12592.06,,,12592.06,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Connecticare,Exchange,,12592.06,,,12592.06,9643.83,14923.31,other,Could be inpatient or outpatient,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,Multiplan,Multiplan,,,14923.31,,14923.31,9643.83,14923.31,percent of total billed charges,,
HC  OPEN/PERQ PLACE STENT EA ADD,37237,CPT,,,both,,,18625.49,11175.29,United Healthcare/Oxford,United Healthcare/Oxford,,12115.97,,,12115.97,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT  ,,,both,,,19592.66,11755.6,Aetna,Commerical,,14171.7,,,14171.7,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Aetna,Middlesex Employees,,12754.53,,,12754.53,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Anthem,Commerical,,12680.51,,,12680.51,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Anthem,Indemnity,,,14249.53,,14248.53,10144.41,15697.93,percent of total billed charges,,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Anthem,State Preferred,,12680.51,,,12680.51,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Anthem,Individual Exchange,,10144.41,,,10144.41,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Cigna,Cigna,,12383.92,,,12383.92,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Connecticare,Commerical,,13245.67,,,13245.67,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Connecticare,Exchange,,13245.67,,,13245.67,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,Multiplan,Multiplan,,,15697.93,,15697.93,10144.41,15697.93,percent of total billed charges,,
HC OPEN/PERQ PLACE STENT SAME,37238,CPT,,,both,,,19592.66,11755.6,United Healthcare/Oxford,United Healthcare/Oxford,,12744.87,,,12744.87,10144.41,15697.93,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT  ,,,both,,,18625.49,11175.29,Aetna,Commerical,,13472.4,,,13472.4,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Aetna,Middlesex Employees,,12125.16,,,12125.16,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Anthem,Commerical,,12054.79,,,12054.79,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Anthem,Indemnity,,,13546.38,,13546.38,9643.83,14923.31,percent of total billed charges,,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Anthem,State Preferred,,12054.79,,,12054.79,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Anthem,Individual Exchange,,9643.83,,,9643.83,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Cigna,Cigna,,11772.83,,,11772.83,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Connecticare,Commerical,,12592.06,,,12592.06,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Connecticare,Exchange,,12592.06,,,12592.06,9643.83,14923.31,other,Could be inpatient or outpatient,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,Multiplan,Multiplan,,,14923.31,,14923.31,9643.83,14923.31,percent of total billed charges,,
HC OPEN/PERQ PLACE STENT EA ADD,37239,CPT,,,both,,,18625.49,11175.29,United Healthcare/Oxford,United Healthcare/Oxford,,12115.97,,,12115.97,9643.83,14923.31,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT  ,,,both,,,47288.33,28373,Aetna,Commerical,,34204.86,,,34204.86,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Aetna,Middlesex Employees,,30784.37,,,30784.37,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Anthem,Commerical,,30605.71,,,30605.71,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Anthem,Indemnity,,,34392.69,,34392.69,24484.56,37888.55,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Anthem,State Preferred,,30605.71,,,30605.71,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Anthem,Individual Exchange,,24484.56,,,24484.56,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Cigna,Cigna,,29889.87,,,29889.87,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Connecticare,Commerical,,31969.79,,,31969.79,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Connecticare,Exchange,,31969.79,,,31969.79,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,Multiplan,Multiplan,,,37888.55,,37888.55,24484.56,37888.55,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE VENOUS,37241,CPT,,,both,,,47288.33,28373,United Healthcare/Oxford,United Healthcare/Oxford,,30761.05,,,30761.05,24484.56,37888.55,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT  ,,,both,,,21914.28,13148.57,Aetna,Commerical,,15850.36,,,15850.36,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Aetna,Middlesex Employees,,14265.33,,,14265.33,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Anthem,Commerical,,14182.53,,,14182.53,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Anthem,Indemnity,,,15937.4,,15937.4,11346.02,17557.36,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Anthem,State Preferred,,14182.53,,,14182.53,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Anthem,Individual Exchange,,11346.02,,,11346.02,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Cigna,Cigna,,13850.81,,,13850.81,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Connecticare,Commerical,,14814.64,,,14814.64,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Connecticare,Exchange,,14814.64,,,14814.64,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,Multiplan,Multiplan,,,17557.36,,17557.36,11346.02,17557.36,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE ARTERY,37242,CPT,,,both,,,21914.28,13148.57,United Healthcare/Oxford,United Healthcare/Oxford,,14254.51,,,14254.51,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT  ,,,both,,,20870.89,12522.53,Aetna,Commerical,,15096.51,,,15096.51,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Aetna,Middlesex Employees,,13586.86,,,13586.86,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Anthem,Commerical,,13508,,,13508,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Anthem,Indemnity,,,15179.41,,15179.41,10806.4,16722.33,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Anthem,State Preferred,,13508,,,13508,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Anthem,Individual Exchange,,10806.4,,,10806.4,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Cigna,Cigna,,13192.07,,,13192.07,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Connecticare,Commerical,,14110.05,,,14110.05,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Connecticare,Exchange,,14110.05,,,14110.05,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,Multiplan,Multiplan,,,16722.33,,16722.33,10806.4,16722.33,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE ORGAN,37243,CPT,,,both,,,20870.89,12522.53,United Healthcare/Oxford,United Healthcare/Oxford,,13576.56,,,13576.56,10806.4,16722.33,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT  ,,,both,,,21914.28,13148.57,Aetna,Commerical,,15850.36,,,15850.36,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Aetna,Middlesex Employees,,14265.33,,,14265.33,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Anthem,Commerical,,14182.53,,,14182.53,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Anthem,Indemnity,,,15937.4,,15937.4,11346.02,17557.36,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Anthem,State Preferred,,14182.53,,,14182.53,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Anthem,Individual Exchange,,11346.02,,,11346.02,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Cigna,Cigna,,13850.81,,,13850.81,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Connecticare,Commerical,,14814.64,,,14814.64,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Connecticare,Exchange,,14814.64,,,14814.64,11346.02,17557.36,other,Could be inpatient or outpatient,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,Multiplan,Multiplan,,,17557.36,,17557.36,11346.02,17557.36,percent of total billed charges,,
HC VASC EMBOLIZE/OCCLUDE BLEED,37244,CPT,,,both,,,21914.28,13148.57,United Healthcare/Oxford,United Healthcare/Oxford,,14254.51,,,14254.51,11346.02,17557.36,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT  ,,,both,,,3940.78,2364.47,Aetna,Commerical,,2850.95,,,2850.95,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Aetna,Middlesex Employees,,2565.86,,,2565.86,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Anthem,Commerical,,2550.96,,,2550.96,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Anthem,Indemnity,,,2866.6,,2866.6,2040.77,3157.98,percent of total billed charges,,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Anthem,State Preferred,,2550.96,,,2550.96,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Anthem,Individual Exchange,,2040.77,,,2040.77,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Cigna,Cigna,,2491.3,,,2491.3,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Connecticare,Commerical,,2664.66,,,2664.66,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Connecticare,Exchange,,2664.66,,,2664.66,2040.77,3157.98,other,Could be inpatient or outpatient,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,Multiplan,Multiplan,,,3157.98,,3157.98,2040.77,3157.98,percent of total billed charges,,
HC UNLISTEDPROC VASC,37799,CPT,,,both,,,3940.78,2364.47,United Healthcare/Oxford,United Healthcare/Oxford,,2563.91,,,2563.91,2040.77,3157.98,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT  ,,,both,,,5185.23,3111.14,Aetna,Commerical,,3750.52,,,3750.52,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Aetna,Middlesex Employees,,3375.46,,,3375.46,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Anthem,Commerical,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Anthem,Indemnity,,,3771.12,,3771.12,2684.7,4154.43,percent of total billed charges,,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Anthem,State Preferred,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Anthem,Individual Exchange,,2684.7,,,2684.7,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Cigna,Cigna,,3277.38,,,3277.38,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Connecticare,Commerical,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Connecticare,Exchange,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,Multiplan,Multiplan,,,4154.43,,4154.43,2684.7,4154.43,percent of total billed charges,,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL ALLOGENIC,38205,CPT,,,both,,,5185.23,3111.14,United Healthcare/Oxford,United Healthcare/Oxford,,3372.91,,,3372.91,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT  ,,,both,,,5185.23,3111.14,Aetna,Commerical,,3750.52,,,3750.52,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Aetna,Middlesex Employees,,3375.46,,,3375.46,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Anthem,Commerical,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Anthem,Indemnity,,,3771.12,,3771.12,2684.7,4154.43,percent of total billed charges,,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Anthem,State Preferred,,3355.87,,,3355.87,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Anthem,Individual Exchange,,2684.7,,,2684.7,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Cigna,Cigna,,3277.38,,,3277.38,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Connecticare,Commerical,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Connecticare,Exchange,,3505.45,,,3505.45,2684.7,4154.43,other,Could be inpatient or outpatient,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,Multiplan,Multiplan,,,4154.43,,4154.43,2684.7,4154.43,percent of total billed charges,,
HC BLD -DERIVED HEMATOPOETIC CELL HARVEST FOR TRANSPLNT PER COLL AUTOLOGOUS,38206,CPT,,,both,,,5185.23,3111.14,United Healthcare/Oxford,United Healthcare/Oxford,,3372.91,,,3372.91,2684.7,4154.43,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW ASPIRATION(S),38220,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.6,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW BIOPSY,38221,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.4,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.1,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Aetna,Commerical,50,6580.7,,,6580.7,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.4,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Aetna,Middlesex Employees,50,5922.6,,,5922.6,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.5,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Anthem,Commerical,50,5888.3,,,5888.3,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.2,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Anthem,Indemnity,50,,6835.95756,,6835.95756,4710.6,7289.4,percent of total billed charges,,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.5,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Anthem,State Preferred,50,5888.3,,,5888.3,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.4,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Anthem,Individual Exchange,50,4710.6,,,4710.6,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.7,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Cigna,Cigna,50,5750.5,,,5750.5,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.5,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Connecticare,Commerical,50,6150.7,,,6150.7,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.5,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Connecticare,Exchange,50,6150.7,,,6150.7,4710.6,7289.4,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.6,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,Multiplan,Multiplan,50,,7735.0425,,7735.0425,4710.6,7735.0425,percent of total billed charges,,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.4,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC DX BONE MARROW BX AND ASPIRATION(S),38222,CPT  ,,,both,,,9100.05,5460.03,United Healthcare/Oxford,United Healthcare/Oxford,50,5918.2,,,5918.2,4710.6,7289.4,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT  ,,,both,,,1393.37,836.02,Aetna,Commerical,,765.7,,,765.69,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT  ,,,both,,,1810.95,1086.57,Aetna,Commerical,,1309.9,,,1309.88,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Aetna,Middlesex Employees,,689.1,,,689.11,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Aetna,Middlesex Employees,,1178.9,,,1178.89,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Anthem,Commerical,,909.1,,,909.14,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Anthem,Commerical,,1172,,,1172.04,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Anthem,Indemnity,,,1013.38,,1013.38,689.11,1116.38,percent of total billed charges,,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Anthem,Indemnity,,,1317.07,,1317.07,937.64,1450.94,percent of total billed charges,,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Anthem,State Preferred,,909.14,,,909.14,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Anthem,State Preferred,,1172.04,,,1172.04,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Anthem,Individual Exchange,,727.32,,,727.32,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Anthem,Individual Exchange,,937.64,,,937.64,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Cigna,Cigna,,1045.19,,,1045.19,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Cigna,Cigna,,1144.63,,,1144.63,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Connecticare,Commerical,,973.03,,,973.03,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Connecticare,Commerical,,1224.28,,,1224.28,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Connecticare,Exchange,,973.03,,,973.03,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Connecticare,Exchange,,1224.28,,,1224.28,937.64,1450.94,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,Multiplan,Multiplan,,,1116.38,,1116.38,689.11,1116.38,percent of total billed charges,,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,Multiplan,Multiplan,,,1450.94,,1450.94,937.64,1450.94,percent of total billed charges,,
HC PERC BX OR EXC LN; SUPERFICIAL,38505,CPT,,,both,,,1393.37,836.02,United Healthcare/Oxford,United Healthcare/Oxford,,848.85,,,848.85,689.11,1116.38,other,Could be inpatient or outpatient,
HC PERC BX OR EXC LN; SUPERFICIAL-OR,38505,CPT,,,both,,,1810.95,1086.57,United Healthcare/Oxford,United Healthcare/Oxford,,1177.99,,,1177.99,937.64,1450.94,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT  ,,,both,,,780.74,468.44,Aetna,Commerical,,564.98,,,564.98,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Aetna,Middlesex Employees,,508.48,,,508.48,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Anthem,Commerical,,505.54,,,505.54,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Anthem,Indemnity,,,568.08,,568.08,404.43,625.82,percent of total billed charges,,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Anthem,State Preferred,,505.54,,,505.54,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Anthem,Individual Exchange,,404.43,,,404.43,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Cigna,Cigna,,493.71,,,493.71,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Connecticare,Commerical,,528.06,,,528.06,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Connecticare,Exchange,,528.06,,,528.06,404.43,625.82,other,Could be inpatient or outpatient,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,Multiplan,Multiplan,,,625.82,,625.82,404.43,625.82,percent of total billed charges,,
HC HH INJ LYMPHANGIO,38790,CPT,,,both,,,780.74,468.44,United Healthcare/Oxford,United Healthcare/Oxford,,508.1,,,508.1,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT  ,,,both,,,1687.14,1012.28,Aetna,Commerical,,1220.32,,,1220.32,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Aetna,Middlesex Employees,,1098.29,,,1098.29,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Anthem,Commerical,,1091.91,,,1091.91,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Anthem,Indemnity,,,1227.02,,1227.02,873.53,1351.75,percent of total billed charges,,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Anthem,State Preferred,,1091.91,,,1091.91,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Anthem,Individual Exchange,,873.53,,,873.53,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Cigna,Cigna,,1066.37,,,1066.37,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Connecticare,Commerical,,1140.58,,,1140.58,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Connecticare,Exchange,,1140.58,,,1140.58,873.53,1351.75,other,Could be inpatient or outpatient,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,Multiplan,Multiplan,,,1351.75,,1351.75,873.53,1351.75,percent of total billed charges,,
HC HH HEMIC/LYMPHSYS,38999,CPT,,,both,,,1687.14,1012.28,United Healthcare/Oxford,United Healthcare/Oxford,,1097.45,,,1097.45,873.53,1351.75,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT  ,,,both,,,938.33,563,Aetna,Commerical,,678.14,,,678.14,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Aetna,Middlesex Employees,,610.33,,,610.33,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Anthem,Commerical,,606.78,,,606.78,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Anthem,Indemnity,,,681.86,,681.86,485.43,751.17,percent of total billed charges,,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Anthem,State Preferred,,606.78,,,606.78,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Anthem,Individual Exchange,,485.43,,,485.43,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Cigna,Cigna,,592.59,,,592.59,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Connecticare,Commerical,,633.82,,,633.82,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Connecticare,Exchange,,633.82,,,633.82,485.43,751.17,other,Could be inpatient or outpatient,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,Multiplan,Multiplan,,,751.17,,751.17,485.43,751.17,percent of total billed charges,,
HC UNLISTED HEMIC OR LYMP SYS,38999,CPT,,,both,,,938.33,563,United Healthcare/Oxford,United Healthcare/Oxford,,609.86,,,609.86,485.43,751.17,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT  ,,,both,,,2070.3,1242.18,Aetna,Commerical,,1497.11,,,1497.11,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Aetna,Middlesex Employees,,1347.4,,,1347.4,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Anthem,Commerical,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Anthem,Indemnity,,,1505.34,,1505.34,1071.66,1658.35,percent of total billed charges,,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Anthem,State Preferred,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Anthem,Individual Exchange,,1071.66,,,1071.66,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Cigna,Cigna,,1308.25,,,1308.25,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Connecticare,Commerical,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Connecticare,Exchange,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,Multiplan,Multiplan,,,1658.35,,1658.35,1071.66,1658.35,percent of total billed charges,,
HC REPAIR LIP FT; VERMILION ONLY,40650,CPT,,,both,,,2070.3,1242.18,United Healthcare/Oxford,United Healthcare/Oxford,,1346.39,,,1346.39,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC REPAIR LIP FT; UP TO HALF VERTICAL HGHT,40652,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX,40654,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT  ,,,both,,,851.81,511.09,Aetna,Commerical,,569.31,,,569.31,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Aetna,Middlesex Employees,,512.38,,,512.38,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Anthem,Commerical,,472.49,,,472.49,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Anthem,Indemnity,,,619.57,,619.57,377.99,682.55,percent of total billed charges,,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Anthem,State Preferred,,472.49,,,472.49,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Anthem,Individual Exchange,,377.99,,,377.99,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Cigna,Cigna,,501.49,,,501.49,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Connecticare,Commerical,,514.42,,,514.42,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Connecticare,Exchange,,514.42,,,514.42,377.99,682.55,other,Could be inpatient or outpatient,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,Multiplan,Multiplan,,,682.55,,682.55,377.99,682.55,percent of total billed charges,,
HC UNLISTED PROCEDURE OF THE LIPS,40799,CPT,,,both,,,851.81,511.09,United Healthcare/Oxford,United Healthcare/Oxford,,527.35,,,527.35,377.99,682.55,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC DR ABSC CYST HEMAT-MOUTH; SIMPLE,40800,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT  ,,,both,,,1787.05,1072.23,Aetna,Commerical,,1193.91,,,1193.91,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Aetna,Middlesex Employees,,1074.52,,,1074.52,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Anthem,Commerical,,990.86,,,990.86,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Anthem,Indemnity,,,1299.33,,1299.33,792.69,1431.4,percent of total billed charges,,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Anthem,State Preferred,,990.86,,,990.86,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Anthem,Individual Exchange,,792.69,,,792.69,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Cigna,Cigna,,1051.69,,,1051.69,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Connecticare,Commerical,,1078.81,,,1078.81,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Connecticare,Exchange,,1078.81,,,1078.81,792.69,1431.4,other,Could be inpatient or outpatient,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,Multiplan,Multiplan,,,1431.4,,1431.4,792.69,1431.4,percent of total billed charges,,
HC DRAINAGE OF MOUTH LESION,40801,CPT,,,both,,,1787.05,1072.23,United Healthcare/Oxford,United Healthcare/Oxford,,1105.93,,,1105.93,792.69,1431.4,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT  ,,,both,,,3346.47,2007.88,Aetna,Commerical,,2420.3,,,2420.3,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Aetna,Middlesex Employees,,2178.27,,,2178.27,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Anthem,Commerical,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Anthem,Indemnity,,,2433.59,,2433.59,1732.5,2680.95,percent of total billed charges,,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Anthem,State Preferred,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Anthem,Individual Exchange,,1732.5,,,1732.5,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Cigna,Cigna,,2114.98,,,2114.98,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Connecticare,Commerical,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Connecticare,Exchange,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,Multiplan,Multiplan,,,2680.95,,2680.95,1732.5,2680.95,percent of total billed charges,,
HC REM EMBEDDED FB MOUTH VESTIB; SIMPLE,40804,CPT,,,both,,,3346.47,2007.88,United Healthcare/Oxford,United Healthcare/Oxford,,2176.62,,,2176.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2122.84,1365.37,2112.84,percent of total billed charges,,
HC REM EMBEDDED FB MOUTH VESTIB; COMPLICATED,40805,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT  ,,,both,,,803.4,482.04,Aetna,Commerical,,581.26,,,581.26,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Aetna,Middlesex Employees,,523.13,,,523.13,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Anthem,Commerical,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Anthem,Indemnity,,,584.45,,584.45,416.08,643.86,percent of total billed charges,,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Anthem,State Preferred,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Anthem,Individual Exchange,,416.08,,,416.08,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Cigna,Cigna,,507.94,,,507.94,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Connecticare,Commerical,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Connecticare,Exchange,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,Multiplan,Multiplan,,,643.86,,643.86,416.08,643.86,percent of total billed charges,,
HC CL LACERATION MOUTH VESTIB; <=2.5CM,40830,CPT,,,both,,,803.4,482.04,United Healthcare/Oxford,United Healthcare/Oxford,,522.74,,,522.74,416.08,643.86,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC CL LACERATION MOUTH VESTIB; > 2.5 CM OR CMPLX,40831,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT  ,,,both,,,3237.29,1942.37,Aetna,Commerical,,2341.33,,,2341.33,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Aetna,Middlesex Employees,,2107.2,,,2107.2,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Anthem,Commerical,,2094.96,,,2094.96,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Anthem,Indemnity,,,2354.18,,2354.18,1675.98,2593.48,percent of total billed charges,,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Anthem,State Preferred,,2094.96,,,2094.96,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Anthem,Individual Exchange,,1675.98,,,1675.98,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Cigna,Cigna,,2045.96,,,2045.96,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Connecticare,Commerical,,2188.33,,,2188.33,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Connecticare,Exchange,,2188.33,,,2188.33,1675.98,2593.48,other,Could be inpatient or outpatient,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,Multiplan,Multiplan,,,2593.48,,2593.48,1675.98,2593.48,percent of total billed charges,,
HC I&D ABSC/CYS FOM; SUBMANDIB,41008,CPT,,,both,,,3237.29,1942.37,United Healthcare/Oxford,United Healthcare/Oxford,,2105.6,,,2105.6,1675.98,2593.48,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT  ,,,both,,,4233.3,2539.98,Aetna,Commerical,,2828.83,,,2828.83,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Aetna,Middlesex Employees,,2545.94,,,2545.94,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Anthem,Commerical,,2347.71,,,2347.71,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Anthem,Indemnity,,,3078.58,,3078.58,1878.17,3391.5,percent of total billed charges,,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Anthem,State Preferred,,2347.71,,,2347.71,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Anthem,Individual Exchange,,1878.17,,,1878.17,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Cigna,Cigna,,2491.84,,,2491.84,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Connecticare,Commerical,,2556.09,,,2556.09,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Connecticare,Exchange,,2556.09,,,2556.09,1878.17,3391.5,other,Could be inpatient or outpatient,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,Multiplan,Multiplan,,,3391.5,,3391.5,1878.17,3391.5,percent of total billed charges,,
HC INCISION OF TONGUE FOLD,41010,CPT,,,both,,,4233.3,2539.98,United Healthcare/Oxford,United Healthcare/Oxford,,2620.34,,,2620.34,1878.17,3391.5,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT  ,,,both,,,6683.67,4010.2,Aetna,Commerical,,4934,,,4934,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Aetna,Middlesex Employees,,4731.29,,,4731.29,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Anthem,Commerical,,4994.7,,,4994.7,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Anthem,Indemnity,,,4860.91,,4860.91,3995.76,5382.47,percent of total billed charges,,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Anthem,State Preferred,,4994.7,,,4994.7,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Anthem,Individual Exchange,,3995.76,,,3995.76,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Cigna,Cigna,,5382.47,,,5382.47,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Connecticare,Commerical,,5259,,,5259,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Connecticare,Exchange,,5259,,,5259,3995.76,5382.47,other,Could be inpatient or outpatient,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,Multiplan,Multiplan,,,5355,,5355,3995.76,5382.47,percent of total billed charges,,
HC DRAINAGE OF FLOOR OF MOUTH LESION,41017,CPT,,,both,,,6683.67,4010.2,United Healthcare/Oxford,United Healthcare/Oxford,,4139.57,,,4139.57,3995.76,5382.47,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC REP LACERAT 2.5 CM/<; FLR-MOUTH/ANT 2/3,41250,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT  ,,,both,,,783.83,470.3,Aetna,Commerical,,566.6,,,566.6,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Aetna,Middlesex Employees,,509.95,,,509.95,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Anthem,Commerical,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Anthem,Indemnity,,,569.72,,569.72,405.59,627.63,percent of total billed charges,,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Anthem,State Preferred,,506.98,,,506.98,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Anthem,Individual Exchange,,405.59,,,405.59,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Cigna,Cigna,,495.13,,,495.13,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Connecticare,Commerical,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Connecticare,Exchange,,529.58,,,529.58,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,Multiplan,Multiplan,,,627.63,,627.63,405.59,627.63,percent of total billed charges,,
HC REP LACERAT 2.5 CM/<; POST 1/3 TONGUE,41251,CPT,,,both,,,783.83,470.3,United Healthcare/Oxford,United Healthcare/Oxford,,509.56,,,509.56,405.59,627.63,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT  ,,,both,,,2636.8,1582.08,Aetna,Commerical,,1907.42,,,1907.42,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Aetna,Middlesex Employees,,1716.68,,,1716.68,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Anthem,Commerical,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Anthem,Indemnity,,,1917.89,,1917.89,1365.37,2112.84,percent of total billed charges,,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Anthem,State Preferred,,1706.72,,,1706.72,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Anthem,Individual Exchange,,1365.37,,,1365.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Cigna,Cigna,,1666.8,,,1666.8,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Connecticare,Commerical,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Connecticare,Exchange,,1782.78,,,1782.78,1365.37,2112.84,other,Could be inpatient or outpatient,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,Multiplan,Multiplan,,,2112.84,,2112.84,1365.37,2112.84,percent of total billed charges,,
HC REP LACERAT-TONGUE FLR-MOUTH > 2.6/CPLX,41252,CPT,,,both,,,2636.8,1582.08,United Healthcare/Oxford,United Healthcare/Oxford,,1715.37,,,1715.37,1365.37,2112.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC DR ABSC CYST HEMATOM - DENTOALVEOLAR,41800,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT  ,,,both,,,5122.19,3073.31,Aetna,Commerical,,3704.11,,,3704.11,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Aetna,Middlesex Employees,,3333.7,,,3333.7,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Anthem,Commerical,,3314.36,,,3314.36,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Anthem,Indemnity,,,3724.46,,3724.46,2651.48,4103.04,percent of total billed charges,,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Anthem,State Preferred,,3314.36,,,3314.36,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Anthem,Individual Exchange,,2651.48,,,2651.48,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Cigna,Cigna,,3236.83,,,3236.83,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Connecticare,Commerical,,3462.08,,,3462.08,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Connecticare,Exchange,,3462.08,,,3462.08,2651.48,4103.04,other,Could be inpatient or outpatient,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,Multiplan,Multiplan,,,4103.04,,4103.04,2651.48,4103.04,percent of total billed charges,,
HC REM EMB FB FROM DENTOALV; SFT TISSUE,41805,CPT,,,both,,,5122.19,3073.31,United Healthcare/Oxford,United Healthcare/Oxford,,3331.17,,,3331.17,2651.48,4103.04,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT  ,,,both,,,8911.79,5347.07,Aetna,Commerical,,6445.97,,,6445.97,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Aetna,Middlesex Employees,,5801.37,,,5801.37,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Anthem,Commerical,,5767.7,,,5767.7,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Anthem,Indemnity,,,6481.38,,6481.38,4614.16,7140.18,percent of total billed charges,,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Anthem,State Preferred,,5767.7,,,5767.7,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Anthem,Individual Exchange,,4614.16,,,4614.16,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Cigna,Cigna,,5632.81,,,5632.81,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Connecticare,Commerical,,6024.77,,,6024.77,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Connecticare,Exchange,,6024.77,,,6024.77,4614.16,7140.18,other,Could be inpatient or outpatient,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,Multiplan,Multiplan,,,7140.18,,7140.18,4614.16,7140.18,percent of total billed charges,,
HC GINGIVECTOMY EXCISION GINGIVA EACH QUADRANT,41820,CPT,,,both,,,8911.79,5347.07,United Healthcare/Oxford,United Healthcare/Oxford,,5796.98,,,5796.98,4614.16,7140.18,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT  ,,,both,,,803.4,482.04,Aetna,Commerical,,581.26,,,581.26,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Aetna,Middlesex Employees,,523.13,,,523.13,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Anthem,Commerical,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Anthem,Indemnity,,,584.45,,584.45,416.08,643.86,percent of total billed charges,,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Anthem,State Preferred,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Anthem,Individual Exchange,,416.08,,,416.08,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Cigna,Cigna,,507.94,,,507.94,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Connecticare,Commerical,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Connecticare,Exchange,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,Multiplan,Multiplan,,,643.86,,643.86,416.08,643.86,percent of total billed charges,,
HC DENTAL SURG PROC,41899,CPT,,,both,,,803.4,482.04,United Healthcare/Oxford,United Healthcare/Oxford,,522.74,,,522.74,416.08,643.86,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT  ,,,both,,,2070.3,1242.18,Aetna,Commerical,,1497.11,,,1497.11,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Aetna,Middlesex Employees,,1347.4,,,1347.4,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Anthem,Commerical,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Anthem,Indemnity,,,1505.34,,1505.34,1071.66,1658.35,percent of total billed charges,,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Anthem,State Preferred,,1339.58,,,1339.58,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Anthem,Individual Exchange,,1071.66,,,1071.66,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Cigna,Cigna,,1308.25,,,1308.25,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Connecticare,Commerical,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Connecticare,Exchange,,1399.29,,,1399.29,1071.66,1658.35,other,Could be inpatient or outpatient,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,Multiplan,Multiplan,,,1658.35,,1658.35,1071.66,1658.35,percent of total billed charges,,
HC REPAIR LACERATION OF PALATE,42180,CPT,,,both,,,2070.3,1242.18,United Healthcare/Oxford,United Healthcare/Oxford,,1346.39,,,1346.39,1071.66,1658.35,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT  ,,,both,,,865.51,519.31,Aetna,Commerical,,626.03,,,626.03,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Aetna,Middlesex Employees,,563.43,,,563.43,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Anthem,Commerical,,560.16,,,560.16,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Anthem,Indemnity,,,629.47,,629.47,448.13,693.46,percent of total billed charges,,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Anthem,State Preferred,,560.16,,,560.16,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Anthem,Individual Exchange,,448.13,,,448.13,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Cigna,Cigna,,547.06,,,547.06,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Connecticare,Commerical,,585.13,,,585.13,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Connecticare,Exchange,,585.13,,,585.13,448.13,693.46,other,Could be inpatient or outpatient,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,Multiplan,Multiplan,,,693.46,,693.46,448.13,693.46,percent of total billed charges,,
HC BIOPSY OF SALIVARY GLAND NEEDLE,42400,CPT,,,both,,,865.51,519.31,United Healthcare/Oxford,United Healthcare/Oxford,,563.01,,,563.01,448.13,693.46,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT  ,,,both,,,769.41,461.65,Aetna,Commerical,,567.8,,,567.8,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Aetna,Middlesex Employees,,544.47,,,544.47,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Anthem,Commerical,,574.79,,,574.79,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Anthem,Indemnity,,,559.39,,559.39,459.83,627.27,percent of total billed charges,,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Anthem,State Preferred,,574.79,,,574.79,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Anthem,Individual Exchange,,459.83,,,459.83,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Cigna,Cigna,,530.67,,,530.67,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Connecticare,Commerical,,605.2,,,605.2,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Connecticare,Exchange,,605.2,,,605.2,459.83,627.27,other,Could be inpatient or outpatient,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,Multiplan,Multiplan,,,616.25,,616.25,459.83,627.27,percent of total billed charges,,
HC UNLISTED PX SALIVARY GLANDS/DUCTS,42699,CPT,,,both,,,769.41,461.65,United Healthcare/Oxford,United Healthcare/Oxford,,627.27,,,627.27,459.83,627.27,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT  ,,,both,,,803.4,482.04,Aetna,Commerical,,581.26,,,581.26,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Aetna,Middlesex Employees,,523.13,,,523.13,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Anthem,Commerical,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Anthem,Indemnity,,,584.45,,584.45,416.08,643.86,percent of total billed charges,,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Anthem,State Preferred,,520.1,,,520.1,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Anthem,Individual Exchange,,416.08,,,416.08,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Cigna,Cigna,,507.94,,,507.94,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Connecticare,Commerical,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Connecticare,Exchange,,543.28,,,543.28,416.08,643.86,other,Could be inpatient or outpatient,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,Multiplan,Multiplan,,,643.86,,643.86,416.08,643.86,percent of total billed charges,,
HC I&D ABSCESS; PERITONSILLAR,42700,CPT,,,both,,,803.4,482.04,United Healthcare/Oxford,United Healthcare/Oxford,,522.74,,,522.74,416.08,643.86,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT  ,,,both,,,1485.26,891.16,Aetna,Commerical,,1073.79,,,1073.79,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Aetna,Middlesex Employees,,966.41,,,966.41,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Anthem,Commerical,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Anthem,Indemnity,,,1079.69,,1079.69,768.64,1189.43,percent of total billed charges,,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Anthem,State Preferred,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Anthem,Individual Exchange,,768.64,,,768.64,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Cigna,Cigna,,938.33,,,938.33,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Connecticare,Commerical,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Connecticare,Exchange,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,Multiplan,Multiplan,,,1189.43,,1189.43,768.64,1189.43,percent of total billed charges,,
HC FORBOD REM PHAYNX,42809,CPT,,,both,,,1485.26,891.16,United Healthcare/Oxford,United Healthcare/Oxford,,965.68,,,965.68,768.64,1189.43,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT  ,,,both,,,13275.36,7965.22,Aetna,Commerical,,10279.74,,,10279.74,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Aetna,Middlesex Employees,,9251.77,,,9251.77,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Anthem,Commerical,,6243.8,,,6243.8,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Anthem,Indemnity,,,9654.92,,9654.92,4995.04,10636.31,percent of total billed charges,,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Anthem,State Preferred,,6243.8,,,6243.8,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Anthem,Individual Exchange,,4995.04,,,4995.04,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Cigna,Cigna,,8404.54,,,8404.54,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Connecticare,Commerical,,7421.43,,,7421.43,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Connecticare,Exchange,,7421.43,,,7421.43,4995.04,10636.31,other,Could be inpatient or outpatient,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,Multiplan,Multiplan,,,10636.31,,10636.31,4995.04,10636.31,percent of total billed charges,,
REMOVAL OF TONSILS AND ADENOID GLANDS PATIENT YOUNGER THAN AGE 12,42820,CPT,,,both,,,13275.36,7965.22,United Healthcare/Oxford,United Healthcare/Oxford,,6645.86,,,6645.86,4995.04,10636.31,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT  ,,,both,,,7605.21,4563.13,Aetna,Commerical,,5735.47,,,5735.47,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Aetna,Middlesex Employees,,5161.92,,,5161.92,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Anthem,Commerical,,6607.18,,,6607.18,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Anthem,Indemnity,,,5531.13,,5531.13,4973.19,6607.18,percent of total billed charges,,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Anthem,State Preferred,,6607.18,,,6607.18,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Anthem,Individual Exchange,,5285.75,,,5285.75,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Cigna,Cigna,,4973.19,,,4973.19,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Connecticare,Commerical,,5471.52,,,5471.52,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Connecticare,Exchange,,5471.52,,,5471.52,4973.19,6607.18,other,Could be inpatient or outpatient,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,Multiplan,Multiplan,,,6093.34,,6093.34,4973.19,6607.18,percent of total billed charges,,
PR REMOVAL ADENOIDS PRIMARY <12 Y/O,42830,CPT,,,both,,,7605.21,4563.13,United Healthcare/Oxford,United Healthcare/Oxford,,6109.07,,,6109.07,4973.19,6607.18,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT  ,,,both,,,835.99,501.59,Aetna,Commerical,,558.68,,,558.68,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Aetna,Middlesex Employees,,502.81,,,502.81,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Anthem,Commerical,,463.66,,,463.66,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Anthem,Indemnity,,,608,,608,370.92,669.8,percent of total billed charges,,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Anthem,State Preferred,,463.66,,,463.66,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Anthem,Individual Exchange,,370.92,,,370.92,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Cigna,Cigna,,492.12,,,492.12,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Connecticare,Commerical,,504.81,,,504.81,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Connecticare,Exchange,,504.81,,,504.81,370.92,669.8,other,Could be inpatient or outpatient,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,Multiplan,Multiplan,,,669.8,,669.8,370.92,669.8,percent of total billed charges,,
HC UNLISTED PRIC PHARYNX ADENOIDS OR TONSILS,42999,CPT,,,both,,,835.99,501.59,United Healthcare/Oxford,United Healthcare/Oxford,,517.5,,,517.5,370.92,669.8,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,43202,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,43204,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,43215,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,43226,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT  ,,,both,,,16705.93,10023.56,Aetna,Commerical,,8435.04,,,8435.04,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Aetna,Middlesex Employees,,7591.53,,,7591.53,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Anthem,Commerical,,9602.46,,,9602.46,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Anthem,Indemnity,,,12149.91,,12149.91,5747.47,13384.9,percent of total billed charges,,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Anthem,State Preferred,,9602.46,,,9602.46,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Anthem,Individual Exchange,,7681.97,,,7681.97,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Cigna,Cigna,,12660.53,,,12660.53,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Connecticare,Commerical,,,,,,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Connecticare,Exchange,,,,,,5747.47,13384.9,other,Could be inpatient or outpatient,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,Multiplan,Multiplan,,,13384.9,,13384.9,5747.47,13384.9,percent of total billed charges,,
DIAGNOSTIC EXAMINATION OF ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AND ENDOSCOPE,43235,CPT,,,both,,,16705.93,10023.56,United Healthcare/Oxford,United Healthcare/Oxford,,5747.47,,,5747.47,5747.47,13384.9,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT  ,,,both,,,3743.02,2245.81,Aetna,Commerical,,2706.85,,,2706.85,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Aetna,Middlesex Employees,,2436.17,,,2436.17,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Anthem,Commerical,,2422.02,,,2422.02,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Anthem,Indemnity,,,2721.72,,2721.72,1937.62,2998.37,percent of total billed charges,,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Anthem,State Preferred,,2422.02,,,2422.02,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Anthem,Individual Exchange,,1937.62,,,1937.62,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Cigna,Cigna,,2365.38,,,2365.38,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Connecticare,Commerical,,2529.98,,,2529.98,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Connecticare,Exchange,,2529.98,,,2529.98,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,Multiplan,Multiplan,,,2998.37,,2998.37,1937.62,2998.37,percent of total billed charges,,
HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DX,43235,CPT,,,both,,,3743.02,2245.81,United Healthcare/Oxford,United Healthcare/Oxford,,2434.32,,,2434.32,1937.62,2998.37,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT  ,,,both,,,7318.01,4390.8,Aetna,Commerical,,5140.36,,,5140.36,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Aetna,Middlesex Employees,,4626.32,,,4626.32,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Anthem,Commerical,,4637.75,,,4637.75,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Anthem,Indemnity,,,5322.25,,5322.25,3710.21,5863.23,percent of total billed charges,,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Anthem,State Preferred,,4637.75,,,4637.75,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Anthem,Individual Exchange,,3710.21,,,3710.21,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Cigna,Cigna,,4894.58,,,4894.58,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Connecticare,Commerical,,5375.79,,,5375.79,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Connecticare,Exchange,,5375.79,,,5375.79,3710.21,5863.23,other,Could be inpatient or outpatient,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,Multiplan,Multiplan,,,5863.23,,5863.23,3710.21,5863.23,percent of total billed charges,,
BIOPSY OF THE ESOPHAGUS STOMACH AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE,43239,CPT,,,both,,,7318.01,4390.8,United Healthcare/Oxford,United Healthcare/Oxford,,4926.12,,,4926.12,3710.21,5863.23,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT  ,,,both,,,2001.29,1200.77,Aetna,Commerical,,424.14,,,424.14,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Aetna,Middlesex Employees,,381.72,,,381.72,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Commerical,,379.51,,,379.51,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Indemnity,,,426.47,,426.47,303.61,469.82,percent of total billed charges,,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,State Preferred,,379.51,,,379.51,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Individual Exchange,,303.61,,,303.61,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Cigna,Cigna,,370.64,,,370.64,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Connecticare,Commerical,,396.43,,,396.43,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Connecticare,Exchange,,396.43,,,396.43,303.61,469.82,other,Could be inpatient or outpatient,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Multiplan,Multiplan,,,469.82,,469.82,303.61,469.82,percent of total billed charges,,
HC EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,United Healthcare/Oxford,United Healthcare/Oxford,,381.44,,,381.44,303.61,469.82,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT  ,,,both,,,2001.29,1200.77,Aetna,Commerical,,380.99,,,380.99,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Aetna,Middlesex Employees,,342.89,,,342.89,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Commerical,,340.91,,,340.91,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Indemnity,,,383.09,,383.09,272.72,422.03,percent of total billed charges,,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,State Preferred,,340.91,,,340.91,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Anthem,Individual Exchange,,272.72,,,272.72,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Cigna,Cigna,,332.94,,,332.94,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Connecticare,Commerical,,356.1,,,356.1,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Connecticare,Exchange,,356.1,,,356.1,272.72,422.03,other,Could be inpatient or outpatient,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,Multiplan,Multiplan,,,422.03,,422.03,272.72,422.03,percent of total billed charges,,
HC HH EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,,,both,,,2001.29,1200.77,United Healthcare/Oxford,United Healthcare/Oxford,,342.64,,,342.64,272.72,422.03,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,43243,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,43244,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT  ,,,both,,,7289.31,4373.59,Aetna,Commerical,,5272.87,,,5272.87,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Aetna,Middlesex Employees,,4745.59,,,4745.59,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Anthem,Commerical,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Anthem,Indemnity,,,5301.83,,5301.83,3774.43,5840.73,percent of total billed charges,,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Anthem,State Preferred,,4718.04,,,4718.04,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Anthem,Individual Exchange,,3774.43,,,3774.43,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Cigna,Cigna,,4607.69,,,4607.69,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Connecticare,Commerical,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Connecticare,Exchange,,4928.32,,,4928.32,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,Multiplan,Multiplan,,,5840.73,,5840.73,3774.43,5840.73,percent of total billed charges,,
HC EGD PERCUTANEOUS PLACEMENT GASTRO TUBE,43246,CPT,,,both,,,7289.31,4373.59,United Healthcare/Oxford,United Healthcare/Oxford,,4741.99,,,4741.99,3774.43,5840.73,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT  ,,,both,,,2001.29,1200.77,Aetna,Commerical,,1447.45,,,1447.45,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Aetna,Middlesex Employees,,1302.7,,,1302.7,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Anthem,Commerical,,1295.15,,,1295.15,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Anthem,Indemnity,,,1455.4,,1455.4,1036.12,1603.34,percent of total billed charges,,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Anthem,State Preferred,,1295.15,,,1295.15,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Anthem,Individual Exchange,,1036.12,,,1036.12,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Cigna,Cigna,,1264.86,,,1264.86,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Connecticare,Commerical,,1352.88,,,1352.88,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Connecticare,Exchange,,1352.88,,,1352.88,1036.12,1603.34,other,Could be inpatient or outpatient,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,Multiplan,Multiplan,,,1603.34,,1603.34,1036.12,1603.34,percent of total billed charges,,
HC EGD REMOVE FOREIGN BODY,43247,CPT,,,both,,,2001.29,1200.77,United Healthcare/Oxford,United Healthcare/Oxford,,1301.72,,,1301.72,1036.12,1603.34,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT  ,,,both,,,5708.26,3424.96,Aetna,Commerical,,4129.07,,,4129.07,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Aetna,Middlesex Employees,,3716.17,,,3716.17,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Anthem,Commerical,,3694.6,,,3694.6,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Anthem,Indemnity,,,4151.74,,4151.74,2955.68,4573.75,percent of total billed charges,,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Anthem,State Preferred,,3694.6,,,3694.6,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Anthem,Individual Exchange,,2955.68,,,2955.68,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Cigna,Cigna,,3608.19,,,3608.19,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Connecticare,Commerical,,3859.26,,,3859.26,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Connecticare,Exchange,,3859.26,,,3859.26,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,Multiplan,Multiplan,,,4573.75,,4573.75,2955.68,4573.75,percent of total billed charges,,
HC HH ASC ERCP W/SPECIMEN COLLECTION,43260,CPT,,,both,,,5708.26,3424.96,United Healthcare/Oxford,United Healthcare/Oxford,,3713.35,,,3713.35,2955.68,4573.75,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT  ,,,both,,,5437.37,3262.42,Aetna,Commerical,,3932.87,,,3932.87,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Aetna,Middlesex Employees,,3539.59,,,3539.59,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Anthem,Commerical,,3519.04,,,3519.04,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Anthem,Indemnity,,,3954.47,,3954.47,2815.23,4356.43,percent of total billed charges,,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Anthem,State Preferred,,3519.04,,,3519.04,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Anthem,Individual Exchange,,2815.23,,,2815.23,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Cigna,Cigna,,3436.74,,,3436.74,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Connecticare,Commerical,,3675.89,,,3675.89,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Connecticare,Exchange,,3675.89,,,3675.89,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,Multiplan,Multiplan,,,4356.43,,4356.43,2815.23,4356.43,percent of total billed charges,,
HC HH ASC ERCP W BX SINGLE/MULTIPLE,43261,CPT,,,both,,,5437.37,3262.42,United Healthcare/Oxford,United Healthcare/Oxford,,3536.91,,,3536.91,2815.23,4356.43,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT  ,,,both,,,12342.49,7405.49,Aetna,Commerical,,8927.32,,,8927.32,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Aetna,Middlesex Employees,,8034.59,,,8034.59,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Anthem,Commerical,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Anthem,Indemnity,,,8976.35,,8976.35,6390.37,9888.76,percent of total billed charges,,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Anthem,State Preferred,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Anthem,Individual Exchange,,6390.37,,,6390.37,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Cigna,Cigna,,7801.13,,,7801.13,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Connecticare,Commerical,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Connecticare,Exchange,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,Multiplan,Multiplan,,,9888.76,,9888.76,6390.37,9888.76,percent of total billed charges,,
HC HH ASC ERCP W SPHINCTER/PAPILLOTOMY,43262,CPT,,,both,,,12342.49,7405.49,United Healthcare/Oxford,United Healthcare/Oxford,,8028.51,,,8028.51,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT  ,,,both,,,12342.49,7405.49,Aetna,Commerical,,8927.32,,,8927.32,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Aetna,Middlesex Employees,,8034.59,,,8034.59,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Anthem,Commerical,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Anthem,Indemnity,,,8976.35,,8976.35,6390.37,9888.76,percent of total billed charges,,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Anthem,State Preferred,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Anthem,Individual Exchange,,6390.37,,,6390.37,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Cigna,Cigna,,7801.13,,,7801.13,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Connecticare,Commerical,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Connecticare,Exchange,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,Multiplan,Multiplan,,,9888.76,,9888.76,6390.37,9888.76,percent of total billed charges,,
HC HH ASC ERCP REMOVE DUCT CALCULI,43264,CPT,,,both,,,12342.49,7405.49,United Healthcare/Oxford,United Healthcare/Oxford,,8028.51,,,8028.51,6390.37,9888.76,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT  ,,,both,,,5317.89,3190.73,Aetna,Commerical,,3846.59,,,3846.59,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Aetna,Middlesex Employees,,3461.93,,,3461.93,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Anthem,Commerical,,3441.83,,,3441.83,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Anthem,Indemnity,,,3867.7,,3867.7,2753.46,4260.84,percent of total billed charges,,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Anthem,State Preferred,,3441.83,,,3441.83,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Anthem,Individual Exchange,,2753.46,,,2753.46,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Cigna,Cigna,,3361.33,,,3361.33,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Connecticare,Commerical,,3595.23,,,3595.23,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Connecticare,Exchange,,3595.23,,,3595.23,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,Multiplan,Multiplan,,,4260.84,,4260.84,2753.46,4260.84,percent of total billed charges,,
HC HH ASC ERCP LITHOTRIPSY CALCULI,43265,CPT,,,both,,,5317.89,3190.73,United Healthcare/Oxford,United Healthcare/Oxford,,3459.3,,,3459.3,2753.46,4260.84,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT  ,,,both,,,3106.48,1863.89,Aetna,Commerical,,2246.9,,,2246.9,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Aetna,Middlesex Employees,,2022.2,,,2022.2,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Anthem,Commerical,,2010.47,,,2010.47,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Anthem,Indemnity,,,2259.23,,2259.23,1608.37,2488.87,percent of total billed charges,,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Anthem,State Preferred,,2010.47,,,2010.47,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Anthem,Individual Exchange,,1608.37,,,1608.37,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Cigna,Cigna,,1963.45,,,1963.45,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Connecticare,Commerical,,2100.08,,,2100.08,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Connecticare,Exchange,,2100.08,,,2100.08,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,Multiplan,Multiplan,,,2488.87,,2488.87,1608.37,2488.87,percent of total billed charges,,
HC HH ASC ERCP STENT,43268,CPT,,,both,,,3106.48,1863.89,United Healthcare/Oxford,United Healthcare/Oxford,,2020.67,,,2020.67,1608.37,2488.87,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT  ,,,both,,,6481.79,3889.07,Aetna,Commerical,,4688.36,,,4688.36,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Aetna,Middlesex Employees,,4219.52,,,4219.52,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Anthem,Commerical,,4195.03,,,4195.03,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Anthem,Indemnity,,,4714.09,,4714.09,3356.03,5193.26,percent of total billed charges,,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Anthem,State Preferred,,4195.03,,,4195.03,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Anthem,Individual Exchange,,3356.03,,,3356.03,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Cigna,Cigna,,4096.91,,,4096.91,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Connecticare,Commerical,,4382,,,4382,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Connecticare,Exchange,,4382,,,4382,3356.03,5193.26,other,Could be inpatient or outpatient,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,Multiplan,Multiplan,,,5193.26,,5193.26,3356.03,5193.26,percent of total billed charges,,
HC HH ERCP REM STENT,43269,CPT,,,both,,,6481.79,3889.07,United Healthcare/Oxford,United Healthcare/Oxford,,4216.32,,,4216.32,3356.03,5193.26,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT  ,,,both,,,12342.49,7405.49,Aetna,Commerical,,8927.32,,,8927.32,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Aetna,Middlesex Employees,,8034.59,,,8034.59,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Anthem,Commerical,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Anthem,Indemnity,,,8976.35,,8976.35,6390.37,9888.76,percent of total billed charges,,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Anthem,State Preferred,,7987.96,,,7987.96,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Anthem,Individual Exchange,,6390.37,,,6390.37,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Cigna,Cigna,,7801.13,,,7801.13,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Connecticare,Commerical,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Connecticare,Exchange,,8343.98,,,8343.98,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,Multiplan,Multiplan,,,9888.76,,9888.76,6390.37,9888.76,percent of total billed charges,,
HC ERCP REMOVE FORGN BODY DUCT,43275,CPT,,,both,,,12342.49,7405.49,United Healthcare/Oxford,United Healthcare/Oxford,,8028.51,,,8028.51,6390.37,9888.76,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT  ,,,both,,,19317.65,11590.59,Aetna,Commerical,,13973.07,,,13973.07,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Aetna,Middlesex Employees,,12575.76,,,12575.76,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Anthem,Commerical,,12502.77,,,12502.77,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Anthem,Indemnity,,,14049.8,,14049.8,10002.22,15477.9,percent of total billed charges,,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Anthem,State Preferred,,12502.77,,,12502.77,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Anthem,Individual Exchange,,10002.22,,,10002.22,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Cigna,Cigna,,12210.34,,,12210.34,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Connecticare,Commerical,,13060.01,,,13060.01,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Connecticare,Exchange,,13060.01,,,13060.01,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,Multiplan,Multiplan,,,15477.9,,15477.9,10002.22,15477.9,percent of total billed charges,,
HC ERCP STENT EXCHANGE W/DILATE,43276,CPT,,,both,,,19317.65,11590.59,United Healthcare/Oxford,United Healthcare/Oxford,,12566.23,,,12566.23,10002.22,15477.9,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT  ,,,both,,,5708.26,3424.96,Aetna,Commerical,,4129.07,,,4129.07,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Aetna,Middlesex Employees,,3716.17,,,3716.17,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Anthem,Commerical,,3694.6,,,3694.6,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Anthem,Indemnity,,,4151.74,,4151.74,2955.68,4573.75,percent of total billed charges,,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Anthem,State Preferred,,3694.6,,,3694.6,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Anthem,Individual Exchange,,2955.68,,,2955.68,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Cigna,Cigna,,3608.19,,,3608.19,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Connecticare,Commerical,,3859.26,,,3859.26,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Connecticare,Exchange,,3859.26,,,3859.26,2955.68,4573.75,other,Could be inpatient or outpatient,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,Multiplan,Multiplan,,,4573.75,,4573.75,2955.68,4573.75,percent of total billed charges,,
HC ERCP EA DUCT/AMPULLA DILATE,43277,CPT,,,both,,,5708.26,3424.96,United Healthcare/Oxford,United Healthcare/Oxford,,3713.35,,,3713.35,2955.68,4573.75,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC PRESSURE TREATMENT ESOPHAGUS,43460,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT  ,,,both,,,1484.55,890.73,Aetna,Commerical,,1073.79,,,1073.79,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Aetna,Middlesex Employees,,966.41,,,966.41,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Anthem,Commerical,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Anthem,Indemnity,,,1079.69,,1079.69,768.64,1189.43,percent of total billed charges,,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Anthem,State Preferred,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Anthem,Individual Exchange,,768.64,,,768.64,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Cigna,Cigna,,938.33,,,938.33,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Connecticare,Commerical,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Connecticare,Exchange,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,Multiplan,Multiplan,,,1189.43,,1189.43,768.64,1189.43,percent of total billed charges,,
HC NASAL /OROGASTRIC W/TUBE PLMT,43752,CPT,,,both,,,1484.55,890.73,United Healthcare/Oxford,United Healthcare/Oxford,,965.68,,,965.68,768.64,1189.43,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT  ,,,both,,,675.68,405.41,Aetna,Commerical,,488.46,,,488.46,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Aetna,Middlesex Employees,,439.62,,,439.62,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Anthem,Commerical,,437.06,,,437.06,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Anthem,Indemnity,,,491.14,,491.14,349.64,541.06,percent of total billed charges,,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Anthem,State Preferred,,437.06,,,437.06,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Anthem,Individual Exchange,,349.64,,,349.64,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Cigna,Cigna,,426.84,,,426.84,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Connecticare,Commerical,,456.54,,,456.54,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Connecticare,Exchange,,456.54,,,456.54,349.64,541.06,other,Could be inpatient or outpatient,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,Multiplan,Multiplan,,,541.06,,541.06,349.64,541.06,percent of total billed charges,,
HC TX GASTRO INTUB W/ASP,43753,CPT,,,both,,,675.68,405.41,United Healthcare/Oxford,United Healthcare/Oxford,,439.27,,,439.27,349.64,541.06,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT  ,,,both,,,1033.09,619.85,Aetna,Commerical,,747.33,,,747.33,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Aetna,Middlesex Employees,,672.6,,,672.6,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Anthem,Commerical,,668.7,,,668.7,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Anthem,Indemnity,,,751.44,,751.44,534.96,827.82,percent of total billed charges,,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Anthem,State Preferred,,668.7,,,668.7,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Anthem,Individual Exchange,,534.96,,,534.96,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Cigna,Cigna,,653.06,,,653.06,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Connecticare,Commerical,,698.5,,,698.5,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Connecticare,Exchange,,698.5,,,698.5,534.96,827.82,other,Could be inpatient or outpatient,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,Multiplan,Multiplan,,,827.82,,827.82,534.96,827.82,percent of total billed charges,,
HC CHANGE GASTRO TUBE,43760,CPT,,,both,,,1033.09,619.85,United Healthcare/Oxford,United Healthcare/Oxford,,672.1,,,672.1,534.96,827.82,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT  ,,,both,,,380.07,228.04,Aetna,Commerical,,275.17,,,275.17,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Aetna,Middlesex Employees,,247.65,,,247.65,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Anthem,Commerical,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Anthem,Indemnity,,,276.67,,276.67,196.96,304.79,percent of total billed charges,,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Anthem,State Preferred,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Anthem,Individual Exchange,,196.96,,,196.96,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,Multiplan,Multiplan,,,304.79,,304.79,196.96,304.79,percent of total billed charges,,
HC REPOSITION GASTROSTOMY TUBE,43761,CPT,,,both,,,380.07,228.04,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT  ,,,both,,,899.19,539.51,Aetna,Commerical,,650.46,,,650.46,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Aetna,Middlesex Employees,,585.42,,,585.42,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Anthem,Commerical,,582.01,,,582.01,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Anthem,Indemnity,,,654.03,,654.03,465.61,720.51,percent of total billed charges,,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Anthem,State Preferred,,582.01,,,582.01,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Anthem,Individual Exchange,,465.61,,,465.61,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Cigna,Cigna,,568.4,,,568.4,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Connecticare,Commerical,,607.96,,,607.96,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Connecticare,Exchange,,607.96,,,607.96,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,Multiplan,Multiplan,,,720.51,,720.51,465.61,720.51,percent of total billed charges,,
HC REPL GASTRO TUBE REQ REV OF GASTM TRACT,43762,CPT,,,both,,,899.19,539.51,United Healthcare/Oxford,United Healthcare/Oxford,,584.97,,,584.97,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT  ,,,both,,,899.19,539.51,Aetna,Commerical,,650.46,,,650.46,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Aetna,Middlesex Employees,,585.42,,,585.42,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Anthem,Commerical,,582.01,,,582.01,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Anthem,Indemnity,,,654.03,,654.03,465.61,720.51,percent of total billed charges,,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Anthem,State Preferred,,582.01,,,582.01,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Anthem,Individual Exchange,,465.61,,,465.61,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Cigna,Cigna,,568.4,,,568.4,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Connecticare,Commerical,,607.96,,,607.96,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Connecticare,Exchange,,607.96,,,607.96,465.61,720.51,other,Could be inpatient or outpatient,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,Multiplan,Multiplan,,,720.51,,720.51,465.61,720.51,percent of total billed charges,,
HC REPL GASTRO TUBE NO REV OF GASTM TRACT,43763,CPT,,,both,,,899.19,539.51,United Healthcare/Oxford,United Healthcare/Oxford,,584.97,,,584.97,465.61,720.51,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT  ,,,both,,,2979.79,1787.87,Aetna,Commerical,,2155.72,,,2155.72,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Aetna,Middlesex Employees,,1940.14,,,1940.14,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Anthem,Commerical,,1928.88,,,1928.88,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Anthem,Indemnity,,,2167.55,,2167.55,1543.1,2387.87,percent of total billed charges,,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Anthem,State Preferred,,1928.88,,,1928.88,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Anthem,Individual Exchange,,1543.1,,,1543.1,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Cigna,Cigna,,1883.76,,,1883.76,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Connecticare,Commerical,,2014.86,,,2014.86,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Connecticare,Exchange,,2014.86,,,2014.86,1543.1,2387.87,other,Could be inpatient or outpatient,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,Multiplan,Multiplan,,,2387.87,,2387.87,1543.1,2387.87,percent of total billed charges,,
HC CONVERT PERC GT TO JT,44373,CPT,,,both,,,2979.79,1787.87,United Healthcare/Oxford,United Healthcare/Oxford,,1938.68,,,1938.68,1543.1,2387.87,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT  ,,,both,,,3743.02,2245.81,Aetna,Commerical,,2706.85,,,2706.85,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Aetna,Middlesex Employees,,2436.17,,,2436.17,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Anthem,Commerical,,2422.02,,,2422.02,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Anthem,Indemnity,,,2721.72,,2721.72,1937.62,2998.37,percent of total billed charges,,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Anthem,State Preferred,,2422.02,,,2422.02,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Anthem,Individual Exchange,,1937.62,,,1937.62,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Cigna,Cigna,,2365.38,,,2365.38,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Connecticare,Commerical,,2529.98,,,2529.98,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Connecticare,Exchange,,2529.98,,,2529.98,1937.62,2998.37,other,Could be inpatient or outpatient,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,Multiplan,Multiplan,,,2998.37,,2998.37,1937.62,2998.37,percent of total billed charges,,
HC ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,44382,CPT,,,both,,,3743.02,2245.81,United Healthcare/Oxford,United Healthcare/Oxford,,2434.32,,,2434.32,1937.62,2998.37,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT  ,,,both,,,3346.47,2007.88,Aetna,Commerical,,2420.3,,,2420.3,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Aetna,Middlesex Employees,,2178.27,,,2178.27,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Anthem,Commerical,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Anthem,Indemnity,,,2433.59,,2433.59,1732.5,2680.95,percent of total billed charges,,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Anthem,State Preferred,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Anthem,Individual Exchange,,1732.5,,,1732.5,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Cigna,Cigna,,2114.98,,,2114.98,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Connecticare,Commerical,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Connecticare,Exchange,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,Multiplan,Multiplan,,,2680.95,,2680.95,1732.5,2680.95,percent of total billed charges,,
HC INTROD LONG GI TUBE,44500,CPT,,,both,,,3346.47,2007.88,United Healthcare/Oxford,United Healthcare/Oxford,,2176.62,,,2176.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT  ,,,both,,,2833.53,1700.12,Aetna,Commerical,,1556.74,,,1556.74,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Aetna,Middlesex Employees,,1401.07,,,1401.07,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Anthem,Commerical,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Anthem,Indemnity,,,2060.32,,2060.32,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Anthem,State Preferred,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Anthem,Individual Exchange,,1478.7,,,1478.7,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Cigna,Cigna,,2124.99,,,2124.99,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Connecticare,Commerical,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Connecticare,Exchange,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,Multiplan,Multiplan,,,2269.75,,2269.75,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN APPE,44901,CPT,,,both,,,2833.53,1700.12,United Healthcare/Oxford,United Healthcare/Oxford,,1725.82,,,1725.82,1401.07,2269.75,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT  ,,,both,,,3682.25,2209.35,Aetna,Commerical,,2663.71,,,2663.71,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Aetna,Middlesex Employees,,2397.34,,,2397.34,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Anthem,Commerical,,2383.42,,,2383.42,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Anthem,Indemnity,,,2678.33,,2678.33,1906.74,2950.57,percent of total billed charges,,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Anthem,State Preferred,,2383.42,,,2383.42,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Anthem,Individual Exchange,,1906.74,,,1906.74,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Cigna,Cigna,,2327.68,,,2327.68,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Connecticare,Commerical,,2489.65,,,2489.65,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Connecticare,Exchange,,2489.65,,,2489.65,1906.74,2950.57,other,Could be inpatient or outpatient,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,Multiplan,Multiplan,,,2950.57,,2950.57,1906.74,2950.57,percent of total billed charges,,
HC HHABSCDRNAPP44901,44901,CPT,,,both,,,3682.25,2209.35,United Healthcare/Oxford,United Healthcare/Oxford,,2395.52,,,2395.52,1906.74,2950.57,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT  ,,,both,,,21845.64,13107.38,Aetna,Commerical,,16435.65,,,16435.65,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Aetna,Middlesex Employees,,14792.08,,,14792.08,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Anthem,Commerical,,17237.87,,,17237.87,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Anthem,Indemnity,,,15887.93,,15887.93,11181.13,19759.04,percent of total billed charges,,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Anthem,State Preferred,,17237.87,,,17237.87,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Anthem,Individual Exchange,,13790.3,,,13790.3,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Cigna,Cigna,,13902.15,,,13902.15,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Connecticare,Commerical,,19759.04,,,19759.04,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Connecticare,Exchange,,19759.04,,,19759.04,11181.13,19759.04,other,Could be inpatient or outpatient,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,Multiplan,Multiplan,,,17502.87,,17502.87,11181.13,19759.04,percent of total billed charges,,
LAPAROSCOPY APPENDECTOMY,44970,CPT,,,both,,,21845.64,13107.38,United Healthcare/Oxford,United Healthcare/Oxford,,11181.13,,,11181.13,11181.13,19759.04,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT  ,,,both,,,5304.5,3182.7,Aetna,Commerical,,3836.81,,,3836.81,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Aetna,Middlesex Employees,,3453.13,,,3453.13,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Anthem,Commerical,,3433.08,,,3433.08,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Anthem,Indemnity,,,3857.88,,3857.88,2746.47,4250.02,percent of total billed charges,,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Anthem,State Preferred,,3433.08,,,3433.08,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Anthem,Individual Exchange,,2746.47,,,2746.47,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Cigna,Cigna,,3352.79,,,3352.79,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Connecticare,Commerical,,3586.1,,,3586.1,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Connecticare,Exchange,,3586.1,,,3586.1,2746.47,4250.02,other,Could be inpatient or outpatient,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,Multiplan,Multiplan,,,4250.02,,4250.02,2746.47,4250.02,percent of total billed charges,,
HC I&D OF SUBMUCOSAL ABSCESS; RECTUM,45005,CPT,,,both,,,5304.5,3182.7,United Healthcare/Oxford,United Healthcare/Oxford,,3450.51,,,3450.51,2746.47,4250.02,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT  ,,,both,,,4464.02,2678.41,Aetna,Commerical,,3228.68,,,3228.68,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Aetna,Middlesex Employees,,2905.81,,,2905.81,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Anthem,Commerical,,2888.95,,,2888.95,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Anthem,Indemnity,,,3246.42,,3246.42,2311.17,3576.4,percent of total billed charges,,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Anthem,State Preferred,,2888.95,,,2888.95,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Anthem,Individual Exchange,,2311.17,,,2311.17,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Cigna,Cigna,,2821.38,,,2821.38,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Connecticare,Commerical,,3017.72,,,3017.72,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Connecticare,Exchange,,3017.72,,,3017.72,2311.17,3576.4,other,Could be inpatient or outpatient,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,Multiplan,Multiplan,,,3576.4,,3576.4,2311.17,3576.4,percent of total billed charges,,
HC BIOPSY OF ANORECTAL WALL ANAL APPROACH,45100,CPT,,,both,,,4464.02,2678.41,United Healthcare/Oxford,United Healthcare/Oxford,,2903.61,,,2903.61,2311.17,3576.4,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT  ,,,both,,,9631.53,5778.92,Aetna,Commerical,,6436.81,,,6436.81,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Aetna,Middlesex Employees,,5793.12,,,5793.12,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Anthem,Commerical,,5342.06,,,5342.06,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Anthem,Indemnity,,,7005.11,,7005.11,4273.65,7717.15,percent of total billed charges,,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Anthem,State Preferred,,5342.06,,,5342.06,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Anthem,Individual Exchange,,4273.65,,,4273.65,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Cigna,Cigna,,5670.02,,,5670.02,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Connecticare,Commerical,,5816.23,,,5816.23,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Connecticare,Exchange,,5816.23,,,5816.23,4273.65,7717.15,other,Could be inpatient or outpatient,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,Multiplan,Multiplan,,,7717.15,,7717.15,4273.65,7717.15,percent of total billed charges,,
HC PROCTOSIGMOIDOSCOPY W/RMVL FOREIGN BODY,45307,CPT,,,both,,,9631.53,5778.92,United Healthcare/Oxford,United Healthcare/Oxford,,5962.43,,,5962.43,4273.65,7717.15,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT  ,,,both,,,3662.68,2197.61,Aetna,Commerical,,2648.24,,,2648.24,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Aetna,Middlesex Employees,,2383.41,,,2383.41,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Anthem,Commerical,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Anthem,Indemnity,,,2662.78,,2662.78,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Anthem,State Preferred,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Anthem,Individual Exchange,,1895.66,,,1895.66,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Cigna,Cigna,,2314.16,,,2314.16,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Connecticare,Commerical,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Connecticare,Exchange,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,Multiplan,Multiplan,,,2933.44,,2933.44,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,45330,CPT,,,both,,,3662.68,2197.61,United Healthcare/Oxford,United Healthcare/Oxford,,2381.61,,,2381.61,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT  ,,,both,,,3662.68,2197.61,Aetna,Commerical,,2648.24,,,2648.24,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Aetna,Middlesex Employees,,2383.41,,,2383.41,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Anthem,Commerical,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Anthem,Indemnity,,,2662.78,,2662.78,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Anthem,State Preferred,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Anthem,Individual Exchange,,1895.66,,,1895.66,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Cigna,Cigna,,2314.16,,,2314.16,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Connecticare,Commerical,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Connecticare,Exchange,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,Multiplan,Multiplan,,,2933.44,,2933.44,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,45331,CPT,,,both,,,3662.68,2197.61,United Healthcare/Oxford,United Healthcare/Oxford,,2381.61,,,2381.61,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT  ,,,both,,,3662.68,2197.61,Aetna,Commerical,,2648.24,,,2648.24,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Aetna,Middlesex Employees,,2383.41,,,2383.41,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Anthem,Commerical,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Anthem,Indemnity,,,2662.78,,2662.78,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Anthem,State Preferred,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Anthem,Individual Exchange,,1895.66,,,1895.66,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Cigna,Cigna,,2314.16,,,2314.16,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Connecticare,Commerical,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Connecticare,Exchange,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,Multiplan,Multiplan,,,2933.44,,2933.44,1895.66,2933.44,percent of total billed charges,,
HC SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,45333,CPT,,,both,,,3662.68,2197.61,United Healthcare/Oxford,United Healthcare/Oxford,,2381.61,,,2381.61,1895.66,2933.44,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT  ,,,both,,,4814.22,2888.53,Aetna,Commerical,,3482.68,,,3482.68,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Aetna,Middlesex Employees,,3134.41,,,3134.41,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Anthem,Commerical,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Anthem,Indemnity,,,3501.81,,3501.81,2492.97,3857.75,percent of total billed charges,,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Anthem,State Preferred,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Anthem,Individual Exchange,,2492.97,,,2492.97,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Cigna,Cigna,,3043.34,,,3043.34,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Connecticare,Commerical,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Connecticare,Exchange,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,Multiplan,Multiplan,,,3857.75,,3857.75,2492.97,3857.75,percent of total billed charges,,
HC SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,45338,CPT,,,both,,,4814.22,2888.53,United Healthcare/Oxford,United Healthcare/Oxford,,3132.04,,,3132.04,2492.97,3857.75,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT  ,,,both,,,8309.63,4985.78,Aetna,Commerical,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Aetna,Middlesex Employees,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Anthem,Commerical,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Anthem,Indemnity,,,6043.44,,6043.44,5415.05,6657.73,percent of total billed charges,,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Anthem,State Preferred,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Anthem,Individual Exchange,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Cigna,Cigna,,5415.05,,,5415.05,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Connecticare,Commerical,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Connecticare,Exchange,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,Multiplan,Multiplan,,,6657.73,,6657.73,5415.05,6657.73,percent of total billed charges,,
DIAGNOSTIC EXMINATION OF LARGE BOWEL USING AN ENDOSCOPE,45378,CPT,,,both,,,8309.63,4985.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5415.05,6657.73,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT  ,,,both,,,3662.68,2197.61,Aetna,Commerical,,2648.24,,,2648.24,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Aetna,Middlesex Employees,,2383.41,,,2383.41,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Anthem,Commerical,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Anthem,Indemnity,,,2662.78,,2662.78,1895.66,2933.44,percent of total billed charges,,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Anthem,State Preferred,,2369.58,,,2369.58,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Anthem,Individual Exchange,,1895.66,,,1895.66,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Cigna,Cigna,,2314.16,,,2314.16,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Connecticare,Commerical,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Connecticare,Exchange,,2475.19,,,2475.19,1895.66,2933.44,other,Could be inpatient or outpatient,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,Multiplan,Multiplan,,,2933.44,,2933.44,1895.66,2933.44,percent of total billed charges,,
HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,CPT,,,both,,,3662.68,2197.61,United Healthcare/Oxford,United Healthcare/Oxford,,2381.61,,,2381.61,1895.66,2933.44,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT  ,,,both,,,10231.65,6138.99,Aetna,Commerical,,6971.18,,,6971.18,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Aetna,Middlesex Employees,,6274.06,,,6274.06,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Anthem,Commerical,,6633.29,,,6633.29,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Anthem,Indemnity,,,7441.29,,7441.29,5306.63,8197.66,percent of total billed charges,,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Anthem,State Preferred,,6633.29,,,6633.29,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Anthem,Individual Exchange,,5306.63,,,5306.63,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Cigna,Cigna,,6682.8,,,6682.8,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Connecticare,Commerical,,5852.84,,,5852.84,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Connecticare,Exchange,,5852.84,,,5852.84,5306.63,8197.66,other,Could be inpatient or outpatient,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,Multiplan,Multiplan,,,8197.66,,8197.66,5306.63,8197.66,percent of total billed charges,,
BIOPSY OF LARGE BOWEL USING AN ENDOSCOPE,45380,CPT,,,both,,,10231.65,6138.99,United Healthcare/Oxford,United Healthcare/Oxford,,5656.61,,,5656.61,5306.63,8197.66,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT  ,,,both,,,4814.22,2888.53,Aetna,Commerical,,3482.68,,,3482.68,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Aetna,Middlesex Employees,,3134.41,,,3134.41,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Anthem,Commerical,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Anthem,Indemnity,,,3501.81,,3501.81,2492.97,3857.75,percent of total billed charges,,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Anthem,State Preferred,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Anthem,Individual Exchange,,2492.97,,,2492.97,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Cigna,Cigna,,3043.34,,,3043.34,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Connecticare,Commerical,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Connecticare,Exchange,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,Multiplan,Multiplan,,,3857.75,,3857.75,2492.97,3857.75,percent of total billed charges,,
HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,CPT,,,both,,,4814.22,2888.53,United Healthcare/Oxford,United Healthcare/Oxford,,3132.04,,,3132.04,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT  ,,,both,,,4814.22,2888.53,Aetna,Commerical,,3482.68,,,3482.68,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Aetna,Middlesex Employees,,3134.41,,,3134.41,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Anthem,Commerical,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Anthem,Indemnity,,,3501.81,,3501.81,2492.97,3857.75,percent of total billed charges,,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Anthem,State Preferred,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Anthem,Individual Exchange,,2492.97,,,2492.97,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Cigna,Cigna,,3043.34,,,3043.34,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Connecticare,Commerical,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Connecticare,Exchange,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,Multiplan,Multiplan,,,3857.75,,3857.75,2492.97,3857.75,percent of total billed charges,,
HC COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,CPT,,,both,,,4814.22,2888.53,United Healthcare/Oxford,United Healthcare/Oxford,,3132.04,,,3132.04,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT  ,,,both,,,4814.22,2888.53,Aetna,Commerical,,3482.68,,,3482.68,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Aetna,Middlesex Employees,,3134.41,,,3134.41,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Anthem,Commerical,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Anthem,Indemnity,,,3501.81,,3501.81,2492.97,3857.75,percent of total billed charges,,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Anthem,State Preferred,,3116.22,,,3116.22,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Anthem,Individual Exchange,,2492.97,,,2492.97,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Cigna,Cigna,,3043.34,,,3043.34,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Connecticare,Commerical,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Connecticare,Exchange,,3255.11,,,3255.11,2492.97,3857.75,other,Could be inpatient or outpatient,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,Multiplan,Multiplan,,,3857.75,,3857.75,2492.97,3857.75,percent of total billed charges,,
HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,CPT,,,both,,,4814.22,2888.53,United Healthcare/Oxford,United Healthcare/Oxford,,3132.04,,,3132.04,2492.97,3857.75,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT  ,,,both,,,12189.75,7313.85,Aetna,Commerical,,6466.48,,,6466.48,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Aetna,Middlesex Employees,,5819.84,,,5819.84,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Anthem,Commerical,,6665.89,,,6665.89,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Anthem,Indemnity,,,8865.38,,8865.38,5332.71,9766.51,percent of total billed charges,,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Anthem,State Preferred,,6665.89,,,6665.89,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Anthem,Individual Exchange,,5332.71,,,5332.71,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Cigna,Cigna,,8664.31,,,8664.31,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Connecticare,Commerical,,5818.62,,,5818.62,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Connecticare,Exchange,,5818.62,,,5818.62,5332.71,9766.51,other,Could be inpatient or outpatient,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,Multiplan,Multiplan,,,9766.51,,9766.51,5332.71,9766.51,percent of total billed charges,,
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE,45385,CPT,,,both,,,12189.75,7313.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5332.71,9766.51,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT  ,,,both,,,2054.85,1232.91,Aetna,Commerical,,1486.53,,,1486.53,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Aetna,Middlesex Employees,,1337.87,,,1337.87,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Anthem,Commerical,,1330.11,,,1330.11,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Anthem,Indemnity,,,1494.69,,1494.69,1064.08,1646.62,percent of total billed charges,,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Anthem,State Preferred,,1330.11,,,1330.11,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Anthem,Individual Exchange,,1064.08,,,1064.08,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Cigna,Cigna,,1299,,,1299,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Connecticare,Commerical,,1389.39,,,1389.39,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Connecticare,Exchange,,1389.39,,,1389.39,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,Multiplan,Multiplan,,,1646.62,,1646.62,1064.08,1646.62,percent of total billed charges,,
HC REDUCTION OF PROCIDENTIA UNDER ANESTH,45900,CPT,,,both,,,2054.85,1232.91,United Healthcare/Oxford,United Healthcare/Oxford,,1336.87,,,1336.87,1064.08,1646.62,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT  ,,,both,,,3580.28,2148.17,Aetna,Commerical,,2590.44,,,2590.44,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Aetna,Middlesex Employees,,2331.39,,,2331.39,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Anthem,Commerical,,2317.86,,,2317.86,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Anthem,Indemnity,,,2604.66,,2604.66,1854.29,2869.41,percent of total billed charges,,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Anthem,State Preferred,,2317.86,,,2317.86,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Anthem,Individual Exchange,,1854.29,,,1854.29,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Cigna,Cigna,,2263.65,,,2263.65,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Connecticare,Commerical,,2421.17,,,2421.17,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Connecticare,Exchange,,2421.17,,,2421.17,1854.29,2869.41,other,Could be inpatient or outpatient,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,Multiplan,Multiplan,,,2869.41,,2869.41,1854.29,2869.41,percent of total billed charges,,
HC REMOVE FECAL IMPACTION OR FB UNDER ANESTH,45915,CPT,,,both,,,3580.28,2148.17,United Healthcare/Oxford,United Healthcare/Oxford,,2329.63,,,2329.63,1854.29,2869.41,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT  ,,,both,,,3195.33,1917.2,Aetna,Commerical,,2311.21,,,2311.21,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Aetna,Middlesex Employees,,2080.09,,,2080.09,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Anthem,Commerical,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Anthem,Indemnity,,,2323.9,,2323.9,1654.41,2560.12,percent of total billed charges,,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Anthem,State Preferred,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Anthem,Individual Exchange,,1654.41,,,1654.41,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Cigna,Cigna,,2019.64,,,2019.64,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Connecticare,Commerical,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Connecticare,Exchange,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,Multiplan,Multiplan,,,2560.12,,2560.12,1654.41,2560.12,percent of total billed charges,,
HC RECTUM PROC UNLISTED,45999,CPT,,,both,,,3195.33,1917.2,United Healthcare/Oxford,United Healthcare/Oxford,,2078.51,,,2078.51,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT  ,,,both,,,4212.7,2527.62,Aetna,Commerical,,3047.14,,,3047.14,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Aetna,Middlesex Employees,,2742.43,,,2742.43,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Anthem,Commerical,,2726.51,,,2726.51,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Anthem,Indemnity,,,3063.88,,3063.88,2181.21,3375.31,percent of total billed charges,,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Anthem,State Preferred,,2726.51,,,2726.51,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Anthem,Individual Exchange,,2181.21,,,2181.21,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Cigna,Cigna,,2662.74,,,2662.74,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Connecticare,Commerical,,2848.03,,,2848.03,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Connecticare,Exchange,,2848.03,,,2848.03,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,Multiplan,Multiplan,,,3375.31,,3375.31,2181.21,3375.31,percent of total billed charges,,
HC I&D OF ISCHIORECTAL AND PERIRECTAL ABSCESS,46040,CPT,,,both,,,4212.7,2527.62,United Healthcare/Oxford,United Healthcare/Oxford,,2740.36,,,2740.36,2181.21,3375.31,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT  ,,,both,,,3195.06,1917.04,Aetna,Commerical,,2311.21,,,2311.21,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Aetna,Middlesex Employees,,2080.09,,,2080.09,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Anthem,Commerical,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Anthem,Indemnity,,,2323.9,,2323.9,1654.41,2560.12,percent of total billed charges,,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Anthem,State Preferred,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Anthem,Individual Exchange,,1654.41,,,1654.41,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Cigna,Cigna,,2019.64,,,2019.64,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Connecticare,Commerical,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Connecticare,Exchange,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,Multiplan,Multiplan,,,2560.12,,2560.12,1654.41,2560.12,percent of total billed charges,,
HC I&D PERIAN ABCES,46050,CPT,,,both,,,3195.06,1917.04,United Healthcare/Oxford,United Healthcare/Oxford,,2078.51,,,2078.51,1654.41,2560.12,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT  ,,,both,,,1745.85,1047.51,Aetna,Commerical,,1262.66,,,1262.66,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Aetna,Middlesex Employees,,1136.39,,,1136.39,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Anthem,Commerical,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Anthem,Indemnity,,,1269.59,,1269.59,903.83,1398.64,percent of total billed charges,,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Anthem,State Preferred,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Anthem,Individual Exchange,,903.83,,,903.83,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Cigna,Cigna,,1103.37,,,1103.37,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Connecticare,Commerical,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Connecticare,Exchange,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,Multiplan,Multiplan,,,1398.64,,1398.64,903.83,1398.64,percent of total billed charges,,
HC I&D THROMBOS HEM,46083,CPT,,,both,,,1745.85,1047.51,United Healthcare/Oxford,United Healthcare/Oxford,,1135.53,,,1135.53,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT  ,,,both,,,1745.85,1047.51,Aetna,Commerical,,1262.66,,,1262.66,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Aetna,Middlesex Employees,,1136.39,,,1136.39,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Anthem,Commerical,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Anthem,Indemnity,,,1269.59,,1269.59,903.83,1398.64,percent of total billed charges,,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Anthem,State Preferred,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Anthem,Individual Exchange,,903.83,,,903.83,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Cigna,Cigna,,1103.37,,,1103.37,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Connecticare,Commerical,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Connecticare,Exchange,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,Multiplan,Multiplan,,,1398.64,,1398.64,903.83,1398.64,percent of total billed charges,,
HC LIGATION OF HEMORRHOID(S),46221,CPT,,,both,,,1745.85,1047.51,United Healthcare/Oxford,United Healthcare/Oxford,,1135.53,,,1135.53,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT  ,,,both,,,1745.85,1047.51,Aetna,Commerical,,1262.66,,,1262.66,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Aetna,Middlesex Employees,,1136.39,,,1136.39,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Anthem,Commerical,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Anthem,Indemnity,,,1269.59,,1269.59,903.83,1398.64,percent of total billed charges,,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Anthem,State Preferred,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Anthem,Individual Exchange,,903.83,,,903.83,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Cigna,Cigna,,1103.37,,,1103.37,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Connecticare,Commerical,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Connecticare,Exchange,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,Multiplan,Multiplan,,,1398.64,,1398.64,903.83,1398.64,percent of total billed charges,,
HC REMOVAL OF HEMORRHOID CLOT,46320,CPT,,,both,,,1745.85,1047.51,United Healthcare/Oxford,United Healthcare/Oxford,,1135.53,,,1135.53,903.83,1398.64,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT  ,,,both,,,256.47,153.88,Aetna,Commerical,,185.61,,,185.61,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Aetna,Middlesex Employees,,167.05,,,167.05,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Anthem,Commerical,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Anthem,Indemnity,,,186.64,,186.64,132.87,205.61,percent of total billed charges,,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Anthem,State Preferred,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Anthem,Individual Exchange,,132.87,,,132.87,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Cigna,Cigna,,162.2,,,162.2,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Connecticare,Commerical,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Connecticare,Exchange,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,Multiplan,Multiplan,,,205.61,,205.61,132.87,205.61,percent of total billed charges,,
HC DIAGNOSTIC ANOSCOPY SPX,46600,CPT,,,both,,,256.47,153.88,United Healthcare/Oxford,United Healthcare/Oxford,,166.92,,,166.92,132.87,205.61,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT  ,,,both,,,3195.06,1917.04,Aetna,Commerical,,2311.21,,,2311.21,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Aetna,Middlesex Employees,,2080.09,,,2080.09,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Anthem,Commerical,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Anthem,Indemnity,,,2323.9,,2323.9,1654.41,2560.12,percent of total billed charges,,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Anthem,State Preferred,,2068.01,,,2068.01,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Anthem,Individual Exchange,,1654.41,,,1654.41,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Cigna,Cigna,,2019.64,,,2019.64,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Connecticare,Commerical,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Connecticare,Exchange,,2160.19,,,2160.19,1654.41,2560.12,other,Could be inpatient or outpatient,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,Multiplan,Multiplan,,,2560.12,,2560.12,1654.41,2560.12,percent of total billed charges,,
HC ANOSCOPY; W REM FB,46608,CPT,,,both,,,3195.06,1917.04,United Healthcare/Oxford,United Healthcare/Oxford,,2078.51,,,2078.51,1654.41,2560.12,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT  ,,,both,,,1666.88,1000.13,Aetna,Commerical,,915.98,,,915.98,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT  ,,,both,,,6065.37,3639.22,Aetna,Commerical,,4387.13,,,4387.13,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT  ,,,both,,,1018.58,611.15,Aetna,Commerical,,736.75,,,736.75,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Aetna,Middlesex Employees,,824.38,,,824.38,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Aetna,Middlesex Employees,,3948.42,,,3948.42,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Aetna,Middlesex Employees,,663.07,,,663.07,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Anthem,Commerical,,1087.59,,,1087.59,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Anthem,Commerical,,3925.51,,,3925.51,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Anthem,Commerical,,659.23,,,659.23,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Anthem,Indemnity,,,1212.29,,1212.29,659.23,1335.51,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Anthem,Indemnity,,,4411.23,,4411.23,659.23,4859.61,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Anthem,Indemnity,,,740.79,,740.79,659.23,816.09,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Anthem,State Preferred,,1087.59,,,1087.59,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Anthem,State Preferred,,3925.51,,,3925.51,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Anthem,State Preferred,,659.23,,,659.23,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Anthem,Individual Exchange,,870.07,,,870.07,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Anthem,Individual Exchange,,3140.41,,,3140.41,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Anthem,Individual Exchange,,527.38,,,527.38,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Cigna,Cigna,,1250.34,,,1250.34,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Cigna,Cigna,,3833.69,,,3833.69,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Cigna,Cigna,,643.81,,,643.81,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Connecticare,Commerical,,1164.02,,,1164.02,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Connecticare,Commerical,,4100.47,,,4100.47,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Connecticare,Commerical,,688.61,,,688.61,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Connecticare,Exchange,,1164.02,,,1164.02,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Connecticare,Exchange,,4100.47,,,4100.47,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Connecticare,Exchange,,688.61,,,688.61,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,Multiplan,Multiplan,,,1335.51,,1335.51,659.23,1335.51,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,Multiplan,Multiplan,,,4859.61,,4859.61,659.23,4859.61,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,Multiplan,Multiplan,,,816.09,,816.09,659.23,816.09,percent of total billed charges,,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD CT HTFD,47000,CPT,,,both,,,1666.88,1000.13,United Healthcare/Oxford,United Healthcare/Oxford,,1015.47,,,1015.47,659.23,1335.51,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS,47000,CPT,,,both,,,6065.37,3639.22,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,659.23,4859.61,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; PERCUTANEOUS RAD ULTRSND HTFD,47000,CPT,,,both,,,1018.58,611.15,United Healthcare/Oxford,United Healthcare/Oxford,,662.58,,,662.58,659.23,816.09,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT  ,,,both,,,1302.95,781.77,Aetna,Commerical,,941.9,,,941.9,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Aetna,Middlesex Employees,,847.71,,,847.71,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Anthem,Commerical,,842.79,,,842.79,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Anthem,Indemnity,,,947.07,,947.07,674.23,1043.34,percent of total billed charges,,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Anthem,State Preferred,,842.79,,,842.79,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Anthem,Individual Exchange,,674.23,,,674.23,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Cigna,Cigna,,823.08,,,823.08,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Connecticare,Commerical,,880.36,,,880.36,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Connecticare,Exchange,,880.36,,,880.36,674.23,1043.34,other,Could be inpatient or outpatient,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,Multiplan,Multiplan,,,1043.34,,1043.34,674.23,1043.34,percent of total billed charges,,
HC NEEDLE BX LIVER; AT MAJOR OP,47001,CPT,,,both,,,1302.95,781.77,United Healthcare/Oxford,United Healthcare/Oxford,,847.07,,,847.07,674.23,1043.34,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT  ,,,both,,,2833.53,1700.12,Aetna,Commerical,,1556.74,,,1556.74,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Aetna,Middlesex Employees,,1401.07,,,1401.07,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Anthem,Commerical,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Anthem,Indemnity,,,2060.32,,2060.32,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Anthem,State Preferred,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Anthem,Individual Exchange,,1478.7,,,1478.7,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Cigna,Cigna,,2124.99,,,2124.99,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Connecticare,Commerical,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Connecticare,Exchange,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,Multiplan,Multiplan,,,2269.75,,2269.75,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN LIVE,47011,CPT,,,both,,,2833.53,1700.12,United Healthcare/Oxford,United Healthcare/Oxford,,1725.82,,,1725.82,1401.07,2269.75,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT  ,,,both,,,597.4,358.44,Aetna,Commerical,,432.28,,,432.28,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Aetna,Middlesex Employees,,389.05,,,389.05,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Anthem,Commerical,,386.8,,,386.8,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Anthem,Indemnity,,,434.66,,434.66,309.44,478.84,percent of total billed charges,,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Anthem,State Preferred,,386.8,,,386.8,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Anthem,Individual Exchange,,309.44,,,309.44,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Cigna,Cigna,,377.75,,,377.75,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Connecticare,Commerical,,404.04,,,404.04,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Connecticare,Exchange,,404.04,,,404.04,309.44,478.84,other,Could be inpatient or outpatient,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,Multiplan,Multiplan,,,478.84,,478.84,309.44,478.84,percent of total billed charges,,
HC HH ABSCESSDRNLIVR,47011,CPT,,,both,,,597.4,358.44,United Healthcare/Oxford,United Healthcare/Oxford,,388.76,,,388.76,309.44,478.84,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT  ,,,both,,,1605.77,963.46,Aetna,Commerical,,1161.71,,,1161.71,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Aetna,Middlesex Employees,,1045.54,,,1045.54,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Anthem,Commerical,,1039.47,,,1039.47,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Anthem,Indemnity,,,1168.08,,1168.08,831.58,1286.82,percent of total billed charges,,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Anthem,State Preferred,,1039.47,,,1039.47,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Anthem,Individual Exchange,,831.58,,,831.58,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Cigna,Cigna,,1015.15,,,1015.15,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Connecticare,Commerical,,1085.8,,,1085.8,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Connecticare,Exchange,,1085.8,,,1085.8,831.58,1286.82,other,Could be inpatient or outpatient,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,Multiplan,Multiplan,,,1286.82,,1286.82,831.58,1286.82,percent of total billed charges,,
HC PERCUT ABLATE 1+ LIVER RF,47382,CPT,,,both,,,1605.77,963.46,United Healthcare/Oxford,United Healthcare/Oxford,,1044.75,,,1044.75,831.58,1286.82,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT  ,,,both,,,12450.64,7470.38,Aetna,Commerical,,9005.48,,,9005.48,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Aetna,Middlesex Employees,,8104.93,,,8104.93,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Anthem,Commerical,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Anthem,Indemnity,,,9054.93,,9054.93,6446.31,9975.33,percent of total billed charges,,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Anthem,State Preferred,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Anthem,Individual Exchange,,6446.31,,,6446.31,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Cigna,Cigna,,7869.42,,,7869.42,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Connecticare,Commerical,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Connecticare,Exchange,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,Multiplan,Multiplan,,,9975.33,,9975.33,6446.31,9975.33,percent of total billed charges,,
HC  PERQ ABLTJ LVR CRYOABLATION,47383,CPT,,,both,,,12450.64,7470.38,United Healthcare/Oxford,United Healthcare/Oxford,,8098.79,,,8098.79,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT  ,,,both,,,2288.66,1373.2,Aetna,Commerical,,1655.05,,,1655.05,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Aetna,Middlesex Employees,,1489.54,,,1489.54,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Anthem,Commerical,,1480.9,,,1480.9,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Anthem,Indemnity,,,1664.14,,1664.14,1184.72,1833.29,percent of total billed charges,,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Anthem,State Preferred,,1480.9,,,1480.9,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Anthem,Individual Exchange,,1184.72,,,1184.72,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Cigna,Cigna,,1446.27,,,1446.27,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Connecticare,Commerical,,1546.9,,,1546.9,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Connecticare,Exchange,,1546.9,,,1546.9,1184.72,1833.29,other,Could be inpatient or outpatient,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,Multiplan,Multiplan,,,1833.29,,1833.29,1184.72,1833.29,percent of total billed charges,,
HC PERCUTANEOUS CHOLECYSTOSTOMY,47490,CPT,,,both,,,2288.66,1373.2,United Healthcare/Oxford,United Healthcare/Oxford,,1488.41,,,1488.41,1184.72,1833.29,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT  ,,,both,,,751.9,451.14,Aetna,Commerical,,543.82,,,543.82,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Aetna,Middlesex Employees,,489.43,,,489.43,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Anthem,Commerical,,486.59,,,486.59,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Anthem,Indemnity,,,546.8,,546.8,389.27,602.38,percent of total billed charges,,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Anthem,State Preferred,,486.59,,,486.59,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Anthem,Individual Exchange,,389.27,,,389.27,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Cigna,Cigna,,475.21,,,475.21,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Connecticare,Commerical,,508.28,,,508.28,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Connecticare,Exchange,,508.28,,,508.28,389.27,602.38,other,Could be inpatient or outpatient,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,Multiplan,Multiplan,,,602.38,,602.38,389.27,602.38,percent of total billed charges,,
HC INJ TRANSHEPATIC CHOLANGIOGRAPHY,47500,CPT,,,both,,,751.9,451.14,United Healthcare/Oxford,United Healthcare/Oxford,,489.06,,,489.06,389.27,602.38,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT  ,,,both,,,7006.06,4203.64,Aetna,Commerical,,5067.72,,,5067.72,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Aetna,Middlesex Employees,,4560.95,,,4560.95,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Anthem,Commerical,,4534.48,,,4534.48,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Anthem,Indemnity,,,5095.55,,5095.55,3627.58,5613.49,percent of total billed charges,,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Anthem,State Preferred,,4534.48,,,4534.48,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Anthem,Individual Exchange,,3627.58,,,3627.58,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Cigna,Cigna,,4428.41,,,4428.41,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Connecticare,Commerical,,4736.58,,,4736.58,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Connecticare,Exchange,,4736.58,,,4736.58,3627.58,5613.49,other,Could be inpatient or outpatient,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,Multiplan,Multiplan,,,5613.49,,5613.48,3627.58,5613.49,percent of total billed charges,,
HC ASC BILIARY DRN,47510,CPT,,,both,,,7006.06,4203.64,United Healthcare/Oxford,United Healthcare/Oxford,,4557.49,,,4557.49,3627.58,5613.49,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT  ,,,both,,,10380.57,6228.34,Aetna,Commerical,,5704.32,,,5704.32,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT  ,,,both,,,650.55,390.33,Aetna,Commerical,,470.54,,,470.54,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Aetna,Middlesex Employees,,5133.89,,,5133.89,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Aetna,Middlesex Employees,,423.49,,,423.49,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Anthem,Commerical,,6773.02,,,6773.02,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Anthem,Commerical,,421.03,,,421.03,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Anthem,Indemnity,,,7549.59,,7549.59,5133.89,8316.98,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Anthem,Indemnity,,,473.13,,473.13,421.03,521.22,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Anthem,State Preferred,,6773.02,,,6773.02,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Anthem,State Preferred,,421.03,,,421.03,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Anthem,Individual Exchange,,5418.41,,,5418.41,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Anthem,Individual Exchange,,336.82,,,336.82,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Cigna,Cigna,,7786.56,,,7786.56,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Cigna,Cigna,,411.18,,,411.18,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Connecticare,Commerical,,7248.99,,,7248.99,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Connecticare,Commerical,,439.8,,,439.8,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Connecticare,Exchange,,7248.99,,,7248.99,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Connecticare,Exchange,,439.8,,,439.8,421.03,521.22,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,Multiplan,Multiplan,,,8316.98,,8316.98,5133.89,8316.98,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,Multiplan,Multiplan,,,521.22,,521.22,421.03,521.22,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM,47531,CPT,,,both,,,10380.57,6228.34,United Healthcare/Oxford,United Healthcare/Oxford,,6323.88,,,6323.88,5133.89,8316.98,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM-OR,47531,CPT,,,both,,,650.55,390.33,United Healthcare/Oxford,United Healthcare/Oxford,,423.17,,,423.17,421.03,521.22,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT  ,,,both,,,5226.22,3135.73,Aetna,Commerical,,2872.26,,,2872.26,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Aetna,Middlesex Employees,,2585.03,,,2585.03,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Anthem,Commerical,,3410.38,,,3410.38,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Anthem,Indemnity,,,3801.4,,3801.4,2585.03,4187.8,percent of total billed charges,,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Anthem,State Preferred,,3410.38,,,3410.38,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Anthem,Individual Exchange,,2728.3,,,2728.3,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Cigna,Cigna,,3920.72,,,3920.72,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Connecticare,Commerical,,3650.03,,,3650.03,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Connecticare,Exchange,,3650.03,,,3650.03,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,Multiplan,Multiplan,,,4187.8,,4187.8,2585.03,4187.8,percent of total billed charges,,
HC HH FL XHEPATIC & INJ FOR CHOLANGIOGRAM,47532,CPT,,,both,,,5226.22,3135.73,United Healthcare/Oxford,United Healthcare/Oxford,,3184.22,,,3184.22,2585.03,4187.8,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT  ,,,both,,,13098.66,7859.2,Aetna,Commerical,,9474.4,,,9474.4,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Aetna,Middlesex Employees,,8526.95,,,8526.95,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Anthem,Commerical,,8477.47,,,8477.47,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Anthem,Indemnity,,,9526.42,,9526.42,6781.97,10494.74,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Anthem,State Preferred,,8477.47,,,8477.47,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Anthem,Individual Exchange,,6781.97,,,6781.97,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Cigna,Cigna,,8279.19,,,8279.19,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Connecticare,Commerical,,8855.3,,,8855.3,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Connecticare,Exchange,,8855.3,,,8855.3,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,Multiplan,Multiplan,,,10494.74,,10494.74,6781.97,10494.74,percent of total billed charges,,
HC HH INJECTION FOR CHOLANGIOGRAM,47532,CPT,,,both,,,13098.66,7859.2,United Healthcare/Oxford,United Healthcare/Oxford,,8520.5,,,8520.5,6781.97,10494.74,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT  ,,,both,,,1595.47,957.28,Aetna,Commerical,,1153.57,,,1153.57,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Aetna,Middlesex Employees,,1038.21,,,1038.21,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Anthem,Commerical,,1032.18,,,1032.18,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Anthem,Indemnity,,,1159.91,,1159.91,825.74,1277.81,percent of total billed charges,,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Anthem,State Preferred,,1032.18,,,1032.18,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Anthem,Individual Exchange,,825.74,,,825.74,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Cigna,Cigna,,1008.04,,,1008.04,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Connecticare,Commerical,,1078.19,,,1078.19,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Connecticare,Exchange,,1078.19,,,1078.19,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,Multiplan,Multiplan,,,1277.81,,1277.81,825.74,1277.81,percent of total billed charges,,
HC HH PLMT BILIARY DRAINAGE CATH,47533,CPT,,,both,,,1595.47,957.28,United Healthcare/Oxford,United Healthcare/Oxford,,1037.43,,,1037.43,825.74,1277.81,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT  ,,,both,,,6787.7,4072.62,Aetna,Commerical,,3730.1,,,3730.1,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Aetna,Middlesex Employees,,3357.09,,,3357.09,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Anthem,Commerical,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Anthem,Indemnity,,,4936.75,,4936.75,3357.09,5438.55,percent of total billed charges,,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Anthem,State Preferred,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Anthem,Individual Exchange,,3543.15,,,3543.15,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Cigna,Cigna,,5091.7,,,5091.7,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Connecticare,Commerical,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Connecticare,Exchange,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,Multiplan,Multiplan,,,5438.55,,5438.55,3357.09,5438.55,percent of total billed charges,,
HC HH PLMT EXTRN BILIARY DRAINAGE CATH,47533,CPT,,,both,,,6787.7,4072.62,United Healthcare/Oxford,United Healthcare/Oxford,,4135.24,,,4135.24,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT  ,,,both,,,6787.7,4072.62,Aetna,Commerical,,3730.1,,,3730.1,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Aetna,Middlesex Employees,,3357.09,,,3357.09,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Anthem,Commerical,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Anthem,Indemnity,,,4936.75,,4936.75,3357.09,5438.55,percent of total billed charges,,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Anthem,State Preferred,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Anthem,Individual Exchange,,3543.15,,,3543.15,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Cigna,Cigna,,5091.7,,,5091.7,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Connecticare,Commerical,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Connecticare,Exchange,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,Multiplan,Multiplan,,,5438.55,,5438.55,3357.09,5438.55,percent of total billed charges,,
HC HH PLMT INTL-EXTN BILIARY DRAINAGE CATH,47534,CPT,,,both,,,6787.7,4072.62,United Healthcare/Oxford,United Healthcare/Oxford,,4135.24,,,4135.24,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT  ,,,both,,,6787.7,4072.62,Aetna,Commerical,,3730.1,,,3730.1,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Aetna,Middlesex Employees,,3357.09,,,3357.09,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Anthem,Commerical,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Anthem,Indemnity,,,4936.75,,4936.75,3357.09,5438.55,percent of total billed charges,,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Anthem,State Preferred,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Anthem,Individual Exchange,,3543.15,,,3543.15,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Cigna,Cigna,,5091.7,,,5091.7,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Connecticare,Commerical,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Connecticare,Exchange,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,Multiplan,Multiplan,,,5438.55,,5438.55,3357.09,5438.55,percent of total billed charges,,
HC HH CONVERSION EXT BIL DRAINAGE CATH,47535,CPT,,,both,,,6787.7,4072.62,United Healthcare/Oxford,United Healthcare/Oxford,,4135.24,,,4135.24,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT  ,,,both,,,6787.7,4072.62,Aetna,Commerical,,3730.1,,,3730.1,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Aetna,Middlesex Employees,,3357.09,,,3357.09,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Anthem,Commerical,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Anthem,Indemnity,,,4936.75,,4936.75,3357.09,5438.55,percent of total billed charges,,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Anthem,State Preferred,,4428.93,,,4428.93,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Anthem,Individual Exchange,,3543.15,,,3543.15,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Cigna,Cigna,,5091.7,,,5091.7,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Connecticare,Commerical,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Connecticare,Exchange,,4740.18,,,4740.18,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,Multiplan,Multiplan,,,5438.55,,5438.55,3357.09,5438.55,percent of total billed charges,,
HC HH EXCHANGE BIL DRAINAGE CATH,47536,CPT,,,both,,,6787.7,4072.62,United Healthcare/Oxford,United Healthcare/Oxford,,4135.24,,,4135.24,3357.09,5438.55,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT  ,,,both,,,1444.06,866.44,Aetna,Commerical,,1044.48,,,1044.48,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Aetna,Middlesex Employees,,940.03,,,940.03,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Anthem,Commerical,,934.57,,,934.57,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Anthem,Indemnity,,,1050.21,,1050.21,747.66,1156.96,percent of total billed charges,,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Anthem,State Preferred,,934.57,,,934.57,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Anthem,Individual Exchange,,747.66,,,747.66,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Cigna,Cigna,,912.71,,,912.71,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Connecticare,Commerical,,976.23,,,976.23,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Connecticare,Exchange,,976.23,,,976.23,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,Multiplan,Multiplan,,,1156.96,,1156.96,747.66,1156.96,percent of total billed charges,,
HC HH EXCHANGE BILIARY DRG CATH,47536,CPT,,,both,,,1444.06,866.44,United Healthcare/Oxford,United Healthcare/Oxford,,939.32,,,939.32,747.66,1156.96,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT  ,,,both,,,3181.67,1909,Aetna,Commerical,,1748.47,,,1748.47,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Aetna,Middlesex Employees,,1573.63,,,1573.63,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Anthem,Commerical,,2076.04,,,2076.04,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Anthem,Indemnity,,,2314.07,,2314.07,1573.63,2549.29,percent of total billed charges,,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Anthem,State Preferred,,2076.04,,,2076.04,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Anthem,Individual Exchange,,1660.83,,,1660.83,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Cigna,Cigna,,2386.71,,,2386.71,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Connecticare,Commerical,,2221.94,,,2221.94,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Connecticare,Exchange,,2221.94,,,2221.94,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,Multiplan,Multiplan,,,2549.29,,2549.29,1573.63,2549.29,percent of total billed charges,,
HC HH REMOVAL BIL DRAINAGE CATH,47537,CPT,,,both,,,3181.67,1909,United Healthcare/Oxford,United Healthcare/Oxford,,1938.38,,,1938.38,1573.63,2549.29,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT  ,,,both,,,10920.06,6552.04,Aetna,Commerical,,6000.57,,,6000.57,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Aetna,Middlesex Employees,,5400.51,,,5400.51,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Anthem,Commerical,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Anthem,Indemnity,,,7941.69,,7941.69,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Anthem,State Preferred,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Anthem,Individual Exchange,,5699.82,,,5699.82,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Cigna,Cigna,,8190.97,,,8190.97,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Connecticare,Commerical,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Connecticare,Exchange,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,Multiplan,Multiplan,,,8748.92,,8748.92,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT,47538,CPT,,,both,,,10920.06,6552.04,United Healthcare/Oxford,United Healthcare/Oxford,,6652.32,,,6652.32,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT  ,,,both,,,10920.06,6552.04,Aetna,Commerical,,6000.57,,,6000.57,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Aetna,Middlesex Employees,,5400.51,,,5400.51,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Anthem,Commerical,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Anthem,Indemnity,,,7941.69,,7941.69,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Anthem,State Preferred,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Anthem,Individual Exchange,,5699.82,,,5699.82,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Cigna,Cigna,,8190.97,,,8190.97,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Connecticare,Commerical,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Connecticare,Exchange,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,Multiplan,Multiplan,,,8748.92,,8748.92,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT- WO SEP CTH,47539,CPT,,,both,,,10920.06,6552.04,United Healthcare/Oxford,United Healthcare/Oxford,,6652.32,,,6652.32,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT  ,,,both,,,10920.06,6552.04,Aetna,Commerical,,6000.57,,,6000.57,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Aetna,Middlesex Employees,,5400.51,,,5400.51,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Anthem,Commerical,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Anthem,Indemnity,,,7941.69,,7941.69,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Anthem,State Preferred,,7124.77,,,7124.77,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Anthem,Individual Exchange,,5699.82,,,5699.82,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Cigna,Cigna,,8190.97,,,8190.97,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Connecticare,Commerical,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Connecticare,Exchange,,7625.46,,,7625.46,5400.51,8748.92,other,Could be inpatient or outpatient,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,Multiplan,Multiplan,,,8748.92,,8748.92,5400.51,8748.92,percent of total billed charges,,
HC HH PERC PLMT BILE DUCT STENT- W SEP CATH,47540,CPT,,,both,,,10920.06,6552.04,United Healthcare/Oxford,United Healthcare/Oxford,,6652.32,,,6652.32,5400.51,8748.92,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT  ,,,both,,,7373.77,4424.26,Aetna,Commerical,,5333.11,,,5333.11,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Aetna,Middlesex Employees,,4799.8,,,4799.8,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Anthem,Commerical,,4771.94,,,4771.94,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Anthem,Indemnity,,,5362.4,,5362.4,3817.56,5907.47,percent of total billed charges,,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Anthem,State Preferred,,4771.94,,,4771.94,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Anthem,Individual Exchange,,3817.56,,,3817.56,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Cigna,Cigna,,4660.33,,,4660.33,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Connecticare,Commerical,,4984.63,,,4984.63,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Connecticare,Exchange,,4984.63,,,4984.63,3817.56,5907.47,other,Could be inpatient or outpatient,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,Multiplan,Multiplan,,,5907.47,,5907.47,3817.56,5907.47,percent of total billed charges,,
HC PERC DIL BILIARY STRICTURE WO STENT,47555,CPT,,,both,,,7373.77,4424.26,United Healthcare/Oxford,United Healthcare/Oxford,,4796.16,,,4796.16,3817.56,5907.47,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT  ,,,both,,,25178.41,15107.05,Aetna,Commerical,,8721.64,,,8721.64,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Aetna,Middlesex Employees,,7849.48,,,7849.48,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Anthem,Commerical,,8735.6,,,8735.6,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Anthem,Indemnity,,,18311.8,,18311.8,6988.48,20173.11,percent of total billed charges,,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Anthem,State Preferred,,8735.6,,,8735.6,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Anthem,Individual Exchange,,6988.48,,,6988.48,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Cigna,Cigna,,13753.59,,,13753.59,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Connecticare,Commerical,,,,,,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Connecticare,Exchange,,,,,,6988.48,20173.11,other,Could be inpatient or outpatient,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,Multiplan,Multiplan,,,20173.11,,20173.11,6988.48,20173.11,percent of total billed charges,,
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE,47562,CPT,,,both,,,25178.41,15107.05,United Healthcare/Oxford,United Healthcare/Oxford,,9849.11,,,9849.11,6988.48,20173.11,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT  ,,,both,,,2346.69,1408.01,Aetna,Commerical,,1697.38,,,1697.38,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Aetna,Middlesex Employees,,1527.65,,,1527.65,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Anthem,Commerical,,1518.78,,,1518.78,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Anthem,Indemnity,,,1706.7,,1706.7,1215.03,1880.18,percent of total billed charges,,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Anthem,State Preferred,,1518.78,,,1518.78,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Anthem,Individual Exchange,,1215.03,,,1215.03,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Cigna,Cigna,,1483.26,,,1483.26,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Connecticare,Commerical,,1586.47,,,1586.47,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Connecticare,Exchange,,1586.47,,,1586.47,1215.03,1880.18,other,Could be inpatient or outpatient,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,Multiplan,Multiplan,,,1880.18,,1880.18,1215.03,1880.18,percent of total billed charges,,
HC BIOPSY OF PANCREAS PERC NEEDLE,48102,CPT,,,both,,,2346.69,1408.01,United Healthcare/Oxford,United Healthcare/Oxford,,1526.48,,,1526.48,1215.03,1880.18,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT  ,,,both,,,2833.53,1700.12,Aetna,Commerical,,1556.74,,,1556.74,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Aetna,Middlesex Employees,,1401.07,,,1401.07,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Anthem,Commerical,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Anthem,Indemnity,,,2060.32,,2060.32,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Anthem,State Preferred,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Anthem,Individual Exchange,,1478.7,,,1478.7,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Cigna,Cigna,,2124.99,,,2124.99,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Connecticare,Commerical,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Connecticare,Exchange,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,Multiplan,Multiplan,,,2269.75,,2269.75,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN PANC,48511,CPT,,,both,,,2833.53,1700.12,United Healthcare/Oxford,United Healthcare/Oxford,,1725.82,,,1725.82,1401.07,2269.75,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT  ,,,both,,,1806.62,1083.97,Aetna,Commerical,,1306.62,,,1306.62,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Aetna,Middlesex Employees,,1175.96,,,1175.96,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Anthem,Commerical,,1169.13,,,1169.13,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Anthem,Indemnity,,,1313.79,,1313.79,935.3,1447.33,percent of total billed charges,,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Anthem,State Preferred,,1169.13,,,1169.13,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Anthem,Individual Exchange,,935.3,,,935.3,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Cigna,Cigna,,1141.78,,,1141.78,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Connecticare,Commerical,,1221.23,,,1221.23,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Connecticare,Exchange,,1221.23,,,1221.23,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,Multiplan,Multiplan,,,1447.33,,1447.33,935.3,1447.33,percent of total billed charges,,
HC HH CT PANCREASASP,48511,CPT,,,both,,,1806.62,1083.97,United Healthcare/Oxford,United Healthcare/Oxford,,1175.07,,,1175.07,935.3,1447.33,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT  ,,,both,,,4161.2,2496.72,Aetna,Commerical,,3009.7,,,3009.7,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Aetna,Middlesex Employees,,2708.73,,,2708.73,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Anthem,Commerical,,2693.01,,,2693.01,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Anthem,Indemnity,,,3026.23,,3026.23,2154.4,3333.83,percent of total billed charges,,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Anthem,State Preferred,,2693.01,,,2693.01,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Anthem,Individual Exchange,,2154.4,,,2154.4,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Cigna,Cigna,,2630.01,,,2630.01,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Connecticare,Commerical,,2813.03,,,2813.03,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Connecticare,Exchange,,2813.03,,,2813.03,2154.4,3333.83,other,Could be inpatient or outpatient,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,Multiplan,Multiplan,,,3333.83,,3333.83,2154.4,3333.83,percent of total billed charges,,
HC HH DRAINAGE ABDOM ABSCESS OPEN,49020,CPT,,,both,,,4161.2,2496.72,United Healthcare/Oxford,United Healthcare/Oxford,,2706.68,,,2706.68,2154.4,3333.83,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT  ,,,both,,,2833.53,1700.12,Aetna,Commerical,,1556.74,,,1556.74,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Aetna,Middlesex Employees,,1401.07,,,1401.07,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Anthem,Commerical,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Anthem,Indemnity,,,2060.32,,2060.32,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Anthem,State Preferred,,1848.39,,,1848.39,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Anthem,Individual Exchange,,1478.7,,,1478.7,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Cigna,Cigna,,2124.99,,,2124.99,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Connecticare,Commerical,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Connecticare,Exchange,,1978.28,,,1978.28,1401.07,2269.75,other,Could be inpatient or outpatient,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,Multiplan,Multiplan,,,2269.75,,2269.75,1401.07,2269.75,percent of total billed charges,,
HC CT ABS DRAIN ABD,49021,CPT,,,both,,,2833.53,1700.12,United Healthcare/Oxford,United Healthcare/Oxford,,1725.82,,,1725.82,1401.07,2269.75,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT  ,,,both,,,2268.06,1360.84,Aetna,Commerical,,1641.2,,,1641.2,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Aetna,Middlesex Employees,,1477.09,,,1477.09,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Anthem,Commerical,,1468.51,,,1468.51,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Anthem,Indemnity,,,1650.22,,1650.22,1174.81,1817.95,percent of total billed charges,,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Anthem,State Preferred,,1468.51,,,1468.51,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Anthem,Individual Exchange,,1174.81,,,1174.81,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Cigna,Cigna,,1434.17,,,1434.17,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Connecticare,Commerical,,1533.97,,,1533.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Connecticare,Exchange,,1533.97,,,1533.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,Multiplan,Multiplan,,,1817.95,,1817.95,1174.81,1817.95,percent of total billed charges,,
HC HH CT ABSDRN PERI,49021,CPT,,,both,,,2268.06,1360.84,United Healthcare/Oxford,United Healthcare/Oxford,,1475.97,,,1475.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT  ,,,both,,,1635.64,981.38,Aetna,Commerical,,1182.87,,,1182.87,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Aetna,Middlesex Employees,,1064.58,,,1064.58,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Anthem,Commerical,,1058.41,,,1058.41,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Anthem,Indemnity,,,1189.37,,1189.37,846.73,1310.27,percent of total billed charges,,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Anthem,State Preferred,,1058.41,,,1058.41,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Anthem,Individual Exchange,,846.73,,,846.73,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Cigna,Cigna,,1033.66,,,1033.66,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Connecticare,Commerical,,1105.59,,,1105.59,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Connecticare,Exchange,,1105.59,,,1105.59,846.73,1310.27,other,Could be inpatient or outpatient,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,Multiplan,Multiplan,,,1310.27,,1310.27,846.73,1310.27,percent of total billed charges,,
HC HH US ABSDRN PERI,49021,CPT,,,both,,,1635.64,981.38,United Healthcare/Oxford,United Healthcare/Oxford,,1063.78,,,1063.78,846.73,1310.27,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT  ,,,both,,,2270.12,1362.07,Aetna,Commerical,,1642.03,,,1642.03,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Aetna,Middlesex Employees,,1477.82,,,1477.82,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Anthem,Commerical,,1469.24,,,1469.24,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Anthem,Indemnity,,,1651.04,,1651.04,1175.4,1818.86,percent of total billed charges,,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Anthem,State Preferred,,1469.24,,,1469.24,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Anthem,Individual Exchange,,1175.4,,,1175.4,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Cigna,Cigna,,1434.88,,,1434.88,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Connecticare,Commerical,,1534.72,,,1534.72,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Connecticare,Exchange,,1534.72,,,1534.72,1175.4,1818.86,other,Could be inpatient or outpatient,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,Multiplan,Multiplan,,,1818.86,,1818.86,1175.4,1818.86,percent of total billed charges,,
HC PERC ABSCESS DRN,49021,CPT,,,both,,,2270.12,1362.07,United Healthcare/Oxford,United Healthcare/Oxford,,1476.7,,,1476.7,1175.4,1818.86,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT  ,,,both,,,911.55,546.93,Aetna,Commerical,,659.42,,,659.42,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Aetna,Middlesex Employees,,593.47,,,593.47,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Anthem,Commerical,,590.03,,,590.03,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Anthem,Indemnity,,,663.04,,663.04,472.02,730.43,percent of total billed charges,,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Anthem,State Preferred,,590.03,,,590.03,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Anthem,Individual Exchange,,472.02,,,472.02,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Cigna,Cigna,,576.23,,,576.23,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Connecticare,Commerical,,616.33,,,616.33,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Connecticare,Exchange,,616.33,,,616.33,472.02,730.43,other,Could be inpatient or outpatient,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,Multiplan,Multiplan,,,730.43,,730.43,472.02,730.43,percent of total billed charges,,
HC HH SUBDIAPABSDRCT,49041,CPT,,,both,,,911.55,546.93,United Healthcare/Oxford,United Healthcare/Oxford,,593.02,,,593.02,472.02,730.43,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT  ,,,both,,,3388.7,2033.22,Aetna,Commerical,,2451.23,,,2451.23,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Aetna,Middlesex Employees,,2206.1,,,2206.1,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Anthem,Commerical,,2193.3,,,2193.3,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Anthem,Indemnity,,,2464.69,,2464.69,1754.64,2715.21,percent of total billed charges,,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Anthem,State Preferred,,2193.3,,,2193.3,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Anthem,Individual Exchange,,1754.64,,,1754.64,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Cigna,Cigna,,2142,,,2142,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Connecticare,Commerical,,2291.06,,,2291.06,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Connecticare,Exchange,,2291.06,,,2291.06,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,Multiplan,Multiplan,,,2715.21,,2715.21,1754.64,2715.21,percent of total billed charges,,
HC HH DRAIN OPEN RETROPERI ABSCESS,49060,CPT,,,both,,,3388.7,2033.22,United Healthcare/Oxford,United Healthcare/Oxford,,2204.44,,,2204.44,1754.64,2715.21,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT  ,,,both,,,906.4,543.84,Aetna,Commerical,,655.34,,,655.34,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Aetna,Middlesex Employees,,589.81,,,589.81,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Anthem,Commerical,,586.39,,,586.39,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Anthem,Indemnity,,,658.94,,658.94,469.11,725.92,percent of total billed charges,,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Anthem,State Preferred,,586.39,,,586.39,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Anthem,Individual Exchange,,469.11,,,469.11,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Cigna,Cigna,,572.68,,,572.68,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Connecticare,Commerical,,612.52,,,612.52,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Connecticare,Exchange,,612.52,,,612.52,469.11,725.92,other,Could be inpatient or outpatient,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,Multiplan,Multiplan,,,725.92,,725.92,469.11,725.92,percent of total billed charges,,
HC HH RETRABSDRAINCT,49061,CPT,,,both,,,906.4,543.84,United Healthcare/Oxford,United Healthcare/Oxford,,589.37,,,589.37,469.11,725.92,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT  ,,,both,,,1393.59,836.15,Aetna,Commerical,,1008.66,,,1008.66,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Aetna,Middlesex Employees,,907.8,,,907.8,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Anthem,Commerical,,902.52,,,902.52,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Anthem,Indemnity,,,1014.2,,1014.2,722.02,1117.29,percent of total billed charges,,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Anthem,State Preferred,,902.52,,,902.52,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Anthem,Individual Exchange,,722.02,,,722.02,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Cigna,Cigna,,881.41,,,881.41,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Connecticare,Commerical,,942.75,,,942.75,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Connecticare,Exchange,,942.75,,,942.75,722.02,1117.29,other,Could be inpatient or outpatient,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,Multiplan,Multiplan,,,1117.29,,1117.29,722.02,1117.29,percent of total billed charges,,
HC USINTRAPERCATHDRN,49061,CPT,,,both,,,1393.59,836.15,United Healthcare/Oxford,United Healthcare/Oxford,,907.1,,,907.1,722.02,1117.29,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT  ,,,both,,,985.71,591.43,Aetna,Commerical,,541.8,,,541.8,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Aetna,Middlesex Employees,,487.62,,,487.62,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Anthem,Commerical,,643.3,,,643.3,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Anthem,Indemnity,,,717.06,,717.06,487.62,789.95,percent of total billed charges,,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Anthem,State Preferred,,643.3,,,643.3,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Anthem,Individual Exchange,,514.64,,,514.64,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Cigna,Cigna,,739.56,,,739.56,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Connecticare,Commerical,,688.5,,,688.5,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Connecticare,Exchange,,688.5,,,688.5,487.62,789.95,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,Multiplan,Multiplan,,,789.95,,789.95,487.62,789.95,percent of total billed charges,,
HC CT ABS DRAIN PARA,49080,CPT,,,both,,,985.71,591.43,United Healthcare/Oxford,United Healthcare/Oxford,,600.64,,,600.64,487.62,789.95,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT  ,,,both,,,635.51,381.31,Aetna,Commerical,,459.96,,,459.96,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Aetna,Middlesex Employees,,413.96,,,413.96,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Anthem,Commerical,,411.57,,,411.57,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Anthem,Indemnity,,,462.49,,462.49,329.25,509.5,percent of total billed charges,,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Anthem,State Preferred,,411.57,,,411.57,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Anthem,Individual Exchange,,329.25,,,329.25,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Cigna,Cigna,,401.94,,,401.94,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Connecticare,Commerical,,429.91,,,429.91,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Connecticare,Exchange,,429.91,,,429.91,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,Multiplan,Multiplan,,,509.5,,509.5,329.25,509.5,percent of total billed charges,,
HC PARACENTESIS WO GUIDE,49080,CPT,,,both,,,635.51,381.31,United Healthcare/Oxford,United Healthcare/Oxford,,413.65,,,413.65,329.25,509.5,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT  ,,,both,,,1342.09,805.25,Aetna,Commerical,,970.4,,,970.4,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Aetna,Middlesex Employees,,873.36,,,873.36,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Anthem,Commerical,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Anthem,Indemnity,,,975.72,,975.72,694.63,1074.9,percent of total billed charges,,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Anthem,State Preferred,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Anthem,Individual Exchange,,694.63,,,694.63,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Cigna,Cigna,,847.98,,,847.98,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Connecticare,Commerical,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Connecticare,Exchange,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,Multiplan,Multiplan,,,1074.9,,1074.9,694.63,1074.9,percent of total billed charges,,
HC PARACENTESIS W GUIDE,49081,CPT,,,both,,,1342.09,805.25,United Healthcare/Oxford,United Healthcare/Oxford,,872.7,,,872.7,694.63,1074.9,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT  ,,,both,,,2652.25,1591.35,Aetna,Commerical,,1917.99,,,1917.99,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Aetna,Middlesex Employees,,1726.2,,,1726.2,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Anthem,Commerical,,1716.19,,,1716.19,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Anthem,Indemnity,,,1928.53,,1928.53,1372.95,2124.56,percent of total billed charges,,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Anthem,State Preferred,,1716.19,,,1716.19,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Anthem,Individual Exchange,,1372.95,,,1372.95,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Cigna,Cigna,,1676.04,,,1676.04,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Connecticare,Commerical,,1792.68,,,1792.68,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Connecticare,Exchange,,1792.68,,,1792.68,1372.95,2124.56,other,Could be inpatient or outpatient,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,Multiplan,Multiplan,,,2124.56,,2124.56,1372.95,2124.56,percent of total billed charges,,
HC ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,2652.25,1591.35,United Healthcare/Oxford,United Healthcare/Oxford,,1724.89,,,1724.89,1372.95,2124.56,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT  ,,,both,,,577.83,346.7,Aetna,Commerical,,418.44,,,418.44,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Aetna,Middlesex Employees,,376.6,,,376.6,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Anthem,Commerical,,374.41,,,374.41,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Anthem,Indemnity,,,420.74,,420.74,299.53,463.51,percent of total billed charges,,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Anthem,State Preferred,,374.41,,,374.41,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Anthem,Individual Exchange,,299.53,,,299.53,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Cigna,Cigna,,365.65,,,365.65,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Connecticare,Commerical,,391.1,,,391.1,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Connecticare,Exchange,,391.1,,,391.1,299.53,463.51,other,Could be inpatient or outpatient,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,Multiplan,Multiplan,,,463.51,,463.51,299.53,463.51,percent of total billed charges,,
HC HH ABD PARACENTESIS W/IMAGING,49083,CPT,,,both,,,577.83,346.7,United Healthcare/Oxford,United Healthcare/Oxford,,376.31,,,376.31,299.53,463.51,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT  ,,,both,,,1824.45,1094.67,Aetna,Commerical,,1319.64,,,1319.64,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Aetna,Middlesex Employees,,1187.68,,,1187.68,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Anthem,Commerical,,1180.78,,,1180.78,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Anthem,Indemnity,,,1326.89,,1326.89,944.62,1461.76,percent of total billed charges,,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Anthem,State Preferred,,1180.78,,,1180.78,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Anthem,Individual Exchange,,944.62,,,944.62,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Cigna,Cigna,,1153.16,,,1153.16,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Connecticare,Commerical,,1233.41,,,1233.41,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Connecticare,Exchange,,1233.41,,,1233.41,944.62,1461.76,other,Could be inpatient or outpatient,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,Multiplan,Multiplan,,,1461.76,,1461.76,944.62,1461.76,percent of total billed charges,,
HC HH PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,1824.45,1094.67,United Healthcare/Oxford,United Healthcare/Oxford,,1186.78,,,1186.78,944.62,1461.76,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT  ,,,both,,,2663.58,1598.15,Aetna,Commerical,,1926.96,,,1926.96,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Aetna,Middlesex Employees,,1734.26,,,1734.26,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Anthem,Commerical,,1724.2,,,1724.2,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Anthem,Indemnity,,,1937.54,,1937.54,1379.35,2134.48,percent of total billed charges,,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Anthem,State Preferred,,1724.2,,,1724.2,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Anthem,Individual Exchange,,1379.35,,,1379.35,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Cigna,Cigna,,1683.86,,,1683.86,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Connecticare,Commerical,,1801.04,,,1801.04,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Connecticare,Exchange,,1801.04,,,1801.04,1379.35,2134.48,other,Could be inpatient or outpatient,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,Multiplan,Multiplan,,,2134.48,,2134.48,1379.35,2134.48,percent of total billed charges,,
HC PERC N BX ABD OR RETROPERITONEAL MASS,49180,CPT,,,both,,,2663.58,1598.15,United Healthcare/Oxford,United Healthcare/Oxford,,1732.94,,,1732.94,1379.35,2134.48,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT  ,,,both,,,2529.68,1517.81,Aetna,Commerical,,1830.08,,,1830.08,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Aetna,Middlesex Employees,,1647.07,,,1647.07,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Anthem,Commerical,,1637.51,,,1637.51,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Anthem,Indemnity,,,1840.12,,1840.12,1310.01,2027.17,percent of total billed charges,,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Anthem,State Preferred,,1637.51,,,1637.51,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Anthem,Individual Exchange,,1310.01,,,1310.01,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Cigna,Cigna,,1599.21,,,1599.21,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Connecticare,Commerical,,1710.49,,,1710.49,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Connecticare,Exchange,,1710.49,,,1710.49,1310.01,2027.17,other,Could be inpatient or outpatient,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,Multiplan,Multiplan,,,2027.17,,2027.17,1310.01,2027.17,percent of total billed charges,,
HC SCLEROTX FLUID COLLECTION,49185,CPT,,,both,,,2529.68,1517.81,United Healthcare/Oxford,United Healthcare/Oxford,,1645.83,,,1645.83,1310.01,2027.17,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT  ,,,both,,,4817.31,2890.39,Aetna,Commerical,,2647.75,,,2647.75,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Aetna,Middlesex Employees,,2382.98,,,2382.98,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Anthem,Commerical,,3143.8,,,3143.8,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Anthem,Indemnity,,,3504.26,,3504.26,2382.98,3860.45,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Anthem,State Preferred,,3143.8,,,3143.8,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Anthem,Individual Exchange,,2515.04,,,2515.04,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Cigna,Cigna,,3614.26,,,3614.26,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Connecticare,Commerical,,3364.73,,,3364.73,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Connecticare,Exchange,,3364.73,,,3364.73,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,Multiplan,Multiplan,,,3860.45,,3860.45,2382.98,3860.45,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN COLXN VISC,49405,CPT,,,both,,,4817.31,2890.39,United Healthcare/Oxford,United Healthcare/Oxford,,2935.32,,,2935.32,2382.98,3860.45,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT  ,,,both,,,4653.54,2792.12,Aetna,Commerical,,2556.83,,,2556.83,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Aetna,Middlesex Employees,,2301.15,,,2301.15,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Anthem,Commerical,,3035.85,,,3035.85,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Anthem,Indemnity,,,3383.93,,3383.93,2301.15,3727.9,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Anthem,State Preferred,,3035.85,,,3035.85,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Anthem,Individual Exchange,,2428.68,,,2428.68,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Cigna,Cigna,,3490.15,,,3490.15,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Connecticare,Commerical,,3249.2,,,3249.2,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Connecticare,Exchange,,3249.2,,,3249.2,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,Multiplan,Multiplan,,,3727.9,,3727.9,2301.15,3727.9,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN PERI/RETRO,49406,CPT,,,both,,,4653.54,2792.12,United Healthcare/Oxford,United Healthcare/Oxford,,2834.54,,,2834.54,2301.15,3727.9,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT  ,,,both,,,6080.09,3648.05,Aetna,Commerical,,4397.72,,,4397.72,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Aetna,Middlesex Employees,,3957.95,,,3957.95,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Anthem,Commerical,,3934.98,,,3934.98,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Anthem,Indemnity,,,4421.87,,4421.87,3147.98,4871.33,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Anthem,State Preferred,,3934.98,,,3934.98,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Anthem,Individual Exchange,,3147.98,,,3147.98,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Cigna,Cigna,,3842.95,,,3842.95,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Connecticare,Commerical,,4110.36,,,4110.36,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Connecticare,Exchange,,4110.36,,,4110.36,3147.98,4871.33,other,Could be inpatient or outpatient,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,Multiplan,Multiplan,,,4871.33,,4871.33,3147.98,4871.33,percent of total billed charges,,
HC IMAGE CATH FLUID DRAIN TRNS/VGNL,49407,CPT,,,both,,,6080.09,3648.05,United Healthcare/Oxford,United Healthcare/Oxford,,3954.95,,,3954.95,3147.98,4871.33,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT  ,,,both,,,192.61,115.57,Aetna,Commerical,,140.02,,,140.02,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Aetna,Middlesex Employees,,126.02,,,126.02,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Anthem,Commerical,,125.29,,,125.29,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Anthem,Indemnity,,,140.79,,140.79,100.23,155.1,percent of total billed charges,,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Anthem,State Preferred,,125.29,,,125.29,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Anthem,Individual Exchange,,100.23,,,100.23,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Cigna,Cigna,,122.36,,,122.36,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Connecticare,Commerical,,130.87,,,130.87,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Connecticare,Exchange,,130.87,,,130.87,100.23,155.1,other,Could be inpatient or outpatient,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,Multiplan,Multiplan,,,155.1,,155.1,100.23,155.1,percent of total billed charges,,
HC EXCHANGE PREVIOUS DRAINAGE CATH,49423,CPT,,,both,,,192.61,115.57,United Healthcare/Oxford,United Healthcare/Oxford,,125.93,,,125.93,100.23,155.1,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT  ,,,both,,,172.01,103.21,Aetna,Commerical,,123.74,,,123.74,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Aetna,Middlesex Employees,,111.37,,,111.37,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Anthem,Commerical,,110.72,,,110.72,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Anthem,Indemnity,,,124.42,,124.42,88.58,137.07,percent of total billed charges,,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Anthem,State Preferred,,110.72,,,110.72,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Anthem,Individual Exchange,,88.58,,,88.58,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Cigna,Cigna,,108.13,,,108.13,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Connecticare,Commerical,,115.66,,,115.66,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Connecticare,Exchange,,115.66,,,115.66,88.58,137.07,other,Could be inpatient or outpatient,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,Multiplan,Multiplan,,,137.07,,137.07,88.58,137.07,percent of total billed charges,,
HC ABSC CYST CONSTRAST INJ,49424,CPT,,,both,,,172.01,103.21,United Healthcare/Oxford,United Healthcare/Oxford,,111.28,,,111.28,88.58,137.07,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT  ,,,both,,,6422.05,3853.23,Aetna,Commerical,,4645.21,,,4645.21,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Aetna,Middlesex Employees,,4180.68,,,4180.68,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Anthem,Commerical,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Anthem,Indemnity,,,4670.72,,4670.72,3325.14,5145.48,percent of total billed charges,,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Anthem,State Preferred,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Anthem,Individual Exchange,,3325.14,,,3325.14,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Cigna,Cigna,,4059.2,,,4059.2,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Connecticare,Commerical,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Connecticare,Exchange,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,Multiplan,Multiplan,,,5145.48,,5145.48,3325.14,5145.48,percent of total billed charges,,
HC PLACE GASTROSTOMY TUBE PERC,49440,CPT,,,both,,,6422.05,3853.23,United Healthcare/Oxford,United Healthcare/Oxford,,4177.52,,,4177.52,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT  ,,,both,,,6422.05,3853.23,Aetna,Commerical,,4645.21,,,4645.21,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Aetna,Middlesex Employees,,4180.68,,,4180.68,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Anthem,Commerical,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Anthem,Indemnity,,,4670.72,,4670.72,3325.14,5145.48,percent of total billed charges,,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Anthem,State Preferred,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Anthem,Individual Exchange,,3325.14,,,3325.14,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Cigna,Cigna,,4059.2,,,4059.2,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Connecticare,Commerical,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Connecticare,Exchange,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,Multiplan,Multiplan,,,5145.48,,5145.48,3325.14,5145.48,percent of total billed charges,,
HC PLACE DUOD/JEJ TUBE PERC,49441,CPT,,,both,,,6422.05,3853.23,United Healthcare/Oxford,United Healthcare/Oxford,,4177.52,,,4177.52,3325.14,5145.48,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT  ,,,both,,,4213.73,2528.24,Aetna,Commerical,,3047.95,,,3047.95,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Aetna,Middlesex Employees,,2743.16,,,2743.16,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Anthem,Commerical,,2727.25,,,2727.25,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Anthem,Indemnity,,,3064.7,,3064.7,2181.8,3376.21,percent of total billed charges,,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Anthem,State Preferred,,2727.25,,,2727.25,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Anthem,Individual Exchange,,2181.8,,,2181.8,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Cigna,Cigna,,2663.45,,,2663.45,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Connecticare,Commerical,,2848.79,,,2848.79,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Connecticare,Exchange,,2848.79,,,2848.79,2181.8,3376.21,other,Could be inpatient or outpatient,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,Multiplan,Multiplan,,,3376.21,,3376.21,2181.8,3376.21,percent of total billed charges,,
HC PLACE CECOSTOMY TUBE PERC,49442,CPT,,,both,,,4213.73,2528.24,United Healthcare/Oxford,United Healthcare/Oxford,,2741.09,,,2741.09,2181.8,3376.21,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT  ,,,both,,,6422.05,3853.23,Aetna,Commerical,,4645.21,,,4645.21,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Aetna,Middlesex Employees,,4180.68,,,4180.68,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Anthem,Commerical,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Anthem,Indemnity,,,4670.72,,4670.72,3325.14,5145.48,percent of total billed charges,,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Anthem,State Preferred,,4156.43,,,4156.43,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Anthem,Individual Exchange,,3325.14,,,3325.14,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Cigna,Cigna,,4059.2,,,4059.2,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Connecticare,Commerical,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Connecticare,Exchange,,4341.67,,,4341.67,3325.14,5145.48,other,Could be inpatient or outpatient,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,Multiplan,Multiplan,,,5145.48,,5145.48,3325.14,5145.48,percent of total billed charges,,
HC CHANGE G-TUBE TO G-J PERC,49446,CPT,,,both,,,6422.05,3853.23,United Healthcare/Oxford,United Healthcare/Oxford,,4177.52,,,4177.52,3325.14,5145.48,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT  ,,,both,,,3346.47,2007.88,Aetna,Commerical,,2420.3,,,2420.3,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Aetna,Middlesex Employees,,2178.27,,,2178.27,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Anthem,Commerical,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Anthem,Indemnity,,,2433.59,,2433.59,1732.5,2680.95,percent of total billed charges,,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Anthem,State Preferred,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Anthem,Individual Exchange,,1732.5,,,1732.5,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Cigna,Cigna,,2114.98,,,2114.98,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Connecticare,Commerical,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Connecticare,Exchange,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,Multiplan,Multiplan,,,2680.95,,2680.95,1732.5,2680.95,percent of total billed charges,,
HC REPLACE G/C TUBE PERC,49450,CPT,,,both,,,3346.47,2007.88,United Healthcare/Oxford,United Healthcare/Oxford,,2176.62,,,2176.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT  ,,,both,,,951.72,571.03,Aetna,Commerical,,688.72,,,688.72,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Aetna,Middlesex Employees,,619.85,,,619.85,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Anthem,Commerical,,616.25,,,616.25,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Anthem,Indemnity,,,692.5,,692.5,493,762.89,percent of total billed charges,,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Anthem,State Preferred,,616.25,,,616.25,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Anthem,Individual Exchange,,493,,,493,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Cigna,Cigna,,601.84,,,601.84,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Connecticare,Commerical,,643.72,,,643.72,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Connecticare,Exchange,,643.72,,,643.72,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,Multiplan,Multiplan,,,762.89,,762.89,493,762.89,percent of total billed charges,,
HC REPLACE DUOD/JEJ TUBE PERC,49451,CPT,,,both,,,951.72,571.03,United Healthcare/Oxford,United Healthcare/Oxford,,619.38,,,619.38,493,762.89,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT  ,,,both,,,3346.47,2007.88,Aetna,Commerical,,2420.3,,,2420.3,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Aetna,Middlesex Employees,,2178.27,,,2178.27,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Anthem,Commerical,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Anthem,Indemnity,,,2433.59,,2433.59,1732.5,2680.95,percent of total billed charges,,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Anthem,State Preferred,,2165.62,,,2165.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Anthem,Individual Exchange,,1732.5,,,1732.5,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Cigna,Cigna,,2114.98,,,2114.98,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Connecticare,Commerical,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Connecticare,Exchange,,2262.15,,,2262.15,1732.5,2680.95,other,Could be inpatient or outpatient,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,Multiplan,Multiplan,,,2680.95,,2680.95,1732.5,2680.95,percent of total billed charges,,
HC REPLACE G-J TUBE PERC,49452,CPT,,,both,,,3346.47,2007.88,United Healthcare/Oxford,United Healthcare/Oxford,,2176.62,,,2176.62,1732.5,2680.95,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT  ,,,both,,,906.4,543.84,Aetna,Commerical,,655.34,,,655.34,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Aetna,Middlesex Employees,,589.81,,,589.81,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Anthem,Commerical,,586.39,,,586.39,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Anthem,Indemnity,,,658.94,,658.94,469.11,725.92,percent of total billed charges,,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Anthem,State Preferred,,586.39,,,586.39,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Anthem,Individual Exchange,,469.11,,,469.11,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Cigna,Cigna,,572.68,,,572.68,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Connecticare,Commerical,,612.52,,,612.52,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Connecticare,Exchange,,612.52,,,612.52,469.11,725.92,other,Could be inpatient or outpatient,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,Multiplan,Multiplan,,,725.92,,725.92,469.11,725.92,percent of total billed charges,,
HC FIX G/COLON TUBE W/DEVICE,49460,CPT,,,both,,,906.4,543.84,United Healthcare/Oxford,United Healthcare/Oxford,,589.37,,,589.37,469.11,725.92,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT  ,,,both,,,1046.48,627.89,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Anthem,Indemnity,,,760.45,,760.45,541.37,837.74,percent of total billed charges,,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC FLUORO EXAM OF G/COLON TUBE,49465,CPT,,,both,,,1046.48,627.89,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT  ,,,both,,,11718.19,7030.91,Aetna,Commerical,,8835.67,,,8835.67,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Aetna,Middlesex Employees,,7952.1,,,7952.1,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Anthem,Commerical,,6623.39,,,6623.39,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Anthem,Indemnity,,,8522.42,,8522.42,5298.71,9388.68,percent of total billed charges,,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Anthem,State Preferred,,6623.39,,,6623.39,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Anthem,Individual Exchange,,5298.71,,,5298.71,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Cigna,Cigna,,7666.46,,,7666.46,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Connecticare,Commerical,,,,,,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Connecticare,Exchange,,,,,,5298.71,9388.68,other,Could be inpatient or outpatient,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,Multiplan,Multiplan,,,9388.68,,9388.68,5298.71,9388.68,percent of total billed charges,,
PR REPAIR ING HERNIA 6MO-5YR REDUC,49500,CPT,,,both,,,11718.19,7030.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5298.71,9388.68,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT  ,,,both,,,10298.7,6179.22,Aetna,Commerical,,6588.24,,,6588.24,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Aetna,Middlesex Employees,,5929.42,,,5929.42,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Anthem,Commerical,,6298.68,,,6298.68,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Anthem,Indemnity,,,7490.05,,7490.05,5038.94,8251.38,percent of total billed charges,,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Anthem,State Preferred,,6298.68,,,6298.68,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Anthem,Individual Exchange,,5038.94,,,5038.94,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Cigna,Cigna,,5970.53,,,5970.53,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Connecticare,Commerical,,7215.08,,,7215.08,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Connecticare,Exchange,,7215.08,,,7215.08,5038.94,8251.38,other,Could be inpatient or outpatient,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,Multiplan,Multiplan,,,8251.38,,8251.38,5038.94,8251.38,percent of total billed charges,,
REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER,49505,CPT,,,both,,,10298.7,6179.22,United Healthcare/Oxford,United Healthcare/Oxford,,6869.43,,,6869.43,5038.94,8251.38,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT  ,,,both,,,1776.75,1066.05,Aetna,Commerical,,1285.45,,,1285.45,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Aetna,Middlesex Employees,,1156.91,,,1156.91,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Anthem,Commerical,,1150.2,,,1150.2,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Anthem,Indemnity,,,1292.51,,1292.51,920.16,1423.89,percent of total billed charges,,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Anthem,State Preferred,,1150.2,,,1150.2,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Anthem,Individual Exchange,,920.16,,,920.16,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Cigna,Cigna,,1123.29,,,1123.29,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Connecticare,Commerical,,1201.46,,,1201.46,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Connecticare,Exchange,,1201.46,,,1201.46,920.16,1423.89,other,Could be inpatient or outpatient,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,Multiplan,Multiplan,,,1423.89,,1423.89,920.16,1423.89,percent of total billed charges,,
HC ABD/PERITON/OMENT,49999,CPT,,,both,,,1776.75,1066.05,United Healthcare/Oxford,United Healthcare/Oxford,,1156.03,,,1156.03,920.16,1423.89,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT  ,,,both,,,1774.69,1064.81,Aetna,Commerical,,1283.82,,,1283.82,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Aetna,Middlesex Employees,,1155.45,,,1155.45,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Anthem,Commerical,,1148.74,,,1148.74,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Anthem,Indemnity,,,1290.87,,1290.87,918.99,1422.08,percent of total billed charges,,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Anthem,State Preferred,,1148.74,,,1148.74,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Anthem,Individual Exchange,,918.99,,,918.99,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Cigna,Cigna,,1121.87,,,1121.87,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Connecticare,Commerical,,1199.93,,,1199.93,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Connecticare,Exchange,,1199.93,,,1199.93,918.99,1422.08,other,Could be inpatient or outpatient,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,Multiplan,Multiplan,,,1422.08,,1422.08,918.99,1422.08,percent of total billed charges,,
HC RENAL ABSCESS OPEN DRAIN,50020,CPT,,,both,,,1774.69,1064.81,United Healthcare/Oxford,United Healthcare/Oxford,,1154.57,,,1154.57,918.99,1422.08,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT  ,,,both,,,369.77,221.86,Aetna,Commerical,,267.84,,,267.84,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Aetna,Middlesex Employees,,241.05,,,241.05,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Anthem,Commerical,,239.65,,,239.65,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Anthem,Indemnity,,,269.31,,269.31,191.72,296.68,percent of total billed charges,,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Anthem,State Preferred,,239.65,,,239.65,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Anthem,Individual Exchange,,191.72,,,191.72,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Cigna,Cigna,,234.05,,,234.05,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Connecticare,Commerical,,250.34,,,250.34,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Connecticare,Exchange,,250.34,,,250.34,191.72,296.68,other,Could be inpatient or outpatient,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,Multiplan,Multiplan,,,296.68,,296.68,191.72,296.68,percent of total billed charges,,
HC HH RENAL ABSDRNCT,50021,CPT,,,both,,,369.77,221.86,United Healthcare/Oxford,United Healthcare/Oxford,,240.87,,,240.87,191.72,296.68,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT  ,,,both,,,4805.98,2883.59,Aetna,Commerical,,2640.95,,,2640.95,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Aetna,Middlesex Employees,,2376.86,,,2376.86,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Anthem,Commerical,,3135.73,,,3135.73,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Anthem,Indemnity,,,3495.26,,3495.26,2376.86,3850.53,percent of total billed charges,,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Anthem,State Preferred,,3135.73,,,3135.73,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Anthem,Individual Exchange,,2508.58,,,2508.58,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Cigna,Cigna,,3604.97,,,3604.97,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Connecticare,Commerical,,3356.08,,,3356.08,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Connecticare,Exchange,,3356.08,,,3356.08,2376.86,3850.53,other,Could be inpatient or outpatient,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,Multiplan,Multiplan,,,3850.53,,3850.53,2376.86,3850.53,percent of total billed charges,,
HC CT GUIDE RENAL BX,50200,CPT,,,both,,,4805.98,2883.59,United Healthcare/Oxford,United Healthcare/Oxford,,2927.79,,,2927.79,2376.86,3850.53,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT  ,,,both,,,6066.7,3640.02,Aetna,Commerical,,4387.13,,,4387.13,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Aetna,Middlesex Employees,,3948.42,,,3948.42,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Anthem,Commerical,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Anthem,Indemnity,,,4411.23,,4411.23,3140.41,4859.61,percent of total billed charges,,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Anthem,State Preferred,,3925.51,,,3925.51,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Anthem,Individual Exchange,,3140.41,,,3140.41,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Cigna,Cigna,,3833.69,,,3833.69,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Connecticare,Commerical,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Connecticare,Exchange,,4100.47,,,4100.47,3140.41,4859.61,other,Could be inpatient or outpatient,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,Multiplan,Multiplan,,,4859.61,,4859.61,3140.41,4859.61,percent of total billed charges,,
HC RENAL BIOPSY PERQ,50200,CPT,,,both,,,6066.7,3640.02,United Healthcare/Oxford,United Healthcare/Oxford,,3945.44,,,3945.44,3140.41,4859.61,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT  ,,,both,,,4660.75,2796.45,Aetna,Commerical,,3371.15,,,3371.15,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Aetna,Middlesex Employees,,3034.04,,,3034.04,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Anthem,Commerical,,3016.42,,,3016.42,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Anthem,Indemnity,,,3389.67,,3389.67,2413.14,3734.21,percent of total billed charges,,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Anthem,State Preferred,,3016.42,,,3016.42,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Anthem,Individual Exchange,,2413.14,,,2413.14,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Cigna,Cigna,,2945.87,,,2945.87,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Connecticare,Commerical,,3150.87,,,3150.87,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Connecticare,Exchange,,3150.87,,,3150.87,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,Multiplan,Multiplan,,,3734.21,,3734.21,2413.14,3734.21,percent of total billed charges,,
HC HH CHANGE STENT VIA TRANSURETH,50385,CPT,,,both,,,4660.75,2796.45,United Healthcare/Oxford,United Healthcare/Oxford,,3031.74,,,3031.74,2413.14,3734.21,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT  ,,,both,,,1553.24,931.94,Aetna,Commerical,,1123.44,,,1123.44,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Aetna,Middlesex Employees,,1011.1,,,1011.1,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Anthem,Commerical,,1005.23,,,1005.23,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Anthem,Indemnity,,,1129.61,,1129.61,804.18,1244.43,percent of total billed charges,,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Anthem,State Preferred,,1005.23,,,1005.23,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Anthem,Individual Exchange,,804.18,,,804.18,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Cigna,Cigna,,981.72,,,981.72,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Connecticare,Commerical,,1050.04,,,1050.04,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Connecticare,Exchange,,1050.04,,,1050.04,804.18,1244.43,other,Could be inpatient or outpatient,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,Multiplan,Multiplan,,,1244.43,,1244.43,804.18,1244.43,percent of total billed charges,,
HC HH REMOVE STENT VIA TRANSURETH,50386,CPT,,,both,,,1553.24,931.94,United Healthcare/Oxford,United Healthcare/Oxford,,1010.34,,,1010.34,804.18,1244.43,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT  ,,,both,,,2448.31,1468.99,Aetna,Commerical,,1771.46,,,1771.46,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Aetna,Middlesex Employees,,1594.31,,,1594.31,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Anthem,Commerical,,1585.06,,,1585.06,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Anthem,Indemnity,,,1781.19,,1781.19,1268.05,1962.24,percent of total billed charges,,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Anthem,State Preferred,,1585.06,,,1585.06,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Anthem,Individual Exchange,,1268.05,,,1268.05,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Cigna,Cigna,,1547.99,,,1547.99,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Connecticare,Commerical,,1655.71,,,1655.71,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Connecticare,Exchange,,1655.71,,,1655.71,1268.05,1962.24,other,Could be inpatient or outpatient,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,Multiplan,Multiplan,,,1962.24,,1962.24,1268.05,1962.24,percent of total billed charges,,
HC PERC ASP OR INJ OF RENAL CYST/PELVIS,50390,CPT,,,both,,,2448.31,1468.99,United Healthcare/Oxford,United Healthcare/Oxford,,1593.11,,,1593.11,1268.05,1962.24,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT  ,,,both,,,3314.54,1988.72,Aetna,Commerical,,2397.5,,,2397.5,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Aetna,Middlesex Employees,,2157.75,,,2157.75,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Anthem,Commerical,,2145.22,,,2145.22,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Anthem,Indemnity,,,2410.66,,2410.66,1716.17,2655.7,percent of total billed charges,,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Anthem,State Preferred,,2145.22,,,2145.22,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Anthem,Individual Exchange,,1716.17,,,1716.17,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Cigna,Cigna,,2095.05,,,2095.05,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Connecticare,Commerical,,2240.83,,,2240.83,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Connecticare,Exchange,,2240.83,,,2240.83,1716.17,2655.7,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,Multiplan,Multiplan,,,2655.7,,2655.7,1716.17,2655.7,percent of total billed charges,,
HC ASC NEPHROSTOMY,50392,CPT,,,both,,,3314.54,1988.72,United Healthcare/Oxford,United Healthcare/Oxford,,2156.11,,,2156.11,1716.17,2655.7,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT  ,,,both,,,4272.44,2563.46,Aetna,Commerical,,3090.29,,,3090.29,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Aetna,Middlesex Employees,,2781.26,,,2781.26,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Anthem,Commerical,,2765.12,,,2765.12,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Anthem,Indemnity,,,3107.26,,3107.26,2212.1,3423.1,percent of total billed charges,,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Anthem,State Preferred,,2765.12,,,2765.12,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Anthem,Individual Exchange,,2212.1,,,2212.1,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Cigna,Cigna,,2700.44,,,2700.44,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Connecticare,Commerical,,2888.36,,,2888.36,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Connecticare,Exchange,,2888.36,,,2888.36,2212.1,3423.1,other,Could be inpatient or outpatient,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,Multiplan,Multiplan,,,3423.1,,3423.1,2212.1,3423.1,percent of total billed charges,,
HC INTRO OF URETRL CATH / STENT IR,50393,CPT,,,both,,,4272.44,2563.46,United Healthcare/Oxford,United Healthcare/Oxford,,2779.16,,,2779.16,2212.1,3423.1,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT  ,,,both,,,452.17,271.3,Aetna,Commerical,,248.63,,,248.63,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Aetna,Middlesex Employees,,223.77,,,223.77,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Anthem,Commerical,,295.21,,,295.21,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Anthem,Indemnity,,,329.06,,329.06,223.77,362.51,percent of total billed charges,,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Anthem,State Preferred,,295.21,,,295.21,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Anthem,Individual Exchange,,236.17,,,236.17,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Cigna,Cigna,,339.39,,,339.39,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Connecticare,Commerical,,315.96,,,315.96,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Connecticare,Exchange,,315.96,,,315.96,223.77,362.51,other,Could be inpatient or outpatient,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,Multiplan,Multiplan,,,362.51,,362.51,223.77,362.51,percent of total billed charges,,
HC ASC NEPHROSTOGM,50394,CPT,,,both,,,452.17,271.3,United Healthcare/Oxford,United Healthcare/Oxford,,275.64,,,275.64,223.77,362.51,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT  ,,,both,,,589.16,353.5,Aetna,Commerical,,425.77,,,425.77,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Aetna,Middlesex Employees,,383.19,,,383.19,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Anthem,Commerical,,380.97,,,380.97,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Anthem,Indemnity,,,428.11,,428.11,304.78,471.62,percent of total billed charges,,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Anthem,State Preferred,,380.97,,,380.97,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Anthem,Individual Exchange,,304.78,,,304.78,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Cigna,Cigna,,372.06,,,372.06,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Connecticare,Commerical,,397.95,,,397.95,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Connecticare,Exchange,,397.95,,,397.95,304.78,471.62,other,Could be inpatient or outpatient,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,Multiplan,Multiplan,,,471.62,,471.62,304.78,471.62,percent of total billed charges,,
HC MANOMETRY THRU INDWELLING CATH,50396,CPT,,,both,,,589.16,353.5,United Healthcare/Oxford,United Healthcare/Oxford,,382.9,,,382.9,304.78,471.62,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT  ,,,both,,,2273.21,1363.93,Aetna,Commerical,,1519.34,,,1519.34,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Aetna,Middlesex Employees,,1367.41,,,1367.41,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Anthem,Commerical,,1260.94,,,1260.94,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Anthem,Indemnity,,,1653.48,,1653.48,1008.75,1821.55,percent of total billed charges,,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Anthem,State Preferred,,1260.94,,,1260.94,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Anthem,Individual Exchange,,1008.75,,,1008.75,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Cigna,Cigna,,1338.34,,,1338.34,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Connecticare,Commerical,,1372.86,,,1372.86,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Connecticare,Exchange,,1372.86,,,1372.86,1008.75,1821.55,other,Could be inpatient or outpatient,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,Multiplan,Multiplan,,,1821.55,,1821.55,1008.75,1821.55,percent of total billed charges,,
HC INJ PROC ANTEGRADE NEPHROSTOGRAM AND/OR URETOGRM,50431,CPT,,,both,,,2273.21,1363.93,United Healthcare/Oxford,United Healthcare/Oxford,,1407.37,,,1407.37,1008.75,1821.55,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT  ,,,both,,,6490.81,3894.49,Aetna,Commerical,,3566.82,,,3566.82,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Aetna,Middlesex Employees,,3210.14,,,3210.14,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Anthem,Commerical,,4235.06,,,4235.06,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Anthem,Indemnity,,,4720.65,,4720.65,3210.14,5200.48,percent of total billed charges,,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Anthem,State Preferred,,4235.06,,,4235.06,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Anthem,Individual Exchange,,3388.05,,,3388.05,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Cigna,Cigna,,4868.82,,,4868.82,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Connecticare,Commerical,,4532.68,,,4532.68,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Connecticare,Exchange,,4532.68,,,4532.68,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,Multiplan,Multiplan,,,5200.48,,5200.48,3210.14,5200.48,percent of total billed charges,,
HC HH PLMT NEPHROSTOMY CATH,50432,CPT,,,both,,,6490.81,3894.49,United Healthcare/Oxford,United Healthcare/Oxford,,3954.23,,,3954.23,3210.14,5200.48,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT  ,,,both,,,6045.07,3627.04,Aetna,Commerical,,3321.9,,,3321.9,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Aetna,Middlesex Employees,,2989.71,,,2989.71,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Anthem,Commerical,,3944.26,,,3944.26,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Anthem,Indemnity,,,4396.49,,4396.49,2989.71,4843.38,percent of total billed charges,,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Anthem,State Preferred,,3944.26,,,3944.26,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Anthem,Individual Exchange,,3155.4,,,3155.4,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Cigna,Cigna,,4534.49,,,4534.49,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Connecticare,Commerical,,4221.43,,,4221.43,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Connecticare,Exchange,,4221.43,,,4221.43,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,Multiplan,Multiplan,,,4843.38,,4843.38,2989.71,4843.38,percent of total billed charges,,
HC HH PLMT NEPHROURETERAL CATH,50433,CPT,,,both,,,6045.07,3627.04,United Healthcare/Oxford,United Healthcare/Oxford,,3682.7,,,3682.7,2989.71,4843.38,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT  ,,,both,,,4225.06,2535.04,Aetna,Commerical,,2321.8,,,2321.8,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Aetna,Middlesex Employees,,2089.62,,,2089.62,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Anthem,Commerical,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Anthem,Indemnity,,,3072.88,,3072.88,2089.62,3385.23,percent of total billed charges,,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Anthem,State Preferred,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Anthem,Individual Exchange,,2205.44,,,2205.44,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Cigna,Cigna,,3169.34,,,3169.34,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Connecticare,Commerical,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Connecticare,Exchange,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,Multiplan,Multiplan,,,3385.23,,3385.23,2089.62,3385.23,percent of total billed charges,,
HC HH CONVERT NEPHROSTOMY CATH,50434,CPT,,,both,,,4225.06,2535.04,United Healthcare/Oxford,United Healthcare/Oxford,,2573.98,,,2573.98,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT  ,,,both,,,7628.18,4576.91,Aetna,Commerical,,5517.92,,,5517.92,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Aetna,Middlesex Employees,,4966.12,,,4966.12,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Anthem,Commerical,,4937.3,,,4937.3,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Anthem,Indemnity,,,5548.21,,5548.21,3949.84,6112.16,percent of total billed charges,,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Anthem,State Preferred,,4937.3,,,4937.3,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Anthem,Individual Exchange,,3949.84,,,3949.84,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Cigna,Cigna,,4821.81,,,4821.81,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Connecticare,Commerical,,5157.35,,,5157.35,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Connecticare,Exchange,,5157.35,,,5157.35,3949.84,6112.16,other,Could be inpatient or outpatient,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,Multiplan,Multiplan,,,6112.16,,6112.16,3949.84,6112.16,percent of total billed charges,,
HC HH EXCHANGE NEPHROSTOMY CATH,50435,CPT,,,both,,,7628.18,4576.91,United Healthcare/Oxford,United Healthcare/Oxford,,4962.35,,,4962.35,3949.84,6112.16,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT  ,,,both,,,12450.64,7470.38,Aetna,Commerical,,9005.48,,,9005.48,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Aetna,Middlesex Employees,,8104.93,,,8104.93,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Anthem,Commerical,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Anthem,Indemnity,,,9054.93,,9054.93,6446.31,9975.33,percent of total billed charges,,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Anthem,State Preferred,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Anthem,Individual Exchange,,6446.31,,,6446.31,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Cigna,Cigna,,7869.42,,,7869.42,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Connecticare,Commerical,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Connecticare,Exchange,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,Multiplan,Multiplan,,,9975.33,,9975.33,6446.31,9975.33,percent of total billed charges,,
HC PERC RF ABLATE 1+ RENAL TUMOR,50592,CPT,,,both,,,12450.64,7470.38,United Healthcare/Oxford,United Healthcare/Oxford,,8098.79,,,8098.79,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT  ,,,both,,,12450.64,7470.38,Aetna,Commerical,,9005.48,,,9005.48,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Aetna,Middlesex Employees,,8104.93,,,8104.93,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Anthem,Commerical,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Anthem,Indemnity,,,9054.93,,9054.93,6446.31,9975.33,percent of total billed charges,,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Anthem,State Preferred,,8057.89,,,8057.89,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Anthem,Individual Exchange,,6446.31,,,6446.31,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Cigna,Cigna,,7869.42,,,7869.42,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Connecticare,Commerical,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Connecticare,Exchange,,8417.02,,,8417.02,6446.31,9975.33,other,Could be inpatient or outpatient,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,Multiplan,Multiplan,,,9975.33,,9975.33,6446.31,9975.33,percent of total billed charges,,
HC PERC CRYO ABLATE RENAL TUM,50593,CPT,,,both,,,12450.64,7470.38,United Healthcare/Oxford,United Healthcare/Oxford,,8098.79,,,8098.79,6446.31,9975.33,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT  ,,,both,,,4225.06,2535.04,Aetna,Commerical,,2321.8,,,2321.8,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Aetna,Middlesex Employees,,2089.62,,,2089.62,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Anthem,Commerical,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Anthem,Indemnity,,,3072.88,,3072.88,2089.62,3385.23,percent of total billed charges,,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Anthem,State Preferred,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Anthem,Individual Exchange,,2205.44,,,2205.44,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Cigna,Cigna,,3169.34,,,3169.34,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Connecticare,Commerical,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Connecticare,Exchange,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,Multiplan,Multiplan,,,3385.23,,3385.23,2089.62,3385.23,percent of total billed charges,,
HC HH ENDOLUMINAL BX URTR ML PLVS,50606,CPT,,,both,,,4225.06,2535.04,United Healthcare/Oxford,United Healthcare/Oxford,,2573.98,,,2573.98,2089.62,3385.23,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT  ,,,both,,,361.53,216.92,Aetna,Commerical,,261.32,,,261.32,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Aetna,Middlesex Employees,,235.19,,,235.19,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Anthem,Commerical,,233.83,,,233.83,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Anthem,Indemnity,,,262.76,,262.76,187.07,289.47,percent of total billed charges,,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Anthem,State Preferred,,233.83,,,233.83,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Anthem,Individual Exchange,,187.07,,,187.07,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Cigna,Cigna,,228.35,,,228.35,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Connecticare,Commerical,,244.25,,,244.25,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Connecticare,Exchange,,244.25,,,244.25,187.07,289.47,other,Could be inpatient or outpatient,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,Multiplan,Multiplan,,,289.47,,289.47,187.07,289.47,percent of total billed charges,,
HC INJ FOR URETEROGRAM THRU INDWELLING CATH,50684,CPT,,,both,,,361.53,216.92,United Healthcare/Oxford,United Healthcare/Oxford,,235.02,,,235.02,187.07,289.47,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT  ,,,both,,,7885.32,4731.19,Aetna,Commerical,,4333.13,,,4333.13,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Aetna,Middlesex Employees,,3899.81,,,3899.81,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Anthem,Commerical,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Anthem,Indemnity,,,5734.85,,5734.85,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Anthem,State Preferred,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Anthem,Individual Exchange,,4115.95,,,4115.95,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Cigna,Cigna,,5914.85,,,5914.85,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Connecticare,Commerical,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Connecticare,Exchange,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,Multiplan,Multiplan,,,6317.77,,6317.77,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50693,CPT,,,both,,,7885.32,4731.19,United Healthcare/Oxford,United Healthcare/Oxford,,4803.77,,,4803.77,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT  ,,,both,,,7885.32,4731.19,Aetna,Commerical,,4333.13,,,4333.13,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Aetna,Middlesex Employees,,3899.81,,,3899.81,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Anthem,Commerical,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Anthem,Indemnity,,,5734.85,,5734.85,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Anthem,State Preferred,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Anthem,Individual Exchange,,4115.95,,,4115.95,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Cigna,Cigna,,5914.85,,,5914.85,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Connecticare,Commerical,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Connecticare,Exchange,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,Multiplan,Multiplan,,,6317.77,,6317.77,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50694,CPT,,,both,,,7885.32,4731.19,United Healthcare/Oxford,United Healthcare/Oxford,,4803.77,,,4803.77,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT  ,,,both,,,7885.32,4731.19,Aetna,Commerical,,4333.13,,,4333.13,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Aetna,Middlesex Employees,,3899.81,,,3899.81,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Anthem,Commerical,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Anthem,Indemnity,,,5734.85,,5734.95,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Anthem,State Preferred,,5144.93,,,5144.93,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Anthem,Individual Exchange,,4115.95,,,4115.95,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Cigna,Cigna,,5914.85,,,5914.85,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Connecticare,Commerical,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Connecticare,Exchange,,5506.49,,,5506.49,3899.81,6317.77,other,Could be inpatient or outpatient,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,Multiplan,Multiplan,,,6317.77,,6317.77,3899.81,6317.77,percent of total billed charges,,
HC PLMT URETERAL STENT PRQ,50695,CPT,,,both,,,7885.32,4731.19,United Healthcare/Oxford,United Healthcare/Oxford,,4803.77,,,4803.77,3899.81,6317.77,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT  ,,,both,,,988.19,592.92,Aetna,Commerical,,714.77,,,714.77,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Aetna,Middlesex Employees,,643.3,,,643.3,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Anthem,Commerical,,639.56,,,639.56,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Anthem,Indemnity,,,718.7,,718.7,511.64,791.75,percent of total billed charges,,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Anthem,State Preferred,,639.56,,,639.56,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Anthem,Individual Exchange,,511.64,,,511.64,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Cigna,Cigna,,624.6,,,624.6,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Connecticare,Commerical,,668.07,,,668.07,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Connecticare,Exchange,,668.07,,,668.07,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,Multiplan,Multiplan,,,791.75,,791.75,511.64,791.75,percent of total billed charges,,
HC ASPIRATION OF BLADDER BY NEEDLE,51100,CPT,,,both,,,988.19,592.92,United Healthcare/Oxford,United Healthcare/Oxford,,642.81,,,642.81,511.64,791.75,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT  ,,,both,,,6492.09,3895.25,Aetna,Commerical,,4695.67,,,4695.67,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Aetna,Middlesex Employees,,4226.1,,,4226.1,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Anthem,Commerical,,4201.58,,,4201.58,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Anthem,Indemnity,,,4721.46,,4721.46,3361.27,5201.38,percent of total billed charges,,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Anthem,State Preferred,,4201.58,,,4201.58,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Anthem,Individual Exchange,,3361.27,,,3361.27,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Cigna,Cigna,,4103.31,,,4103.31,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Connecticare,Commerical,,4388.85,,,4388.85,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Connecticare,Exchange,,4388.85,,,4388.85,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,Multiplan,Multiplan,,,5201.38,,5201.38,3361.27,5201.38,percent of total billed charges,,
HC ASPIRATE BLADDER W/SUPRAPUBIC CATH INSERT,51102,CPT,,,both,,,6492.09,3895.25,United Healthcare/Oxford,United Healthcare/Oxford,,4222.91,,,4222.91,3361.27,5201.38,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT  ,,,both,,,202.91,121.75,Aetna,Commerical,,146.54,,,146.54,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Aetna,Middlesex Employees,,131.88,,,131.88,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Anthem,Commerical,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Anthem,Indemnity,,,147.34,,147.34,104.89,162.32,percent of total billed charges,,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Anthem,State Preferred,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Anthem,Individual Exchange,,104.89,,,104.89,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Cigna,Cigna,,128.06,,,128.06,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Connecticare,Commerical,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Connecticare,Exchange,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,Multiplan,Multiplan,,,162.32,,162.32,104.89,162.32,percent of total billed charges,,
HC ASC INJ CYSTOGRAM,51600,CPT,,,both,,,202.91,121.75,United Healthcare/Oxford,United Healthcare/Oxford,,131.78,,,131.78,104.89,162.32,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT  ,,,both,,,271.92,163.15,Aetna,Commerical,,197.01,,,197.01,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Aetna,Middlesex Employees,,177.31,,,177.31,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Anthem,Commerical,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Anthem,Indemnity,,,198.09,,198.09,141.03,218.23,percent of total billed charges,,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Anthem,State Preferred,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Anthem,Individual Exchange,,141.03,,,141.03,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Cigna,Cigna,,172.16,,,172.16,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Connecticare,Commerical,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Connecticare,Exchange,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,Multiplan,Multiplan,,,218.23,,218.23,141.03,218.23,percent of total billed charges,,
HC RETRO INJ URETHRA,51610,CPT,,,both,,,271.92,163.15,United Healthcare/Oxford,United Healthcare/Oxford,,177.17,,,177.17,141.03,218.23,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT  ,,,both,,,280.16,168.1,Aetna,Commerical,,202.71,,,202.71,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Aetna,Middlesex Employees,,182.44,,,182.44,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Anthem,Commerical,,181.38,,,181.38,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Anthem,Indemnity,,,203.82,,203.82,145.11,224.54,percent of total billed charges,,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Anthem,State Preferred,,181.38,,,181.38,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Anthem,Individual Exchange,,145.11,,,145.11,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Cigna,Cigna,,177.13,,,177.13,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Connecticare,Commerical,,189.46,,,189.46,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Connecticare,Exchange,,189.46,,,189.46,145.11,224.54,other,Could be inpatient or outpatient,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,Multiplan,Multiplan,,,224.54,,224.54,145.11,224.54,percent of total billed charges,,
HC INSERT BLDDER CATH,51701,CPT,,,both,,,280.16,168.1,United Healthcare/Oxford,United Healthcare/Oxford,,182.3,,,182.3,145.11,224.54,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT  ,,,both,,,2865.54,1719.33,Aetna,Commerical,,2072.68,,,2072.68,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT  ,,,both,,,471.6,282.96,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Aetna,Middlesex Employees,,1865.42,,,1865.42,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Anthem,Commerical,,1854.59,,,1854.59,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Anthem,Indemnity,,,2084.06,,2084.06,1483.67,2295.89,percent of total billed charges,,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Anthem,State Preferred,,1854.59,,,1854.59,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Anthem,Individual Exchange,,1483.67,,,1483.67,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Cigna,Cigna,,1811.2,,,1811.2,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Connecticare,Commerical,,1937.24,,,1937.24,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Connecticare,Exchange,,1937.24,,,1937.24,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,Multiplan,Multiplan,,,2295.89,,2295.89,1483.67,2295.89,percent of total billed charges,,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC INS TEMP BLADDER CATH,51702,CPT,,,both,,,2865.54,1719.33,United Healthcare/Oxford,United Healthcare/Oxford,,1863.99,,,1863.99,1483.67,2295.89,other,Could be inpatient or outpatient,
HC INS TEMP BLADDER CATH-OR,51702,CPT,,,both,,,471.6,282.96,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT  ,,,both,,,32.91,19.75,Aetna,Commerical,,23.8,,,23.8,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Aetna,Middlesex Employees,,21.43,,,21.43,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Anthem,Commerical,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Anthem,Indemnity,,,23.93,,23.93,17.04,26.37,percent of total billed charges,,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Anthem,State Preferred,,21.3,,,21.3,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Anthem,Individual Exchange,,17.04,,,17.04,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Cigna,Cigna,,20.8,,,20.8,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Connecticare,Commerical,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Connecticare,Exchange,,22.25,,,22.25,17.04,26.37,other,Could be inpatient or outpatient,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,Multiplan,Multiplan,,,26.37,,26.37,17.04,26.37,percent of total billed charges,,
HC INS BLADDER CATH COMPLEX,51703,CPT,,,both,,,32.91,19.75,United Healthcare/Oxford,United Healthcare/Oxford,,21.4,,,21.4,17.04,26.37,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT  ,,,both,,,684.95,410.97,Aetna,Commerical,,495.78,,,495.78,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Aetna,Middlesex Employees,,446.2,,,446.2,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Anthem,Commerical,,443.61,,,443.61,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Anthem,Indemnity,,,498.51,,498.51,354.89,549.18,percent of total billed charges,,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Anthem,State Preferred,,443.61,,,443.61,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Anthem,Individual Exchange,,354.89,,,354.89,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Cigna,Cigna,,433.24,,,433.24,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Connecticare,Commerical,,463.38,,,463.38,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Connecticare,Exchange,,463.38,,,463.38,354.89,549.18,other,Could be inpatient or outpatient,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,Multiplan,Multiplan,,,549.18,,549.18,354.89,549.18,percent of total billed charges,,
HC CHANGE BLADDER TUBE,51705,CPT,,,both,,,684.95,410.97,United Healthcare/Oxford,United Healthcare/Oxford,,445.87,,,445.87,354.89,549.18,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT  ,,,both,,,1103.13,661.88,Aetna,Commerical,,798.62,,,798.62,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Aetna,Middlesex Employees,,718.76,,,718.76,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Anthem,Commerical,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Anthem,Indemnity,,,803.01,,803.01,571.67,884.63,percent of total billed charges,,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Anthem,State Preferred,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Anthem,Individual Exchange,,571.67,,,571.67,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Cigna,Cigna,,697.87,,,697.87,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Connecticare,Commerical,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Connecticare,Exchange,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,Multiplan,Multiplan,,,884.63,,884.63,571.67,884.63,percent of total billed charges,,
HC SIMPLE CYSTOMETROGRAM,51725,CPT,,,both,,,1103.13,661.88,United Healthcare/Oxford,United Healthcare/Oxford,,718.22,,,718.22,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT  ,,,both,,,1103.13,661.88,Aetna,Commerical,,798.62,,,798.62,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Aetna,Middlesex Employees,,718.76,,,718.76,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Anthem,Commerical,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Anthem,Indemnity,,,803.01,,803.01,571.67,884.63,percent of total billed charges,,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Anthem,State Preferred,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Anthem,Individual Exchange,,571.67,,,571.67,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Cigna,Cigna,,697.87,,,697.87,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Connecticare,Commerical,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Connecticare,Exchange,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,Multiplan,Multiplan,,,884.63,,884.63,571.67,884.63,percent of total billed charges,,
HC BLADDER PRESSURE MEASUREMENT DURING FILLING,51726,CPT,,,both,,,1103.13,661.88,United Healthcare/Oxford,United Healthcare/Oxford,,718.22,,,718.22,571.67,884.63,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT  ,,,both,,,2682.12,1609.27,Aetna,Commerical,,1939.98,,,1939.98,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Aetna,Middlesex Employees,,1745.98,,,1745.98,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Anthem,Commerical,,1735.85,,,1735.85,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Anthem,Indemnity,,,1950.63,,1950.63,1388.68,2148.9,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Anthem,State Preferred,,1735.85,,,1735.85,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Anthem,Individual Exchange,,1388.68,,,1388.68,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Cigna,Cigna,,1695.25,,,1695.25,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Connecticare,Commerical,,1813.21,,,1813.21,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Connecticare,Exchange,,1813.21,,,1813.21,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,Multiplan,Multiplan,,,2148.9,,2148.9,1388.68,2148.9,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) URETHRAL PRESS PROFILE,51727,CPT,,,both,,,2682.12,1609.27,United Healthcare/Oxford,United Healthcare/Oxford,,1744.66,,,1744.66,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT  ,,,both,,,2974.64,1784.78,Aetna,Commerical,,2151.65,,,2151.65,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Aetna,Middlesex Employees,,1936.49,,,1936.49,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Anthem,Commerical,,1925.24,,,1925.24,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Anthem,Indemnity,,,2163.46,,2163.46,1540.19,2383.37,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Anthem,State Preferred,,1925.24,,,1925.24,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Anthem,Individual Exchange,,1540.19,,,1540.19,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Cigna,Cigna,,1880.21,,,1880.21,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Connecticare,Commerical,,2011.05,,,2011.05,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Connecticare,Exchange,,2011.05,,,2011.05,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,Multiplan,Multiplan,,,2383.37,,2383.37,1540.19,2383.37,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) VOIDING PRESSURE STUDIES,51728,CPT,,,both,,,2974.64,1784.78,United Healthcare/Oxford,United Healthcare/Oxford,,1935.01,,,1935.01,1540.19,2383.37,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT  ,,,both,,,2682.12,1609.27,Aetna,Commerical,,1939.98,,,1939.98,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Aetna,Middlesex Employees,,1745.98,,,1745.98,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Anthem,Commerical,,1735.85,,,1735.85,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Anthem,Indemnity,,,1950.63,,1950.63,1388.68,2148.9,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Anthem,State Preferred,,1735.85,,,1735.85,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Anthem,Individual Exchange,,1388.68,,,1388.68,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Cigna,Cigna,,1695.25,,,1695.25,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Connecticare,Commerical,,1813.21,,,1813.21,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Connecticare,Exchange,,1813.21,,,1813.21,1388.68,2148.9,other,Could be inpatient or outpatient,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,Multiplan,Multiplan,,,2148.9,,2148.9,1388.68,2148.9,percent of total billed charges,,
HC COMPLEX CYSTOMETROGRAM (CMG) W VOID PRESS & URETHRAL PROFIL,51729,CPT,,,both,,,2682.12,1609.27,United Healthcare/Oxford,United Healthcare/Oxford,,1744.66,,,1744.66,1388.68,2148.9,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT  ,,,both,,,507.79,304.67,Aetna,Commerical,,367.16,,,367.16,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Aetna,Middlesex Employees,,330.44,,,330.44,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Anthem,Commerical,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Anthem,Indemnity,,,369.17,,369.17,262.82,406.7,percent of total billed charges,,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Anthem,State Preferred,,328.52,,,328.52,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Anthem,Individual Exchange,,262.82,,,262.82,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Cigna,Cigna,,320.84,,,320.84,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Connecticare,Commerical,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Connecticare,Exchange,,343.16,,,343.16,262.82,406.7,other,Could be inpatient or outpatient,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,Multiplan,Multiplan,,,406.7,,406.7,262.82,406.7,percent of total billed charges,,
HC SIMPLE UROFLOMETRY,51736,CPT,,,both,,,507.79,304.67,United Healthcare/Oxford,United Healthcare/Oxford,,330.19,,,330.19,262.82,406.7,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT  ,,,both,,,647.87,388.72,Aetna,Commerical,,468.92,,,468.92,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Aetna,Middlesex Employees,,422.03,,,422.03,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Anthem,Commerical,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Anthem,Indemnity,,,471.49,,471.49,335.66,519.42,percent of total billed charges,,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Anthem,State Preferred,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Anthem,Individual Exchange,,335.66,,,335.66,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Cigna,Cigna,,409.76,,,409.76,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Connecticare,Commerical,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Connecticare,Exchange,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,Multiplan,Multiplan,,,519.42,,519.42,335.66,519.42,percent of total billed charges,,
HC COMPLEX UROFLOMETRY,51741,CPT,,,both,,,647.87,388.72,United Healthcare/Oxford,United Healthcare/Oxford,,421.7,,,421.7,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT  ,,,both,,,647.87,388.72,Aetna,Commerical,,468.92,,,468.92,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Aetna,Middlesex Employees,,422.03,,,422.03,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Anthem,Commerical,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Anthem,Indemnity,,,471.49,,471.49,335.66,519.42,percent of total billed charges,,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Anthem,State Preferred,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Anthem,Individual Exchange,,335.66,,,335.66,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Cigna,Cigna,,409.76,,,409.76,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Connecticare,Commerical,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Connecticare,Exchange,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,Multiplan,Multiplan,,,519.42,,519.42,335.66,519.42,percent of total billed charges,,
HC EMG STUDYS OF ANAL OR URETHRAL SPHINCTER OTHER THAN NEEDLE,51784,CPT,,,both,,,647.87,388.72,United Healthcare/Oxford,United Healthcare/Oxford,,421.7,,,421.7,335.66,519.42,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT  ,,,both,,,1103.13,661.88,Aetna,Commerical,,798.62,,,798.62,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Aetna,Middlesex Employees,,718.76,,,718.76,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Anthem,Commerical,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Anthem,Indemnity,,,803.01,,803.01,571.67,884.63,percent of total billed charges,,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Anthem,State Preferred,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Anthem,Individual Exchange,,571.67,,,571.67,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Cigna,Cigna,,697.87,,,697.87,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Connecticare,Commerical,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Connecticare,Exchange,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,Multiplan,Multiplan,,,884.63,,884.63,571.67,884.63,percent of total billed charges,,
HC NEEDLE EMG STUDYS EMG OF ANAL OR URETHRAL SPHINCTER ANY TQ,51785,CPT,,,both,,,1103.13,661.88,United Healthcare/Oxford,United Healthcare/Oxford,,718.22,,,718.22,571.67,884.63,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT  ,,,both,,,266.77,160.06,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Anthem,Indemnity,,,194,,194,138.11,213.72,percent of total billed charges,,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC STIMULUS EVOKED RESPONSE,51792,CPT,,,both,,,266.77,160.06,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT  ,,,both,,,1342.09,805.25,Aetna,Commerical,,970.4,,,970.4,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Aetna,Middlesex Employees,,873.36,,,873.36,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Anthem,Commerical,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Anthem,Indemnity,,,975.72,,975.72,694.63,1074.9,percent of total billed charges,,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Anthem,State Preferred,,868.29,,,868.29,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Anthem,Individual Exchange,,694.63,,,694.63,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Cigna,Cigna,,847.98,,,847.98,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Connecticare,Commerical,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Connecticare,Exchange,,906.99,,,906.99,694.63,1074.9,other,Could be inpatient or outpatient,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,Multiplan,Multiplan,,,1074.9,,1074.9,694.63,1074.9,percent of total billed charges,,
HC VOID PRESSURE STUDIES INTRAABDOMINAL,51797,CPT,,,both,,,1342.09,805.25,United Healthcare/Oxford,United Healthcare/Oxford,,872.7,,,872.7,694.63,1074.9,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT  ,,,both,,,266.74,160.04,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Anthem,Indemnity,,,194,,194,138.11,213.72,percent of total billed charges,,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC MEAS OF POST-VOIDING RESIDUAL URINE &/OR BLADDER CAP BY US NON-IMAGING,51798,CPT,,,both,,,266.74,160.04,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT  ,,,both,,,3925.33,2355.2,Aetna,Commerical,,2838.73,,,2838.73,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Aetna,Middlesex Employees,,2554.86,,,2554.86,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Anthem,Commerical,,2540.03,,,2540.03,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Anthem,Indemnity,,,2854.33,,2854.33,2032.03,3144.46,percent of total billed charges,,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Anthem,State Preferred,,2540.03,,,2540.03,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Anthem,Individual Exchange,,2032.03,,,2032.03,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Cigna,Cigna,,2480.63,,,2480.63,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Connecticare,Commerical,,2653.24,,,2653.24,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Connecticare,Exchange,,2653.24,,,2653.24,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,Multiplan,Multiplan,,,3144.46,,3144.46,2032.03,3144.46,percent of total billed charges,,
HC CIRCUMCISION W/REGIONL BLOCK,54150,CPT,,,both,,,3925.33,2355.2,United Healthcare/Oxford,United Healthcare/Oxford,,2552.93,,,2552.93,2032.03,3144.46,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT  ,,,both,,,3702.85,2221.71,Aetna,Commerical,,2677.55,,,2677.55,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Aetna,Middlesex Employees,,2409.79,,,2409.79,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Anthem,Commerical,,2395.81,,,2395.81,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Anthem,Indemnity,,,2692.25,,2692.25,1916.64,2965.91,percent of total billed charges,,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Anthem,State Preferred,,2395.81,,,2395.81,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Anthem,Individual Exchange,,1916.64,,,1916.64,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Cigna,Cigna,,2339.77,,,2339.77,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Connecticare,Commerical,,2502.58,,,2502.58,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Connecticare,Exchange,,2502.58,,,2502.58,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,Multiplan,Multiplan,,,2965.91,,2965.91,1916.64,2965.91,percent of total billed charges,,
HC CIRCUMCISION NEONATE <=28 DAYS,54160,CPT,,,both,,,3702.85,2221.71,United Healthcare/Oxford,United Healthcare/Oxford,,2407.96,,,2407.96,1916.64,2965.91,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT  ,,,both,,,3593.74,2156.25,Aetna,Commerical,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Aetna,Middlesex Employees,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Anthem,Commerical,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Anthem,Indemnity,,,2613.66,,2613.66,2613.66,2879.33,percent of total billed charges,,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Anthem,State Preferred,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Anthem,Individual Exchange,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Cigna,Cigna,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Connecticare,Commerical,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Connecticare,Exchange,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,Multiplan,Multiplan,,,2879.33,,2879.33,2613.66,2879.33,percent of total billed charges,,
CIRCUMCISION 28 DAYS OR OLDER,54161,CPT,,,both,,,3593.74,2156.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2613.66,2879.33,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT  ,,,both,,,3702.85,2221.71,Aetna,Commerical,,2677.55,,,2677.55,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Aetna,Middlesex Employees,,2409.79,,,2409.79,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Anthem,Commerical,,2395.81,,,2395.81,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Anthem,Indemnity,,,2692.25,,2695.25,1916.64,2965.91,percent of total billed charges,,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Anthem,State Preferred,,2395.81,,,2395.81,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Anthem,Individual Exchange,,1916.64,,,1916.64,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Cigna,Cigna,,2339.77,,,2339.77,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Connecticare,Commerical,,2502.58,,,2502.58,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Connecticare,Exchange,,2502.58,,,2502.58,1916.64,2965.91,other,Could be inpatient or outpatient,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,Multiplan,Multiplan,,,2965.91,,2965.91,1916.64,2965.91,percent of total billed charges,,
HC CIRCUM 28 DAYS OR OLDER,54161,CPT,,,both,,,3702.85,2221.71,United Healthcare/Oxford,United Healthcare/Oxford,,2407.96,,,2407.96,1916.64,2965.91,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT  ,,,both,,,988.8,593.28,Aetna,Commerical,,715.59,,,715.59,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Aetna,Middlesex Employees,,644.03,,,644.03,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Anthem,Commerical,,640.29,,,640.29,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Anthem,Indemnity,,,719.51,,719.51,512.23,792.65,percent of total billed charges,,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Anthem,State Preferred,,640.29,,,640.29,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Anthem,Individual Exchange,,512.23,,,512.23,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Cigna,Cigna,,625.31,,,625.31,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Connecticare,Commerical,,668.83,,,668.83,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Connecticare,Exchange,,668.83,,,668.83,512.23,792.65,other,Could be inpatient or outpatient,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,Multiplan,Multiplan,,,792.65,,792.65,512.23,792.65,percent of total billed charges,,
HC TX OF PENIS LESION,54220,CPT,,,both,,,988.8,593.28,United Healthcare/Oxford,United Healthcare/Oxford,,643.54,,,643.54,512.23,792.65,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT  ,,,both,,,1033.09,619.85,Aetna,Commerical,,747.33,,,747.33,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Aetna,Middlesex Employees,,672.6,,,672.6,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Anthem,Commerical,,668.7,,,668.7,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Anthem,Indemnity,,,751.44,,751.44,534.96,827.82,percent of total billed charges,,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Anthem,State Preferred,,668.7,,,668.7,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Anthem,Individual Exchange,,534.96,,,534.96,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Cigna,Cigna,,653.06,,,653.06,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Connecticare,Commerical,,698.5,,,698.5,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Connecticare,Exchange,,698.5,,,698.5,534.96,827.82,other,Could be inpatient or outpatient,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,Multiplan,Multiplan,,,827.82,,827.82,534.96,827.82,percent of total billed charges,,
HC FORESKIN MANIPULATION,54450,CPT,,,both,,,1033.09,619.85,United Healthcare/Oxford,United Healthcare/Oxford,,672.1,,,672.1,534.96,827.82,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT  ,,,both,,,5769.03,3461.42,Aetna,Commerical,,3855.42,,,3855.42,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Aetna,Middlesex Employees,,3469.88,,,3469.88,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Anthem,Commerical,,3199.7,,,3199.7,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Anthem,Indemnity,,,4195.81,,4195.81,2559.76,4622.3,percent of total billed charges,,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Anthem,State Preferred,,3199.7,,,3199.7,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Anthem,Individual Exchange,,2559.76,,,2559.76,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Cigna,Cigna,,3396.14,,,3396.14,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Connecticare,Commerical,,3483.72,,,3483.72,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Connecticare,Exchange,,3483.72,,,3483.72,2559.76,4622.3,other,Could be inpatient or outpatient,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,Multiplan,Multiplan,,,4622.3,,4622.3,2559.76,4622.3,percent of total billed charges,,
HC REDUCE TESTIS TORSION W/WO FIXJ CLAT TESTIS,54600,CPT,,,both,,,5769.03,3461.42,United Healthcare/Oxford,United Healthcare/Oxford,,3571.29,,,3571.29,2559.76,4622.3,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT  ,,,both,,,10183.91,6110.35,Aetna,Commerical,,7680.09,,,7680.09,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Aetna,Middlesex Employees,,6912.08,,,6912.08,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Anthem,Commerical,,6864.38,,,6864.38,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Anthem,Indemnity,,,7406.57,,7406.57,5491.5,8995.37,percent of total billed charges,,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Anthem,State Preferred,,6864.38,,,6864.38,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Anthem,Individual Exchange,,5491.5,,,5491.5,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Cigna,Cigna,,6666.2,,,6666.2,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Connecticare,Commerical,,8995.37,,,8995.37,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Connecticare,Exchange,,8995.37,,,8995.37,5491.5,8995.37,other,Could be inpatient or outpatient,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,Multiplan,Multiplan,,,8159.41,,8159.41,5491.5,8995.37,percent of total billed charges,,
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,54640,CPT,,,both,,,10183.91,6110.35,United Healthcare/Oxford,United Healthcare/Oxford,,7200.35,,,7200.35,5491.5,8995.37,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT  ,,,both,,,9329.74,5597.84,Aetna,Commerical,,6748,,,6748,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Aetna,Middlesex Employees,,6073.2,,,6073.2,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Anthem,Commerical,,6037.95,,,6037.95,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Anthem,Indemnity,,,6785.06,,6785.06,4830.37,7474.73,percent of total billed charges,,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Anthem,State Preferred,,6037.95,,,6037.95,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Anthem,Individual Exchange,,4830.37,,,4830.37,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Cigna,Cigna,,5896.74,,,5896.74,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Connecticare,Commerical,,6307.06,,,6307.06,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Connecticare,Exchange,,6307.06,,,6307.06,4830.37,7474.73,other,Could be inpatient or outpatient,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,Multiplan,Multiplan,,,7474.73,,7474.73,4830.37,7474.73,percent of total billed charges,,
HC I & D EPIDIDYMIS TESTIS/SCROTAL SP,54700,CPT,,,both,,,9329.74,5597.84,United Healthcare/Oxford,United Healthcare/Oxford,,6068.61,,,6068.61,4830.37,7474.73,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT  ,,,both,,,4275.53,2565.32,Aetna,Commerical,,3092.74,,,3092.74,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Aetna,Middlesex Employees,,2783.46,,,2783.46,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Anthem,Commerical,,2767.3,,,2767.3,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Anthem,Indemnity,,,3109.72,,3109.72,2213.84,3425.81,percent of total billed charges,,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Anthem,State Preferred,,2767.3,,,2767.3,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Anthem,Individual Exchange,,2213.84,,,2213.84,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Cigna,Cigna,,2702.58,,,2702.58,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Connecticare,Commerical,,2890.64,,,2890.64,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Connecticare,Exchange,,2890.64,,,2890.64,2213.84,3425.81,other,Could be inpatient or outpatient,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,Multiplan,Multiplan,,,3425.81,,3425.81,2213.84,3425.81,percent of total billed charges,,
HC BIOPSY EPIDIDYMIS NEEDLE,54800,CPT,,,both,,,4275.53,2565.32,United Healthcare/Oxford,United Healthcare/Oxford,,2781.35,,,2781.35,2213.84,3425.81,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT  ,,,both,,,7181.16,4308.7,Aetna,Commerical,,5194.72,,,5194.72,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Aetna,Middlesex Employees,,4675.25,,,4675.25,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Anthem,Commerical,,4648.11,,,4648.11,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Anthem,Indemnity,,,5223.24,,5223.24,3718.49,5754.16,percent of total billed charges,,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Anthem,State Preferred,,4648.11,,,4648.11,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Anthem,Individual Exchange,,3718.49,,,3718.49,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Cigna,Cigna,,4539.39,,,4539.39,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Connecticare,Commerical,,4855.28,,,4855.28,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Connecticare,Exchange,,4855.28,,,4855.28,3718.49,5754.16,other,Could be inpatient or outpatient,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,Multiplan,Multiplan,,,5754.16,,5754.16,3718.49,5754.16,percent of total billed charges,,
HC EXCISE HYDROCELE; UNILATERAL,55040,CPT,,,both,,,7181.16,4308.7,United Healthcare/Oxford,United Healthcare/Oxford,,4671.7,,,4671.7,3718.49,5754.16,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT  ,,,both,,,5757.7,3454.62,Aetna,Commerical,,4250.29,,,4250.29,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Aetna,Middlesex Employees,,4075.67,,,4075.67,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Anthem,Commerical,,4302.58,,,4302.58,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Anthem,Indemnity,,,4187.33,,4187.33,3442.06,4636.61,percent of total billed charges,,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Anthem,State Preferred,,4302.58,,,4302.58,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Anthem,Individual Exchange,,3442.06,,,3442.06,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Cigna,Cigna,,4636.61,,,4636.61,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Connecticare,Commerical,,4530.26,,,4530.26,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Connecticare,Exchange,,4530.26,,,4530.26,3442.06,4636.61,other,Could be inpatient or outpatient,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,Multiplan,Multiplan,,,4612.95,,4612.95,3442.06,4636.61,percent of total billed charges,,
HC DRAINAGE OF SCROTUM ABSCESS,55100,CPT,,,both,,,5757.7,3454.62,United Healthcare/Oxford,United Healthcare/Oxford,,4139.57,,,4139.57,3442.06,4636.61,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT  ,,,both,,,518.85,311.31,Aetna,Commerical,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Aetna,Middlesex Employees,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Anthem,Commerical,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Anthem,Indemnity,,,377.35,,377.35,377.35,415.71,percent of total billed charges,,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Anthem,State Preferred,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Anthem,Individual Exchange,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Cigna,Cigna,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Connecticare,Commerical,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Connecticare,Exchange,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,Multiplan,Multiplan,,,415.71,,415.71,377.35,415.71,percent of total billed charges,,
BIOPSY OF PROSTATE GLAND,55700,CPT,,,both,,,518.85,311.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,377.35,415.71,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT  ,,,both,,,534.62,320.77,Aetna,Commerical,,386.69,,,386.69,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Aetna,Middlesex Employees,,348.02,,,348.02,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Anthem,Commerical,,346,,,346,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Anthem,Indemnity,,,388.82,,388.82,276.8,428.34,percent of total billed charges,,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Anthem,State Preferred,,346,,,346,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Anthem,Individual Exchange,,276.8,,,276.8,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Cigna,Cigna,,337.91,,,337.91,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Connecticare,Commerical,,361.42,,,361.42,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Connecticare,Exchange,,361.42,,,361.42,276.8,428.34,other,Could be inpatient or outpatient,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,Multiplan,Multiplan,,,428.34,,428.34,276.8,428.34,percent of total billed charges,,
HC BIOPSY PROSTATE NDL OR PUNCH ANY,55700,CPT,,,both,,,534.62,320.77,United Healthcare/Oxford,United Healthcare/Oxford,,347.76,,,347.76,276.8,428.34,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT  ,,,both,,,1549.12,929.47,Aetna,Commerical,,1120.19,,,1120.19,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Aetna,Middlesex Employees,,1008.18,,,1008.18,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Anthem,Commerical,,1002.31,,,1002.31,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Anthem,Indemnity,,,1126.34,,1126.34,801.86,1240.83,percent of total billed charges,,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Anthem,State Preferred,,1002.31,,,1002.31,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Anthem,Individual Exchange,,801.86,,,801.86,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Cigna,Cigna,,978.88,,,978.88,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Connecticare,Commerical,,1046.99,,,1046.99,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Connecticare,Exchange,,1046.99,,,1046.99,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,Multiplan,Multiplan,,,1240.83,,1240.83,801.86,1240.83,percent of total billed charges,,
HC I & D OF VULVA OR PERINEAL ABSCESS,56405,CPT,,,both,,,1549.12,929.47,United Healthcare/Oxford,United Healthcare/Oxford,,1007.4,,,1007.4,801.86,1240.83,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT  ,,,both,,,868.29,520.97,Aetna,Commerical,,627.67,,,627.67,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Aetna,Middlesex Employees,,564.9,,,564.9,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Anthem,Commerical,,561.62,,,561.62,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Anthem,Indemnity,,,631.11,,631.11,449.29,695.26,percent of total billed charges,,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Anthem,State Preferred,,561.62,,,561.62,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Anthem,Individual Exchange,,449.29,,,449.29,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Cigna,Cigna,,548.49,,,548.49,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Connecticare,Commerical,,586.65,,,586.65,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Connecticare,Exchange,,586.65,,,586.65,449.29,695.26,other,Could be inpatient or outpatient,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,Multiplan,Multiplan,,,695.26,,695.26,449.29,695.26,percent of total billed charges,,
HC I & D OF BARTHOLIN'S GLAND ABSCESS,56420,CPT,,,both,,,868.29,520.97,United Healthcare/Oxford,United Healthcare/Oxford,,564.47,,,564.47,449.29,695.26,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT  ,,,both,,,3905.76,2343.46,Aetna,Commerical,,2825.71,,,2825.71,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Aetna,Middlesex Employees,,2543.14,,,2543.14,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Anthem,Commerical,,2528.38,,,2528.38,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Anthem,Indemnity,,,2841.22,,2841.22,2022.7,3130.02,percent of total billed charges,,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Anthem,State Preferred,,2528.38,,,2528.38,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Anthem,Individual Exchange,,2022.7,,,2022.7,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Cigna,Cigna,,2469.24,,,2469.24,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Connecticare,Commerical,,2641.07,,,2641.07,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Connecticare,Exchange,,2641.07,,,2641.07,2022.7,3130.02,other,Could be inpatient or outpatient,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,Multiplan,Multiplan,,,3130.02,,3130.02,2022.7,3130.02,percent of total billed charges,,
HC LYSIS OF LABIAL ADHESIONS,56441,CPT,,,both,,,3905.76,2343.46,United Healthcare/Oxford,United Healthcare/Oxford,,2541.22,,,2541.22,2022.7,3130.02,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT  ,,,both,,,1549.12,929.47,Aetna,Commerical,,1120.19,,,1120.19,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Aetna,Middlesex Employees,,1008.18,,,1008.18,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Anthem,Commerical,,1002.31,,,1002.31,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Anthem,Indemnity,,,1126.34,,1126.34,801.86,1240.83,percent of total billed charges,,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Anthem,State Preferred,,1002.31,,,1002.31,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Anthem,Individual Exchange,,801.86,,,801.86,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Cigna,Cigna,,978.88,,,978.88,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Connecticare,Commerical,,1046.99,,,1046.99,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Connecticare,Exchange,,1046.99,,,1046.99,801.86,1240.83,other,Could be inpatient or outpatient,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,Multiplan,Multiplan,,,1240.83,,1240.83,801.86,1240.83,percent of total billed charges,,
HC COLPOCENTESIS,57020,CPT,,,both,,,1549.12,929.47,United Healthcare/Oxford,United Healthcare/Oxford,,1007.4,,,1007.4,801.86,1240.83,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT  ,,,both,,,447.02,268.21,Aetna,Commerical,,323.2,,,323.2,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Aetna,Middlesex Employees,,290.88,,,290.88,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Anthem,Commerical,,289.19,,,289.19,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Anthem,Indemnity,,,324.97,,324.97,231.35,358,percent of total billed charges,,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Anthem,State Preferred,,289.19,,,289.19,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Anthem,Individual Exchange,,231.35,,,231.35,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Cigna,Cigna,,282.42,,,282.42,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Connecticare,Commerical,,302.08,,,302.08,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Connecticare,Exchange,,302.08,,,302.08,231.35,358,other,Could be inpatient or outpatient,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,Multiplan,Multiplan,,,358,,358,231.35,358,percent of total billed charges,,
HC INSERT PESSARY DEVICE,57160,CPT,,,both,,,447.02,268.21,United Healthcare/Oxford,United Healthcare/Oxford,,290.66,,,290.66,231.35,358,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT  ,,,both,,,7734.27,4640.56,Aetna,Commerical,,5594.44,,,5594.44,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Aetna,Middlesex Employees,,5034.99,,,5034.99,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Anthem,Commerical,,5005.77,,,5005.77,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Anthem,Indemnity,,,5625.15,,5625.15,4004.61,6196.93,percent of total billed charges,,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Anthem,State Preferred,,5005.77,,,5005.77,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Anthem,Individual Exchange,,4004.61,,,4004.61,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Cigna,Cigna,,4888.69,,,4888.69,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Connecticare,Commerical,,5228.88,,,5228.88,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Connecticare,Exchange,,5228.88,,,5228.88,4004.61,6196.93,other,Could be inpatient or outpatient,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,Multiplan,Multiplan,,,6196.93,,6196.93,4004.61,6196.93,percent of total billed charges,,
HC SUT VAGINAL INJURY,57200,CPT,,,both,,,7734.27,4640.56,United Healthcare/Oxford,United Healthcare/Oxford,,5031.18,,,5031.18,4004.61,6196.93,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT  ,,,both,,,3449.47,2069.68,Aetna,Commerical,,2304.88,,,2304.88,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Aetna,Middlesex Employees,,2074.4,,,2074.4,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Anthem,Commerical,,1912.88,,,1912.88,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Anthem,Indemnity,,,2508.38,,2508.38,1530.3,2763.35,percent of total billed charges,,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Anthem,State Preferred,,1912.88,,,1912.88,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Anthem,Individual Exchange,,1530.3,,,1530.3,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Cigna,Cigna,,2030.32,,,2030.32,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Connecticare,Commerical,,2082.67,,,2082.67,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Connecticare,Exchange,,2082.67,,,2082.67,1530.3,2763.35,other,Could be inpatient or outpatient,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,Multiplan,Multiplan,,,2763.35,,2763.35,1530.3,2763.35,percent of total billed charges,,
HC PELVIC EXAM W/ANESTH OR OTHER LOCAL,57410,CPT,,,both,,,3449.47,2069.68,United Healthcare/Oxford,United Healthcare/Oxford,,2135.03,,,2135.03,1530.3,2763.35,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT  ,,,both,,,6779.46,4067.68,Aetna,Commerical,,4903.27,,,4903.27,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Aetna,Middlesex Employees,,4412.95,,,4412.95,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Anthem,Commerical,,4387.33,,,4387.33,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Anthem,Indemnity,,,4930.2,,4930.2,3509.87,5431.33,percent of total billed charges,,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Anthem,State Preferred,,4387.33,,,4387.33,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Anthem,Individual Exchange,,3509.87,,,3509.87,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Cigna,Cigna,,4284.72,,,4284.72,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Connecticare,Commerical,,4582.87,,,4582.87,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Connecticare,Exchange,,4582.87,,,4582.87,3509.87,5431.33,other,Could be inpatient or outpatient,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,Multiplan,Multiplan,,,5431.33,,5431.33,3509.87,5431.33,percent of total billed charges,,
HC REMOVAL OF IMPACTED VAGINAL FB W/ANES,57415,CPT,,,both,,,6779.46,4067.68,United Healthcare/Oxford,United Healthcare/Oxford,,4409.61,,,4409.61,3509.87,5431.33,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT  ,,,both,,,1005.28,603.17,Aetna,Commerical,,726.98,,,726.98,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Aetna,Middlesex Employees,,654.29,,,654.29,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Anthem,Commerical,,650.49,,,650.49,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Anthem,Indemnity,,,730.97,,730.97,520.39,805.27,percent of total billed charges,,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Anthem,State Preferred,,650.49,,,650.49,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Anthem,Individual Exchange,,520.39,,,520.39,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Cigna,Cigna,,635.27,,,635.27,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Connecticare,Commerical,,679.48,,,679.48,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Connecticare,Exchange,,679.48,,,679.48,520.39,805.27,other,Could be inpatient or outpatient,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,Multiplan,Multiplan,,,805.27,,805.27,520.39,805.27,percent of total billed charges,,
HC COLPOSCOPY,57420,CPT,,,both,,,1005.28,603.17,United Healthcare/Oxford,United Healthcare/Oxford,,653.79,,,653.79,520.39,805.27,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT  ,,,both,,,6849.5,4109.7,Aetna,Commerical,,4953.75,,,4953.75,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Aetna,Middlesex Employees,,4458.38,,,4458.38,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Anthem,Commerical,,4432.49,,,4432.49,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Anthem,Indemnity,,,4980.95,,4980.95,3545.99,5487.24,percent of total billed charges,,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Anthem,State Preferred,,4432.49,,,4432.49,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Anthem,Individual Exchange,,3545.99,,,3545.99,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Cigna,Cigna,,4328.82,,,4328.82,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Connecticare,Commerical,,4630.05,,,4630.05,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Connecticare,Exchange,,4630.05,,,4630.05,3545.99,5487.24,other,Could be inpatient or outpatient,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,Multiplan,Multiplan,,,5487.24,,5487.24,3545.99,5487.24,percent of total billed charges,,
HC D&C NON-OBSTET,58120,CPT,,,both,,,6849.5,4109.7,United Healthcare/Oxford,United Healthcare/Oxford,,4455,,,4455,3545.99,5487.24,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT  ,,,both,,,868.29,520.97,Aetna,Commerical,,627.67,,,627.67,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Aetna,Middlesex Employees,,564.9,,,564.9,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Anthem,Commerical,,561.62,,,561.62,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Anthem,Indemnity,,,631.11,,631.11,449.29,695.26,percent of total billed charges,,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Anthem,State Preferred,,561.62,,,561.62,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Anthem,Individual Exchange,,449.29,,,449.29,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Cigna,Cigna,,548.49,,,548.49,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Connecticare,Commerical,,586.65,,,586.65,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Connecticare,Exchange,,586.65,,,586.65,449.29,695.26,other,Could be inpatient or outpatient,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,Multiplan,Multiplan,,,695.26,,695.26,449.29,695.26,percent of total billed charges,,
HC REMOVAL OF  IUD,58301,CPT,,,both,,,868.29,520.97,United Healthcare/Oxford,United Healthcare/Oxford,,564.47,,,564.47,449.29,695.26,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1126.26,,,1126.26,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1013.64,,,1013.64,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1337.27,,,1337.27,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1013.64,1642.12,percent of total billed charges,,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1337.27,,,1337.27,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1069.82,,,1069.82,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1537.39,,,1537.39,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1431.24,,,1431.24,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1431.24,,,1431.24,1013.64,1642.12,other,Could be inpatient or outpatient,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1013.64,1642.12,percent of total billed charges,,
HC CT ABS DRAIN PELVIC,58823,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1248.6,,,1248.6,1013.64,1642.12,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT  ,,,both,,,2268.06,1360.84,Aetna,Commerical,,1641.2,,,1641.2,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Aetna,Middlesex Employees,,1477.09,,,1477.09,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Anthem,Commerical,,1468.51,,,1468.51,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Anthem,Indemnity,,,1650.22,,1650.22,1174.81,1817.95,percent of total billed charges,,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Anthem,State Preferred,,1468.51,,,1468.51,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Anthem,Individual Exchange,,1174.81,,,1174.81,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Cigna,Cigna,,1434.17,,,1434.17,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Connecticare,Commerical,,1533.97,,,1533.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Connecticare,Exchange,,1533.97,,,1533.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,Multiplan,Multiplan,,,1817.95,,1817.95,1174.81,1817.95,percent of total billed charges,,
HC HHABSCDRNPEL,58823,CPT,,,both,,,2268.06,1360.84,United Healthcare/Oxford,United Healthcare/Oxford,,1475.97,,,1475.97,1174.81,1817.95,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT  ,,,both,,,6849.5,4109.7,Aetna,Commerical,,4953.75,,,4953.75,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Aetna,Middlesex Employees,,4458.38,,,4458.38,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Anthem,Commerical,,4432.49,,,4432.49,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Anthem,Indemnity,,,4980.95,,4980.95,3545.99,5487.24,percent of total billed charges,,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Anthem,State Preferred,,4432.49,,,4432.49,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Anthem,Individual Exchange,,3545.99,,,3545.99,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Cigna,Cigna,,4328.82,,,4328.82,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Connecticare,Commerical,,4630.05,,,4630.05,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Connecticare,Exchange,,4630.05,,,4630.05,3545.99,5487.24,other,Could be inpatient or outpatient,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,Multiplan,Multiplan,,,5487.24,,5487.24,3545.99,5487.24,percent of total billed charges,,
HC CURETTAGE POSTPARTUM,59160,CPT,,,both,,,6849.5,4109.7,United Healthcare/Oxford,United Healthcare/Oxford,,4455,,,4455,3545.99,5487.24,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT  ,,,both,,,10363.86,6218.32,Aetna,Commerical,,6926,,,6926,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Aetna,Middlesex Employees,,6233.41,,,6233.41,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Anthem,Commerical,,5748.06,,,5748.06,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Anthem,Indemnity,,,7537.5,,7537.5,4598.44,8303.65,percent of total billed charges,,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Anthem,State Preferred,,5748.06,,,5748.06,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Anthem,Individual Exchange,,4598.44,,,4598.44,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Cigna,Cigna,,6100.93,,,6100.93,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Connecticare,Commerical,,6258.26,,,6258.26,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Connecticare,Exchange,,6258.26,,,6258.26,4598.44,8303.65,other,Could be inpatient or outpatient,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,Multiplan,Multiplan,,,8303.65,,8303.65,4598.44,8303.65,percent of total billed charges,,
HC VAGINAL DELIVERY,59409,CPT,,,both,,,10363.86,6218.32,United Healthcare/Oxford,United Healthcare/Oxford,,6415.57,,,6415.57,4598.44,8303.65,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC ASC THYROID BX,60100,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT  ,,,both,,,2042.49,1225.49,Aetna,Commerical,,1122.56,,,1122.56,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Aetna,Middlesex Employees,,1010.3,,,1010.3,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Anthem,Commerical,,1332.86,,,1332.86,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Anthem,Indemnity,,,1485.69,,1485.69,1010.3,1636.7,percent of total billed charges,,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Anthem,State Preferred,,1332.86,,,1332.86,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Anthem,Individual Exchange,,1066.29,,,1066.29,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Cigna,Cigna,,1532.33,,,1532.33,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Connecticare,Commerical,,1426.53,,,1426.53,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Connecticare,Exchange,,1426.53,,,1426.53,1010.3,1636.7,other,Could be inpatient or outpatient,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,Multiplan,Multiplan,,,1636.7,,1636.7,1010.3,1636.7,percent of total billed charges,,
HC THYROID BIOPSY,60100,CPT,,,both,,,2042.49,1225.49,United Healthcare/Oxford,United Healthcare/Oxford,,1244.48,,,1244.48,1010.3,1636.7,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT  ,,,both,,,1224.67,734.8,Aetna,Commerical,,884.92,,,884.92,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Aetna,Middlesex Employees,,796.43,,,796.43,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Anthem,Commerical,,791.81,,,791.81,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Anthem,Indemnity,,,889.78,,889.78,633.44,980.22,percent of total billed charges,,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Anthem,State Preferred,,791.81,,,791.81,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Anthem,Individual Exchange,,633.44,,,633.44,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Cigna,Cigna,,773.28,,,773.28,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Connecticare,Commerical,,827.09,,,827.09,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Connecticare,Exchange,,827.09,,,827.09,633.44,980.22,other,Could be inpatient or outpatient,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,Multiplan,Multiplan,,,980.22,,980.22,633.44,980.22,percent of total billed charges,,
HC ASPIR/INJ THYROID CYST,60300,CPT,,,both,,,1224.67,734.8,United Healthcare/Oxford,United Healthcare/Oxford,,795.82,,,795.82,633.44,980.22,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT  ,,,both,,,2941.68,1765.01,Aetna,Commerical,,2128.04,,,2128.04,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Aetna,Middlesex Employees,,1915.23,,,1915.23,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Anthem,Commerical,,1904.12,,,1904.12,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Anthem,Indemnity,,,2139.72,,2139.72,1523.29,2357.21,percent of total billed charges,,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Anthem,State Preferred,,1904.12,,,1904.12,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Anthem,Individual Exchange,,1523.29,,,1523.29,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Cigna,Cigna,,1859.58,,,1859.58,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Connecticare,Commerical,,1988.98,,,1988.98,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Connecticare,Exchange,,1988.98,,,1988.98,1523.29,2357.21,other,Could be inpatient or outpatient,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,Multiplan,Multiplan,,,2357.21,,2357.21,1523.29,2357.21,percent of total billed charges,,
HC SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,61000,CPT,,,both,,,2941.68,1765.01,United Healthcare/Oxford,United Healthcare/Oxford,,1913.78,,,1913.78,1523.29,2357.21,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT  ,,,both,,,2731.56,1638.94,Aetna,Commerical,,1825.62,,,1825.62,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Aetna,Middlesex Employees,,1643.06,,,1643.06,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Anthem,Commerical,,1515.13,,,1515.13,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Anthem,Indemnity,,,1986.8,,1986.8,1212.1,2188.75,percent of total billed charges,,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Anthem,State Preferred,,1515.13,,,1515.13,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Anthem,Individual Exchange,,1212.1,,,1212.1,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Cigna,Cigna,,1608.14,,,1608.14,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Connecticare,Commerical,,1649.61,,,1649.61,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Connecticare,Exchange,,1649.61,,,1649.61,1212.1,2188.75,other,Could be inpatient or outpatient,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,Multiplan,Multiplan,,,2188.75,,2188.75,1212.1,2188.75,percent of total billed charges,,
HC VENT PUNCT PREV BURR HOLE W/O NJX,61020,CPT,,,both,,,2731.56,1638.94,United Healthcare/Oxford,United Healthcare/Oxford,,1691.07,,,1691.07,1212.1,2188.75,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT  ,,,both,,,484.1,290.46,Aetna,Commerical,,350.06,,,350.06,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Aetna,Middlesex Employees,,315.06,,,315.06,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Anthem,Commerical,,313.22,,,313.22,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Anthem,Indemnity,,,351.98,,351.98,250.57,387.76,percent of total billed charges,,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Anthem,State Preferred,,313.22,,,313.22,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Anthem,Individual Exchange,,250.57,,,250.57,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Cigna,Cigna,,305.9,,,305.9,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Connecticare,Commerical,,327.19,,,327.19,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Connecticare,Exchange,,327.19,,,327.19,250.57,387.76,other,Could be inpatient or outpatient,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,Multiplan,Multiplan,,,387.76,,387.76,250.57,387.76,percent of total billed charges,,
HC  INJECTION INTO BRAIN CANAL,61055,CPT,,,both,,,484.1,290.46,United Healthcare/Oxford,United Healthcare/Oxford,,314.82,,,314.82,250.57,387.76,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC PUNC SHUNT ASPINJ,61070,CPT,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT  ,,,both,,,8390.38,5034.23,Aetna,Commerical,,6069.05,,,6069.05,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Aetna,Middlesex Employees,,5462.14,,,5462.14,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Anthem,Commerical,,5430.45,,,5430.45,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Anthem,Indemnity,,,6102.38,,6102.38,4344.36,6722.66,percent of total billed charges,,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Anthem,State Preferred,,5430.45,,,5430.45,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Anthem,Individual Exchange,,4344.36,,,4344.36,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Cigna,Cigna,,5303.43,,,5303.43,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Connecticare,Commerical,,5672.47,,,5672.47,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Connecticare,Exchange,,5672.47,,,5672.47,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,Multiplan,Multiplan,,,6722.66,,6722.66,4344.36,6722.66,percent of total billed charges,,
HC TRANSCATH OCCLUSION CNS,61624,CPT,,,both,,,8390.38,5034.23,United Healthcare/Oxford,United Healthcare/Oxford,,5458.01,,,5458.01,4344.36,6722.66,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT  ,,,both,,,3525.69,2115.41,Aetna,Commerical,,2549.73,,,2549.73,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Aetna,Middlesex Employees,,2294.76,,,2294.76,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Anthem,Commerical,,2281.44,,,2281.44,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Anthem,Indemnity,,,2563.74,,2563.74,1825.15,2824.33,percent of total billed charges,,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Anthem,State Preferred,,2281.44,,,2281.44,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Anthem,Individual Exchange,,1825.15,,,1825.15,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Cigna,Cigna,,2228.09,,,2228.09,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Connecticare,Commerical,,2383.13,,,2383.13,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Connecticare,Exchange,,2383.13,,,2383.13,1825.15,2824.33,other,Could be inpatient or outpatient,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,Multiplan,Multiplan,,,2824.33,,2824.33,1825.15,2824.33,percent of total billed charges,,
HC TC EMBOLIZ - HEMOST TUMOR; NOT CNS,61626,CPT,,,both,,,3525.69,2115.41,United Healthcare/Oxford,United Healthcare/Oxford,,2293.02,,,2293.02,1825.15,2824.33,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT  ,,,both,,,4225.16,2535.1,Aetna,Commerical,,2321.8,,,2321.8,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT  ,,,both,,,2050.68,1230.41,Aetna,Commerical,,1483.27,,,1483.27,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Aetna,Middlesex Employees,,2089.62,,,2089.62,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Aetna,Middlesex Employees,,1334.95,,,1334.95,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Anthem,Commerical,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Anthem,Commerical,,1327.2,,,1327.2,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Anthem,Indemnity,,,3072.88,,3072.88,2089.62,3385.23,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Anthem,Indemnity,,,1491.42,,1491.42,1061.77,1643.02,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Anthem,State Preferred,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Anthem,State Preferred,,1327.2,,,1327.2,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Anthem,Individual Exchange,,2205.44,,,2205.44,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Anthem,Individual Exchange,,1061.77,,,1061.77,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Cigna,Cigna,,3169.34,,,3169.34,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Cigna,Cigna,,1296.16,,,1296.16,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Connecticare,Commerical,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Connecticare,Commerical,,1386.35,,,1386.35,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Connecticare,Exchange,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Connecticare,Exchange,,1386.35,,,1386.35,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,Multiplan,Multiplan,,,3385.23,,3385.23,2089.62,3385.23,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,Multiplan,Multiplan,,,1643.02,,1643.02,1061.77,1643.02,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT 1ST,61650,CPT,,,both,,,4225.16,2535.1,United Healthcare/Oxford,United Healthcare/Oxford,,2573.98,,,2573.98,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT 1ST-OR,61650,CPT,,,both,,,2050.68,1230.41,United Healthcare/Oxford,United Healthcare/Oxford,,1333.93,,,1333.93,1061.77,1643.02,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT  ,,,both,,,4225.16,2535.1,Aetna,Commerical,,2321.8,,,2321.8,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT  ,,,both,,,805.86,483.52,Aetna,Commerical,,582.89,,,582.89,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Aetna,Middlesex Employees,,2089.62,,,2089.62,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Aetna,Middlesex Employees,,524.6,,,524.6,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Anthem,Commerical,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Anthem,Commerical,,521.56,,,521.56,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Anthem,Indemnity,,,3072.88,,3072.88,2089.62,3385.23,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Anthem,Indemnity,,,586.09,,586.09,417.25,645.66,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Anthem,State Preferred,,2756.79,,,2756.79,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Anthem,State Preferred,,521.56,,,521.56,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Anthem,Individual Exchange,,2205.44,,,2205.44,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Anthem,Individual Exchange,,417.25,,,417.25,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Cigna,Cigna,,3169.34,,,3169.34,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Cigna,Cigna,,509.36,,,509.36,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Connecticare,Commerical,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Connecticare,Commerical,,544.8,,,544.8,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Connecticare,Exchange,,2950.53,,,2950.53,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Connecticare,Exchange,,544.8,,,544.8,417.25,645.66,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,Multiplan,Multiplan,,,3385.23,,3385.23,2089.62,3385.23,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,Multiplan,Multiplan,,,645.66,,645.66,417.25,645.66,percent of total billed charges,,
HC EVASC PRLNG ADMN RX AGNT ADD,61651,CPT,,,both,,,4225.16,2535.1,United Healthcare/Oxford,United Healthcare/Oxford,,2573.98,,,2573.98,2089.62,3385.23,other,Could be inpatient or outpatient,
HC EVASC PRLNG ADMN RX AGNT ADD-OR,61651,CPT,,,both,,,805.86,483.52,United Healthcare/Oxford,United Healthcare/Oxford,,524.2,,,524.2,417.25,645.66,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT  ,,,both,,,322.39,193.43,Aetna,Commerical,,232.83,,,232.83,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Aetna,Middlesex Employees,,209.55,,,209.55,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Anthem,Commerical,,208.34,,,208.34,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Anthem,Indemnity,,,234.11,,234.11,166.67,257.91,percent of total billed charges,,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Anthem,State Preferred,,208.34,,,208.34,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Anthem,Individual Exchange,,166.67,,,166.67,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Cigna,Cigna,,203.46,,,203.46,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Connecticare,Commerical,,217.62,,,217.62,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Connecticare,Exchange,,217.62,,,217.62,166.67,257.91,other,Could be inpatient or outpatient,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,Multiplan,Multiplan,,,257.91,,257.91,166.67,257.91,percent of total billed charges,,
HC REPLACE OR IRRIGATE VENTRICULAR CATH,62225,CPT,,,both,,,322.39,193.43,United Healthcare/Oxford,United Healthcare/Oxford,,209.39,,,209.39,166.67,257.91,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT  ,,,both,,,1176.26,705.76,Aetna,Commerical,,851.54,,,851.54,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Aetna,Middlesex Employees,,766.39,,,766.39,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Anthem,Commerical,,761.94,,,761.94,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Anthem,Indemnity,,,856.21,,856.21,609.55,943.25,percent of total billed charges,,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Anthem,State Preferred,,761.94,,,761.94,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Anthem,Individual Exchange,,609.55,,,609.55,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Cigna,Cigna,,744.12,,,744.12,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Connecticare,Commerical,,795.89,,,795.89,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Connecticare,Exchange,,795.89,,,795.89,609.55,943.25,other,Could be inpatient or outpatient,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,Multiplan,Multiplan,,,943.25,,943.25,609.55,943.25,percent of total billed charges,,
HC REPROGRAMMING OF CEREBROSPINAL  SHUNT,62252,CPT,,,both,,,1176.26,705.76,United Healthcare/Oxford,United Healthcare/Oxford,,765.81,,,765.81,609.55,943.25,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT  ,,,both,,,987.77,592.66,Aetna,Commerical,,714.77,,,714.77,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Aetna,Middlesex Employees,,643.3,,,643.3,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Anthem,Commerical,,639.56,,,639.56,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Anthem,Indemnity,,,718.7,,718.7,511.64,791.75,percent of total billed charges,,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Anthem,State Preferred,,639.56,,,639.56,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Anthem,Individual Exchange,,511.64,,,511.64,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Cigna,Cigna,,624.6,,,624.6,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Connecticare,Commerical,,668.07,,,668.07,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Connecticare,Exchange,,668.07,,,668.07,511.64,791.75,other,Could be inpatient or outpatient,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,Multiplan,Multiplan,,,791.75,,791.75,511.64,791.75,percent of total billed charges,,
HC INTERDISCAL PERQ ASPIR DX,62267,CPT,,,both,,,987.77,592.66,United Healthcare/Oxford,United Healthcare/Oxford,,642.81,,,642.81,511.64,791.75,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT  ,,,both,,,3023.12,1813.87,Aetna,Commerical,,2186.64,,,2186.64,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Aetna,Middlesex Employees,,1967.98,,,1967.98,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Anthem,Commerical,,1956.56,,,1956.56,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Anthem,Indemnity,,,2198.66,,2198.66,1565.25,2422.14,percent of total billed charges,,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Anthem,State Preferred,,1956.56,,,1956.56,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Anthem,Individual Exchange,,1565.25,,,1565.25,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Cigna,Cigna,,1910.8,,,1910.8,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Connecticare,Commerical,,2043.76,,,2043.76,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Connecticare,Exchange,,2043.76,,,2043.76,1565.25,2422.14,other,Could be inpatient or outpatient,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,Multiplan,Multiplan,,,2422.14,,2422.14,1565.25,2422.14,percent of total billed charges,,
HC PERC ASP SPINAL CORD CYST OR SYRINX,62268,CPT,,,both,,,3023.12,1813.87,United Healthcare/Oxford,United Healthcare/Oxford,,1966.5,,,1966.5,1565.25,2422.14,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT  ,,,both,,,1611.95,967.17,Aetna,Commerical,,885.68,,,885.68,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Aetna,Middlesex Employees,,797.11,,,797.11,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Anthem,Commerical,,1051.6,,,1051.6,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Anthem,Indemnity,,,1172.18,,1172.18,797.11,1291.33,percent of total billed charges,,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Anthem,State Preferred,,1051.6,,,1051.6,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Anthem,Individual Exchange,,841.28,,,841.28,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Cigna,Cigna,,1208.97,,,1208.97,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Connecticare,Commerical,,1125.51,,,1125.51,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Connecticare,Exchange,,1125.51,,,1125.51,797.11,1291.33,other,Could be inpatient or outpatient,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,Multiplan,Multiplan,,,1291.33,,1291.33,797.11,1291.33,percent of total billed charges,,
HC CT GUIDE SPINE BX,62269,CPT,,,both,,,1611.95,967.17,United Healthcare/Oxford,United Healthcare/Oxford,,981.87,,,981.87,797.11,1291.33,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT  ,,,both,,,2092.96,1255.78,Aetna,Commerical,,1514.21,,,1514.21,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Aetna,Middlesex Employees,,1362.79,,,1362.79,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Anthem,Commerical,,1354.88,,,1354.88,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Anthem,Indemnity,,,1522.52,,1522.52,1083.9,1677.28,percent of total billed charges,,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Anthem,State Preferred,,1354.88,,,1354.88,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Anthem,Individual Exchange,,1083.9,,,1083.9,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Cigna,Cigna,,1323.19,,,1323.19,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Connecticare,Commerical,,1415.27,,,1415.27,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Connecticare,Exchange,,1415.27,,,1415.27,1083.9,1677.28,other,Could be inpatient or outpatient,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,Multiplan,Multiplan,,,1677.28,,1677.28,1083.9,1677.28,percent of total billed charges,,
HC PERC NEEDLE BX OF SPINAL CORD,62269,CPT,,,both,,,2092.96,1255.78,United Healthcare/Oxford,United Healthcare/Oxford,,1361.75,,,1361.75,1083.9,1677.28,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC LUMBAR PUNC DX,62270,CPT,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC DRAIN CEREBRO SPINAL FLUID,62272,CPT,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT  ,,,both,,,1138.15,682.89,Aetna,Commerical,,823.87,,,823.87,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Aetna,Middlesex Employees,,741.48,,,741.48,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Anthem,Commerical,,737.17,,,737.17,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Anthem,Indemnity,,,828.38,,828.38,589.73,912.59,percent of total billed charges,,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Anthem,State Preferred,,737.17,,,737.17,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Anthem,Individual Exchange,,589.73,,,589.73,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Cigna,Cigna,,719.93,,,719.93,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Connecticare,Commerical,,770.03,,,770.03,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Connecticare,Exchange,,770.03,,,770.03,589.73,912.59,other,Could be inpatient or outpatient,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,Multiplan,Multiplan,,,912.59,,912.59,589.73,912.59,percent of total billed charges,,
HC EPI INJ BLD PATCH,62273,CPT,,,both,,,1138.15,682.89,United Healthcare/Oxford,United Healthcare/Oxford,,740.91,,,740.91,589.73,912.59,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT  ,,,both,,,248.23,148.94,Aetna,Commerical,,179.1,,,179.1,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Aetna,Middlesex Employees,,161.19,,,161.19,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Anthem,Commerical,,160.26,,,160.26,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Anthem,Indemnity,,,180.09,,180.09,128.21,198.39,percent of total billed charges,,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Anthem,State Preferred,,160.26,,,160.26,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Anthem,Individual Exchange,,128.21,,,128.21,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Cigna,Cigna,,156.51,,,156.51,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Connecticare,Commerical,,167.4,,,167.4,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Connecticare,Exchange,,167.4,,,167.4,128.21,198.39,other,Could be inpatient or outpatient,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,Multiplan,Multiplan,,,198.39,,198.39,128.21,198.39,percent of total billed charges,,
HC INJECTION FOR MYELOGRAM,62284,CPT,,,both,,,248.23,148.94,United Healthcare/Oxford,United Healthcare/Oxford,,161.07,,,161.07,128.21,198.39,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT  ,,,both,,,1392.56,835.54,Aetna,Commerical,,1007.84,,,1007.84,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Aetna,Middlesex Employees,,907.06,,,907.06,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Anthem,Commerical,,901.8,,,901.8,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Anthem,Indemnity,,,1013.38,,1013.38,721.44,1116.38,percent of total billed charges,,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Anthem,State Preferred,,901.8,,,901.8,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Anthem,Individual Exchange,,721.44,,,721.44,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Cigna,Cigna,,880.7,,,880.7,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Connecticare,Commerical,,941.99,,,941.99,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Connecticare,Exchange,,941.99,,,941.99,721.44,1116.38,other,Could be inpatient or outpatient,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,Multiplan,Multiplan,,,1116.38,,1116.38,721.44,1116.38,percent of total billed charges,,
HC HH EPID INJ LS,62311,CPT,,,both,,,1392.56,835.54,United Healthcare/Oxford,United Healthcare/Oxford,,906.37,,,906.37,721.44,1116.38,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC INJ OF DX/TX SUB EPIDURAL LUMBAR/SAC,62322,CPT,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT  ,,,both,,,2373.7,1424.22,Aetna,Commerical,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Aetna,Middlesex Employees,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Anthem,Commerical,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Anthem,Indemnity,,,1726.35,,1726.35,1726.35,1901.82,percent of total billed charges,,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Anthem,State Preferred,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Anthem,Individual Exchange,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Cigna,Cigna,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Connecticare,Commerical,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Connecticare,Exchange,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,Multiplan,Multiplan,,,1901.82,,1901.82,1726.35,1901.82,percent of total billed charges,,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62322,CPT,,,both,,,2373.7,1424.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1726.35,1901.82,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT  ,,,both,,,2444.6,1466.76,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC INJ DX OR THRP SUB INTRALAMIAR LMBR/SAC WO GUID,62323,CPT,,,both,,,2444.6,1466.76,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT  ,,,both,,,3429.06,2057.43,Aetna,Commerical,,2406.79,,,2406.79,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Aetna,Middlesex Employees,,2166.11,,,2166.11,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Anthem,Commerical,,1976.81,,,1976.81,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Anthem,Indemnity,,,2493.89,,2493.89,1581.45,5004,percent of total billed charges,,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Anthem,State Preferred,,1976.81,,,1976.81,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Anthem,Individual Exchange,,1581.45,,,1581.45,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Cigna,Cigna,,3702.63,,,3702.63,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Connecticare,Commerical,,5004,,,5004,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Connecticare,Exchange,,5004,,,5004,1581.45,5004,other,Could be inpatient or outpatient,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,Multiplan,Multiplan,,,2747.38,,2747.38,1581.45,5004,percent of total billed charges,,
INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM USING IMAGING GUIDANCE,62323,CPT,,,both,,,3429.06,2057.43,United Healthcare/Oxford,United Healthcare/Oxford,,3536.06,,,3536.06,1581.45,5004,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT  ,,,both,,,2317.5,1390.5,Aetna,Commerical,,1548.4,,,1548.4,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Aetna,Middlesex Employees,,1393.56,,,1393.56,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Anthem,Commerical,,1285.06,,,1285.06,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Anthem,Indemnity,,,1685.12,,1685.12,1028.04,1856.4,percent of total billed charges,,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Anthem,State Preferred,,1285.06,,,1285.06,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Anthem,Individual Exchange,,1028.04,,,1028.04,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Cigna,Cigna,,1363.95,,,1363.95,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Connecticare,Commerical,,1399.13,,,1399.13,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Connecticare,Exchange,,1399.13,,,1399.13,1028.04,1856.4,other,Could be inpatient or outpatient,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,Multiplan,Multiplan,,,1856.4,,1856.4,1028.04,1856.4,percent of total billed charges,,
HC DX LUMBAR SPINAL PUNC W/FLUOR OR CT,62328,CPT,,,both,,,2317.5,1390.5,United Healthcare/Oxford,United Healthcare/Oxford,,1434.3,,,1434.3,1028.04,1856.4,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT  ,,,both,,,2630.31,1578.19,Aetna,Commerical,,1902.54,,,1902.54,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Aetna,Middlesex Employees,,1712.28,,,1712.28,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Anthem,Commerical,,1702.34,,,1702.34,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Anthem,Indemnity,,,1912.98,,1912.98,1361.87,2107.42,percent of total billed charges,,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Anthem,State Preferred,,1702.34,,,1702.34,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Anthem,Individual Exchange,,1361.87,,,1361.87,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Cigna,Cigna,,1662.52,,,1662.52,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Connecticare,Commerical,,1778.22,,,1778.22,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Connecticare,Exchange,,1778.22,,,1778.22,1361.87,2107.42,other,Could be inpatient or outpatient,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,Multiplan,Multiplan,,,2107.42,,2107.42,1361.87,2107.42,percent of total billed charges,,
HC SPINAL PUNCTURE THERAPEUTIC W FLUOR OR CT GUIDANCE,62329,CPT,,,both,,,2630.31,1578.19,United Healthcare/Oxford,United Healthcare/Oxford,,1710.98,,,1710.98,1361.87,2107.42,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT  ,,,both,,,1379.17,827.5,Aetna,Commerical,,997.26,,,997.26,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Aetna,Middlesex Employees,,897.53,,,897.53,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Anthem,Commerical,,892.33,,,892.33,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Anthem,Indemnity,,,1002.74,,1002.74,713.86,1104.66,percent of total billed charges,,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Anthem,State Preferred,,892.33,,,892.33,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Anthem,Individual Exchange,,713.86,,,713.86,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Cigna,Cigna,,871.46,,,871.46,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Connecticare,Commerical,,932.1,,,932.1,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Connecticare,Exchange,,932.1,,,932.1,713.86,1104.66,other,Could be inpatient or outpatient,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,Multiplan,Multiplan,,,1104.66,,1104.66,713.86,1104.66,percent of total billed charges,,
HC ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,62368,CPT,,,both,,,1379.17,827.5,United Healthcare/Oxford,United Healthcare/Oxford,,896.85,,,896.85,713.86,1104.66,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT  ,,,both,,,542.81,325.69,Aetna,Commerical,,393.21,,,393.21,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Aetna,Middlesex Employees,,353.89,,,353.89,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Anthem,Commerical,,351.83,,,351.83,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Anthem,Indemnity,,,395.36,,395.36,281.46,435.55,percent of total billed charges,,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Anthem,State Preferred,,351.83,,,351.83,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Anthem,Individual Exchange,,281.46,,,281.46,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Cigna,Cigna,,343.61,,,343.61,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Connecticare,Commerical,,367.51,,,367.51,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Connecticare,Exchange,,367.51,,,367.51,281.46,435.55,other,Could be inpatient or outpatient,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,Multiplan,Multiplan,,,435.55,,435.55,281.46,435.55,percent of total billed charges,,
HC N BLCK INJ FACIAL,64402,CPT,,,both,,,542.81,325.69,United Healthcare/Oxford,United Healthcare/Oxford,,353.62,,,353.62,281.46,435.55,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,338.78,203.27,Aetna,Commerical,,245.04,,,245.04,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Aetna,Commerical,50,367.56,,,367.5,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Aetna,Middlesex Employees,,220.54,,,220.54,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Aetna,Middlesex Employees,50,330.81,,,330.81,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Anthem,Commerical,,219.25,,,219.25,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Anthem,Commerical,50,328.88,,,328.88,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Anthem,Indemnity,,,246.39,,246.39,175.4,271.43,percent of total billed charges,,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Anthem,Indemnity,50,,381.737304,,381.737304,263.1,407.15,percent of total billed charges,,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Anthem,State Preferred,,219.25,,,219.25,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Anthem,State Preferred,50,328.88,,,328.88,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Anthem,Individual Exchange,,175.4,,,175.4,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Anthem,Individual Exchange,50,263.1,,,263.1,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Cigna,Cigna,,214.13,,,214.13,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Cigna,Cigna,50,321.2,,,321.2,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Connecticare,Commerical,,229.03,,,229.03,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Connecticare,Commerical,50,343.55,,,343.55,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Connecticare,Exchange,,229.03,,,229.03,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Connecticare,Exchange,50,343.55,,,343.55,263.1,407.15,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,Multiplan,Multiplan,,,271.43,,271.43,175.4,271.43,percent of total billed charges,,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,Multiplan,Multiplan,50,,431.9445,,431.9445,263.1,431.9445,percent of total billed charges,,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT,,,both,,,338.78,203.27,United Healthcare/Oxford,United Healthcare/Oxford,,220.37,,,220.37,175.4,271.43,other,Could be inpatient or outpatient,
HC INJ ANESTH AGENT GREATER OCCIPITAL NERVE,64405,CPT  ,,,both,,,508.17,304.9,United Healthcare/Oxford,United Healthcare/Oxford,50,330.56,,,330.56,263.1,407.15,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT  ,,,both,,,2065.15,1239.09,Aetna,Commerical,,1380.38,,,1380.38,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Aetna,Middlesex Employees,,1242.34,,,1242.34,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Anthem,Commerical,,1145.61,,,1145.61,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Anthem,Indemnity,,,1502.25,,1502.25,916.49,1654.95,percent of total billed charges,,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Anthem,State Preferred,,1145.61,,,1145.61,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Anthem,Individual Exchange,,916.49,,,916.49,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Cigna,Cigna,,1215.94,,,1215.94,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Connecticare,Commerical,,1247.29,,,1247.29,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Connecticare,Exchange,,1247.29,,,1247.29,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,Multiplan,Multiplan,,,1654.95,,1654.95,916.49,1654.95,percent of total billed charges,,
HC INJECTION AA&/STRD FEMORAL NERVE,64447,CPT,,,both,,,2065.15,1239.09,United Healthcare/Oxford,United Healthcare/Oxford,,1278.65,,,1278.65,916.49,1654.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Aetna,Commerical,,1768.21,,,1768.21,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Aetna,Commerical,50,2652.32,,,2652.32,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Aetna,Middlesex Employees,,1591.39,,,1591.39,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Aetna,Middlesex Employees,50,2387.09,,,2387.09,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Anthem,Commerical,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Anthem,Commerical,50,2373.23,,,2373.23,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Anthem,Indemnity,,,1777.91,,1777.91,1265.72,1958.63,percent of total billed charges,,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Anthem,Indemnity,50,,2754.117048,,2754.117048,1898.58,2937.95,percent of total billed charges,,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Anthem,State Preferred,,1582.15,,,1582.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Anthem,State Preferred,50,2373.23,,,2373.23,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Anthem,Individual Exchange,,1265.72,,,1265.72,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Anthem,Individual Exchange,50,1898.58,,,1898.58,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Cigna,Cigna,,1545.15,,,1545.15,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Cigna,Cigna,50,2317.73,,,2317.73,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Connecticare,Commerical,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Connecticare,Commerical,50,2478.99,,,2478.99,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Connecticare,Exchange,,1652.66,,,1652.66,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Connecticare,Exchange,50,2478.99,,,2478.99,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,Multiplan,Multiplan,,,1958.63,,1958.63,1265.72,1958.63,percent of total billed charges,,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,Multiplan,Multiplan,50,,3116.3465,,3116.3465,1898.58,3116.3465,percent of total billed charges,,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,2444.19,1466.51,United Healthcare/Oxford,United Healthcare/Oxford,,1590.18,,,1590.18,1265.72,1958.63,other,Could be inpatient or outpatient,
HC INJ ANESTH; OTHR PERIPHERAL NRV/BRANCH,64450,CPT  ,,,both,,,3666.29,2199.77,United Healthcare/Oxford,United Healthcare/Oxford,50,2385.27,,,2385.27,1898.58,2937.95,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT  ,,,both,,,1172.14,703.28,Aetna,Commerical,,848.29,,,848.29,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Aetna,Middlesex Employees,,763.46,,,763.46,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Anthem,Commerical,,759.03,,,759.03,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Anthem,Indemnity,,,852.94,,852.94,607.22,939.64,percent of total billed charges,,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Anthem,State Preferred,,759.03,,,759.03,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Anthem,Individual Exchange,,607.22,,,607.22,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Cigna,Cigna,,741.27,,,741.27,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Connecticare,Commerical,,792.85,,,792.85,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Connecticare,Exchange,,792.85,,,792.85,607.22,939.64,other,Could be inpatient or outpatient,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,Multiplan,Multiplan,,,939.64,,939.64,607.22,939.64,percent of total billed charges,,
HC INJ FORAMEN EPIDURAL ADD-ON,64480,CPT,,,both,,,1172.14,703.28,United Healthcare/Oxford,United Healthcare/Oxford,,762.88,,,762.88,607.22,939.64,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT  ,,,both,,,4873.46,2924.07,Aetna,Commerical,,4083.37,,,4083.37,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Aetna,Middlesex Employees,,3675.03,,,3675.03,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Anthem,Commerical,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Anthem,Indemnity,,,3544.37,,3544.37,3544.37,4083.37,percent of total billed charges,,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Anthem,State Preferred,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Anthem,Individual Exchange,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Cigna,Cigna,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Connecticare,Commerical,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Connecticare,Exchange,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,Multiplan,Multiplan,,,3904.65,,3904.65,3544.37,4083.37,percent of total billed charges,,
INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO LOWER OR SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE,64483,CPT,,,both,,,4873.46,2924.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3544.37,4083.37,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT  ,,,both,,,538.69,323.21,Aetna,Commerical,,389.95,,,389.95,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Aetna,Middlesex Employees,,350.96,,,350.96,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Anthem,Commerical,,348.92,,,348.92,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Anthem,Indemnity,,,392.09,,392.09,279.14,431.94,percent of total billed charges,,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Anthem,State Preferred,,348.92,,,348.92,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Anthem,Individual Exchange,,279.14,,,279.14,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Cigna,Cigna,,340.76,,,340.76,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Connecticare,Commerical,,364.47,,,364.47,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Connecticare,Exchange,,364.47,,,364.47,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,Multiplan,Multiplan,,,431.94,,431.94,279.14,431.94,percent of total billed charges,,
HC INJ PARAVERT FACET JOINT LUMB/SACRAL 1 LEVEL,64493,CPT,,,both,,,538.69,323.21,United Healthcare/Oxford,United Healthcare/Oxford,,350.68,,,350.68,279.14,431.94,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT  ,,,both,,,538.69,323.21,Aetna,Commerical,,360.16,,,360.16,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Aetna,Middlesex Employees,,324.15,,,324.15,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Anthem,Commerical,,298.91,,,298.91,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Anthem,Indemnity,,,391.96,,391.96,239.13,431.8,percent of total billed charges,,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Anthem,State Preferred,,298.91,,,298.91,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Anthem,Individual Exchange,,239.13,,,239.13,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Cigna,Cigna,,317.25,,,317.25,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Connecticare,Commerical,,325.44,,,325.44,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Connecticare,Exchange,,325.44,,,325.44,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,Multiplan,Multiplan,,,431.8,,431.8,239.13,431.8,percent of total billed charges,,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 2ND LEVEL,64494,CPT,,,both,,,538.69,323.21,United Healthcare/Oxford,United Healthcare/Oxford,,333.62,,,333.62,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT  ,,,both,,,538.69,323.21,Aetna,Commerical,,360.16,,,360.16,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Aetna,Middlesex Employees,,324.15,,,324.15,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Anthem,Commerical,,298.91,,,298.91,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Anthem,Indemnity,,,391.96,,391.96,239.13,431.8,percent of total billed charges,,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Anthem,State Preferred,,298.91,,,298.91,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Anthem,Individual Exchange,,239.13,,,239.13,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Cigna,Cigna,,317.25,,,317.25,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Connecticare,Commerical,,325.44,,,325.44,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Connecticare,Exchange,,325.44,,,325.44,239.13,431.8,other,Could be inpatient or outpatient,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,Multiplan,Multiplan,,,431.8,,431.8,239.13,431.8,percent of total billed charges,,
HC INJ DX/THER AGT PVRT FACET JNT LMBR/SAC 3+ LEVEL,64495,CPT,,,both,,,538.69,323.21,United Healthcare/Oxford,United Healthcare/Oxford,,333.62,,,333.62,239.13,431.8,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Aetna,Commerical,,883.38,,,883.38,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Aetna,Commerical,50,1325.07,,,1325.07,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1321.88,793.13,Aetna,Middlesex Employees,,795.05,,,795.05,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Aetna,Middlesex Employees,50,1192.58,,,1192.58,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Anthem,Commerical,,733.14,,,733.14,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1982.82,1189.69,Anthem,Commerical,50,1099.71,,,1099.71,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Anthem,Indemnity,,,961.38,,961.38,586.51,1059.1,percent of total billed charges,,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Anthem,Indemnity,50,,1489.494384,,1489.494384,879.77,1588.65,percent of total billed charges,,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1321.88,793.13,Anthem,State Preferred,,733.14,,,733.14,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Anthem,State Preferred,50,1099.71,,,1099.71,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Anthem,Individual Exchange,,586.51,,,586.51,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1982.82,1189.69,Anthem,Individual Exchange,50,879.77,,,879.77,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Cigna,Cigna,,778.15,,,778.15,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Cigna,Cigna,50,1167.23,,,1167.23,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1321.88,793.13,Connecticare,Commerical,,798.22,,,798.22,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Connecticare,Commerical,50,1197.33,,,1197.33,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Connecticare,Exchange,,798.22,,,798.22,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1982.82,1189.69,Connecticare,Exchange,50,1197.33,,,1197.33,879.77,1588.65,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1321.88,793.13,Multiplan,Multiplan,,,1059.1,,1059.1,586.51,1059.1,percent of total billed charges,,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,Multiplan,Multiplan,50,,1685.397,,1685.397,879.77,1685.397,percent of total billed charges,,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT,,,both,,,1321.88,793.13,United Healthcare/Oxford,United Healthcare/Oxford,,818.28,,,818.28,586.51,1059.1,other,Could be inpatient or outpatient,
HC INJECTION ANESTHEIC AGENT (NERVE BLOCK),64505,CPT  ,,,both,,,1982.82,1189.69,United Healthcare/Oxford,United Healthcare/Oxford,50,1227.42,,,1227.42,879.77,1588.65,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT  ,,,both,,,960.99,576.59,Aetna,Commerical,,695.23,,,695.23,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Aetna,Middlesex Employees,,625.71,,,625.71,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Anthem,Commerical,,622.08,,,622.08,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Anthem,Indemnity,,,699.05,,699.05,497.66,770.11,percent of total billed charges,,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Anthem,State Preferred,,622.08,,,622.08,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Anthem,Individual Exchange,,497.66,,,497.66,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Cigna,Cigna,,607.53,,,607.53,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Connecticare,Commerical,,649.8,,,649.8,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Connecticare,Exchange,,649.8,,,649.8,497.66,770.11,other,Could be inpatient or outpatient,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,Multiplan,Multiplan,,,770.11,,770.11,497.66,770.11,percent of total billed charges,,
HC DESTRUCTION BY NEUROLYTIC AGENTM TRIGEMINAL NERVE,64600,CPT,,,both,,,960.99,576.59,United Healthcare/Oxford,United Healthcare/Oxford,,625.24,,,625.24,497.66,770.11,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT  ,,,both,,,1101.87,661.12,Aetna,Commerical,,797,,,797,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Aetna,Middlesex Employees,,717.3,,,717.3,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Anthem,Commerical,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Anthem,Indemnity,,,801.37,,801.37,570.51,882.83,percent of total billed charges,,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Anthem,State Preferred,,713.14,,,713.14,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Anthem,Individual Exchange,,570.51,,,570.51,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Cigna,Cigna,,696.46,,,696.46,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Connecticare,Commerical,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Connecticare,Exchange,,744.92,,,744.92,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,Multiplan,Multiplan,,,882.83,,882.83,570.51,882.83,percent of total billed charges,,
HC CHEMODENERV SALIVARY GLANDS BILAT,64611,CPT,,,both,,,1101.87,661.12,United Healthcare/Oxford,United Healthcare/Oxford,,716.76,,,716.76,570.51,882.83,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT  ,,,both,,,469.68,281.81,Aetna,Commerical,,339.48,,,339.48,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Aetna,Middlesex Employees,,305.53,,,305.53,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Anthem,Commerical,,303.75,,,303.75,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Anthem,Indemnity,,,341.34,,341.34,243,376.04,percent of total billed charges,,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Anthem,State Preferred,,303.75,,,303.75,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Anthem,Individual Exchange,,243,,,243,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Cigna,Cigna,,296.65,,,296.65,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Connecticare,Commerical,,317.3,,,317.3,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Connecticare,Exchange,,317.3,,,317.3,243,376.04,other,Could be inpatient or outpatient,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,Multiplan,Multiplan,,,376.04,,376.04,243,376.04,percent of total billed charges,,
HC CHEMODENERV MUSCLE MIGRAINE,64615,CPT,,,both,,,469.68,281.81,United Healthcare/Oxford,United Healthcare/Oxford,,305.29,,,305.29,243,376.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT  ,,,both,,,6585.12,3951.07,Aetna,Commerical,,4959.57,,,4959.57,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Aetna,Middlesex Employees,,4463.61,,,4463.61,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Anthem,Commerical,,3368.77,,,3368.77,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Anthem,Indemnity,,,4789.24,,4789.24,2695.02,5276.04,percent of total billed charges,,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Anthem,State Preferred,,3368.77,,,3368.77,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Anthem,Individual Exchange,,2695.02,,,2695.02,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Cigna,Cigna,,3058.81,,,3058.81,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Connecticare,Commerical,,5144.55,,,5144.55,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Connecticare,Exchange,,5144.55,,,5144.55,2695.02,5276.04,other,Could be inpatient or outpatient,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,Multiplan,Multiplan,,,5276.04,,5276.04,2695.02,5276.04,percent of total billed charges,,
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,64615,CPT,,,both,,,6585.12,3951.07,United Healthcare/Oxford,United Healthcare/Oxford,,4016.89,,,4016.89,2695.02,5276.04,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT  ,,,both,,,2856.19,1713.71,Aetna,Commerical,,2066.16,,,2066.16,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Aetna,Middlesex Employees,,1859.55,,,1859.55,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Anthem,Commerical,,1848.76,,,1848.76,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Anthem,Indemnity,,,2077.51,,2077.51,1479,2288.68,percent of total billed charges,,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Anthem,State Preferred,,1848.76,,,1848.76,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Anthem,Individual Exchange,,1479,,,1479,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Cigna,Cigna,,1805.51,,,1805.51,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Connecticare,Commerical,,1931.15,,,1931.15,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Connecticare,Exchange,,1931.15,,,1931.15,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,Multiplan,Multiplan,,,2288.68,,2288.68,1479,2288.68,percent of total billed charges,,
HC CHEMODENERVATION 1 EXTREMITY 1-4 MUSCLE,64642,CPT,,,both,,,2856.19,1713.71,United Healthcare/Oxford,United Healthcare/Oxford,,1858.14,,,1858.14,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT  ,,,both,,,2856.19,1713.71,Aetna,Commerical,,2066.16,,,2066.16,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Aetna,Middlesex Employees,,1859.55,,,1859.55,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Anthem,Commerical,,1848.76,,,1848.76,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Anthem,Indemnity,,,2077.51,,2077.51,1479,2288.68,percent of total billed charges,,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Anthem,State Preferred,,1848.76,,,1848.76,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Anthem,Individual Exchange,,1479,,,1479,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Cigna,Cigna,,1805.51,,,1805.51,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Connecticare,Commerical,,1931.15,,,1931.15,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Connecticare,Exchange,,1931.15,,,1931.15,1479,2288.68,other,Could be inpatient or outpatient,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,Multiplan,Multiplan,,,2288.68,,2288.68,1479,2288.68,percent of total billed charges,,
HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,64643,CPT,,,both,,,2856.19,1713.71,United Healthcare/Oxford,United Healthcare/Oxford,,1858.14,,,1858.14,1479,2288.68,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT  ,,,both,,,1100.04,660.02,Aetna,Commerical,,796.19,,,796.19,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Aetna,Middlesex Employees,,716.57,,,716.57,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Anthem,Commerical,,712.4,,,712.4,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Anthem,Indemnity,,,800.55,,800.55,569.92,881.93,percent of total billed charges,,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Anthem,State Preferred,,712.4,,,712.4,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Anthem,Individual Exchange,,569.92,,,569.92,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Cigna,Cigna,,695.74,,,695.74,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Connecticare,Commerical,,744.15,,,744.15,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Connecticare,Exchange,,744.15,,,744.15,569.92,881.93,other,Could be inpatient or outpatient,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,Multiplan,Multiplan,,,881.93,,887.93,569.92,881.93,percent of total billed charges,,
HC UNLISTED PROC NERVOUS SYSTEM,64999,CPT,,,both,,,1100.04,660.02,United Healthcare/Oxford,United Healthcare/Oxford,,716.03,,,716.03,569.92,881.93,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT  ,,,both,,,592.25,355.35,Aetna,Commerical,,428.21,,,428.21,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Aetna,Middlesex Employees,,385.39,,,385.39,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Anthem,Commerical,,383.16,,,383.16,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Anthem,Indemnity,,,430.56,,430.56,306.53,474.33,percent of total billed charges,,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Anthem,State Preferred,,383.16,,,383.16,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Anthem,Individual Exchange,,306.53,,,306.53,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Cigna,Cigna,,374.19,,,374.19,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Connecticare,Commerical,,400.23,,,400.23,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Connecticare,Exchange,,400.23,,,400.23,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,Multiplan,Multiplan,,,474.33,,474.33,306.53,474.33,percent of total billed charges,,
HC REM FB CONJUNCTIVA; SUPERFICIAL,65205,CPT,,,both,,,592.25,355.35,United Healthcare/Oxford,United Healthcare/Oxford,,385.1,,,385.1,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT  ,,,both,,,592.25,355.35,Aetna,Commerical,,428.21,,,428.21,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Aetna,Middlesex Employees,,385.39,,,385.39,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Anthem,Commerical,,383.16,,,383.16,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Anthem,Indemnity,,,430.56,,430.56,306.53,474.33,percent of total billed charges,,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Anthem,State Preferred,,383.16,,,383.16,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Anthem,Individual Exchange,,306.53,,,306.53,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Cigna,Cigna,,374.19,,,374.19,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Connecticare,Commerical,,400.23,,,400.23,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Connecticare,Exchange,,400.23,,,400.23,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,Multiplan,Multiplan,,,474.33,,474.33,306.53,474.33,percent of total billed charges,,
HC REM FB CONJUNCTIVA; EMBEDDED,65210,CPT,,,both,,,592.25,355.35,United Healthcare/Oxford,United Healthcare/Oxford,,385.1,,,385.1,306.53,474.33,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT  ,,,both,,,1485.26,891.16,Aetna,Commerical,,1073.79,,,1073.79,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Aetna,Middlesex Employees,,966.41,,,966.41,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Anthem,Commerical,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Anthem,Indemnity,,,1079.69,,1079.69,768.64,1189.43,percent of total billed charges,,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Anthem,State Preferred,,960.8,,,960.8,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Anthem,Individual Exchange,,768.64,,,768.64,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Cigna,Cigna,,938.33,,,938.33,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Connecticare,Commerical,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Connecticare,Exchange,,1003.62,,,1003.62,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,Multiplan,Multiplan,,,1189.43,,1189.43,768.64,1189.43,percent of total billed charges,,
HC REM FB EXT EYE; CORNEAL WO SLIT LAMP,65220,CPT,,,both,,,1485.26,891.16,United Healthcare/Oxford,United Healthcare/Oxford,,965.68,,,965.68,768.64,1189.43,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC REM FB CORNEAL W SLIT LAMP,65222,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT  ,,,both,,,13541,8124.6,Aetna,Commerical,,10212.17,,,10212.17,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Aetna,Middlesex Employees,,9190.96,,,9190.96,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Anthem,Commerical,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Anthem,Indemnity,,,9848.12,,9848.12,9190.96,10849.14,percent of total billed charges,,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Anthem,State Preferred,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Anthem,Individual Exchange,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Cigna,Cigna,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Connecticare,Commerical,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Connecticare,Exchange,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,Multiplan,Multiplan,,,10849.14,,10849.14,9190.96,10849.14,percent of total billed charges,,
REMOVAL OF CATARACT WITH INSERTION OF LENS,66984,CPT,,,both,,,13541,8124.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9190.96,10849.14,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT  ,,,both,,,1340.03,804.02,Aetna,Commerical,,968.77,,,968.77,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Aetna,Middlesex Employees,,871.9,,,871.9,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Anthem,Commerical,,866.83,,,866.83,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Anthem,Indemnity,,,974.09,,974.09,693.47,1073.1,percent of total billed charges,,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Anthem,State Preferred,,866.83,,,866.83,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Anthem,Individual Exchange,,693.47,,,693.47,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Cigna,Cigna,,846.56,,,846.56,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Connecticare,Commerical,,905.46,,,905.46,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Connecticare,Exchange,,905.46,,,905.46,693.47,1073.1,other,Could be inpatient or outpatient,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,Multiplan,Multiplan,,,1073.1,,1073.1,693.47,1073.1,percent of total billed charges,,
HC INTRAVITREAL INJ FP PHARMACOLOGIC AGENT,67028,CPT,,,both,,,1340.03,804.02,United Healthcare/Oxford,United Healthcare/Oxford,,871.24,,,871.24,693.47,1073.1,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT  ,,,both,,,9126.07,5475.64,Aetna,Commerical,,6882.43,,,6882.43,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Aetna,Middlesex Employees,,6194.19,,,6194.19,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Anthem,Commerical,,5095.34,,,5095.34,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Anthem,Indemnity,,,6637.22,,6637.22,4076.26,7311.86,percent of total billed charges,,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Anthem,State Preferred,,5095.34,,,5095.34,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Anthem,Individual Exchange,,4076.26,,,4076.26,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Cigna,Cigna,,5979.79,,,5979.79,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Connecticare,Commerical,,,,,,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Connecticare,Exchange,,,,,,4076.26,7311.86,other,Could be inpatient or outpatient,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,Multiplan,Multiplan,,,7311.86,,7311.86,4076.26,7311.86,percent of total billed charges,,
PR STABISMUS SURG ONE HORIZ MUSCLE,67311,CPT,,,both,,,9126.07,5475.64,United Healthcare/Oxford,United Healthcare/Oxford,,6606.84,,,6606.84,4076.26,7311.86,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT  ,,,both,,,1197.89,718.73,Aetna,Commerical,,866.19,,,866.19,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Aetna,Middlesex Employees,,779.57,,,779.57,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Anthem,Commerical,,775.05,,,775.05,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Anthem,Indemnity,,,870.95,,870.95,620.04,959.48,percent of total billed charges,,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Anthem,State Preferred,,775.05,,,775.05,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Anthem,Individual Exchange,,620.04,,,620.04,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Cigna,Cigna,,756.92,,,756.92,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Connecticare,Commerical,,809.59,,,809.59,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Connecticare,Exchange,,809.59,,,809.59,620.04,959.48,other,Could be inpatient or outpatient,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,Multiplan,Multiplan,,,959.48,,959.48,620.04,959.48,percent of total billed charges,,
HC BLEPHAROTOMY DRAIN ABSC EYELID,67700,CPT,,,both,,,1197.89,718.73,United Healthcare/Oxford,United Healthcare/Oxford,,778.98,,,778.98,620.04,959.48,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT  ,,,both,,,1203.04,721.82,Aetna,Commerical,,870.26,,,870.26,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Aetna,Middlesex Employees,,783.23,,,783.23,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Anthem,Commerical,,778.69,,,778.69,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Anthem,Indemnity,,,875.04,,875.04,622.96,963.99,percent of total billed charges,,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Anthem,State Preferred,,778.69,,,778.69,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Anthem,Individual Exchange,,622.96,,,622.96,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Cigna,Cigna,,760.48,,,760.48,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Connecticare,Commerical,,813.4,,,813.4,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Connecticare,Exchange,,813.4,,,813.4,622.96,963.99,other,Could be inpatient or outpatient,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,Multiplan,Multiplan,,,963.99,,963.99,622.96,963.99,percent of total billed charges,,
HC REMOVE EMBEDDED FB EYELID,67938,CPT,,,both,,,1203.04,721.82,United Healthcare/Oxford,United Healthcare/Oxford,,782.65,,,782.65,622.96,963.99,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT  ,,,both,,,2578.09,1546.85,Aetna,Commerical,,1864.27,,,1864.27,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Aetna,Middlesex Employees,,1677.85,,,1677.85,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Anthem,Commerical,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Anthem,Indemnity,,,1874.51,,1874.51,1334.48,2065.04,percent of total billed charges,,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Anthem,State Preferred,,1668.1,,,1668.1,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Anthem,Individual Exchange,,1334.48,,,1334.48,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Cigna,Cigna,,1629.09,,,1629.09,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Connecticare,Commerical,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Connecticare,Exchange,,1742.45,,,1742.45,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,Multiplan,Multiplan,,,2065.04,,2065.04,1334.48,2065.04,percent of total billed charges,,
HC DR EXT EAR ABSCESS/HEMATOMA; SIMPLE,69000,CPT,,,both,,,2578.09,1546.85,United Healthcare/Oxford,United Healthcare/Oxford,,1676.57,,,1676.57,1334.48,2065.04,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT  ,,,both,,,5035.67,3021.4,Aetna,Commerical,,3643.06,,,3643.06,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Aetna,Middlesex Employees,,3278.75,,,3278.75,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Anthem,Commerical,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Anthem,Indemnity,,,3663.07,,3663.07,2607.78,4035.4,percent of total billed charges,,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Anthem,State Preferred,,3259.72,,,3259.72,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Anthem,Individual Exchange,,2607.78,,,2607.78,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Cigna,Cigna,,3183.48,,,3183.48,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Connecticare,Commerical,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Connecticare,Exchange,,3405.01,,,3405.01,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,Multiplan,Multiplan,,,4035.4,,4035.4,2607.78,4035.4,percent of total billed charges,,
HC DR EXT EAR ABSCESS/HEMATOMA; COMPLIC,69005,CPT,,,both,,,5035.67,3021.4,United Healthcare/Oxford,United Healthcare/Oxford,,3276.27,,,3276.27,2607.78,4035.4,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT  ,,,both,,,469.68,281.81,Aetna,Commerical,,339.48,,,339.48,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Aetna,Middlesex Employees,,305.53,,,305.53,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Anthem,Commerical,,303.75,,,303.75,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Anthem,Indemnity,,,341.34,,341.34,243,376.04,percent of total billed charges,,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Anthem,State Preferred,,303.75,,,303.75,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Anthem,Individual Exchange,,243,,,243,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Cigna,Cigna,,296.65,,,296.65,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Connecticare,Commerical,,317.3,,,317.3,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Connecticare,Exchange,,317.3,,,317.3,243,376.04,other,Could be inpatient or outpatient,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,Multiplan,Multiplan,,,376.04,,376.04,243,376.04,percent of total billed charges,,
HC DRAIN EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,,both,,,469.68,281.81,United Healthcare/Oxford,United Healthcare/Oxford,,305.29,,,305.29,243,376.04,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Aetna,Commerical,50,511.65,,,511.65,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Aetna,Middlesex Employees,50,460.49,,,460.49,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,707.61,424.57,Anthem,Commerical,50,457.82,,,457.82,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Anthem,Indemnity,50,,531.556632,,531.556632,366.26,566.76,percent of total billed charges,,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Anthem,State Preferred,50,457.82,,,457.82,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,707.61,424.57,Anthem,Individual Exchange,50,366.26,,,366.26,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Cigna,Cigna,50,447.11,,,447.11,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Connecticare,Commerical,50,478.23,,,478.23,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,707.61,424.57,Connecticare,Exchange,50,478.23,,,478.23,366.26,566.76,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,Multiplan,Multiplan,50,,601.4685,,601.4685,366.26,601.4685,percent of total billed charges,,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC REM FB EXT AUDITORY CANAL; WO ANESTH,69200,CPT  ,,,both,,,707.61,424.57,United Healthcare/Oxford,United Healthcare/Oxford,50,460.14,,,460.14,366.26,566.76,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT  ,,,both,,,6759.89,4055.93,Aetna,Commerical,,4889.43,,,4889.43,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Aetna,Middlesex Employees,,4400.48,,,4400.48,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Anthem,Commerical,,4374.95,,,4374.95,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Anthem,Indemnity,,,4916.29,,4916.29,3499.96,5416,percent of total billed charges,,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Anthem,State Preferred,,4374.95,,,4374.95,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Anthem,Individual Exchange,,3499.96,,,3499.96,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Cigna,Cigna,,4272.62,,,4272.62,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Connecticare,Commerical,,4569.94,,,4569.94,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Connecticare,Exchange,,4569.94,,,4569.94,3499.96,5416,other,Could be inpatient or outpatient,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,Multiplan,Multiplan,,,5416,,5416,3499.96,5416,percent of total billed charges,,
HC REMVL OF FB FROM EXT AUDITORY CANAL W/ ANESTH,69205,CPT,,,both,,,6759.89,4055.93,United Healthcare/Oxford,United Healthcare/Oxford,,4397.15,,,4397.15,3499.96,5416,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,252.35,151.41,Aetna,Commerical,,182.35,,,182.35,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Aetna,Commerical,50,273.53,,,273.53,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Aetna,Middlesex Employees,,164.12,,,164.12,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Aetna,Middlesex Employees,50,246.18,,,246.18,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Anthem,Commerical,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Anthem,Commerical,50,244.76,,,244.76,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Anthem,Indemnity,,,183.36,,183.36,130.53,201.99,percent of total billed charges,,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Anthem,Indemnity,50,,284.351736,,284.351736,195.8,302.99,percent of total billed charges,,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Anthem,State Preferred,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Anthem,State Preferred,50,244.76,,,244.76,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Anthem,Individual Exchange,,130.53,,,130.53,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Anthem,Individual Exchange,50,195.8,,,195.8,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Cigna,Cigna,,159.35,,,159.35,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Cigna,Cigna,50,239.03,,,239.03,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Connecticare,Commerical,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Connecticare,Commerical,50,255.66,,,255.66,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Connecticare,Exchange,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Connecticare,Exchange,50,255.66,,,255.66,195.8,302.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,Multiplan,Multiplan,,,201.99,,201.99,130.53,201.99,percent of total billed charges,,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,Multiplan,Multiplan,50,,321.7505,,321.7505,195.8,321.7505,percent of total billed charges,,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT,,,both,,,252.35,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,164,,,164,130.53,201.99,other,Could be inpatient or outpatient,
HC REM IMPACTED CERUMEN USING IRR/LAVAGE UNILATERAL,69209,CPT  ,,,both,,,378.53,227.12,United Healthcare/Oxford,United Healthcare/Oxford,50,246,,,246,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,252.35,151.41,Aetna,Commerical,,182.35,,,182.35,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Aetna,Commerical,50,273.53,,,273.53,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Aetna,Middlesex Employees,,164.12,,,164.12,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Aetna,Middlesex Employees,50,246.18,,,246.18,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Anthem,Commerical,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Anthem,Commerical,50,244.76,,,244.76,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Anthem,Indemnity,,,183.36,,183.36,130.53,201.99,percent of total billed charges,,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Anthem,Indemnity,50,,284.351736,,284.351736,195.8,302.99,percent of total billed charges,,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Anthem,State Preferred,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Anthem,State Preferred,50,244.76,,,244.76,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Anthem,Individual Exchange,,130.53,,,130.53,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Anthem,Individual Exchange,50,195.8,,,195.8,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Cigna,Cigna,,159.35,,,159.35,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Cigna,Cigna,50,239.03,,,239.03,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Connecticare,Commerical,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Connecticare,Commerical,50,255.66,,,255.66,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Connecticare,Exchange,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Connecticare,Exchange,50,255.66,,,255.66,195.8,302.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,Multiplan,Multiplan,,,201.99,,201.99,130.53,201.99,percent of total billed charges,,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,Multiplan,Multiplan,50,,321.7505,,321.7505,195.8,321.7505,percent of total billed charges,,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT,,,both,,,252.35,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,164,,,164,130.53,201.99,other,Could be inpatient or outpatient,
HC REMOVE CERUMEN W/INSTRUMENT UNLATERAL,69210,CPT  ,,,both,,,378.53,227.12,United Healthcare/Oxford,United Healthcare/Oxford,50,246,,,246,195.8,302.99,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT  ,,,both,,,5135.58,3081.35,Aetna,Commerical,,3432.16,,,3432.16,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Aetna,Middlesex Employees,,3088.95,,,3088.95,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Anthem,Commerical,,2848.43,,,2848.43,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Anthem,Indemnity,,,3735.18,,3735.18,2278.75,4114.85,percent of total billed charges,,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Anthem,State Preferred,,2848.43,,,2848.43,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Anthem,Individual Exchange,,2278.75,,,2278.75,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Cigna,Cigna,,3023.3,,,3023.3,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Connecticare,Commerical,,3101.26,,,3101.26,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Connecticare,Exchange,,3101.26,,,3101.26,2278.75,4114.85,other,Could be inpatient or outpatient,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,Multiplan,Multiplan,,,4114.85,,4114.85,2278.75,4114.85,percent of total billed charges,,
HC VENT TUBE REMOVAL REQUIRING GEN ANES,69424,CPT,,,both,,,5135.58,3081.35,United Healthcare/Oxford,United Healthcare/Oxford,,3179.22,,,3179.22,2278.75,4114.85,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT  ,,,both,,,4462.18,2677.31,Aetna,Commerical,,3364.23,,,3364.23,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Aetna,Middlesex Employees,,3027.81,,,3027.81,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Anthem,Commerical,,3980.59,,,3980.59,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Anthem,Indemnity,,,3245.26,,3245.26,2921.91,4010.39,percent of total billed charges,,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Anthem,State Preferred,,3980.59,,,3980.59,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Anthem,Individual Exchange,,3184.47,,,3184.47,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Cigna,Cigna,,2921.91,,,2921.91,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Connecticare,Commerical,,3452.21,,,3452.21,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Connecticare,Exchange,,3452.21,,,3452.21,2921.91,4010.39,other,Could be inpatient or outpatient,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,Multiplan,Multiplan,,,3575.13,,3575.13,2921.91,4010.39,percent of total billed charges,,
PR CREATE EARDRUM OPENING GEN ANESTH,69436,CPT,,,both,,,4462.18,2677.31,United Healthcare/Oxford,United Healthcare/Oxford,,4010.39,,,4010.39,2921.91,4010.39,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,121.84,,,121.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,109.66,,,109.66,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,109.66,177.65,percent of total billed charges,,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,115.73,,,115.73,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,166.32,,,166.32,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,109.66,177.65,percent of total billed charges,,
HC XR MANDIBLE <4 VIEWS,70100,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,135.07,,,135.07,109.66,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,101.23,,,101.23,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,91.11,,,91.11,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,56.84,327.34,percent of total billed charges,,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,68.29,,,68.29,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,56.84,,,56.84,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,110.16,,,110.16,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,110.16,,,110.16,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,56.84,327.34,percent of total billed charges,,
HC X-RAY EXAM OF JAW 4+ VIEWS,70110,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,56.84,327.34,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,455.21,,,455.21,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,409.68,,,409.68,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,409.68,663.7,percent of total billed charges,,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,432.39,,,432.39,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,621.37,,,621.37,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,409.68,663.7,percent of total billed charges,,
HC INT AUD MEATI COMPL,70134,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,504.65,,,504.65,409.68,663.7,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT  ,,,both,,,452.17,271.3,Aetna,Commerical,,71.95,,,71.95,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Aetna,Middlesex Employees,,64.76,,,64.76,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Anthem,Commerical,,85.37,,,85.37,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Anthem,Indemnity,,,329.06,,329.06,56.84,362.51,percent of total billed charges,,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Anthem,State Preferred,,85.37,,,85.37,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Anthem,Individual Exchange,,68.29,,,68.29,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Cigna,Cigna,,56.84,,,56.84,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Connecticare,Commerical,,81.58,,,81.58,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Connecticare,Exchange,,81.58,,,81.58,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,Multiplan,Multiplan,,,362.51,,362.51,56.84,362.51,percent of total billed charges,,
HC XR FACIAL BONES<3 VIEWS,70140,CPT,,,both,,,452.17,271.3,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,56.84,362.51,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,224.51,,,224.51,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,202.06,,,202.06,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,202.06,327.34,percent of total billed charges,,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,213.26,,,213.26,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,306.47,,,306.47,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,202.06,327.34,percent of total billed charges,,
HC XR FACIAL BONES MIN  3 VIEWS,70150,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,248.9,,,248.9,202.06,327.34,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,93.91,,,93.91,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,84.52,,,84.52,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,103.03,,,103.03,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,103.03,,,103.03,47.4,177.65,other,Could be inpatient or outpatient,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC XR NASAL BONES COMPLETE MIN 3 VIEWS,70160,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,111.01,,,111.01,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,99.91,,,99.91,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,107.4,,,107.4,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,72.33,327.34,percent of total billed charges,,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,107.4,,,107.4,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,85.93,,,85.93,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,72.33,,,72.33,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,120.14,,,120.14,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,120.14,,,120.14,72.33,327.34,other,Could be inpatient or outpatient,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,72.33,327.34,percent of total billed charges,,
HC XR ORBITS MIN 4VIEWS,70200,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,72.33,327.34,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,75.63,,,75.63,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,68.07,,,68.07,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,85.37,,,85.37,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,56.84,177.65,percent of total billed charges,,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,85.37,,,85.37,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,68.29,,,68.29,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,56.84,,,56.84,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,91.59,,,91.59,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,91.59,,,91.59,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,56.84,177.65,percent of total billed charges,,
HC XR SINUSES <3 VIEWS,70210,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,56.84,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT  ,,,both,,,221.73,133.04,Aetna,Commerical,,121.84,,,121.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Aetna,Middlesex Employees,,109.66,,,109.66,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Anthem,Commerical,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Anthem,Indemnity,,,161.26,,161.26,109.66,177.65,percent of total billed charges,,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Anthem,State Preferred,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Anthem,Individual Exchange,,115.73,,,115.73,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Cigna,Cigna,,166.32,,,166.32,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Connecticare,Commerical,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Connecticare,Exchange,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,Multiplan,Multiplan,,,177.65,,177.65,109.66,177.65,percent of total billed charges,,
HC XR SINUSES MIN 3VIEWS,70220,CPT,,,both,,,221.73,133.04,United Healthcare/Oxford,United Healthcare/Oxford,,135.07,,,135.07,109.66,177.65,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,86.59,,,86.59,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,77.93,,,77.93,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,56.84,327.34,percent of total billed charges,,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,68.29,,,68.29,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,56.84,,,56.84,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,101.61,,,101.61,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,101.61,,,101.61,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,56.84,327.34,percent of total billed charges,,
HC XR SKULL(LIMITED)<4V,70250,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT  ,,,both,,,408.56,245.14,Aetna,Commerical,,101.23,,,101.23,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Aetna,Middlesex Employees,,91.11,,,91.11,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Anthem,Commerical,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Anthem,Indemnity,,,297.14,,297.14,82.64,327.34,percent of total billed charges,,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Anthem,State Preferred,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Anthem,Individual Exchange,,98.02,,,98.02,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Cigna,Cigna,,82.64,,,82.64,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Connecticare,Commerical,,120.14,,,120.14,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Connecticare,Exchange,,120.14,,,120.14,82.64,327.34,other,Could be inpatient or outpatient,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,Multiplan,Multiplan,,,327.34,,327.34,82.64,327.34,percent of total billed charges,,
HC XR SKULL MIN 4VWS,70260,CPT,,,both,,,408.56,245.14,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,82.64,327.34,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT  ,,,both,,,679.8,407.88,Aetna,Commerical,,373.57,,,373.57,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Aetna,Middlesex Employees,,336.22,,,336.22,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Anthem,Commerical,,443.56,,,443.56,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Anthem,Indemnity,,,494.41,,494.41,336.22,544.66,percent of total billed charges,,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Anthem,State Preferred,,443.56,,,443.56,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Anthem,Individual Exchange,,354.85,,,354.85,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Cigna,Cigna,,509.93,,,509.93,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Connecticare,Commerical,,474.72,,,474.72,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Connecticare,Exchange,,474.72,,,474.72,336.22,544.66,other,Could be inpatient or outpatient,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,Multiplan,Multiplan,,,544.66,,544.66,336.22,544.66,percent of total billed charges,,
HC XR T-M JNTS BILATERL,70330,CPT,,,both,,,679.8,407.88,United Healthcare/Oxford,United Healthcare/Oxford,,414.14,,,414.14,336.22,544.66,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI TEMPOROMANDIBULAR JOINTS,70336,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT  ,,,both,,,2097.08,1258.25,Aetna,Commerical,,1516.65,,,1516.65,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Aetna,Middlesex Employees,,1364.99,,,1364.99,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Anthem,Commerical,,1357.06,,,1357.06,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Anthem,Indemnity,,,1524.98,,1524.98,1085.65,1679.99,percent of total billed charges,,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Anthem,State Preferred,,1357.06,,,1357.06,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Anthem,Individual Exchange,,1085.65,,,1085.65,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Cigna,Cigna,,1325.32,,,1325.32,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Connecticare,Commerical,,1417.55,,,1417.55,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Connecticare,Exchange,,1417.55,,,1417.55,1085.65,1679.99,other,Could be inpatient or outpatient,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,Multiplan,Multiplan,,,1679.99,,1679.99,1085.65,1679.99,percent of total billed charges,,
HC MRI TMPMND JOINTS,70336,CPT,,,both,,,2097.08,1258.25,United Healthcare/Oxford,United Healthcare/Oxford,,1363.96,,,1363.96,1085.65,1679.99,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,73.16,,,73.16,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,65.84,,,65.84,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,38.74,177.65,percent of total billed charges,,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,45.17,,,45.17,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,38.74,,,38.74,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,87.32,,,87.32,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,87.32,,,87.32,38.74,177.65,other,Could be inpatient or outpatient,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,38.74,177.65,percent of total billed charges,,
HC XR SOFT TISSUE NECK,70360,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,38.74,177.65,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT  ,,,both,,,952.75,571.65,Aetna,Commerical,,523.86,,,523.86,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Aetna,Middlesex Employees,,471.48,,,471.48,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Anthem,Commerical,,622,,,622,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Anthem,Indemnity,,,693.32,,693.32,471.48,763.79,percent of total billed charges,,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Anthem,State Preferred,,622,,,622,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Anthem,Individual Exchange,,497.61,,,497.61,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Cigna,Cigna,,715.08,,,715.08,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Connecticare,Commerical,,665.71,,,665.71,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Connecticare,Exchange,,665.71,,,665.71,471.48,763.79,other,Could be inpatient or outpatient,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,Multiplan,Multiplan,,,763.79,,763.79,471.48,763.79,percent of total billed charges,,
HC CINE OR VIDEO SPEECH EVAL,70371,CPT,,,both,,,952.75,571.65,United Healthcare/Oxford,United Healthcare/Oxford,,580.76,,,580.76,471.48,763.79,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT  ,,,both,,,734.39,440.63,Aetna,Commerical,,403.25,,,403.25,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Aetna,Middlesex Employees,,362.92,,,362.92,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Anthem,Commerical,,478.8,,,478.8,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Anthem,Indemnity,,,533.7,,533.7,362.92,587.95,percent of total billed charges,,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Anthem,State Preferred,,478.8,,,478.8,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Anthem,Individual Exchange,,383.04,,,383.04,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Cigna,Cigna,,550.45,,,550.45,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Connecticare,Commerical,,512.45,,,512.45,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Connecticare,Exchange,,512.45,,,512.45,362.92,587.95,other,Could be inpatient or outpatient,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,Multiplan,Multiplan,,,587.95,,587.95,362.92,587.95,percent of total billed charges,,
HC FL SIALOGRAM,70390,CPT,,,both,,,734.39,440.63,United Healthcare/Oxford,United Healthcare/Oxford,,447.05,,,447.05,362.92,587.95,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,248.87,,,248.87,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,223.98,,,223.98,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,338.04,,,338.04,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,196.71,464.41,percent of total billed charges,,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,338.04,,,338.04,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,270.44,,,270.44,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,433.31,,,433.31,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,377.19,,,377.19,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,377.19,,,377.19,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,196.71,464.41,percent of total billed charges,,
HC CT BRAIN NO CONTR,70450,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,464.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,364.73,,,364.73,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,328.26,,,328.26,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,487.38,,,487.38,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,328.26,721.41,percent of total billed charges,,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,487.38,,,487.38,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,389.91,,,389.91,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,519.46,,,519.46,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,550.04,,,550.04,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,550.04,,,550.04,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,328.26,721.41,percent of total billed charges,,
HC CT BRAIN WITH CON,70460,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,328.26,721.41,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT  ,,,both,,,919.79,551.87,Aetna,Commerical,,436.71,,,436.71,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Aetna,Middlesex Employees,,393.04,,,393.04,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Anthem,Commerical,,590.77,,,590.77,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Anthem,Indemnity,,,668.77,,668.77,352.71,736.75,percent of total billed charges,,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Anthem,State Preferred,,590.77,,,590.77,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Anthem,Individual Exchange,,472.61,,,472.61,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Cigna,Cigna,,648.74,,,648.74,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Connecticare,Commerical,,658.52,,,658.52,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Connecticare,Exchange,,658.52,,,658.52,352.71,736.75,other,Could be inpatient or outpatient,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,Multiplan,Multiplan,,,736.75,,736.75,352.71,736.75,percent of total billed charges,,
HC CT BRAIN W/WO CONT,70470,CPT,,,both,,,919.79,551.87,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,736.75,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT  ,,,both,,,645.81,387.49,Aetna,Commerical,,379.37,,,379.37,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Aetna,Middlesex Employees,,341.43,,,341.43,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Anthem,Commerical,,779.48,,,779.48,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Anthem,Indemnity,,,469.86,,469.86,196.71,779.48,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Anthem,State Preferred,,779.48,,,779.48,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Anthem,Individual Exchange,,623.59,,,623.59,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Cigna,Cigna,,433.31,,,433.31,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Connecticare,Commerical,,575.78,,,575.78,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Connecticare,Exchange,,575.78,,,575.78,196.71,779.48,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,Multiplan,Multiplan,,,517.62,,517.62,196.71,779.48,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR WO CONT,70480,CPT,,,both,,,645.81,387.49,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,779.48,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT  ,,,both,,,1356.51,813.91,Aetna,Commerical,,379.37,,,379.37,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Aetna,Middlesex Employees,,341.43,,,341.43,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Anthem,Commerical,,779.48,,,779.48,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Anthem,Indemnity,,,987.19,,987.19,196.71,1087.53,percent of total billed charges,,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Anthem,State Preferred,,779.48,,,779.48,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Anthem,Individual Exchange,,623.59,,,623.59,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Cigna,Cigna,,433.31,,,433.31,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Connecticare,Commerical,,575.78,,,575.78,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Connecticare,Exchange,,575.78,,,575.78,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,Multiplan,Multiplan,,,1087.53,,1087.53,196.71,1087.53,percent of total billed charges,,
HC CT MASTOIDS,70480,CPT,,,both,,,1356.51,813.91,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,1087.53,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT  ,,,both,,,1022.79,613.67,Aetna,Commerical,,572.14,,,572.14,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Aetna,Middlesex Employees,,514.92,,,514.92,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Anthem,Commerical,,953.41,,,953.41,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Anthem,Indemnity,,,744.07,,744.07,352.71,1029.96,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Anthem,State Preferred,,953.41,,,953.41,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Anthem,Individual Exchange,,762.73,,,762.73,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Cigna,Cigna,,519.46,,,519.46,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Connecticare,Commerical,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Connecticare,Exchange,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,Multiplan,Multiplan,,,819.71,,819.71,352.71,1029.96,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR W CONTR,70481,CPT,,,both,,,1022.79,613.67,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT  ,,,both,,,1615.04,969.02,Aetna,Commerical,,572.14,,,572.14,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Aetna,Middlesex Employees,,514.92,,,514.92,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Anthem,Commerical,,953.41,,,953.41,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Anthem,Indemnity,,,1174.64,,1174.64,352.71,1294.03,percent of total billed charges,,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Anthem,State Preferred,,953.41,,,953.41,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Anthem,Individual Exchange,,762.73,,,762.73,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Cigna,Cigna,,519.46,,,519.46,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Connecticare,Commerical,,1029.96,,,1029.96,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Connecticare,Exchange,,1029.96,,,1029.96,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,Multiplan,Multiplan,,,1294.03,,1294.03,352.71,1294.03,percent of total billed charges,,
HC CT MASTOIDS WC,70481,CPT,,,both,,,1615.04,969.02,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1294.03,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT  ,,,both,,,1891.08,1134.65,Aetna,Commerical,,1039.67,,,1039.67,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Aetna,Middlesex Employees,,935.71,,,935.71,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Anthem,Commerical,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Anthem,Indemnity,,,1376,,1376,935.71,1515.86,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Anthem,State Preferred,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Anthem,Individual Exchange,,987.58,,,987.58,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Cigna,Cigna,,1419.19,,,1419.19,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Connecticare,Commerical,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Connecticare,Exchange,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,Multiplan,Multiplan,,,1515.86,,1515.86,935.71,1515.86,percent of total billed charges,,
HC CT - ORBIT SELLA MID/INNER EAR W & WO,70482,CPT,,,both,,,1891.08,1134.65,United Healthcare/Oxford,United Healthcare/Oxford,,1152.6,,,1152.6,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT  ,,,both,,,1872.54,1123.52,Aetna,Commerical,,1029.17,,,1029.17,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Aetna,Middlesex Employees,,926.25,,,926.25,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Anthem,Commerical,,1221.97,,,1221.97,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Anthem,Indemnity,,,1362.09,,1362.09,926.25,1500.54,percent of total billed charges,,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Anthem,State Preferred,,1221.97,,,1221.97,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Anthem,Individual Exchange,,977.58,,,977.58,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Cigna,Cigna,,1404.84,,,1404.84,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Connecticare,Commerical,,1307.85,,,1307.85,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Connecticare,Exchange,,1307.85,,,1307.85,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,Multiplan,Multiplan,,,1500.54,,1500.54,926.25,1500.54,percent of total billed charges,,
HC CT MASTOIDS W/WO,70482,CPT,,,both,,,1872.54,1123.52,United Healthcare/Oxford,United Healthcare/Oxford,,1140.94,,,1140.94,926.25,1500.54,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT  ,,,both,,,645.81,387.49,Aetna,Commerical,,329.38,,,329.38,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Aetna,Middlesex Employees,,296.44,,,296.44,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Anthem,Commerical,,444.72,,,444.72,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Anthem,Indemnity,,,469.86,,469.86,196.71,517.62,percent of total billed charges,,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Anthem,State Preferred,,444.72,,,444.72,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Anthem,Individual Exchange,,355.77,,,355.77,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Cigna,Cigna,,433.31,,,433.31,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Connecticare,Commerical,,496.71,,,496.71,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Connecticare,Exchange,,496.71,,,496.71,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,Multiplan,Multiplan,,,517.62,,517.62,196.71,517.62,percent of total billed charges,,
HC CT MAXLOFACIAL WO CONTR,70486,CPT,,,both,,,645.81,387.49,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,517.62,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT  ,,,both,,,905.37,543.22,Aetna,Commerical,,378.16,,,378.16,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Aetna,Middlesex Employees,,340.34,,,340.34,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Anthem,Commerical,,511.98,,,511.98,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Anthem,Indemnity,,,658.12,,658.12,340.34,725.02,percent of total billed charges,,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Anthem,State Preferred,,511.98,,,511.98,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Anthem,Individual Exchange,,409.59,,,409.59,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Cigna,Cigna,,519.46,,,519.46,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Connecticare,Commerical,,572.1,,,572.1,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Connecticare,Exchange,,572.1,,,572.1,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,Multiplan,Multiplan,,,725.02,,725.02,340.34,725.02,percent of total billed charges,,
HC CT MAXO/FACIAL WC,70487,CPT,,,both,,,905.37,543.22,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,340.34,725.02,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT  ,,,both,,,1131.97,679.18,Aetna,Commerical,,479.41,,,479.41,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Aetna,Middlesex Employees,,431.48,,,431.48,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Anthem,Commerical,,649.85,,,649.85,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Anthem,Indemnity,,,823.48,,823.48,352.71,907.18,percent of total billed charges,,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Anthem,State Preferred,,649.85,,,649.85,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Anthem,Individual Exchange,,519.88,,,519.88,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Cigna,Cigna,,648.74,,,648.74,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Connecticare,Commerical,,722.88,,,722.88,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Connecticare,Exchange,,722.88,,,722.88,352.71,907.18,other,Could be inpatient or outpatient,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,Multiplan,Multiplan,,,907.18,,907.18,352.71,907.18,percent of total billed charges,,
HC CT MAXO/FACL W/WO,70488,CPT,,,both,,,1131.97,679.18,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,907.18,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT  ,,,both,,,644.78,386.87,Aetna,Commerical,,342.78,,,342.78,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Aetna,Middlesex Employees,,308.5,,,308.5,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Anthem,Commerical,,594.06,,,594.06,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Anthem,Indemnity,,,469.04,,469.04,196.71,594.06,percent of total billed charges,,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Anthem,State Preferred,,594.06,,,594.06,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Anthem,Individual Exchange,,475.25,,,475.25,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Cigna,Cigna,,433.31,,,433.31,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Connecticare,Commerical,,516.94,,,516.94,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Connecticare,Exchange,,516.94,,,516.94,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,Multiplan,Multiplan,,,516.72,,516.72,196.71,594.06,percent of total billed charges,,
HC CT NECK W/O CON,70490,CPT,,,both,,,644.78,386.87,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,594.06,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,456.24,,,456.24,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,410.62,,,410.62,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,766.36,,,766.36,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,352.71,766.36,percent of total billed charges,,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,766.36,,,766.36,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,613.08,,,613.08,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,519.46,,,519.46,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,687.94,,,687.94,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,687.94,,,687.94,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,352.71,766.36,percent of total billed charges,,
HC CT NECK W CON,70491,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,766.36,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT  ,,,both,,,1101.07,660.64,Aetna,Commerical,,558.72,,,558.72,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Aetna,Middlesex Employees,,502.84,,,502.84,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Anthem,Commerical,,946.87,,,946.87,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Anthem,Indemnity,,,801.37,,801.37,352.71,946.87,percent of total billed charges,,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Anthem,State Preferred,,946.87,,,946.87,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Anthem,Individual Exchange,,757.5,,,757.5,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Cigna,Cigna,,648.74,,,648.74,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Connecticare,Commerical,,842.4,,,842.4,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Connecticare,Exchange,,842.4,,,842.4,352.71,946.87,other,Could be inpatient or outpatient,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,Multiplan,Multiplan,,,882.83,,882.83,352.71,946.87,percent of total billed charges,,
HC CT NECK W/WO CON,70492,CPT,,,both,,,1101.07,660.64,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,946.87,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT  ,,,both,,,1169.05,701.43,Aetna,Commerical,,616.02,,,616.02,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Anthem,Commerical,,948.52,,,948.52,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Anthem,Indemnity,,,850.49,,850.49,352.71,1030.2,percent of total billed charges,,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Anthem,State Preferred,,948.52,,,948.52,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Anthem,Individual Exchange,,758.81,,,758.81,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Cigna,Cigna,,644.57,,,644.57,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Connecticare,Commerical,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Connecticare,Exchange,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,Multiplan,Multiplan,,,936.94,,936.94,352.71,1030.2,percent of total billed charges,,
HC CTA HEAD W/WO CON,70496,CPT,,,both,,,1169.05,701.43,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT  ,,,both,,,1169.05,701.43,Aetna,Commerical,,616.02,,,616.02,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Anthem,Commerical,,945.22,,,945.22,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Anthem,Indemnity,,,850.49,,850.49,352.71,1030.2,percent of total billed charges,,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Anthem,State Preferred,,945.22,,,945.22,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Anthem,Individual Exchange,,756.18,,,756.18,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Cigna,Cigna,,644.57,,,644.57,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Connecticare,Commerical,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Connecticare,Exchange,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,Multiplan,Multiplan,,,936.94,,936.94,352.71,1030.2,percent of total billed charges,,
HC CTA NECK W/WO CON,70498,CPT,,,both,,,1169.05,701.43,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1030.2,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI ORBIT/FACE/NECK W/O DYE,70540,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI ORBIT FACE OR NECK W CON,70542,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT  ,,,both,,,2571.91,1543.15,Aetna,Commerical,,1859.39,,,1859.39,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Aetna,Middlesex Employees,,1673.45,,,1673.45,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Anthem,Commerical,,1663.73,,,1663.73,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Anthem,Indemnity,,,1869.6,,1869.6,1330.99,2059.64,percent of total billed charges,,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Anthem,State Preferred,,1663.73,,,1663.73,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Anthem,Individual Exchange,,1330.99,,,1330.99,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Cigna,Cigna,,1624.82,,,1624.82,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Connecticare,Commerical,,1737.88,,,1737.88,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Connecticare,Exchange,,1737.88,,,1737.88,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,Multiplan,Multiplan,,,2059.64,,2059.64,1330.99,2059.64,percent of total billed charges,,
HC MRI ORBIT/FACE/NECK W/DYE,70542,CPT,,,both,,,2571.91,1543.15,United Healthcare/Oxford,United Healthcare/Oxford,,1672.17,,,1672.17,1330.99,2059.64,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT  ,,,both,,,2703.75,1622.25,Aetna,Commerical,,1956.26,,,1956.26,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Aetna,Middlesex Employees,,1760.64,,,1760.64,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Anthem,Commerical,,1750.41,,,1750.41,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Anthem,Indemnity,,,1967,,1967,1400.33,2166.94,percent of total billed charges,,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Anthem,State Preferred,,1750.41,,,1750.41,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Anthem,Individual Exchange,,1400.33,,,1400.33,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Cigna,Cigna,,1709.48,,,1709.48,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Connecticare,Commerical,,1828.43,,,1828.43,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Connecticare,Exchange,,1828.43,,,1828.43,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,Multiplan,Multiplan,,,2166.94,,2166.94,1400.33,2166.94,percent of total billed charges,,
HC MRI ORBIT FACE OR NECK WWO CON,70543,CPT,,,both,,,2703.75,1622.25,United Healthcare/Oxford,United Healthcare/Oxford,,1759.3,,,1759.3,1400.33,2166.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA; HEAD; WO CONTRAST,70544,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA; HEAD W CONTRAST,70545,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT  ,,,both,,,2525.56,1515.34,Aetna,Commerical,,1827.64,,,1827.64,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Aetna,Middlesex Employees,,1644.88,,,1644.88,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Anthem,Commerical,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Anthem,Indemnity,,,1837.67,,1837.67,1308.26,2024.46,percent of total billed charges,,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Anthem,State Preferred,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Anthem,Individual Exchange,,1308.26,,,1308.26,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Cigna,Cigna,,1597.08,,,1597.08,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Connecticare,Commerical,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Connecticare,Exchange,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,Multiplan,Multiplan,,,2024.46,,2024.46,1308.26,2024.46,percent of total billed charges,,
HC MRA; HEAD W & WO CONTRAST,70546,CPT,,,both,,,2525.56,1515.34,United Healthcare/Oxford,United Healthcare/Oxford,,1643.62,,,1643.62,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA; NECK WO CONTRAST,70547,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA; NECK W CONTRAST,70548,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT  ,,,both,,,2420.5,1452.3,Aetna,Commerical,,1751.11,,,1751.11,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Aetna,Middlesex Employees,,1576,,,1576,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Anthem,Commerical,,1566.86,,,1566.86,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Anthem,Indemnity,,,1760.73,,1760.73,1253.49,1939.7,percent of total billed charges,,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Anthem,State Preferred,,1566.86,,,1566.86,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Anthem,Individual Exchange,,1253.49,,,1253.49,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Cigna,Cigna,,1530.2,,,1530.2,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Connecticare,Commerical,,1636.68,,,1636.68,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Connecticare,Exchange,,1636.68,,,1636.68,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,Multiplan,Multiplan,,,1939.7,,1939.7,1253.49,1939.7,percent of total billed charges,,
HC MRA; NECK W & WO CONTRAST,70549,CPT,,,both,,,2420.5,1452.3,United Healthcare/Oxford,United Healthcare/Oxford,,1574.81,,,1574.81,1253.49,1939.7,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI BRAIN WO CONTRAST,70551,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI BRAIN W CONTRAST,70552,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT  ,,,both,,,2748.04,1648.82,Aetna,Commerical,,1988.01,,,1988.01,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Aetna,Middlesex Employees,,1789.21,,,1789.21,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Anthem,Commerical,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Anthem,Indemnity,,,1998.93,,1998.93,1423.06,2202.11,percent of total billed charges,,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Anthem,State Preferred,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Anthem,Individual Exchange,,1423.06,,,1423.06,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Cigna,Cigna,,1737.22,,,1737.22,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Connecticare,Commerical,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Connecticare,Exchange,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,Multiplan,Multiplan,,,2202.11,,2202.11,1423.06,2202.11,percent of total billed charges,,
HC MRI BRAIN W & WO CONTRAST,70553,CPT,,,both,,,2748.04,1648.82,United Healthcare/Oxford,United Healthcare/Oxford,,1787.85,,,1787.85,1423.06,2202.11,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT  ,,,both,,,2131.71,1279.03,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC FMRI BRAIN MOVMT AND/OR VIS STIM BY TECH,70554,CPT,,,both,,,2131.71,1279.03,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT  ,,,both,,,2131.71,1279.03,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC FMRI  BRAIN MOVMT AND/OR VIS STIM BY PHYS/PSYCH,70555,CPT,,,both,,,2131.71,1279.03,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,121.84,,,121.84,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,109.66,,,109.66,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,109.66,177.65,percent of total billed charges,,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,115.73,,,115.73,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,166.32,,,166.32,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,109.66,177.65,percent of total billed charges,,
HC CHEST SINGLE VIEW,71010,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,135.07,,,135.07,109.66,177.65,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT  ,,,both,,,316.21,189.73,Aetna,Commerical,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Aetna,Middlesex Employees,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Anthem,Commerical,,85.37,,,85.37,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Anthem,Indemnity,,,230.01,,230.01,68.29,253.39,percent of total billed charges,,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Anthem,State Preferred,,85.37,,,85.37,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Anthem,Individual Exchange,,68.29,,,68.29,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Cigna,Cigna,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Connecticare,Commerical,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Connecticare,Exchange,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,Multiplan,Multiplan,,,253.39,,253.39,68.29,253.39,percent of total billed charges,,
HC CHEST X-RAY 2 VIEWS FR&LAT,71020,CPT,,,both,,,316.21,189.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.29,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT  ,,,both,,,412,247.2,Aetna,Commerical,,226.37,,,226.37,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Aetna,Middlesex Employees,,203.73,,,203.73,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Anthem,Commerical,,268.78,,,268.78,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Anthem,Indemnity,,,299.59,,299.59,203.73,330.05,percent of total billed charges,,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Anthem,State Preferred,,268.78,,,268.78,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Anthem,Individual Exchange,,215.02,,,215.02,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Cigna,Cigna,,308.99,,,308.99,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Connecticare,Commerical,,287.67,,,287.67,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Connecticare,Exchange,,287.67,,,287.67,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,Multiplan,Multiplan,,,330.05,,330.05,203.73,330.05,percent of total billed charges,,
HC XR CHEST 4+ VIEWS,71030,CPT,,,both,,,412,247.2,United Healthcare/Oxford,United Healthcare/Oxford,,250.95,,,250.95,203.73,330.05,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT  ,,,both,,,355.35,213.21,Aetna,Commerical,,195.44,,,195.44,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Aetna,Middlesex Employees,,175.9,,,175.9,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Anthem,Commerical,,232.06,,,232.06,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Anthem,Indemnity,,,258.66,,258.66,175.9,284.95,percent of total billed charges,,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Anthem,State Preferred,,232.06,,,232.06,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Anthem,Individual Exchange,,185.65,,,185.65,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Cigna,Cigna,,266.78,,,266.78,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Connecticare,Commerical,,248.36,,,248.36,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Connecticare,Exchange,,248.36,,,248.36,175.9,284.95,other,Could be inpatient or outpatient,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,Multiplan,Multiplan,,,284.95,,284.95,175.9,284.95,percent of total billed charges,,
HC CHEST SPECIAL VIEWS,71035,CPT,,,both,,,355.35,213.21,United Healthcare/Oxford,United Healthcare/Oxford,,216.67,,,216.67,175.9,284.95,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,56.1,,,56.1,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,50.49,,,50.49,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,33.98,,,33.98,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,27.18,177.65,percent of total billed charges,,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,33.98,,,33.98,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,27.18,,,27.18,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,,,,,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,63.01,,,63.01,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,63.01,,,63.01,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,27.18,177.65,percent of total billed charges,,
HC XR CHEST SINGLE VIEW,71045,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,27.18,177.65,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT  ,,,both,,,316.21,189.73,Aetna,Commerical,,74.41,,,74.41,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Aetna,Middlesex Employees,,66.97,,,66.97,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Anthem,Commerical,,62.18,,,62.18,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Anthem,Indemnity,,,230.01,,230.01,49.74,253.39,percent of total billed charges,,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Anthem,State Preferred,,62.18,,,62.18,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Anthem,Individual Exchange,,49.74,,,49.74,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Cigna,Cigna,,,,,,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Connecticare,Commerical,,83.04,,,83.04,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Connecticare,Exchange,,83.04,,,83.04,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,Multiplan,Multiplan,,,253.39,,253.39,49.74,253.39,percent of total billed charges,,
HC XR CHEST 2 VIEWS,71046,CPT,,,both,,,316.21,189.73,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,49.74,253.39,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT  ,,,both,,,360.5,216.3,Aetna,Commerical,,93.91,,,93.91,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Aetna,Middlesex Employees,,84.52,,,84.52,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Anthem,Commerical,,79.08,,,79.08,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Anthem,Indemnity,,,261.94,,261.94,63.27,288.57,percent of total billed charges,,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Anthem,State Preferred,,79.08,,,79.08,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Anthem,Individual Exchange,,63.27,,,63.27,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Cigna,Cigna,,,,,,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Connecticare,Commerical,,103.03,,,103.03,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Connecticare,Exchange,,103.03,,,103.03,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,Multiplan,Multiplan,,,288.57,,288.57,63.27,288.57,percent of total billed charges,,
HC XR CHEST 3 VIEWS,71047,CPT,,,both,,,360.5,216.3,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,63.27,288.57,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT  ,,,both,,,412,247.2,Aetna,Commerical,,226.37,,,226.37,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Aetna,Middlesex Employees,,203.73,,,203.73,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Anthem,Commerical,,268.78,,,268.78,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Anthem,Indemnity,,,299.59,,299.59,203.73,330.05,percent of total billed charges,,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Anthem,State Preferred,,268.78,,,268.78,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Anthem,Individual Exchange,,215.02,,,215.02,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Cigna,Cigna,,308.99,,,308.99,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Connecticare,Commerical,,287.67,,,287.67,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Connecticare,Exchange,,287.67,,,287.67,203.73,330.05,other,Could be inpatient or outpatient,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,Multiplan,Multiplan,,,330.05,,330.05,203.73,330.05,percent of total billed charges,,
HC XR CHEST 4 OR MORE VIEWS,71048,CPT,,,both,,,412,247.2,United Healthcare/Oxford,United Healthcare/Oxford,,250.95,,,250.95,203.73,330.05,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,82.95,,,82.95,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,74.65,,,74.65,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,93.01,,,93.01,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,93.01,,,93.01,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF RIBS 2 VIEWS UNILAT,71100,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,93.91,,,93.91,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,84.52,,,84.52,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,61.18,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,72.69,,,72.69,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,61.18,,,61.18,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,103.03,,,103.03,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,103.03,,,103.03,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,61.18,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS/CHEST 3+ VIEWS UNILAT,71101,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,61.18,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,96.36,,,96.36,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,86.73,,,86.73,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,107.4,,,107.4,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,72.33,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,107.4,,,107.4,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,85.93,,,85.93,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,72.33,,,72.33,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,105.88,,,105.88,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,105.88,,,105.88,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,72.33,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS 3 VIEWS BILAT,71110,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,119.55,,,119.55,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,107.59,,,107.59,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,82.64,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,98.02,,,98.02,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,82.64,,,82.64,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,130.16,,,130.16,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,130.16,,,130.16,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,82.64,327.34,percent of total billed charges,,
HC X-RAY EXAM OF RIBS/CHEST 4+ VIEWS BILAT,71111,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,82.64,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,76.84,,,76.84,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,69.15,,,69.15,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,89.49,,,89.49,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,59.43,177.65,percent of total billed charges,,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,89.49,,,89.49,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,71.59,,,71.59,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,59.43,,,59.43,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,84.47,,,84.47,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,84.47,,,84.47,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,59.43,177.65,percent of total billed charges,,
HC X-RAY EXAM OF BREASTBONE 2+ VIEWS,71120,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,59.43,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,97.58,,,97.58,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,87.83,,,87.83,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,96.39,,,96.39,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,64.64,177.65,percent of total billed charges,,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,96.39,,,96.39,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,77.11,,,77.11,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,64.64,,,64.64,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,105.88,,,105.88,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,105.88,,,105.88,64.64,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,64.64,177.65,percent of total billed charges,,
HC X-RAY EXAM OF BREASTBONE 3+ VIEWS,71130,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,64.64,177.65,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT  ,,,both,,,650.96,390.58,Aetna,Commerical,,342.78,,,342.78,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Aetna,Middlesex Employees,,308.5,,,308.5,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Anthem,Commerical,,597.31,,,597.31,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Anthem,Indemnity,,,473.95,,473.95,196.71,597.31,percent of total billed charges,,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Anthem,State Preferred,,597.31,,,597.31,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Anthem,Individual Exchange,,477.85,,,477.85,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Cigna,Cigna,,542.73,,,542.73,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Connecticare,Commerical,,516.94,,,516.94,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Connecticare,Exchange,,516.94,,,516.94,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,Multiplan,Multiplan,,,522.12,,522.12,196.71,597.31,percent of total billed charges,,
HC CT CHST W/O CONT,71250,CPT,,,both,,,650.96,390.58,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,597.31,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT  ,,,both,,,924.94,554.96,Aetna,Commerical,,457.46,,,457.46,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Aetna,Middlesex Employees,,411.71,,,411.71,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Anthem,Commerical,,771.29,,,771.29,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Anthem,Indemnity,,,672.86,,672.86,352.71,771.29,percent of total billed charges,,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Anthem,State Preferred,,771.29,,,771.29,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Anthem,Individual Exchange,,617.04,,,617.04,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Cigna,Cigna,,648.74,,,648.74,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Connecticare,Commerical,,691.62,,,691.62,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Connecticare,Exchange,,691.62,,,691.62,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,Multiplan,Multiplan,,,741.25,,741.25,352.71,771.29,percent of total billed charges,,
HC CT CHEST W/ CONT,71260,CPT,,,both,,,924.94,554.96,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,771.29,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT  ,,,both,,,1130.94,678.56,Aetna,Commerical,,558.72,,,558.72,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Aetna,Middlesex Employees,,502.84,,,502.84,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Anthem,Commerical,,950.16,,,950.16,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Anthem,Indemnity,,,822.65,,822.65,352.71,950.16,percent of total billed charges,,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Anthem,State Preferred,,950.16,,,950.16,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Anthem,Individual Exchange,,760.12,,,760.12,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Cigna,Cigna,,810.79,,,810.79,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Connecticare,Commerical,,844.24,,,844.24,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Connecticare,Exchange,,844.24,,,844.24,352.71,950.16,other,Could be inpatient or outpatient,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,Multiplan,Multiplan,,,906.27,,906.27,352.71,950.16,percent of total billed charges,,
HC CT CHEST W/WO CONT,71270,CPT,,,both,,,1130.94,678.56,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,950.16,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT  ,,,both,,,1170.08,702.05,Aetna,Commerical,,616.02,,,616.02,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Anthem,Commerical,,964.93,,,964.93,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Anthem,Indemnity,,,851.31,,851.31,352.71,1030.2,percent of total billed charges,,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Anthem,State Preferred,,964.93,,,964.93,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Anthem,Individual Exchange,,771.94,,,771.94,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Cigna,Cigna,,790.22,,,790.22,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Connecticare,Commerical,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Connecticare,Exchange,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,Multiplan,Multiplan,,,937.84,,937.84,352.71,1030.2,percent of total billed charges,,
HC CTA CHEST W/WO CONT,71275,CPT,,,both,,,1170.08,702.05,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1030.2,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI CHEST WO CONTRAST,71550,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI CHEST WC,71551,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT  ,,,both,,,2690.36,1614.22,Aetna,Commerical,,1945.67,,,1945.67,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Aetna,Middlesex Employees,,1751.11,,,1751.11,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Anthem,Commerical,,1740.94,,,1740.94,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Anthem,Indemnity,,,1956.36,,1956.36,1392.76,2155.22,percent of total billed charges,,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Anthem,State Preferred,,1740.94,,,1740.94,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Anthem,Individual Exchange,,1392.76,,,1392.76,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Cigna,Cigna,,1700.22,,,1700.22,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Connecticare,Commerical,,1818.54,,,1818.54,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Connecticare,Exchange,,1818.54,,,1818.54,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,Multiplan,Multiplan,,,2155.22,,2155.22,1392.76,2155.22,percent of total billed charges,,
HC MRI CHEST W/WO CONTRAST,71552,CPT,,,both,,,2690.36,1614.22,United Healthcare/Oxford,United Healthcare/Oxford,,1749.78,,,1749.78,1392.76,2155.22,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT  ,,,both,,,2202.14,1321.28,Aetna,Commerical,,1593.17,,,1593.17,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Aetna,Middlesex Employees,,1433.86,,,1433.86,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Anthem,Commerical,,1425.54,,,1425.54,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Anthem,Indemnity,,,1601.92,,1601.92,1140.43,1764.75,percent of total billed charges,,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Anthem,State Preferred,,1425.54,,,1425.54,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Anthem,Individual Exchange,,1140.43,,,1140.43,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Cigna,Cigna,,1392.2,,,1392.2,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Connecticare,Commerical,,1489.07,,,1489.07,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Connecticare,Exchange,,1489.07,,,1489.07,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,Multiplan,Multiplan,,,1764.75,,1764.75,1140.43,1764.75,percent of total billed charges,,
HC MRA THORACIC INLET/OUTLET W CONTRAST,71555,CPT,,,both,,,2202.14,1321.28,United Healthcare/Oxford,United Healthcare/Oxford,,1432.77,,,1432.77,1140.43,1764.75,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT  ,,,both,,,1626.37,975.82,Aetna,Commerical,,1176.36,,,1176.36,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Aetna,Middlesex Employees,,1058.73,,,1058.73,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Anthem,Commerical,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Anthem,Indemnity,,,1182.82,,1182.82,842.07,1303.05,percent of total billed charges,,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Anthem,State Preferred,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Anthem,Individual Exchange,,842.07,,,842.07,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Cigna,Cigna,,1027.97,,,1027.97,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Connecticare,Commerical,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Connecticare,Exchange,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,Multiplan,Multiplan,,,1303.05,,1303.05,842.07,1303.05,percent of total billed charges,,
HC MRA THORACIC INLET/OUTLET W WO CONTRAST,71555,CPT,,,both,,,1626.37,975.82,United Healthcare/Oxford,United Healthcare/Oxford,,1057.92,,,1057.92,842.07,1303.05,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT  ,,,both,,,530.45,318.27,Aetna,Commerical,,291.31,,,291.31,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Aetna,Middlesex Employees,,262.17,,,262.17,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Anthem,Commerical,,345.89,,,345.89,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Anthem,Indemnity,,,385.54,,385.54,262.17,424.73,percent of total billed charges,,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Anthem,State Preferred,,345.89,,,345.89,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Anthem,Individual Exchange,,276.71,,,276.71,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Cigna,Cigna,,397.64,,,397.64,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Connecticare,Commerical,,370.19,,,370.19,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Connecticare,Exchange,,370.19,,,370.19,262.17,424.73,other,Could be inpatient or outpatient,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,Multiplan,Multiplan,,,424.73,,424.73,262.17,424.73,percent of total billed charges,,
HC SPINE--ENTIRE 2V,72010,CPT,,,both,,,530.45,318.27,United Healthcare/Oxford,United Healthcare/Oxford,,322.95,,,322.95,262.17,424.73,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,54.88,,,54.88,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,49.39,,,49.39,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,38.74,177.65,percent of total billed charges,,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,45.17,,,45.17,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,38.74,,,38.74,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,61.59,,,61.59,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,61.59,,,61.59,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,38.74,177.65,percent of total billed charges,,
HC XR CERVICAL SPINE 1V,72020,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,38.74,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,91.48,,,91.48,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,82.34,,,82.34,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,82.61,,,82.61,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,55.11,177.65,percent of total billed charges,,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,82.61,,,82.61,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,66.1,,,66.1,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,55.11,,,55.11,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,101.61,,,101.61,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,101.61,,,101.61,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,55.11,177.65,percent of total billed charges,,
HC XR CERV SPINE 2/3V,72040,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,55.11,177.65,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,125.65,,,125.65,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,113.08,,,113.08,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,82.64,327.34,percent of total billed charges,,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,122.53,,,122.53,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,98.02,,,98.02,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,82.64,,,82.64,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,138.7,,,138.7,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,138.7,,,138.7,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,82.64,327.34,percent of total billed charges,,
HC XR CERV SPINE 4 OR 5 VIEWS,72050,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,82.64,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,151.26,,,151.26,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,136.13,,,136.13,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,154.2,,,154.2,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,104.26,327.34,percent of total billed charges,,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,154.2,,,154.2,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,123.36,,,123.36,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,104.26,,,104.26,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,167.29,,,167.29,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,167.29,,,167.29,104.26,327.34,other,Could be inpatient or outpatient,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,104.26,327.34,percent of total billed charges,,
HC XR CERV SPINE 6+ VIEWS,72052,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,104.26,327.34,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT  ,,,both,,,548.99,329.39,Aetna,Commerical,,301.2,,,301.2,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Aetna,Middlesex Employees,,271.09,,,271.09,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Anthem,Commerical,,357.63,,,357.63,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Anthem,Indemnity,,,398.64,,398.64,271.09,439.16,percent of total billed charges,,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Anthem,State Preferred,,357.63,,,357.63,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Anthem,Individual Exchange,,286.11,,,286.11,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Cigna,Cigna,,411.15,,,411.15,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Connecticare,Commerical,,382.76,,,382.76,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Connecticare,Exchange,,382.76,,,382.76,271.09,439.16,other,Could be inpatient or outpatient,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,Multiplan,Multiplan,,,439.16,,439.16,271.09,439.16,percent of total billed charges,,
HC SPINE LONG1 ERECT,72069,CPT,,,both,,,548.99,329.39,United Healthcare/Oxford,United Healthcare/Oxford,,333.92,,,333.92,271.09,439.16,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,73.16,,,73.16,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,65.84,,,65.84,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,89.49,,,89.49,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,59.43,327.34,percent of total billed charges,,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,89.49,,,89.49,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,71.59,,,71.59,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,59.43,,,59.43,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,91.59,,,91.59,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,91.59,,,91.59,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,59.43,327.34,percent of total billed charges,,
HC XR THORACIC SP 2V,72070,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,59.43,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,91.48,,,91.48,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,82.34,,,82.34,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,101.89,,,101.89,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,68.02,327.34,percent of total billed charges,,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,101.89,,,101.89,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,81.51,,,81.51,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,68.02,,,68.02,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,101.61,,,101.61,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,101.61,,,101.61,68.02,327.34,other,Could be inpatient or outpatient,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,68.02,327.34,percent of total billed charges,,
HC XR THORACIC SP 3V,72072,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,79.27,,,79.27,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,71.34,,,71.34,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,90.86,,,90.86,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,61.18,177.65,percent of total billed charges,,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,90.86,,,90.86,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,72.69,,,72.69,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,61.18,,,61.18,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,90.16,,,90.16,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,90.16,,,90.16,61.18,177.65,other,Could be inpatient or outpatient,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,61.18,177.65,percent of total billed charges,,
HC XR SPINE LONG 2V,72080,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,61.18,177.65,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,96.36,,,96.36,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,86.73,,,86.73,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,80.47,,,80.47,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,64.38,270.46,percent of total billed charges,,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,80.47,,,80.47,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,64.38,,,64.38,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,270.46,,,270.46,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,107.31,,,107.31,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,107.31,,,107.31,64.38,270.46,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,64.38,270.46,percent of total billed charges,,
HC XR ENTIRE SPINE 1 VIEW,72081,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,64.38,270.46,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,175.64,,,175.64,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,158.08,,,158.08,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,146.09,,,146.09,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,116.87,509.35,percent of total billed charges,,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,146.09,,,146.09,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,116.87,,,116.87,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,509.35,,,509.35,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,195.84,,,195.84,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,195.84,,,195.84,116.87,509.35,other,Could be inpatient or outpatient,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,116.87,509.35,percent of total billed charges,,
HC XR SPINE--2 OR 3 VIEWS,72082,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,116.87,509.35,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,206.17,,,206.17,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,185.55,,,185.55,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,158.54,,,158.54,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,126.83,1020.76,percent of total billed charges,,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,158.54,,,158.54,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,126.83,,,126.83,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,1020.76,,,1020.76,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,234.43,,,234.43,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,234.43,,,234.43,126.83,1020.76,other,Could be inpatient or outpatient,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,126.83,1020.76,percent of total billed charges,,
HC XR ENTIRE SPINE  4 OR 5 VIEWS,72083,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,126.83,1020.76,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT  ,,,both,,,1276.32,765.79,Aetna,Commerical,,247.62,,,247.62,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Aetna,Middlesex Employees,,222.85,,,222.85,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Anthem,Commerical,,190.21,,,190.21,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Anthem,Indemnity,,,928.25,,928.25,152.17,1022.6,percent of total billed charges,,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Anthem,State Preferred,,190.21,,,190.21,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Anthem,Individual Exchange,,152.17,,,152.17,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Cigna,Cigna,,1020.76,,,1020.76,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Connecticare,Commerical,,274.43,,,274.43,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Connecticare,Exchange,,274.43,,,274.43,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,Multiplan,Multiplan,,,1022.6,,1022.6,152.17,1022.6,percent of total billed charges,,
HC SCOLI SERIES,72084,CPT,,,both,,,1276.32,765.79,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,152.17,1022.6,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT  ,,,both,,,1170.53,702.32,Aetna,Commerical,,643.23,,,643.23,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Aetna,Middlesex Employees,,578.91,,,578.91,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Anthem,Commerical,,763.74,,,763.74,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Anthem,Indemnity,,,851.31,,851.31,578.91,937.84,percent of total billed charges,,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Anthem,State Preferred,,763.74,,,763.74,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Anthem,Individual Exchange,,610.99,,,610.99,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Cigna,Cigna,,878.03,,,878.03,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Connecticare,Commerical,,817.4,,,817.4,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Connecticare,Exchange,,817.4,,,817.4,578.91,937.84,other,Could be inpatient or outpatient,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,Multiplan,Multiplan,,,937.84,,937.84,578.91,937.84,percent of total billed charges,,
HC SCOLI SERIES,72090,CPT,,,both,,,1170.53,702.32,United Healthcare/Oxford,United Healthcare/Oxford,,713.09,,,713.09,578.91,937.84,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,91.48,,,91.48,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,82.34,,,82.34,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,61.18,327.34,percent of total billed charges,,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,72.69,,,72.69,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,61.18,,,61.18,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,101.61,,,101.61,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,101.61,,,101.61,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,61.18,327.34,percent of total billed charges,,
HC XR LUMBAR SPINE 2/3V,72100,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,61.18,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,120.75,,,120.75,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,108.68,,,108.68,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,125.3,,,125.3,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,84.36,327.34,percent of total billed charges,,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,125.3,,,125.3,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,100.24,,,100.24,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,84.36,,,84.36,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,141.59,,,141.59,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,141.59,,,141.59,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,84.36,327.34,percent of total billed charges,,
HC XR LUMBAR SPINE 4V MIN,72110,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,84.36,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,151.26,,,151.26,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,136.13,,,136.13,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,162.48,,,162.48,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,109.45,327.34,percent of total billed charges,,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,162.48,,,162.48,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,129.99,,,129.99,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,109.45,,,109.45,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,167.29,,,167.29,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,167.29,,,167.29,109.45,327.34,other,Could be inpatient or outpatient,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,109.45,327.34,percent of total billed charges,,
HC XR LSPINE COMP W BEND,72114,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,109.45,327.34,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT  ,,,both,,,233.81,140.29,Aetna,Commerical,,128.64,,,128.64,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Aetna,Middlesex Employees,,115.78,,,115.78,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Anthem,Commerical,,152.75,,,152.75,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Anthem,Indemnity,,,170.26,,170.26,115.78,187.57,percent of total billed charges,,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Anthem,State Preferred,,152.75,,,152.75,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Anthem,Individual Exchange,,122.19,,,122.19,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Cigna,Cigna,,175.6,,,175.6,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Connecticare,Commerical,,163.48,,,163.48,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Connecticare,Exchange,,163.48,,,163.48,115.78,187.57,other,Could be inpatient or outpatient,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,Multiplan,Multiplan,,,187.57,,187.57,115.78,187.57,percent of total billed charges,,
HC XRAY LUMBAR SPINE BENDING VIEWS,72120,CPT,,,both,,,233.81,140.29,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,115.78,187.57,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT  ,,,both,,,650.96,390.58,Aetna,Commerical,,361.09,,,361.09,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Aetna,Middlesex Employees,,324.98,,,324.98,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Anthem,Commerical,,605.54,,,605.54,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Anthem,Indemnity,,,473.95,,473.95,196.71,605.54,percent of total billed charges,,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Anthem,State Preferred,,605.54,,,605.54,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Anthem,Individual Exchange,,484.43,,,484.43,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Cigna,Cigna,,542.73,,,542.73,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Connecticare,Commerical,,573.94,,,573.94,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Connecticare,Exchange,,573.94,,,573.94,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,Multiplan,Multiplan,,,522.12,,522.12,196.71,605.54,percent of total billed charges,,
HC CT CRV SPINE WO CONT,72125,CPT,,,both,,,650.96,390.58,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,605.54,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT  ,,,both,,,1886.96,1132.18,Aetna,Commerical,,1037.21,,,1037.21,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Aetna,Middlesex Employees,,933.49,,,933.49,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Anthem,Commerical,,1231.53,,,1231.53,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Anthem,Indemnity,,,1372.73,,1372.73,933.49,1512.26,percent of total billed charges,,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Anthem,State Preferred,,1231.53,,,1231.53,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Anthem,Individual Exchange,,985.22,,,985.22,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Cigna,Cigna,,1415.81,,,1415.81,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Connecticare,Commerical,,1318.06,,,1318.06,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Connecticare,Exchange,,1318.06,,,1318.06,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,Multiplan,Multiplan,,,1512.26,,1512.26,933.49,1512.26,percent of total billed charges,,
HC CT CRV SPINE W/ CON,72126,CPT,,,both,,,1886.96,1132.18,United Healthcare/Oxford,United Healthcare/Oxford,,1149.86,,,1149.86,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT  ,,,both,,,2177.42,1306.45,Aetna,Commerical,,1196.16,,,1196.16,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Aetna,Middlesex Employees,,1076.54,,,1076.54,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Anthem,Commerical,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Anthem,Indemnity,,,1583.1,,1583.1,1076.54,1744.01,percent of total billed charges,,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Anthem,State Preferred,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Anthem,Individual Exchange,,1136.2,,,1136.2,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Cigna,Cigna,,1632.79,,,1632.79,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Connecticare,Commerical,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Connecticare,Exchange,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,Multiplan,Multiplan,,,1744.01,,1744.01,1076.54,1744.01,percent of total billed charges,,
HC CT CERV SPINE W & WO CONTR,72127,CPT,,,both,,,2177.42,1306.45,United Healthcare/Oxford,United Healthcare/Oxford,,1326.07,,,1326.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT  ,,,both,,,650.96,390.58,Aetna,Commerical,,361.09,,,361.09,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Aetna,Middlesex Employees,,324.98,,,324.98,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Anthem,Commerical,,602.25,,,602.25,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Anthem,Indemnity,,,473.95,,473.95,196.71,602.25,percent of total billed charges,,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Anthem,State Preferred,,602.25,,,602.25,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Anthem,Individual Exchange,,481.79,,,481.79,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Cigna,Cigna,,542.73,,,542.73,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Connecticare,Commerical,,573.94,,,573.94,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Connecticare,Exchange,,573.94,,,573.94,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,Multiplan,Multiplan,,,522.12,,522.12,196.71,602.25,percent of total billed charges,,
HC CT THOR SPINE WO CON,72128,CPT,,,both,,,650.96,390.58,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,602.25,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT  ,,,both,,,1886.96,1132.18,Aetna,Commerical,,1037.21,,,1037.21,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Aetna,Middlesex Employees,,933.49,,,933.49,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Anthem,Commerical,,1231.53,,,1231.53,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Anthem,Indemnity,,,1372.73,,1372.73,933.49,1512.26,percent of total billed charges,,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Anthem,State Preferred,,1231.53,,,1231.53,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Anthem,Individual Exchange,,985.22,,,985.22,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Cigna,Cigna,,1415.81,,,1415.81,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Connecticare,Commerical,,1318.06,,,1318.06,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Connecticare,Exchange,,1318.06,,,1318.06,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,Multiplan,Multiplan,,,1512.26,,1512.26,933.49,1512.26,percent of total billed charges,,
HC CT THOR SPINE W CON,72129,CPT,,,both,,,1886.96,1132.18,United Healthcare/Oxford,United Healthcare/Oxford,,1149.86,,,1149.86,933.49,1512.26,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT  ,,,both,,,2177.42,1306.45,Aetna,Commerical,,1196.16,,,1196.16,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Aetna,Middlesex Employees,,1076.54,,,1076.54,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Anthem,Commerical,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Anthem,Indemnity,,,1583.1,,1583.1,1076.54,1744.01,percent of total billed charges,,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Anthem,State Preferred,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Anthem,Individual Exchange,,1136.2,,,1136.2,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Cigna,Cigna,,1632.79,,,1632.79,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Connecticare,Commerical,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Connecticare,Exchange,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,Multiplan,Multiplan,,,1744.01,,1744.01,1076.54,1744.01,percent of total billed charges,,
HC CT CHEST SPINE W/ WO CONT,72130,CPT,,,both,,,2177.42,1306.45,United Healthcare/Oxford,United Healthcare/Oxford,,1326.07,,,1326.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT  ,,,both,,,650.96,390.58,Aetna,Commerical,,358.66,,,358.66,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Aetna,Middlesex Employees,,322.79,,,322.79,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Anthem,Commerical,,598.95,,,598.95,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Anthem,Indemnity,,,473.95,,473.95,196.71,598.95,percent of total billed charges,,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Anthem,State Preferred,,598.95,,,598.95,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Anthem,Individual Exchange,,479.16,,,479.16,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Cigna,Cigna,,542.73,,,542.73,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Connecticare,Commerical,,573.94,,,573.94,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Connecticare,Exchange,,573.94,,,573.94,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,Multiplan,Multiplan,,,522.12,,522.12,196.71,598.95,percent of total billed charges,,
HC CT LSPINE W/O CONT,72131,CPT,,,both,,,650.96,390.58,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT  ,,,both,,,1626.37,975.82,Aetna,Commerical,,893.72,,,893.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Aetna,Middlesex Employees,,804.35,,,804.35,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Anthem,Commerical,,1061.15,,,1061.15,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Anthem,Indemnity,,,1182.82,,1182.82,804.35,1303.05,percent of total billed charges,,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Anthem,State Preferred,,1061.15,,,1061.15,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Anthem,Individual Exchange,,848.93,,,848.93,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Cigna,Cigna,,1219.95,,,1219.95,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Connecticare,Commerical,,1135.72,,,1135.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Connecticare,Exchange,,1135.72,,,1135.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,Multiplan,Multiplan,,,1303.05,,1303.05,804.35,1303.05,percent of total billed charges,,
HC CT LSPINE W/ CONT,72132,CPT,,,both,,,1626.37,975.82,United Healthcare/Oxford,United Healthcare/Oxford,,990.79,,,990.79,804.35,1303.05,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT  ,,,both,,,2177.42,1306.45,Aetna,Commerical,,1196.16,,,1196.16,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Aetna,Middlesex Employees,,1076.54,,,1076.54,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Anthem,Commerical,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Anthem,Indemnity,,,1583.1,,1583.1,1076.54,1744.01,percent of total billed charges,,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Anthem,State Preferred,,1420.26,,,1420.26,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Anthem,Individual Exchange,,1136.2,,,1136.2,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Cigna,Cigna,,1632.79,,,1632.79,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Connecticare,Commerical,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Connecticare,Exchange,,1520.07,,,1520.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,Multiplan,Multiplan,,,1744.01,,1744.01,1076.54,1744.01,percent of total billed charges,,
HC CT LUMBAR SPINE W/ WO CONT,72133,CPT,,,both,,,2177.42,1306.45,United Healthcare/Oxford,United Healthcare/Oxford,,1326.07,,,1326.07,1076.54,1744.01,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI CERV SPINE WO CON,72141,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI CERV SPINE W/ CON,72142,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE THORACIC WO CONTR,72146,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE THORACIC W CONTR,72147,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE LUMBAR WO CONTR,72148,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI SPINE LUMBAR W CONTR,72149,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT  ,,,both,,,2748.04,1648.82,Aetna,Commerical,,1988.01,,,1988.01,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Aetna,Middlesex Employees,,1789.21,,,1789.21,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Anthem,Commerical,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Anthem,Indemnity,,,1998.93,,1998.93,1423.06,2202.11,percent of total billed charges,,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Anthem,State Preferred,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Anthem,Individual Exchange,,1423.06,,,1423.06,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Cigna,Cigna,,1737.22,,,1737.22,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Connecticare,Commerical,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Connecticare,Exchange,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,Multiplan,Multiplan,,,2202.11,,2202.11,1423.06,2202.11,percent of total billed charges,,
HC MRI CERV SPINE W & WO CONTR,72156,CPT,,,both,,,2748.04,1648.82,United Healthcare/Oxford,United Healthcare/Oxford,,1787.85,,,1787.85,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT  ,,,both,,,2748.04,1648.82,Aetna,Commerical,,1988.01,,,1988.01,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Aetna,Middlesex Employees,,1789.21,,,1789.21,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Anthem,Commerical,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Anthem,Indemnity,,,1998.93,,1998.93,1423.06,2202.11,percent of total billed charges,,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Anthem,State Preferred,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Anthem,Individual Exchange,,1423.06,,,1423.06,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Cigna,Cigna,,1737.22,,,1737.22,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Connecticare,Commerical,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Connecticare,Exchange,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,Multiplan,Multiplan,,,2202.11,,2202.11,1423.06,2202.11,percent of total billed charges,,
HC MRI THORAC SPINE W & WO CONTR,72157,CPT,,,both,,,2748.04,1648.82,United Healthcare/Oxford,United Healthcare/Oxford,,1787.85,,,1787.85,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT  ,,,both,,,2748.04,1648.82,Aetna,Commerical,,1988.01,,,1988.01,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Aetna,Middlesex Employees,,1789.21,,,1789.21,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Anthem,Commerical,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Anthem,Indemnity,,,1998.93,,1998.93,1423.06,2202.11,percent of total billed charges,,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Anthem,State Preferred,,1778.82,,,1778.82,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Anthem,Individual Exchange,,1423.06,,,1423.06,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Cigna,Cigna,,1737.22,,,1737.22,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Connecticare,Commerical,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Connecticare,Exchange,,1858.11,,,1858.11,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,Multiplan,Multiplan,,,2202.11,,2202.11,1423.06,2202.11,percent of total billed charges,,
HC MRI LUMBAR SPINE W & WO CONTR,72158,CPT,,,both,,,2748.04,1648.82,United Healthcare/Oxford,United Healthcare/Oxford,,1787.85,,,1787.85,1423.06,2202.11,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT  ,,,both,,,2055.88,1233.53,Aetna,Commerical,,1487.34,,,1487.34,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Aetna,Middlesex Employees,,1338.6,,,1338.6,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Anthem,Commerical,,1330.84,,,1330.84,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Anthem,Indemnity,,,1495.51,,1495.51,1064.67,1647.52,percent of total billed charges,,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Anthem,State Preferred,,1330.84,,,1330.84,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Anthem,Individual Exchange,,1064.67,,,1064.67,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Cigna,Cigna,,1299.72,,,1299.72,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Connecticare,Commerical,,1390.16,,,1390.16,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Connecticare,Exchange,,1390.16,,,1390.16,1064.67,1647.52,other,Could be inpatient or outpatient,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,Multiplan,Multiplan,,,1647.52,,1647.52,1064.67,1647.52,percent of total billed charges,,
HC MRA SPINE W/WO CONTR,72159,CPT,,,both,,,2055.88,1233.53,United Healthcare/Oxford,United Healthcare/Oxford,,1337.6,,,1337.6,1064.67,1647.52,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,67.09,,,67.09,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,60.38,,,60.38,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,71.59,,,71.59,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,47.4,327.34,percent of total billed charges,,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,71.59,,,71.59,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,57.28,,,57.28,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,47.4,,,47.4,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,97.3,,,97.3,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,97.3,,,97.3,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,47.4,327.34,percent of total billed charges,,
HC XR PELVIS 1/2 VIEWS,72170,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,47.4,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,95.13,,,95.13,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,85.62,,,85.62,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,61.18,327.34,percent of total billed charges,,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,90.86,,,90.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,72.69,,,72.69,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,61.18,,,61.18,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,115.86,,,115.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,115.86,,,115.86,61.18,327.34,other,Could be inpatient or outpatient,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,61.18,327.34,percent of total billed charges,,
HC XR PELVIS 3 OR MORE VIEWS,72190,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,61.18,327.34,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT  ,,,both,,,1930.22,1158.13,Aetna,Commerical,,1060.71,,,1060.71,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Aetna,Middlesex Employees,,954.64,,,954.64,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Anthem,Commerical,,1259.43,,,1259.43,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Anthem,Indemnity,,,1403.83,,1403.83,954.64,1546.52,percent of total billed charges,,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Anthem,State Preferred,,1259.43,,,1259.43,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Anthem,Individual Exchange,,1007.54,,,1007.54,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Cigna,Cigna,,1447.9,,,1447.9,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Connecticare,Commerical,,1347.93,,,1347.93,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Connecticare,Exchange,,1347.93,,,1347.93,954.64,1546.52,other,Could be inpatient or outpatient,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,Multiplan,Multiplan,,,1546.52,,1546.52,954.64,1546.52,percent of total billed charges,,
HC CTA PELVIS W/WO,72191,CPT,,,both,,,1930.22,1158.13,United Healthcare/Oxford,United Healthcare/Oxford,,1175.91,,,1175.91,954.64,1546.52,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT  ,,,both,,,650.96,390.58,Aetna,Commerical,,311.07,,,311.07,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Aetna,Middlesex Employees,,279.96,,,279.96,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Anthem,Commerical,,421.72,,,421.72,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Anthem,Indemnity,,,473.95,,473.95,196.71,542.73,percent of total billed charges,,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Anthem,State Preferred,,421.72,,,421.72,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Anthem,Individual Exchange,,337.38,,,337.38,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Cigna,Cigna,,542.73,,,542.73,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Connecticare,Commerical,,469.13,,,469.13,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Connecticare,Exchange,,469.13,,,469.13,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,Multiplan,Multiplan,,,522.12,,522.12,196.71,542.73,percent of total billed charges,,
HC CT PELVIS W/O CONT,72192,CPT,,,both,,,650.96,390.58,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,542.73,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT  ,,,both,,,1985.84,1191.5,Aetna,Commerical,,616.05,,,616.05,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Aetna,Middlesex Employees,,554.45,,,554.45,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Anthem,Commerical,,774.53,,,774.53,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Anthem,Indemnity,,,1443.94,,1443.94,352.71,1590.72,percent of total billed charges,,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Anthem,State Preferred,,774.53,,,774.53,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Anthem,Individual Exchange,,619.62,,,619.62,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Cigna,Cigna,,628.09,,,628.09,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Connecticare,Commerical,,906.76,,,906.76,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Connecticare,Exchange,,906.76,,,906.76,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,Multiplan,Multiplan,,,1590.72,,1590.72,352.71,1590.72,percent of total billed charges,,
HC CT PELVIS W/ CONT,72193,CPT,,,both,,,1985.84,1191.5,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1590.72,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT  ,,,both,,,1131.97,679.18,Aetna,Commerical,,616.02,,,616.02,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Anthem,Commerical,,918.98,,,918.98,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Anthem,Indemnity,,,823.48,,823.48,352.71,1029.96,percent of total billed charges,,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Anthem,State Preferred,,918.98,,,918.98,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Anthem,Individual Exchange,,735.18,,,735.18,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Cigna,Cigna,,778.1,,,778.1,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Connecticare,Commerical,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Connecticare,Exchange,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,Multiplan,Multiplan,,,907.18,,907.18,352.71,1029.96,percent of total billed charges,,
HC CT PELVIS W/WO CONT,72194,CPT,,,both,,,1131.97,679.18,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1029.96,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI PELVIS WO CONTRAST,72195,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI PELVIS W CONTRAST,72196,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT  ,,,both,,,2710.96,1626.58,Aetna,Commerical,,1961.14,,,1961.14,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Aetna,Middlesex Employees,,1765.02,,,1765.02,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Anthem,Commerical,,1754.79,,,1754.79,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Anthem,Indemnity,,,1971.92,,1971.92,1403.83,2172.35,percent of total billed charges,,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Anthem,State Preferred,,1754.79,,,1754.79,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Anthem,Individual Exchange,,1403.83,,,1403.83,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Cigna,Cigna,,1713.74,,,1713.74,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Connecticare,Commerical,,1833,,,1833,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Connecticare,Exchange,,1833,,,1833,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,Multiplan,Multiplan,,,2172.35,,2172.35,1403.83,2172.35,percent of total billed charges,,
HC MRI PELVIS W & WO CONTRAST,72197,CPT,,,both,,,2710.96,1626.58,United Healthcare/Oxford,United Healthcare/Oxford,,1763.69,,,1763.69,1403.83,2172.35,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT  ,,,both,,,2120.77,1272.46,Aetna,Commerical,,1533.75,,,1533.75,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Aetna,Middlesex Employees,,1380.37,,,1380.37,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Anthem,Commerical,,1372.36,,,1372.36,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Anthem,Indemnity,,,1542.17,,1542.17,1097.89,1698.93,percent of total billed charges,,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Anthem,State Preferred,,1372.36,,,1372.36,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Anthem,Individual Exchange,,1097.89,,,1097.89,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Cigna,Cigna,,1340.27,,,1340.27,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Connecticare,Commerical,,1433.52,,,1433.52,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Connecticare,Exchange,,1433.52,,,1433.52,1097.89,1698.93,other,Could be inpatient or outpatient,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,Multiplan,Multiplan,,,1698.93,,1698.93,1097.89,1698.93,percent of total billed charges,,
HC HH MRA PELVIS W /WO CONTR,72198,CPT,,,both,,,2120.77,1272.46,United Healthcare/Oxford,United Healthcare/Oxford,,1379.32,,,1379.32,1097.89,1698.93,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA PELVIS W/ WO CONTR,72198,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT  ,,,both,,,408.56,245.14,Aetna,Commerical,,90.26,,,90.26,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Aetna,Middlesex Employees,,81.24,,,81.24,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Anthem,Commerical,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Anthem,Indemnity,,,297.14,,297.14,56.84,327.34,percent of total billed charges,,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Anthem,State Preferred,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Anthem,Individual Exchange,,68.29,,,68.29,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Cigna,Cigna,,56.84,,,56.84,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Connecticare,Commerical,,101.61,,,101.61,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Connecticare,Exchange,,101.61,,,101.61,56.84,327.34,other,Could be inpatient or outpatient,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,Multiplan,Multiplan,,,327.34,,327.34,56.84,327.34,percent of total billed charges,,
HC XR SI JOINTS 3+VWS,72202,CPT,,,both,,,408.56,245.14,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,56.84,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,76.84,,,76.84,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,69.15,,,69.15,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,87.32,,,87.32,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,87.32,,,87.32,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF TAILBONE 2+ VIEWS,72220,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT  ,,,both,,,816.79,490.07,Aetna,Commerical,,449.03,,,449.03,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Aetna,Middlesex Employees,,404.12,,,404.12,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Anthem,Commerical,,533.15,,,533.15,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Anthem,Indemnity,,,594.27,,594.27,404.12,654.68,percent of total billed charges,,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Anthem,State Preferred,,533.15,,,533.15,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Anthem,Individual Exchange,,426.52,,,426.52,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Cigna,Cigna,,612.93,,,612.93,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Connecticare,Commerical,,570.62,,,570.62,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Connecticare,Exchange,,570.62,,,570.62,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,Multiplan,Multiplan,,,654.68,,654.68,404.12,654.68,percent of total billed charges,,
HC FL MYELOGRAM CERVICAL,72240,CPT,,,both,,,816.79,490.07,United Healthcare/Oxford,United Healthcare/Oxford,,497.79,,,497.79,404.12,654.68,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT  ,,,both,,,743.66,446.2,Aetna,Commerical,,408.82,,,408.82,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Aetna,Middlesex Employees,,367.94,,,367.94,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Anthem,Commerical,,485.42,,,485.42,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Anthem,Indemnity,,,541.07,,541.07,367.94,596.06,percent of total billed charges,,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Anthem,State Preferred,,485.42,,,485.42,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Anthem,Individual Exchange,,388.33,,,388.33,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Cigna,Cigna,,558.05,,,558.05,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Connecticare,Commerical,,519.53,,,519.53,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Connecticare,Exchange,,519.53,,,519.53,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,Multiplan,Multiplan,,,596.06,,596.06,367.94,596.06,percent of total billed charges,,
HC FL MYELOGRAM THORACIC SPINE,72255,CPT,,,both,,,743.66,446.2,United Healthcare/Oxford,United Healthcare/Oxford,,453.22,,,453.22,367.94,596.06,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT  ,,,both,,,2427.71,1456.63,Aetna,Commerical,,1333.46,,,1333.46,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Aetna,Middlesex Employees,,1200.12,,,1200.12,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Anthem,Commerical,,1583.28,,,1583.28,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Anthem,Indemnity,,,1764.82,,1764.82,1200.12,1944.21,percent of total billed charges,,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Anthem,State Preferred,,1583.28,,,1583.28,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Anthem,Individual Exchange,,1266.62,,,1266.62,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Cigna,Cigna,,1820.22,,,1820.22,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Connecticare,Commerical,,1694.54,,,1694.54,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Connecticare,Exchange,,1694.54,,,1694.54,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,Multiplan,Multiplan,,,1944.21,,1944.21,1200.12,1944.21,percent of total billed charges,,
HC FL MYELOGRAM LUMBAR SPINE,72265,CPT,,,both,,,2427.71,1456.63,United Healthcare/Oxford,United Healthcare/Oxford,,1478.3,,,1478.3,1200.12,1944.21,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT  ,,,both,,,1851.94,1111.16,Aetna,Commerical,,1018.03,,,1018.03,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Aetna,Middlesex Employees,,916.23,,,916.23,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Anthem,Commerical,,1208.76,,,1208.76,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Anthem,Indemnity,,,1347.35,,1347.35,916.23,1484.3,percent of total billed charges,,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Anthem,State Preferred,,1208.76,,,1208.76,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Anthem,Individual Exchange,,967,,,967,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Cigna,Cigna,,1389.65,,,1389.65,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Connecticare,Commerical,,1293.71,,,1293.71,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Connecticare,Exchange,,1293.71,,,1293.71,916.23,1484.3,other,Could be inpatient or outpatient,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,Multiplan,Multiplan,,,1484.3,,1484.3,916.23,1484.3,percent of total billed charges,,
HC FL MYELOGRAM 2 OR MORE REGIONS,72270,CPT,,,both,,,1851.94,1111.16,United Healthcare/Oxford,United Healthcare/Oxford,,1128.6,,,1128.6,916.23,1484.3,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,78.05,,,78.05,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,70.25,,,70.25,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,83.04,,,83.04,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,83.04,,,83.04,47.4,177.65,other,Could be inpatient or outpatient,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC CLAVICLE COMPLETE,73000,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,63.42,,,63.42,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,57.07,,,57.07,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,71.59,,,71.59,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,47.4,327.34,percent of total billed charges,,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,71.59,,,71.59,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,57.28,,,57.28,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,47.4,,,47.4,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,91.59,,,91.59,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,91.59,,,91.59,47.4,327.34,other,Could be inpatient or outpatient,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,47.4,327.34,percent of total billed charges,,
HC SCAPULA COMPLETE,73010,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,47.4,327.34,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,46.34,,,46.34,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,41.71,,,41.71,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,64.72,,,64.72,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,41.71,177.65,percent of total billed charges,,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,64.72,,,64.72,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,51.77,,,51.77,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,43.97,,,43.97,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,63.01,,,63.01,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,63.01,,,63.01,41.71,177.65,other,Could be inpatient or outpatient,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,41.71,177.65,percent of total billed charges,,
HC XR SHOULDER 1 VIEW,73020,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,41.71,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,80.49,,,80.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,72.44,,,72.44,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,83.04,,,83.04,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,83.04,,,83.04,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF SHOULDER 2+ VIEWS,73030,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT  ,,,both,,,862.11,517.27,Aetna,Commerical,,473.76,,,473.76,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Aetna,Middlesex Employees,,426.38,,,426.38,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Anthem,Commerical,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Anthem,Indemnity,,,627.02,,627.02,426.38,690.75,percent of total billed charges,,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Anthem,State Preferred,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Anthem,Individual Exchange,,450.02,,,450.02,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Cigna,Cigna,,646.7,,,646.7,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Connecticare,Commerical,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Connecticare,Exchange,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,Multiplan,Multiplan,,,690.75,,690.75,426.38,690.75,percent of total billed charges,,
HC SHOULDER ARTHROGRAM,73040,CPT,,,both,,,862.11,517.27,United Healthcare/Oxford,United Healthcare/Oxford,,525.22,,,525.22,426.38,690.75,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,74.41,,,74.41,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,66.97,,,66.97,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,90.86,,,90.86,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,61.18,177.65,percent of total billed charges,,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,90.86,,,90.86,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,72.69,,,72.69,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,61.18,,,61.18,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,107.31,,,107.31,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,107.31,,,107.31,61.18,177.65,other,Could be inpatient or outpatient,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,61.18,177.65,percent of total billed charges,,
HC ACJ BILATERAL W/WO WEIGHTS,73050,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,61.18,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,78.05,,,78.05,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,70.25,,,70.25,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,87.32,,,87.32,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,87.32,,,87.32,52.53,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,68.31,,,68.31,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,61.48,,,61.48,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,75.88,,,75.88,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,75.88,,,75.88,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC XR ELBOW 2 VIEWS,73070,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,75.63,,,75.63,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,68.07,,,68.07,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,84.47,,,84.47,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,84.47,,,84.47,52.53,177.65,other,Could be inpatient or outpatient,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC XR ELBOW 3VIEWS,73080,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT  ,,,both,,,1848.85,1109.31,Aetna,Commerical,,1016.18,,,1016.18,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Aetna,Middlesex Employees,,914.56,,,914.56,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Anthem,Commerical,,1206.55,,,1206.55,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Anthem,Indemnity,,,1344.9,,1344.9,914.56,1481.6,percent of total billed charges,,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Anthem,State Preferred,,1206.55,,,1206.55,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Anthem,Individual Exchange,,965.24,,,965.24,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Cigna,Cigna,,1387.11,,,1387.11,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Connecticare,Commerical,,1291.34,,,1291.34,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Connecticare,Exchange,,1291.34,,,1291.34,914.56,1481.6,other,Could be inpatient or outpatient,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,Multiplan,Multiplan,,,1481.6,,1481.6,914.56,1481.6,percent of total billed charges,,
HC ELBOW ARTHRO,73085,CPT,,,both,,,1848.85,1109.31,United Healthcare/Oxford,United Healthcare/Oxford,,1126.54,,,1126.54,914.56,1481.6,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,69.52,,,69.52,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,62.56,,,62.56,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,78.73,,,78.73,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,78.73,,,78.73,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC X-RAY EXAM OF FOREARM 2 VIEWS,73090,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,75.63,,,75.63,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,68.07,,,68.07,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,67.48,,,67.48,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,45.68,327.34,percent of total billed charges,,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,67.48,,,67.48,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,53.99,,,53.99,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,45.68,,,45.68,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,83.04,,,83.04,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,83.04,,,83.04,45.68,327.34,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,45.68,327.34,percent of total billed charges,,
HC X-RAY EXAM OF ARM INFANT 2+ VIEWS,73092,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,45.68,327.34,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,82.95,,,82.95,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,74.65,,,74.65,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,45.68,177.65,percent of total billed charges,,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,53.99,,,53.99,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,45.68,,,45.68,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,94.45,,,94.45,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,94.45,,,94.45,45.68,177.65,other,Could be inpatient or outpatient,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,45.68,177.65,percent of total billed charges,,
HC XR WRIST  2 VIEWS,73100,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,45.68,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,102.44,,,102.44,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,92.2,,,92.2,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,48.31,177.65,percent of total billed charges,,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,58.38,,,58.38,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,48.31,,,48.31,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,111.59,,,111.59,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,111.59,,,111.59,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,48.31,177.65,percent of total billed charges,,
HC WRIST 3 VIEWS,73110,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,48.31,177.65,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT  ,,,both,,,862.11,517.27,Aetna,Commerical,,336.7,,,336.7,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Aetna,Middlesex Employees,,303.03,,,303.03,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Anthem,Commerical,,217.54,,,217.54,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Anthem,Indemnity,,,627.02,,627.02,145.54,690.75,percent of total billed charges,,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Anthem,State Preferred,,217.54,,,217.54,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Anthem,Individual Exchange,,174.02,,,174.02,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Cigna,Cigna,,145.54,,,145.54,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Connecticare,Commerical,,360.1,,,360.1,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Connecticare,Exchange,,360.1,,,360.1,145.54,690.75,other,Could be inpatient or outpatient,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,Multiplan,Multiplan,,,690.75,,690.75,145.54,690.75,percent of total billed charges,,
HC WRIST ARTHROGRAM,73115,CPT,,,both,,,862.11,517.27,United Healthcare/Oxford,United Healthcare/Oxford,,674.66,,,674.66,145.54,690.75,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,74.41,,,74.41,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,66.97,,,66.97,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,67.48,,,67.48,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,45.68,327.34,percent of total billed charges,,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,67.48,,,67.48,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,53.99,,,53.99,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,45.68,,,45.68,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,83.04,,,83.04,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,83.04,,,83.04,45.68,327.34,other,Could be inpatient or outpatient,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,45.68,327.34,percent of total billed charges,,
HC XR HAND 2 VIEWS,73120,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,45.68,327.34,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,89.05,,,89.05,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,80.14,,,80.14,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,48.31,177.65,percent of total billed charges,,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,58.38,,,58.38,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,48.31,,,48.31,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,98.72,,,98.72,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,98.72,,,98.72,48.31,177.65,other,Could be inpatient or outpatient,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,48.31,177.65,percent of total billed charges,,
HC HAND 3 VIEWS,73130,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,48.31,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,97.58,,,97.58,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,87.83,,,87.83,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,38.74,177.65,percent of total billed charges,,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,45.17,,,45.17,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,38.74,,,38.74,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,107.31,,,107.31,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,107.31,,,107.31,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,38.74,177.65,percent of total billed charges,,
HC X-RAY EXAM OF FINGER(S) 2+ VIEWS,73140,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,38.74,177.65,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT  ,,,both,,,644.78,386.87,Aetna,Commerical,,379.37,,,379.37,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Aetna,Middlesex Employees,,341.43,,,341.43,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Anthem,Commerical,,597.31,,,597.31,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Anthem,Indemnity,,,469.04,,496.04,196.71,597.31,percent of total billed charges,,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Anthem,State Preferred,,597.31,,,597.31,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Anthem,Individual Exchange,,477.85,,,477.85,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Cigna,Cigna,,454.97,,,454.97,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Connecticare,Commerical,,573.94,,,573.94,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Connecticare,Exchange,,573.94,,,573.94,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,Multiplan,Multiplan,,,516.72,,516.72,196.71,597.31,percent of total billed charges,,
HC CT UP EXT WO CON,73200,CPT,,,both,,,644.78,386.87,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,597.31,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,494.79,,,494.79,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,445.31,,,445.31,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,445.31,721.41,percent of total billed charges,,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,469.99,,,469.99,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,675.41,,,675.41,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,445.31,721.41,percent of total billed charges,,
HC CT UP EXT W CON,73201,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,548.53,,,548.53,445.31,721.41,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT  ,,,both,,,1891.08,1134.65,Aetna,Commerical,,1039.67,,,1039.67,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Aetna,Middlesex Employees,,935.71,,,935.71,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Anthem,Commerical,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Anthem,Indemnity,,,1376,,1376,935.71,1515.86,percent of total billed charges,,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Anthem,State Preferred,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Anthem,Individual Exchange,,987.58,,,987.58,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Cigna,Cigna,,1419.19,,,1419.19,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Connecticare,Commerical,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Connecticare,Exchange,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,Multiplan,Multiplan,,,1515.86,,1515.86,935.71,1515.86,percent of total billed charges,,
HC CT UP EXT WWO CON,73202,CPT,,,both,,,1891.08,1134.65,United Healthcare/Oxford,United Healthcare/Oxford,,1152.6,,,1152.6,935.71,1515.86,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT  ,,,both,,,1097.98,658.79,Aetna,Commerical,,603.64,,,603.64,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Aetna,Middlesex Employees,,543.28,,,543.28,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Anthem,Commerical,,716.74,,,716.74,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Anthem,Indemnity,,,798.92,,798.92,543.28,880.12,percent of total billed charges,,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Anthem,State Preferred,,716.74,,,716.74,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Anthem,Individual Exchange,,573.39,,,573.39,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Cigna,Cigna,,823.99,,,823.99,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Connecticare,Commerical,,767.11,,,767.11,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Connecticare,Exchange,,767.11,,,767.11,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,Multiplan,Multiplan,,,880.12,,880.12,543.28,880.12,percent of total billed charges,,
HC CTA UP EXT W/WO CON,73206,CPT,,,both,,,1097.98,658.79,United Healthcare/Oxford,United Healthcare/Oxford,,669.21,,,669.21,543.28,880.12,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT  ,,,both,,,1079.44,647.66,Aetna,Commerical,,592.52,,,592.52,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Aetna,Middlesex Employees,,533.26,,,533.26,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Anthem,Commerical,,703.52,,,703.52,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Anthem,Indemnity,,,784.18,,784.18,533.26,863.89,percent of total billed charges,,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Anthem,State Preferred,,703.52,,,703.52,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Anthem,Individual Exchange,,562.81,,,562.81,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Cigna,Cigna,,808.8,,,808.8,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Connecticare,Commerical,,752.96,,,752.96,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Connecticare,Exchange,,752.96,,,752.96,533.26,863.89,other,Could be inpatient or outpatient,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,Multiplan,Multiplan,,,863.89,,863.89,533.26,863.89,percent of total billed charges,,
HC CTA UPPER EXTREMITY WWO CON,73206,CPT,,,both,,,1079.44,647.66,United Healthcare/Oxford,United Healthcare/Oxford,,656.86,,,656.86,533.26,863.89,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRI U EXT NOT JOINT WO CONTRAST,73218,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT  ,,,both,,,1896.23,1137.74,Aetna,Commerical,,1370.93,,,1370.93,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Aetna,Middlesex Employees,,1233.83,,,1233.83,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Anthem,Commerical,,1226.67,,,1226.67,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Anthem,Indemnity,,,1378.46,,1378.46,981.34,1518.58,percent of total billed charges,,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Anthem,State Preferred,,1226.67,,,1226.67,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Anthem,Individual Exchange,,981.34,,,981.34,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Cigna,Cigna,,1197.99,,,1197.99,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Connecticare,Commerical,,1281.35,,,1281.35,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Connecticare,Exchange,,1281.35,,,1281.35,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,Multiplan,Multiplan,,,1518.58,,1518.58,981.34,1518.58,percent of total billed charges,,
HC MRI UPPER EXTREMITY W CON,73219,CPT,,,both,,,1896.23,1137.74,United Healthcare/Oxford,United Healthcare/Oxford,,1232.9,,,1232.9,981.34,1518.58,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT  ,,,both,,,1626.37,975.82,Aetna,Commerical,,1176.36,,,1176.36,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Aetna,Middlesex Employees,,1058.73,,,1058.73,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Anthem,Commerical,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Anthem,Indemnity,,,1182.82,,1182.82,842.07,1303.05,percent of total billed charges,,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Anthem,State Preferred,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Anthem,Individual Exchange,,842.07,,,842.07,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Cigna,Cigna,,1027.97,,,1027.97,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Connecticare,Commerical,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Connecticare,Exchange,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,Multiplan,Multiplan,,,1303.05,,1303.05,842.07,1303.05,percent of total billed charges,,
HC MRI UPPER EXTREMITY WWO CONTRAST,73220,CPT,,,both,,,1626.37,975.82,United Healthcare/Oxford,United Healthcare/Oxford,,1057.92,,,1057.92,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Aetna,Commerical,50,1371.33,,,1371.33,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Aetna,Middlesex Employees,50,1234.2,,,1234.2,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1897.26,1138.36,Anthem,Commerical,50,1227.03,,,1227.03,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Anthem,Indemnity,50,,1425.221712,,1425.221712,981.63,1519.02,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Anthem,State Preferred,50,1227.03,,,1227.03,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1897.26,1138.36,Anthem,Individual Exchange,50,981.63,,,981.63,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Cigna,Cigna,50,1198.35,,,1198.35,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Connecticare,Commerical,50,1281.74,,,1281.74,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1897.26,1138.36,Connecticare,Exchange,50,1281.74,,,1281.74,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,Multiplan,Multiplan,50,,1612.671,,1612.671,981.63,1612.671,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WO,73221,CPT  ,,,both,,,1897.26,1138.36,United Healthcare/Oxford,United Healthcare/Oxford,50,1233.27,,,1233.27,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT  ,,,both,,,2427.71,1456.63,Aetna,Commerical,,1755.18,,,1755.18,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Aetna,Middlesex Employees,,1579.66,,,1579.66,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Anthem,Commerical,,1570.5,,,1570.5,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Anthem,Indemnity,,,1764.82,,1764.82,1256.4,1944.21,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Anthem,State Preferred,,1570.5,,,1570.5,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Anthem,Individual Exchange,,1256.4,,,1256.4,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Cigna,Cigna,,1533.76,,,1533.76,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Connecticare,Commerical,,1640.49,,,1640.49,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Connecticare,Exchange,,1640.49,,,1640.49,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,Multiplan,Multiplan,,,1944.21,,1944.21,1256.4,1944.21,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT W CONTRAST,73222,CPT,,,both,,,2427.71,1456.63,United Healthcare/Oxford,United Healthcare/Oxford,,1578.46,,,1578.46,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT  ,,,both,,,2526.77,1516.06,Aetna,Commerical,,1827.64,,,1827.64,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Aetna,Middlesex Employees,,1644.88,,,1644.88,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Anthem,Commerical,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Anthem,Indemnity,,,1837.67,,1837.67,1308.26,2024.46,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Anthem,State Preferred,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Anthem,Individual Exchange,,1308.26,,,1308.26,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Cigna,Cigna,,1597.08,,,1597.08,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Connecticare,Commerical,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Connecticare,Exchange,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,Multiplan,Multiplan,,,2024.46,,2024.46,1308.26,2024.46,percent of total billed charges,,
HC MRI UPPER EXTREMITY JOINT WWO CONTRAST,73223,CPT,,,both,,,2526.77,1516.06,United Healthcare/Oxford,United Healthcare/Oxford,,1643.62,,,1643.62,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRA U EXTR W OR WO CONTRAST,73225,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT  ,,,both,,,409.94,245.96,Aetna,Commerical,,225.13,,,225.13,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Aetna,Middlesex Employees,,202.61,,,202.61,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Anthem,Commerical,,267.31,,,267.31,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Anthem,Indemnity,,,297.96,,297.96,202.61,328.24,percent of total billed charges,,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Anthem,State Preferred,,267.31,,,267.31,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Anthem,Individual Exchange,,213.85,,,213.85,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Cigna,Cigna,,307.31,,,307.31,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Connecticare,Commerical,,286.09,,,286.09,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Connecticare,Exchange,,286.09,,,286.09,202.61,328.24,other,Could be inpatient or outpatient,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,Multiplan,Multiplan,,,328.24,,328.24,202.61,328.24,percent of total billed charges,,
HC HIP 1 VIEW,73500,CPT,,,both,,,409.94,245.96,United Healthcare/Oxford,United Healthcare/Oxford,,249.58,,,249.58,202.61,328.24,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,75.63,,,75.63,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,68.07,,,68.07,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,64.6,,,64.6,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,51.69,270.46,percent of total billed charges,,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,64.6,,,64.6,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,51.69,,,51.69,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,270.46,,,270.46,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,85.89,,,85.89,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,85.89,,,85.89,51.69,270.46,other,Could be inpatient or outpatient,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,51.69,270.46,percent of total billed charges,,
HC XR HIP & PELVIS 1 VIEW,73501,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,51.69,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,115.87,,,115.87,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,104.28,,,104.28,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,95.18,,,95.18,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,76.14,270.46,percent of total billed charges,,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,95.18,,,95.18,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,76.14,,,76.14,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,270.46,,,270.46,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,127.3,,,127.3,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,127.3,,,127.3,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,76.14,270.46,percent of total billed charges,,
HC X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,76.14,270.46,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT  ,,,both,,,478.95,287.37,Aetna,Commerical,,262.85,,,262.85,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Aetna,Middlesex Employees,,236.57,,,236.57,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Anthem,Commerical,,312.1,,,312.1,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Anthem,Indemnity,,,347.89,,347.89,236.57,383.25,percent of total billed charges,,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Anthem,State Preferred,,312.1,,,312.1,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Anthem,Individual Exchange,,249.68,,,249.68,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Cigna,Cigna,,358.81,,,358.81,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Connecticare,Commerical,,334.04,,,334.04,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Connecticare,Exchange,,334.04,,,334.04,236.57,383.25,other,Could be inpatient or outpatient,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,Multiplan,Multiplan,,,383.25,,383.25,236.57,383.25,percent of total billed charges,,
HC X-RAY EXAM HIP UNI 4/> VIEWS,73503,CPT,,,both,,,478.95,287.37,United Healthcare/Oxford,United Healthcare/Oxford,,291.41,,,291.41,236.57,383.25,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT  ,,,both,,,438.78,263.27,Aetna,Commerical,,241.21,,,241.21,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Aetna,Middlesex Employees,,217.1,,,217.1,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Anthem,Commerical,,286.41,,,286.41,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Anthem,Indemnity,,,319.24,,319.24,217.1,351.69,percent of total billed charges,,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Anthem,State Preferred,,286.41,,,286.41,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Anthem,Individual Exchange,,229.13,,,229.13,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Cigna,Cigna,,329.26,,,329.26,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Connecticare,Commerical,,306.52,,,306.52,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Connecticare,Exchange,,306.52,,,306.52,217.1,351.69,other,Could be inpatient or outpatient,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,Multiplan,Multiplan,,,351.69,,351.69,217.1,351.69,percent of total billed charges,,
HC HIP COMP,73510,CPT,,,both,,,438.78,263.27,United Healthcare/Oxford,United Healthcare/Oxford,,267.41,,,267.41,217.1,351.69,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT  ,,,both,,,615.94,369.56,Aetna,Commerical,,338.93,,,338.93,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Aetna,Middlesex Employees,,305.04,,,305.04,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Anthem,Commerical,,402.43,,,402.43,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Anthem,Indemnity,,,448.57,,448.57,305.04,494.16,percent of total billed charges,,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Anthem,State Preferred,,402.43,,,402.43,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Anthem,Individual Exchange,,321.95,,,321.95,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Cigna,Cigna,,462.65,,,462.65,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Connecticare,Commerical,,430.71,,,430.71,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Connecticare,Exchange,,430.71,,,430.71,305.04,494.16,other,Could be inpatient or outpatient,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,Multiplan,Multiplan,,,494.16,,494.16,305.04,494.16,percent of total billed charges,,
HC HIPS BIL+ AP  PEL,73520,CPT,,,both,,,615.94,369.56,United Healthcare/Oxford,United Healthcare/Oxford,,375.74,,,375.74,305.04,494.16,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,97.58,,,97.58,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,87.83,,,87.83,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,89.52,,,89.52,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,71.61,509.35,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,89.52,,,89.52,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,71.61,,,71.61,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,509.35,,,509.35,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,108.73,,,108.73,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,108.73,,,108.73,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,71.61,509.35,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 2 VIEWS,73521,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,71.61,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,126.86,,,126.86,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,114.18,,,114.18,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,106.47,,,106.47,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,85.18,509.35,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,106.47,,,106.47,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,85.18,,,85.18,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,509.35,,,509.35,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,140.17,,,140.17,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,140.17,,,140.17,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,85.18,509.35,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 3-4 VIEWS,73522,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,85.18,509.35,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,224.51,,,224.51,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,202.06,,,202.06,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,202.06,327.34,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,213.26,,,213.26,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,306.47,,,306.47,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,202.06,327.34,percent of total billed charges,,
HC XR HIPS BIL+ PELVIS 5+ VIEWS,73523,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,248.9,,,248.9,202.06,327.34,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT  ,,,both,,,912.58,547.55,Aetna,Commerical,,320.81,,,320.81,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Aetna,Middlesex Employees,,288.73,,,288.73,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Anthem,Commerical,,287.78,,,287.78,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Anthem,Indemnity,,,663.85,,663.85,192.93,731.33,percent of total billed charges,,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Anthem,State Preferred,,287.78,,,287.78,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Anthem,Individual Exchange,,230.23,,,230.23,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Cigna,Cigna,,192.93,,,192.93,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Connecticare,Commerical,,335.82,,,335.82,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Connecticare,Exchange,,335.82,,,335.82,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,Multiplan,Multiplan,,,731.33,,731.33,192.93,731.33,percent of total billed charges,,
HC HIP ARTHRO,73525,CPT,,,both,,,912.58,547.55,United Healthcare/Oxford,United Healthcare/Oxford,,674.66,,,674.66,192.93,731.33,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT  ,,,both,,,293.55,176.13,Aetna,Commerical,,161.43,,,161.43,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Aetna,Middlesex Employees,,145.29,,,145.29,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Anthem,Commerical,,191.67,,,191.67,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Anthem,Indemnity,,,213.64,,213.64,145.29,235.36,percent of total billed charges,,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Anthem,State Preferred,,191.67,,,191.67,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Anthem,Individual Exchange,,153.34,,,153.34,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Cigna,Cigna,,220.36,,,220.36,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Connecticare,Commerical,,205.14,,,205.14,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Connecticare,Exchange,,205.14,,,205.14,145.29,235.36,other,Could be inpatient or outpatient,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,Multiplan,Multiplan,,,235.36,,235.36,145.29,235.36,percent of total billed charges,,
HC HIP DURING SURGRY,73530,CPT,,,both,,,293.55,176.13,United Healthcare/Oxford,United Healthcare/Oxford,,178.96,,,178.96,145.29,235.36,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT  ,,,both,,,445.99,267.59,Aetna,Commerical,,244.92,,,244.92,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Aetna,Middlesex Employees,,220.43,,,220.43,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Anthem,Commerical,,290.8,,,290.8,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Anthem,Indemnity,,,324.15,,324.15,220.43,357.1,percent of total billed charges,,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Anthem,State Preferred,,290.8,,,290.8,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Anthem,Individual Exchange,,232.65,,,232.65,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Cigna,Cigna,,334.33,,,334.33,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Connecticare,Commerical,,311.24,,,311.24,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Connecticare,Exchange,,311.24,,,311.24,220.43,357.1,other,Could be inpatient or outpatient,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,Multiplan,Multiplan,,,357.1,,357.1,220.43,357.1,percent of total billed charges,,
HC PELV/HIPS INFCHLD,73540,CPT,,,both,,,445.99,267.59,United Healthcare/Oxford,United Healthcare/Oxford,,271.52,,,271.52,220.43,357.1,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT  ,,,both,,,438.78,263.27,Aetna,Commerical,,241.21,,,241.21,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Aetna,Middlesex Employees,,217.1,,,217.1,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Anthem,Commerical,,286.41,,,286.41,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Anthem,Indemnity,,,319.24,,319.24,217.1,351.69,percent of total billed charges,,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Anthem,State Preferred,,286.41,,,286.41,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Anthem,Individual Exchange,,229.13,,,229.13,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Cigna,Cigna,,329.26,,,329.26,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Connecticare,Commerical,,306.52,,,306.52,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Connecticare,Exchange,,306.52,,,306.52,217.1,351.69,other,Could be inpatient or outpatient,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,Multiplan,Multiplan,,,351.69,,351.69,217.1,351.69,percent of total billed charges,,
HC FEMUR,73550,CPT,,,both,,,438.78,263.27,United Healthcare/Oxford,United Healthcare/Oxford,,267.41,,,267.41,217.1,351.69,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,70.74,,,70.74,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,63.66,,,63.66,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,61.22,,,61.22,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,48.98,270.46,percent of total billed charges,,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,61.22,,,61.22,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,48.98,,,48.98,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,270.46,,,270.46,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,80.15,,,80.15,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,80.15,,,80.15,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,48.98,270.46,percent of total billed charges,,
HC XR FEMUR 1 VIEW,73551,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,48.98,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,86.59,,,86.59,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,77.93,,,77.93,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,72.52,,,72.52,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,58.02,270.46,percent of total billed charges,,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,72.52,,,72.52,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,58.02,,,58.02,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,270.46,,,270.46,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,97.3,,,97.3,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,97.3,,,97.3,58.02,270.46,other,Could be inpatient or outpatient,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,58.02,270.46,percent of total billed charges,,
HC XR FEMUR 2+ VIEW,73552,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,58.02,270.46,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,85.37,,,85.37,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,76.84,,,76.84,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,95.87,,,95.87,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,95.87,,,95.87,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC XR KNEE 1/2V,73560,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,101.23,,,101.23,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,91.11,,,91.11,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,52.53,177.65,percent of total billed charges,,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,78.49,,,78.49,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,62.79,,,62.79,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,52.53,,,52.53,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,111.59,,,111.59,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,111.59,,,111.59,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,52.53,177.65,percent of total billed charges,,
HC XR KNEE 3 VIEWS,73562,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,52.53,177.65,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,111.01,,,111.01,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Aetna,Commerical,50,166.52,,,166.52,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,99.91,,,99.91,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Aetna,Middlesex Employees,50,149.87,,,149.87,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Anthem,Commerical,50,128.06,,,128.06,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,56.84,327.34,percent of total billed charges,,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Anthem,Indemnity,50,,460.763544,,460.763544,85.26,491.01,percent of total billed charges,,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,85.37,,,85.37,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Anthem,State Preferred,50,128.06,,,128.06,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,68.29,,,68.29,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Anthem,Individual Exchange,50,102.44,,,102.44,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,56.84,,,56.84,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Cigna,Cigna,50,85.26,,,85.26,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,121.6,,,121.6,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Connecticare,Commerical,50,182.4,,,182.4,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,121.6,,,121.6,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Connecticare,Exchange,50,182.4,,,182.4,85.26,491.01,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,56.84,327.34,percent of total billed charges,,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,Multiplan,Multiplan,50,,521.3645,,521.3645,85.26,521.3645,percent of total billed charges,,
HC XR KNEE MIN 4+ VIEWS,73564,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,56.84,327.34,other,Could be inpatient or outpatient,
HC XR KNEE MIN 4+ VIEWS,73564,CPT  ,,,both,,,613.37,368.02,United Healthcare/Oxford,United Healthcare/Oxford,50,295.07,,,295.07,85.26,491.01,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,102.44,,,102.44,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,92.2,,,92.2,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,45.68,177.65,percent of total billed charges,,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,53.99,,,53.99,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,45.68,,,45.68,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,114.44,,,114.44,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,114.44,,,114.44,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,45.68,177.65,percent of total billed charges,,
HC KNEE; BOTH KNEES STANDING AP,73565,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,45.68,177.65,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT  ,,,both,,,862.11,517.27,Aetna,Commerical,,473.76,,,473.76,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Aetna,Middlesex Employees,,426.38,,,426.38,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Anthem,Commerical,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Anthem,Indemnity,,,627.02,,627.02,426.38,690.75,percent of total billed charges,,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Anthem,State Preferred,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Anthem,Individual Exchange,,450.02,,,450.02,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Cigna,Cigna,,646.7,,,646.7,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Connecticare,Commerical,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Connecticare,Exchange,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,Multiplan,Multiplan,,,690.75,,690.75,426.38,690.75,percent of total billed charges,,
HC KNEE ARTHROGRAM,73580,CPT,,,both,,,862.11,517.27,United Healthcare/Oxford,United Healthcare/Oxford,,525.22,,,525.22,426.38,690.75,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,76.84,,,76.84,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,69.15,,,69.15,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,85.89,,,85.89,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,85.89,,,85.89,47.4,177.65,other,Could be inpatient or outpatient,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC XR TIBIA  & FIBULA 2 VIEWS,73590,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,75.63,,,75.63,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,68.07,,,68.07,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,45.68,177.65,percent of total billed charges,,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,53.99,,,53.99,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,45.68,,,45.68,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,83.04,,,83.04,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,83.04,,,83.04,45.68,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,45.68,177.65,percent of total billed charges,,
HC X-RAY EXAM OF LEG INFANT 2 VIEWS,73592,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,79.27,,,79.27,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,71.34,,,71.34,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,45.68,177.65,percent of total billed charges,,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,53.99,,,53.99,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,45.68,,,45.68,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,90.16,,,90.16,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,90.16,,,90.16,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,45.68,177.65,percent of total billed charges,,
HC XR ANKLE 1-2 VIEWS,73600,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,45.68,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,89.05,,,89.05,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Aetna,Commerical,50,133.58,,,133.58,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,80.14,,,80.14,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Aetna,Middlesex Employees,50,120.21,,,120.21,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Anthem,Commerical,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,332.18,199.31,Anthem,Commerical,50,109.47,,,109.47,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,48.31,177.65,percent of total billed charges,,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Anthem,Indemnity,50,,249.533616,,249.533616,72.47,266.48,percent of total billed charges,,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Anthem,State Preferred,50,109.47,,,109.47,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Anthem,Individual Exchange,,58.38,,,58.38,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,332.18,199.31,Anthem,Individual Exchange,50,87.57,,,87.57,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Cigna,Cigna,,48.31,,,48.31,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Cigna,Cigna,50,72.47,,,72.47,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,98.72,,,98.72,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Connecticare,Commerical,50,148.08,,,148.08,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Connecticare,Exchange,,98.72,,,98.72,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,332.18,199.31,Connecticare,Exchange,50,148.08,,,148.08,72.47,266.48,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,48.31,177.65,percent of total billed charges,,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,Multiplan,Multiplan,50,,282.353,,282.353,72.47,282.353,percent of total billed charges,,
HC XR ANKLE MIN 3 VIEWS,73610,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,48.31,177.65,other,Could be inpatient or outpatient,
HC XR ANKLE MIN 3 VIEWS,73610,CPT  ,,,both,,,332.18,199.31,United Healthcare/Oxford,United Healthcare/Oxford,50,163.38,,,163.38,72.47,266.48,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT  ,,,both,,,862.11,517.27,Aetna,Commerical,,473.76,,,473.76,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Aetna,Middlesex Employees,,426.38,,,426.38,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Anthem,Commerical,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Anthem,Indemnity,,,627.02,,627.02,426.38,690.75,percent of total billed charges,,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Anthem,State Preferred,,562.52,,,562.52,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Anthem,Individual Exchange,,450.02,,,450.02,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Cigna,Cigna,,646.7,,,646.7,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Connecticare,Commerical,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Connecticare,Exchange,,602.05,,,602.05,426.38,690.75,other,Could be inpatient or outpatient,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,Multiplan,Multiplan,,,690.75,,690.75,426.38,690.75,percent of total billed charges,,
HC ANKLE ARTHROGRAM,73615,CPT,,,both,,,862.11,517.27,United Healthcare/Oxford,United Healthcare/Oxford,,525.22,,,525.22,426.38,690.75,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,68.31,,,68.31,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,61.48,,,61.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,45.68,177.65,percent of total billed charges,,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,67.48,,,67.48,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,53.99,,,53.99,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,45.68,,,45.68,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,77.3,,,77.3,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,77.3,,,77.3,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,45.68,177.65,percent of total billed charges,,
HC XR FOOT 2 VIEWS,73620,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,45.68,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,82.95,,,82.95,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,74.65,,,74.65,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,48.31,177.65,percent of total billed charges,,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,72.98,,,72.98,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,58.38,,,58.38,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,48.31,,,48.31,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,91.59,,,91.59,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,91.59,,,91.59,48.31,177.65,other,Could be inpatient or outpatient,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,48.31,177.65,percent of total billed charges,,
HC XR FOOT 3 VIEWS,73630,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,48.31,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,68.31,,,68.31,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Aetna,Commerical,50,102.47,,,102.47,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,61.48,,,61.48,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Aetna,Middlesex Employees,50,92.22,,,92.22,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,64.72,,,64.72,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Anthem,Commerical,50,97.08,,,97.08,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,43.97,177.65,percent of total billed charges,,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Anthem,Indemnity,50,,249.533616,,249.533616,65.96,266.48,percent of total billed charges,,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,64.72,,,64.72,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Anthem,State Preferred,50,97.08,,,97.08,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,51.77,,,51.77,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Anthem,Individual Exchange,50,77.66,,,77.66,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,43.97,,,43.97,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Cigna,Cigna,50,65.96,,,65.96,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,75.88,,,75.88,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Connecticare,Commerical,50,113.82,,,113.82,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,75.88,,,75.88,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Connecticare,Exchange,50,113.82,,,113.82,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,43.97,177.65,percent of total billed charges,,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,Multiplan,Multiplan,50,,282.353,,282.353,65.96,282.353,percent of total billed charges,,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,43.97,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF HEEL 2+ VIEWS,73650,CPT  ,,,both,,,332.18,199.31,United Healthcare/Oxford,United Healthcare/Oxford,50,163.38,,,163.38,65.96,266.48,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,73.16,,,73.16,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,65.84,,,65.84,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,38.74,177.65,percent of total billed charges,,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,56.46,,,56.46,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,45.17,,,45.17,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,38.74,,,38.74,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,88.74,,,88.74,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,88.74,,,88.74,38.74,177.65,other,Could be inpatient or outpatient,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,38.74,177.65,percent of total billed charges,,
HC X-RAY EXAM OF TOE(S) 2+ VIEWS,73660,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,38.74,177.65,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,644.78,386.87,Aetna,Commerical,,358.66,,,358.66,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Aetna,Commerical,50,537.99,,,537.88,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Aetna,Middlesex Employees,,322.79,,,322.79,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Aetna,Middlesex Employees,50,484.19,,,484.19,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Anthem,Commerical,,598.95,,,598.95,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Anthem,Commerical,50,898.43,,,898.43,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Anthem,Indemnity,,,469.04,,469.04,196.71,598.95,percent of total billed charges,,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Anthem,Indemnity,50,,726.538104,,726.538104,295.07,898.43,percent of total billed charges,,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Anthem,State Preferred,,598.95,,,598.95,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Anthem,State Preferred,50,898.43,,,898.43,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Anthem,Individual Exchange,,479.16,,,479.16,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Anthem,Individual Exchange,50,718.74,,,718.74,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Cigna,Cigna,,454.97,,,454.97,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Cigna,Cigna,50,682.46,,,682.46,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Connecticare,Commerical,,573.94,,,573.94,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Connecticare,Commerical,50,860.91,,,860.91,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Connecticare,Exchange,,573.94,,,573.94,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Connecticare,Exchange,50,860.91,,,860.91,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,Multiplan,Multiplan,,,516.72,,516.72,196.71,598.95,percent of total billed charges,,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,Multiplan,Multiplan,50,,822.0945,,822.0945,295.07,898.43,percent of total billed charges,,
HC CT LOW EXT W/O CON,73700,CPT,,,both,,,644.78,386.87,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,598.95,other,Could be inpatient or outpatient,
HC CT LOW EXT W/O CON,73700,CPT  ,,,both,,,967.17,580.3,United Healthcare/Oxford,United Healthcare/Oxford,50,295.07,,,295.07,295.07,898.43,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,494.79,,,494.79,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,445.31,,,445.31,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,445.31,721.41,percent of total billed charges,,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,469.99,,,469.99,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,675.41,,,675.41,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,445.31,721.41,percent of total billed charges,,
HC CT LOW EXT W CON,73701,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,548.53,,,548.53,445.31,721.41,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT  ,,,both,,,1891.08,1134.65,Aetna,Commerical,,1039.67,,,1039.67,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Aetna,Middlesex Employees,,935.71,,,935.71,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Anthem,Commerical,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Anthem,Indemnity,,,1376,,1376,935.71,1515.86,percent of total billed charges,,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Anthem,State Preferred,,1234.47,,,1234.47,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Anthem,Individual Exchange,,987.58,,,987.58,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Cigna,Cigna,,1419.19,,,1419.19,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Connecticare,Commerical,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Connecticare,Exchange,,1321.21,,,1321.21,935.71,1515.86,other,Could be inpatient or outpatient,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,Multiplan,Multiplan,,,1515.86,,1515.86,935.71,1515.86,percent of total billed charges,,
HC CT LOW EXT W/WO CON,73702,CPT,,,both,,,1891.08,1134.65,United Healthcare/Oxford,United Healthcare/Oxford,,1152.6,,,1152.6,935.71,1515.86,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT  ,,,both,,,1169.05,701.43,Aetna,Commerical,,616.02,,,616.02,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Anthem,Commerical,,1204.49,,,1204.49,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Anthem,Indemnity,,,850.49,,850.49,352.71,1204.49,percent of total billed charges,,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Anthem,State Preferred,,1204.49,,,1204.49,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Anthem,Individual Exchange,,963.6,,,963.6,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Cigna,Cigna,,666.42,,,666.42,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Connecticare,Commerical,,1028.35,,,1028.35,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Connecticare,Exchange,,1028.35,,,1028.35,352.71,1204.49,other,Could be inpatient or outpatient,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,Multiplan,Multiplan,,,936.94,,936.94,352.71,1204.49,percent of total billed charges,,
HC CTA LOW EXT WWO CON,73706,CPT,,,both,,,1169.05,701.43,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT  ,,,both,,,1079.44,647.66,Aetna,Commerical,,616.02,,,616.02,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Anthem,Commerical,,1204.49,,,1204.49,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Anthem,Indemnity,,,784.18,,784.18,352.71,1204.49,percent of total billed charges,,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Anthem,State Preferred,,1204.49,,,1204.49,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Anthem,Individual Exchange,,963.6,,,963.6,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Cigna,Cigna,,666.42,,,666.42,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Connecticare,Commerical,,1028.35,,,1028.35,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Connecticare,Exchange,,1028.35,,,1028.35,352.71,1204.49,other,Could be inpatient or outpatient,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,Multiplan,Multiplan,,,863.89,,863.89,352.71,1204.49,percent of total billed charges,,
HC HH CTAEXTLOW W/WO,73706,CPT,,,both,,,1079.44,647.66,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1204.49,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRI LOWER EXTREMITY,73718,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT  ,,,both,,,1461.57,876.94,Aetna,Commerical,,1057.51,,,1057.51,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Aetna,Middlesex Employees,,951.76,,,951.76,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Anthem,Commerical,,946.23,,,946.23,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Anthem,Indemnity,,,1063.31,,1063.31,756.98,1171.39,percent of total billed charges,,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Anthem,State Preferred,,946.23,,,946.23,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Anthem,Individual Exchange,,756.98,,,756.98,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Cigna,Cigna,,924.1,,,924.1,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Connecticare,Commerical,,988.4,,,988.4,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Connecticare,Exchange,,988.4,,,988.4,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,Multiplan,Multiplan,,,1171.39,,1171.39,756.98,1171.39,percent of total billed charges,,
HC MRI LOWER EXTREMITY W CON,73719,CPT,,,both,,,1461.57,876.94,United Healthcare/Oxford,United Healthcare/Oxford,,951.03,,,951.03,756.98,1171.39,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT  ,,,both,,,1626.37,975.82,Aetna,Commerical,,1176.36,,,1176.36,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Aetna,Middlesex Employees,,1058.73,,,1058.73,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Anthem,Commerical,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Anthem,Indemnity,,,1182.82,,1182.82,842.07,1303.05,percent of total billed charges,,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Anthem,State Preferred,,1052.58,,,1052.58,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Anthem,Individual Exchange,,842.07,,,842.07,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Cigna,Cigna,,1027.97,,,1027.97,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Connecticare,Commerical,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Connecticare,Exchange,,1099.5,,,1099.5,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,Multiplan,Multiplan,,,1303.05,,1303.05,842.07,1303.05,percent of total billed charges,,
HC MRI LOWER EXTREMITY WWO CON,73720,CPT,,,both,,,1626.37,975.82,United Healthcare/Oxford,United Healthcare/Oxford,,1057.92,,,1057.92,842.07,1303.05,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Aetna,Commerical,50,1371.33,,,1371.22,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Aetna,Middlesex Employees,50,1234.2,,,1234.2,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Anthem,Commerical,50,1227.03,,,1227.03,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Anthem,Indemnity,50,,1425.221712,,1425.221712,981.63,1519.02,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Anthem,State Preferred,50,1227.03,,,1227.03,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Anthem,Individual Exchange,50,981.63,,,981.63,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Cigna,Cigna,50,1198.35,,,1198.35,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Connecticare,Commerical,50,1281.74,,,1281.74,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Connecticare,Exchange,50,1281.74,,,1281.74,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,Multiplan,Multiplan,50,,1612.671,,1612.671,981.63,1612.671,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WO CONT,73721,CPT  ,,,both,,,1897.26,1138.36,United Healthcare/Oxford,United Healthcare/Oxford,50,1233.27,,,1233.27,981.63,1519.02,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT  ,,,both,,,2427.71,1456.63,Aetna,Commerical,,1755.18,,,1755.18,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Aetna,Middlesex Employees,,1579.66,,,1579.66,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Anthem,Commerical,,1570.5,,,1570.5,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Anthem,Indemnity,,,1764.82,,1764.82,1256.4,1944.21,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Anthem,State Preferred,,1570.5,,,1570.5,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Anthem,Individual Exchange,,1256.4,,,1256.4,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Cigna,Cigna,,1533.76,,,1533.76,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Connecticare,Commerical,,1640.49,,,1640.49,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Connecticare,Exchange,,1640.49,,,1640.49,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,Multiplan,Multiplan,,,1944.21,,1944.21,1256.4,1944.21,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT W CONTRAST,73722,CPT,,,both,,,2427.71,1456.63,United Healthcare/Oxford,United Healthcare/Oxford,,1578.46,,,1578.46,1256.4,1944.21,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT  ,,,both,,,2525.56,1515.34,Aetna,Commerical,,1827.64,,,1827.64,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Aetna,Middlesex Employees,,1644.88,,,1644.88,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Anthem,Commerical,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Anthem,Indemnity,,,1837.67,,1837.67,1308.26,2024.46,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Anthem,State Preferred,,1635.32,,,1635.32,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Anthem,Individual Exchange,,1308.26,,,1308.26,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Cigna,Cigna,,1597.08,,,1597.08,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Connecticare,Commerical,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Connecticare,Exchange,,1708.21,,,1708.21,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,Multiplan,Multiplan,,,2024.46,,2024.46,1308.26,2024.46,percent of total billed charges,,
HC MRI LOWER EXTREMITY JOINT WWO CONTRAST,73723,CPT,,,both,,,2525.56,1515.34,United Healthcare/Oxford,United Healthcare/Oxford,,1643.62,,,1643.62,1308.26,2024.46,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT  ,,,both,,,1264.84,758.9,Aetna,Commerical,,914.22,,,914.22,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Aetna,Middlesex Employees,,822.8,,,822.8,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Anthem,Commerical,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Anthem,Indemnity,,,919.24,,919.24,654.42,1012.68,percent of total billed charges,,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Anthem,State Preferred,,818.02,,,818.02,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Anthem,Individual Exchange,,654.42,,,654.42,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Cigna,Cigna,,798.9,,,798.9,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Connecticare,Commerical,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Connecticare,Exchange,,854.49,,,854.49,654.42,1012.68,other,Could be inpatient or outpatient,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,Multiplan,Multiplan,,,1012.68,,1012.68,654.42,1012.68,percent of total billed charges,,
HC MRA LWR EXTREM W/WO CONTR,73725,CPT,,,both,,,1264.84,758.9,United Healthcare/Oxford,United Healthcare/Oxford,,822.18,,,822.18,654.42,1012.68,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT  ,,,both,,,426.56,255.94,Aetna,Commerical,,234.4,,,234.4,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Aetna,Middlesex Employees,,210.97,,,210.97,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Anthem,Commerical,,278.32,,,278.32,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Anthem,Indemnity,,,310.23,,310.23,210.97,341.77,percent of total billed charges,,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Anthem,State Preferred,,278.32,,,278.32,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Anthem,Individual Exchange,,222.66,,,222.66,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Cigna,Cigna,,319.98,,,319.98,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Connecticare,Commerical,,297.88,,,297.88,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Connecticare,Exchange,,297.88,,,297.88,210.97,341.77,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,Multiplan,Multiplan,,,341.77,,341.77,210.97,341.77,percent of total billed charges,,
HC XR ABDOMEN 1 VIEW,74000,CPT,,,both,,,426.56,255.94,United Healthcare/Oxford,United Healthcare/Oxford,,259.87,,,259.87,210.97,341.77,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT  ,,,both,,,498.52,299.11,Aetna,Commerical,,273.99,,,273.99,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Aetna,Middlesex Employees,,246.59,,,246.59,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Anthem,Commerical,,325.32,,,325.32,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Anthem,Indemnity,,,362.62,,362.62,246.59,399.48,percent of total billed charges,,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Anthem,State Preferred,,325.32,,,325.32,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Anthem,Individual Exchange,,260.26,,,260.26,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Cigna,Cigna,,374,,,374,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Connecticare,Commerical,,348.18,,,348.18,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Connecticare,Exchange,,348.18,,,348.18,246.59,399.48,other,Could be inpatient or outpatient,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,Multiplan,Multiplan,,,399.48,,399.48,246.59,399.48,percent of total billed charges,,
HC AP ABD + OBLIQ & CONE,74010,CPT,,,both,,,498.52,299.11,United Healthcare/Oxford,United Healthcare/Oxford,,303.75,,,303.75,246.59,399.48,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT  ,,,both,,,221.73,133.04,Aetna,Commerical,,68.31,,,68.31,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Aetna,Middlesex Employees,,61.48,,,61.48,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Anthem,Commerical,,57.67,,,57.67,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Anthem,Indemnity,,,161.26,,161.26,46.14,177.65,percent of total billed charges,,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Anthem,State Preferred,,57.67,,,57.67,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Anthem,Individual Exchange,,46.14,,,46.14,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Cigna,Cigna,,,,,,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Connecticare,Commerical,,77.3,,,77.3,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Connecticare,Exchange,,77.3,,,77.3,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,Multiplan,Multiplan,,,177.65,,177.65,46.14,177.65,percent of total billed charges,,
HC XR ABDOMEN 1 VIEW,74018,CPT,,,both,,,221.73,133.04,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,46.14,177.65,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,82.95,,,82.95,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,74.65,,,74.65,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,68.94,,,68.94,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,55.16,327.34,percent of total billed charges,,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,68.94,,,68.94,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,55.16,,,55.16,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,,,,,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,93.01,,,93.01,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,93.01,,,93.01,55.16,327.34,other,Could be inpatient or outpatient,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,55.16,327.34,percent of total billed charges,,
HC XR ABDOMEN 2 VIEWS,74019,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,55.16,327.34,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT  ,,,both,,,660.23,396.14,Aetna,Commerical,,362.44,,,362.44,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Aetna,Middlesex Employees,,326.19,,,326.19,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Anthem,Commerical,,430.33,,,430.33,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Anthem,Indemnity,,,479.68,,479.68,326.19,528.44,percent of total billed charges,,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Anthem,State Preferred,,430.33,,,430.33,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Anthem,Individual Exchange,,344.26,,,344.26,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Cigna,Cigna,,494.74,,,494.74,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Connecticare,Commerical,,460.57,,,460.57,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Connecticare,Exchange,,460.57,,,460.57,326.19,528.44,other,Could be inpatient or outpatient,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,Multiplan,Multiplan,,,528.44,,528.44,326.19,528.44,percent of total billed charges,,
HC ABDOMEN COMPLETE,74020,CPT,,,both,,,660.23,396.14,United Healthcare/Oxford,United Healthcare/Oxford,,401.8,,,401.8,326.19,528.44,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT  ,,,both,,,529.42,317.65,Aetna,Commerical,,290.69,,,290.69,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Aetna,Middlesex Employees,,261.62,,,261.62,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Anthem,Commerical,,345.15,,,345.15,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Anthem,Indemnity,,,384.72,,384.72,261.62,423.83,percent of total billed charges,,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Anthem,State Preferred,,345.15,,,345.15,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Anthem,Individual Exchange,,276.12,,,276.12,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Cigna,Cigna,,396.8,,,396.8,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Connecticare,Commerical,,369.41,,,369.41,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Connecticare,Exchange,,369.41,,,369.41,261.62,423.83,other,Could be inpatient or outpatient,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,Multiplan,Multiplan,,,423.83,,423.83,261.62,423.83,percent of total billed charges,,
HC XR ABDOMEN 3 OR MORE VIEWS,74021,CPT,,,both,,,529.42,317.65,United Healthcare/Oxford,United Healthcare/Oxford,,322.27,,,322.27,261.62,423.83,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT  ,,,both,,,644.78,386.87,Aetna,Commerical,,306.17,,,306.17,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Aetna,Middlesex Employees,,275.56,,,275.56,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Anthem,Commerical,,415.18,,,415.18,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Anthem,Indemnity,,,469.04,,469.04,196.71,519.46,percent of total billed charges,,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Anthem,State Preferred,,415.18,,,415.18,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Anthem,Individual Exchange,,332.14,,,332.14,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Cigna,Cigna,,519.46,,,519.46,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Connecticare,Commerical,,463.61,,,463.61,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Connecticare,Exchange,,463.61,,,463.61,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,Multiplan,Multiplan,,,516.72,,516.72,196.71,519.46,percent of total billed charges,,
HC CT ABD W/O CON,74150,CPT,,,both,,,644.78,386.87,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,196.71,519.46,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT  ,,,both,,,989.83,593.9,Aetna,Commerical,,616.05,,,616.05,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Aetna,Middlesex Employees,,554.45,,,554.45,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Anthem,Commerical,,771.29,,,771.29,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Anthem,Indemnity,,,720.33,,720.33,352.71,903.09,percent of total billed charges,,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Anthem,State Preferred,,771.29,,,771.29,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Anthem,Individual Exchange,,617.04,,,617.04,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Cigna,Cigna,,628.09,,,628.09,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Connecticare,Commerical,,903.09,,,903.09,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Connecticare,Exchange,,903.09,,,903.09,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,Multiplan,Multiplan,,,793.55,,793.55,352.71,903.09,percent of total billed charges,,
HC CT ABD W/ CON,74160,CPT,,,both,,,989.83,593.9,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,903.09,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT  ,,,both,,,1131.97,679.18,Aetna,Commerical,,616.02,,,616.02,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Anthem,Commerical,,887.79,,,887.79,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Anthem,Indemnity,,,823.48,,823.48,352.71,1029.96,percent of total billed charges,,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Anthem,State Preferred,,887.79,,,887.79,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Anthem,Individual Exchange,,710.24,,,710.24,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Cigna,Cigna,,778.1,,,778.1,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Connecticare,Commerical,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Connecticare,Exchange,,1029.96,,,1029.96,352.71,1029.96,other,Could be inpatient or outpatient,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,Multiplan,Multiplan,,,907.18,,907.18,352.71,1029.96,percent of total billed charges,,
HC CT ABD W/WO CONTRAST,74170,CPT,,,both,,,1131.97,679.18,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1029.96,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT  ,,,both,,,2404.02,1442.41,Aetna,Commerical,,643.84,,,643.84,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Aetna,Middlesex Employees,,579.46,,,579.46,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Anthem,Commerical,,764.47,,,764.47,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Anthem,Indemnity,,,852.13,,852.13,579.46,938.74,percent of total billed charges,,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Anthem,State Preferred,,764.47,,,764.47,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Anthem,Individual Exchange,,611.58,,,611.58,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Cigna,Cigna,,878.87,,,878.87,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Connecticare,Commerical,,818.2,,,818.2,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Connecticare,Exchange,,818.2,,,818.2,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,Multiplan,Multiplan,,,938.74,,938.74,579.46,938.74,percent of total billed charges,,
HC CTA ABD & PELVIS W/WO CONT,74174,CPT,,,both,,,2404.02,1442.41,United Healthcare/Oxford,United Healthcare/Oxford,,713.78,,,713.78,579.46,938.74,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT  ,,,both,,,1170.08,702.05,Aetna,Commerical,,616.02,,,616.02,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Anthem,Commerical,,999.36,,,999.36,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Anthem,Indemnity,,,851.31,,851.31,352.71,1030.2,percent of total billed charges,,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Anthem,State Preferred,,999.36,,,999.36,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Anthem,Individual Exchange,,799.5,,,799.5,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Cigna,Cigna,,759.48,,,759.48,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Connecticare,Commerical,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Connecticare,Exchange,,1030.2,,,1030.2,352.71,1030.2,other,Could be inpatient or outpatient,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,Multiplan,Multiplan,,,937.84,,937.84,352.71,1030.2,percent of total billed charges,,
HC CTA ABD W/WO,74175,CPT,,,both,,,1170.08,702.05,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1030.2,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT  ,,,both,,,1052.35,631.41,Aetna,Commerical,,385.48,,,385.48,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Aetna,Middlesex Employees,,346.93,,,346.93,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Anthem,Commerical,,523.46,,,523.46,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Anthem,Indemnity,,,765.35,,765.35,346.93,843.15,percent of total billed charges,,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Anthem,State Preferred,,523.46,,,523.46,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Anthem,Individual Exchange,,418.77,,,418.77,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Cigna,Cigna,,796.66,,,796.66,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Connecticare,Commerical,,583.14,,,583.14,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Connecticare,Exchange,,583.14,,,583.14,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,Multiplan,Multiplan,,,843.15,,843.15,346.93,843.15,percent of total billed charges,,
HC CT ABD / PELVIS WO,74176,CPT,,,both,,,1052.35,631.41,United Healthcare/Oxford,United Healthcare/Oxford,,403.11,,,403.11,346.93,843.15,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT  ,,,both,,,1052.66,631.6,Aetna,Commerical,,807.58,,,807.58,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Aetna,Middlesex Employees,,726.83,,,726.83,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Anthem,Commerical,,1015.78,,,1015.78,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Anthem,Indemnity,,,765.35,,765.35,674.66,1175.22,percent of total billed charges,,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Anthem,State Preferred,,1015.78,,,1015.78,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Anthem,Individual Exchange,,812.62,,,812.62,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Cigna,Cigna,,942.1,,,942.1,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Connecticare,Commerical,,1175.22,,,1175.22,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Connecticare,Exchange,,1175.22,,,1175.22,674.66,1175.22,other,Could be inpatient or outpatient,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,Multiplan,Multiplan,,,843.15,,843.15,674.66,1175.22,percent of total billed charges,,
HC CT ABD & PELV W/CONTRAST,74177,CPT,,,both,,,1052.66,631.6,United Healthcare/Oxford,United Healthcare/Oxford,,674.66,,,674.66,674.66,1175.22,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT  ,,,both,,,3911.94,2347.16,Aetna,Commerical,,807.58,,,807.58,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Aetna,Middlesex Employees,,726.83,,,726.83,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Anthem,Commerical,,1015.78,,,1015.78,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Anthem,Indemnity,,,2845.32,,2845.32,674.66,3134.54,percent of total billed charges,,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Anthem,State Preferred,,1015.78,,,1015.78,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Anthem,Individual Exchange,,812.62,,,812.62,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Cigna,Cigna,,942.1,,,942.1,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Connecticare,Commerical,,1175.22,,,1175.22,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Connecticare,Exchange,,1175.22,,,1175.22,674.66,3134.54,other,Could be inpatient or outpatient,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,Multiplan,Multiplan,,,3134.54,,3134.54,674.66,3134.54,percent of total billed charges,,
HC ENTEROGRAPHY,74177,CPT,,,both,,,3911.94,2347.16,United Healthcare/Oxford,United Healthcare/Oxford,,674.66,,,674.66,674.66,3134.54,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT  ,,,both,,,1126.82,676.09,Aetna,Commerical,,916.16,,,916.16,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Aetna,Middlesex Employees,,824.55,,,824.55,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Anthem,Commerical,,1166.77,,,1166.77,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Anthem,Indemnity,,,819.38,,819.38,674.66,1342.79,percent of total billed charges,,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Anthem,State Preferred,,1166.77,,,1166.77,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Anthem,Individual Exchange,,933.41,,,933.41,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Cigna,Cigna,,1167.17,,,1167.17,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Connecticare,Commerical,,1342.79,,,1342.79,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Connecticare,Exchange,,1342.79,,,1342.79,674.66,1342.79,other,Could be inpatient or outpatient,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,Multiplan,Multiplan,,,902.67,,902.67,674.66,1342.79,percent of total billed charges,,
HC CT ABD & PELVIS >= 1 REGIONS W/WO CONTRAST,74178,CPT,,,both,,,1126.82,676.09,United Healthcare/Oxford,United Healthcare/Oxford,,674.66,,,674.66,674.66,1342.79,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI ABDOMEN WO CONT,74181,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI ABDOMEN W CONTRAST,74182,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT  ,,,both,,,2710.96,1626.58,Aetna,Commerical,,1961.14,,,1961.14,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Aetna,Middlesex Employees,,1765.02,,,1765.02,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Anthem,Commerical,,1754.79,,,1754.79,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Anthem,Indemnity,,,1971.92,,1971.92,1403.83,2172.35,percent of total billed charges,,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Anthem,State Preferred,,1754.79,,,1754.79,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Anthem,Individual Exchange,,1403.83,,,1403.83,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Cigna,Cigna,,1713.74,,,1713.74,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Connecticare,Commerical,,1833,,,1833,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Connecticare,Exchange,,1833,,,1833,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,Multiplan,Multiplan,,,2172.35,,2172.35,1403.83,2172.35,percent of total billed charges,,
HC MRI ABDOMEN W & WO CONTRAST,74183,CPT,,,both,,,2710.96,1626.58,United Healthcare/Oxford,United Healthcare/Oxford,,1763.69,,,1763.69,1403.83,2172.35,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRA ABDOMEN W / W/O CONT,74185,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,222.02,,,222.02,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,199.82,,,199.82,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,162.48,,,162.48,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,109.45,721.41,percent of total billed charges,,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,162.48,,,162.48,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,129.99,,,129.99,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,109.45,,,109.45,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,235.86,,,235.86,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,235.86,,,235.86,109.45,721.41,other,Could be inpatient or outpatient,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,109.45,721.41,percent of total billed charges,,
HC XR PHARYNX/CERV ESOPH,74210,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,226.9,,,226.9,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,204.22,,,204.22,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,162.48,,,162.48,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,109.45,721.41,percent of total billed charges,,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,162.48,,,162.48,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,129.99,,,129.99,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,109.45,,,109.45,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,253,,,253,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,253,,,253,109.45,721.41,other,Could be inpatient or outpatient,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,109.45,721.41,percent of total billed charges,,
HC ESOPHOGRAM COMPLETE,74220,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,109.45,721.41,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,352.55,,,352.55,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,317.3,,,317.3,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,178.99,,,178.99,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,119.76,404.4,percent of total billed charges,,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,178.99,,,178.99,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,143.19,,,143.19,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,119.76,,,119.76,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,404.4,,,404.4,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,404.4,,,404.4,119.76,404.4,other,Could be inpatient or outpatient,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,119.76,404.4,percent of total billed charges,,
HC SWALLOWING FCN W CINE/VIDEO,74230,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,119.76,404.4,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT  ,,,both,,,339.9,203.94,Aetna,Commerical,,186.78,,,186.78,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Aetna,Middlesex Employees,,168.1,,,168.1,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Anthem,Commerical,,221.78,,,221.78,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Anthem,Indemnity,,,247.2,,247.2,168.1,272.33,percent of total billed charges,,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Anthem,State Preferred,,221.78,,,221.78,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Anthem,Individual Exchange,,177.42,,,177.42,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Cigna,Cigna,,254.97,,,254.97,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Connecticare,Commerical,,237.36,,,237.36,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Connecticare,Exchange,,237.36,,,237.36,168.1,272.33,other,Could be inpatient or outpatient,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,Multiplan,Multiplan,,,272.33,,272.33,168.1,272.33,percent of total billed charges,,
HC RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,74235,CPT,,,both,,,339.9,203.94,United Healthcare/Oxford,United Healthcare/Oxford,,207.07,,,207.07,168.1,272.33,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,273.25,,,273.25,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,245.92,,,245.92,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,201.03,,,201.03,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,134.38,721.41,percent of total billed charges,,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,201.03,,,201.03,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,160.82,,,160.82,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,134.38,,,134.38,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,351.54,,,351.54,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,351.54,,,351.54,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,134.38,721.41,percent of total billed charges,,
HC FL UPPER GI WO KUB,74240,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,134.38,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,,,,,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,,,,,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,203.79,,,203.79,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,163.03,721.41,percent of total billed charges,,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,203.79,,,203.79,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,163.03,,,163.03,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,,,,,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,372.96,,,372.96,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,372.96,,,372.96,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,163.03,721.41,percent of total billed charges,,
HC FL UPPER GI W KUB,74241,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,163.03,721.41,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,,,,,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,,,,,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,326.33,,,326.33,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,261.06,663.7,percent of total billed charges,,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,326.33,,,326.33,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,261.06,,,261.06,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,,,,,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,564.34,,,564.34,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,564.34,,,564.34,261.06,663.7,other,Could be inpatient or outpatient,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,261.06,663.7,percent of total billed charges,,
HC FL UPPER GI SMALL BOWEL FOLLOW THROUGH,74245,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,261.06,663.7,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT  ,,,both,,,985.71,591.43,Aetna,Commerical,,162.25,,,162.25,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Aetna,Middlesex Employees,,146.03,,,146.03,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Anthem,Commerical,,619.74,,,619.74,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Anthem,Indemnity,,,717.06,,717.06,146.03,789.95,percent of total billed charges,,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Anthem,State Preferred,,619.74,,,619.74,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Anthem,Individual Exchange,,495.79,,,495.79,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Cigna,Cigna,,,,,,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Connecticare,Commerical,,258,,,258,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Connecticare,Exchange,,258,,,258,146.03,789.95,other,Could be inpatient or outpatient,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,Multiplan,Multiplan,,,789.95,,789.95,146.03,789.95,percent of total billed charges,,
HC XRAY SMALL INT FOLLOW THROUGH STUDY,74248,CPT,,,both,,,985.71,591.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.03,789.95,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,274.47,,,274.47,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,247.02,,,247.02,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,178.99,,,178.99,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,119.76,358.68,percent of total billed charges,,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,178.99,,,178.99,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,143.19,,,143.19,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,119.76,,,119.76,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,358.68,,,358.68,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,358.68,,,358.68,119.76,358.68,other,Could be inpatient or outpatient,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,119.76,358.68,percent of total billed charges,,
HC SMALL BOWEL(ONLY),74250,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,119.76,358.68,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,350.09,,,350.09,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,315.09,,,315.09,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,235.46,,,235.46,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,157.56,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,235.46,,,235.46,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,188.37,,,188.37,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,157.56,,,157.56,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,508.64,,,508.64,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,508.64,,,508.64,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,157.56,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA,74270,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,157.56,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,544.08,,,544.08,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,489.68,,,489.68,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,307.05,,,307.05,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,205.83,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,307.05,,,307.05,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,245.65,,,245.65,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,205.83,,,205.83,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,714.32,,,714.32,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,714.32,,,714.32,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,205.83,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA AIR CONTRAST,74280,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,205.83,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,495.27,,,495.27,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,445.75,,,445.75,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,351.12,,,351.12,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,235.16,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,351.12,,,351.12,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,280.9,,,280.9,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,235.16,,,235.16,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,524.36,,,524.36,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,524.36,,,524.36,235.16,721.41,other,Could be inpatient or outpatient,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,235.16,721.41,percent of total billed charges,,
HC FL BARIUM ENEMA INTUSSUSCEPTION REDUCTION,74283,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,235.16,721.41,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT  ,,,both,,,106.09,63.65,Aetna,Commerical,,58.86,,,58.86,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Aetna,Middlesex Employees,,52.97,,,52.97,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Anthem,Commerical,,130.81,,,130.81,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Anthem,Indemnity,,,76.94,,76.94,52.97,139.46,percent of total billed charges,,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Anthem,State Preferred,,130.81,,,130.81,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Anthem,Individual Exchange,,104.65,,,104.65,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Cigna,Cigna,,82.04,,,82.04,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Connecticare,Commerical,,139.46,,,139.46,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Connecticare,Exchange,,139.46,,,139.46,52.97,139.46,other,Could be inpatient or outpatient,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,Multiplan,Multiplan,,,84.76,,84.76,52.97,139.46,percent of total billed charges,,
HC XR CHOLANGIOGRAM-OR,74300,CPT,,,both,,,106.09,63.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.97,139.46,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,33.39,,,33.39,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,30.05,,,30.05,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.65,,,39.65,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,30.05,48.7,percent of total billed charges,,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,39.65,,,39.65,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.72,,,31.72,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,45.59,,,45.59,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,42.44,,,42.44,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,42.44,,,42.44,30.05,48.7,other,Could be inpatient or outpatient,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,30.05,48.7,percent of total billed charges,,
HC CHOLANGIOGRAM ADDTL INTRAOP,74301,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,37.03,,,37.03,30.05,48.7,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT  ,,,both,,,775.59,465.35,Aetna,Commerical,,426.14,,,426.14,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Aetna,Middlesex Employees,,383.53,,,383.53,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Anthem,Commerical,,505.97,,,505.97,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Anthem,Indemnity,,,563.99,,563.99,383.53,621.32,percent of total billed charges,,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Anthem,State Preferred,,505.97,,,505.97,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Anthem,Individual Exchange,,404.78,,,404.78,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Cigna,Cigna,,581.69,,,581.69,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Connecticare,Commerical,,541.53,,,541.53,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Connecticare,Exchange,,541.53,,,541.53,383.53,621.32,other,Could be inpatient or outpatient,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,Multiplan,Multiplan,,,621.32,,621.32,383.53,621.32,percent of total billed charges,,
HC HH TTUBE CHOLANG,74305,CPT,,,both,,,775.59,465.35,United Healthcare/Oxford,United Healthcare/Oxford,,472.42,,,472.42,383.53,621.32,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT  ,,,both,,,575.77,345.46,Aetna,Commerical,,316.67,,,316.67,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Aetna,Middlesex Employees,,285,,,285,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Anthem,Commerical,,375.99,,,375.99,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Anthem,Indemnity,,,419.1,,419.1,285,461.7,percent of total billed charges,,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Anthem,State Preferred,,375.99,,,375.99,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Anthem,Individual Exchange,,300.79,,,300.79,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Cigna,Cigna,,432.26,,,432.26,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Connecticare,Commerical,,402.42,,,402.42,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Connecticare,Exchange,,402.42,,,402.42,285,461.7,other,Could be inpatient or outpatient,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,Multiplan,Multiplan,,,461.7,,461.7,285,461.7,percent of total billed charges,,
HC FL XHEPATIC CHOLANGIOGRAM,74320,CPT,,,both,,,575.77,345.46,United Healthcare/Oxford,United Healthcare/Oxford,,351.07,,,351.07,285,461.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT  ,,,both,,,1150.51,690.31,Aetna,Commerical,,631.47,,,631.47,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Aetna,Middlesex Employees,,568.33,,,568.33,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Anthem,Commerical,,749.79,,,749.79,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Anthem,Indemnity,,,835.75,,835.75,568.33,920.7,percent of total billed charges,,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Anthem,State Preferred,,749.79,,,749.79,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Anthem,Individual Exchange,,599.82,,,599.82,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Cigna,Cigna,,861.98,,,861.98,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Connecticare,Commerical,,802.48,,,802.48,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Connecticare,Exchange,,802.48,,,802.48,568.33,920.7,other,Could be inpatient or outpatient,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,Multiplan,Multiplan,,,920.7,,920.7,568.33,920.7,percent of total billed charges,,
HC ERCP,74330,CPT,,,both,,,1150.51,690.31,United Healthcare/Oxford,United Healthcare/Oxford,,700.06,,,700.06,568.33,920.7,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT  ,,,both,,,290.46,174.28,Aetna,Commerical,,88.89,,,88.89,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Aetna,Middlesex Employees,,80,,,80,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Anthem,Commerical,,359.37,,,359.37,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Anthem,Indemnity,,,211.19,,211.19,80,359.37,percent of total billed charges,,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Anthem,State Preferred,,359.37,,,359.37,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Anthem,Individual Exchange,,287.5,,,287.5,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Cigna,Cigna,,240.36,,,240.36,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Connecticare,Commerical,,332.12,,,332.12,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Connecticare,Exchange,,332.12,,,332.12,80,359.37,other,Could be inpatient or outpatient,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,Multiplan,Multiplan,,,232.65,,232.65,80,359.37,percent of total billed charges,,
HC X-RAY GUIDE FOR GI TUBE,74340,CPT,,,both,,,290.46,174.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80,359.37,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT  ,,,both,,,306.94,184.16,Aetna,Commerical,,168.85,,,168.85,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Aetna,Middlesex Employees,,151.97,,,151.97,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Anthem,Commerical,,200.48,,,200.48,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Anthem,Indemnity,,,223.47,,223.47,151.97,246.19,percent of total billed charges,,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Anthem,State Preferred,,200.48,,,200.48,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Anthem,Individual Exchange,,160.38,,,160.38,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Cigna,Cigna,,230.48,,,230.48,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Connecticare,Commerical,,214.57,,,214.57,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Connecticare,Exchange,,214.57,,,214.57,151.97,246.19,other,Could be inpatient or outpatient,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,Multiplan,Multiplan,,,246.19,,246.19,151.97,246.19,percent of total billed charges,,
HC PERC ENTEROCLYSIS TUBE,74355,CPT,,,both,,,306.94,184.16,United Healthcare/Oxford,United Healthcare/Oxford,,187.18,,,187.18,151.97,246.19,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT  ,,,both,,,348.14,208.88,Aetna,Commerical,,191.11,,,191.11,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Aetna,Middlesex Employees,,172,,,172,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Anthem,Commerical,,226.91,,,226.91,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Anthem,Indemnity,,,252.94,,252.94,172,278.65,percent of total billed charges,,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Anthem,State Preferred,,226.91,,,226.91,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Anthem,Individual Exchange,,181.53,,,181.53,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Cigna,Cigna,,260.87,,,260.87,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Connecticare,Commerical,,242.86,,,242.86,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Connecticare,Exchange,,242.86,,,242.86,172,278.65,other,Could be inpatient or outpatient,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,Multiplan,Multiplan,,,278.65,,278.65,172,278.65,percent of total billed charges,,
HC DILATE FOR STRICTURE/OBSTR,74360,CPT,,,both,,,348.14,208.88,United Healthcare/Oxford,United Healthcare/Oxford,,211.87,,,211.87,172,278.65,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT  ,,,both,,,1439.94,863.96,Aetna,Commerical,,791.05,,,791.05,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Aetna,Middlesex Employees,,711.94,,,711.94,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Anthem,Commerical,,939.25,,,939.25,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Anthem,Indemnity,,,1046.94,,1046.94,711.94,1153.36,percent of total billed charges,,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Anthem,State Preferred,,939.25,,,939.25,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Anthem,Individual Exchange,,751.4,,,751.4,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Cigna,Cigna,,1079.8,,,1079.8,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Connecticare,Commerical,,1005.26,,,1005.26,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Connecticare,Exchange,,1005.26,,,1005.26,711.94,1153.36,other,Could be inpatient or outpatient,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,Multiplan,Multiplan,,,1153.36,,1153.36,711.94,1153.36,percent of total billed charges,,
HC PTHD BILE DUCT STRICTURE,74363,CPT,,,both,,,1439.94,863.96,United Healthcare/Oxford,United Healthcare/Oxford,,876.96,,,876.96,711.94,1153.36,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT  ,,,both,,,912.58,547.55,Aetna,Commerical,,354.99,,,354.99,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Aetna,Middlesex Employees,,319.49,,,319.49,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Anthem,Commerical,,232.7,,,232.7,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Anthem,Indemnity,,,663.85,,663.85,155.81,731.33,percent of total billed charges,,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Anthem,State Preferred,,232.7,,,232.7,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Anthem,Individual Exchange,,186.16,,,186.16,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Cigna,Cigna,,155.81,,,155.81,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Connecticare,Commerical,,380.09,,,380.09,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Connecticare,Exchange,,380.09,,,380.09,155.81,731.33,other,Could be inpatient or outpatient,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,Multiplan,Multiplan,,,731.33,,731.33,155.81,731.33,percent of total billed charges,,
HC IVP W/WO TOMO/KUB,74400,CPT,,,both,,,912.58,547.55,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,155.81,731.33,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT  ,,,both,,,978.5,587.1,Aetna,Commerical,,537.46,,,537.46,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Aetna,Middlesex Employees,,483.72,,,483.72,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Anthem,Commerical,,638.16,,,638.16,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Anthem,Indemnity,,,711.33,,711.33,483.72,783.63,percent of total billed charges,,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Anthem,State Preferred,,638.16,,,638.16,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Anthem,Individual Exchange,,510.52,,,510.52,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Cigna,Cigna,,733.66,,,733.66,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Connecticare,Commerical,,683,,,683,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Connecticare,Exchange,,683,,,683,483.72,783.63,other,Could be inpatient or outpatient,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,Multiplan,Multiplan,,,783.63,,782.63,483.72,783.63,percent of total billed charges,,
HC INFUSION STUDY,74410,CPT,,,both,,,978.5,587.1,United Healthcare/Oxford,United Healthcare/Oxford,,595.84,,,595.84,483.72,783.63,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT  ,,,both,,,1626.37,975.82,Aetna,Commerical,,893.72,,,893.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Aetna,Middlesex Employees,,804.35,,,804.35,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Anthem,Commerical,,1061.15,,,1061.15,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Anthem,Indemnity,,,1182.82,,1182.82,804.35,1303.05,percent of total billed charges,,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Anthem,State Preferred,,1061.15,,,1061.15,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Anthem,Individual Exchange,,848.93,,,848.93,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Cigna,Cigna,,1219.95,,,1219.95,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Connecticare,Commerical,,1135.72,,,1135.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Connecticare,Exchange,,1135.72,,,1135.72,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,Multiplan,Multiplan,,,1303.05,,1303.05,804.35,1303.05,percent of total billed charges,,
HC FL RETROGRADE PYELOGRAM WWO KUB,74420,CPT,,,both,,,1626.37,975.82,United Healthcare/Oxford,United Healthcare/Oxford,,990.79,,,990.79,804.35,1303.05,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,494.79,,,494.79,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,445.31,,,445.31,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,445.31,721.41,percent of total billed charges,,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,469.99,,,469.99,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,675.41,,,675.41,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,445.31,721.41,percent of total billed charges,,
HC FL LOOPOGRAM/ANTEGRADE PYELOGRAM,74425,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,548.53,,,548.53,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT  ,,,both,,,900.22,540.13,Aetna,Commerical,,494.79,,,494.79,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Aetna,Middlesex Employees,,445.31,,,445.31,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Anthem,Commerical,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Anthem,Indemnity,,,654.85,,654.85,445.31,721.41,percent of total billed charges,,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Anthem,State Preferred,,587.49,,,587.49,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Anthem,Individual Exchange,,469.99,,,469.99,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Cigna,Cigna,,675.41,,,675.41,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Connecticare,Commerical,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Connecticare,Exchange,,628.78,,,628.78,445.31,721.41,other,Could be inpatient or outpatient,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,Multiplan,Multiplan,,,721.41,,721.41,445.31,721.41,percent of total billed charges,,
HC CONTRAST X-RAY BLADDER 3+ VIEWS,74430,CPT,,,both,,,900.22,540.13,United Healthcare/Oxford,United Healthcare/Oxford,,548.53,,,548.53,445.31,721.41,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,455.21,,,455.21,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,409.68,,,409.68,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,409.68,663.7,percent of total billed charges,,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,432.39,,,432.39,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,621.37,,,621.37,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,409.68,663.7,percent of total billed charges,,
HC XR URETHRG RETRD S/I,74450,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,504.65,,,504.65,409.68,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,278.14,,,278.14,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,250.33,,,250.33,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,217.54,,,217.54,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,145.54,663.7,percent of total billed charges,,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,217.54,,,217.54,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,174.02,,,174.02,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,145.54,,,145.54,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,297.27,,,297.27,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,297.27,,,297.27,145.54,663.7,other,Could be inpatient or outpatient,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,145.54,663.7,percent of total billed charges,,
HC VOIDING URETHROCYSTOGRAM,74455,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,403.11,,,403.11,145.54,663.7,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT  ,,,both,,,3018.93,1811.36,Aetna,Commerical,,1659.4,,,1659.4,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Aetna,Middlesex Employees,,1493.46,,,1493.46,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Anthem,Commerical,,1970.29,,,1970.29,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Anthem,Indemnity,,,2196.2,,2196.2,1493.46,2419.43,percent of total billed charges,,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Anthem,State Preferred,,1970.29,,,1970.29,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Anthem,Individual Exchange,,1576.23,,,1576.23,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Cigna,Cigna,,2265.14,,,2265.14,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Connecticare,Commerical,,2108.76,,,2108.76,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Connecticare,Exchange,,2108.76,,,2108.76,1493.46,2419.43,other,Could be inpatient or outpatient,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,Multiplan,Multiplan,,,2419.43,,2419.43,1493.46,2419.43,percent of total billed charges,,
HC NEPHROSTOGRAM,74475,CPT,,,both,,,3018.93,1811.36,United Healthcare/Oxford,United Healthcare/Oxford,,1839.64,,,1839.64,1493.46,2419.43,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT  ,,,both,,,15186.32,9111.79,Aetna,Commerical,,8345.26,,,8345.26,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Aetna,Middlesex Employees,,7510.74,,,7510.74,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Anthem,Commerical,,9908.74,,,9908.74,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Anthem,Indemnity,,,11044.85,,11044.85,7510.74,12167.51,percent of total billed charges,,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Anthem,State Preferred,,9908.74,,,9908.74,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Anthem,Individual Exchange,,7926.99,,,7926.99,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Cigna,Cigna,,11391.54,,,11391.54,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Connecticare,Commerical,,10605.08,,,10605.08,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Connecticare,Exchange,,10605.08,,,10605.08,7510.74,12167.51,other,Could be inpatient or outpatient,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,Multiplan,Multiplan,,,12167.51,,12167.51,7510.74,12167.51,percent of total billed charges,,
HC PERCSTNTPLACUREIR,74480,CPT,,,both,,,15186.32,9111.79,United Healthcare/Oxford,United Healthcare/Oxford,,9251.67,,,9251.67,7510.74,12167.51,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT  ,,,both,,,365.65,219.39,Aetna,Commerical,,201.01,,,201.01,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Aetna,Middlesex Employees,,180.91,,,180.91,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Anthem,Commerical,,238.67,,,238.67,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Anthem,Indemnity,,,266.03,,266.03,180.91,293.07,percent of total billed charges,,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Anthem,State Preferred,,238.67,,,238.67,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Anthem,Individual Exchange,,190.94,,,190.94,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Cigna,Cigna,,274.38,,,274.38,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Connecticare,Commerical,,255.44,,,255.44,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Connecticare,Exchange,,255.44,,,255.44,180.91,293.07,other,Could be inpatient or outpatient,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,Multiplan,Multiplan,,,293.07,,293.07,180.91,293.07,percent of total billed charges,,
HC DILATE URETERS/URETHRA/NEPHROSTOMY,74485,CPT,,,both,,,365.65,219.39,United Healthcare/Oxford,United Healthcare/Oxford,,222.84,,,222.84,180.91,293.07,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT  ,,,both,,,902.28,541.37,Aetna,Commerical,,805.37,,,805.37,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Aetna,Middlesex Employees,,725.35,,,725.35,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Anthem,Commerical,,979.28,,,979.28,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Anthem,Indemnity,,,655.84,,655.84,387.28,1243.64,percent of total billed charges,,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Anthem,State Preferred,,979.28,,,979.28,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Anthem,Individual Exchange,,783.42,,,783.42,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Cigna,Cigna,,855.63,,,855.63,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Connecticare,Commerical,,1243.64,,,1243.64,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Connecticare,Exchange,,1243.64,,,1243.64,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,Multiplan,Multiplan,,,722.5,,722.5,387.28,1243.64,percent of total billed charges,,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,74712,CPT,,,both,,,902.28,541.37,United Healthcare/Oxford,United Healthcare/Oxford,,387.28,,,387.28,387.28,1243.64,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT  ,,,both,,,520.15,312.09,Aetna,Commerical,,419.71,,,419.71,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Aetna,Middlesex Employees,,378.01,,,378.01,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Anthem,Commerical,,419.71,,,419.71,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Anthem,Indemnity,,,378.07,,378.07,335.77,855.63,percent of total billed charges,,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Anthem,State Preferred,,419.71,,,419.71,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Anthem,Individual Exchange,,335.77,,,335.77,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Cigna,Cigna,,855.63,,,855.63,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Connecticare,Commerical,,768.87,,,768.87,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Connecticare,Exchange,,768.87,,,768.87,335.77,855.63,other,Could be inpatient or outpatient,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,Multiplan,Multiplan,,,416.5,,416.5,335.77,855.63,percent of total billed charges,,
HC FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,74713,CPT,,,both,,,520.15,312.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,335.77,855.63,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,224.51,,,224.51,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,202.06,,,202.06,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,202.06,327.34,percent of total billed charges,,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,266.57,,,266.57,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,213.26,,,213.26,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,306.47,,,306.47,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,285.3,,,285.3,202.06,327.34,other,Could be inpatient or outpatient,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,202.06,327.34,percent of total billed charges,,
HC PERINEOGRAM (FOR SEX DETERM OR EXT OF ANOMALIES),74775,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,248.9,,,248.9,202.06,327.34,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT  ,,,both,,,2448.31,1468.99,Aetna,Commerical,,1771.46,,,1771.46,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Aetna,Middlesex Employees,,1594.31,,,1594.31,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Anthem,Commerical,,1585.06,,,1585.06,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Anthem,Indemnity,,,1781.19,,1781.19,1268.05,1962.24,percent of total billed charges,,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Anthem,State Preferred,,1585.06,,,1585.06,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Anthem,Individual Exchange,,1268.05,,,1268.05,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Cigna,Cigna,,1547.99,,,1547.99,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Connecticare,Commerical,,1655.71,,,1655.71,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Connecticare,Exchange,,1655.71,,,1655.71,1268.05,1962.24,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,Multiplan,Multiplan,,,1962.24,,1962.24,1268.05,1962.24,percent of total billed charges,,
HC CARDIAC MRI FOR MORPH,75557,CPT,,,both,,,2448.31,1468.99,United Healthcare/Oxford,United Healthcare/Oxford,,1593.11,,,1593.11,1268.05,1962.24,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT  ,,,both,,,2132.1,1279.26,Aetna,Commerical,,1541.89,,,1541.89,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Aetna,Middlesex Employees,,1387.7,,,1387.7,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Anthem,Commerical,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Anthem,Indemnity,,,1550.35,,1550.35,1103.71,1707.94,percent of total billed charges,,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Anthem,State Preferred,,1379.64,,,1379.64,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Anthem,Individual Exchange,,1103.71,,,1103.71,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Cigna,Cigna,,1347.38,,,1347.38,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Connecticare,Commerical,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Connecticare,Exchange,,1441.13,,,1441.13,1103.71,1707.94,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,Multiplan,Multiplan,,,1707.94,,1707.94,1103.71,1707.94,percent of total billed charges,,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O CON,75559,CPT,,,both,,,2132.1,1279.26,United Healthcare/Oxford,United Healthcare/Oxford,,1386.65,,,1386.65,1103.71,1707.94,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT  ,,,both,,,3438.14,2062.88,Aetna,Commerical,,2487.04,,,2487.04,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Aetna,Middlesex Employees,,2238.34,,,2238.34,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Anthem,Commerical,,2225.35,,,2225.35,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Anthem,Indemnity,,,2500.71,,2500.71,1780.28,2754.89,percent of total billed charges,,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Anthem,State Preferred,,2225.35,,,2225.35,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Anthem,Individual Exchange,,1780.28,,,1780.28,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Cigna,Cigna,,2173.31,,,2173.31,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Connecticare,Commerical,,2324.54,,,2324.54,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Connecticare,Exchange,,2324.54,,,2324.54,1780.28,2754.89,other,Could be inpatient or outpatient,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,Multiplan,Multiplan,,,2754.89,,2754.89,1780.28,2754.89,percent of total billed charges,,
HC CARDIAC MRI FOR MORPH W/DYE,75561,CPT,,,both,,,3438.14,2062.88,United Healthcare/Oxford,United Healthcare/Oxford,,2236.65,,,2236.65,1780.28,2754.89,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT  ,,,both,,,2694.48,1616.69,Aetna,Commerical,,1948.93,,,1948.93,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Aetna,Middlesex Employees,,1754.04,,,1754.04,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Anthem,Commerical,,1743.86,,,1743.86,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Anthem,Indemnity,,,1959.63,,1959.63,1395.09,2158.82,percent of total billed charges,,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Anthem,State Preferred,,1743.86,,,1743.86,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Anthem,Individual Exchange,,1395.09,,,1395.09,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Cigna,Cigna,,1703.07,,,1703.07,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Connecticare,Commerical,,1821.58,,,1821.58,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Connecticare,Exchange,,1821.58,,,1821.58,1395.09,2158.82,other,Could be inpatient or outpatient,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,Multiplan,Multiplan,,,2158.82,,2158.82,1395.09,2158.82,percent of total billed charges,,
HC MRI CARD MORPH & FUNCT W/STRESS IMG W/O THEN W/CON,75563,CPT,,,both,,,2694.48,1616.69,United Healthcare/Oxford,United Healthcare/Oxford,,1752.71,,,1752.71,1395.09,2158.82,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT  ,,,both,,,2873.7,1724.22,Aetna,Commerical,,2078.37,,,2078.37,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Aetna,Middlesex Employees,,1870.53,,,1870.53,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Anthem,Commerical,,1859.68,,,1859.68,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Anthem,Indemnity,,,2089.79,,2089.79,1487.74,2302.21,percent of total billed charges,,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Anthem,State Preferred,,1859.68,,,1859.68,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Anthem,Individual Exchange,,1487.74,,,1487.74,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Cigna,Cigna,,1816.18,,,1816.18,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Connecticare,Commerical,,1942.57,,,1942.57,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Connecticare,Exchange,,1942.57,,,1942.57,1487.74,2302.21,other,Could be inpatient or outpatient,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,Multiplan,Multiplan,,,2302.21,,2302.21,1487.74,2302.21,percent of total billed charges,,
HC CARD MRI VEL FLW MAP ADD-ON,75565,CPT,,,both,,,2873.7,1724.22,United Healthcare/Oxford,United Healthcare/Oxford,,1869.12,,,1869.12,1487.74,2302.21,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT  ,,,both,,,264.49,158.7,Aetna,Commerical,,145.35,,,145.35,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Aetna,Middlesex Employees,,130.81,,,130.81,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Anthem,Commerical,,172.58,,,172.58,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Anthem,Indemnity,,,192.36,,192.36,130.81,211.91,percent of total billed charges,,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Anthem,State Preferred,,172.58,,,172.58,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Anthem,Individual Exchange,,138.06,,,138.06,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Cigna,Cigna,,198.4,,,198.4,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Connecticare,Commerical,,184.7,,,184.7,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Connecticare,Exchange,,184.7,,,184.7,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,Multiplan,Multiplan,,,211.91,,211.91,130.81,211.91,percent of total billed charges,,
HC HH CT HRT W/O DYE W/CA TEST,75571,CPT,,,both,,,264.49,158.7,United Healthcare/Oxford,United Healthcare/Oxford,,161.13,,,161.13,130.81,211.91,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT  ,,,both,,,610.03,366.02,Aetna,Commerical,,335.22,,,335.22,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Aetna,Middlesex Employees,,301.7,,,301.7,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Anthem,Commerical,,398.02,,,398.02,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Anthem,Indemnity,,,443.66,,443.66,301.7,488.76,percent of total billed charges,,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Anthem,State Preferred,,398.02,,,398.02,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Anthem,Individual Exchange,,318.42,,,318.42,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Cigna,Cigna,,457.59,,,457.59,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Connecticare,Commerical,,426,,,426,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Connecticare,Exchange,,426,,,426,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,Multiplan,Multiplan,,,488.76,,488.76,301.7,488.76,percent of total billed charges,,
HC HH CT+HRT EVA CSM,75572,CPT,,,both,,,610.03,366.02,United Healthcare/Oxford,United Healthcare/Oxford,,371.63,,,371.63,301.7,488.76,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT  ,,,both,,,1170.53,702.32,Aetna,Commerical,,643.23,,,643.23,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Aetna,Middlesex Employees,,578.91,,,578.91,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Anthem,Commerical,,763.74,,,763.74,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Anthem,Indemnity,,,851.31,,851.31,578.91,937.84,percent of total billed charges,,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Anthem,State Preferred,,763.74,,,763.74,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Anthem,Individual Exchange,,610.99,,,610.99,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Cigna,Cigna,,878.03,,,878.03,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Connecticare,Commerical,,817.4,,,817.4,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Connecticare,Exchange,,817.4,,,817.4,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,Multiplan,Multiplan,,,937.84,,937.84,578.91,937.84,percent of total billed charges,,
HC HH CT+HRT EV CONG,75573,CPT,,,both,,,1170.53,702.32,United Healthcare/Oxford,United Healthcare/Oxford,,713.09,,,713.09,578.91,937.84,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT  ,,,both,,,1171.66,702.99,Aetna,Commerical,,643.84,,,643.84,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Aetna,Middlesex Employees,,579.46,,,579.46,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Anthem,Commerical,,764.47,,,764.47,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Anthem,Indemnity,,,852.13,,852.13,579.46,938.74,percent of total billed charges,,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Anthem,State Preferred,,764.47,,,764.47,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Anthem,Individual Exchange,,611.58,,,611.58,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Cigna,Cigna,,878.87,,,878.87,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Connecticare,Commerical,,818.2,,,818.2,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Connecticare,Exchange,,818.2,,,818.2,579.46,938.74,other,Could be inpatient or outpatient,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,Multiplan,Multiplan,,,938.74,,938.74,579.46,938.74,percent of total billed charges,,
HC HH CT ANGIO HRT W/3D IMAGE,75574,CPT,,,both,,,1171.66,702.99,United Healthcare/Oxford,United Healthcare/Oxford,,713.78,,,713.78,579.46,938.74,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT  ,,,both,,,6250.04,3750.02,Aetna,Commerical,,3433.85,,,3433.85,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Aetna,Middlesex Employees,,3090.46,,,3090.46,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Anthem,Commerical,,4077.18,,,4077.18,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Anthem,Indemnity,,,4544.66,,4544.66,3090.46,5006.6,percent of total billed charges,,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Anthem,State Preferred,,4077.18,,,4077.18,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Anthem,Individual Exchange,,3261.74,,,3261.74,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Cigna,Cigna,,4687.3,,,4687.3,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Connecticare,Commerical,,4363.7,,,4363.7,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Connecticare,Exchange,,4363.7,,,4363.7,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,Multiplan,Multiplan,,,5006.6,,5006.6,3090.46,5006.6,percent of total billed charges,,
HC HH THORACIC AORTOGRAM W SERIALOGRAPHY,75605,CPT,,,both,,,6250.04,3750.02,United Healthcare/Oxford,United Healthcare/Oxford,,3806.81,,,3806.81,3090.46,5006.6,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT  ,,,both,,,3258.92,1955.35,Aetna,Commerical,,1791.14,,,1791.14,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Aetna,Middlesex Employees,,1612.02,,,1612.02,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Anthem,Commerical,,2126.71,,,2126.71,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Anthem,Indemnity,,,2370.56,,2370.56,1612.02,2611.51,percent of total billed charges,,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Anthem,State Preferred,,2126.71,,,2126.71,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Anthem,Individual Exchange,,1701.36,,,1701.36,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Cigna,Cigna,,2444.97,,,2444.97,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Connecticare,Commerical,,2276.16,,,2276.16,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Connecticare,Exchange,,2276.16,,,2276.16,1612.02,2611.51,other,Could be inpatient or outpatient,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,Multiplan,Multiplan,,,2611.51,,2611.51,1612.02,2611.51,percent of total billed charges,,
HC HH ABD AORTAGRAM,75625,CPT,,,both,,,3258.92,1955.35,United Healthcare/Oxford,United Healthcare/Oxford,,1985.69,,,1985.69,1612.02,2611.51,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT  ,,,both,,,1046.48,627.89,Aetna,Commerical,,616.02,,,616.02,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Aetna,Middlesex Employees,,554.42,,,554.42,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Anthem,Commerical,,1211.07,,,1211.07,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Anthem,Indemnity,,,760.45,,760.45,352.71,1211.07,percent of total billed charges,,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Anthem,State Preferred,,1211.07,,,1211.07,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Anthem,Individual Exchange,,968.86,,,968.86,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Cigna,Cigna,,759.48,,,759.48,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Connecticare,Commerical,,1030.2,,,1030.2,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Connecticare,Exchange,,1030.2,,,1030.2,352.71,1211.07,other,Could be inpatient or outpatient,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,Multiplan,Multiplan,,,837.74,,837.74,352.71,1211.07,percent of total billed charges,,
HC CTA ABD AORTA WITH RUNOFF BI,75635,CPT,,,both,,,1046.48,627.89,United Healthcare/Oxford,United Healthcare/Oxford,,352.71,,,352.71,352.71,1211.07,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT  ,,,both,,,3153.86,1892.32,Aetna,Commerical,,1733,,,1733,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Aetna,Middlesex Employees,,1559.7,,,1559.7,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Anthem,Commerical,,2057.68,,,2057.68,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Anthem,Indemnity,,,2293.61,,2293.61,1559.7,2526.74,percent of total billed charges,,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Anthem,State Preferred,,2057.68,,,2057.68,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Anthem,Individual Exchange,,1646.15,,,1646.15,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Cigna,Cigna,,2365.6,,,2365.6,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Connecticare,Commerical,,2202.28,,,2202.28,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Connecticare,Exchange,,2202.28,,,2202.28,1559.7,2526.74,other,Could be inpatient or outpatient,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,Multiplan,Multiplan,,,2526.74,,2526.74,1559.7,2526.74,percent of total billed charges,,
HC ANGIO SPINE SEL IR,75705,CPT,,,both,,,3153.86,1892.32,United Healthcare/Oxford,United Healthcare/Oxford,,1921.23,,,1921.23,1559.7,2526.74,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT  ,,,both,,,3463.89,2078.33,Aetna,Commerical,,1903.7,,,1903.7,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Aetna,Middlesex Employees,,1713.33,,,1713.33,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Anthem,Commerical,,2260.37,,,2260.37,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Anthem,Indemnity,,,2519.53,,2519.53,1713.33,2775.63,percent of total billed charges,,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Anthem,State Preferred,,2260.37,,,2260.37,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Anthem,Individual Exchange,,1808.29,,,1808.29,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Cigna,Cigna,,2598.62,,,2598.62,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Connecticare,Commerical,,2419.21,,,2419.21,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Connecticare,Exchange,,2419.21,,,2419.21,1713.33,2775.63,other,Could be inpatient or outpatient,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,Multiplan,Multiplan,,,2775.63,,2775.63,1713.33,2775.63,percent of total billed charges,,
HC EXTREMITY ANGIO - UNIL,75710,CPT,,,both,,,3463.89,2078.33,United Healthcare/Oxford,United Healthcare/Oxford,,2110.47,,,2110.47,1713.33,2775.63,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT  ,,,both,,,2154.76,1292.86,Aetna,Commerical,,1184.4,,,1184.4,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Aetna,Middlesex Employees,,1065.96,,,1065.96,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Anthem,Commerical,,1406.31,,,1406.31,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Anthem,Indemnity,,,1567.54,,1567.54,1065.96,1726.88,percent of total billed charges,,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Anthem,State Preferred,,1406.31,,,1406.31,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Anthem,Individual Exchange,,1125.05,,,1125.05,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Cigna,Cigna,,1616.75,,,1616.75,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Connecticare,Commerical,,1505.13,,,1505.13,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Connecticare,Exchange,,1505.13,,,1505.13,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,Multiplan,Multiplan,,,1726.88,,1726.88,1065.96,1726.88,percent of total billed charges,,
HC ANGIO EXTREMITY BILAT,75716,CPT,,,both,,,2154.76,1292.86,United Healthcare/Oxford,United Healthcare/Oxford,,1313.04,,,1313.04,1065.96,1726.88,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT  ,,,both,,,3685.34,2211.2,Aetna,Commerical,,2025.54,,,2025.54,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Aetna,Middlesex Employees,,1822.99,,,1822.99,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Anthem,Commerical,,2405.03,,,2405.03,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Anthem,Indemnity,,,2680.79,,2680.79,1822.99,2953.28,percent of total billed charges,,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Anthem,State Preferred,,2405.03,,,2405.03,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Anthem,Individual Exchange,,1924.02,,,1924.02,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Cigna,Cigna,,2764.93,,,2764.93,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Connecticare,Commerical,,2574.05,,,2574.05,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Connecticare,Exchange,,2574.05,,,2574.05,1822.99,2953.28,other,Could be inpatient or outpatient,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,Multiplan,Multiplan,,,2953.28,,2953.28,1822.99,2953.28,percent of total billed charges,,
HC ARTERY X-RAYS ABDOMEN,75726,CPT,,,both,,,3685.34,2211.2,United Healthcare/Oxford,United Healthcare/Oxford,,2245.55,,,2245.55,1822.99,2953.28,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT  ,,,both,,,1521.31,912.79,Aetna,Commerical,,835.58,,,835.58,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Aetna,Middlesex Employees,,752.02,,,752.02,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Anthem,Commerical,,992.12,,,992.12,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Anthem,Indemnity,,,1105.88,,1105.88,752.02,1218.29,percent of total billed charges,,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Anthem,State Preferred,,992.12,,,992.12,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Anthem,Individual Exchange,,793.7,,,793.7,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Cigna,Cigna,,1140.59,,,1140.59,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Connecticare,Commerical,,1061.85,,,1061.85,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Connecticare,Exchange,,1061.85,,,1061.85,752.02,1218.29,other,Could be inpatient or outpatient,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,Multiplan,Multiplan,,,1218.29,,1218.29,752.02,1218.29,percent of total billed charges,,
HC HH PELVIC ANGIO,75736,CPT,,,both,,,1521.31,912.79,United Healthcare/Oxford,United Healthcare/Oxford,,926.33,,,926.33,752.02,1218.29,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT  ,,,both,,,3087.94,1852.76,Aetna,Commerical,,1697.13,,,1697.13,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Aetna,Middlesex Employees,,1527.42,,,1527.42,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Anthem,Commerical,,2015.09,,,2015.09,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Anthem,Indemnity,,,2246.13,,2246.13,1527.42,2474.44,percent of total billed charges,,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Anthem,State Preferred,,2015.09,,,2015.09,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Anthem,Individual Exchange,,1612.07,,,1612.07,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Cigna,Cigna,,2316.64,,,2316.64,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Connecticare,Commerical,,2156.7,,,2156.7,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Connecticare,Exchange,,2156.7,,,2156.7,1527.42,2474.44,other,Could be inpatient or outpatient,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,Multiplan,Multiplan,,,2474.44,,2474.44,1527.42,2474.44,percent of total billed charges,,
HC ANGIOGR EA ADDTL VESSEL,75774,CPT,,,both,,,3087.94,1852.76,United Healthcare/Oxford,United Healthcare/Oxford,,1881.46,,,1881.46,1527.42,2474.44,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT  ,,,both,,,2211.41,1326.85,Aetna,Commerical,,1214.71,,,1214.71,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Aetna,Middlesex Employees,,1093.24,,,1093.24,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Anthem,Commerical,,1442.28,,,1442.28,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Anthem,Indemnity,,,1607.66,,1607.66,1093.24,1771.07,percent of total billed charges,,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Anthem,State Preferred,,1442.28,,,1442.28,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Anthem,Individual Exchange,,1153.83,,,1153.83,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Cigna,Cigna,,1658.11,,,1658.11,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Connecticare,Commerical,,1543.64,,,1543.64,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Connecticare,Exchange,,1543.64,,,1543.64,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,Multiplan,Multiplan,,,1771.07,,1771.07,1093.24,1771.07,percent of total billed charges,,
HC HH AVFISTULOSHUNT,75791,CPT,,,both,,,2211.41,1326.85,United Healthcare/Oxford,United Healthcare/Oxford,,1346.64,,,1346.64,1093.24,1771.07,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT  ,,,both,,,1163.9,698.34,Aetna,Commerical,,639.52,,,639.52,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Aetna,Middlesex Employees,,575.57,,,575.57,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Anthem,Commerical,,759.33,,,759.33,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Anthem,Indemnity,,,846.39,,846.39,575.57,932.42,percent of total billed charges,,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Anthem,State Preferred,,759.33,,,759.33,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Anthem,Individual Exchange,,607.46,,,607.46,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Cigna,Cigna,,872.96,,,872.96,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Connecticare,Commerical,,812.7,,,812.7,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Connecticare,Exchange,,812.7,,,812.7,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,Multiplan,Multiplan,,,932.42,,932.42,575.57,932.42,percent of total billed charges,,
HC HH LYMPHGR EXTUNI,75801,CPT,,,both,,,1163.9,698.34,United Healthcare/Oxford,United Healthcare/Oxford,,708.98,,,708.98,575.57,932.42,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT  ,,,both,,,1128.88,677.33,Aetna,Commerical,,620.35,,,620.35,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Aetna,Middlesex Employees,,558.31,,,558.31,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Anthem,Commerical,,736.57,,,736.57,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Anthem,Indemnity,,,821.02,,821.02,558.31,904.47,percent of total billed charges,,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Anthem,State Preferred,,736.57,,,736.57,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Anthem,Individual Exchange,,589.26,,,589.26,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Cigna,Cigna,,846.79,,,846.79,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Connecticare,Commerical,,788.33,,,788.33,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Connecticare,Exchange,,788.33,,,788.33,558.31,904.47,other,Could be inpatient or outpatient,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,Multiplan,Multiplan,,,904.47,,904.47,558.31,904.47,percent of total billed charges,,
HC HH LYMPHGR EXTBIL,75803,CPT,,,both,,,1128.88,677.33,United Healthcare/Oxford,United Healthcare/Oxford,,687.72,,,687.72,558.31,904.47,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT  ,,,both,,,1847.82,1108.69,Aetna,Commerical,,1015.56,,,1015.56,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Aetna,Middlesex Employees,,914.01,,,914.01,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Anthem,Commerical,,1205.83,,,1205.83,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Anthem,Indemnity,,,1344.08,,1344.08,914.01,1480.7,percent of total billed charges,,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Anthem,State Preferred,,1205.83,,,1205.83,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Anthem,Individual Exchange,,964.66,,,964.66,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Cigna,Cigna,,1386.27,,,1386.27,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Connecticare,Commerical,,1290.56,,,1290.56,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Connecticare,Exchange,,1290.56,,,1290.56,914.01,1480.7,other,Could be inpatient or outpatient,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,Multiplan,Multiplan,,,1480.7,,1480.7,914.01,1480.7,percent of total billed charges,,
HC VENOGR EXT UNI,75820,CPT,,,both,,,1847.82,1108.69,United Healthcare/Oxford,United Healthcare/Oxford,,1125.86,,,1125.86,914.01,1480.7,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT  ,,,both,,,2401.96,1441.18,Aetna,Commerical,,1319.86,,,1319.86,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Aetna,Middlesex Employees,,1187.87,,,1187.87,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Anthem,Commerical,,1567.12,,,1567.12,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Anthem,Indemnity,,,1746.81,,1746.81,1187.87,1924.37,percent of total billed charges,,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Anthem,State Preferred,,1567.12,,,1567.12,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Anthem,Individual Exchange,,1253.7,,,1253.7,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Cigna,Cigna,,1801.64,,,1801.64,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Connecticare,Commerical,,1677.26,,,1677.26,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Connecticare,Exchange,,1677.26,,,1677.26,1187.87,1924.37,other,Could be inpatient or outpatient,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,Multiplan,Multiplan,,,1924.37,,1924.37,1187.87,1924.37,percent of total billed charges,,
HC FL VENOGRAM EXTREMITY BILATERAL,75822,CPT,,,both,,,2401.96,1441.18,United Healthcare/Oxford,United Healthcare/Oxford,,1463.21,,,1463.21,1187.87,1924.37,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT  ,,,both,,,3252.74,1951.64,Aetna,Commerical,,1787.44,,,1787.44,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Aetna,Middlesex Employees,,1608.69,,,1608.69,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Anthem,Commerical,,2122.31,,,2122.31,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Anthem,Indemnity,,,2365.64,,2365.64,1608.69,2606.1,percent of total billed charges,,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Anthem,State Preferred,,2122.31,,,2122.31,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Anthem,Individual Exchange,,1697.85,,,1697.85,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Cigna,Cigna,,2439.9,,,2439.9,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Connecticare,Commerical,,2271.45,,,2271.45,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Connecticare,Exchange,,2271.45,,,2271.45,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,Multiplan,Multiplan,,,2606.1,,2606.1,1608.69,2606.1,percent of total billed charges,,
HC VENOGRAM IVC W SERIALOGRAPHY,75825,CPT,,,both,,,3252.74,1951.64,United Healthcare/Oxford,United Healthcare/Oxford,,1981.57,,,1981.57,1608.69,2606.1,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT  ,,,both,,,1991.02,1194.61,Aetna,Commerical,,1094.11,,,1094.11,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT  ,,,both,,,2195.87,1317.52,Aetna,Commerical,,1206.67,,,1206.67,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Aetna,Middlesex Employees,,984.7,,,984.7,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Aetna,Middlesex Employees,,1086.01,,,1086.01,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Anthem,Commerical,,1299.09,,,1299.09,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Anthem,Commerical,,1432.74,,,1432.74,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Anthem,Indemnity,,,1448.03,,1448.03,984.7,1595.22,percent of total billed charges,,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Anthem,Indemnity,,,1597.02,,1597.02,1146.19,1759.35,percent of total billed charges,,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Anthem,State Preferred,,1299.09,,,1299.09,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Anthem,State Preferred,,1432.74,,,1432.74,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Anthem,Individual Exchange,,1039.27,,,1039.27,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Anthem,Individual Exchange,,1146.19,,,1146.19,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Cigna,Cigna,,1493.49,,,1493.49,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Cigna,Cigna,,1647.14,,,1647.14,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Connecticare,Commerical,,1390.37,,,1390.37,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Connecticare,Commerical,,1533.42,,,1533.42,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Connecticare,Exchange,,1390.37,,,1390.37,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Connecticare,Exchange,,1533.42,,,1533.42,1146.19,1759.35,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,Multiplan,Multiplan,,,1595.22,,1595.22,984.7,1595.22,percent of total billed charges,,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,Multiplan,Multiplan,,,1759.35,,1759.35,1146.19,1759.35,percent of total billed charges,,
HC VENOGRAM SVC W SERIALOGRAPHY,75827,CPT,,,both,,,1991.02,1194.61,United Healthcare/Oxford,United Healthcare/Oxford,,1212.94,,,1212.94,984.7,1595.22,other,Could be inpatient or outpatient,
HC VENOGRAM SVC W SERIALOGRAPHY-2,75827,CPT,,,both,,,2195.87,1317.52,United Healthcare/Oxford,United Healthcare/Oxford,,1337.73,,,1337.73,1146.19,1759.35,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT  ,,,both,,,3506.12,2103.67,Aetna,Commerical,,1927.21,,,1927.21,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Aetna,Middlesex Employees,,1734.49,,,1734.49,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Anthem,Commerical,,2288.27,,,2288.27,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Anthem,Indemnity,,,2550.64,,2550.64,1734.49,2809.9,percent of total billed charges,,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Anthem,State Preferred,,2288.27,,,2288.27,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Anthem,Individual Exchange,,1830.61,,,1830.61,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Cigna,Cigna,,2630.7,,,2630.7,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Connecticare,Commerical,,2449.08,,,2449.08,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Connecticare,Exchange,,2449.08,,,2449.08,1734.49,2809.9,other,Could be inpatient or outpatient,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,Multiplan,Multiplan,,,2809.9,,2809.9,1734.49,2809.9,percent of total billed charges,,
HC UNIL SELCTV RENAL VENOGRAM,75831,CPT,,,both,,,3506.12,2103.67,United Healthcare/Oxford,United Healthcare/Oxford,,2136.53,,,2136.53,1734.49,2809.9,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT  ,,,both,,,1777.78,1066.67,Aetna,Commerical,,977.21,,,977.21,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Aetna,Middlesex Employees,,879.49,,,879.49,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Anthem,Commerical,,1160.29,,,1160.29,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Anthem,Indemnity,,,1293.33,,1293.33,879.49,1424.79,percent of total billed charges,,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Anthem,State Preferred,,1160.29,,,1160.29,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Anthem,Individual Exchange,,928.23,,,928.23,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Cigna,Cigna,,1333.92,,,1333.92,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Connecticare,Commerical,,1241.83,,,1241.83,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Connecticare,Exchange,,1241.83,,,1241.83,879.49,1424.79,other,Could be inpatient or outpatient,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,Multiplan,Multiplan,,,1424.79,,1424.79,879.49,1424.79,percent of total billed charges,,
HC SINUS OR JUGL CATH VENOGRAM,75860,CPT,,,both,,,1777.78,1066.67,United Healthcare/Oxford,United Healthcare/Oxford,,1083.35,,,1083.35,879.49,1424.79,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT  ,,,both,,,2154.76,1292.86,Aetna,Commerical,,1184.4,,,1184.4,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Aetna,Middlesex Employees,,1065.96,,,1065.96,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Anthem,Commerical,,1406.31,,,1406.31,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Anthem,Indemnity,,,1567.54,,1567.54,1065.96,1726.88,percent of total billed charges,,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Anthem,State Preferred,,1406.31,,,1406.31,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Anthem,Individual Exchange,,1125.05,,,1125.05,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Cigna,Cigna,,1616.75,,,1616.75,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Connecticare,Commerical,,1505.13,,,1505.13,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Connecticare,Exchange,,1505.13,,,1505.13,1065.96,1726.88,other,Could be inpatient or outpatient,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,Multiplan,Multiplan,,,1726.88,,1726.88,1065.96,1726.88,percent of total billed charges,,
HC PERC TRANSHEP PORTOGRAM W HDM,75885,CPT,,,both,,,2154.76,1292.86,United Healthcare/Oxford,United Healthcare/Oxford,,1313.04,,,1313.04,1065.96,1726.88,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT  ,,,both,,,8887.87,5332.72,Aetna,Commerical,,4884.2,,,4884.2,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Aetna,Middlesex Employees,,4395.78,,,4395.78,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Anthem,Commerical,,5799.25,,,5799.25,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Anthem,Indemnity,,,6464.18,,6464.18,4395.78,7121.24,percent of total billed charges,,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Anthem,State Preferred,,5799.25,,,5799.25,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Anthem,Individual Exchange,,4639.4,,,4639.4,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Cigna,Cigna,,6667.09,,,6667.09,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Connecticare,Commerical,,6206.79,,,6206.79,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Connecticare,Exchange,,6206.79,,,6206.79,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,Multiplan,Multiplan,,,7121.24,,7121.24,4395.78,7121.24,percent of total billed charges,,
HC HEPATIC  VENOGRAM W HDM,75889,CPT,,,both,,,8887.87,5332.72,United Healthcare/Oxford,United Healthcare/Oxford,,5414.69,,,5414.69,4395.78,7121.24,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT  ,,,both,,,4747.27,2848.36,Aetna,Commerical,,2608.78,,,2608.78,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Aetna,Middlesex Employees,,2347.91,,,2347.91,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Anthem,Commerical,,3097.54,,,3097.54,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Anthem,Indemnity,,,3452.7,,3452.7,2347.91,3803.65,percent of total billed charges,,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Anthem,State Preferred,,3097.54,,,3097.54,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Anthem,Individual Exchange,,2478.03,,,2478.03,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Cigna,Cigna,,3561.06,,,3561.06,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Connecticare,Commerical,,3315.22,,,3315.22,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Connecticare,Exchange,,3315.22,,,3315.22,2347.91,3803.65,other,Could be inpatient or outpatient,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,Multiplan,Multiplan,,,3803.65,,3803.65,2347.91,3803.65,percent of total billed charges,,
HC HEPATIC VENOGRAM WO HDM,75891,CPT,,,both,,,4747.27,2848.36,United Healthcare/Oxford,United Healthcare/Oxford,,2892.14,,,2892.14,2347.91,3803.65,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT  ,,,both,,,2145.49,1287.29,Aetna,Commerical,,1178.84,,,1178.84,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Aetna,Middlesex Employees,,1060.96,,,1060.96,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Anthem,Commerical,,1399.69,,,1399.69,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Anthem,Indemnity,,,1560.18,,1560.18,1060.96,1718.77,percent of total billed charges,,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Anthem,State Preferred,,1399.69,,,1399.69,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Anthem,Individual Exchange,,1119.76,,,1119.76,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Cigna,Cigna,,1609.15,,,1609.15,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Connecticare,Commerical,,1498.05,,,1498.05,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Connecticare,Exchange,,1498.05,,,1498.05,1060.96,1718.77,other,Could be inpatient or outpatient,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,Multiplan,Multiplan,,,1718.77,,1718.77,1060.96,1718.77,percent of total billed charges,,
HC RENIN VEIN SAMPLING,75893,CPT,,,both,,,2145.49,1287.29,United Healthcare/Oxford,United Healthcare/Oxford,,1306.87,,,1306.87,1060.96,1718.77,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT  ,,,both,,,5316.9,3190.14,Aetna,Commerical,,2921.74,,,2921.74,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT  ,,,both,,,5365.3,3219.18,Aetna,Commerical,,2948.33,,,2948.33,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Aetna,Middlesex Employees,,2629.56,,,2629.56,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Aetna,Middlesex Employees,,2653.49,,,2653.49,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Anthem,Commerical,,3469.12,,,3469.12,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Anthem,Commerical,,3500.7,,,3500.7,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Anthem,Indemnity,,,3866.88,,3866.88,2629.56,4259.94,percent of total billed charges,,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Anthem,Indemnity,,,3902.08,,3902.08,2653.49,4298.71,percent of total billed charges,,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Anthem,State Preferred,,3469.12,,,3469.12,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Anthem,State Preferred,,3500.7,,,3500.7,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Anthem,Individual Exchange,,2775.3,,,2775.3,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Anthem,Individual Exchange,,2800.57,,,2800.57,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Cigna,Cigna,,3988.26,,,3988.26,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Cigna,Cigna,,4024.56,,,4024.56,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Connecticare,Commerical,,3712.92,,,3712.92,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Connecticare,Commerical,,3746.71,,,3746.71,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Connecticare,Exchange,,3712.92,,,3712.92,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Connecticare,Exchange,,3746.71,,,3746.71,2653.49,4298.71,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,Multiplan,Multiplan,,,4259.94,,4259.94,2629.56,4259.94,percent of total billed charges,,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,Multiplan,Multiplan,,,4298.71,,4298.71,2653.49,4298.71,percent of total billed charges,,
HC TRANSCATH EMBOLIZATION TX,75894,CPT,,,both,,,5316.9,3190.14,United Healthcare/Oxford,United Healthcare/Oxford,,3239.08,,,3239.08,2629.56,4259.94,other,Could be inpatient or outpatient,
HC TRANSCATH EMBOLIZATION TX-RAD HH SVCS,75894,CPT,,,both,,,5365.3,3219.18,United Healthcare/Oxford,United Healthcare/Oxford,,3268.56,,,3268.56,2653.49,4298.71,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT  ,,,both,,,2789.24,1673.54,Aetna,Commerical,,1532.61,,,1532.61,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Aetna,Middlesex Employees,,1379.34,,,1379.34,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Anthem,Commerical,,1819.75,,,1819.75,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Anthem,Indemnity,,,2028.4,,2028.4,1379.34,2234.57,percent of total billed charges,,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Anthem,State Preferred,,1819.75,,,1819.75,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Anthem,Individual Exchange,,1455.8,,,1455.8,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Cigna,Cigna,,2092.06,,,2092.06,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Connecticare,Commerical,,1947.62,,,1947.62,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Connecticare,Exchange,,1947.62,,,1947.62,1379.34,2234.57,other,Could be inpatient or outpatient,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,Multiplan,Multiplan,,,2234.57,,2234.57,1379.34,2234.57,percent of total billed charges,,
HC UKTHROMBOLYSIS,75896,CPT,,,both,,,2789.24,1673.54,United Healthcare/Oxford,United Healthcare/Oxford,,1699.08,,,1699.08,1379.34,2234.57,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT  ,,,both,,,1964.21,1178.53,Aetna,Commerical,,1079.26,,,1079.26,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Aetna,Middlesex Employees,,971.33,,,971.33,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Anthem,Commerical,,1281.46,,,1281.46,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Anthem,Indemnity,,,1428.39,,1428.39,971.33,1573.58,percent of total billed charges,,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Anthem,State Preferred,,1281.46,,,1281.46,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Anthem,Individual Exchange,,1025.17,,,1025.17,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Cigna,Cigna,,1473.22,,,1473.22,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Connecticare,Commerical,,1371.52,,,1371.52,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Connecticare,Exchange,,1371.52,,,1371.52,971.33,1573.58,other,Could be inpatient or outpatient,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,Multiplan,Multiplan,,,1573.58,,1573.58,971.33,1573.58,percent of total billed charges,,
HC FOLLOW-UP ANGIOGRAPHY,75898,CPT,,,both,,,1964.21,1178.53,United Healthcare/Oxford,United Healthcare/Oxford,,1196.49,,,1196.49,971.33,1573.58,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT  ,,,both,,,432.6,259.56,Aetna,Commerical,,237.5,,,237.5,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Aetna,Middlesex Employees,,213.75,,,213.75,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Anthem,Commerical,,282,,,282,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Anthem,Indemnity,,,314.33,,314.33,213.75,346.28,percent of total billed charges,,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Anthem,State Preferred,,282,,,282,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Anthem,Individual Exchange,,225.6,,,225.6,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Cigna,Cigna,,324.2,,,324.2,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Connecticare,Commerical,,301.81,,,301.81,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Connecticare,Exchange,,301.81,,,301.81,213.75,346.28,other,Could be inpatient or outpatient,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,Multiplan,Multiplan,,,346.28,,346.28,213.75,346.28,percent of total billed charges,,
HC REM OBSTRUCTN FROM CVD,75901,CPT,,,both,,,432.6,259.56,United Healthcare/Oxford,United Healthcare/Oxford,,263.3,,,263.3,213.75,346.28,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT  ,,,both,,,4829.67,2897.8,Aetna,Commerical,,2653.31,,,2653.31,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Aetna,Middlesex Employees,,2387.98,,,2387.98,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Anthem,Commerical,,3150.42,,,3150.42,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Anthem,Indemnity,,,3511.63,,3511.63,2387.98,3868.57,percent of total billed charges,,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Anthem,State Preferred,,3150.42,,,3150.42,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Anthem,Individual Exchange,,2520.33,,,2520.33,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Cigna,Cigna,,3621.85,,,3621.85,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Connecticare,Commerical,,3371.81,,,3371.81,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Connecticare,Exchange,,3371.81,,,3371.81,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,Multiplan,Multiplan,,,3868.57,,2868.57,2387.98,3868.57,percent of total billed charges,,
HC HH TRANSCATHSTENT,75960,CPT,,,both,,,4829.67,2897.8,United Healthcare/Oxford,United Healthcare/Oxford,,2941.5,,,2941.5,2387.98,3868.57,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT  ,,,both,,,3016.87,1810.12,Aetna,Commerical,,1658.16,,,1658.16,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Aetna,Middlesex Employees,,1492.34,,,1492.34,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Anthem,Commerical,,1968.83,,,1968.83,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Anthem,Indemnity,,,2194.56,,2194.56,1492.34,2417.63,percent of total billed charges,,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Anthem,State Preferred,,1968.83,,,1968.83,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Anthem,Individual Exchange,,1575.06,,,1575.06,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Cigna,Cigna,,2263.45,,,2263.45,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Connecticare,Commerical,,2107.18,,,2107.18,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Connecticare,Exchange,,2107.18,,,2107.18,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,Multiplan,Multiplan,,,2417.63,,2417.63,1492.34,2417.63,percent of total billed charges,,
HC HHPLSTYPERIPH ART,75962,CPT,,,both,,,3016.87,1810.12,United Healthcare/Oxford,United Healthcare/Oxford,,1838.26,,,1838.26,1492.34,2417.63,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT  ,,,both,,,718.94,431.36,Aetna,Commerical,,395.21,,,395.21,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Aetna,Middlesex Employees,,355.69,,,355.69,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Anthem,Commerical,,469.26,,,469.26,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Anthem,Indemnity,,,523.06,,523.06,355.69,576.23,percent of total billed charges,,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Anthem,State Preferred,,469.26,,,469.26,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Anthem,Individual Exchange,,375.4,,,375.4,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Cigna,Cigna,,539.48,,,539.48,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Connecticare,Commerical,,502.23,,,502.23,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Connecticare,Exchange,,502.23,,,502.23,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,Multiplan,Multiplan,,,576.23,,576.23,355.69,576.23,percent of total billed charges,,
HC HHPLSTYPERIPH ADD,75964,CPT,,,both,,,718.94,431.36,United Healthcare/Oxford,United Healthcare/Oxford,,438.14,,,438.14,355.69,576.23,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT  ,,,both,,,2890.18,1734.11,Aetna,Commerical,,1588.28,,,1588.28,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Aetna,Middlesex Employees,,1429.45,,,1429.45,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Anthem,Commerical,,1885.84,,,1885.84,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Anthem,Indemnity,,,2102.07,,2102.07,1429.45,2315.73,percent of total billed charges,,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Anthem,State Preferred,,1885.84,,,1885.84,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Anthem,Individual Exchange,,1508.68,,,1508.68,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Cigna,Cigna,,2168.05,,,2168.05,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Connecticare,Commerical,,2018.36,,,2018.36,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Connecticare,Exchange,,2018.36,,,2018.36,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,Multiplan,Multiplan,,,2315.73,,2315.73,1429.45,2315.73,percent of total billed charges,,
HC HH ANGPLVISC/RENL,75966,CPT,,,both,,,2890.18,1734.11,United Healthcare/Oxford,United Healthcare/Oxford,,1760.79,,,1760.79,1429.45,2315.73,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT  ,,,both,,,718.94,431.36,Aetna,Commerical,,395.21,,,395.21,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Aetna,Middlesex Employees,,355.69,,,355.69,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Anthem,Commerical,,469.26,,,469.26,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Anthem,Indemnity,,,523.06,,523.06,355.69,576.23,percent of total billed charges,,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Anthem,State Preferred,,469.26,,,469.26,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Anthem,Individual Exchange,,375.4,,,375.4,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Cigna,Cigna,,539.48,,,539.48,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Connecticare,Commerical,,502.23,,,502.23,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Connecticare,Exchange,,502.23,,,502.23,355.69,576.23,other,Could be inpatient or outpatient,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,Multiplan,Multiplan,,,576.23,,576.23,355.69,576.23,percent of total billed charges,,
HC HHPLSTYVISCARTADD,75968,CPT,,,both,,,718.94,431.36,United Healthcare/Oxford,United Healthcare/Oxford,,438.14,,,438.14,355.69,576.23,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT  ,,,both,,,1274.11,764.47,Aetna,Commerical,,700.13,,,700.13,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Aetna,Middlesex Employees,,630.11,,,630.11,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Anthem,Commerical,,831.3,,,831.3,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Anthem,Indemnity,,,926.61,,926.61,630.11,1020.8,percent of total billed charges,,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Anthem,State Preferred,,831.3,,,831.3,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Anthem,Individual Exchange,,665.04,,,665.04,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Cigna,Cigna,,955.7,,,955.7,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Connecticare,Commerical,,889.71,,,889.71,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Connecticare,Exchange,,889.71,,,889.71,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,Multiplan,Multiplan,,,1020.8,,1020.8,630.11,1020.8,percent of total billed charges,,
HC HH TRANSCATHBX IR,75970,CPT,,,both,,,1274.11,764.47,United Healthcare/Oxford,United Healthcare/Oxford,,776.18,,,776.18,630.11,1020.8,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT  ,,,both,,,2814.99,1688.99,Aetna,Commerical,,1546.84,,,1546.84,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Aetna,Middlesex Employees,,1392.15,,,1392.15,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Anthem,Commerical,,1836.64,,,1836.64,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Anthem,Indemnity,,,2047.22,,2047.22,1392.15,2255.31,percent of total billed charges,,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Anthem,State Preferred,,1836.64,,,1836.64,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Anthem,Individual Exchange,,1469.31,,,1469.31,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Cigna,Cigna,,2111.48,,,2111.48,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Connecticare,Commerical,,1965.71,,,1965.71,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Connecticare,Exchange,,1965.71,,,1965.71,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,Multiplan,Multiplan,,,2255.31,,2255.31,1392.15,2255.31,percent of total billed charges,,
HC HH ANGPLST VEN IR,75978,CPT,,,both,,,2814.99,1688.99,United Healthcare/Oxford,United Healthcare/Oxford,,1714.85,,,1714.85,1392.15,2255.31,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT  ,,,both,,,1625.34,975.2,Aetna,Commerical,,893.1,,,893.1,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Aetna,Middlesex Employees,,803.79,,,803.79,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Anthem,Commerical,,1060.42,,,1060.42,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Anthem,Indemnity,,,1182,,1182,803.79,1302.15,percent of total billed charges,,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Anthem,State Preferred,,1060.42,,,1060.42,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Anthem,Individual Exchange,,848.34,,,848.34,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Cigna,Cigna,,1219.11,,,1219.11,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Connecticare,Commerical,,1134.94,,,1134.94,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Connecticare,Exchange,,1134.94,,,1134.94,803.79,1302.15,other,Could be inpatient or outpatient,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,Multiplan,Multiplan,,,1302.15,,1302.15,803.79,1302.15,percent of total billed charges,,
HC HH BILIARY DRAIN,75980,CPT,,,both,,,1625.34,975.2,United Healthcare/Oxford,United Healthcare/Oxford,,990.1,,,990.1,803.79,1302.15,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT  ,,,both,,,2021.89,1213.13,Aetna,Commerical,,1110.81,,,1110.81,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Aetna,Middlesex Employees,,999.72,,,999.72,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Anthem,Commerical,,1318.91,,,1318.91,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Anthem,Indemnity,,,1470.14,,1470.15,999.72,1619.57,percent of total billed charges,,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Anthem,State Preferred,,1318.91,,,1318.91,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Anthem,Individual Exchange,,1055.13,,,1055.13,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Cigna,Cigna,,1516.28,,,1516.28,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Connecticare,Commerical,,1411.6,,,1411.6,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Connecticare,Exchange,,1411.6,,,1411.6,999.72,1619.57,other,Could be inpatient or outpatient,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,Multiplan,Multiplan,,,1619.57,,1619.57,999.72,1619.57,percent of total billed charges,,
HC PERC BIL DRAIN,75980,CPT,,,both,,,2021.89,1213.13,United Healthcare/Oxford,United Healthcare/Oxford,,1231.46,,,1231.46,999.72,1619.57,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT  ,,,both,,,2091.93,1255.16,Aetna,Commerical,,1149.77,,,1149.77,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Aetna,Middlesex Employees,,1034.79,,,1034.79,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Anthem,Commerical,,1365.18,,,1365.18,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Anthem,Indemnity,,,1521.7,,1521.7,1034.79,1676.38,percent of total billed charges,,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Anthem,State Preferred,,1365.18,,,1365.18,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Anthem,Individual Exchange,,1092.14,,,1092.14,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Cigna,Cigna,,1569.47,,,1569.47,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Connecticare,Commerical,,1461.11,,,1461.11,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Connecticare,Exchange,,1461.11,,,1461.11,1034.79,1676.38,other,Could be inpatient or outpatient,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,Multiplan,Multiplan,,,1676.38,,1676.38,1034.79,1676.38,percent of total billed charges,,
HC HHPERDRNINTEXTBIL,75982,CPT,,,both,,,2091.93,1255.16,United Healthcare/Oxford,United Healthcare/Oxford,,1274.65,,,1274.65,1034.79,1676.38,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT  ,,,both,,,754.99,452.99,Aetna,Commerical,,415,,,415,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Aetna,Middlesex Employees,,373.5,,,373.5,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Anthem,Commerical,,492.75,,,492.75,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Anthem,Indemnity,,,549.25,,549.25,373.5,605.08,percent of total billed charges,,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Anthem,State Preferred,,492.75,,,492.75,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Anthem,Individual Exchange,,394.2,,,394.2,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Cigna,Cigna,,566.5,,,566.5,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Connecticare,Commerical,,527.38,,,527.38,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Connecticare,Exchange,,527.38,,,527.38,373.5,605.08,other,Could be inpatient or outpatient,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,Multiplan,Multiplan,,,605.08,,605.08,373.5,605.08,percent of total billed charges,,
HC XRAY CONTROL CATHETER CHANGE,75984,CPT,,,both,,,754.99,452.99,United Healthcare/Oxford,United Healthcare/Oxford,,460.08,,,460.08,373.5,605.08,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT  ,,,both,,,348.14,208.88,Aetna,Commerical,,215.91,,,215.91,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Aetna,Middlesex Employees,,194.32,,,194.32,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Anthem,Commerical,,430.96,,,430.96,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Anthem,Indemnity,,,252.94,,252.94,194.32,430.96,percent of total billed charges,,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Anthem,State Preferred,,430.96,,,430.96,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Anthem,Individual Exchange,,344.77,,,344.77,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Cigna,Cigna,,289.48,,,289.48,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Connecticare,Commerical,,253,,,253,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Connecticare,Exchange,,253,,,253,194.32,430.96,other,Could be inpatient or outpatient,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,Multiplan,Multiplan,,,278.65,,278.65,194.32,430.96,percent of total billed charges,,
HC ABSCESS DRAIN FLUOR,75989,CPT,,,both,,,348.14,208.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT  ,,,both,,,348.14,208.88,Aetna,Commerical,,215.91,,,215.91,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Aetna,Middlesex Employees,,194.32,,,194.32,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Anthem,Commerical,,430.96,,,430.96,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Anthem,Indemnity,,,252.94,,252.94,194.32,430.96,percent of total billed charges,,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Anthem,State Preferred,,430.96,,,430.96,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Anthem,Individual Exchange,,344.77,,,344.77,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Cigna,Cigna,,289.48,,,289.48,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Connecticare,Commerical,,253,,,253,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Connecticare,Exchange,,253,,,253,194.32,430.96,other,Could be inpatient or outpatient,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,Multiplan,Multiplan,,,278.65,,278.65,194.32,430.96,percent of total billed charges,,
HC CT ABCESS DRAINAGE,75989,CPT,,,both,,,348.14,208.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.32,430.96,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT  ,,,both,,,232.78,139.67,Aetna,Commerical,,168.52,,,168.52,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Aetna,Middlesex Employees,,151.67,,,151.67,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Anthem,Commerical,,150.79,,,150.79,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Anthem,Indemnity,,,169.45,,169.45,120.63,186.67,percent of total billed charges,,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Anthem,State Preferred,,150.79,,,150.79,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Anthem,Individual Exchange,,120.63,,,120.63,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Cigna,Cigna,,147.25,,,147.25,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Connecticare,Commerical,,157.51,,,157.51,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Connecticare,Exchange,,157.51,,,157.51,120.63,186.67,other,Could be inpatient or outpatient,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,Multiplan,Multiplan,,,186.67,,186.67,120.63,186.67,percent of total billed charges,,
HC US GUIDE DRAINAGE INC NDL PLC,75989,CPT,,,both,,,232.78,139.67,United Healthcare/Oxford,United Healthcare/Oxford,,151.55,,,151.55,120.63,186.67,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,90.26,,,90.26,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,81.24,,,81.24,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,178.99,,,178.99,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,81.24,663.7,percent of total billed charges,,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,178.99,,,178.99,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,143.19,,,143.19,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,119.76,,,119.76,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,127.3,,,127.3,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,127.3,,,127.3,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,81.24,663.7,percent of total billed charges,,
HC FLUORO <=1 HR,76000,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,403.11,,,403.11,81.24,663.7,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT  ,,,both,,,324.45,194.67,Aetna,Commerical,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Aetna,Middlesex Employees,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Anthem,Commerical,,359.37,,,359.37,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Anthem,Indemnity,,,235.75,,235.75,235.75,359.37,percent of total billed charges,,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Anthem,State Preferred,,359.37,,,359.37,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Anthem,Individual Exchange,,287.5,,,287.5,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Cigna,Cigna,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Connecticare,Commerical,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Connecticare,Exchange,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,Multiplan,Multiplan,,,259.71,,259.71,235.75,359.37,percent of total billed charges,,
HC FLUORO GREATER THAN 1HR,76001,CPT,,,both,,,324.45,194.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,235.75,359.37,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,67.09,,,67.09,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,60.38,,,60.38,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,47.4,177.65,percent of total billed charges,,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,71.59,,,71.59,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,57.28,,,57.28,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,47.4,,,47.4,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,73.02,,,73.02,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,73.02,,,73.02,47.4,177.65,other,Could be inpatient or outpatient,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,47.4,177.65,percent of total billed charges,,
HC NOSE TO RECTUM FOR FB CHILD,76010,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,47.4,177.65,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,455.21,,,455.21,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,409.68,,,409.68,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,409.68,663.7,percent of total billed charges,,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,540.49,,,540.49,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,432.39,,,432.39,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,621.37,,,621.37,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,578.47,,,578.47,409.68,663.7,other,Could be inpatient or outpatient,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,409.68,663.7,percent of total billed charges,,
HC ABSCESS FISTULA/SINUS TRACT STUDY,76080,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,504.65,,,504.65,409.68,663.7,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT  ,,,both,,,1351.36,810.82,Aetna,Commerical,,742.81,,,742.81,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Aetna,Middlesex Employees,,668.53,,,668.53,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Anthem,Commerical,,881.96,,,881.96,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Anthem,Indemnity,,,983.09,,983.09,668.53,1083.02,percent of total billed charges,,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Anthem,State Preferred,,881.96,,,881.96,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Anthem,Individual Exchange,,705.57,,,705.57,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Cigna,Cigna,,1013.95,,,1013.95,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Connecticare,Commerical,,943.95,,,943.95,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Connecticare,Exchange,,943.95,,,943.95,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,Multiplan,Multiplan,,,1083.02,,1083.02,668.53,1083.02,percent of total billed charges,,
HC COMPLEX MOTION; UNILATERAL,76101,CPT,,,both,,,1351.36,810.82,United Healthcare/Oxford,United Healthcare/Oxford,,823.49,,,823.49,668.53,1083.02,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT  ,,,both,,,1755.12,1053.07,Aetna,Commerical,,964.22,,,964.22,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Aetna,Middlesex Employees,,867.79,,,867.79,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Anthem,Commerical,,1144.87,,,1144.87,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Anthem,Indemnity,,,1276.14,,1276.14,867.79,1405.85,percent of total billed charges,,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Anthem,State Preferred,,1144.87,,,1144.87,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Anthem,Individual Exchange,,915.89,,,915.89,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Cigna,Cigna,,1316.19,,,1316.19,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Connecticare,Commerical,,1225.32,,,1225.32,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Connecticare,Exchange,,1225.32,,,1225.32,867.79,1405.85,other,Could be inpatient or outpatient,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,Multiplan,Multiplan,,,1405.85,,1405.85,867.79,1405.85,percent of total billed charges,,
HC COMPLEX MOTION; BILATERAL,76102,CPT,,,both,,,1755.12,1053.07,United Healthcare/Oxford,United Healthcare/Oxford,,1068.95,,,1068.95,867.79,1405.85,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT  ,,,both,,,379.04,227.42,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
ECHO 3D REND W/O POST PROCESSING,76376,CPT,,,both,,,379.04,227.42,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT  ,,,both,,,379.04,227.42,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
HC CT 3D W/ POST-PROCESSING,76376,CPT,,,both,,,379.04,227.42,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT  ,,,both,,,565.01,339,Aetna,Commerical,,274.34,,,274.34,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Commerical,,245.48,,,245.48,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Indemnity,,,412.41,,412.41,196.38,466.65,percent of total billed charges,,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,State Preferred,,245.48,,,245.48,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Individual Exchange,,196.38,,,196.38,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Cigna,Cigna,,239.74,,,239.74,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Connecticare,Commerical,,256.43,,,256.43,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Connecticare,Exchange,,256.43,,,256.43,196.38,466.65,other,Could be inpatient or outpatient,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,Multiplan,Multiplan,,,466.65,,466.65,196.38,466.65,percent of total billed charges,,
HC MRA POST PROCESSING,76376,CPT,,,both,,,565.01,339,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,466.65,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT  ,,,both,,,565.01,339,Aetna,Commerical,,45.14,,,45.14,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT  ,,,both,,,379.3,227.58,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Aetna,Middlesex Employees,,40.62,,,40.62,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Commerical,,469.77,,,469.77,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Indemnity,,,410.92,,410.92,40.62,1147.27,percent of total billed charges,,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,State Preferred,,469.77,,,469.77,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Anthem,Individual Exchange,,375.81,,,375.81,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Cigna,Cigna,,310.14,,,310.14,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Connecticare,Commerical,,1147.27,,,1147.27,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Connecticare,Exchange,,1147.27,,,1147.27,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,Multiplan,Multiplan,,,452.68,,452.68,40.62,1147.27,percent of total billed charges,,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,565.01,339,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT  ,,,both,,,565.47,339.28,Aetna,Commerical,,45.14,,,45.14,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Aetna,Middlesex Employees,,40.62,,,40.62,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Anthem,Commerical,,469.77,,,469.77,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Anthem,Indemnity,,,410.92,,410.92,40.62,1147.27,percent of total billed charges,,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Anthem,State Preferred,,469.77,,,469.77,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Anthem,Individual Exchange,,375.81,,,375.81,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Cigna,Cigna,,310.14,,,310.14,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Connecticare,Commerical,,1147.27,,,1147.27,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Connecticare,Exchange,,1147.27,,,1147.27,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,Multiplan,Multiplan,,,452.68,,452.68,40.62,1147.27,percent of total billed charges,,
HC MRI 3D RENDER W/O IMAGE POSTPROCESS,76376,CPT,,,both,,,565.47,339.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.62,1147.27,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT  ,,,both,,,379.3,227.58,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
HC MRI MP RAGE - POST PROCESSING,76376,CPT,,,both,,,379.3,227.58,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT  ,,,both,,,403.76,242.26,Aetna,Commerical,,292.26,,,292.26,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Aetna,Middlesex Employees,,263.04,,,263.04,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Commerical,,261.5,,,261.5,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Indemnity,,,293.86,,293.86,209.2,323.73,percent of total billed charges,,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,State Preferred,,261.5,,,261.5,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Individual Exchange,,209.2,,,209.2,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Cigna,Cigna,,255.39,,,255.39,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Connecticare,Commerical,,273.17,,,273.17,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Connecticare,Exchange,,273.17,,,273.17,209.2,323.73,other,Could be inpatient or outpatient,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Multiplan,Multiplan,,,323.73,,323.73,209.2,323.73,percent of total billed charges,,
ECHO 3D REND W/POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,United Healthcare/Oxford,United Healthcare/Oxford,,262.84,,,262.84,209.2,323.73,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,109.76,,,109.76,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,98.79,,,98.79,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,500.54,,,500.54,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,98.79,1147.27,percent of total billed charges,,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,500.54,,,500.54,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,400.43,,,400.43,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,323.42,,,323.42,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,1147.27,,,1147.27,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,1147.27,,,1147.27,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,98.79,1147.27,percent of total billed charges,,
HC CT 3D RECON - IND WS,76377,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT  ,,,both,,,403.76,242.26,Aetna,Commerical,,109.76,,,109.76,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Aetna,Middlesex Employees,,98.79,,,98.79,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Commerical,,500.54,,,500.54,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Indemnity,,,293.86,,293.86,98.79,1147.27,percent of total billed charges,,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,State Preferred,,500.54,,,500.54,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Anthem,Individual Exchange,,400.43,,,400.43,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Cigna,Cigna,,323.42,,,323.42,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Connecticare,Commerical,,1147.27,,,1147.27,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Connecticare,Exchange,,1147.27,,,1147.27,98.79,1147.27,other,Could be inpatient or outpatient,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,Multiplan,Multiplan,,,323.73,,323.73,98.79,1147.27,percent of total billed charges,,
HC CT 3D REND W/ POST PROCESSING,76377,CPT,,,both,,,403.76,242.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,98.79,1147.27,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT  ,,,both,,,768.72,461.23,Aetna,Commerical,,1750.44,,,1750.44,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Aetna,Middlesex Employees,,1573.98,,,1573.98,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Commerical,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Indemnity,,,559.07,,559.07,398.01,1750.44,percent of total billed charges,,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,State Preferred,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Individual Exchange,,398.01,,,398.01,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Cigna,Cigna,,644.08,,,644.08,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Commerical,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Exchange,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Multiplan,Multiplan,,,634.1,,634.1,398.01,1750.44,percent of total billed charges,,
HC MRA 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,United Healthcare/Oxford,United Healthcare/Oxford,,500.04,,,500.04,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT  ,,,both,,,768.72,461.23,Aetna,Commerical,,1750.44,,,1750.44,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Aetna,Middlesex Employees,,1573.98,,,1573.98,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Commerical,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Indemnity,,,559.07,,559.07,398.01,1750.44,percent of total billed charges,,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,State Preferred,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Individual Exchange,,398.01,,,398.01,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Cigna,Cigna,,644.08,,,644.08,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Commerical,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Exchange,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,Multiplan,Multiplan,,,634.1,,634.1,398.01,1750.44,percent of total billed charges,,
HC MRI 3D POST PROCESSING - IND WS,76377,CPT,,,both,,,768.72,461.23,United Healthcare/Oxford,United Healthcare/Oxford,,500.04,,,500.04,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT  ,,,both,,,768.72,461.23,Aetna,Commerical,,1750.44,,,1750.44,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Aetna,Middlesex Employees,,1573.98,,,1573.98,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Commerical,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Indemnity,,,559.07,,559.07,398.01,1750.44,percent of total billed charges,,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,State Preferred,,468.68,,,468.68,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Anthem,Individual Exchange,,374.94,,,374.94,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Cigna,Cigna,,644.08,,,644.08,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Commerical,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Connecticare,Exchange,,1145,,,1145,398.01,1750.44,other,Could be inpatient or outpatient,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,Multiplan,Multiplan,,,634.1,,634.1,398.01,1750.44,percent of total billed charges,,
HC MRI MP RAGE 3D - IND WS,76377,CPT,,,both,,,768.72,461.23,United Healthcare/Oxford,United Healthcare/Oxford,,500.04,,,500.04,398.01,1750.44,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT  ,,,both,,,1663.45,998.07,Aetna,Commerical,,914.13,,,914.13,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Aetna,Middlesex Employees,,822.72,,,822.72,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Anthem,Commerical,,1085.38,,,1085.38,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Anthem,Indemnity,,,1209.83,,1209.83,822.72,1332.81,percent of total billed charges,,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Anthem,State Preferred,,1085.38,,,1085.38,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Anthem,Individual Exchange,,868.3,,,868.3,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Cigna,Cigna,,1247.81,,,1247.81,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Connecticare,Commerical,,1161.66,,,1161.66,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Connecticare,Exchange,,1161.66,,,1161.66,822.72,1332.81,other,Could be inpatient or outpatient,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,Multiplan,Multiplan,,,1332.81,,1332.81,822.72,1332.81,percent of total billed charges,,
HC CT LIMITED/FOLLOW,76380,CPT,,,both,,,1663.45,998.07,United Healthcare/Oxford,United Healthcare/Oxford,,1013.42,,,1013.42,822.72,1332.81,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT  ,,,both,,,2137.25,1282.35,Aetna,Commerical,,1545.96,,,1545.96,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Aetna,Middlesex Employees,,1391.36,,,1391.36,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Anthem,Commerical,,1383.29,,,1383.29,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Anthem,Indemnity,,,1554.45,,1554.45,1106.63,1712.45,percent of total billed charges,,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Anthem,State Preferred,,1383.29,,,1383.29,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Anthem,Individual Exchange,,1106.63,,,1106.63,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Cigna,Cigna,,1350.94,,,1350.94,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Connecticare,Commerical,,1444.94,,,1444.94,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Connecticare,Exchange,,1444.94,,,1444.94,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,Multiplan,Multiplan,,,1712.45,,1712.45,1106.63,1712.45,percent of total billed charges,,
HC MRI SPECTROSCOPY,76390,CPT,,,both,,,2137.25,1282.35,United Healthcare/Oxford,United Healthcare/Oxford,,1390.3,,,1390.3,1106.63,1712.45,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT  ,,,both,,,616.97,370.18,Aetna,Commerical,,446.93,,,446.93,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Aetna,Middlesex Employees,,402.24,,,402.24,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Anthem,Commerical,,399.9,,,399.9,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Anthem,Indemnity,,,449.39,,449.39,319.92,495.07,percent of total billed charges,,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Anthem,State Preferred,,399.9,,,399.9,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Anthem,Individual Exchange,,319.92,,,319.92,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Cigna,Cigna,,390.55,,,390.55,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Connecticare,Commerical,,417.73,,,417.73,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Connecticare,Exchange,,417.73,,,417.73,319.92,495.07,other,Could be inpatient or outpatient,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,Multiplan,Multiplan,,,495.07,,495.07,319.92,495.07,percent of total billed charges,,
HC MAGNETIC RESONANCE ELASTOGRAPHY (MRE),76391,CPT,,,both,,,616.97,370.18,United Healthcare/Oxford,United Healthcare/Oxford,,401.94,,,401.94,319.92,495.07,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT  ,,,both,,,1287.5,772.5,Aetna,Commerical,,708.17,,,708.17,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Aetna,Middlesex Employees,,637.35,,,637.35,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Anthem,Commerical,,840.84,,,840.84,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Anthem,Indemnity,,,937.25,,937.25,637.35,1032.52,percent of total billed charges,,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Anthem,State Preferred,,840.84,,,840.84,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Anthem,Individual Exchange,,672.68,,,672.68,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Cigna,Cigna,,966.67,,,966.67,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Connecticare,Commerical,,899.93,,,899.93,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Connecticare,Exchange,,899.93,,,899.93,637.35,1032.52,other,Could be inpatient or outpatient,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,Multiplan,Multiplan,,,1032.52,,1032.52,637.35,1032.52,percent of total billed charges,,
HC MANIP DIALYS CATH,76496,CPT,,,both,,,1287.5,772.5,United Healthcare/Oxford,United Healthcare/Oxford,,785.09,,,785.09,637.35,1032.52,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC ULTRASOUND CRANIAL,76506,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC DX OPTHAL B-SCAN US,76512,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US HEAD NECK,76536,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US CHEST,76604,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,408.56,245.14,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Aetna,Commerical,50,443.28,,,443.28,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Aetna,Middlesex Employees,50,398.96,,,398.96,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Anthem,Commerical,50,396.63,,,396.63,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Anthem,Indemnity,50,,460.365408,,460.365408,317.3,491.01,percent of total billed charges,,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Anthem,State Preferred,50,396.63,,,396.63,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Anthem,Individual Exchange,50,317.3,,,317.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Cigna,Cigna,50,387.35,,,387.35,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Connecticare,Commerical,50,414.3,,,414.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Connecticare,Exchange,50,414.3,,,414.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US BREAST UNILATERAL COMPLETE,76641,CPT  ,,,both,,,612.84,367.7,Multiplan,Multiplan,50,,520.914,,520.914,317.3,520.914,percent of total billed charges,,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,408.56,245.14,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL COMPLETE,76641,CPT,,,both,,,612.84,367.7,United Healthcare/Oxford,United Healthcare/Oxford,50,398.64,,,398.65,317.3,491.01,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT  ,,,both,,,615.65,369.39,Aetna,Commerical,,445.31,,,445.31,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Aetna,Middlesex Employees,,400.78,,,400.78,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Anthem,Commerical,,398.45,,,398.45,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Anthem,Indemnity,,,447.75,,447.75,318.76,493.26,percent of total billed charges,,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Anthem,State Preferred,,398.45,,,398.45,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Anthem,Individual Exchange,,318.76,,,318.76,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Cigna,Cigna,,389.14,,,389.14,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Connecticare,Commerical,,416.21,,,416.21,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Connecticare,Exchange,,416.21,,,416.21,318.76,493.26,other,Could be inpatient or outpatient,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,Multiplan,Multiplan,,,493.26,,493.26,318.76,493.26,percent of total billed charges,,
HC US BREAST UNILATERAL LIMITED,76642,CPT,,,both,,,615.65,369.39,United Healthcare/Oxford,United Healthcare/Oxford,,400.47,,,400.47,318.76,493.26,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US ABDOMEN COMPLETE,76700,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US ABDOMEN LIMITED,76705,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US RETROPERITONEAL COMPLETE,76770,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US RETROPERITONEAL LIMITED,76775,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US RENAL TRANSPLANT,76776,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US SPINAL CANAL,76800,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT  ,,,both,,,669.5,401.7,Aetna,Commerical,,484.39,,,484.39,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Aetna,Middlesex Employees,,435.95,,,435.95,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Anthem,Commerical,,433.42,,,433.42,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Anthem,Indemnity,,,487.05,,487.05,346.74,536.55,percent of total billed charges,,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Anthem,State Preferred,,433.42,,,433.42,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Anthem,Individual Exchange,,346.74,,,346.74,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Cigna,Cigna,,423.28,,,423.28,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Connecticare,Commerical,,452.73,,,452.73,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Connecticare,Exchange,,452.73,,,452.73,346.74,536.55,other,Could be inpatient or outpatient,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,Multiplan,Multiplan,,,536.55,,536.55,346.74,536.55,percent of total billed charges,,
HC OB US < 14 WKS SINGLE FETUS,76801,CPT,,,both,,,669.5,401.7,United Healthcare/Oxford,United Healthcare/Oxford,,435.62,,,435.62,346.74,536.55,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC DOPPLER UMBILICAL,76820,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC DOPPLER MCA,76821,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT  ,,,both,,,1735.55,1041.33,Aetna,Commerical,,1255.33,,,1255.33,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Aetna,Middlesex Employees,,1129.8,,,1129.8,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Anthem,Commerical,,1123.23,,,1123.23,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Anthem,Indemnity,,,1262.22,,1262.22,898.59,1390.52,percent of total billed charges,,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Anthem,State Preferred,,1123.23,,,1123.23,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Anthem,Individual Exchange,,898.59,,,898.59,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Cigna,Cigna,,1096.97,,,1096.97,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Connecticare,Commerical,,1173.3,,,1173.3,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Connecticare,Exchange,,1173.3,,,1173.3,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,Multiplan,Multiplan,,,1390.52,,1390.52,898.59,1390.52,percent of total billed charges,,
HC FETAL ECH 2D CMPLT,76825,CPT,,,both,,,1735.55,1041.33,United Healthcare/Oxford,United Healthcare/Oxford,,1128.94,,,1128.94,898.59,1390.52,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT  ,,,both,,,828.12,496.87,Aetna,Commerical,,599.17,,,599.17,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Aetna,Middlesex Employees,,539.26,,,539.26,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Anthem,Commerical,,536.12,,,536.12,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Anthem,Indemnity,,,602.46,,602.46,428.89,663.7,percent of total billed charges,,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Anthem,State Preferred,,536.12,,,536.12,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Anthem,Individual Exchange,,428.89,,,428.89,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Cigna,Cigna,,523.59,,,523.59,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Connecticare,Commerical,,560.02,,,560.02,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Connecticare,Exchange,,560.02,,,560.02,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,Multiplan,Multiplan,,,663.7,,663.7,428.89,663.7,percent of total billed charges,,
HC FETAL EA D2 FOLLOW UP/REPEAT,76826,CPT,,,both,,,828.12,496.87,United Healthcare/Oxford,United Healthcare/Oxford,,538.84,,,538.84,428.89,663.7,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC FETAL DOPPLER COMPLETE,76827,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC FETAL DOPPLER RPT,76828,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT  ,,,both,,,365.65,219.39,Aetna,Commerical,,264.58,,,264.58,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Aetna,Middlesex Employees,,238.12,,,238.12,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Anthem,Commerical,,236.74,,,236.74,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Anthem,Indemnity,,,266.03,,266.03,189.38,293.07,percent of total billed charges,,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Anthem,State Preferred,,236.74,,,236.74,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Anthem,Individual Exchange,,189.38,,,189.38,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Cigna,Cigna,,231.2,,,231.2,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Connecticare,Commerical,,247.29,,,247.29,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Connecticare,Exchange,,247.29,,,247.29,189.38,293.07,other,Could be inpatient or outpatient,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,Multiplan,Multiplan,,,293.07,,293.07,189.38,293.07,percent of total billed charges,,
HC US ENDO VAGINAL,76830,CPT,,,both,,,365.65,219.39,United Healthcare/Oxford,United Healthcare/Oxford,,237.94,,,237.94,189.38,293.07,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US TRANSVAGINL,76830,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US PELVIS COMPLETE,76856,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US PELVIS LIMITED,76857,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US TESTI/SCROTUM,76870,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT  ,,,both,,,693.19,415.91,Aetna,Commerical,,501.48,,,501.48,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Aetna,Middlesex Employees,,451.33,,,451.33,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Anthem,Commerical,,448.71,,,448.71,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Anthem,Indemnity,,,504.23,,504.23,358.97,555.48,percent of total billed charges,,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Anthem,State Preferred,,448.71,,,448.71,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Anthem,Individual Exchange,,358.97,,,358.97,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Cigna,Cigna,,438.21,,,438.21,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Connecticare,Commerical,,468.71,,,468.71,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Connecticare,Exchange,,468.71,,,468.71,358.97,555.48,other,Could be inpatient or outpatient,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,Multiplan,Multiplan,,,555.48,,555.48,358.97,555.48,percent of total billed charges,,
HC US TRANSRECTAL,76872,CPT,,,both,,,693.19,415.91,United Healthcare/Oxford,United Healthcare/Oxford,,450.99,,,450.99,358.97,555.48,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Aetna,Commerical,50,443.28,,,443.28,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Aetna,Middlesex Employees,50,398.96,,,398.96,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Anthem,Commerical,50,396.63,,,396.63,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Anthem,Indemnity,50,,460.763544,,460.763544,317.3,491.01,percent of total billed charges,,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Anthem,State Preferred,50,396.63,,,396.63,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Anthem,Individual Exchange,50,317.3,,,317.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Cigna,Cigna,50,387.35,,,387.35,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Connecticare,Commerical,50,414.3,,,414.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Connecticare,Exchange,50,414.3,,,414.3,317.3,491.01,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,Multiplan,Multiplan,50,,521.3645,,521.3645,317.3,521.3645,percent of total billed charges,,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US COMPLETE JOINT  IMAGE & DOC,76881,CPT  ,,,both,,,613.37,368.02,United Healthcare/Oxford,United Healthcare/Oxford,50,398.64,,,398.64,317.3,491.01,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US XTR NON-VASC LMTD,76882,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,160.38,,,160.38,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,144.34,,,144.34,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,143.5,,,143.5,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,114.8,177.65,percent of total billed charges,,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,143.5,,,143.5,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,114.8,,,114.8,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,140.14,,,140.14,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,149.89,,,149.89,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,149.89,,,149.89,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,114.8,177.65,percent of total billed charges,,
HC US HIPS INFANT W/ MANIPULATION,76885,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,144.23,,,144.23,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,160.38,,,160.38,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,144.34,,,144.34,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,143.5,,,143.5,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,114.8,177.65,percent of total billed charges,,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,143.5,,,143.5,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,114.8,,,114.8,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,140.14,,,140.14,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,149.89,,,149.89,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,149.89,,,149.89,114.8,177.65,other,Could be inpatient or outpatient,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,114.8,177.65,percent of total billed charges,,
HC US HIPS INFANT W/O MANIPULATION,76886,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,144.23,,,144.23,114.8,177.65,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT  ,,,both,,,206,123.6,Aetna,Commerical,,148.98,,,148.98,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Aetna,Middlesex Employees,,134.08,,,134.08,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Anthem,Commerical,,133.3,,,133.3,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Anthem,Indemnity,,,149.79,,149.79,106.64,165.02,percent of total billed charges,,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Anthem,State Preferred,,133.3,,,133.3,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Anthem,Individual Exchange,,106.64,,,106.64,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Cigna,Cigna,,130.19,,,130.19,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Connecticare,Commerical,,139.24,,,139.24,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Connecticare,Exchange,,139.24,,,139.24,106.64,165.02,other,Could be inpatient or outpatient,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,Multiplan,Multiplan,,,165.02,,165.02,106.64,165.02,percent of total billed charges,,
HC US GUIDED VASCULAR ACCESS,76937,CPT,,,both,,,206,123.6,United Healthcare/Oxford,United Healthcare/Oxford,,133.98,,,133.98,106.64,165.02,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT  ,,,both,,,704.52,422.71,Aetna,Commerical,,509.62,,,509.62,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Aetna,Middlesex Employees,,458.66,,,458.66,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Anthem,Commerical,,456,,,456,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Anthem,Indemnity,,,512.42,,512.42,364.8,564.5,percent of total billed charges,,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Anthem,State Preferred,,456,,,456,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Anthem,Individual Exchange,,364.8,,,364.8,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Cigna,Cigna,,445.33,,,445.33,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Connecticare,Commerical,,476.32,,,476.32,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Connecticare,Exchange,,476.32,,,476.32,364.8,564.5,other,Could be inpatient or outpatient,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,Multiplan,Multiplan,,,564.5,,564.5,364.8,564.5,percent of total billed charges,,
HC HH USGUIDE ABLATN,76940,CPT,,,both,,,704.52,422.71,United Healthcare/Oxford,United Healthcare/Oxford,,458.31,,,458.31,364.8,564.5,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT  ,,,both,,,498.52,299.11,Aetna,Commerical,,360.64,,,360.64,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Aetna,Middlesex Employees,,324.58,,,324.58,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Anthem,Commerical,,322.69,,,322.69,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Anthem,Indemnity,,,362.62,,362.62,258.15,399.48,percent of total billed charges,,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Anthem,State Preferred,,322.69,,,322.69,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Anthem,Individual Exchange,,258.15,,,258.15,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Cigna,Cigna,,315.15,,,315.15,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Connecticare,Commerical,,337.07,,,337.07,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Connecticare,Exchange,,337.07,,,337.07,258.15,399.48,other,Could be inpatient or outpatient,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,Multiplan,Multiplan,,,399.48,,399.48,258.15,399.48,percent of total billed charges,,
HC US GUIDED NEEDLE PLACEMENT,76942,CPT,,,both,,,498.52,299.11,United Healthcare/Oxford,United Healthcare/Oxford,,324.34,,,324.34,258.15,399.48,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT  ,,,both,,,563.41,338.05,Aetna,Commerical,,407.86,,,407.86,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Aetna,Middlesex Employees,,367.07,,,367.07,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Anthem,Commerical,,364.94,,,364.94,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Anthem,Indemnity,,,410.1,,410.1,291.95,451.78,percent of total billed charges,,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Anthem,State Preferred,,364.94,,,364.94,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Anthem,Individual Exchange,,291.95,,,291.95,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Cigna,Cigna,,356.41,,,356.41,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Connecticare,Commerical,,381.21,,,381.21,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Connecticare,Exchange,,381.21,,,381.21,291.95,451.78,other,Could be inpatient or outpatient,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,Multiplan,Multiplan,,,451.78,,451.78,291.95,451.78,percent of total billed charges,,
HC US FOLLOW-UP,76970,CPT,,,both,,,563.41,338.05,United Healthcare/Oxford,United Healthcare/Oxford,,366.79,,,366.79,291.95,451.78,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT  ,,,both,,,263.37,158.02,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
US MICROBUBBLE SONO CONT INITIAL LESION,76978,CPT,,,both,,,263.37,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT  ,,,both,,,87.79,52.67,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Anthem,Indemnity,,,63.85,,63.85,45.46,70.34,percent of total billed charges,,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
US MICROBUBBLE SONO CONT EA ADDL W SEP INJ,76979,CPT,,,both,,,87.79,52.67,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT  ,,,both,,,351.16,210.69,Aetna,Commerical,,253.99,,,253.99,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Aetna,Middlesex Employees,,228.6,,,228.6,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Anthem,Commerical,,227.27,,,227.27,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Anthem,Indemnity,,,255.39,,255.39,181.81,281.35,percent of total billed charges,,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Anthem,State Preferred,,227.27,,,227.27,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Anthem,Individual Exchange,,181.81,,,181.81,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Cigna,Cigna,,221.96,,,221.96,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Connecticare,Commerical,,237.4,,,237.4,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Connecticare,Exchange,,237.4,,,237.4,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,Multiplan,Multiplan,,,281.35,,281.35,181.81,281.35,percent of total billed charges,,
HC US ELASTOGRAPY PARENCHYMA,76981,CPT,,,both,,,351.16,210.69,United Healthcare/Oxford,United Healthcare/Oxford,,228.42,,,228.42,181.81,281.35,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT  ,,,both,,,263.37,158.02,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC US ELASTOGRAPY FIRST TARGET LESION,76982,CPT,,,both,,,263.37,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT  ,,,both,,,87.79,52.67,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Anthem,Indemnity,,,63.85,,63.85,45.46,70.34,percent of total billed charges,,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC US ELASTOGRAPY EA ADDL LESION,76983,CPT,,,both,,,87.79,52.67,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT  ,,,both,,,226.6,135.96,Aetna,Commerical,,164.45,,,164.45,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Aetna,Middlesex Employees,,148.01,,,148.01,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Anthem,Commerical,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Anthem,Indemnity,,,165.35,,165.35,117.72,182.16,percent of total billed charges,,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Anthem,State Preferred,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Anthem,Individual Exchange,,117.72,,,117.72,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Cigna,Cigna,,143.7,,,143.7,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Connecticare,Commerical,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Connecticare,Exchange,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,Multiplan,Multiplan,,,182.16,,182.16,117.72,182.16,percent of total billed charges,,
HC US GUIDANCE INTRAOPERATIVE,76998,CPT,,,both,,,226.6,135.96,United Healthcare/Oxford,United Healthcare/Oxford,,147.89,,,147.89,117.72,182.16,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT  ,,,both,,,336.81,202.09,Aetna,Commerical,,243.42,,,243.42,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Aetna,Middlesex Employees,,219.08,,,219.08,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Anthem,Commerical,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Anthem,Indemnity,,,244.75,,244.75,174.24,269.63,percent of total billed charges,,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Anthem,State Preferred,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Anthem,Individual Exchange,,174.24,,,174.24,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Cigna,Cigna,,212.71,,,212.71,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Connecticare,Commerical,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Connecticare,Exchange,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,Multiplan,Multiplan,,,269.63,,269.63,174.24,269.63,percent of total billed charges,,
HC US UNLISTED PROC,76999,CPT,,,both,,,336.81,202.09,United Healthcare/Oxford,United Healthcare/Oxford,,218.91,,,218.91,174.24,269.63,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT  ,,,both,,,282.22,169.33,Aetna,Commerical,,265.93,,,265.93,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Aetna,Middlesex Employees,,239.34,,,239.34,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Anthem,Commerical,,209.68,,,209.68,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Anthem,Indemnity,,,204.64,,204.64,104.51,288.68,percent of total billed charges,,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Anthem,State Preferred,,209.68,,,209.68,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Anthem,Individual Exchange,,167.74,,,167.74,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Cigna,Cigna,,104.51,,,104.51,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Connecticare,Commerical,,288.68,,,288.68,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Connecticare,Exchange,,288.68,,,288.68,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,Multiplan,Multiplan,,,225.45,,225.45,104.51,288.68,percent of total billed charges,,
HC FL GUIDED CENTRAL VENOUS ACCESS DEVICE PLACEMENT,77001,CPT,,,both,,,282.22,169.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,104.51,288.68,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT  ,,,both,,,243.08,145.85,Aetna,Commerical,,275.68,,,275.68,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Aetna,Middlesex Employees,,248.12,,,248.12,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Anthem,Commerical,,161.81,,,161.81,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Anthem,Indemnity,,,176.81,,176.81,119.76,295.84,percent of total billed charges,,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Anthem,State Preferred,,161.81,,,161.81,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Anthem,Individual Exchange,,129.45,,,129.45,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Cigna,Cigna,,119.76,,,119.76,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Connecticare,Commerical,,295.84,,,295.84,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Connecticare,Exchange,,295.84,,,295.84,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,Multiplan,Multiplan,,,194.78,,194.78,119.76,295.84,percent of total billed charges,,
HC FL GUIDED NEEDLE PLACEMENT,77002,CPT,,,both,,,243.08,145.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,119.76,295.84,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT  ,,,both,,,237.93,142.76,Aetna,Commerical,,243.98,,,243.98,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Aetna,Middlesex Employees,,219.57,,,219.57,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Anthem,Commerical,,148.04,,,148.04,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Anthem,Indemnity,,,172.72,,172.72,118.02,272.99,percent of total billed charges,,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Anthem,State Preferred,,148.04,,,148.04,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Anthem,Individual Exchange,,118.42,,,118.42,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Cigna,Cigna,,118.02,,,118.02,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Connecticare,Commerical,,272.99,,,272.99,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Connecticare,Exchange,,272.99,,,272.99,118.02,272.99,other,Could be inpatient or outpatient,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,Multiplan,Multiplan,,,190.27,,190.27,118.02,272.99,percent of total billed charges,,
HC FL GUIDED SPINAL INJECTION,77003,CPT,,,both,,,237.93,142.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,118.02,272.99,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT  ,,,both,,,703.49,422.09,Aetna,Commerical,,263.5,,,263.5,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Aetna,Middlesex Employees,,237.15,,,237.15,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Anthem,Commerical,,871.94,,,871.94,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Anthem,Indemnity,,,511.6,,511.6,237.15,871.94,percent of total billed charges,,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Anthem,State Preferred,,871.94,,,871.94,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Anthem,Individual Exchange,,697.55,,,697.55,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Cigna,Cigna,,756.56,,,756.56,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Connecticare,Commerical,,399.26,,,399.26,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Connecticare,Exchange,,399.26,,,399.26,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,Multiplan,Multiplan,,,563.6,,563.6,237.15,871.94,percent of total billed charges,,
HC CT GUIDANCE NEEDLE PLACEMENT,77012,CPT,,,both,,,703.49,422.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,237.15,871.94,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION ,77013,CPT  ,,,both,,,1520.57,912.34,Aetna,Commerical,,835.58,,,835.58,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT  ,,,both,,,1433.9,860.34,Aetna,Commerical,,787.95,,,787.95,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Aetna,Middlesex Employees,,752.02,,,752.02,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Aetna,Middlesex Employees,,709.16,,,709.16,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Anthem,Commerical,,992.12,,,992.12,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Anthem,Commerical,,935.58,,,935.58,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Anthem,Indemnity,,,1105.88,,1105.88,752.02,1218.29,percent of total billed charges,,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Anthem,Indemnity,,,1042.85,,1042.85,709.16,1148.85,percent of total billed charges,,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Anthem,State Preferred,,992.12,,,992.12,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Anthem,State Preferred,,935.58,,,935.58,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Anthem,Individual Exchange,,793.7,,,793.7,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Anthem,Individual Exchange,,748.46,,,748.46,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Cigna,Cigna,,1140.59,,,1140.59,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Cigna,Cigna,,1075.58,,,1075.58,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Connecticare,Commerical,,1061.85,,,1061.85,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Connecticare,Commerical,,1001.32,,,1001.32,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Connecticare,Exchange,,1061.85,,,1061.85,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Connecticare,Exchange,,1001.32,,,1001.32,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,Multiplan,Multiplan,,,1218.29,,1218.29,752.02,1218.29,percent of total billed charges,,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,Multiplan,Multiplan,,,1148.85,,1148.85,709.16,1148.85,percent of total billed charges,,
HC CT GUIDE FOR TISSUE ABLATION,77013,CPT,,,both,,,1520.57,912.34,United Healthcare/Oxford,United Healthcare/Oxford,,926.33,,,926.33,752.02,1218.29,other,Could be inpatient or outpatient,
HC CT GUIDE FOR TISSUE ABLATION - Body Scan,77013,CPT,,,both,,,1433.9,860.34,United Healthcare/Oxford,United Healthcare/Oxford,,873.53,,,873.53,709.16,1148.85,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT  ,,,both,,,1836.49,1101.89,Aetna,Commerical,,1009.38,,,1009.38,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Aetna,Middlesex Employees,,908.44,,,908.44,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Anthem,Commerical,,1198.48,,,1198.48,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Anthem,Indemnity,,,1335.89,,1335.89,908.44,1471.68,percent of total billed charges,,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Anthem,State Preferred,,1198.48,,,1198.48,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Anthem,Individual Exchange,,958.78,,,958.78,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Cigna,Cigna,,1377.82,,,1377.82,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Connecticare,Commerical,,1282.7,,,1282.7,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Connecticare,Exchange,,1282.7,,,1282.7,908.44,1471.68,other,Could be inpatient or outpatient,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,Multiplan,Multiplan,,,1471.68,,1471.68,908.44,1471.68,percent of total billed charges,,
HC CT PLCMT RX FIELD,77014,CPT,,,both,,,1836.49,1101.89,United Healthcare/Oxford,United Healthcare/Oxford,,1119,,,1119,908.44,1471.68,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT  ,,,both,,,533.54,320.12,Aetna,Commerical,,385.88,,,385.88,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Aetna,Middlesex Employees,,347.29,,,347.29,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Anthem,Commerical,,345.28,,,345.28,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Anthem,Indemnity,,,388,,388,276.22,427.44,percent of total billed charges,,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Anthem,State Preferred,,345.28,,,345.28,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Anthem,Individual Exchange,,276.22,,,276.22,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Cigna,Cigna,,337.2,,,337.2,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Connecticare,Commerical,,360.67,,,360.67,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Connecticare,Exchange,,360.67,,,360.67,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,Multiplan,Multiplan,,,427.44,,427.44,276.22,427.44,percent of total billed charges,,
HC MRI BREAST W/O CONT UNLAT,77046,CPT,,,both,,,533.54,320.12,United Healthcare/Oxford,United Healthcare/Oxford,,347.03,,,347.03,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT  ,,,both,,,802.37,481.42,Aetna,Commerical,,580.45,,,580.45,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Aetna,Middlesex Employees,,522.4,,,522.4,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Anthem,Commerical,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Anthem,Indemnity,,,583.63,,583.63,415.5,642.96,percent of total billed charges,,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Anthem,State Preferred,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Anthem,Individual Exchange,,415.5,,,415.5,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Cigna,Cigna,,507.22,,,507.22,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Connecticare,Commerical,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Connecticare,Exchange,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,Multiplan,Multiplan,,,642.96,,642.96,415.5,642.96,percent of total billed charges,,
HC MRI BREAST W/O CONT BILAT,77047,CPT,,,both,,,802.37,481.42,United Healthcare/Oxford,United Healthcare/Oxford,,522,,,522,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT  ,,,both,,,533.5,320.1,Aetna,Commerical,,385.88,,,385.88,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Aetna,Middlesex Employees,,347.29,,,347.29,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Anthem,Commerical,,345.28,,,345.28,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Anthem,Indemnity,,,388,,388,276.22,427.44,percent of total billed charges,,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Anthem,State Preferred,,345.28,,,345.28,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Anthem,Individual Exchange,,276.22,,,276.22,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Cigna,Cigna,,337.2,,,337.2,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Connecticare,Commerical,,360.67,,,360.67,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Connecticare,Exchange,,360.67,,,360.67,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,Multiplan,Multiplan,,,427.44,,427.44,276.22,427.44,percent of total billed charges,,
HC MRI BREAST W/WO CONT CAD UNLAT,77048,CPT,,,both,,,533.5,320.1,United Healthcare/Oxford,United Healthcare/Oxford,,347.03,,,347.03,276.22,427.44,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT  ,,,both,,,802.48,481.49,Aetna,Commerical,,580.45,,,580.45,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Aetna,Middlesex Employees,,522.4,,,522.4,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Anthem,Commerical,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Anthem,Indemnity,,,583.63,,583.63,415.5,642.96,percent of total billed charges,,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Anthem,State Preferred,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Anthem,Individual Exchange,,415.5,,,415.5,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Cigna,Cigna,,507.22,,,507.22,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Connecticare,Commerical,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Connecticare,Exchange,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,Multiplan,Multiplan,,,642.96,,642.96,415.5,642.96,percent of total billed charges,,
HC MRI BREAST W/WO CONT CAD BILAT,77049,CPT,,,both,,,802.48,481.49,United Healthcare/Oxford,United Healthcare/Oxford,,522,,,522,415.5,642.96,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,179.04,,,179.04,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Aetna,Commerical,50,268.56,,,268.56,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,161.13,,,161.13,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Aetna,Middlesex Employees,50,241.7,,,241.7,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,92.42,,,92.42,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Anthem,Commerical,50,138.63,,,138.63,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,73.93,256.87,percent of total billed charges,,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Anthem,Indemnity,50,,249.533616,,249.533616,110.91,301.08,percent of total billed charges,,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,92.42,,,92.42,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Anthem,State Preferred,50,138.63,,,138.63,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,73.93,,,73.93,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Anthem,Individual Exchange,50,110.9,,,110.91,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,256.87,,,256.87,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Cigna,Cigna,50,385.31,,,385.3,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,200.72,,,200.72,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Connecticare,Commerical,50,301.08,,,301.08,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,200.72,,,200.72,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Connecticare,Exchange,50,301.08,,,301.08,110.91,301.08,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,73.93,256.87,percent of total billed charges,,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,Multiplan,Multiplan,50,,282.353,,282.353,110.91,301.08,percent of total billed charges,,
HC XR STRESS JOINT,77071,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,108.92,,,108.92,73.93,256.87,other,Could be inpatient or outpatient,
HC XR STRESS JOINT,77071,CPT  ,,,both,,,332.18,199.31,United Healthcare/Oxford,United Healthcare/Oxford,50,163.38,,,163.38,110.91,301.08,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,53.66,,,53.66,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,48.29,,,48.29,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,44.43,,,44.43,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,35.54,327.34,percent of total billed charges,,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,44.43,,,44.43,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,35.54,,,35.54,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,47.4,,,47.4,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,58.74,,,58.74,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,58.74,,,58.74,35.54,327.34,other,Could be inpatient or outpatient,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,35.54,327.34,percent of total billed charges,,
HC XR BONE AGE STUDY,77072,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,35.54,327.34,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT  ,,,both,,,1930.22,1158.13,Aetna,Commerical,,103.69,,,103.69,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Aetna,Middlesex Employees,,93.32,,,93.32,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Anthem,Commerical,,94.84,,,94.84,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Anthem,Indemnity,,,1403.83,,1403.83,72.33,1546.52,percent of total billed charges,,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Anthem,State Preferred,,94.84,,,94.84,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Anthem,Individual Exchange,,75.87,,,75.87,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Cigna,Cigna,,72.33,,,72.33,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Connecticare,Commerical,,93.01,,,93.01,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Connecticare,Exchange,,93.01,,,93.01,72.33,1546.52,other,Could be inpatient or outpatient,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,Multiplan,Multiplan,,,1546.52,,1546.52,72.33,1546.52,percent of total billed charges,,
HC SCANOGRAM,77073,CPT,,,both,,,1930.22,1158.13,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT  ,,,both,,,408.56,245.14,Aetna,Commerical,,103.69,,,103.69,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT  ,,,both,,,1930.24,1158.14,Aetna,Commerical,,103.69,,,103.69,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Aetna,Middlesex Employees,,93.32,,,93.32,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Aetna,Middlesex Employees,,93.32,,,93.32,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Anthem,Commerical,,94.84,,,94.84,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Anthem,Commerical,,94.84,,,94.84,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Anthem,Indemnity,,,297.14,,297.14,72.33,327.34,percent of total billed charges,,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Anthem,Indemnity,,,1403.83,,1403.83,72.33,1546.52,percent of total billed charges,,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Anthem,State Preferred,,94.84,,,94.84,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Anthem,State Preferred,,94.84,,,94.84,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Anthem,Individual Exchange,,75.87,,,75.87,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Anthem,Individual Exchange,,75.87,,,75.87,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Cigna,Cigna,,72.33,,,72.33,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Cigna,Cigna,,72.33,,,72.33,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Connecticare,Commerical,,93.01,,,93.01,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Connecticare,Commerical,,93.01,,,93.01,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Connecticare,Exchange,,93.01,,,93.01,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Connecticare,Exchange,,93.01,,,93.01,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,Multiplan,Multiplan,,,327.34,,327.34,72.33,327.34,percent of total billed charges,,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,Multiplan,Multiplan,,,1546.52,,1546.52,72.33,1546.52,percent of total billed charges,,
HC X-RAYS BONE LENGTH STUDIES,77073,CPT,,,both,,,408.56,245.14,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,72.33,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE LENGTH STUDIES-2,77073,CPT,,,both,,,1930.24,1158.14,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,72.33,1546.52,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,140.28,,,140.28,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,126.26,,,126.26,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,137.08,,,137.08,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,92.14,327.34,percent of total billed charges,,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,137.08,,,137.08,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,109.66,,,109.66,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,92.14,,,92.14,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,180.15,,,180.15,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,180.15,,,180.15,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,92.14,327.34,percent of total billed charges,,
HC X-RAYS BONE SURVEY LIMITED,77074,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,92.14,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,230.55,,,230.55,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,207.5,,,207.5,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,205.28,,,205.28,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,132.62,327.34,percent of total billed charges,,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,205.28,,,205.28,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,164.22,,,164.22,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,132.62,,,132.62,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,261.55,,,261.55,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,261.55,,,261.55,132.62,327.34,other,Could be inpatient or outpatient,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,132.62,327.34,percent of total billed charges,,
HC X-RAYS BONE SURVEY COMPLETE,77075,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,132.62,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,232.98,,,232.98,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,209.69,,,209.69,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,127.38,,,127.38,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,68.02,327.34,percent of total billed charges,,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,127.38,,,127.38,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,101.91,,,101.91,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,68.02,,,68.02,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,264.4,,,264.4,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,264.4,,,264.4,68.02,327.34,other,Could be inpatient or outpatient,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,68.02,327.34,percent of total billed charges,,
HC XR SKELETL SURVEY INFNT,77076,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,68.02,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,97.58,,,97.58,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,87.83,,,87.83,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,127.07,,,127.07,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,87.83,327.34,percent of total billed charges,,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,127.07,,,127.07,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,101.66,,,101.66,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,102.54,,,102.54,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,90.16,,,90.16,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,90.16,,,90.16,87.83,327.34,other,Could be inpatient or outpatient,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,87.83,327.34,percent of total billed charges,,
HC JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,87.83,327.34,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT  ,,,both,,,408.91,245.35,Aetna,Commerical,,101.23,,,101.23,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Aetna,Middlesex Employees,,91.11,,,91.11,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Anthem,Commerical,,328.94,,,328.94,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Anthem,Indemnity,,,297.14,,297.14,91.11,328.94,percent of total billed charges,,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Anthem,State Preferred,,328.94,,,328.94,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Anthem,Individual Exchange,,263.16,,,263.16,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Cigna,Cigna,,284.32,,,284.32,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Connecticare,Commerical,,121.6,,,121.6,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Connecticare,Exchange,,121.6,,,121.6,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,Multiplan,Multiplan,,,327.34,,327.34,91.11,328.94,percent of total billed charges,,
HC DXA BONE DENSITY AXIAL 1+ SITES,77080,CPT,,,both,,,408.91,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,196.71,,,196.71,91.11,328.94,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,121.84,,,121.84,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,109.66,,,109.66,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,109.66,177.65,percent of total billed charges,,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,144.67,,,144.67,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,115.73,,,115.73,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,166.32,,,166.32,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,154.84,,,154.84,109.66,177.65,other,Could be inpatient or outpatient,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,109.66,177.65,percent of total billed charges,,
HC DXA BONE DENSITY/PERIPHERAL 1+ SITES,77081,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,135.07,,,135.07,109.66,177.65,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT  ,,,both,,,517.06,310.24,Aetna,Commerical,,283.89,,,283.89,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Aetna,Middlesex Employees,,255.5,,,255.5,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Anthem,Commerical,,337.07,,,337.07,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Anthem,Indemnity,,,375.72,,375.72,255.5,413.91,percent of total billed charges,,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Anthem,State Preferred,,337.07,,,337.07,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Anthem,Individual Exchange,,269.66,,,269.66,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Cigna,Cigna,,387.51,,,387.51,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Connecticare,Commerical,,360.76,,,360.76,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Connecticare,Exchange,,360.76,,,360.76,255.5,413.91,other,Could be inpatient or outpatient,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,Multiplan,Multiplan,,,413.91,,413.91,255.5,413.91,percent of total billed charges,,
HC DEXA VERTEBRAL FX,77082,CPT,,,both,,,517.06,310.24,United Healthcare/Oxford,United Healthcare/Oxford,,314.72,,,314.72,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT  ,,,both,,,517.06,310.24,Aetna,Commerical,,283.89,,,283.89,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Aetna,Middlesex Employees,,255.5,,,255.5,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Anthem,Commerical,,337.07,,,337.07,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Anthem,Indemnity,,,375.72,,375.72,255.5,413.91,percent of total billed charges,,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Anthem,State Preferred,,337.07,,,337.07,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Anthem,Individual Exchange,,269.66,,,269.66,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Cigna,Cigna,,387.51,,,387.51,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Connecticare,Commerical,,360.76,,,360.76,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Connecticare,Exchange,,360.76,,,360.76,255.5,413.91,other,Could be inpatient or outpatient,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,Multiplan,Multiplan,,,413.91,,413.91,255.5,413.91,percent of total billed charges,,
HC DUAL-ENRGY DXA BONE DEN STUDY 1 OR MORE SITES,77085,CPT,,,both,,,517.06,310.24,United Healthcare/Oxford,United Healthcare/Oxford,,314.72,,,314.72,255.5,413.91,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT  ,,,both,,,490.28,294.17,Aetna,Commerical,,269.67,,,269.67,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Aetna,Middlesex Employees,,242.7,,,242.7,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Anthem,Commerical,,320.18,,,320.18,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Anthem,Indemnity,,,356.89,,356.89,242.7,393.17,percent of total billed charges,,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Anthem,State Preferred,,320.18,,,320.18,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Anthem,Individual Exchange,,256.14,,,256.14,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Cigna,Cigna,,368.1,,,368.1,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Connecticare,Commerical,,342.68,,,342.68,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Connecticare,Exchange,,342.68,,,342.68,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,Multiplan,Multiplan,,,393.17,,393.17,242.7,393.17,percent of total billed charges,,
HC SIMULATION-S,77280,CPT,,,both,,,490.28,294.17,United Healthcare/Oxford,United Healthcare/Oxford,,298.95,,,298.95,242.7,393.17,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT  ,,,both,,,613.88,368.33,Aetna,Commerical,,337.69,,,337.69,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Aetna,Middlesex Employees,,303.92,,,303.92,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Anthem,Commerical,,400.96,,,400.96,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Anthem,Indemnity,,,446.93,,446.93,303.92,492.36,percent of total billed charges,,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Anthem,State Preferred,,400.96,,,400.96,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Anthem,Individual Exchange,,320.77,,,320.77,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Cigna,Cigna,,460.96,,,460.96,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Connecticare,Commerical,,429.14,,,429.14,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Connecticare,Exchange,,429.14,,,429.14,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,Multiplan,Multiplan,,,492.36,,492.36,303.92,492.36,percent of total billed charges,,
HC SIMULATION-I,77285,CPT,,,both,,,613.88,368.33,United Healthcare/Oxford,United Healthcare/Oxford,,374.37,,,374.37,303.92,492.36,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT  ,,,both,,,736.45,441.87,Aetna,Commerical,,404.49,,,404.49,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Aetna,Middlesex Employees,,364.04,,,364.04,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Anthem,Commerical,,480.27,,,480.27,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Anthem,Indemnity,,,535.34,,535.34,364.04,589.76,percent of total billed charges,,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Anthem,State Preferred,,480.27,,,480.27,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Anthem,Individual Exchange,,384.21,,,384.21,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Cigna,Cigna,,552.15,,,552.15,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Connecticare,Commerical,,514.03,,,514.03,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Connecticare,Exchange,,514.03,,,514.03,364.04,589.76,other,Could be inpatient or outpatient,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,Multiplan,Multiplan,,,589.76,,589.76,364.04,589.76,percent of total billed charges,,
HC SIMULATION-C,77290,CPT,,,both,,,736.45,441.87,United Healthcare/Oxford,United Healthcare/Oxford,,448.42,,,448.42,364.04,589.76,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT  ,,,both,,,430.54,258.32,Aetna,Commerical,,236.88,,,236.88,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Aetna,Middlesex Employees,,213.19,,,213.19,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Anthem,Commerical,,281.26,,,281.26,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Anthem,Indemnity,,,313.51,,313.51,213.19,345.37,percent of total billed charges,,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Anthem,State Preferred,,281.26,,,281.26,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Anthem,Individual Exchange,,225.01,,,225.01,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Cigna,Cigna,,323.35,,,323.35,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Connecticare,Commerical,,301.02,,,301.02,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Connecticare,Exchange,,301.02,,,301.02,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,Multiplan,Multiplan,,,345.37,,345.37,213.19,345.37,percent of total billed charges,,
HC THYROID UPTAKE MEASUREMENT,78012,CPT,,,both,,,430.54,258.32,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,213.19,345.37,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT  ,,,both,,,1260.72,756.43,Aetna,Commerical,,692.09,,,692.09,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Aetna,Middlesex Employees,,622.88,,,622.88,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Anthem,Commerical,,821.75,,,821.75,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Anthem,Indemnity,,,915.97,,915.97,622.88,1009.08,percent of total billed charges,,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Anthem,State Preferred,,821.75,,,821.75,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Anthem,Individual Exchange,,657.4,,,657.4,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Cigna,Cigna,,944.73,,,944.73,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Connecticare,Commerical,,879.49,,,879.49,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Connecticare,Exchange,,879.49,,,879.49,622.88,1009.08,other,Could be inpatient or outpatient,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,Multiplan,Multiplan,,,1009.08,,1009.08,622.88,1009.08,percent of total billed charges,,
HC THYROID IMAGING W/BLOOD FLOW,78014,CPT,,,both,,,1260.72,756.43,United Healthcare/Oxford,United Healthcare/Oxford,,767.26,,,767.26,622.88,1009.08,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT  ,,,both,,,666.41,399.85,Aetna,Commerical,,366.14,,,366.14,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Aetna,Middlesex Employees,,329.53,,,329.53,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Anthem,Commerical,,434.74,,,434.74,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Anthem,Indemnity,,,484.59,,484.59,329.53,533.84,percent of total billed charges,,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Anthem,State Preferred,,434.74,,,434.74,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Anthem,Individual Exchange,,347.79,,,347.79,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Cigna,Cigna,,499.8,,,499.8,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Connecticare,Commerical,,465.29,,,465.29,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Connecticare,Exchange,,465.29,,,465.29,329.53,533.84,other,Could be inpatient or outpatient,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,Multiplan,Multiplan,,,533.84,,533.84,329.53,533.84,percent of total billed charges,,
HC WHITE BLOOD VOLUME DETERM,78122,CPT,,,both,,,666.41,399.85,United Healthcare/Oxford,United Healthcare/Oxford,,405.91,,,405.91,329.53,533.84,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT  ,,,both,,,894.04,536.42,Aetna,Commerical,,491.08,,,491.08,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Aetna,Middlesex Employees,,441.97,,,441.97,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Anthem,Commerical,,583.09,,,583.09,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Anthem,Indemnity,,,649.93,,649.93,441.97,716,percent of total billed charges,,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Anthem,State Preferred,,583.09,,,583.09,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Anthem,Individual Exchange,,466.47,,,466.47,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Cigna,Cigna,,670.34,,,670.34,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Connecticare,Commerical,,624.06,,,624.06,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Connecticare,Exchange,,624.06,,,624.06,441.97,716,other,Could be inpatient or outpatient,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,Multiplan,Multiplan,,,716,,716,441.97,716,percent of total billed charges,,
HC HHRED CELL SEQUESTRATION,78140,CPT,,,both,,,894.04,536.42,United Healthcare/Oxford,United Healthcare/Oxford,,544.42,,,544.42,441.97,716,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT  ,,,both,,,805.46,483.28,Aetna,Commerical,,442.83,,,442.83,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Aetna,Middlesex Employees,,398.55,,,398.55,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Anthem,Commerical,,525.8,,,525.8,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Anthem,Indemnity,,,586.09,,586.09,398.55,645.66,percent of total billed charges,,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Anthem,State Preferred,,525.8,,,525.8,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Anthem,Individual Exchange,,420.64,,,420.64,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Cigna,Cigna,,604.49,,,604.49,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Connecticare,Commerical,,562.75,,,562.75,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Connecticare,Exchange,,562.75,,,562.75,398.55,645.66,other,Could be inpatient or outpatient,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,Multiplan,Multiplan,,,645.66,,645.55,398.55,645.66,percent of total billed charges,,
HC LYMPH OR LN NM SCAN,78195,CPT,,,both,,,805.46,483.28,United Healthcare/Oxford,United Healthcare/Oxford,,490.94,,,490.94,398.55,645.66,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT  ,,,both,,,2463.76,1478.26,Aetna,Commerical,,1353.25,,,1353.25,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Aetna,Middlesex Employees,,1217.93,,,1217.93,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Anthem,Commerical,,1606.79,,,1606.79,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Anthem,Indemnity,,,1791.01,,1791.01,1217.93,1973.06,percent of total billed charges,,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Anthem,State Preferred,,1606.79,,,1606.79,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Anthem,Individual Exchange,,1285.43,,,1285.43,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Cigna,Cigna,,1847.23,,,1847.23,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Connecticare,Commerical,,1719.7,,,1719.7,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Connecticare,Exchange,,1719.7,,,1719.7,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,Multiplan,Multiplan,,,1973.06,,1973.06,1217.93,1973.06,percent of total billed charges,,
HC HH LIVER - SPECT (3D),78205,CPT,,,both,,,2463.76,1478.26,United Healthcare/Oxford,United Healthcare/Oxford,,1500.24,,,1500.24,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT  ,,,both,,,169.95,101.97,Aetna,Commerical,,92.77,,,92.77,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Aetna,Middlesex Employees,,83.49,,,83.49,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Anthem,Commerical,,110.16,,,110.16,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Anthem,Indemnity,,,122.79,,122.79,83.49,135.27,percent of total billed charges,,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Anthem,State Preferred,,110.16,,,110.16,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Anthem,Individual Exchange,,88.12,,,88.12,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Cigna,Cigna,,126.64,,,126.64,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Connecticare,Commerical,,117.9,,,117.9,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Connecticare,Exchange,,117.9,,,117.9,83.49,135.27,other,Could be inpatient or outpatient,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,Multiplan,Multiplan,,,135.27,,135.27,83.49,135.27,percent of total billed charges,,
HC HH LIVER & SPLEEN; STATIC ONLY,78215,CPT,,,both,,,169.95,101.97,United Healthcare/Oxford,United Healthcare/Oxford,,102.85,,,102.85,83.49,135.27,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT  ,,,both,,,1245.27,747.16,Aetna,Commerical,,1018.57,,,1018.57,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Aetna,Middlesex Employees,,916.72,,,916.72,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Anthem,Commerical,,783.06,,,783.06,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Anthem,Indemnity,,,906.15,,906.15,618.02,1211.9,percent of total billed charges,,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Anthem,State Preferred,,783.06,,,783.06,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Anthem,Individual Exchange,,626.44,,,626.44,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Cigna,Cigna,,,,,,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Connecticare,Commerical,,1211.9,,,1211.9,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Connecticare,Exchange,,1211.9,,,1211.9,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,Multiplan,Multiplan,,,998.26,,998.26,618.02,1211.9,percent of total billed charges,,
HC HH HEPATOBILIARY SYSTEM IMAGING,78226,CPT,,,both,,,1245.27,747.16,United Healthcare/Oxford,United Healthcare/Oxford,,618.02,,,618.02,618.02,1211.9,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT  ,,,both,,,1616.07,969.64,Aetna,Commerical,,888.15,,,888.15,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Aetna,Middlesex Employees,,799.33,,,799.33,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Anthem,Commerical,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Anthem,Indemnity,,,1175.45,,1175.45,799.33,1294.93,percent of total billed charges,,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Anthem,State Preferred,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Anthem,Individual Exchange,,843.63,,,843.63,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Cigna,Cigna,,1212.35,,,1212.35,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Connecticare,Commerical,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Connecticare,Exchange,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,Multiplan,Multiplan,,,1294.93,,1294.93,799.33,1294.93,percent of total billed charges,,
HC HH HEPATOBIL SYST IMAGE W/DRUG,78227,CPT,,,both,,,1616.07,969.64,United Healthcare/Oxford,United Healthcare/Oxford,,984.62,,,984.62,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT  ,,,both,,,1245.27,747.16,Aetna,Commerical,,684.67,,,684.67,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Aetna,Middlesex Employees,,616.21,,,616.21,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Anthem,Commerical,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Anthem,Indemnity,,,906.15,,906.15,616.21,998.26,percent of total billed charges,,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Anthem,State Preferred,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Anthem,Individual Exchange,,650.35,,,650.35,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Cigna,Cigna,,934.59,,,934.59,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Connecticare,Commerical,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Connecticare,Exchange,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,Multiplan,Multiplan,,,998.26,,998.26,616.21,998.26,percent of total billed charges,,
HC HH GASTRIC EMPTYING IMAG STUDY,78264,CPT,,,both,,,1245.27,747.16,United Healthcare/Oxford,United Healthcare/Oxford,,759.03,,,759.03,616.21,998.26,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT  ,,,both,,,1915.8,1149.48,Aetna,Commerical,,1052.67,,,1052.67,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Aetna,Middlesex Employees,,947.4,,,947.4,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Anthem,Commerical,,1249.89,,,1249.89,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Anthem,Indemnity,,,1393.19,,1393.19,947.4,1534.8,percent of total billed charges,,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Anthem,State Preferred,,1249.89,,,1249.89,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Anthem,Individual Exchange,,999.91,,,999.91,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Cigna,Cigna,,1436.93,,,1436.93,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Connecticare,Commerical,,1337.72,,,1337.72,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Connecticare,Exchange,,1337.72,,,1337.72,947.4,1534.8,other,Could be inpatient or outpatient,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,Multiplan,Multiplan,,,1534.8,,1534.8,947.4,1534.8,percent of total billed charges,,
HC ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1915.8,1149.48,United Healthcare/Oxford,United Healthcare/Oxford,,1167,,,1167,947.4,1534.8,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT  ,,,both,,,1120.64,672.38,Aetna,Commerical,,615.39,,,615.39,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Aetna,Middlesex Employees,,553.86,,,553.86,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Anthem,Commerical,,730.69,,,730.69,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Anthem,Indemnity,,,814.47,,814.47,553.86,897.26,percent of total billed charges,,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Anthem,State Preferred,,730.69,,,730.69,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Anthem,Individual Exchange,,584.55,,,584.55,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Cigna,Cigna,,840.04,,,840.04,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Connecticare,Commerical,,782.04,,,782.04,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Connecticare,Exchange,,782.04,,,782.04,553.86,897.26,other,Could be inpatient or outpatient,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,Multiplan,Multiplan,,,897.26,,897.26,553.86,897.26,percent of total billed charges,,
HC HH ACUTE GI BLEED STUDY,78278,CPT,,,both,,,1120.64,672.38,United Healthcare/Oxford,United Healthcare/Oxford,,682.24,,,682.24,553.86,897.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT  ,,,both,,,1245.27,747.16,Aetna,Commerical,,684.67,,,684.67,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Aetna,Middlesex Employees,,616.21,,,616.21,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Anthem,Commerical,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Anthem,Indemnity,,,906.15,,906.15,616.21,998.26,percent of total billed charges,,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Anthem,State Preferred,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Anthem,Individual Exchange,,650.35,,,650.35,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Cigna,Cigna,,934.59,,,934.59,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Connecticare,Commerical,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Connecticare,Exchange,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,Multiplan,Multiplan,,,998.26,,998.26,616.21,998.26,percent of total billed charges,,
HC HH MECKELS DIVERT EXAM,78290,CPT,,,both,,,1245.27,747.16,United Healthcare/Oxford,United Healthcare/Oxford,,759.03,,,759.03,616.21,998.26,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT  ,,,both,,,448.05,268.83,Aetna,Commerical,,246.16,,,246.16,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Aetna,Middlesex Employees,,221.54,,,221.54,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Anthem,Commerical,,292.27,,,292.27,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Anthem,Indemnity,,,325.79,,325.79,221.54,358.9,percent of total billed charges,,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Anthem,State Preferred,,292.27,,,292.27,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Anthem,Individual Exchange,,233.82,,,233.82,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Cigna,Cigna,,336.01,,,336.01,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Connecticare,Commerical,,312.82,,,312.82,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Connecticare,Exchange,,312.82,,,312.82,221.54,358.9,other,Could be inpatient or outpatient,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,Multiplan,Multiplan,,,358.9,,358.9,221.54,358.9,percent of total billed charges,,
HC HH GIASPIRATNM,78299,CPT,,,both,,,448.05,268.83,United Healthcare/Oxford,United Healthcare/Oxford,,272.9,,,272.9,221.54,358.9,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT  ,,,both,,,1226.73,736.04,Aetna,Commerical,,673.53,,,673.53,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Aetna,Middlesex Employees,,606.18,,,606.18,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Anthem,Commerical,,799.72,,,799.72,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Anthem,Indemnity,,,891.41,,891.41,606.18,982.02,percent of total billed charges,,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Anthem,State Preferred,,799.72,,,799.72,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Anthem,Individual Exchange,,639.77,,,639.77,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Cigna,Cigna,,919.39,,,919.39,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Connecticare,Commerical,,855.92,,,855.92,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Connecticare,Exchange,,855.92,,,855.92,606.18,982.02,other,Could be inpatient or outpatient,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,Multiplan,Multiplan,,,982.02,,982.02,606.18,982.02,percent of total billed charges,,
HC HH LTD BONE SCAN,78300,CPT,,,both,,,1226.73,736.04,United Healthcare/Oxford,United Healthcare/Oxford,,746.69,,,746.69,606.18,982.02,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT  ,,,both,,,378.01,226.81,Aetna,Commerical,,207.81,,,207.81,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Aetna,Middlesex Employees,,187.03,,,187.03,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Anthem,Commerical,,246.74,,,246.74,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Anthem,Indemnity,,,275.03,,275.03,187.03,302.99,percent of total billed charges,,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Anthem,State Preferred,,246.74,,,246.74,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Anthem,Individual Exchange,,197.4,,,197.4,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Cigna,Cigna,,283.67,,,283.67,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Connecticare,Commerical,,264.08,,,264.08,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Connecticare,Exchange,,264.08,,,264.08,187.03,302.99,other,Could be inpatient or outpatient,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,Multiplan,Multiplan,,,302.99,,302.99,187.03,302.99,percent of total billed charges,,
HC HH BONE/JOINT SCAN; MULTI AREAS,78305,CPT,,,both,,,378.01,226.81,United Healthcare/Oxford,United Healthcare/Oxford,,230.38,,,230.38,187.03,302.99,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT  ,,,both,,,2475.09,1485.05,Aetna,Commerical,,1360.06,,,1360.06,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Aetna,Middlesex Employees,,1224.05,,,1224.05,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Anthem,Commerical,,1614.86,,,1614.86,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Anthem,Indemnity,,,1800.02,,1800.02,1224.05,1982.98,percent of total billed charges,,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Anthem,State Preferred,,1614.86,,,1614.86,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Anthem,Individual Exchange,,1291.89,,,1291.89,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Cigna,Cigna,,1856.51,,,1856.51,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Connecticare,Commerical,,1728.34,,,1728.34,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Connecticare,Exchange,,1728.34,,,1728.34,1224.05,1982.98,other,Could be inpatient or outpatient,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,Multiplan,Multiplan,,,1982.98,,1982.98,1224.05,1982.98,percent of total billed charges,,
HC BONE/JOINT; WHOLE BODY,78306,CPT,,,both,,,2475.09,1485.05,United Healthcare/Oxford,United Healthcare/Oxford,,1507.78,,,1507.78,1224.05,1982.98,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT  ,,,both,,,698.34,419,Aetna,Commerical,,383.47,,,383.47,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Aetna,Middlesex Employees,,345.12,,,345.12,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Anthem,Commerical,,455.31,,,455.31,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Anthem,Indemnity,,,507.51,,507.51,345.12,559.1,percent of total billed charges,,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Anthem,State Preferred,,455.31,,,455.31,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Anthem,Individual Exchange,,364.25,,,364.25,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Cigna,Cigna,,523.44,,,523.44,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Connecticare,Commerical,,487.3,,,487.3,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Connecticare,Exchange,,487.3,,,487.3,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,Multiplan,Multiplan,,,559.1,,559.1,345.12,559.1,percent of total billed charges,,
HC HH BONE IMAGING 3 PHASE,78315,CPT,,,both,,,698.34,419,United Healthcare/Oxford,United Healthcare/Oxford,,425.11,,,425.11,345.12,559.1,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT  ,,,both,,,2463.76,1478.26,Aetna,Commerical,,1353.25,,,1353.25,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Aetna,Middlesex Employees,,1217.93,,,1217.93,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Anthem,Commerical,,1606.79,,,1606.79,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Anthem,Indemnity,,,1791.01,,1791.01,1217.93,1973.06,percent of total billed charges,,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Anthem,State Preferred,,1606.79,,,1606.79,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Anthem,Individual Exchange,,1285.43,,,1285.43,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Cigna,Cigna,,1847.23,,,1847.23,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Connecticare,Commerical,,1719.7,,,1719.7,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Connecticare,Exchange,,1719.7,,,1719.7,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,Multiplan,Multiplan,,,1973.06,,1973.06,1217.93,1973.06,percent of total billed charges,,
HC HH BONE/JOINT; SPECT (3D),78320,CPT,,,both,,,2463.76,1478.26,United Healthcare/Oxford,United Healthcare/Oxford,,1500.24,,,1500.24,1217.93,1973.06,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT  ,,,both,,,2581.18,1548.71,Aetna,Commerical,,1418.19,,,1418.19,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Aetna,Middlesex Employees,,1276.37,,,1276.37,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Anthem,Commerical,,1683.89,,,1683.89,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Anthem,Indemnity,,,1876.96,,1876.96,1276.37,2067.74,percent of total billed charges,,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Anthem,State Preferred,,1683.89,,,1683.89,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Anthem,Individual Exchange,,1347.11,,,1347.11,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Cigna,Cigna,,1935.88,,,1935.88,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Connecticare,Commerical,,1802.22,,,1802.22,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Connecticare,Exchange,,1802.22,,,1802.22,1276.37,2067.74,other,Could be inpatient or outpatient,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,Multiplan,Multiplan,,,2067.74,,2067.74,1276.37,2067.74,percent of total billed charges,,
HC HH BONE MINERAL DUAL PHOTON 1+ SITES,78351,CPT,,,both,,,2581.18,1548.71,United Healthcare/Oxford,United Healthcare/Oxford,,1572.23,,,1572.23,1276.37,2067.74,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT  ,,,both,,,1134.03,680.42,Aetna,Commerical,,623.43,,,623.43,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Aetna,Middlesex Employees,,561.09,,,561.09,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Anthem,Commerical,,740.23,,,740.23,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Anthem,Indemnity,,,825.11,,825.11,561.09,908.98,percent of total billed charges,,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Anthem,State Preferred,,740.23,,,740.23,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Anthem,Individual Exchange,,592.19,,,592.19,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Cigna,Cigna,,851.01,,,851.01,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Connecticare,Commerical,,792.26,,,792.26,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Connecticare,Exchange,,792.26,,,792.26,561.09,908.98,other,Could be inpatient or outpatient,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,Multiplan,Multiplan,,,908.98,,908.98,561.09,908.98,percent of total billed charges,,
HC CARDIAC SHUNT DETECT,78428,CPT,,,both,,,1134.03,680.42,United Healthcare/Oxford,United Healthcare/Oxford,,691.15,,,691.15,561.09,908.98,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT  ,,,both,,,1800.44,1080.26,Aetna,Commerical,,989.58,,,989.58,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Aetna,Middlesex Employees,,890.62,,,890.62,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Anthem,Commerical,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Anthem,Indemnity,,,1309.7,,1309.7,890.62,1442.82,percent of total billed charges,,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Anthem,State Preferred,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Anthem,Individual Exchange,,939.99,,,939.99,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Cigna,Cigna,,1350.8,,,1350.8,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Connecticare,Commerical,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Connecticare,Exchange,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,Multiplan,Multiplan,,,1442.82,,1442.82,890.62,1442.82,percent of total billed charges,,
HC MYOCARD PERF SNGL,78451,CPT,,,both,,,1800.44,1080.26,United Healthcare/Oxford,United Healthcare/Oxford,,1097.06,,,1097.06,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT  ,,,both,,,1800.44,1080.26,Aetna,Commerical,,989.58,,,989.58,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Aetna,Middlesex Employees,,890.62,,,890.62,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Anthem,Commerical,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Anthem,Indemnity,,,1309.7,,1309.7,890.62,1442.82,percent of total billed charges,,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Anthem,State Preferred,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Anthem,Individual Exchange,,939.99,,,939.99,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Cigna,Cigna,,1350.8,,,1350.8,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Connecticare,Commerical,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Connecticare,Exchange,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,Multiplan,Multiplan,,,1442.82,,1442.82,890.62,1442.82,percent of total billed charges,,
HC MYOCARD PERF MULT,78452,CPT,,,both,,,1800.44,1080.26,United Healthcare/Oxford,United Healthcare/Oxford,,1097.06,,,1097.06,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT  ,,,both,,,1800.44,1080.26,Aetna,Commerical,,989.58,,,989.58,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Aetna,Middlesex Employees,,890.62,,,890.62,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Anthem,Commerical,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Anthem,Indemnity,,,1309.7,,1309.7,890.62,1442.82,percent of total billed charges,,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Anthem,State Preferred,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Anthem,Individual Exchange,,939.99,,,939.99,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Cigna,Cigna,,1350.8,,,1350.8,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Connecticare,Commerical,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Connecticare,Exchange,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,Multiplan,Multiplan,,,1442.82,,1442.82,890.62,1442.82,percent of total billed charges,,
HC HT MUSCLE IMAGE PLANAR SING,78453,CPT,,,both,,,1800.44,1080.26,United Healthcare/Oxford,United Healthcare/Oxford,,1097.06,,,1097.06,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT  ,,,both,,,1800.44,1080.26,Aetna,Commerical,,989.58,,,989.58,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Aetna,Middlesex Employees,,890.62,,,890.62,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Anthem,Commerical,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Anthem,Indemnity,,,1309.7,,1309.7,890.62,1442.82,percent of total billed charges,,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Anthem,State Preferred,,1174.98,,,1174.98,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Anthem,Individual Exchange,,939.99,,,939.99,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Cigna,Cigna,,1350.8,,,1350.8,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Connecticare,Commerical,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Connecticare,Exchange,,1257.55,,,1257.55,890.62,1442.82,other,Could be inpatient or outpatient,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,Multiplan,Multiplan,,,1442.82,,1442.82,890.62,1442.82,percent of total billed charges,,
HC HT MUSC IMAGE PLANAR MULT,78454,CPT,,,both,,,1800.44,1080.26,United Healthcare/Oxford,United Healthcare/Oxford,,1097.06,,,1097.06,890.62,1442.82,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT  ,,,both,,,568.56,341.14,Aetna,Commerical,,312.34,,,312.34,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Aetna,Middlesex Employees,,281.1,,,281.1,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Anthem,Commerical,,370.85,,,370.85,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Anthem,Indemnity,,,413.37,,413.37,281.1,455.39,percent of total billed charges,,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Anthem,State Preferred,,370.85,,,370.85,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Anthem,Individual Exchange,,296.68,,,296.68,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Cigna,Cigna,,426.35,,,426.35,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Connecticare,Commerical,,396.91,,,396.91,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Connecticare,Exchange,,396.91,,,396.91,281.1,455.39,other,Could be inpatient or outpatient,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,Multiplan,Multiplan,,,455.39,,455.39,281.1,455.39,percent of total billed charges,,
HC MI PLANAR; QUAL/QUAN,78466,CPT,,,both,,,568.56,341.14,United Healthcare/Oxford,United Healthcare/Oxford,,346.27,,,346.27,281.1,455.39,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT  ,,,both,,,1321.49,792.89,Aetna,Commerical,,726.72,,,726.72,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Aetna,Middlesex Employees,,654.05,,,654.05,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Anthem,Commerical,,862.88,,,862.88,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Anthem,Indemnity,,,961.81,,961.81,654.05,1059.58,percent of total billed charges,,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Anthem,State Preferred,,862.88,,,862.88,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Anthem,Individual Exchange,,690.3,,,690.3,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Cigna,Cigna,,992,,,992,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Connecticare,Commerical,,923.51,,,923.51,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Connecticare,Exchange,,923.51,,,923.51,654.05,1059.58,other,Could be inpatient or outpatient,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,Multiplan,Multiplan,,,1059.58,,1059.58,654.05,1059.58,percent of total billed charges,,
HC MUGA; SGL  W WM & EF,78472,CPT,,,both,,,1321.49,792.89,United Healthcare/Oxford,United Healthcare/Oxford,,805.66,,,805.66,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT  ,,,both,,,1321.49,792.89,Aetna,Commerical,,726.72,,,726.72,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Aetna,Middlesex Employees,,654.05,,,654.05,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Anthem,Commerical,,862.88,,,862.88,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Anthem,Indemnity,,,961.81,,961.81,654.05,1059.58,percent of total billed charges,,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Anthem,State Preferred,,862.88,,,862.88,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Anthem,Individual Exchange,,690.3,,,690.3,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Cigna,Cigna,,992,,,992,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Connecticare,Commerical,,923.51,,,923.51,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Connecticare,Exchange,,923.51,,,923.51,654.05,1059.58,other,Could be inpatient or outpatient,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,Multiplan,Multiplan,,,1059.58,,1059.58,654.05,1059.58,percent of total billed charges,,
HC HEART FIRST PASS SINGLE,78481,CPT,,,both,,,1321.49,792.89,United Healthcare/Oxford,United Healthcare/Oxford,,805.66,,,805.66,654.05,1059.58,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT  ,,,both,,,1166.99,700.19,Aetna,Commerical,,641.37,,,641.37,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Aetna,Middlesex Employees,,577.23,,,577.23,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Anthem,Commerical,,761.53,,,761.53,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Anthem,Indemnity,,,848.85,,848.85,577.23,935.13,percent of total billed charges,,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Anthem,State Preferred,,761.53,,,761.53,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Anthem,Individual Exchange,,609.22,,,609.22,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Cigna,Cigna,,875.49,,,875.49,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Connecticare,Commerical,,815.05,,,815.05,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Connecticare,Exchange,,815.05,,,815.05,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,Multiplan,Multiplan,,,935.13,,935.13,577.23,935.13,percent of total billed charges,,
HC HH LUNG VENTILATION IMAGING,78579,CPT,,,both,,,1166.99,700.19,United Healthcare/Oxford,United Healthcare/Oxford,,711.03,,,711.03,577.23,935.13,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT  ,,,both,,,1023.09,613.85,Aetna,Commerical,,562.21,,,562.21,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Aetna,Middlesex Employees,,505.99,,,505.99,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Anthem,Commerical,,667.53,,,667.53,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Anthem,Indemnity,,,744.07,,744.07,505.99,819.71,percent of total billed charges,,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Anthem,State Preferred,,667.53,,,667.53,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Anthem,Individual Exchange,,534.03,,,534.03,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Cigna,Cigna,,767.43,,,767.43,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Connecticare,Commerical,,714.44,,,714.44,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Connecticare,Exchange,,714.44,,,714.44,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,Multiplan,Multiplan,,,819.71,,819.71,505.99,819.71,percent of total billed charges,,
HC HH LUNG PERFUSION IMAGING,78580,CPT,,,both,,,1023.09,613.85,United Healthcare/Oxford,United Healthcare/Oxford,,623.27,,,623.27,505.99,819.71,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT  ,,,both,,,733.36,440.02,Aetna,Commerical,,402.64,,,402.64,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Aetna,Middlesex Employees,,362.38,,,362.38,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Anthem,Commerical,,478.07,,,478.07,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Anthem,Indemnity,,,532.89,,532.89,362.38,587.05,percent of total billed charges,,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Anthem,State Preferred,,478.07,,,478.07,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Anthem,Individual Exchange,,382.45,,,382.45,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Cigna,Cigna,,549.61,,,549.61,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Connecticare,Commerical,,511.66,,,511.66,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Connecticare,Exchange,,511.66,,,511.66,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,Multiplan,Multiplan,,,587.05,,587.05,362.38,587.05,percent of total billed charges,,
HC HH LUNG VENTILAT&PERFUS IMAGING,78582,CPT,,,both,,,733.36,440.02,United Healthcare/Oxford,United Healthcare/Oxford,,446.37,,,446.37,362.38,587.05,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT  ,,,both,,,1245.27,747.16,Aetna,Commerical,,684.67,,,684.67,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Aetna,Middlesex Employees,,616.21,,,616.21,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Anthem,Commerical,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Anthem,Indemnity,,,906.15,,906.15,616.21,998.26,percent of total billed charges,,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Anthem,State Preferred,,812.94,,,812.94,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Anthem,Individual Exchange,,650.35,,,650.35,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Cigna,Cigna,,934.59,,,934.59,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Connecticare,Commerical,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Connecticare,Exchange,,870.07,,,870.07,616.21,998.26,other,Could be inpatient or outpatient,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,Multiplan,Multiplan,,,998.26,,998.26,616.21,998.26,percent of total billed charges,,
HC HH LUNG PERFUSION DIFFERENTIAL,78597,CPT,,,both,,,1245.27,747.16,United Healthcare/Oxford,United Healthcare/Oxford,,759.03,,,759.03,616.21,998.26,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT  ,,,both,,,1529.55,917.73,Aetna,Commerical,,840.52,,,840.52,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Aetna,Middlesex Employees,,756.47,,,756.47,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Anthem,Commerical,,998,,,998,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Anthem,Indemnity,,,1112.42,,1112.42,756.47,1225.5,percent of total billed charges,,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Anthem,State Preferred,,998,,,998,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Anthem,Individual Exchange,,798.4,,,798.4,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Cigna,Cigna,,1147.34,,,1147.34,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Connecticare,Commerical,,1068.13,,,1068.13,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Connecticare,Exchange,,1068.13,,,1068.13,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,Multiplan,Multiplan,,,1225.5,,1225.5,756.47,1225.5,percent of total billed charges,,
HC HH BRAIN IMAGING (3D),78607,CPT,,,both,,,1529.55,917.73,United Healthcare/Oxford,United Healthcare/Oxford,,931.82,,,931.82,756.47,1225.5,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT  ,,,both,,,1872.54,1123.52,Aetna,Commerical,,1029.17,,,1029.17,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Aetna,Middlesex Employees,,926.25,,,926.25,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Anthem,Commerical,,1221.97,,,1221.97,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Anthem,Indemnity,,,1362.09,,1362.09,926.25,1500.54,percent of total billed charges,,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Anthem,State Preferred,,1221.97,,,1221.97,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Anthem,Individual Exchange,,977.58,,,977.58,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Cigna,Cigna,,1404.84,,,1404.84,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Connecticare,Commerical,,1307.85,,,1307.85,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Connecticare,Exchange,,1307.85,,,1307.85,926.25,1500.54,other,Could be inpatient or outpatient,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,Multiplan,Multiplan,,,1500.54,,1500.54,926.25,1500.54,percent of total billed charges,,
HC HH BRAIN VASCULAR FLOW ONLY,78610,CPT,,,both,,,1872.54,1123.52,United Healthcare/Oxford,United Healthcare/Oxford,,1140.94,,,1140.94,926.25,1500.54,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT  ,,,both,,,1052.66,631.6,Aetna,Commerical,,578.29,,,578.29,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Aetna,Middlesex Employees,,520.46,,,520.46,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Anthem,Commerical,,686.63,,,686.63,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Anthem,Indemnity,,,765.35,,765.35,520.46,843.15,percent of total billed charges,,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Anthem,State Preferred,,686.63,,,686.63,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Anthem,Individual Exchange,,549.31,,,549.31,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Cigna,Cigna,,789.38,,,789.38,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Connecticare,Commerical,,734.88,,,734.88,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Connecticare,Exchange,,734.88,,,734.88,520.46,843.15,other,Could be inpatient or outpatient,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,Multiplan,Multiplan,,,843.15,,843.15,520.46,843.15,percent of total billed charges,,
HC CSF FLOW; CISTEROGRAM,78630,CPT,,,both,,,1052.66,631.6,United Healthcare/Oxford,United Healthcare/Oxford,,641.09,,,641.09,520.46,843.15,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT  ,,,both,,,1022.79,613.67,Aetna,Commerical,,562.21,,,562.21,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Aetna,Middlesex Employees,,505.99,,,505.99,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Anthem,Commerical,,667.53,,,667.53,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Anthem,Indemnity,,,744.07,,744.07,505.99,819.71,percent of total billed charges,,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Anthem,State Preferred,,667.53,,,667.53,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Anthem,Individual Exchange,,534.03,,,534.03,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Cigna,Cigna,,767.43,,,767.43,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Connecticare,Commerical,,714.44,,,714.44,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Connecticare,Exchange,,714.44,,,714.44,505.99,819.71,other,Could be inpatient or outpatient,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,Multiplan,Multiplan,,,819.71,,819.71,505.99,819.71,percent of total billed charges,,
HC HH CSF ; SHUNT EVAL/PATENCY,78645,CPT,,,both,,,1022.79,613.67,United Healthcare/Oxford,United Healthcare/Oxford,,623.27,,,623.27,505.99,819.71,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT  ,,,both,,,1556.33,933.8,Aetna,Commerical,,855.37,,,855.37,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Aetna,Middlesex Employees,,769.84,,,769.84,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Anthem,Commerical,,1015.62,,,1015.62,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Anthem,Indemnity,,,1132.07,,1132.07,769.84,1247.14,percent of total billed charges,,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Anthem,State Preferred,,1015.62,,,1015.62,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Anthem,Individual Exchange,,812.5,,,812.5,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Cigna,Cigna,,1167.61,,,1167.61,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Connecticare,Commerical,,1087,,,1087,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Connecticare,Exchange,,1087,,,1087,769.84,1247.14,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,Multiplan,Multiplan,,,1247.14,,1247.14,769.84,1247.14,percent of total billed charges,,
HC HH KIDNEY IMAGING MORPHOL,78700,CPT,,,both,,,1556.33,933.8,United Healthcare/Oxford,United Healthcare/Oxford,,948.27,,,948.27,769.84,1247.14,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT  ,,,both,,,2675.94,1605.56,Aetna,Commerical,,1470.77,,,1470.77,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Aetna,Middlesex Employees,,1323.69,,,1323.69,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Anthem,Commerical,,1746.31,,,1746.31,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Anthem,Indemnity,,,1946.54,,1946.54,1323.69,2144.4,percent of total billed charges,,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Anthem,State Preferred,,1746.31,,,1746.31,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Anthem,Individual Exchange,,1397.05,,,1397.05,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Cigna,Cigna,,2007.64,,,2007.64,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Connecticare,Commerical,,1869.03,,,1869.03,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Connecticare,Exchange,,1869.03,,,1869.03,1323.69,2144.4,other,Could be inpatient or outpatient,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,Multiplan,Multiplan,,,2144.4,,2144.4,1323.69,2144.4,percent of total billed charges,,
HC KIDNEY IMAGING WITH FLOW,78701,CPT,,,both,,,2675.94,1605.56,United Healthcare/Oxford,United Healthcare/Oxford,,1630.51,,,1630.51,1323.69,2144.4,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT  ,,,both,,,1616.07,969.64,Aetna,Commerical,,888.15,,,888.15,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Aetna,Middlesex Employees,,799.33,,,799.33,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Anthem,Commerical,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Anthem,Indemnity,,,1175.45,,1175.45,799.33,1294.93,percent of total billed charges,,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Anthem,State Preferred,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Anthem,Individual Exchange,,843.63,,,843.63,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Cigna,Cigna,,1212.35,,,1212.35,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Connecticare,Commerical,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Connecticare,Exchange,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,Multiplan,Multiplan,,,1294.93,,1294.93,799.33,1294.93,percent of total billed charges,,
HC HH K FLOW/FUNCT IMAGE W/O DRUG,78707,CPT,,,both,,,1616.07,969.64,United Healthcare/Oxford,United Healthcare/Oxford,,984.62,,,984.62,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT  ,,,both,,,2447.28,1468.37,Aetna,Commerical,,1345.21,,,1345.21,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Aetna,Middlesex Employees,,1210.69,,,1210.69,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Anthem,Commerical,,1597.23,,,1597.23,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Anthem,Indemnity,,,1780.37,,1780.37,1210.69,1961.34,percent of total billed charges,,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Anthem,State Preferred,,1597.23,,,1597.23,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Anthem,Individual Exchange,,1277.79,,,1277.79,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Cigna,Cigna,,1836.26,,,1836.26,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Connecticare,Commerical,,1709.48,,,1709.48,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Connecticare,Exchange,,1709.48,,,1709.48,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,Multiplan,Multiplan,,,1961.34,,1961.34,1210.69,1961.34,percent of total billed charges,,
HC HH K FLOW/FUNCT IMAGE W/DRUG,78708,CPT,,,both,,,2447.28,1468.37,United Healthcare/Oxford,United Healthcare/Oxford,,1491.32,,,1491.32,1210.69,1961.34,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT  ,,,both,,,2585.3,1551.18,Aetna,Commerical,,1420.67,,,1420.67,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Aetna,Middlesex Employees,,1278.6,,,1278.6,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Anthem,Commerical,,1686.83,,,1686.83,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Anthem,Indemnity,,,1880.24,,1880.24,1278.6,2071.36,percent of total billed charges,,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Anthem,State Preferred,,1686.83,,,1686.83,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Anthem,Individual Exchange,,1349.46,,,1349.46,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Cigna,Cigna,,1939.26,,,1939.26,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Connecticare,Commerical,,1805.37,,,1805.37,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Connecticare,Exchange,,1805.37,,,1805.37,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,Multiplan,Multiplan,,,2071.36,,2071.36,1278.6,2071.36,percent of total billed charges,,
HC HH KIDNEY IMAGING (3D),78710,CPT,,,both,,,2585.3,1551.18,United Healthcare/Oxford,United Healthcare/Oxford,,1574.97,,,1574.97,1278.6,2071.36,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT  ,,,both,,,2464.79,1478.87,Aetna,Commerical,,1353.87,,,1353.87,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Aetna,Middlesex Employees,,1218.48,,,1218.48,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Anthem,Commerical,,1607.52,,,1607.52,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Anthem,Indemnity,,,1791.83,,1791.83,1218.48,1973.96,percent of total billed charges,,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Anthem,State Preferred,,1607.52,,,1607.52,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Anthem,Individual Exchange,,1286.02,,,1286.02,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Cigna,Cigna,,1848.08,,,1848.08,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Connecticare,Commerical,,1720.48,,,1720.48,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Connecticare,Exchange,,1720.48,,,1720.48,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,Multiplan,Multiplan,,,1973.96,,1973.96,1218.48,1973.96,percent of total billed charges,,
HC HH TESTICULAR IMAGING W/FLOW,78761,CPT,,,both,,,2464.79,1478.87,United Healthcare/Oxford,United Healthcare/Oxford,,1500.92,,,1500.92,1218.48,1973.96,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT  ,,,both,,,834.3,500.58,Aetna,Commerical,,458.3,,,458.3,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Aetna,Middlesex Employees,,412.48,,,412.48,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Anthem,Commerical,,544.16,,,544.16,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Anthem,Indemnity,,,606.56,,606.56,412.48,668.21,percent of total billed charges,,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Anthem,State Preferred,,544.16,,,544.16,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Anthem,Individual Exchange,,435.33,,,435.33,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Cigna,Cigna,,625.59,,,625.59,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Connecticare,Commerical,,582.4,,,582.4,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Connecticare,Exchange,,582.4,,,582.4,412.48,668.21,other,Could be inpatient or outpatient,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,Multiplan,Multiplan,,,668.21,,668.21,412.48,668.21,percent of total billed charges,,
HC HHNMUNLISTDURINRY,78799,CPT,,,both,,,834.3,500.58,United Healthcare/Oxford,United Healthcare/Oxford,,508.08,,,508.08,412.48,668.21,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT  ,,,both,,,2039.4,1223.64,Aetna,Commerical,,1120.7,,,1120.7,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Aetna,Middlesex Employees,,1008.64,,,1008.64,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Anthem,Commerical,,1330.67,,,1330.67,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Anthem,Indemnity,,,1483.23,,1483.23,1008.64,1634,percent of total billed charges,,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Anthem,State Preferred,,1330.67,,,1330.67,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Anthem,Individual Exchange,,1064.54,,,1064.54,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Cigna,Cigna,,1529.79,,,1529.79,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Connecticare,Commerical,,1424.17,,,1424.17,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Connecticare,Exchange,,1424.17,,,1424.17,1008.64,1634,other,Could be inpatient or outpatient,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,Multiplan,Multiplan,,,1634,,1634,1008.64,1634,percent of total billed charges,,
HC HH LIMITED TUMOR LOCALIZ/RP DISTRIB 1 AREA,78800,CPT,,,both,,,2039.4,1223.64,United Healthcare/Oxford,United Healthcare/Oxford,,1242.43,,,1242.43,1008.64,1634,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT  ,,,both,,,4183.86,2510.32,Aetna,Commerical,,2298.92,,,2298.92,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Aetna,Middlesex Employees,,2069.04,,,2069.04,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Anthem,Commerical,,2729.63,,,2729.63,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Anthem,Indemnity,,,3042.6,,3042.6,2069.04,3351.86,percent of total billed charges,,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Anthem,State Preferred,,2729.63,,,2729.63,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Anthem,Individual Exchange,,2183.71,,,2183.71,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Cigna,Cigna,,3138.1,,,3138.1,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Connecticare,Commerical,,2921.44,,,2921.44,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Connecticare,Exchange,,2921.44,,,2921.44,2069.04,3351.86,other,Could be inpatient or outpatient,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,Multiplan,Multiplan,,,3351.86,,3351.86,2069.04,3351.86,percent of total billed charges,,
HC HH TUMOR LOCALIZ; 2+ AREAS,78801,CPT,,,both,,,4183.86,2510.32,United Healthcare/Oxford,United Healthcare/Oxford,,2548.61,,,2548.61,2069.04,3351.86,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT  ,,,both,,,2508.05,1504.83,Aetna,Commerical,,1377.99,,,1377.99,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Aetna,Middlesex Employees,,1240.2,,,1240.2,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Anthem,Commerical,,1636.16,,,1636.16,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Anthem,Indemnity,,,1823.76,,1823.76,1240.2,2009.14,percent of total billed charges,,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Anthem,State Preferred,,1636.16,,,1636.16,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Anthem,Individual Exchange,,1308.92,,,1308.92,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Cigna,Cigna,,1881,,,1881,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Connecticare,Commerical,,1751.13,,,1751.13,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Connecticare,Exchange,,1751.13,,,1751.13,1240.2,2009.14,other,Could be inpatient or outpatient,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,Multiplan,Multiplan,,,2009.14,,2009.14,1240.2,2009.14,percent of total billed charges,,
HC WHOLE BODY 1 DAY TUMOR IMAGING,78802,CPT,,,both,,,2508.05,1504.83,United Healthcare/Oxford,United Healthcare/Oxford,,1527.67,,,1527.67,1240.2,2009.14,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT  ,,,both,,,1616.07,969.64,Aetna,Commerical,,888.15,,,888.15,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Aetna,Middlesex Employees,,799.33,,,799.33,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Anthem,Commerical,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Anthem,Indemnity,,,1175.45,,1175.45,799.33,1294.93,percent of total billed charges,,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Anthem,State Preferred,,1054.54,,,1054.54,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Anthem,Individual Exchange,,843.63,,,843.63,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Cigna,Cigna,,1212.35,,,1212.35,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Connecticare,Commerical,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Connecticare,Exchange,,1128.65,,,1128.65,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,Multiplan,Multiplan,,,1294.93,,1294.93,799.33,1294.93,percent of total billed charges,,
HC HH SPECT TUMOR,78803,CPT,,,both,,,1616.07,969.64,United Healthcare/Oxford,United Healthcare/Oxford,,984.62,,,984.62,799.33,1294.93,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT  ,,,both,,,2013.65,1208.19,Aetna,Commerical,,1106.47,,,1106.47,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Aetna,Middlesex Employees,,995.83,,,995.83,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Anthem,Commerical,,1313.78,,,1313.78,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Anthem,Indemnity,,,1464.41,,1464.41,995.83,1613.26,percent of total billed charges,,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Anthem,State Preferred,,1313.78,,,1313.78,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Anthem,Individual Exchange,,1051.02,,,1051.02,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Cigna,Cigna,,1510.37,,,1510.37,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Connecticare,Commerical,,1406.1,,,1406.1,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Connecticare,Exchange,,1406.1,,,1406.1,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,Multiplan,Multiplan,,,1613.26,,1613.26,995.83,1613.26,percent of total billed charges,,
HC HH LOCALIZ INFLAMM; LIMITED AREA,78805,CPT,,,both,,,2013.65,1208.19,United Healthcare/Oxford,United Healthcare/Oxford,,1226.66,,,1226.66,995.83,1613.26,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT  ,,,both,,,1736.58,1041.95,Aetna,Commerical,,954.32,,,954.32,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Aetna,Middlesex Employees,,858.89,,,858.89,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Anthem,Commerical,,1133.12,,,1133.12,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Anthem,Indemnity,,,1263.04,,1263.04,858.89,1391.42,percent of total billed charges,,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Anthem,State Preferred,,1133.12,,,1133.12,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Anthem,Individual Exchange,,906.49,,,906.49,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Cigna,Cigna,,1302.68,,,1302.68,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Connecticare,Commerical,,1212.75,,,1212.75,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Connecticare,Exchange,,1212.75,,,1212.75,858.89,1391.42,other,Could be inpatient or outpatient,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,Multiplan,Multiplan,,,1391.42,,1391.42,858.89,1391.42,percent of total billed charges,,
HC HH ABSC LOCWBNM,78806,CPT,,,both,,,1736.58,1041.95,United Healthcare/Oxford,United Healthcare/Oxford,,1057.99,,,1057.99,858.89,1391.42,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT  ,,,both,,,3353.68,2012.21,Aetna,Commerical,,2425.99,,,2425.99,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Aetna,Middlesex Employees,,2183.4,,,2183.4,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Anthem,Commerical,,2170.72,,,2170.72,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Anthem,Indemnity,,,2439.31,,2439.31,1736.57,2687.26,percent of total billed charges,,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Anthem,State Preferred,,2170.72,,,2170.72,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Anthem,Individual Exchange,,1736.57,,,1736.57,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Cigna,Cigna,,2119.95,,,2119.95,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Connecticare,Commerical,,2267.47,,,2267.47,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Connecticare,Exchange,,2267.47,,,2267.47,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,Multiplan,Multiplan,,,2687.26,,2687.26,1736.57,2687.26,percent of total billed charges,,
HC PET IMAGE W/CT LIMITED AREA,78814,CPT,,,both,,,3353.68,2012.21,United Healthcare/Oxford,United Healthcare/Oxford,,2181.74,,,2181.74,1736.57,2687.26,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT  ,,,both,,,6034.77,3620.86,Aetna,Commerical,,4364.35,,,4364.35,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Aetna,Middlesex Employees,,3927.92,,,3927.92,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Anthem,Commerical,,3905.12,,,3905.12,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Anthem,Indemnity,,,4388.31,,4388.31,3124.1,4834.36,percent of total billed charges,,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Anthem,State Preferred,,3905.12,,,3905.12,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Anthem,Individual Exchange,,3124.1,,,3124.1,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Cigna,Cigna,,3813.77,,,3813.77,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Connecticare,Commerical,,4079.16,,,4079.16,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Connecticare,Exchange,,4079.16,,,4079.16,3124.1,4834.36,other,Could be inpatient or outpatient,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,Multiplan,Multiplan,,,4834.36,,4834.36,3124.1,4834.36,percent of total billed charges,,
HC PETCT SKULL THIGH,78815,CPT,,,both,,,6034.77,3620.86,United Healthcare/Oxford,United Healthcare/Oxford,,3924.93,,,3924.93,3124.1,4834.36,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT  ,,,both,,,6956.62,4173.97,Aetna,Commerical,,5031.9,,,5031.9,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Aetna,Middlesex Employees,,4528.72,,,4528.72,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Anthem,Commerical,,4502.43,,,4502.43,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Anthem,Indemnity,,,5059.53,,5059.53,3601.94,5573.81,percent of total billed charges,,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Anthem,State Preferred,,4502.43,,,4502.43,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Anthem,Individual Exchange,,3601.94,,,3601.94,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Cigna,Cigna,,4397.12,,,4397.12,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Connecticare,Commerical,,4703.09,,,4703.09,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Connecticare,Exchange,,4703.09,,,4703.09,3601.94,5573.81,other,Could be inpatient or outpatient,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,Multiplan,Multiplan,,,5573.81,,5573.81,3601.94,5573.81,percent of total billed charges,,
HC HH PET WHOLE BODY,78816,CPT,,,both,,,6956.62,4173.97,United Healthcare/Oxford,United Healthcare/Oxford,,4525.27,,,4525.27,3601.94,5573.81,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT  ,,,both,,,5164.42,3098.65,Aetna,Commerical,,3451.3,,,3451.3,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Aetna,Middlesex Employees,,3106.17,,,3106.17,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Anthem,Commerical,,2864.32,,,2864.32,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Anthem,Indemnity,,,3756.02,,3756.02,2291.46,4137.8,percent of total billed charges,,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Anthem,State Preferred,,2864.32,,,2864.32,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Anthem,Individual Exchange,,2291.46,,,2291.46,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Cigna,Cigna,,3040.16,,,3040.16,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Connecticare,Commerical,,3118.56,,,3118.56,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Connecticare,Exchange,,3118.56,,,3118.56,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,Multiplan,Multiplan,,,4137.8,,4137.8,2291.46,4137.8,percent of total billed charges,,
HC RP LOCLZ TUMORW/CT 1 AREA  (MIBG SCAN),78830,CPT,,,both,,,5164.42,3098.65,United Healthcare/Oxford,United Healthcare/Oxford,,3196.96,,,3196.96,2291.46,4137.8,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT  ,,,both,,,5551.7,3331.02,Aetna,Commerical,,2625.38,,,2625.38,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Aetna,Middlesex Employees,,2364.53,,,2364.53,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Anthem,Commerical,,2498.2,,,2498.2,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Anthem,Indemnity,,,4158.78,,4158.78,1998.56,4743.46,percent of total billed charges,,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Anthem,State Preferred,,2498.2,,,2498.2,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Anthem,Individual Exchange,,1998.56,,,1998.56,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Cigna,Cigna,,4743.46,,,4743.46,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Connecticare,Commerical,,4590.6,,,4590.6,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Connecticare,Exchange,,4590.6,,,4590.6,1998.56,4743.46,other,Could be inpatient or outpatient,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,Multiplan,Multiplan,,,4581.5,,4581.5,1998.56,4743.46,percent of total billed charges,,
HC RADPHARM LOCATLIZED OF TUMOR SPECT W/CR 2,78832,CPT,,,both,,,5551.7,3331.02,United Healthcare/Oxford,United Healthcare/Oxford,,2491.06,,,2491.06,1998.56,4743.46,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT  ,,,both,,,2577.06,1546.24,Aetna,Commerical,,1415.72,,,1415.72,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Aetna,Middlesex Employees,,1274.15,,,1274.15,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Anthem,Commerical,,1680.95,,,1680.95,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Anthem,Indemnity,,,1873.69,,1873.69,1274.15,2064.14,percent of total billed charges,,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Anthem,State Preferred,,1680.95,,,1680.95,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Anthem,Individual Exchange,,1344.77,,,1344.77,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Cigna,Cigna,,1932.5,,,1932.5,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Connecticare,Commerical,,1799.08,,,1799.08,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Connecticare,Exchange,,1799.08,,,1799.08,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,Multiplan,Multiplan,,,2064.14,,2064.14,1274.15,2064.14,percent of total billed charges,,
HC HH IODINE TREATMT,79005,CPT,,,both,,,2577.06,1546.24,United Healthcare/Oxford,United Healthcare/Oxford,,1569.48,,,1569.48,1274.15,2064.14,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT  ,,,both,,,5578.48,3347.09,Aetna,Commerical,,3065.23,,,3065.23,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Aetna,Middlesex Employees,,2758.71,,,2758.71,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Anthem,Commerical,,3639.49,,,3639.49,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Anthem,Indemnity,,,4056.79,,4056.79,2758.71,4469.15,percent of total billed charges,,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Anthem,State Preferred,,3639.49,,,3639.49,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Anthem,Individual Exchange,,2911.6,,,2911.6,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Cigna,Cigna,,4184.13,,,4184.13,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Connecticare,Commerical,,3895.26,,,3895.26,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Connecticare,Exchange,,3895.26,,,3895.26,2758.71,4469.15,other,Could be inpatient or outpatient,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,Multiplan,Multiplan,,,4469.15,,4469.15,2758.71,4469.15,percent of total billed charges,,
HC HH TREAT ISO SR89,79101,CPT,,,both,,,5578.48,3347.09,United Healthcare/Oxford,United Healthcare/Oxford,,3398.16,,,3398.16,2758.71,4469.15,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT  ,,,both,,,45.13,27.08,Aetna,Commerical,,15.92,,,15.92,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT  ,,,both,,,132.82,79.69,Aetna,Commerical,,15.92,,,15.92,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Aetna,Middlesex Employees,,14.32,,,14.32,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Aetna,Middlesex Employees,,14.32,,,14.32,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Anthem,Commerical,,15.6,,,15.6,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Anthem,Commerical,,15.6,,,15.6,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Anthem,Indemnity,,,32.82,,32.82,12.48,36.16,percent of total billed charges,,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Anthem,Indemnity,,,96.59,,96.59,12.48,106.41,percent of total billed charges,,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Anthem,State Preferred,,17.74,,,17.74,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Anthem,State Preferred,,17.74,,,17.74,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Anthem,Individual Exchange,,12.48,,,12.48,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Anthem,Individual Exchange,,12.48,,,12.48,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Cigna,Cigna,,30.92,,,30.92,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Cigna,Cigna,,30.92,,,30.92,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Connecticare,Commerical,,15.37,,,15.37,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Connecticare,Commerical,,15.37,,,15.37,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Connecticare,Exchange,,15.37,,,15.37,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Connecticare,Exchange,,15.37,,,15.37,12.48,106.41,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,Multiplan,Multiplan,,,36.16,,36.16,12.48,36.16,percent of total billed charges,,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,Multiplan,Multiplan,,,106.41,,106.41,12.48,106.41,percent of total billed charges,,
HC I-STAT BASIC METABL PANEL,80047,CPT,,,both,,,45.13,27.08,United Healthcare/Oxford,United Healthcare/Oxford,,18,,,18,12.48,36.16,other,Could be inpatient or outpatient,
HC I-STAT BASIC METABL PANEL-2,80047,CPT,,,both,,,132.82,79.69,United Healthcare/Oxford,United Healthcare/Oxford,,18,,,18,12.48,106.41,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT  ,,,both,,,45.13,27.08,Aetna,Commerical,,15.92,,,15.92,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Aetna,Middlesex Employees,,14.32,,,14.32,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Anthem,Commerical,,15.6,,,15.6,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Anthem,Indemnity,,,32.82,,32.82,12.48,36.16,percent of total billed charges,,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Anthem,State Preferred,,17.74,,,17.74,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Anthem,Individual Exchange,,12.48,,,12.48,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Cigna,Cigna,,30.92,,,30.92,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Connecticare,Commerical,,15.37,,,15.37,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Connecticare,Exchange,,15.37,,,15.37,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,Multiplan,Multiplan,,,36.16,,36.16,12.48,36.16,percent of total billed charges,,
HC METABOLIC PANEL IONIZED CA,80047,CPT,,,both,,,45.13,27.08,United Healthcare/Oxford,United Healthcare/Oxford,,18,,,18,12.48,36.16,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,9.8,,,9.8,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,8.82,,,8.82,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,15.6,,,15.6,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,8.82,27.33,percent of total billed charges,,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,10.02,,,10.02,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,12.48,,,12.48,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,19,,,19,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,9.46,,,9.46,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,9.46,,,9.46,8.82,27.33,other,Could be inpatient or outpatient,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,8.82,27.33,percent of total billed charges,,
HC METABOLIC PANEL TOTAL CA,80048,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,12.33,,,12.33,8.82,27.33,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,8.3,56.81,percent of total billed charges,,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,8.3,,,8.3,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,8.3,56.81,other,Could be inpatient or outpatient,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,8.3,56.81,percent of total billed charges,,
HC ELECTROLYTE PANEL,80051,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,8.3,56.81,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT  ,,,both,,,42.13,25.28,Aetna,Commerical,,12.24,,,12.24,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Aetna,Middlesex Employees,,11.01,,,11.01,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Anthem,Commerical,,19.48,,,19.48,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Anthem,Indemnity,,,30.64,,30.64,11.01,33.75,percent of total billed charges,,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Anthem,State Preferred,,12.51,,,12.51,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Anthem,Individual Exchange,,15.59,,,15.59,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Cigna,Cigna,,23.74,,,23.74,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Connecticare,Commerical,,11.82,,,11.82,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Connecticare,Exchange,,11.82,,,11.82,11.01,33.75,other,Could be inpatient or outpatient,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,Multiplan,Multiplan,,,33.75,,33.75,11.01,33.75,percent of total billed charges,,
HC COMPREHENSIVE METABOLIC PANEL,80053,CPT,,,both,,,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,15.4,,,15.4,11.01,33.75,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10.07,,,10.07,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9.06,,,9.06,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,16.01,,,16.01,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,9.06,28.13,percent of total billed charges,,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,10.28,,,10.28,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,12.81,,,12.81,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.71,,,9.71,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.71,,,9.71,9.06,28.13,other,Could be inpatient or outpatient,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,9.06,28.13,percent of total billed charges,,
HC RENAL FUNCTION PANEL,80069,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.66,,,12.66,9.06,28.13,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT  ,,,both,,,180.25,108.15,Aetna,Commerical,,98.96,,,98.96,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Aetna,Middlesex Employees,,89.07,,,89.07,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Anthem,Commerical,,117.49,,,117.49,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Anthem,Indemnity,,,130.97,,130.97,56.39,144.28,percent of total billed charges,,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Anthem,State Preferred,,56.39,,,56.39,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Anthem,Individual Exchange,,94,,,94,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Cigna,Cigna,,135.09,,,135.09,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Connecticare,Commerical,,125.75,,,125.75,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Connecticare,Exchange,,125.75,,,125.75,56.39,144.28,other,Could be inpatient or outpatient,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,Multiplan,Multiplan,,,144.28,,144.28,56.39,144.28,percent of total billed charges,,
HC ACUTE HEPATITIS PANEL,80074,CPT,,,both,,,180.25,108.15,United Healthcare/Oxford,United Healthcare/Oxford,,109.71,,,109.71,56.39,144.28,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT  ,,,both,,,33.1,19.86,Aetna,Commerical,,9.47,,,9.47,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Aetna,Middlesex Employees,,8.53,,,8.53,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Anthem,Commerical,,15.06,,,15.06,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Anthem,Indemnity,,,24.07,,24.07,8.53,26.52,percent of total billed charges,,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Anthem,State Preferred,,9.69,,,9.69,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Anthem,Individual Exchange,,12.05,,,12.05,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Cigna,Cigna,,18.41,,,18.41,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Connecticare,Commerical,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Connecticare,Exchange,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,Multiplan,Multiplan,,,26.52,,26.52,8.53,26.52,percent of total billed charges,,
HC HEPATIC FUNCTION PANEL,80076,CPT,,,both,,,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,11.91,,,11.91,8.53,26.52,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,12.42,64.02,percent of total billed charges,,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,12.42,,,12.42,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,12.42,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,12.42,64.02,percent of total billed charges,,
HC GEN TOXICOLOGY SCREEN URINE RANDOM,80100,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,12.42,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC AMPHET QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC BARBIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC BENZODIAZ QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC CANNABIN QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,30.58,,,30.58,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,27.53,,,27.53,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,16.3,44.58,percent of total billed charges,,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.3,,,16.3,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,16.3,44.58,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,16.3,44.58,percent of total billed charges,,
HC DRUG SCREEN MECON,80101,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,16.3,44.58,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC ECSTASY SCREEN,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC OPIATES EMIT QLUR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC OXYCODONE SCREEN,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC PCP EMIT QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.3,65.83,percent of total billed charges,,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.3,,,16.3,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.3,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.3,65.83,percent of total billed charges,,
HC TRICYCLIC QUAL-UR,80101,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.3,65.83,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,39.59,,,39.59,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,35.63,,,35.63,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,47,,,47,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,15.68,57.72,percent of total billed charges,,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,15.68,,,15.68,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,37.6,,,37.6,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,54.03,,,54.03,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,50.3,,,50.3,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,50.3,,,50.3,15.68,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,15.68,57.72,percent of total billed charges,,
HC AMPHET UR CONF,80102,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,39.59,,,39.59,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,35.63,,,35.63,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,47,,,47,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,15.68,57.72,percent of total billed charges,,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,15.68,,,15.68,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,37.6,,,37.6,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,54.03,,,54.03,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,50.3,,,50.3,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,50.3,,,50.3,15.68,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,15.68,57.72,percent of total billed charges,,
HC BUPRENORPH UR CNF,80102,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,15.68,57.72,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT  ,,,both,,,65.28,39.17,Aetna,Commerical,,35.87,,,35.87,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Aetna,Middlesex Employees,,32.29,,,32.29,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Anthem,Commerical,,42.59,,,42.59,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Anthem,Indemnity,,,47.47,,47.47,15.68,52.3,percent of total billed charges,,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Anthem,State Preferred,,15.68,,,15.68,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Anthem,Individual Exchange,,34.07,,,34.07,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Cigna,Cigna,,48.96,,,48.96,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Connecticare,Commerical,,45.59,,,45.59,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Connecticare,Exchange,,45.59,,,45.59,15.68,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,Multiplan,Multiplan,,,52.3,,52.3,15.68,52.3,percent of total billed charges,,
HC COCAINE M UR CONE,80102,CPT,,,both,,,65.28,39.17,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,15.68,52.3,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,33.39,,,33.39,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,30.05,,,30.05,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.65,,,39.65,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,17.85,48.7,percent of total billed charges,,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,17.85,,,17.85,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.72,,,31.72,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,45.59,,,45.59,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,42.44,,,42.44,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,42.44,,,42.44,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,17.85,48.7,percent of total billed charges,,
HC AMIKACIN,80150,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,37.03,,,37.03,17.85,48.7,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT  ,,,both,,,111.24,66.74,Aetna,Commerical,,61.23,,,61.23,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Aetna,Middlesex Employees,,55.11,,,55.11,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Anthem,Commerical,,72.7,,,72.7,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Anthem,Indemnity,,,81.04,,81.04,17.85,89.28,percent of total billed charges,,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Anthem,State Preferred,,17.85,,,17.85,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Anthem,Individual Exchange,,58.16,,,58.16,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Cigna,Cigna,,83.58,,,83.58,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Connecticare,Commerical,,77.81,,,77.81,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Connecticare,Exchange,,77.81,,,77.81,17.85,89.28,other,Could be inpatient or outpatient,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,Multiplan,Multiplan,,,89.28,,89.28,17.85,89.28,percent of total billed charges,,
HC AMIKACIN - YALE,80150,CPT,,,both,,,111.24,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,67.88,,,67.88,17.85,89.28,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,21.2,68.54,percent of total billed charges,,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,21.2,,,21.2,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,21.2,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,21.2,68.54,percent of total billed charges,,
HC AMITRIPTYLINE,80152,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,21.2,68.54,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT  ,,,both,,,116.39,69.83,Aetna,Commerical,,64.32,,,64.32,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Aetna,Middlesex Employees,,57.89,,,57.89,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Anthem,Commerical,,76.37,,,76.37,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Anthem,Indemnity,,,85.13,,85.13,21.2,93.78,percent of total billed charges,,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Anthem,State Preferred,,21.2,,,21.2,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Anthem,Individual Exchange,,61.1,,,61.1,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Cigna,Cigna,,87.81,,,87.81,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Connecticare,Commerical,,81.74,,,81.74,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Connecticare,Exchange,,81.74,,,81.74,21.2,93.78,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,Multiplan,Multiplan,,,93.78,,93.78,21.2,93.78,percent of total billed charges,,
HC NORTRIPLYLINE,80152,CPT,,,both,,,116.39,69.83,United Healthcare/Oxford,United Healthcare/Oxford,,71.31,,,71.31,21.2,93.78,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT  ,,,both,,,125.66,75.4,Aetna,Commerical,,69.27,,,69.27,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Aetna,Middlesex Employees,,62.35,,,62.35,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Anthem,Commerical,,82.25,,,82.25,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Anthem,Indemnity,,,91.68,,91.68,21.9,101,percent of total billed charges,,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Anthem,State Preferred,,21.9,,,21.9,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Anthem,Individual Exchange,,65.81,,,65.81,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Cigna,Cigna,,94.56,,,94.56,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Connecticare,Commerical,,88.03,,,88.03,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Connecticare,Exchange,,88.03,,,88.03,21.9,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,Multiplan,Multiplan,,,101,,101,21.9,101,percent of total billed charges,,
HC CLONEZEPAM,80154,CPT,,,both,,,125.66,75.4,United Healthcare/Oxford,United Healthcare/Oxford,,76.8,,,76.8,21.9,101,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,31.85,,,31.85,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,28.66,,,28.66,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.82,,,37.82,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,17.24,46.44,percent of total billed charges,,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,17.24,,,17.24,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.25,,,30.25,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,43.48,,,43.48,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,40.48,,,40.48,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,40.48,,,40.48,17.24,46.44,other,Could be inpatient or outpatient,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,17.24,46.44,percent of total billed charges,,
HC CARBAMAZE TOTAL,80156,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,17.24,46.44,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.93,,,20.93,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.84,,,18.84,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33.26,,,33.26,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,18.84,57.72,percent of total billed charges,,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.37,,,21.37,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.61,,,26.61,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,40.34,,,40.34,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.2,,,20.2,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.2,,,20.2,18.84,57.72,other,Could be inpatient or outpatient,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,18.84,57.72,percent of total billed charges,,
HC CYCLOSPORINE,80158,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.31,,,26.31,18.84,57.72,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,29.3,,,29.3,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,26.37,,,26.37,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,34.8,,,34.8,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,15.71,42.73,percent of total billed charges,,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.71,,,15.71,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,27.84,,,27.84,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,40,,,40,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,37.24,,,37.24,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,37.24,,,37.24,15.71,42.73,other,Could be inpatient or outpatient,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,15.71,42.73,percent of total billed charges,,
HC DIGOXIN,80162,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,32.49,,,32.49,15.71,42.73,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,15.7,,,15.7,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,14.13,,,14.13,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,24.97,,,24.97,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,14.13,43.66,percent of total billed charges,,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,16.04,,,16.04,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,19.98,,,19.98,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,30.25,,,30.25,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,14.13,43.66,percent of total billed charges,,
HC VALPROIC ACID FREE,80164,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,19.73,,,19.73,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT  ,,,both,,,54.49,32.69,Aetna,Commerical,,15.7,,,15.7,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Aetna,Middlesex Employees,,14.13,,,14.13,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Anthem,Commerical,,24.97,,,24.97,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Anthem,Indemnity,,,39.63,,39.63,14.13,43.66,percent of total billed charges,,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Anthem,State Preferred,,16.04,,,16.04,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Anthem,Individual Exchange,,19.98,,,19.98,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Cigna,Cigna,,30.25,,,30.25,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Connecticare,Commerical,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Connecticare,Exchange,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,Multiplan,Multiplan,,,43.66,,43.66,14.13,43.66,percent of total billed charges,,
HC VALPROIC ACID TOTAL,80164,CPT,,,both,,,54.49,32.69,United Healthcare/Oxford,United Healthcare/Oxford,,19.73,,,19.73,14.13,43.66,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,36.49,,,36.49,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,32.85,,,32.85,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,43.33,,,43.33,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,19.34,53.2,percent of total billed charges,,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,19.34,,,19.34,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.66,,,34.66,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,49.82,,,49.82,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,46.37,,,46.37,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,46.37,,,46.37,19.34,53.2,other,Could be inpatient or outpatient,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,19.34,53.2,percent of total billed charges,,
HC ETHOSUXIMIDE,80168,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,40.46,,,40.46,19.34,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,36.49,,,36.49,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,32.85,,,32.85,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,43.33,,,43.33,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,19.41,53.2,percent of total billed charges,,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,19.41,,,19.41,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.66,,,34.66,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,49.82,,,49.82,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,46.37,,,46.37,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,46.37,,,46.37,19.41,53.2,other,Could be inpatient or outpatient,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,19.41,53.2,percent of total billed charges,,
HC GENTAMICIN LEVEL,80170,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,40.46,,,40.46,19.41,53.2,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,82.26,,,82.26,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,74.03,,,74.03,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,97.67,,,97.67,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,17.24,119.94,percent of total billed charges,,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,17.24,,,17.24,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,78.14,,,78.14,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,112.29,,,112.29,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,104.53,,,104.53,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,104.53,,,104.53,17.24,119.94,other,Could be inpatient or outpatient,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,17.24,119.94,percent of total billed charges,,
HC HALOPERIDOL,80173,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,91.2,,,91.2,17.24,119.94,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,17.03,,,17.03,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.33,,,15.33,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,27.07,,,27.07,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.33,47.8,percent of total billed charges,,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.39,,,17.39,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,21.65,,,21.65,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.64,,,32.64,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.44,,,16.44,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.44,,,16.44,15.33,47.8,other,Could be inpatient or outpatient,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.33,47.8,percent of total billed charges,,
HC LIDOCAINE,80176,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.39,,,21.39,15.33,47.8,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.37,,,15.37,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.83,,,13.83,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,24.25,,,24.25,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,13.83,48.47,percent of total billed charges,,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.33,,,15.33,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,19.4,,,19.4,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,48.47,,,48.47,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.83,,,14.83,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.83,,,14.83,13.83,48.47,other,Could be inpatient or outpatient,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,13.83,48.47,percent of total billed charges,,
HC LEVETIRACETAM,80177,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.32,,,19.32,13.83,48.47,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.66,,,7.66,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.9,,,6.9,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.19,,,12.19,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.9,21.7,percent of total billed charges,,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.82,,,7.82,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.75,,,9.75,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.4,,,7.4,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.4,,,7.4,6.9,21.7,other,Could be inpatient or outpatient,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.9,21.7,percent of total billed charges,,
HC LITHIUM,80178,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.64,,,9.64,6.9,21.7,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT  ,,,both,,,49.85,29.91,Aetna,Commerical,,17.74,,,17.74,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Aetna,Middlesex Employees,,15.97,,,15.97,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Anthem,Commerical,,21.1,,,21.1,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Anthem,Indemnity,,,36.26,,36.26,13.57,39.94,percent of total billed charges,,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Anthem,State Preferred,,13.57,,,13.57,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Anthem,Individual Exchange,,16.88,,,16.88,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Cigna,Cigna,,25.51,,,25.51,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Connecticare,Commerical,,17.12,,,17.12,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Connecticare,Exchange,,17.12,,,17.12,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,Multiplan,Multiplan,,,39.94,,39.94,13.57,39.94,percent of total billed charges,,
HC PHENOBARBITAL,80184,CPT,,,both,,,49.85,29.91,United Healthcare/Oxford,United Healthcare/Oxford,,20.06,,,20.06,13.57,39.94,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.37,,,15.37,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.83,,,13.83,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,24.43,,,24.43,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,13.83,42.73,percent of total billed charges,,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.69,,,15.69,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,19.54,,,19.54,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,29.67,,,29.67,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.83,,,14.83,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.83,,,14.83,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,13.83,42.73,percent of total billed charges,,
HC PHENYTOIN TOTAL,80185,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.32,,,19.32,13.83,42.73,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.96,,,15.96,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.36,,,14.36,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,25.37,,,25.37,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,14.36,44.58,percent of total billed charges,,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.29,,,16.29,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,20.3,,,20.3,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.83,,,30.83,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.4,,,15.4,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.4,,,15.4,14.36,44.58,other,Could be inpatient or outpatient,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,14.36,44.58,percent of total billed charges,,
HC PHENYTOIN FREE,80186,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,20.05,,,20.05,14.36,44.58,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,19.84,57.72,percent of total billed charges,,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,19.84,,,19.84,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,19.84,57.72,other,Could be inpatient or outpatient,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,19.84,57.72,percent of total billed charges,,
HC PROCAINAMIDE,80190,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,19.84,57.72,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,19.84,73.94,percent of total billed charges,,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,19.84,,,19.84,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,19.84,73.94,other,Could be inpatient or outpatient,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,19.84,73.94,percent of total billed charges,,
HC NAPA,80192,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,19.84,73.94,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,30.58,,,30.58,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,27.53,,,27.53,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,16.25,44.58,percent of total billed charges,,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.25,,,16.25,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,16.25,44.58,other,Could be inpatient or outpatient,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,16.25,44.58,percent of total billed charges,,
HC SIROLIMUS,80195,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,16.25,44.58,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,8.4,60.42,percent of total billed charges,,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,8.4,,,8.4,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,8.4,60.42,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,8.4,60.42,percent of total billed charges,,
HC SALICYLATE QUANT,80196,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,8.4,60.42,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.92,,,15.92,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.32,,,14.32,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,25.3,,,25.3,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,14.32,44.58,percent of total billed charges,,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.25,,,16.25,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,20.23,,,20.23,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.37,,,15.37,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.37,,,15.37,14.32,44.58,other,Could be inpatient or outpatient,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,14.32,44.58,percent of total billed charges,,
HC TACROLIMUS,80197,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,20.01,,,20.01,14.32,44.58,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,31.21,,,31.21,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,28.1,,,28.1,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,37.06,,,37.06,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,16.76,45.51,percent of total billed charges,,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,16.76,,,16.76,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,29.65,,,29.65,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,42.61,,,42.61,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,39.66,,,39.66,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,39.66,,,39.66,16.76,45.51,other,Could be inpatient or outpatient,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,16.76,45.51,percent of total billed charges,,
HC THEOPHYLLINE,80198,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,34.61,,,34.61,16.76,45.51,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,35.87,,,35.87,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,32.29,,,32.29,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.59,,,42.59,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,19.09,52.3,percent of total billed charges,,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,19.09,,,19.09,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,34.07,,,34.07,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,48.96,,,48.96,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,45.59,,,45.59,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,45.59,,,45.59,19.09,52.3,other,Could be inpatient or outpatient,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,19.09,52.3,percent of total billed charges,,
HC TOBRAMYCIN LEVEL,80200,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,19.09,52.3,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.82,,,13.82,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.44,,,12.44,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,21.97,,,21.97,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.44,38.58,percent of total billed charges,,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.13,,,14.13,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.57,,,17.57,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.33,,,13.33,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.33,,,13.33,12.44,38.58,other,Could be inpatient or outpatient,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.44,38.58,percent of total billed charges,,
HC TOPOMAX,80201,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.37,,,17.37,12.44,38.58,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,15.7,,,15.7,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,14.13,,,14.13,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,24.97,,,24.97,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,14.13,43.66,percent of total billed charges,,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,16.04,,,16.04,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,19.98,,,19.98,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,30.25,,,30.25,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,15.15,,,15.15,14.13,43.66,other,Could be inpatient or outpatient,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,14.13,43.66,percent of total billed charges,,
HC VANCOMYCIN,80202,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,19.73,,,19.73,14.13,43.66,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,21.61,,,21.61,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,25.24,,,25.24,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,16.21,110.02,percent of total billed charges,,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,16.21,,,16.21,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,20.19,,,20.19,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,30.25,,,30.25,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,20.86,,,20.86,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,20.86,,,20.86,16.21,110.02,other,Could be inpatient or outpatient,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,16.21,110.02,percent of total billed charges,,
HC 5' FLUOROCYTOCINE,80299,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,110.02,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC ABILIFY (ARIPIPZLE),80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT  ,,,both,,,136.99,82.19,Aetna,Commerical,,21.61,,,21.61,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Anthem,Commerical,,25.24,,,25.24,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Anthem,Indemnity,,,99.05,,99.05,16.21,109.11,percent of total billed charges,,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Anthem,State Preferred,,16.21,,,16.21,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Anthem,Individual Exchange,,20.19,,,20.19,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Cigna,Cigna,,30.25,,,30.25,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Connecticare,Commerical,,20.86,,,20.86,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Connecticare,Exchange,,20.86,,,20.86,16.21,109.11,other,Could be inpatient or outpatient,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,Multiplan,Multiplan,,,109.11,,109.11,16.21,109.11,percent of total billed charges,,
HC AMIODARONE,80299,CPT,,,both,,,136.99,82.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,109.11,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT  ,,,both,,,201.88,121.13,Aetna,Commerical,,21.61,,,21.61,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Anthem,Commerical,,25.24,,,25.24,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Anthem,Indemnity,,,146.52,,146.52,16.21,161.42,percent of total billed charges,,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Anthem,State Preferred,,16.21,,,16.21,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Anthem,Individual Exchange,,20.19,,,20.19,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Cigna,Cigna,,30.25,,,30.25,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Connecticare,Commerical,,20.86,,,20.86,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Connecticare,Exchange,,20.86,,,20.86,16.21,161.42,other,Could be inpatient or outpatient,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,Multiplan,Multiplan,,,161.42,,161.42,16.21,161.42,percent of total billed charges,,
HC FELBAMATE,80299,CPT,,,both,,,201.88,121.13,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,161.42,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,21.61,,,21.61,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,25.24,,,25.24,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,16.21,49.6,percent of total billed charges,,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,16.21,,,16.21,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,20.19,,,20.19,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,30.25,,,30.25,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,16.21,49.6,percent of total billed charges,,
HC FLECAINIDE,80299,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,49.6,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,21.61,,,21.61,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,25.24,,,25.24,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,16.21,91.98,percent of total billed charges,,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,16.21,,,16.21,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,20.19,,,20.19,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,30.25,,,30.25,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,20.86,,,20.86,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,20.86,,,20.86,16.21,91.98,other,Could be inpatient or outpatient,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,16.21,91.98,percent of total billed charges,,
HC GABAPENTIN,80299,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,91.98,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT  ,,,both,,,223.51,134.11,Aetna,Commerical,,21.61,,,21.61,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Anthem,Commerical,,25.24,,,25.24,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Anthem,Indemnity,,,162.89,,162.89,16.21,179.45,percent of total billed charges,,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Anthem,State Preferred,,16.21,,,16.21,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Anthem,Individual Exchange,,20.19,,,20.19,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Cigna,Cigna,,30.25,,,30.25,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Connecticare,Commerical,,20.86,,,20.86,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Connecticare,Exchange,,20.86,,,20.86,16.21,179.45,other,Could be inpatient or outpatient,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,Multiplan,Multiplan,,,179.45,,179.45,16.21,179.45,percent of total billed charges,,
HC METHOTREXATE,80299,CPT,,,both,,,223.51,134.11,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,179.45,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT  ,,,both,,,129.78,77.87,Aetna,Commerical,,21.61,,,21.61,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Anthem,Commerical,,25.24,,,25.24,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Anthem,Indemnity,,,94.13,,94.13,16.21,103.7,percent of total billed charges,,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Anthem,State Preferred,,16.21,,,16.21,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Anthem,Individual Exchange,,20.19,,,20.19,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Cigna,Cigna,,30.25,,,30.25,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Connecticare,Commerical,,20.86,,,20.86,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Connecticare,Exchange,,20.86,,,20.86,16.21,103.7,other,Could be inpatient or outpatient,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,Multiplan,Multiplan,,,103.7,,103.7,16.21,103.7,percent of total billed charges,,
HC POSACONZOLE,80299,CPT,,,both,,,129.78,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,103.7,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT  ,,,both,,,177.16,106.3,Aetna,Commerical,,21.61,,,21.61,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Anthem,Commerical,,25.24,,,25.24,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Anthem,Indemnity,,,128.51,,128.51,16.21,141.58,percent of total billed charges,,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Anthem,State Preferred,,16.21,,,16.21,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Anthem,Individual Exchange,,20.19,,,20.19,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Cigna,Cigna,,30.25,,,30.25,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Connecticare,Commerical,,20.86,,,20.86,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Connecticare,Exchange,,20.86,,,20.86,16.21,141.58,other,Could be inpatient or outpatient,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,Multiplan,Multiplan,,,141.58,,141.58,16.21,141.58,percent of total billed charges,,
HC PROZAC,80299,CPT,,,both,,,177.16,106.3,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,141.58,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC QUANTITATION DRUG NOS DEXAMETHASONE,80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC QUANTITATION DRUG NOS LACOSAMIDE (VIMPAT),80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT  ,,,both,,,105.06,63.04,Aetna,Commerical,,21.61,,,21.61,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Anthem,Commerical,,25.24,,,25.24,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Anthem,Indemnity,,,76.12,,76.12,16.21,83.86,percent of total billed charges,,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Anthem,State Preferred,,16.21,,,16.21,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Anthem,Individual Exchange,,20.19,,,20.19,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Cigna,Cigna,,30.25,,,30.25,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Connecticare,Commerical,,20.86,,,20.86,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Connecticare,Exchange,,20.86,,,20.86,16.21,83.86,other,Could be inpatient or outpatient,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,Multiplan,Multiplan,,,83.86,,83.86,16.21,83.86,percent of total billed charges,,
HC QUETIAPINE,80299,CPT,,,both,,,105.06,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,83.86,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,21.61,,,21.61,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,25.24,,,25.24,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,16.21,49.6,percent of total billed charges,,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,16.21,,,16.21,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,20.19,,,20.19,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,30.25,,,30.25,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,16.21,49.6,percent of total billed charges,,
HC RISPERIDONE,80299,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,49.6,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT  ,,,both,,,153.47,92.08,Aetna,Commerical,,21.61,,,21.61,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Anthem,Commerical,,25.24,,,25.24,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Anthem,Indemnity,,,112.14,,112.14,16.21,123.54,percent of total billed charges,,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Anthem,State Preferred,,16.21,,,16.21,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Anthem,Individual Exchange,,20.19,,,20.19,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Cigna,Cigna,,30.25,,,30.25,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Connecticare,Commerical,,20.86,,,20.86,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Connecticare,Exchange,,20.86,,,20.86,16.21,123.54,other,Could be inpatient or outpatient,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,Multiplan,Multiplan,,,123.54,,123.54,16.21,123.54,percent of total billed charges,,
HC TEGRETOL EPOXIDE,80299,CPT,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,123.54,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC TRAZODONE,80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC VORCONAZOLE,80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT  ,,,both,,,133.9,80.34,Aetna,Commerical,,21.61,,,21.61,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Commerical,,25.24,,,25.24,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Indemnity,,,96.59,,96.59,16.21,106.41,percent of total billed charges,,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,State Preferred,,16.21,,,16.21,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Anthem,Individual Exchange,,20.19,,,20.19,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Cigna,Cigna,,30.25,,,30.25,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Commerical,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Connecticare,Exchange,,20.86,,,20.86,16.21,106.41,other,Could be inpatient or outpatient,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,Multiplan,Multiplan,,,106.41,,106.41,16.21,106.41,percent of total billed charges,,
HC VORICONAZOLE,80299,CPT,,,both,,,133.9,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,106.41,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,21.61,,,21.61,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,19.45,,,19.45,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,25.24,,,25.24,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,16.21,49.6,percent of total billed charges,,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,16.21,,,16.21,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,20.19,,,20.19,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,30.25,,,30.25,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,20.86,,,20.86,16.21,49.6,other,Could be inpatient or outpatient,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,16.21,49.6,percent of total billed charges,,
HC ZONISAMIDE,80299,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,16.21,49.6,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A MLTP,80300,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,39.59,,,39.59,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,35.63,,,35.63,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,47,,,47,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,16.67,57.72,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,16.67,,,16.67,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,37.6,,,37.6,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,54.03,,,54.03,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,50.3,,,50.3,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,50.3,,,50.3,16.67,57.72,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,16.67,57.72,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,16.67,57.72,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,39.59,,,39.59,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,35.63,,,35.63,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,47,,,47,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,16.67,57.72,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,16.67,,,16.67,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,37.6,,,37.6,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,54.03,,,54.03,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,50.3,,,50.3,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,50.3,,,50.3,16.67,57.72,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,16.67,57.72,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A MLTP,80300,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,16.67,57.72,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT  ,,,both,,,65.28,39.17,Aetna,Commerical,,35.87,,,35.87,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Aetna,Middlesex Employees,,32.29,,,32.29,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Anthem,Commerical,,42.59,,,42.59,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Anthem,Indemnity,,,47.47,,47.47,16.67,52.3,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Anthem,State Preferred,,16.67,,,16.67,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Anthem,Individual Exchange,,34.07,,,34.07,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Cigna,Cigna,,48.96,,,48.96,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Connecticare,Commerical,,45.59,,,45.59,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Connecticare,Exchange,,45.59,,,45.59,16.67,52.3,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,Multiplan,Multiplan,,,52.3,,52.3,16.67,52.3,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A MLTP,80300,CPT,,,both,,,65.28,39.17,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,16.67,52.3,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,16.67,60.42,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,16.67,,,16.67,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,16.67,60.42,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,16.67,60.42,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A MLTP,80300,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,16.67,60.42,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC ECSTASY DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,16.67,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,16.67,,,16.67,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,16.67,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80300,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,16.67,62.22,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,66.18,,,66.18,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,59.56,,,59.56,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,78.58,,,78.58,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,16.67,96.49,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,16.67,,,16.67,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,62.87,,,62.87,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,90.33,,,90.33,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,84.1,,,84.1,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,84.1,,,84.1,16.67,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,16.67,96.49,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A MLTP,80300,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,73.37,,,73.37,16.67,96.49,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC OXYCODONE DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,45.15,,,45.15,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,40.63,,,40.63,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,53.61,,,53.61,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,16.67,65.83,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,16.67,,,16.67,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,42.89,,,42.89,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,61.63,,,61.63,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,57.37,,,57.37,16.67,65.83,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,16.67,65.83,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A MLTP,80300,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,16.67,65.83,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT  ,,,both,,,70.92,42.55,Aetna,Commerical,,38.97,,,38.97,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Aetna,Middlesex Employees,,35.07,,,35.07,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Commerical,,46.26,,,46.26,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Indemnity,,,51.57,,51.57,16.67,56.81,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,State Preferred,,16.67,,,16.67,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Individual Exchange,,37.01,,,37.01,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Cigna,Cigna,,53.19,,,53.19,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Connecticare,Commerical,,49.52,,,49.52,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Connecticare,Exchange,,49.52,,,49.52,16.67,56.81,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Multiplan,Multiplan,,,56.81,,56.81,16.67,56.81,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,16.67,56.81,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT  ,,,both,,,70.92,42.55,Aetna,Commerical,,38.97,,,38.97,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Aetna,Middlesex Employees,,35.07,,,35.07,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Commerical,,46.26,,,46.26,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Indemnity,,,51.57,,51.57,16.67,56.81,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,State Preferred,,16.67,,,16.67,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Anthem,Individual Exchange,,37.01,,,37.01,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Cigna,Cigna,,53.19,,,53.19,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Connecticare,Commerical,,49.52,,,49.52,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Connecticare,Exchange,,49.52,,,49.52,16.67,56.81,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,Multiplan,Multiplan,,,56.81,,56.81,16.67,56.81,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80301,CPT,,,both,,,70.92,42.55,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,16.67,56.81,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,128.64,,,128.64,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,115.78,,,115.78,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,152.75,,,152.75,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,16.67,187.57,percent of total billed charges,,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,16.67,,,16.67,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,122.19,,,122.19,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,175.6,,,175.6,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,163.48,,,163.48,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,163.48,,,163.48,16.67,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,16.67,187.57,percent of total billed charges,,
HC CANNABINOIDS SYNTHETIC URINE - QUEST,80301,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,16.67,187.57,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC COCAIN EM QUAL UR,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT  ,,,both,,,64.15,38.49,Aetna,Commerical,,35.25,,,35.25,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Aetna,Middlesex Employees,,31.73,,,31.73,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Anthem,Commerical,,41.86,,,41.86,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Anthem,Indemnity,,,46.66,,46.66,16.67,51.4,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Anthem,State Preferred,,16.67,,,16.67,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Anthem,Individual Exchange,,33.48,,,33.48,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Cigna,Cigna,,48.12,,,48.12,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Connecticare,Commerical,,44.8,,,44.8,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Connecticare,Exchange,,44.8,,,44.8,16.67,51.4,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,Multiplan,Multiplan,,,51.4,,51.4,16.67,51.4,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A SNGL,80301,CPT,,,both,,,64.15,38.49,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,16.67,51.4,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT  ,,,both,,,73.16,43.9,Aetna,Commerical,,40.2,,,40.2,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Aetna,Middlesex Employees,,36.18,,,36.18,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Anthem,Commerical,,47.73,,,47.73,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Anthem,Indemnity,,,53.21,,53.21,16.67,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Anthem,State Preferred,,16.67,,,16.67,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Anthem,Individual Exchange,,38.19,,,38.19,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Cigna,Cigna,,54.88,,,54.88,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Connecticare,Commerical,,51.09,,,51.09,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Connecticare,Exchange,,51.09,,,51.09,16.67,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,Multiplan,Multiplan,,,58.62,,58.62,16.67,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A SNGL,80301,CPT,,,both,,,73.16,43.9,United Healthcare/Oxford,United Healthcare/Oxford,,44.57,,,44.57,16.67,58.62,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC ECSTASY DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,16.67,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,16.67,,,16.67,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,16.67,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,16.67,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80301,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,16.67,62.22,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT  ,,,both,,,115.93,69.56,Aetna,Commerical,,63.7,,,63.7,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Aetna,Middlesex Employees,,57.33,,,57.33,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Anthem,Commerical,,75.64,,,75.64,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Anthem,Indemnity,,,84.31,,84.31,16.67,92.88,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Anthem,State Preferred,,16.67,,,16.67,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Anthem,Individual Exchange,,60.51,,,60.51,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Cigna,Cigna,,86.95,,,86.95,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Connecticare,Commerical,,80.96,,,80.96,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Connecticare,Exchange,,80.96,,,80.96,16.67,92.88,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,Multiplan,Multiplan,,,92.88,,92.88,16.67,92.88,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A SNGL,80301,CPT,,,both,,,115.93,69.56,United Healthcare/Oxford,United Healthcare/Oxford,,70.63,,,70.63,16.67,92.88,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC OXYCODONE DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,16.67,64.02,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,16.67,,,16.67,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,16.67,64.02,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,16.67,64.02,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80301,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,16.67,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,28.2,64.02,percent of total billed charges,,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,28.2,,,28.2,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,28.2,64.02,percent of total billed charges,,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80302,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,28.2,64.02,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT  ,,,both,,,73.16,43.9,Aetna,Commerical,,40.2,,,40.2,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Aetna,Middlesex Employees,,36.18,,,36.18,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Anthem,Commerical,,47.73,,,47.73,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Anthem,Indemnity,,,53.21,,53.21,28.2,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Anthem,State Preferred,,28.2,,,28.2,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Anthem,Individual Exchange,,38.19,,,38.19,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Cigna,Cigna,,54.88,,,54.88,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Connecticare,Commerical,,51.09,,,51.09,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Connecticare,Exchange,,51.09,,,51.09,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,Multiplan,Multiplan,,,58.62,,58.62,28.2,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR B SNGL,80302,CPT,,,both,,,73.16,43.9,United Healthcare/Oxford,United Healthcare/Oxford,,44.57,,,44.57,28.2,58.62,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,28.2,62.22,percent of total billed charges,,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,28.2,,,28.2,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,28.2,62.22,percent of total billed charges,,
HC ETHYL GLUCURONIDE URINE,80302,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,28.2,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,28.2,,,28.2,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,28.2,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80302,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,28.2,62.22,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,28.2,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,28.2,,,28.2,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,28.2,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80302,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,28.2,64.02,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT  ,,,both,,,73.16,43.9,Aetna,Commerical,,40.2,,,40.2,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Aetna,Middlesex Employees,,36.18,,,36.18,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Anthem,Commerical,,47.73,,,47.73,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Anthem,Indemnity,,,53.21,,53.21,28.88,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Anthem,State Preferred,,28.88,,,28.88,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Anthem,Individual Exchange,,38.19,,,38.19,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Cigna,Cigna,,54.88,,,54.88,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Connecticare,Commerical,,51.09,,,51.09,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Connecticare,Exchange,,51.09,,,51.09,28.88,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,Multiplan,Multiplan,,,58.62,,58.62,28.88,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80303,CPT,,,both,,,73.16,43.9,United Healthcare/Oxford,United Healthcare/Oxford,,44.57,,,44.57,28.88,58.62,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,28.88,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,28.88,,,28.88,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,28.88,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,28.88,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80303,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,28.88,62.22,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,28.88,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,28.88,,,28.88,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,28.88,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,28.88,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80303,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,28.88,64.02,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT  ,,,both,,,73.16,43.9,Aetna,Commerical,,40.2,,,40.2,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Aetna,Middlesex Employees,,36.18,,,36.18,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Anthem,Commerical,,47.73,,,47.73,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Anthem,Indemnity,,,53.21,,53.21,28.2,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Anthem,State Preferred,,28.2,,,28.2,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Anthem,Individual Exchange,,38.19,,,38.19,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Cigna,Cigna,,54.88,,,54.88,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Connecticare,Commerical,,51.09,,,51.09,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Connecticare,Exchange,,51.09,,,51.09,28.2,58.62,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,Multiplan,Multiplan,,,58.62,,58.62,28.2,58.62,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY EA,80304,CPT,,,both,,,73.16,43.9,United Healthcare/Oxford,United Healthcare/Oxford,,44.57,,,44.57,28.2,58.62,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,28.2,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,28.2,,,28.2,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,28.2,62.22,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,28.2,62.22,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80304,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,28.2,62.22,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,43.91,,,43.91,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,39.51,,,39.51,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,52.14,,,52.14,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,28.2,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,28.2,,,28.2,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,41.71,,,41.71,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,59.95,,,59.95,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,55.81,,,55.81,28.2,64.02,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,28.2,64.02,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80304,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,48.68,,,48.68,28.2,64.02,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC AMPHET QUAL UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,48.74,287.44,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,48.74,287.44,percent of total billed charges,,
HC AMPHET UR CONF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC BARBIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC BENZODIAZ QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,48.74,287.44,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,48.74,287.44,percent of total billed charges,,
HC BUPRENORPH UR CNF DRG SCR A SNGL,80307,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC CANNABIN QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC COCAIN EM QUAL UR,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT  ,,,both,,,65.28,39.17,Aetna,Commerical,,72.04,,,72.04,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Aetna,Middlesex Employees,,64.84,,,64.84,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Anthem,Commerical,,77.12,,,77.12,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Anthem,Indemnity,,,47.47,,47.47,47.47,287.44,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Anthem,State Preferred,,48.74,,,48.74,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Anthem,Individual Exchange,,61.7,,,61.7,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Cigna,Cigna,,287.44,,,287.44,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Connecticare,Commerical,,69.53,,,69.53,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Connecticare,Exchange,,69.53,,,69.53,47.47,287.44,other,Could be inpatient or outpatient,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,Multiplan,Multiplan,,,52.3,,52.3,47.47,287.44,percent of total billed charges,,
HC COCAINE M UR CONE DRG SCR A SNGL,80307,CPT,,,both,,,65.28,39.17,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,47.47,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT  ,,,both,,,75.41,45.24,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Indemnity,,,54.84,,54.84,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,Multiplan,Multiplan,,,60.42,,60.42,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY EA,80307,CPT,,,both,,,75.41,45.24,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT  ,,,both,,,75.41,45.24,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Indemnity,,,54.84,,54.84,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,Multiplan,Multiplan,,,60.42,,60.42,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR ANY TLC EA,80307,CPT,,,both,,,75.41,45.24,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT  ,,,both,,,75.41,45.24,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Anthem,Indemnity,,,54.84,,54.84,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,Multiplan,Multiplan,,,60.42,,60.42,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN MECON DRG SCR B SNGL,80307,CPT,,,both,,,75.41,45.24,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT  ,,,both,,,100.17,60.1,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Anthem,Indemnity,,,72.85,,72.85,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,Multiplan,Multiplan,,,80.26,,80.26,48.74,287.44,percent of total billed charges,,
HC DRUG SCREEN PANEL 9 MECONIUM,80307,CPT,,,both,,,100.17,60.1,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,48.74,287.44,percent of total billed charges,,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,48.74,287.44,percent of total billed charges,,
HC ECSTASY DRG SCR A SNGL,80307,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC ETHYL GLUCURONIDE URINE,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A MLTP,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR A SNGL,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY EA,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR ANY TLC EA,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,48.74,287.44,percent of total billed charges,,
HC GEN TOXICGY SCR UR RDM DRG SCR B SNGL,80307,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC METHADONE-BLOOD DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC OPIATES EMIT QLUR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC OXYCODONE DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A MLTP,80307,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY EA,80307,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR ANY TLC EA,80307,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,48.74,287.44,percent of total billed charges,,
HC PCP EMIT QUAL-UR DRG SCR B SNGL,80307,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,72.04,,,72.04,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,64.84,,,64.84,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,77.12,,,77.12,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,48.74,287.44,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,48.74,,,48.74,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,61.7,,,61.7,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,287.44,,,287.44,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,69.53,,,69.53,48.74,287.44,other,Could be inpatient or outpatient,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,48.74,287.44,percent of total billed charges,,
HC TRICYCLIC QUAL-UR DRG SCR A SNGL,80307,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,84.77,,,84.77,48.74,287.44,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT  ,,,both,,,76.53,45.92,Aetna,Commerical,,,,,,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Aetna,Middlesex Employees,,,,,,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Anthem,Commerical,,19.76,,,19.76,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Anthem,Indemnity,,,55.66,,55.66,15.8,61.32,percent of total billed charges,,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Anthem,State Preferred,,16.65,,,16.65,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Anthem,Individual Exchange,,15.8,,,15.8,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Cigna,Cigna,,,,,,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Connecticare,Commerical,,33.09,,,33.09,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Connecticare,Exchange,,33.09,,,33.09,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,Multiplan,Multiplan,,,61.32,,61.32,15.8,61.32,percent of total billed charges,,
HC ETHANOL,80320,CPT,,,both,,,76.53,45.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.8,61.32,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,60,,,60,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,54,,,54,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,71.23,,,71.23,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,16.65,87.47,percent of total billed charges,,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,16.65,,,16.65,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,56.99,,,56.99,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,81.89,,,81.89,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,76.24,,,76.24,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,76.24,,,76.24,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,16.65,87.47,percent of total billed charges,,
HC ETHANOL BIOMARKERS 1-2,80321,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,66.51,,,66.51,16.65,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,60,,,60,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,54,,,54,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,71.23,,,71.23,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,18.31,87.47,percent of total billed charges,,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,18.31,,,18.31,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,56.99,,,56.99,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,81.89,,,81.89,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,76.24,,,76.24,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,76.24,,,76.24,18.31,87.47,other,Could be inpatient or outpatient,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,18.31,87.47,percent of total billed charges,,
HC ETHANOL BIOMARKERS 3 OR>,80322,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,66.51,,,66.51,18.31,87.47,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT  ,,,both,,,27.09,16.25,Aetna,Commerical,,14.88,,,14.88,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Aetna,Middlesex Employees,,13.39,,,13.39,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Anthem,Commerical,,17.67,,,17.67,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Anthem,Indemnity,,,19.7,,19.7,13.39,35.85,percent of total billed charges,,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Anthem,State Preferred,,35.85,,,35.85,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Anthem,Individual Exchange,,14.14,,,14.14,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Cigna,Cigna,,20.31,,,20.31,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Connecticare,Commerical,,18.91,,,18.91,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Connecticare,Exchange,,18.91,,,18.91,13.39,35.85,other,Could be inpatient or outpatient,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,Multiplan,Multiplan,,,21.7,,21.7,13.39,35.85,percent of total billed charges,,
HC NICTIN COTIN RANDM,80323,CPT,,,both,,,27.09,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,16.5,,,16.5,13.39,35.85,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT  ,,,both,,,373.67,224.2,Aetna,Commerical,,205.33,,,205.33,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Aetna,Middlesex Employees,,184.8,,,184.8,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Anthem,Commerical,,243.8,,,243.8,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Anthem,Indemnity,,,271.76,,271.76,14.78,299.39,percent of total billed charges,,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Anthem,State Preferred,,14.78,,,14.78,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Anthem,Individual Exchange,,195.05,,,195.05,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Cigna,Cigna,,280.29,,,280.29,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Connecticare,Commerical,,260.95,,,260.95,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Connecticare,Exchange,,260.95,,,260.95,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,Multiplan,Multiplan,,,299.39,,299.39,14.78,299.39,percent of total billed charges,,
HC AMPHETAMINE CONF UR 1-2,80324,CPT,,,both,,,373.67,224.2,United Healthcare/Oxford,United Healthcare/Oxford,,227.64,,,227.64,14.78,299.39,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT  ,,,both,,,244.24,146.55,Aetna,Commerical,,134.21,,,134.21,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Aetna,Middlesex Employees,,120.8,,,120.8,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Anthem,Commerical,,159.36,,,159.36,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Anthem,Indemnity,,,177.63,,177.63,16.26,195.69,percent of total billed charges,,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Anthem,State Preferred,,16.26,,,16.26,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Anthem,Individual Exchange,,127.49,,,127.49,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Cigna,Cigna,,183.21,,,183.21,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Connecticare,Commerical,,170.55,,,170.55,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Connecticare,Exchange,,170.55,,,170.55,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,Multiplan,Multiplan,,,195.69,,195.69,16.26,195.69,percent of total billed charges,,
HC AMPHETAMINE CONF UR 3-4,80325,CPT,,,both,,,244.24,146.55,United Healthcare/Oxford,United Healthcare/Oxford,,148.79,,,148.79,16.26,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT  ,,,both,,,244.24,146.55,Aetna,Commerical,,134.21,,,134.21,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Aetna,Middlesex Employees,,120.8,,,120.8,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Anthem,Commerical,,159.36,,,159.36,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Anthem,Indemnity,,,177.63,,177.63,17.74,195.69,percent of total billed charges,,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Anthem,State Preferred,,17.74,,,17.74,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Anthem,Individual Exchange,,127.49,,,127.49,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Cigna,Cigna,,183.21,,,183.21,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Connecticare,Commerical,,170.55,,,170.55,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Connecticare,Exchange,,170.55,,,170.55,17.74,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,Multiplan,Multiplan,,,195.69,,195.69,17.74,195.69,percent of total billed charges,,
HC AMPHETAMINE CONF UR 5 OR>,80326,CPT,,,both,,,244.24,146.55,United Healthcare/Oxford,United Healthcare/Oxford,,148.79,,,148.79,17.74,195.69,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT  ,,,both,,,309,185.4,Aetna,Commerical,,170.08,,,170.08,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Aetna,Middlesex Employees,,153.07,,,153.07,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Anthem,Commerical,,201.95,,,201.95,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Anthem,Indemnity,,,225.11,,225.11,39.8,247.99,percent of total billed charges,,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Anthem,State Preferred,,39.8,,,39.8,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Anthem,Individual Exchange,,161.56,,,161.56,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Cigna,Cigna,,232.17,,,232.17,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Connecticare,Commerical,,216.14,,,216.14,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Connecticare,Exchange,,216.14,,,216.14,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,Multiplan,Multiplan,,,247.99,,247.99,39.8,247.99,percent of total billed charges,,
HC DIHYDROTESTOSTERO 1-2,80327,CPT,,,both,,,309,185.4,United Healthcare/Oxford,United Healthcare/Oxford,,188.56,,,188.56,39.8,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT  ,,,both,,,309,185.4,Aetna,Commerical,,170.08,,,170.08,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Aetna,Middlesex Employees,,153.07,,,153.07,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Anthem,Commerical,,201.95,,,201.95,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Anthem,Indemnity,,,225.11,,225.11,43.77,247.99,percent of total billed charges,,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Anthem,State Preferred,,43.77,,,43.77,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Anthem,Individual Exchange,,161.56,,,161.56,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Cigna,Cigna,,232.17,,,232.17,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Connecticare,Commerical,,216.14,,,216.14,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Connecticare,Exchange,,216.14,,,216.14,43.77,247.99,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,Multiplan,Multiplan,,,247.99,,247.99,43.77,247.99,percent of total billed charges,,
HC DIHYDROTESTOSTERO 3 OR>,80328,CPT,,,both,,,309,185.4,United Healthcare/Oxford,United Healthcare/Oxford,,188.56,,,188.56,43.77,247.99,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT  ,,,both,,,89.61,53.77,Aetna,Commerical,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Aetna,Middlesex Employees,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Commerical,,37.02,,,37.02,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Indemnity,,,65.48,,65.48,29.62,72.14,percent of total billed charges,,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,State Preferred,,31.19,,,31.19,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Individual Exchange,,29.62,,,29.62,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Cigna,Cigna,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Connecticare,Commerical,,33.09,,,33.09,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Connecticare,Exchange,,33.09,,,33.09,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,Multiplan,Multiplan,,,72.14,,72.14,29.62,72.14,percent of total billed charges,,
HC ACETAMINOPHEN 1-2,80329,CPT,,,both,,,89.61,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT  ,,,both,,,89.61,53.77,Aetna,Commerical,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Aetna,Middlesex Employees,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Commerical,,37.02,,,37.02,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Indemnity,,,65.48,,65.48,29.62,72.14,percent of total billed charges,,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,State Preferred,,31.19,,,31.19,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Anthem,Individual Exchange,,29.62,,,29.62,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Cigna,Cigna,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Connecticare,Commerical,,33.09,,,33.09,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Connecticare,Exchange,,33.09,,,33.09,29.62,72.14,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,Multiplan,Multiplan,,,72.14,,72.14,29.62,72.14,percent of total billed charges,,
HC SALICYLATE QUANT 1-2,80329,CPT,,,both,,,89.61,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.62,72.14,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT  ,,,both,,,143.17,85.9,Aetna,Commerical,,78.55,,,78.55,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Aetna,Middlesex Employees,,70.69,,,70.69,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Anthem,Commerical,,93.26,,,93.26,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Anthem,Indemnity,,,103.95,,103.95,34.31,114.52,percent of total billed charges,,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Anthem,State Preferred,,34.31,,,34.31,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Anthem,Individual Exchange,,74.61,,,74.61,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Cigna,Cigna,,107.22,,,107.22,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Connecticare,Commerical,,99.81,,,99.81,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Connecticare,Exchange,,99.81,,,99.81,34.31,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,Multiplan,Multiplan,,,114.52,,114.52,34.31,114.52,percent of total billed charges,,
HC ACETAMINOPHEN 3-5,80330,CPT,,,both,,,143.17,85.9,United Healthcare/Oxford,United Healthcare/Oxford,,87.08,,,87.08,34.31,114.52,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,34.31,68.54,percent of total billed charges,,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,34.31,,,34.31,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,34.31,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,34.31,68.54,percent of total billed charges,,
HC SALICYLATE QUANT 3-5,80330,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,34.31,68.54,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT  ,,,both,,,143.17,85.9,Aetna,Commerical,,78.55,,,78.55,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Aetna,Middlesex Employees,,70.69,,,70.69,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Anthem,Commerical,,93.26,,,93.26,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Anthem,Indemnity,,,103.95,,103.95,37.43,114.52,percent of total billed charges,,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Anthem,State Preferred,,37.43,,,37.43,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Anthem,Individual Exchange,,74.61,,,74.61,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Cigna,Cigna,,107.22,,,107.22,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Connecticare,Commerical,,99.81,,,99.81,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Connecticare,Exchange,,99.81,,,99.81,37.43,114.52,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,Multiplan,Multiplan,,,114.52,,114.52,37.43,114.52,percent of total billed charges,,
HC ACETAMINOPHEN 6 OR>,80331,CPT,,,both,,,143.17,85.9,United Healthcare/Oxford,United Healthcare/Oxford,,87.08,,,87.08,37.43,114.52,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,37.43,68.54,percent of total billed charges,,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,37.43,,,37.43,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,37.43,68.54,other,Could be inpatient or outpatient,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,37.43,68.54,percent of total billed charges,,
HC SALICYLATE QUANT 6 OR>,80331,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,37.43,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,27.59,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,27.59,,,27.59,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,27.59,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,27.59,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 1 OR 2,80335,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,27.59,68.54,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,27.59,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,27.59,,,27.59,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,27.59,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,27.59,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 1-2,80335,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,27.59,73.94,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,30.35,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,30.35,,,30.35,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,30.35,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,30.35,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 3 OR 5,80336,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,30.35,68.54,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,30.35,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,30.35,,,30.35,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,30.35,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,30.35,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 3-5,80336,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,30.35,73.94,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,33.1,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,33.1,,,33.1,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,33.1,68.54,other,Could be inpatient or outpatient,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,33.1,68.54,percent of total billed charges,,
HC AMITRIPTYLINE 6 OR>,80337,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,33.1,68.54,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,33.1,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,33.1,,,33.1,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,33.1,73.94,other,Could be inpatient or outpatient,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,33.1,73.94,percent of total billed charges,,
HC NORTRIPLYLINE 6 OR>,80337,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,33.1,73.94,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,85.35,,,85.35,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,76.82,,,76.82,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,101.34,,,101.34,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,24.01,124.44,percent of total billed charges,,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,24.01,,,24.01,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,81.07,,,81.07,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,116.51,,,116.51,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,108.46,,,108.46,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,108.46,,,108.46,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,24.01,124.44,percent of total billed charges,,
HC PERPHENAZINE 1-3,80342,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,94.63,,,94.63,24.01,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,85.35,,,85.35,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,76.82,,,76.82,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,101.34,,,101.34,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,26.41,124.44,percent of total billed charges,,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,26.41,,,26.41,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,81.07,,,81.07,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,116.51,,,116.51,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,108.46,,,108.46,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,108.46,,,108.46,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,26.41,124.44,percent of total billed charges,,
HC PERPHENAZINE 4-6,80343,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,94.63,,,94.63,26.41,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,85.35,,,85.35,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,76.82,,,76.82,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,101.34,,,101.34,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,28.81,124.44,percent of total billed charges,,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,28.81,,,28.81,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,81.07,,,81.07,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,116.51,,,116.51,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,108.46,,,108.46,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,108.46,,,108.46,28.81,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,28.81,124.44,percent of total billed charges,,
HC PERPHENAZINE 7 OR>,80344,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,94.63,,,94.63,28.81,124.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT  ,,,both,,,85.49,51.29,Aetna,Commerical,,47.62,,,47.62,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Aetna,Middlesex Employees,,42.86,,,42.86,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Anthem,Commerical,,56.54,,,56.54,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Anthem,Indemnity,,,63.03,,63.03,17.65,69.44,percent of total billed charges,,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Anthem,State Preferred,,17.65,,,17.65,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Anthem,Individual Exchange,,45.23,,,45.23,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Cigna,Cigna,,65.01,,,65.01,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Connecticare,Commerical,,60.52,,,60.52,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Connecticare,Exchange,,60.52,,,60.52,17.65,69.44,other,Could be inpatient or outpatient,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,Multiplan,Multiplan,,,69.44,,69.44,17.65,69.44,percent of total billed charges,,
HC PENTOBARBITAL,80345,CPT,,,both,,,85.49,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,52.8,,,52.8,17.65,69.44,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT  ,,,both,,,86.52,51.91,Aetna,Commerical,,48.24,,,48.24,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Aetna,Middlesex Employees,,43.42,,,43.42,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Anthem,Commerical,,57.28,,,57.28,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Anthem,Indemnity,,,63.85,,63.85,28.5,70.34,percent of total billed charges,,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Anthem,State Preferred,,28.5,,,28.5,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Anthem,Individual Exchange,,45.82,,,45.82,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Cigna,Cigna,,65.85,,,65.85,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Connecticare,Commerical,,61.31,,,61.31,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Connecticare,Exchange,,61.31,,,61.31,28.5,70.34,other,Could be inpatient or outpatient,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,Multiplan,Multiplan,,,70.34,,70.34,28.5,70.34,percent of total billed charges,,
HC CLONEZEPAM 1 -12,80346,CPT,,,both,,,86.52,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,53.48,,,53.48,28.5,70.34,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT  ,,,both,,,145.23,87.14,Aetna,Commerical,,79.79,,,79.79,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Aetna,Middlesex Employees,,71.81,,,71.81,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Anthem,Commerical,,94.73,,,94.73,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Anthem,Indemnity,,,105.6,,105.6,28.5,116.33,percent of total billed charges,,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Anthem,State Preferred,,28.5,,,28.5,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Anthem,Individual Exchange,,75.78,,,75.78,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Cigna,Cigna,,108.91,,,108.91,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Connecticare,Commerical,,101.39,,,101.39,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Connecticare,Exchange,,101.39,,,101.39,28.5,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,Multiplan,Multiplan,,,116.33,,116.33,28.5,116.33,percent of total billed charges,,
HC OXAZEPAM 1-12,80346,CPT,,,both,,,145.23,87.14,United Healthcare/Oxford,United Healthcare/Oxford,,88.45,,,88.45,28.5,116.33,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT  ,,,both,,,589.77,353.86,Aetna,Commerical,,324.09,,,324.09,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Aetna,Middlesex Employees,,291.68,,,291.68,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Anthem,Commerical,,384.8,,,384.8,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Anthem,Indemnity,,,428.93,,428.93,28.5,472.52,percent of total billed charges,,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Anthem,State Preferred,,28.5,,,28.5,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Anthem,Individual Exchange,,307.84,,,307.84,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Cigna,Cigna,,442.38,,,442.38,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Connecticare,Commerical,,411.85,,,411.85,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Connecticare,Exchange,,411.85,,,411.85,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,Multiplan,Multiplan,,,472.52,,472.52,28.5,472.52,percent of total billed charges,,
HC SQ CONF URINE BENZODIAZEPINE  8-14,80346,CPT,,,both,,,589.77,353.86,United Healthcare/Oxford,United Healthcare/Oxford,,359.28,,,359.28,28.5,472.52,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT  ,,,both,,,431.07,258.64,Aetna,Commerical,,236.88,,,236.88,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Aetna,Middlesex Employees,,213.19,,,213.19,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Anthem,Commerical,,281.26,,,281.26,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Anthem,Indemnity,,,313.51,,313.51,28.5,345.37,percent of total billed charges,,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Anthem,State Preferred,,28.5,,,28.5,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Anthem,Individual Exchange,,225.01,,,225.01,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Cigna,Cigna,,323.35,,,323.35,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Connecticare,Commerical,,301.02,,,301.02,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Connecticare,Exchange,,301.02,,,301.02,28.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,Multiplan,Multiplan,,,345.37,,345.37,28.5,345.37,percent of total billed charges,,
HC SQ CONF URINE BENZODIAZEPINE 1-7,80346,CPT,,,both,,,431.07,258.64,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,28.5,345.37,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT  ,,,both,,,125.66,75.4,Aetna,Commerical,,69.27,,,69.27,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Aetna,Middlesex Employees,,62.35,,,62.35,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Anthem,Commerical,,82.25,,,82.25,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Anthem,Indemnity,,,91.68,,91.68,31.35,101,percent of total billed charges,,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Anthem,State Preferred,,31.35,,,31.35,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Anthem,Individual Exchange,,65.81,,,65.81,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Cigna,Cigna,,94.56,,,94.56,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Connecticare,Commerical,,88.03,,,88.03,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Connecticare,Exchange,,88.03,,,88.03,31.35,101,other,Could be inpatient or outpatient,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,Multiplan,Multiplan,,,101,,101,31.35,101,percent of total billed charges,,
HC CLONEZEPAM 13 OR>,80347,CPT,,,both,,,125.66,75.4,United Healthcare/Oxford,United Healthcare/Oxford,,76.8,,,76.8,31.35,101,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT  ,,,both,,,145.23,87.14,Aetna,Commerical,,79.79,,,79.79,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Aetna,Middlesex Employees,,71.81,,,71.81,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Anthem,Commerical,,94.73,,,94.73,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Anthem,Indemnity,,,105.6,,105.6,31.35,116.33,percent of total billed charges,,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Anthem,State Preferred,,31.35,,,31.35,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Anthem,Individual Exchange,,75.78,,,75.78,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Cigna,Cigna,,108.91,,,108.91,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Connecticare,Commerical,,101.39,,,101.39,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Connecticare,Exchange,,101.39,,,101.39,31.35,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,Multiplan,Multiplan,,,116.33,,116.33,31.35,116.33,percent of total billed charges,,
HC OXAZEPAM 13 OR>,80347,CPT,,,both,,,145.23,87.14,United Healthcare/Oxford,United Healthcare/Oxford,,88.45,,,88.45,31.35,116.33,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT  ,,,both,,,431.07,258.64,Aetna,Commerical,,236.88,,,236.88,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Aetna,Middlesex Employees,,213.19,,,213.19,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Anthem,Commerical,,281.26,,,281.26,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Anthem,Indemnity,,,313.51,,313.51,36.5,345.37,percent of total billed charges,,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Anthem,State Preferred,,36.5,,,36.5,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Anthem,Individual Exchange,,225.01,,,225.01,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Cigna,Cigna,,323.35,,,323.35,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Connecticare,Commerical,,301.02,,,301.02,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Connecticare,Exchange,,301.02,,,301.02,36.5,345.37,other,Could be inpatient or outpatient,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,Multiplan,Multiplan,,,345.37,,345.37,36.5,345.37,percent of total billed charges,,
HC SQ CONF URINE CANNABINOID METABOLITE NATURAL,80349,CPT,,,both,,,431.07,258.64,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,36.5,345.37,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,128.64,,,128.64,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,115.78,,,115.78,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,152.75,,,152.75,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,44.38,187.57,percent of total billed charges,,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,44.38,,,44.38,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,122.19,,,122.19,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,175.6,,,175.6,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,163.48,,,163.48,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,163.48,,,163.48,44.38,187.57,other,Could be inpatient or outpatient,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,44.38,187.57,percent of total billed charges,,
HC CANNABINOIDS SYNTHETIC CONFIRMED 7/MORE - QUEST,80352,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,44.38,187.57,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,23.36,56.81,percent of total billed charges,,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,23.36,,,23.36,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,23.36,56.81,other,Could be inpatient or outpatient,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,23.36,56.81,percent of total billed charges,,
HC COCAINE & METABOLITE,80353,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,23.36,56.81,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT  ,,,both,,,430.54,258.32,Aetna,Commerical,,236.88,,,236.88,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Aetna,Middlesex Employees,,213.19,,,213.19,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Anthem,Commerical,,281.26,,,281.26,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Anthem,Indemnity,,,313.51,,313.51,29.98,345.37,percent of total billed charges,,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Anthem,State Preferred,,29.98,,,29.98,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Anthem,Individual Exchange,,225.01,,,225.01,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Cigna,Cigna,,323.35,,,323.35,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Connecticare,Commerical,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Connecticare,Exchange,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,Multiplan,Multiplan,,,345.37,,345.37,29.98,345.37,percent of total billed charges,,
HC DRUG SCREENING FENTANYL,80354,CPT,,,both,,,430.54,258.32,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT  ,,,both,,,431.07,258.64,Aetna,Commerical,,236.88,,,236.88,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Aetna,Middlesex Employees,,213.19,,,213.19,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Anthem,Commerical,,281.26,,,281.26,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Anthem,Indemnity,,,313.51,,313.51,29.98,345.37,percent of total billed charges,,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Anthem,State Preferred,,29.98,,,29.98,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Anthem,Individual Exchange,,225.01,,,225.01,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Cigna,Cigna,,323.35,,,323.35,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Connecticare,Commerical,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Connecticare,Exchange,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,Multiplan,Multiplan,,,345.37,,345.37,29.98,345.37,percent of total billed charges,,
HC DRUG SCREENING FENTANYL REFLEX CONF URINE,80354,CPT,,,both,,,431.07,258.64,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT  ,,,both,,,431.07,258.64,Aetna,Commerical,,236.88,,,236.88,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Aetna,Middlesex Employees,,213.19,,,213.19,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Anthem,Commerical,,281.26,,,281.26,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Anthem,Indemnity,,,313.51,,313.51,29.98,345.37,percent of total billed charges,,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Anthem,State Preferred,,29.98,,,29.98,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Anthem,Individual Exchange,,225.01,,,225.01,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Cigna,Cigna,,323.35,,,323.35,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Connecticare,Commerical,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Connecticare,Exchange,,301.02,,,301.02,29.98,345.37,other,Could be inpatient or outpatient,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,Multiplan,Multiplan,,,345.37,,345.37,29.98,345.37,percent of total billed charges,,
HC SQ FENTANYL NORFENTANYL CONF UA QT,80354,CPT,,,both,,,431.07,258.64,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,29.98,345.37,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,66.18,,,66.18,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,59.56,,,59.56,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,78.58,,,78.58,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,25.17,96.49,percent of total billed charges,,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,25.17,,,25.17,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,62.87,,,62.87,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,90.33,,,90.33,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,84.1,,,84.1,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,84.1,,,84.1,25.17,96.49,other,Could be inpatient or outpatient,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,25.17,96.49,percent of total billed charges,,
HC METHADONE-BLOOD,80358,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,73.37,,,73.37,25.17,96.49,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT  ,,,both,,,430.54,258.32,Aetna,Commerical,,236.88,,,236.88,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Aetna,Middlesex Employees,,213.19,,,213.19,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Anthem,Commerical,,281.26,,,281.26,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Anthem,Indemnity,,,313.51,,313.51,14.78,345.37,percent of total billed charges,,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Anthem,State Preferred,,14.78,,,14.78,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Anthem,Individual Exchange,,225.01,,,225.01,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Cigna,Cigna,,323.35,,,323.35,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Connecticare,Commerical,,301.02,,,301.02,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Connecticare,Exchange,,301.02,,,301.02,14.78,345.37,other,Could be inpatient or outpatient,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,Multiplan,Multiplan,,,345.37,,345.37,14.78,345.37,percent of total billed charges,,
HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES CONFIRMATION,80359,CPT,,,both,,,430.54,258.32,United Healthcare/Oxford,United Healthcare/Oxford,,262.61,,,262.61,14.78,345.37,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,29.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,29.98,,,29.98,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,29.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 1 OR MORE,80361,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,29.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,29.98,,,29.98,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,29.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 1 OR 2,80362,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,29.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,32.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,32.98,,,32.98,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,32.98,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 3 OR 4,80363,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,32.98,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,35.99,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,35.99,,,35.99,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,35.99,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,35.99,101.9,percent of total billed charges,,
HC OPIATE-BLOOD 5 OR>,80364,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,35.99,101.9,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT  ,,,both,,,11.34,6.8,Aetna,Commerical,,6.23,,,6.23,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Aetna,Middlesex Employees,,5.61,,,5.61,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Anthem,Commerical,,7.4,,,7.4,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Anthem,Indemnity,,,8.25,,8.25,3.75,9.09,percent of total billed charges,,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Anthem,State Preferred,,3.75,,,3.75,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Anthem,Individual Exchange,,5.92,,,5.92,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Cigna,Cigna,,8.51,,,8.51,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Connecticare,Commerical,,7.93,,,7.93,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Connecticare,Exchange,,7.93,,,7.93,3.75,9.09,other,Could be inpatient or outpatient,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,Multiplan,Multiplan,,,9.09,,9.09,3.75,9.09,percent of total billed charges,,
HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,81000,CPT,,,both,,,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,6.91,,,6.91,3.75,9.09,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT  ,,,both,,,12.77,7.66,Aetna,Commerical,,3.67,,,3.67,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Aetna,Middlesex Employees,,3.31,,,3.31,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Anthem,Commerical,,5.84,,,5.84,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Anthem,Indemnity,,,9.29,,9.29,3.31,10.23,percent of total billed charges,,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Anthem,State Preferred,,3.75,,,3.75,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Anthem,Individual Exchange,,4.67,,,4.67,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Cigna,Cigna,,7.11,,,7.11,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Connecticare,Commerical,,3.55,,,3.55,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Connecticare,Exchange,,3.55,,,3.55,3.31,10.23,other,Could be inpatient or outpatient,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,Multiplan,Multiplan,,,10.23,,10.23,3.31,10.23,percent of total billed charges,,
HC URINAL-DIAGNOSTIC,81001,CPT,,,both,,,12.77,7.66,United Healthcare/Oxford,United Healthcare/Oxford,,4.61,,,4.61,3.31,10.23,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT  ,,,both,,,11.34,6.8,Aetna,Commerical,,4.04,,,4.04,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Aetna,Middlesex Employees,,3.63,,,3.63,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Anthem,Commerical,,4.72,,,4.72,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Anthem,Indemnity,,,8.25,,8.25,3.03,9.09,percent of total billed charges,,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Anthem,State Preferred,,3.03,,,3.03,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Anthem,Individual Exchange,,3.78,,,3.78,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Cigna,Cigna,,5.93,,,5.93,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Connecticare,Commerical,,3.89,,,3.89,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Connecticare,Exchange,,3.89,,,3.89,3.03,9.09,other,Could be inpatient or outpatient,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,Multiplan,Multiplan,,,9.09,,9.09,3.03,9.09,percent of total billed charges,,
HC N-AUTOM URINALYSIS WO  MICRO,81002,CPT,,,both,,,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,4.56,,,4.56,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT  ,,,both,,,11.34,6.8,Aetna,Commerical,,4.04,,,4.04,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Aetna,Middlesex Employees,,3.63,,,3.63,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Anthem,Commerical,,4.72,,,4.72,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Anthem,Indemnity,,,8.25,,8.25,3.03,9.09,percent of total billed charges,,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Anthem,State Preferred,,3.03,,,3.03,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Anthem,Individual Exchange,,3.78,,,3.78,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Cigna,Cigna,,5.93,,,5.93,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Connecticare,Commerical,,3.89,,,3.89,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Connecticare,Exchange,,3.89,,,3.89,3.03,9.09,other,Could be inpatient or outpatient,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,Multiplan,Multiplan,,,9.09,,9.09,3.03,9.09,percent of total billed charges,,
HC REDUCING SUBSRANC,81002,CPT,,,both,,,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,4.56,,,4.56,3.03,9.09,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT  ,,,both,,,9.03,5.42,Aetna,Commerical,,2.61,,,2.61,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Aetna,Middlesex Employees,,2.34,,,2.34,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Anthem,Commerical,,4.14,,,4.14,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Anthem,Indemnity,,,6.57,,6.57,2.34,7.23,percent of total billed charges,,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Anthem,State Preferred,,2.67,,,2.67,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Anthem,Individual Exchange,,3.31,,,3.31,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Cigna,Cigna,,4.74,,,4.74,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Connecticare,Commerical,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Connecticare,Exchange,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,Multiplan,Multiplan,,,7.23,,7.23,2.34,7.23,percent of total billed charges,,
HC AUTOM URINALYSIS WO MICRO,81003,CPT,,,both,,,9.03,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,3.27,,,3.27,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT  ,,,both,,,9.03,5.42,Aetna,Commerical,,2.61,,,2.61,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Aetna,Middlesex Employees,,2.34,,,2.34,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Anthem,Commerical,,4.14,,,4.14,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Anthem,Indemnity,,,6.57,,6.57,2.34,7.23,percent of total billed charges,,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Anthem,State Preferred,,2.67,,,2.67,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Anthem,Individual Exchange,,3.31,,,3.31,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Cigna,Cigna,,4.74,,,4.74,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Connecticare,Commerical,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Connecticare,Exchange,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,Multiplan,Multiplan,,,7.23,,7.23,2.34,7.23,percent of total billed charges,,
HC AUTOM URINALYSIS WO MICRO-WAIVED,81003,CPT,,,both,,,9.03,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,3.27,,,3.27,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT  ,,,both,,,9.03,5.42,Aetna,Commerical,,2.61,,,2.61,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Aetna,Middlesex Employees,,2.34,,,2.34,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Anthem,Commerical,,4.14,,,4.14,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Anthem,Indemnity,,,6.57,,6.57,2.34,7.23,percent of total billed charges,,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Anthem,State Preferred,,2.67,,,2.67,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Anthem,Individual Exchange,,3.31,,,3.31,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Cigna,Cigna,,4.74,,,4.74,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Connecticare,Commerical,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Connecticare,Exchange,,2.52,,,2.52,2.34,7.23,other,Could be inpatient or outpatient,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,Multiplan,Multiplan,,,7.23,,7.23,2.34,7.23,percent of total billed charges,,
HC URINE SCREEN,81003,CPT,,,both,,,9.03,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,3.27,,,3.27,2.34,7.23,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,21.49,,,21.49,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,19.34,,,19.34,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,25.52,,,25.52,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,2.57,31.34,percent of total billed charges,,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,2.57,,,2.57,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,20.42,,,20.42,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,29.34,,,29.34,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,27.31,,,27.31,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,27.31,,,27.31,2.57,31.34,other,Could be inpatient or outpatient,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,2.57,31.34,percent of total billed charges,,
HC REDUCING SUBSTNCE,81005,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,23.82,,,23.82,2.57,31.34,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT  ,,,both,,,12.28,7.37,Aetna,Commerical,,3.53,,,3.53,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Aetna,Middlesex Employees,,3.18,,,3.18,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Anthem,Commerical,,5.6,,,5.6,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Anthem,Indemnity,,,8.92,,8.92,3.18,9.83,percent of total billed charges,,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Anthem,State Preferred,,3.59,,,3.59,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Anthem,Individual Exchange,,4.48,,,4.48,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Cigna,Cigna,,6.54,,,6.54,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Connecticare,Commerical,,3.42,,,3.42,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Connecticare,Exchange,,3.42,,,3.42,3.18,9.83,other,Could be inpatient or outpatient,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,Multiplan,Multiplan,,,9.83,,9.83,3.18,9.83,percent of total billed charges,,
HC URINE MICROSCOPIC,81015,CPT,,,both,,,12.28,7.37,United Healthcare/Oxford,United Healthcare/Oxford,,4.45,,,4.45,3.18,9.83,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT  ,,,both,,,38.21,22.93,Aetna,Commerical,,9.99,,,9.99,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Aetna,Middlesex Employees,,8.99,,,8.99,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Anthem,Commerical,,11.66,,,11.66,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Anthem,Indemnity,,,27.79,,27.79,7.49,30.62,percent of total billed charges,,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Anthem,State Preferred,,7.49,,,7.49,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Anthem,Individual Exchange,,9.34,,,9.34,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Cigna,Cigna,,14.23,,,14.23,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Connecticare,Commerical,,9.63,,,9.63,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Connecticare,Exchange,,9.63,,,9.63,7.49,30.62,other,Could be inpatient or outpatient,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,Multiplan,Multiplan,,,30.62,,30.62,7.49,30.62,percent of total billed charges,,
HC PREG TEST,81025,CPT,,,both,,,38.21,22.93,United Healthcare/Oxford,United Healthcare/Oxford,,11.29,,,11.29,7.49,30.62,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,9.99,,,9.99,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,8.99,,,8.99,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,11.66,,,11.66,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,7.49,22.51,percent of total billed charges,,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,7.49,,,7.49,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,9.34,,,9.34,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,14.23,,,14.23,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,9.63,,,9.63,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,9.63,,,9.63,7.49,22.51,other,Could be inpatient or outpatient,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,7.49,22.51,percent of total billed charges,,
HC URINE PREGNANCY VISUAL,81025,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,11.29,,,11.29,7.49,22.51,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT  ,,,both,,,12.08,7.25,Aetna,Commerical,,4.22,,,4.22,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Aetna,Middlesex Employees,,3.8,,,3.8,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Anthem,Commerical,,5.53,,,5.53,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Anthem,Indemnity,,,8.79,,8.79,3.55,9.68,percent of total billed charges,,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Anthem,State Preferred,,3.55,,,3.55,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Anthem,Individual Exchange,,4.42,,,4.42,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Cigna,Cigna,,6.54,,,6.54,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Connecticare,Commerical,,4.08,,,4.08,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Connecticare,Exchange,,4.08,,,4.08,3.55,9.68,other,Could be inpatient or outpatient,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,Multiplan,Multiplan,,,9.68,,9.68,3.55,9.68,percent of total billed charges,,
HC VOLUME MEASURE,81050,CPT,,,both,,,12.08,7.25,United Healthcare/Oxford,United Healthcare/Oxford,,4.78,,,4.78,3.55,9.68,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT  ,,,both,,,155.53,93.32,Aetna,Commerical,,85.97,,,85.97,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Aetna,Middlesex Employees,,77.37,,,77.37,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Anthem,Commerical,,102.07,,,102.07,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Anthem,Indemnity,,,113.78,,113.78,77.37,127.86,percent of total billed charges,,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Anthem,State Preferred,,127.86,,,127.86,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Anthem,Individual Exchange,,81.66,,,81.66,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Cigna,Cigna,,117.35,,,117.35,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Connecticare,Commerical,,109.25,,,109.25,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Connecticare,Exchange,,109.25,,,109.25,77.37,127.86,other,Could be inpatient or outpatient,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,Multiplan,Multiplan,,,125.35,,125.35,77.37,127.86,percent of total billed charges,,
HC HPA-1,81105,CPT,,,both,,,155.53,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,95.31,,,95.31,77.37,127.86,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT  ,,,both,,,629.33,377.6,Aetna,Commerical,,345.74,,,345.74,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Aetna,Middlesex Employees,,311.17,,,311.17,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Anthem,Commerical,,410.51,,,410.51,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Anthem,Indemnity,,,457.57,,457.57,163.76,504.08,percent of total billed charges,,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Anthem,State Preferred,,163.76,,,163.76,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Anthem,Individual Exchange,,328.41,,,328.41,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Cigna,Cigna,,471.94,,,471.94,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Connecticare,Commerical,,439.35,,,439.35,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Connecticare,Exchange,,439.35,,,439.35,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,Multiplan,Multiplan,,,504.08,,504.08,163.76,504.08,percent of total billed charges,,
HC IDH1 COMMON VARIANTS,81120,CPT,,,both,,,629.33,377.6,United Healthcare/Oxford,United Healthcare/Oxford,,383.28,,,383.28,163.76,504.08,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT  ,,,both,,,964.08,578.45,Aetna,Commerical,,530.04,,,530.04,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Aetna,Middlesex Employees,,477.04,,,477.04,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Anthem,Commerical,,629.35,,,629.35,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Anthem,Indemnity,,,701.51,,701.51,250.64,772.81,percent of total billed charges,,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Anthem,State Preferred,,250.64,,,250.64,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Anthem,Individual Exchange,,503.49,,,503.49,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Cigna,Cigna,,723.53,,,723.53,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Connecticare,Commerical,,673.58,,,673.58,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Connecticare,Exchange,,673.58,,,673.58,250.64,772.81,other,Could be inpatient or outpatient,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,Multiplan,Multiplan,,,772.81,,772.81,250.64,772.81,percent of total billed charges,,
HC IDH2 COMMON VARIANTS,81121,CPT,,,both,,,964.08,578.45,United Healthcare/Oxford,United Healthcare/Oxford,,587.62,,,587.62,250.64,772.81,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT  ,,,both,,,220.42,132.25,Aetna,Commerical,,121.22,,,121.22,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Aetna,Middlesex Employees,,109.1,,,109.1,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Anthem,Commerical,,143.94,,,143.94,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Anthem,Indemnity,,,160.44,,160.44,53.35,176.75,percent of total billed charges,,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Anthem,State Preferred,,53.35,,,53.35,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Anthem,Individual Exchange,,115.15,,,115.15,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Cigna,Cigna,,165.47,,,165.47,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Connecticare,Commerical,,154.05,,,154.05,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Connecticare,Exchange,,154.05,,,154.05,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,Multiplan,Multiplan,,,176.75,,176.75,53.35,176.75,percent of total billed charges,,
HC BCRABL IDENT PCR,81206,CPT,,,both,,,220.42,132.25,United Healthcare/Oxford,United Healthcare/Oxford,,134.39,,,134.39,53.35,176.75,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT  ,,,both,,,660.23,396.14,Aetna,Commerical,,362.44,,,362.44,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Aetna,Middlesex Employees,,326.19,,,326.19,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Anthem,Commerical,,430.33,,,430.33,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Anthem,Indemnity,,,479.68,,479.68,53.35,528.44,percent of total billed charges,,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Anthem,State Preferred,,53.35,,,53.35,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Anthem,Individual Exchange,,344.26,,,344.26,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Cigna,Cigna,,494.74,,,494.74,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Connecticare,Commerical,,460.57,,,460.57,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Connecticare,Exchange,,460.57,,,460.57,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,Multiplan,Multiplan,,,528.44,,528.44,53.35,528.44,percent of total billed charges,,
HC BCRABL QN MAJOR,81206,CPT,,,both,,,660.23,396.14,United Healthcare/Oxford,United Healthcare/Oxford,,401.8,,,401.8,53.35,528.44,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT  ,,,both,,,128.75,77.25,Aetna,Commerical,,70.51,,,70.51,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Aetna,Middlesex Employees,,63.46,,,63.46,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Anthem,Commerical,,83.72,,,83.72,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Anthem,Indemnity,,,93.31,,93.31,53.35,102.8,percent of total billed charges,,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Anthem,State Preferred,,53.35,,,53.35,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Anthem,Individual Exchange,,66.97,,,66.97,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Cigna,Cigna,,96.24,,,96.24,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Connecticare,Commerical,,89.6,,,89.6,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Connecticare,Exchange,,89.6,,,89.6,53.35,102.8,other,Could be inpatient or outpatient,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,Multiplan,Multiplan,,,102.8,,102.8,53.35,102.8,percent of total billed charges,,
HC BCRABL QN MINOR,81207,CPT,,,both,,,128.75,77.25,United Healthcare/Oxford,United Healthcare/Oxford,,78.17,,,78.17,53.35,102.8,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT  ,,,both,,,571.65,342.99,Aetna,Commerical,,314.19,,,314.19,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Aetna,Middlesex Employees,,282.78,,,282.78,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Anthem,Commerical,,373.06,,,373.06,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Anthem,Indemnity,,,415.83,,415.83,64.12,458.1,percent of total billed charges,,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Anthem,State Preferred,,64.12,,,64.12,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Anthem,Individual Exchange,,298.44,,,298.44,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Cigna,Cigna,,428.89,,,428.89,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Connecticare,Commerical,,399.27,,,399.27,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Connecticare,Exchange,,399.27,,,399.27,64.12,458.1,other,Could be inpatient or outpatient,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,Multiplan,Multiplan,,,458.1,,458.1,64.12,458.1,percent of total billed charges,,
HC BRAF GEN MUT,81210,CPT,,,both,,,571.65,342.99,United Healthcare/Oxford,United Healthcare/Oxford,,348.32,,,348.32,64.12,458.1,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT  ,,,both,,,1916.74,1150.04,Aetna,Commerical,,1053.29,,,1053.29,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Aetna,Middlesex Employees,,947.96,,,947.96,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Anthem,Commerical,,1250.62,,,1250.62,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Anthem,Indemnity,,,1394.01,,1394.01,567.21,1535.7,percent of total billed charges,,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Anthem,State Preferred,,567.21,,,567.21,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Anthem,Individual Exchange,,1000.49,,,1000.49,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Cigna,Cigna,,1437.77,,,1437.77,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Connecticare,Commerical,,1338.5,,,1338.5,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Connecticare,Exchange,,1338.5,,,1338.5,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,Multiplan,Multiplan,,,1535.7,,1535.7,567.21,1535.7,percent of total billed charges,,
HC CF 139 NGS,81220,CPT,,,both,,,1916.74,1150.04,United Healthcare/Oxford,United Healthcare/Oxford,,1167.69,,,1167.69,567.21,1535.7,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT  ,,,both,,,737.48,442.49,Aetna,Commerical,,405.11,,,405.11,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Aetna,Middlesex Employees,,364.6,,,364.6,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Anthem,Commerical,,481.01,,,481.01,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Anthem,Indemnity,,,536.16,,536.16,364.6,590.66,percent of total billed charges,,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Anthem,State Preferred,,567.21,,,567.21,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Anthem,Individual Exchange,,384.8,,,384.8,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Cigna,Cigna,,552.99,,,552.99,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Connecticare,Commerical,,514.81,,,514.81,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Connecticare,Exchange,,514.81,,,514.81,364.6,590.66,other,Could be inpatient or outpatient,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,Multiplan,Multiplan,,,590.66,,590.66,364.6,590.66,percent of total billed charges,,
HC CF ACOG/ACMG,81220,CPT,,,both,,,737.48,442.49,United Healthcare/Oxford,United Healthcare/Oxford,,449.11,,,449.11,364.6,590.66,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT  ,,,both,,,1481.14,888.68,Aetna,Commerical,,813.93,,,813.93,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Aetna,Middlesex Employees,,732.54,,,732.54,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Anthem,Commerical,,966.42,,,966.42,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Anthem,Indemnity,,,1077.22,,1077.22,567.21,1186.72,percent of total billed charges,,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Anthem,State Preferred,,567.21,,,567.21,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Anthem,Individual Exchange,,773.13,,,773.13,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Cigna,Cigna,,1111.04,,,1111.04,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Connecticare,Commerical,,1034.33,,,1034.33,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Connecticare,Exchange,,1034.33,,,1034.33,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,Multiplan,Multiplan,,,1186.72,,1186.72,567.21,1186.72,percent of total billed charges,,
HC CF AFAM 66 MUT,81220,CPT,,,both,,,1481.14,888.68,United Healthcare/Oxford,United Healthcare/Oxford,,902.33,,,902.33,567.21,1186.72,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT  ,,,both,,,1065.02,639.01,Aetna,Commerical,,585.71,,,585.71,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Aetna,Middlesex Employees,,527.14,,,527.14,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Anthem,Commerical,,695.44,,,695.44,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Anthem,Indemnity,,,775.18,,775.18,527.14,853.97,percent of total billed charges,,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Anthem,State Preferred,,567.21,,,567.21,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Anthem,Individual Exchange,,556.35,,,556.35,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Cigna,Cigna,,799.51,,,799.51,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Connecticare,Commerical,,744.31,,,744.31,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Connecticare,Exchange,,744.31,,,744.31,527.14,853.97,other,Could be inpatient or outpatient,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,Multiplan,Multiplan,,,853.97,,853.97,527.14,853.97,percent of total billed charges,,
HC CF EXPCAU 45 MUT,81220,CPT,,,both,,,1065.02,639.01,United Healthcare/Oxford,United Healthcare/Oxford,,649.32,,,649.32,527.14,853.97,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT  ,,,both,,,905.37,543.22,Aetna,Commerical,,497.27,,,497.27,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Aetna,Middlesex Employees,,447.54,,,447.54,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Anthem,Commerical,,590.43,,,590.43,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Anthem,Indemnity,,,658.12,,658.12,148.87,725.02,percent of total billed charges,,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Anthem,State Preferred,,148.87,,,148.87,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Anthem,Individual Exchange,,472.34,,,472.34,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Cigna,Cigna,,678.78,,,678.78,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Connecticare,Commerical,,631.91,,,631.91,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Connecticare,Exchange,,631.91,,,631.91,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,Multiplan,Multiplan,,,725.02,,725.02,148.87,725.02,percent of total billed charges,,
HC CYP450-2D6,81226,CPT,,,both,,,905.37,543.22,United Healthcare/Oxford,United Healthcare/Oxford,,551.28,,,551.28,148.87,725.02,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT  ,,,both,,,599.46,359.68,Aetna,Commerical,,329.65,,,329.65,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Aetna,Middlesex Employees,,296.68,,,296.68,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Anthem,Commerical,,391.42,,,391.42,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Anthem,Indemnity,,,436.29,,436.29,52.94,480.64,percent of total billed charges,,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Anthem,State Preferred,,52.94,,,52.94,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Anthem,Individual Exchange,,313.13,,,313.13,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Cigna,Cigna,,449.99,,,449.99,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Connecticare,Commerical,,418.92,,,418.92,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Connecticare,Exchange,,418.92,,,418.92,52.94,480.64,other,Could be inpatient or outpatient,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,Multiplan,Multiplan,,,480.64,,480.64,52.94,480.64,percent of total billed charges,,
HC CYP450-2C9,81227,CPT,,,both,,,599.46,359.68,United Healthcare/Oxford,United Healthcare/Oxford,,365.45,,,365.45,52.94,480.64,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT  ,,,both,,,1276.17,765.7,Aetna,Commerical,,701.37,,,701.37,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Aetna,Middlesex Employees,,631.23,,,631.23,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Anthem,Commerical,,832.76,,,832.76,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Anthem,Indemnity,,,928.25,,928.26,401.89,1022.6,percent of total billed charges,,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Anthem,State Preferred,,401.89,,,401.89,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Anthem,Individual Exchange,,666.21,,,666.21,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Cigna,Cigna,,957.38,,,957.38,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Connecticare,Commerical,,891.29,,,891.29,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Connecticare,Exchange,,891.29,,,891.29,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,Multiplan,Multiplan,,,1022.6,,1022.6,401.89,1022.6,percent of total billed charges,,
HC CHROMOSOME  MICROARRAY C,81228,CPT,,,both,,,1276.17,765.7,United Healthcare/Oxford,United Healthcare/Oxford,,777.55,,,777.55,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT  ,,,both,,,1276.17,765.7,Aetna,Commerical,,701.37,,,701.37,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Aetna,Middlesex Employees,,631.23,,,631.23,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Anthem,Commerical,,832.76,,,832.76,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Anthem,Indemnity,,,928.25,,928.25,401.89,1022.6,percent of total billed charges,,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Anthem,State Preferred,,401.89,,,401.89,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Anthem,Individual Exchange,,666.21,,,666.21,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Cigna,Cigna,,957.38,,,957.38,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Connecticare,Commerical,,891.29,,,891.29,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Connecticare,Exchange,,891.29,,,891.29,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,Multiplan,Multiplan,,,1022.6,,1022.6,401.89,1022.6,percent of total billed charges,,
HC CHROMOZONE  MICROARRAY H,81228,CPT,,,both,,,1276.17,765.7,United Healthcare/Oxford,United Healthcare/Oxford,,777.55,,,777.55,401.89,1022.6,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT  ,,,both,,,3782.16,2269.3,Aetna,Commerical,,1344.95,,,1344.95,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Aetna,Middlesex Employees,,1210.45,,,1210.45,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Commerical,,22.28,,,22.28,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Indemnity,,,2750.36,,2750.36,14.09,3029.93,percent of total billed charges,,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Anthem,State Preferred,,14.09,,,14.09,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Individual Exchange,,17.82,,,17.82,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Cigna,Cigna,,1988.12,,,1988.12,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Connecticare,Commerical,,1298,,,1298,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Connecticare,Exchange,,1298,,,1298,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,Multiplan,Multiplan,,,3029.93,,3029.93,14.09,3029.93,percent of total billed charges,,
HC CHRM MICROARRAY C,81229,CPT,,,both,,,3782.16,2269.3,United Healthcare/Oxford,United Healthcare/Oxford,,1521.07,,,1521.07,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT  ,,,both,,,3782.16,2269.3,Aetna,Commerical,,1344.95,,,1344.95,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Aetna,Middlesex Employees,,1210.45,,,1210.45,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Commerical,,22.28,,,22.28,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Indemnity,,,2750.36,,2750.36,14.09,3029.93,percent of total billed charges,,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Anthem,State Preferred,,14.09,,,14.09,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Anthem,Individual Exchange,,17.82,,,17.82,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Cigna,Cigna,,1988.12,,,1988.12,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Connecticare,Commerical,,1298,,,1298,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Connecticare,Exchange,,1298,,,1298,14.09,3029.93,other,Could be inpatient or outpatient,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,Multiplan,Multiplan,,,3029.93,,3029.93,14.09,3029.93,percent of total billed charges,,
HC CHRM MICROARRAY H,81229,CPT,,,both,,,3782.16,2269.3,United Healthcare/Oxford,United Healthcare/Oxford,,1521.07,,,1521.07,14.09,3029.93,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT  ,,,both,,,1128.88,677.33,Aetna,Commerical,,1344.95,,,1344.95,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Aetna,Middlesex Employees,,1210.45,,,1210.45,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Anthem,Commerical,,22.28,,,22.28,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Anthem,Indemnity,,,821.02,,821.02,14.09,1988.12,percent of total billed charges,,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Anthem,State Preferred,,14.09,,,14.09,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Anthem,Individual Exchange,,17.82,,,17.82,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Cigna,Cigna,,1988.12,,,1988.12,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Connecticare,Commerical,,1298,,,1298,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Connecticare,Exchange,,1298,,,1298,14.09,1988.12,other,Could be inpatient or outpatient,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,Multiplan,Multiplan,,,904.47,,904.47,14.09,1988.12,percent of total billed charges,,
HC MICROARRAY SDOUT,81229,CPT,,,both,,,1128.88,677.33,United Healthcare/Oxford,United Healthcare/Oxford,,1521.07,,,1521.07,14.09,1988.12,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT  ,,,both,,,685.98,411.59,Aetna,Commerical,,377.28,,,377.28,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Aetna,Middlesex Employees,,339.55,,,339.55,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Anthem,Commerical,,447.96,,,447.96,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Anthem,Indemnity,,,499.32,,499.32,339.55,550.08,percent of total billed charges,,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Anthem,State Preferred,,447.96,,,447.96,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Anthem,Individual Exchange,,358.37,,,358.37,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Cigna,Cigna,,515,,,515,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Connecticare,Commerical,,479.44,,,479.44,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Connecticare,Exchange,,479.44,,,479.44,339.55,550.08,other,Could be inpatient or outpatient,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,Multiplan,Multiplan,,,550.08,,550.08,339.55,550.08,percent of total billed charges,,
HC EGFR PCR,81235,CPT,,,both,,,685.98,411.59,United Healthcare/Oxford,United Healthcare/Oxford,,418.25,,,418.25,339.55,550.08,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT  ,,,both,,,214.24,128.54,Aetna,Commerical,,117.52,,,117.52,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Aetna,Middlesex Employees,,105.76,,,105.76,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Anthem,Commerical,,139.53,,,139.53,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Anthem,Indemnity,,,155.53,,155.53,31.04,171.33,percent of total billed charges,,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Anthem,State Preferred,,31.04,,,31.04,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Anthem,Individual Exchange,,111.62,,,111.62,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Cigna,Cigna,,160.41,,,160.41,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Connecticare,Commerical,,149.33,,,149.33,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Connecticare,Exchange,,149.33,,,149.33,31.04,171.33,other,Could be inpatient or outpatient,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,Multiplan,Multiplan,,,171.33,,171.33,31.04,171.33,percent of total billed charges,,
HC FII PT GENE MUT,81240,CPT,,,both,,,214.24,128.54,United Healthcare/Oxford,United Healthcare/Oxford,,130.27,,,130.27,31.04,171.33,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT  ,,,both,,,246.17,147.7,Aetna,Commerical,,134.83,,,134.83,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Aetna,Middlesex Employees,,121.35,,,121.35,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Anthem,Commerical,,160.09,,,160.09,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Anthem,Indemnity,,,178.45,,178.45,33.45,196.59,percent of total billed charges,,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Anthem,State Preferred,,33.45,,,33.45,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Anthem,Individual Exchange,,128.07,,,128.07,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Cigna,Cigna,,184.05,,,184.05,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Connecticare,Commerical,,171.34,,,171.34,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Connecticare,Exchange,,171.34,,,171.34,33.45,196.59,other,Could be inpatient or outpatient,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,Multiplan,Multiplan,,,196.59,,196.59,33.45,196.59,percent of total billed charges,,
HC FV LEIDEN GEN MUT,81241,CPT,,,both,,,246.17,147.7,United Healthcare/Oxford,United Healthcare/Oxford,,149.47,,,149.47,33.45,196.59,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT  ,,,both,,,70.92,42.55,Aetna,Commerical,,38.97,,,38.97,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Aetna,Middlesex Employees,,35.07,,,35.07,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Anthem,Commerical,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Anthem,Indemnity,,,51.57,,51.57,35.07,56.81,percent of total billed charges,,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Anthem,State Preferred,,55.48,,,55.48,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Anthem,Individual Exchange,,37.01,,,37.01,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Cigna,Cigna,,53.19,,,53.19,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Connecticare,Commerical,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Connecticare,Exchange,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,Multiplan,Multiplan,,,56.81,,56.81,35.07,56.81,percent of total billed charges,,
HC FRAGILE X DNA,81243,CPT,,,both,,,70.92,42.55,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,35.07,56.81,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT  ,,,both,,,432.2,259.32,Aetna,Commerical,,237.5,,,237.5,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Aetna,Middlesex Employees,,213.75,,,213.75,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Anthem,Commerical,,282,,,282,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Anthem,Indemnity,,,314.33,,314.33,75.5,346.28,percent of total billed charges,,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Anthem,State Preferred,,75.5,,,75.5,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Anthem,Individual Exchange,,225.6,,,225.6,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Cigna,Cigna,,324.2,,,324.2,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Connecticare,Commerical,,301.81,,,301.81,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Connecticare,Exchange,,301.81,,,301.81,75.5,346.28,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,Multiplan,Multiplan,,,346.28,,346.28,75.5,346.28,percent of total billed charges,,
HC FLT3 MUTATION,81245,CPT,,,both,,,432.2,259.32,United Healthcare/Oxford,United Healthcare/Oxford,,263.3,,,263.3,75.5,346.28,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT  ,,,both,,,125.66,75.4,Aetna,Commerical,,69.27,,,69.27,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Aetna,Middlesex Employees,,62.35,,,62.35,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Anthem,Commerical,,82.25,,,82.25,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Anthem,Indemnity,,,91.68,,91.68,48.28,101,percent of total billed charges,,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Anthem,State Preferred,,48.28,,,48.28,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Anthem,Individual Exchange,,65.81,,,65.81,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Cigna,Cigna,,94.56,,,94.56,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Connecticare,Commerical,,88.03,,,88.03,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Connecticare,Exchange,,88.03,,,88.03,48.28,101,other,Could be inpatient or outpatient,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,Multiplan,Multiplan,,,101,,101,48.28,101,percent of total billed charges,,
HC HEMOCHROMATOSIS,81256,CPT,,,both,,,125.66,75.4,United Healthcare/Oxford,United Healthcare/Oxford,,76.8,,,76.8,48.28,101,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,104.52,,,104.52,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,94.07,,,94.07,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,124.11,,,124.11,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,79.07,152.4,percent of total billed charges,,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,79.07,,,79.07,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,99.29,,,99.29,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,142.68,,,142.68,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,132.83,,,132.83,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,132.83,,,132.83,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,79.07,152.4,percent of total billed charges,,
HC BCELL GR PCR FRSH,81261,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,115.88,,,115.88,79.07,152.4,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT  ,,,both,,,327.54,196.52,Aetna,Commerical,,179.98,,,179.98,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Aetna,Middlesex Employees,,161.98,,,161.98,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Anthem,Commerical,,213.7,,,213.7,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Anthem,Indemnity,,,238.2,,238.2,79.07,262.41,percent of total billed charges,,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Anthem,State Preferred,,79.07,,,79.07,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Anthem,Individual Exchange,,170.96,,,170.96,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Cigna,Cigna,,245.68,,,245.68,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Connecticare,Commerical,,228.71,,,228.71,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Connecticare,Exchange,,228.71,,,228.71,79.07,262.41,other,Could be inpatient or outpatient,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,Multiplan,Multiplan,,,262.41,,262.41,79.07,262.41,percent of total billed charges,,
HC BCELL GR PCR PARF,81261,CPT,,,both,,,327.54,196.52,United Healthcare/Oxford,United Healthcare/Oxford,,199.53,,,199.53,79.07,262.41,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT  ,,,both,,,639.63,383.78,Aetna,Commerical,,351.3,,,351.3,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Aetna,Middlesex Employees,,316.17,,,316.17,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Anthem,Commerical,,417.12,,,417.12,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Anthem,Indemnity,,,464.94,,464.94,116.76,512.2,percent of total billed charges,,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Anthem,State Preferred,,116.76,,,116.76,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Anthem,Individual Exchange,,333.69,,,333.69,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Cigna,Cigna,,479.53,,,479.53,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Connecticare,Commerical,,446.43,,,446.43,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Connecticare,Exchange,,446.43,,,446.43,116.76,512.2,other,Could be inpatient or outpatient,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,Multiplan,Multiplan,,,512.2,,512.2,116.76,512.2,percent of total billed charges,,
HC CLL HYPRMUTATION,81263,CPT,,,both,,,639.63,383.78,United Healthcare/Oxford,United Healthcare/Oxford,,389.45,,,389.45,116.76,512.2,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,87.83,,,87.83,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,79.05,,,79.05,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,104.28,,,104.28,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,79.05,284.89,percent of total billed charges,,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,284.89,,,284.89,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,83.42,,,83.42,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,119.88,,,119.88,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,111.61,,,111.61,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,111.61,,,111.61,79.05,284.89,other,Could be inpatient or outpatient,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,79.05,284.89,percent of total billed charges,,
HC IDENTITY TESTING,81265,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,97.37,,,97.37,79.05,284.89,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT  ,,,both,,,151.95,91.17,Aetna,Commerical,,83.49,,,83.49,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Aetna,Middlesex Employees,,75.14,,,75.14,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Anthem,Commerical,,99.14,,,99.14,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Anthem,Indemnity,,,110.5,,110.5,38.41,121.74,percent of total billed charges,,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Anthem,State Preferred,,38.41,,,38.41,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Anthem,Individual Exchange,,79.31,,,79.31,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Cigna,Cigna,,113.97,,,113.97,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Connecticare,Commerical,,106.11,,,106.11,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Connecticare,Exchange,,106.11,,,106.11,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,Multiplan,Multiplan,,,121.74,,121.74,38.41,121.74,percent of total billed charges,,
HC JAK2 MUT BM,81270,CPT,,,both,,,151.95,91.17,United Healthcare/Oxford,United Healthcare/Oxford,,92.57,,,92.57,38.41,121.74,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT  ,,,both,,,144.07,86.44,Aetna,Commerical,,79.17,,,79.17,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Aetna,Middlesex Employees,,71.25,,,71.25,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Anthem,Commerical,,94,,,94,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Anthem,Indemnity,,,104.78,,104.78,38.41,115.43,percent of total billed charges,,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Anthem,State Preferred,,38.41,,,38.41,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Anthem,Individual Exchange,,75.2,,,75.2,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Cigna,Cigna,,108.07,,,108.07,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Connecticare,Commerical,,100.6,,,100.6,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Connecticare,Exchange,,100.6,,,100.6,38.41,115.43,other,Could be inpatient or outpatient,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,Multiplan,Multiplan,,,115.43,,115.43,38.41,115.43,percent of total billed charges,,
HC JAK2 MUT PB,81270,CPT,,,both,,,144.07,86.44,United Healthcare/Oxford,United Healthcare/Oxford,,87.77,,,87.77,38.41,115.43,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT  ,,,both,,,640.66,384.4,Aetna,Commerical,,351.92,,,351.92,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Aetna,Middlesex Employees,,316.73,,,316.73,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Anthem,Commerical,,417.85,,,417.85,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Anthem,Indemnity,,,465.76,,465.76,109.33,513.1,percent of total billed charges,,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Anthem,State Preferred,,109.33,,,109.33,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Anthem,Individual Exchange,,334.28,,,334.28,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Cigna,Cigna,,480.39,,,480.39,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Connecticare,Commerical,,447.22,,,447.22,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Connecticare,Exchange,,447.22,,,447.22,109.33,513.1,other,Could be inpatient or outpatient,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,Multiplan,Multiplan,,,513.1,,513.1,109.33,513.1,percent of total billed charges,,
HC KRAS GEN MUT,81275,CPT,,,both,,,640.66,384.4,United Healthcare/Oxford,United Healthcare/Oxford,,390.14,,,390.14,109.33,513.1,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT  ,,,both,,,226.23,135.74,Aetna,Commerical,,124.32,,,124.32,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Aetna,Middlesex Employees,,111.88,,,111.88,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Anthem,Commerical,,147.61,,,147.61,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Anthem,Indemnity,,,164.53,,164.53,111.88,3431.79,percent of total billed charges,,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Anthem,State Preferred,,3431.79,,,3431.79,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Anthem,Individual Exchange,,118.09,,,118.09,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Cigna,Cigna,,169.7,,,169.7,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Connecticare,Commerical,,157.98,,,157.98,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Connecticare,Exchange,,157.98,,,157.98,111.88,3431.79,other,Could be inpatient or outpatient,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,Multiplan,Multiplan,,,181.25,,181.25,111.88,3431.79,percent of total billed charges,,
HC HLA I TYPING HIGH RES EA LOCUS,81280,CPT,,,both,,,226.23,135.74,United Healthcare/Oxford,United Healthcare/Oxford,,137.81,,,137.81,111.88,3431.79,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT  ,,,both,,,405.82,243.49,Aetna,Commerical,,223.27,,,223.27,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Aetna,Middlesex Employees,,200.94,,,200.94,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Anthem,Commerical,,265.1,,,265.1,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Anthem,Indemnity,,,295.5,,295.5,200.94,325.53,percent of total billed charges,,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Anthem,State Preferred,,265.1,,,265.1,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Anthem,Individual Exchange,,212.08,,,212.08,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Cigna,Cigna,,304.77,,,304.77,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Connecticare,Commerical,,283.73,,,283.73,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Connecticare,Exchange,,283.73,,,283.73,200.94,325.53,other,Could be inpatient or outpatient,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,Multiplan,Multiplan,,,325.53,,325.53,200.94,325.53,percent of total billed charges,,
HC MGMT METHYLATION,81287,CPT,,,both,,,405.82,243.49,United Healthcare/Oxford,United Healthcare/Oxford,,247.53,,,247.53,200.94,325.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT  ,,,both,,,212.18,127.31,Aetna,Commerical,,116.28,,,116.28,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Aetna,Middlesex Employees,,104.65,,,104.65,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Anthem,Commerical,,138.06,,,138.06,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Anthem,Indemnity,,,153.89,,153.89,38.41,169.53,percent of total billed charges,,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Anthem,State Preferred,,38.41,,,38.41,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Anthem,Individual Exchange,,110.44,,,110.44,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Cigna,Cigna,,158.72,,,158.72,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Connecticare,Commerical,,147.77,,,147.77,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Connecticare,Exchange,,147.77,,,147.77,38.41,169.53,other,Could be inpatient or outpatient,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,Multiplan,Multiplan,,,169.53,,169.53,38.41,169.53,percent of total billed charges,,
HC MTHFR GEN MUT,81291,CPT,,,both,,,212.18,127.31,United Healthcare/Oxford,United Healthcare/Oxford,,128.9,,,128.9,38.41,169.53,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT  ,,,both,,,542.81,325.69,Aetna,Commerical,,298.73,,,298.73,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Aetna,Middlesex Employees,,268.86,,,268.86,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Anthem,Commerical,,354.69,,,354.69,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Anthem,Indemnity,,,395.36,,395.36,164.96,435.55,percent of total billed charges,,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Anthem,State Preferred,,164.96,,,164.96,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Anthem,Individual Exchange,,283.76,,,283.76,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Cigna,Cigna,,407.77,,,407.77,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Connecticare,Commerical,,379.63,,,379.63,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Connecticare,Exchange,,379.63,,,379.63,164.96,435.55,other,Could be inpatient or outpatient,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,Multiplan,Multiplan,,,435.55,,435.55,164.96,435.55,percent of total billed charges,,
HC MSI ASSAY,81301,CPT,,,both,,,542.81,325.69,United Healthcare/Oxford,United Healthcare/Oxford,,331.18,,,331.18,164.96,435.55,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT  ,,,both,,,233.81,140.29,Aetna,Commerical,,128.64,,,128.64,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Aetna,Middlesex Employees,,115.78,,,115.78,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Anthem,Commerical,,152.75,,,152.75,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Anthem,Indemnity,,,170.26,,170.26,30.25,187.57,percent of total billed charges,,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Anthem,State Preferred,,30.25,,,30.25,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Anthem,Individual Exchange,,122.19,,,122.19,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Cigna,Cigna,,175.6,,,175.6,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Connecticare,Commerical,,163.48,,,163.48,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Connecticare,Exchange,,163.48,,,163.48,30.25,187.57,other,Could be inpatient or outpatient,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,Multiplan,Multiplan,,,187.57,,187.57,30.25,187.57,percent of total billed charges,,
HC NPM1 GEN MUT,81310,CPT,,,both,,,233.81,140.29,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,30.25,187.57,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT  ,,,both,,,220.42,132.25,Aetna,Commerical,,121.22,,,121.22,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Aetna,Middlesex Employees,,109.1,,,109.1,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Anthem,Commerical,,143.94,,,143.94,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Anthem,Indemnity,,,160.44,,160.44,51.59,176.75,percent of total billed charges,,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Anthem,State Preferred,,51.59,,,51.59,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Anthem,Individual Exchange,,115.15,,,115.15,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Cigna,Cigna,,165.47,,,165.47,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Connecticare,Commerical,,154.05,,,154.05,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Connecticare,Exchange,,154.05,,,154.05,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,Multiplan,Multiplan,,,176.75,,176.75,51.59,176.75,percent of total billed charges,,
HC PMLRARA ID PCR,81315,CPT,,,both,,,220.42,132.25,United Healthcare/Oxford,United Healthcare/Oxford,,134.39,,,134.39,51.59,176.75,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT  ,,,both,,,182.31,109.39,Aetna,Commerical,,100.19,,,100.19,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Aetna,Middlesex Employees,,90.17,,,90.17,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Anthem,Commerical,,118.96,,,118.96,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Anthem,Indemnity,,,132.61,,132.61,51.59,146.09,percent of total billed charges,,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Anthem,State Preferred,,51.59,,,51.59,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Anthem,Individual Exchange,,95.17,,,95.17,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Cigna,Cigna,,136.77,,,136.77,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Connecticare,Commerical,,127.33,,,127.33,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Connecticare,Exchange,,127.33,,,127.33,51.59,146.09,other,Could be inpatient or outpatient,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,Multiplan,Multiplan,,,146.09,,146.09,51.59,146.09,percent of total billed charges,,
HC PMLRARA QN PCR,81315,CPT,,,both,,,182.31,109.39,United Healthcare/Oxford,United Healthcare/Oxford,,111.08,,,111.08,51.59,146.09,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT  ,,,both,,,472.77,283.66,Aetna,Commerical,,259.77,,,259.77,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Aetna,Middlesex Employees,,233.8,,,233.8,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Anthem,Commerical,,308.43,,,308.43,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Anthem,Indemnity,,,343.8,,343.8,42.46,378.74,percent of total billed charges,,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Anthem,State Preferred,,42.46,,,42.46,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Anthem,Individual Exchange,,246.74,,,246.74,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Cigna,Cigna,,354.59,,,354.59,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Connecticare,Commerical,,330.11,,,330.11,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Connecticare,Exchange,,330.11,,,330.11,42.46,378.74,other,Could be inpatient or outpatient,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,Multiplan,Multiplan,,,378.74,,378.74,42.46,378.74,percent of total billed charges,,
HC PRADWILANG DNAMET,81331,CPT,,,both,,,472.77,283.66,United Healthcare/Oxford,United Healthcare/Oxford,,287.98,,,287.98,42.46,378.74,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT  ,,,both,,,164.8,98.88,Aetna,Commerical,,90.29,,,90.29,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Aetna,Middlesex Employees,,81.26,,,81.26,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Anthem,Commerical,,107.22,,,107.22,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Anthem,Indemnity,,,119.51,,119.51,48.28,131.66,percent of total billed charges,,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Anthem,State Preferred,,48.28,,,48.28,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Anthem,Individual Exchange,,85.77,,,85.77,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Cigna,Cigna,,123.26,,,123.26,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Connecticare,Commerical,,114.75,,,114.75,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Connecticare,Exchange,,114.75,,,114.75,48.28,131.66,other,Could be inpatient or outpatient,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,Multiplan,Multiplan,,,131.66,,131.66,48.28,131.66,percent of total billed charges,,
HC SERPINA1 GENE ANALYSIS COMMON VARIANTS,81332,CPT,,,both,,,164.8,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,48.28,131.66,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT  ,,,both,,,233.81,140.29,Aetna,Commerical,,128.64,,,128.64,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Aetna,Middlesex Employees,,115.78,,,115.78,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Anthem,Commerical,,152.75,,,152.75,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Anthem,Indemnity,,,170.26,,170.26,91.12,187.57,percent of total billed charges,,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Anthem,State Preferred,,91.12,,,91.12,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Anthem,Individual Exchange,,122.19,,,122.19,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Cigna,Cigna,,175.6,,,175.6,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Connecticare,Commerical,,163.48,,,163.48,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Connecticare,Exchange,,163.48,,,163.48,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,Multiplan,Multiplan,,,187.57,,187.57,91.12,187.57,percent of total billed charges,,
HC TCELL GR PCR FRSH,81342,CPT,,,both,,,233.81,140.29,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,91.12,187.57,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT  ,,,both,,,248.23,148.94,Aetna,Commerical,,136.07,,,136.07,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Aetna,Middlesex Employees,,122.46,,,122.46,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Anthem,Commerical,,161.56,,,161.56,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Anthem,Indemnity,,,180.09,,180.09,91.12,198.39,percent of total billed charges,,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Anthem,State Preferred,,91.12,,,91.12,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Anthem,Individual Exchange,,129.25,,,129.25,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Cigna,Cigna,,185.73,,,185.73,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Connecticare,Commerical,,172.92,,,172.92,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Connecticare,Exchange,,172.92,,,172.92,91.12,198.39,other,Could be inpatient or outpatient,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,Multiplan,Multiplan,,,198.39,,198.39,91.12,198.39,percent of total billed charges,,
HC TCELL GR PCR PARF,81342,CPT,,,both,,,248.23,148.94,United Healthcare/Oxford,United Healthcare/Oxford,,150.84,,,150.84,91.12,198.39,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT  ,,,both,,,640.66,384.4,Aetna,Commerical,,351.92,,,351.92,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Aetna,Middlesex Employees,,316.73,,,316.73,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Anthem,Commerical,,417.85,,,417.85,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Anthem,Indemnity,,,465.76,,465.76,316.73,513.1,percent of total billed charges,,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Anthem,State Preferred,,347.56,,,347.56,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Anthem,Individual Exchange,,334.28,,,334.28,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Cigna,Cigna,,480.39,,,480.39,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Connecticare,Commerical,,447.22,,,447.22,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Connecticare,Exchange,,447.22,,,447.22,316.73,513.1,other,Could be inpatient or outpatient,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,Multiplan,Multiplan,,,513.1,,513.1,316.73,513.1,percent of total billed charges,,
HC REF HLA LOW RESOLUTION,81372,CPT,,,both,,,640.66,384.4,United Healthcare/Oxford,United Healthcare/Oxford,,390.14,,,390.14,316.73,513.1,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT  ,,,both,,,142.93,85.76,Aetna,Commerical,,78.55,,,78.55,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Aetna,Middlesex Employees,,70.69,,,70.69,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Anthem,Commerical,,93.26,,,93.26,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Anthem,Indemnity,,,103.95,,103.95,70.69,117.8,percent of total billed charges,,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Anthem,State Preferred,,117.8,,,117.8,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Anthem,Individual Exchange,,74.61,,,74.61,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Cigna,Cigna,,107.22,,,107.22,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Connecticare,Commerical,,99.81,,,99.81,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Connecticare,Exchange,,99.81,,,99.81,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,Multiplan,Multiplan,,,114.52,,114.52,70.69,117.8,percent of total billed charges,,
HC HLA I TYPING LOW RES  EA LOCUS.,81373,CPT,,,both,,,142.93,85.76,United Healthcare/Oxford,United Healthcare/Oxford,,87.08,,,87.08,70.69,117.8,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT  ,,,both,,,88.91,53.35,Aetna,Commerical,,86.18,,,86.18,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Aetna,Middlesex Employees,,77.57,,,77.57,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Anthem,Commerical,,133.07,,,133.07,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Anthem,Indemnity,,,64.67,,64.67,64.67,265.95,percent of total billed charges,,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Anthem,State Preferred,,117.8,,,117.8,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Anthem,Individual Exchange,,106.46,,,106.46,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Cigna,Cigna,,265.95,,,265.95,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Connecticare,Commerical,,83.18,,,83.18,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Connecticare,Exchange,,83.18,,,83.18,64.67,265.95,other,Could be inpatient or outpatient,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,Multiplan,Multiplan,,,71.24,,71.24,64.67,265.95,percent of total billed charges,,
HC HLA-B27 PCR,81374,CPT,,,both,,,88.91,53.35,United Healthcare/Oxford,United Healthcare/Oxford,,106,,,106,64.67,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT  ,,,both,,,211.15,126.69,Aetna,Commerical,,86.18,,,86.18,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Aetna,Middlesex Employees,,77.57,,,77.57,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Anthem,Commerical,,133.07,,,133.07,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Anthem,Indemnity,,,153.07,,153.07,77.57,265.95,percent of total billed charges,,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Anthem,State Preferred,,117.8,,,117.8,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Anthem,Individual Exchange,,106.46,,,106.46,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Cigna,Cigna,,265.95,,,265.95,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Connecticare,Commerical,,83.18,,,83.18,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Connecticare,Exchange,,83.18,,,83.18,77.57,265.95,other,Could be inpatient or outpatient,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,Multiplan,Multiplan,,,168.63,,168.63,77.57,265.95,percent of total billed charges,,
HC REF HLA B27 TYPING,81374,CPT,,,both,,,211.15,126.69,United Healthcare/Oxford,United Healthcare/Oxford,,106,,,106,77.57,265.95,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT  ,,,both,,,640.66,384.4,Aetna,Commerical,,351.92,,,351.92,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Aetna,Middlesex Employees,,316.73,,,316.73,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Anthem,Commerical,,417.85,,,417.85,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Anthem,Indemnity,,,465.76,,465.76,130.01,513.1,percent of total billed charges,,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Anthem,State Preferred,,130.01,,,130.01,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Anthem,Individual Exchange,,334.28,,,334.28,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Cigna,Cigna,,480.39,,,480.39,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Connecticare,Commerical,,447.22,,,447.22,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Connecticare,Exchange,,447.22,,,447.22,130.01,513.1,other,Could be inpatient or outpatient,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,Multiplan,Multiplan,,,513.1,,513.1,130.01,513.1,percent of total billed charges,,
HC REF DR LOW RESOLUTION,81375,CPT,,,both,,,640.66,384.4,United Healthcare/Oxford,United Healthcare/Oxford,,390.14,,,390.14,130.01,513.1,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT  ,,,both,,,441.2,264.72,Aetna,Commerical,,242.44,,,242.44,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Aetna,Middlesex Employees,,218.19,,,218.19,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Anthem,Commerical,,287.87,,,287.87,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Anthem,Indemnity,,,320.87,,320.87,218.19,548.62,percent of total billed charges,,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Anthem,State Preferred,,548.62,,,548.62,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Anthem,Individual Exchange,,230.3,,,230.3,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Cigna,Cigna,,330.95,,,330.95,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Connecticare,Commerical,,308.1,,,308.1,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Connecticare,Exchange,,308.1,,,308.1,218.19,548.62,other,Could be inpatient or outpatient,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,Multiplan,Multiplan,,,353.49,,353.49,218.19,548.62,percent of total billed charges,,
HC HLA I & II TYPING HIGH RES (HLA TRANSPLANT WKUP),81378,CPT,,,both,,,441.2,264.72,United Healthcare/Oxford,United Healthcare/Oxford,,268.78,,,268.78,218.19,548.62,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,196.68,,,196.68,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,177.01,,,177.01,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,233.53,,,233.53,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,260.31,,260.31,177.01,451.37,percent of total billed charges,,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,451.37,,,451.37,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,186.82,,,186.82,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,268.48,,,268.48,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,249.93,,,249.93,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,249.93,,,249.93,177.01,451.37,other,Could be inpatient or outpatient,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,286.76,,286.76,177.01,451.37,percent of total billed charges,,
HC REF HLA HIGH RESOLUTION,81379,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,218.04,,,218.04,177.01,451.37,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,196.68,,,196.68,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,177.01,,,177.01,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,233.53,,,233.53,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,260.31,,260.31,79.07,286.76,percent of total billed charges,,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,79.07,,,79.07,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,186.82,,,186.82,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,268.48,,,268.48,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,249.93,,,249.93,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,249.93,,,249.93,79.07,286.76,other,Could be inpatient or outpatient,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,286.76,,286.76,79.07,286.76,percent of total billed charges,,
HC REF DR HIGH RESOLUTION,81382,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,218.04,,,218.04,79.07,286.76,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT  ,,,both,,,121.54,72.92,Aetna,Commerical,,67.42,,,67.42,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Aetna,Middlesex Employees,,60.68,,,60.68,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Anthem,Commerical,,80.05,,,80.05,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Anthem,Indemnity,,,89.22,,89.22,36.83,98.29,percent of total billed charges,,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Anthem,State Preferred,,36.83,,,36.83,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Anthem,Individual Exchange,,64.04,,,64.04,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Cigna,Cigna,,92.02,,,92.02,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Connecticare,Commerical,,85.67,,,85.67,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Connecticare,Exchange,,85.67,,,85.67,36.83,98.29,other,Could be inpatient or outpatient,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,Multiplan,Multiplan,,,98.29,,98.29,36.83,98.29,percent of total billed charges,,
HC FV HR2 GEN MUT,81400,CPT,,,both,,,121.54,72.92,United Healthcare/Oxford,United Healthcare/Oxford,,74.74,,,74.74,36.83,98.29,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT  ,,,both,,,190.21,114.13,Aetna,Commerical,,158.84,,,158.84,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Aetna,Middlesex Employees,,142.95,,,142.95,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Anthem,Commerical,,58.26,,,58.26,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Anthem,Indemnity,,,138.34,,138.34,36.83,374,percent of total billed charges,,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Anthem,State Preferred,,36.83,,,36.83,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Anthem,Individual Exchange,,46.61,,,46.61,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Cigna,Cigna,,374,,,374,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Connecticare,Commerical,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Connecticare,Exchange,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,Multiplan,Multiplan,,,152.4,,152.4,36.83,374,percent of total billed charges,,
HC HGBOPATHY DNA,81401,CPT,,,both,,,190.21,114.13,United Healthcare/Oxford,United Healthcare/Oxford,,179.64,,,179.64,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,158.84,,,158.84,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,142.95,,,142.95,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,58.26,,,58.26,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,36.83,374,percent of total billed charges,,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,36.83,,,36.83,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,46.61,,,46.61,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,374,,,374,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,36.83,374,percent of total billed charges,,
HC MOLE PATH PROC LEVEL 2 - GALAC-1-PHOS URIDYLTRANSFERASE PHENO.,81401,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,179.64,,,179.64,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,158.84,,,158.84,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,142.95,,,142.95,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,58.26,,,58.26,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,36.83,374,percent of total billed charges,,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,36.83,,,36.83,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,46.61,,,46.61,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,374,,,374,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,153.3,,,153.3,36.83,374,other,Could be inpatient or outpatient,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,36.83,374,percent of total billed charges,,
HC TPMT GENOTYPE,81401,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,179.64,,,179.64,36.83,374,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT  ,,,both,,,299.39,179.63,Aetna,Commerical,,164.52,,,164.52,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Aetna,Middlesex Employees,,148.07,,,148.07,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Anthem,Commerical,,195.34,,,195.34,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Anthem,Indemnity,,,217.74,,217.74,104.39,239.87,percent of total billed charges,,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Anthem,State Preferred,,104.39,,,104.39,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Anthem,Individual Exchange,,156.26,,,156.26,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Cigna,Cigna,,224.57,,,224.57,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Connecticare,Commerical,,209.07,,,209.07,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Connecticare,Exchange,,209.07,,,209.07,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,Multiplan,Multiplan,,,239.87,,239.87,104.39,239.87,percent of total billed charges,,
HC MPL MUT BM,81402,CPT,,,both,,,299.39,179.63,United Healthcare/Oxford,United Healthcare/Oxford,,182.38,,,182.38,104.39,239.87,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT  ,,,both,,,292.62,175.57,Aetna,Commerical,,160.81,,,160.81,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Aetna,Middlesex Employees,,144.73,,,144.73,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Anthem,Commerical,,190.94,,,190.94,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Anthem,Indemnity,,,212.82,,212.82,104.39,234.46,percent of total billed charges,,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Anthem,State Preferred,,104.39,,,104.39,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Anthem,Individual Exchange,,152.75,,,152.75,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Cigna,Cigna,,219.5,,,219.5,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Connecticare,Commerical,,204.36,,,204.36,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Connecticare,Exchange,,204.36,,,204.36,104.39,234.46,other,Could be inpatient or outpatient,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,Multiplan,Multiplan,,,234.46,,234.46,104.39,234.46,percent of total billed charges,,
HC MPL MUT PB,81402,CPT,,,both,,,292.62,175.57,United Healthcare/Oxford,United Healthcare/Oxford,,178.27,,,178.27,104.39,234.46,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT  ,,,both,,,442.9,265.74,Aetna,Commerical,,243.06,,,243.06,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Aetna,Middlesex Employees,,218.75,,,218.75,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Anthem,Commerical,,288.6,,,288.6,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Anthem,Indemnity,,,321.69,,321.69,218.75,354.39,percent of total billed charges,,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Anthem,State Preferred,,221.69,,,221.69,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Anthem,Individual Exchange,,230.88,,,230.88,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Cigna,Cigna,,331.79,,,331.79,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Connecticare,Commerical,,308.89,,,308.89,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Connecticare,Exchange,,308.89,,,308.89,218.75,354.39,other,Could be inpatient or outpatient,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,Multiplan,Multiplan,,,354.39,,354.39,218.75,354.39,percent of total billed charges,,
HC CHROM Y MICRODEL,81403,CPT,,,both,,,442.9,265.74,United Healthcare/Oxford,United Healthcare/Oxford,,269.47,,,269.47,218.75,354.39,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT  ,,,both,,,276.04,165.62,Aetna,Commerical,,151.53,,,151.53,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Aetna,Middlesex Employees,,136.38,,,136.38,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Anthem,Commerical,,179.91,,,179.91,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Anthem,Indemnity,,,200.55,,200.55,136.38,221.69,percent of total billed charges,,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Anthem,State Preferred,,221.69,,,221.69,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Anthem,Individual Exchange,,143.93,,,143.93,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Cigna,Cigna,,206.85,,,206.85,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Connecticare,Commerical,,192.56,,,192.56,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Connecticare,Exchange,,192.56,,,192.56,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,Multiplan,Multiplan,,,220.93,,220.93,136.38,221.69,percent of total billed charges,,
HC REF PRECISETYPE HEA DNA ARRAY- HH ROUTINE,81403,CPT,,,both,,,276.04,165.62,United Healthcare/Oxford,United Healthcare/Oxford,,167.98,,,167.98,136.38,221.69,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT  ,,,both,,,400.67,240.4,Aetna,Commerical,,220.18,,,220.18,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Aetna,Middlesex Employees,,198.17,,,198.17,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Anthem,Commerical,,261.43,,,261.43,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Anthem,Indemnity,,,291.41,,291.41,198.17,321.03,percent of total billed charges,,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Anthem,State Preferred,,221.69,,,221.69,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Anthem,Individual Exchange,,209.14,,,209.14,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Cigna,Cigna,,300.56,,,300.56,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Connecticare,Commerical,,279.8,,,279.8,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Connecticare,Exchange,,279.8,,,279.8,198.17,321.03,other,Could be inpatient or outpatient,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,Multiplan,Multiplan,,,321.03,,321.03,198.17,321.03,percent of total billed charges,,
HC REF PRECISETYPE HEA DNA ARRAY- HH STAT,81403,CPT,,,both,,,400.67,240.4,United Healthcare/Oxford,United Healthcare/Oxford,,244.1,,,244.1,198.17,321.03,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT  ,,,both,,,296.64,177.98,Aetna,Commerical,,163.28,,,163.28,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Aetna,Middlesex Employees,,146.95,,,146.95,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Anthem,Commerical,,193.88,,,193.88,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Anthem,Indemnity,,,216.1,,216.1,146.95,238.07,percent of total billed charges,,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Anthem,State Preferred,,182.67,,,182.67,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Anthem,Individual Exchange,,155.11,,,155.11,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Cigna,Cigna,,222.88,,,222.88,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Connecticare,Commerical,,207.49,,,207.49,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Connecticare,Exchange,,207.49,,,207.49,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,Multiplan,Multiplan,,,238.07,,238.07,146.95,238.07,percent of total billed charges,,
HC BTHAL AFR AM DNA,81404,CPT,,,both,,,296.64,177.98,United Healthcare/Oxford,United Healthcare/Oxford,,181.01,,,181.01,146.95,238.07,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT  ,,,both,,,261.62,156.97,Aetna,Commerical,,144.11,,,144.11,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Aetna,Middlesex Employees,,129.7,,,129.7,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Anthem,Commerical,,171.11,,,171.11,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Anthem,Indemnity,,,190.73,,190.73,129.7,210.11,percent of total billed charges,,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Anthem,State Preferred,,182.67,,,182.67,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Anthem,Individual Exchange,,136.89,,,136.89,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Cigna,Cigna,,196.72,,,196.72,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Connecticare,Commerical,,183.13,,,183.13,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Connecticare,Exchange,,183.13,,,183.13,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,Multiplan,Multiplan,,,210.11,,210.11,129.7,210.11,percent of total billed charges,,
HC BTHAL ASIAN DNA,81404,CPT,,,both,,,261.62,156.97,United Healthcare/Oxford,United Healthcare/Oxford,,159.76,,,159.76,129.7,210.11,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT  ,,,both,,,474.83,284.9,Aetna,Commerical,,261,,,261,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Aetna,Middlesex Employees,,234.9,,,234.9,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Anthem,Commerical,,309.9,,,309.9,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Anthem,Indemnity,,,345.43,,345.43,182.67,380.55,percent of total billed charges,,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Anthem,State Preferred,,182.67,,,182.67,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Anthem,Individual Exchange,,247.92,,,247.92,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Cigna,Cigna,,356.27,,,356.27,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Connecticare,Commerical,,331.68,,,331.68,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Connecticare,Exchange,,331.68,,,331.68,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,Multiplan,Multiplan,,,380.55,,380.55,182.67,380.55,percent of total billed charges,,
HC BTHAL PANEL DNA,81404,CPT,,,both,,,474.83,284.9,United Healthcare/Oxford,United Healthcare/Oxford,,289.35,,,289.35,182.67,380.55,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT  ,,,both,,,332.69,199.61,Aetna,Commerical,,183.08,,,183.08,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Aetna,Middlesex Employees,,164.76,,,164.76,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Anthem,Commerical,,217.37,,,217.37,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Anthem,Indemnity,,,242.3,,242.3,164.76,266.93,percent of total billed charges,,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Anthem,State Preferred,,182.67,,,182.67,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Anthem,Individual Exchange,,173.9,,,173.9,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Cigna,Cigna,,249.9,,,249.9,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Connecticare,Commerical,,232.65,,,232.65,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Connecticare,Exchange,,232.65,,,232.65,164.76,266.93,other,Could be inpatient or outpatient,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,Multiplan,Multiplan,,,266.93,,266.93,164.76,266.93,percent of total billed charges,,
HC BTHAL SEQUENCING,81404,CPT,,,both,,,332.69,199.61,United Healthcare/Oxford,United Healthcare/Oxford,,202.96,,,202.96,164.76,266.93,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT  ,,,both,,,420.24,252.14,Aetna,Commerical,,230.7,,,230.7,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Aetna,Middlesex Employees,,207.63,,,207.63,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Anthem,Commerical,,273.91,,,273.91,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Anthem,Indemnity,,,305.33,,305.33,182.67,336.36,percent of total billed charges,,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Anthem,State Preferred,,182.67,,,182.67,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Anthem,Individual Exchange,,219.13,,,219.13,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Cigna,Cigna,,314.91,,,314.91,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Connecticare,Commerical,,293.17,,,293.17,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Connecticare,Exchange,,293.17,,,293.17,182.67,336.36,other,Could be inpatient or outpatient,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,Multiplan,Multiplan,,,336.36,,336.36,182.67,336.36,percent of total billed charges,,
HC C-KIT TEST,81404,CPT,,,both,,,420.24,252.14,United Healthcare/Oxford,United Healthcare/Oxford,,255.75,,,255.75,182.67,336.36,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT  ,,,both,,,2252.61,1351.57,Aetna,Commerical,,693.23,,,693.23,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Aetna,Middlesex Employees,,623.91,,,623.91,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Anthem,Commerical,,4882.77,,,4882.77,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Anthem,Indemnity,,,1637.94,,1637.94,623.91,4882.77,percent of total billed charges,,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Anthem,State Preferred,,4114.46,,,4114.46,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Anthem,Individual Exchange,,3906.21,,,3906.21,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Cigna,Cigna,,1604.78,,,1604.78,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Connecticare,Commerical,,669.04,,,669.04,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Connecticare,Exchange,,669.04,,,669.04,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,Multiplan,Multiplan,,,1804.43,,1804.43,623.91,4882.77,percent of total billed charges,,
HC NGS SARCOMA RNA PANEL,81445,CPT,,,both,,,2252.61,1351.57,United Healthcare/Oxford,United Healthcare/Oxford,,784.03,,,784.03,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT  ,,,both,,,3939.75,2363.85,Aetna,Commerical,,693.23,,,693.23,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Aetna,Middlesex Employees,,623.91,,,623.91,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Anthem,Commerical,,4882.77,,,4882.77,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Anthem,Indemnity,,,2865.78,,2865.78,623.91,4882.77,percent of total billed charges,,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Anthem,State Preferred,,4114.46,,,4114.46,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Anthem,Individual Exchange,,3906.21,,,3906.21,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Cigna,Cigna,,1604.78,,,1604.78,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Connecticare,Commerical,,669.04,,,669.04,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Connecticare,Exchange,,669.04,,,669.04,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,Multiplan,Multiplan,,,3157.08,,3157.08,623.91,4882.77,percent of total billed charges,,
HC NGS SOLID TUMOR PANEL- 50 GENES / RNA PANEL,81445,CPT,,,both,,,3939.75,2363.85,United Healthcare/Oxford,United Healthcare/Oxford,,784.03,,,784.03,623.91,4882.77,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT  ,,,both,,,2252.61,1351.57,Aetna,Commerical,,1662.68,,,1662.68,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Aetna,Middlesex Employees,,1594.37,,,1594.37,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Anthem,Commerical,,750.64,,,750.64,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Anthem,Indemnity,,,1638.05,,1638.05,531.98,1868.34,percent of total billed charges,,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Anthem,State Preferred,,531.98,,,531.98,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Anthem,Individual Exchange,,600.52,,,600.52,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Cigna,Cigna,,1868.34,,,1868.34,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Connecticare,Commerical,,1128.22,,,1128.22,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Connecticare,Exchange,,1128.22,,,1128.22,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,Multiplan,Multiplan,,,1804.55,,1804.55,531.98,1868.34,percent of total billed charges,,
HC NGS SARCOMA RNA PANEL,81449,CPT,,,both,,,2252.61,1351.57,United Healthcare/Oxford,United Healthcare/Oxford,,739.01,,,739.01,531.98,1868.34,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT  ,,,both,,,3939.75,2363.85,Aetna,Commerical,,880.62,,,880.62,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Aetna,Middlesex Employees,,792.56,,,792.56,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Anthem,Commerical,,4882.77,,,4882.77,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Anthem,Indemnity,,,2865.78,,2865.78,792.56,4882.77,percent of total billed charges,,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Anthem,State Preferred,,4114.46,,,4114.46,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Anthem,Individual Exchange,,3906.21,,,3906.21,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Cigna,Cigna,,1740.26,,,1740.26,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Connecticare,Commerical,,849.88,,,849.88,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Connecticare,Exchange,,849.88,,,849.88,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,Multiplan,Multiplan,,,3157.08,,3157.08,792.56,4882.77,percent of total billed charges,,
HC NGS HEMPATH TUMOR PANEL - 49 GENES,81450,CPT,,,both,,,3939.75,2363.85,United Healthcare/Oxford,United Healthcare/Oxford,,995.96,,,995.96,792.56,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT  ,,,both,,,4433.12,2659.87,Aetna,Commerical,,3385.08,,,3385.08,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Aetna,Middlesex Employees,,3046.57,,,3046.57,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Commerical,,4882.77,,,4882.77,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Indemnity,,,3224.32,,3224.32,3046.57,4882.77,percent of total billed charges,,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,State Preferred,,4114.46,,,4114.46,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Individual Exchange,,3906.21,,,3906.21,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Cigna,Cigna,,,,,,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Commerical,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Exchange,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Multiplan,Multiplan,,,3552.06,,3552.06,3046.57,4882.77,percent of total billed charges,,
HC NGS HEMEPATH 75 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,United Healthcare/Oxford,United Healthcare/Oxford,,3828.39,,,3828.39,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT  ,,,both,,,4433.12,2659.87,Aetna,Commerical,,3385.08,,,3385.08,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Aetna,Middlesex Employees,,3046.57,,,3046.57,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Commerical,,4882.77,,,4882.77,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Indemnity,,,3224.32,,3224.32,3046.57,4882.77,percent of total billed charges,,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,State Preferred,,4114.46,,,4114.46,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Individual Exchange,,3906.21,,,3906.21,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Cigna,Cigna,,,,,,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Commerical,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Exchange,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Multiplan,Multiplan,,,3552.06,,3552.06,3046.57,4882.77,percent of total billed charges,,
HC NGS HENMEPATH 150 GENE DNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,United Healthcare/Oxford,United Healthcare/Oxford,,3828.39,,,3828.39,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT  ,,,both,,,4433.12,2659.87,Aetna,Commerical,,3385.08,,,3385.08,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Aetna,Middlesex Employees,,3046.57,,,3046.57,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Commerical,,4882.77,,,4882.77,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Indemnity,,,3224.32,,3224.32,3046.57,4882.77,percent of total billed charges,,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,State Preferred,,4114.46,,,4114.46,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Anthem,Individual Exchange,,3906.21,,,3906.21,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Cigna,Cigna,,,,,,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Commerical,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Connecticare,Exchange,,4013.06,,,4013.06,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,Multiplan,Multiplan,,,3552.06,,3552.06,3046.57,4882.77,percent of total billed charges,,
HC NGS HENMEPATH 207 GENE RNA PANEL,81455,CPT,,,both,,,4433.12,2659.87,United Healthcare/Oxford,United Healthcare/Oxford,,3828.39,,,3828.39,3046.57,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT  ,,,both,,,3874.86,2324.92,Aetna,Commerical,,3385.08,,,3385.08,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Aetna,Middlesex Employees,,3046.57,,,3046.57,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Anthem,Commerical,,4882.77,,,4882.77,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Anthem,Indemnity,,,2818.31,,2818.31,2818.31,4882.77,percent of total billed charges,,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Anthem,State Preferred,,4114.46,,,4114.46,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Anthem,Individual Exchange,,3906.21,,,3906.21,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Cigna,Cigna,,,,,,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Connecticare,Commerical,,4013.06,,,4013.06,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Connecticare,Exchange,,4013.06,,,4013.06,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,Multiplan,Multiplan,,,3104.78,,3104.78,2818.31,4882.77,percent of total billed charges,,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81455,CPT,,,both,,,3874.86,2324.92,United Healthcare/Oxford,United Healthcare/Oxford,,3828.39,,,3828.39,2818.31,4882.77,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT  ,,,both,,,4433.12,2659.87,Aetna,Commerical,,3272.88,,,3272.88,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Aetna,Middlesex Employees,,3138.42,,,3138.42,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Anthem,Commerical,,3665.42,,,3665.42,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Anthem,Indemnity,,,3224.4,,3224.4,2220.84,3677.72,percent of total billed charges,,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Anthem,State Preferred,,2597.67,,,2597.67,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Anthem,Individual Exchange,,2932.34,,,2932.34,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Cigna,Cigna,,3677.72,,,3677.72,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Connecticare,Commerical,,2220.84,,,2220.84,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Connecticare,Exchange,,2220.84,,,2220.84,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,Multiplan,Multiplan,,,3552.15,,3552.15,2220.84,3677.72,percent of total billed charges,,
HC NGS HENMEPATH 207 GENE RNA PANEL,81456,CPT,,,both,,,4433.12,2659.87,United Healthcare/Oxford,United Healthcare/Oxford,,3608.63,,,3608.63,2220.84,3677.72,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT  ,,,both,,,3874.86,2324.92,Aetna,Commerical,,2860.15,,,2860.15,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Aetna,Middlesex Employees,,2742.65,,,2742.65,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Anthem,Commerical,,3665.42,,,3665.42,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Anthem,Indemnity,,,2817.78,,2817.78,1940.77,3665.42,percent of total billed charges,,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Anthem,State Preferred,,2597.67,,,2597.67,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Anthem,Individual Exchange,,2932.34,,,2932.34,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Cigna,Cigna,,3213.94,,,3213.94,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Connecticare,Commerical,,1940.78,,,1940.78,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Connecticare,Exchange,,1940.77,,,1940.77,1940.77,3665.42,other,Could be inpatient or outpatient,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,Multiplan,Multiplan,,,3104.2,,3104.2,1940.77,3665.42,percent of total billed charges,,
HC NGS SOLID TUMOR 99 GENES DNA / 65 GENES RNA FUSION PANEL,81456,CPT,,,both,,,3874.86,2324.92,United Healthcare/Oxford,United Healthcare/Oxford,,3608.63,,,3608.63,1940.77,3665.42,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT  ,,,both,,,270.89,162.53,Aetna,Commerical,,149.05,,,149.05,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Aetna,Middlesex Employees,,134.15,,,134.15,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Anthem,Commerical,,176.99,,,176.99,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Anthem,Indemnity,,,197.28,,197.28,134.15,217.33,percent of total billed charges,,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Anthem,State Preferred,,176.99,,,176.99,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Anthem,Individual Exchange,,141.59,,,141.59,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Cigna,Cigna,,203.47,,,203.47,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Connecticare,Commerical,,189.42,,,189.42,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Connecticare,Exchange,,189.42,,,189.42,134.15,217.33,other,Could be inpatient or outpatient,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,Multiplan,Multiplan,,,217.33,,217.33,134.15,217.33,percent of total billed charges,,
HC MLH1 METHYLATION,81479,CPT,,,both,,,270.89,162.53,United Healthcare/Oxford,United Healthcare/Oxford,,165.24,,,165.24,134.15,217.33,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT  ,,,both,,,86.52,51.91,Aetna,Commerical,,48.24,,,48.24,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Aetna,Middlesex Employees,,43.42,,,43.42,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Anthem,Commerical,,57.28,,,57.28,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Anthem,Indemnity,,,63.85,,63.85,23.96,70.34,percent of total billed charges,,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Anthem,State Preferred,,23.96,,,23.96,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Anthem,Individual Exchange,,45.82,,,45.82,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Cigna,Cigna,,65.85,,,65.85,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Connecticare,Commerical,,61.31,,,61.31,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Connecticare,Exchange,,61.31,,,61.31,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,Multiplan,Multiplan,,,70.34,,70.34,23.96,70.34,percent of total billed charges,,
HC ACETAMINOPHEN,82003,CPT,,,both,,,86.52,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,53.48,,,53.48,23.96,70.34,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT  ,,,both,,,33.1,19.86,Aetna,Commerical,,9.47,,,9.47,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Aetna,Middlesex Employees,,8.53,,,8.53,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Anthem,Commerical,,15.06,,,15.06,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Anthem,Indemnity,,,24.07,,24.07,8.53,26.52,percent of total billed charges,,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Anthem,State Preferred,,9.69,,,9.69,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Anthem,Individual Exchange,,12.05,,,12.05,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Cigna,Cigna,,18.41,,,18.41,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Connecticare,Commerical,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Connecticare,Exchange,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,Multiplan,Multiplan,,,26.52,,26.52,8.53,26.52,percent of total billed charges,,
HC ACETONE QUANT,82010,CPT,,,both,,,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,11.91,,,11.91,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT  ,,,both,,,33.1,19.86,Aetna,Commerical,,9.47,,,9.47,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Aetna,Middlesex Employees,,8.53,,,8.53,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Commerical,,15.06,,,15.06,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Indemnity,,,24.07,,24.07,8.53,26.52,percent of total billed charges,,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,State Preferred,,9.69,,,9.69,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Individual Exchange,,12.05,,,12.05,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Cigna,Cigna,,18.41,,,18.41,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Connecticare,Commerical,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Connecticare,Exchange,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,Multiplan,Multiplan,,,26.52,,26.52,8.53,26.52,percent of total billed charges,,
HC BETA OH BUTYRATE,82010,CPT,,,both,,,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,11.91,,,11.91,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT  ,,,both,,,33.1,19.86,Aetna,Commerical,,9.47,,,9.47,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Aetna,Middlesex Employees,,8.53,,,8.53,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Commerical,,15.06,,,15.06,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Indemnity,,,24.07,,24.07,8.53,26.52,percent of total billed charges,,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,State Preferred,,9.69,,,9.69,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Anthem,Individual Exchange,,12.05,,,12.05,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Cigna,Cigna,,18.41,,,18.41,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Connecticare,Commerical,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Connecticare,Exchange,,9.14,,,9.14,8.53,26.52,other,Could be inpatient or outpatient,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,Multiplan,Multiplan,,,26.52,,26.52,8.53,26.52,percent of total billed charges,,
HC SQ KETONE B SERUM QUANTITATIVE; BETA-HYROXBUTYRATE,82010,CPT,,,both,,,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,11.91,,,11.91,8.53,26.52,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,19.12,,,19.12,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,17.21,,,17.21,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,25.55,,,25.55,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,16.42,44.58,percent of total billed charges,,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.42,,,16.42,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,20.44,,,20.44,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.83,,,30.83,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,18.45,,,18.45,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,18.45,,,18.45,16.42,44.58,other,Could be inpatient or outpatient,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,16.42,44.58,percent of total billed charges,,
HC ACYLCARNITINE,82016,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,21.63,,,21.63,16.42,44.58,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT  ,,,both,,,155.31,93.19,Aetna,Commerical,,44.78,,,44.78,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Aetna,Middlesex Employees,,40.31,,,40.31,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Anthem,Commerical,,71.2,,,71.2,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Anthem,Indemnity,,,112.96,,112.96,40.31,124.44,percent of total billed charges,,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Anthem,State Preferred,,45.74,,,45.74,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Anthem,Individual Exchange,,56.96,,,56.96,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Cigna,Cigna,,86.06,,,86.06,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Connecticare,Commerical,,43.21,,,43.21,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Connecticare,Exchange,,43.21,,,43.21,40.31,124.44,other,Could be inpatient or outpatient,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,Multiplan,Multiplan,,,124.44,,124.44,40.31,124.44,percent of total billed charges,,
HC ACTH PLASMA,82024,CPT,,,both,,,155.31,93.19,United Healthcare/Oxford,United Healthcare/Oxford,,56.27,,,56.27,40.31,124.44,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT  ,,,both,,,19.93,11.96,Aetna,Commerical,,5.73,,,5.73,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Aetna,Middlesex Employees,,5.17,,,5.17,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Anthem,Commerical,,8.4,,,8.4,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Anthem,Indemnity,,,14.5,,14.5,5.17,15.97,percent of total billed charges,,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Anthem,State Preferred,,5.4,,,5.4,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Anthem,Individual Exchange,,6.73,,,6.73,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Cigna,Cigna,,11.28,,,11.28,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Connecticare,Commerical,,5.54,,,5.54,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Connecticare,Exchange,,5.54,,,5.54,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,Multiplan,Multiplan,,,15.97,,15.97,5.17,15.97,percent of total billed charges,,
HC ALBUMIN,82040,CPT,,,both,,,19.93,11.96,United Healthcare/Oxford,United Healthcare/Oxford,,7.21,,,7.21,5.17,15.97,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,5.73,,,5.73,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,5.17,,,5.17,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,8.4,,,8.4,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,5.17,50.5,percent of total billed charges,,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,5.4,,,5.4,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,6.73,,,6.73,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,11.28,,,11.28,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,5.54,,,5.54,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,5.54,,,5.54,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,5.17,50.5,percent of total billed charges,,
HC ALBUMIN SERUM,82040,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,7.21,,,7.21,5.17,50.5,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT  ,,,both,,,14.94,8.96,Aetna,Commerical,,9.02,,,9.02,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Aetna,Middlesex Employees,,8.12,,,8.12,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Anthem,Commerical,,9.53,,,9.53,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Anthem,Indemnity,,,10.86,,10.86,6.13,11.97,percent of total billed charges,,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Anthem,State Preferred,,6.13,,,6.13,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Anthem,Individual Exchange,,7.63,,,7.63,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Cigna,Cigna,,11.28,,,11.28,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Connecticare,Commerical,,8.7,,,8.7,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Connecticare,Exchange,,8.7,,,8.7,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,Multiplan,Multiplan,,,11.97,,11.97,6.13,11.97,percent of total billed charges,,
HC ALBUMIN FLUID,82042,CPT,,,both,,,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,10.21,,,10.21,6.13,11.97,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT  ,,,both,,,25.08,15.05,Aetna,Commerical,,9.02,,,9.02,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Aetna,Middlesex Employees,,8.12,,,8.12,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Anthem,Commerical,,9.53,,,9.53,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Anthem,Indemnity,,,18.24,,18.24,6.13,20.09,percent of total billed charges,,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Anthem,State Preferred,,6.13,,,6.13,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Anthem,Individual Exchange,,7.63,,,7.63,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Cigna,Cigna,,11.28,,,11.28,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Connecticare,Commerical,,8.7,,,8.7,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Connecticare,Exchange,,8.7,,,8.7,6.13,20.09,other,Could be inpatient or outpatient,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,Multiplan,Multiplan,,,20.09,,20.09,6.13,20.09,percent of total billed charges,,
HC ALBUMIN URINE,82042,CPT,,,both,,,25.08,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,10.21,,,10.21,6.13,20.09,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,25.35,,,25.35,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,22.82,,,22.82,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,30.1,,,30.1,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,6.86,36.97,percent of total billed charges,,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,6.86,,,6.86,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,24.07,,,24.07,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,34.61,,,34.61,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,32.21,,,32.21,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,32.21,,,32.21,6.86,36.97,other,Could be inpatient or outpatient,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,6.86,36.97,percent of total billed charges,,
HC MICROALB UR24HR,82043,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,28.11,,,28.11,6.86,36.97,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,60,,,60,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,54,,,54,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,71.23,,,71.23,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,12.8,87.47,percent of total billed charges,,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,12.8,,,12.8,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,56.99,,,56.99,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,81.89,,,81.89,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,76.24,,,76.24,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,76.24,,,76.24,12.8,87.47,other,Could be inpatient or outpatient,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,12.8,87.47,percent of total billed charges,,
HC ETHANOL,82055,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,66.51,,,66.51,12.8,87.47,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT  ,,,both,,,39.12,23.47,Aetna,Commerical,,11.26,,,11.26,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Aetna,Middlesex Employees,,10.13,,,10.13,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Anthem,Commerical,,17.88,,,17.88,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Anthem,Indemnity,,,28.45,,28.45,10.13,31.34,percent of total billed charges,,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Anthem,State Preferred,,11.49,,,11.49,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Anthem,Individual Exchange,,14.3,,,14.3,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Cigna,Cigna,,21.35,,,21.35,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Connecticare,Commerical,,10.87,,,10.87,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Connecticare,Exchange,,10.87,,,10.87,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,Multiplan,Multiplan,,,31.34,,31.34,10.13,31.34,percent of total billed charges,,
HC ALDOLASE SERUM,82085,CPT,,,both,,,39.12,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,14.15,,,14.15,10.13,31.34,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT  ,,,both,,,164.33,98.6,Aetna,Commerical,,90.29,,,90.29,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Aetna,Middlesex Employees,,81.26,,,81.26,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Anthem,Commerical,,107.22,,,107.22,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Anthem,Indemnity,,,119.51,,119.51,48.25,131.66,percent of total billed charges,,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Anthem,State Preferred,,48.25,,,48.25,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Anthem,Individual Exchange,,85.77,,,85.77,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Cigna,Cigna,,123.26,,,123.26,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Connecticare,Commerical,,114.75,,,114.75,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Connecticare,Exchange,,114.75,,,114.75,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,Multiplan,Multiplan,,,131.66,,131.66,48.25,131.66,percent of total billed charges,,
HC ALDOSTERONE SERUM,82088,CPT,,,both,,,164.33,98.6,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,48.25,131.66,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT  ,,,both,,,187.96,112.78,Aetna,Commerical,,103.29,,,103.29,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Aetna,Middlesex Employees,,92.95,,,92.95,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Anthem,Commerical,,122.64,,,122.64,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Anthem,Indemnity,,,136.7,,136.7,48.25,150.59,percent of total billed charges,,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Anthem,State Preferred,,48.25,,,48.25,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Anthem,Individual Exchange,,98.11,,,98.11,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Cigna,Cigna,,140.99,,,140.99,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Connecticare,Commerical,,131.25,,,131.25,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Connecticare,Exchange,,131.25,,,131.25,48.25,150.59,other,Could be inpatient or outpatient,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,Multiplan,Multiplan,,,150.59,,150.59,48.25,150.59,percent of total billed charges,,
HC ALDOSTERONE URINE,82088,CPT,,,both,,,187.96,112.78,United Healthcare/Oxford,United Healthcare/Oxford,,114.51,,,114.51,48.25,150.59,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT  ,,,both,,,54.49,32.69,Aetna,Commerical,,29.94,,,29.94,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Aetna,Middlesex Employees,,26.95,,,26.95,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Anthem,Commerical,,35.55,,,35.55,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Anthem,Indemnity,,,39.63,,39.63,15.91,43.66,percent of total billed charges,,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Anthem,State Preferred,,15.91,,,15.91,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Anthem,Individual Exchange,,28.44,,,28.44,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Cigna,Cigna,,40.87,,,40.87,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Connecticare,Commerical,,38.05,,,38.05,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Connecticare,Exchange,,38.05,,,38.05,15.91,43.66,other,Could be inpatient or outpatient,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,Multiplan,Multiplan,,,43.66,,43.66,15.91,43.66,percent of total billed charges,,
HC A-1 ANTITRYP STL,82103,CPT,,,both,,,54.49,32.69,United Healthcare/Oxford,United Healthcare/Oxford,,33.2,,,33.2,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,29.94,,,29.94,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,26.95,,,26.95,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,35.55,,,35.55,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,15.91,43.66,percent of total billed charges,,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,15.91,,,15.91,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,28.44,,,28.44,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,40.87,,,40.87,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,38.05,,,38.05,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,38.05,,,38.05,15.91,43.66,other,Could be inpatient or outpatient,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,15.91,43.66,percent of total billed charges,,
HC ALPHA I ANTRYPS T,82103,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,33.2,,,33.2,15.91,43.66,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,16.77,,,16.77,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,15.09,,,15.09,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,16.78,,,16.78,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,10.77,46.44,percent of total billed charges,,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,10.77,,,10.77,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,13.42,,,13.42,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,32.03,,,32.03,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,16.18,,,16.18,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,16.18,,,16.18,10.77,46.44,other,Could be inpatient or outpatient,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,10.77,46.44,percent of total billed charges,,
HC A1A (AAT) PHENOTYPE,82104,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,21.06,,,21.06,10.77,46.44,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT  ,,,both,,,67.98,40.79,Aetna,Commerical,,19.45,,,19.45,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Aetna,Middlesex Employees,,17.5,,,17.5,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Anthem,Commerical,,30.92,,,30.92,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Anthem,Indemnity,,,49.11,,49.11,17.5,54.1,percent of total billed charges,,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Anthem,State Preferred,,19.86,,,19.86,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Anthem,Individual Exchange,,24.74,,,24.74,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Cigna,Cigna,,37.38,,,37.38,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Connecticare,Commerical,,18.76,,,18.76,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Connecticare,Exchange,,18.76,,,18.76,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,Multiplan,Multiplan,,,54.1,,54.1,17.5,54.1,percent of total billed charges,,
HC AFP-TUMOR,82105,CPT,,,both,,,67.98,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,17.5,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT  ,,,both,,,67.98,40.79,Aetna,Commerical,,37.11,,,37.11,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Aetna,Middlesex Employees,,33.39,,,33.39,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Anthem,Commerical,,44.06,,,44.06,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Anthem,Indemnity,,,49.11,,49.11,19.86,54.1,percent of total billed charges,,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Anthem,State Preferred,,19.86,,,19.86,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Anthem,Individual Exchange,,35.25,,,35.25,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Cigna,Cigna,,50.66,,,50.66,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Connecticare,Commerical,,47.16,,,47.16,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Connecticare,Exchange,,47.16,,,47.16,19.86,54.1,other,Could be inpatient or outpatient,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,Multiplan,Multiplan,,,54.1,,54.1,19.86,54.1,percent of total billed charges,,
HC AFP FLUIDS,82106,CPT,,,both,,,67.98,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,41.14,,,41.14,19.86,54.1,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,35.07,107.04,percent of total billed charges,,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,107.04,,,107.04,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,35.07,107.04,other,Could be inpatient or outpatient,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,35.07,107.04,percent of total billed charges,,
HC ALPHA-FETOPROTEIN SER TMR,82107,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,35.07,107.04,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT  ,,,both,,,108.06,64.83,Aetna,Commerical,,59.38,,,59.38,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Aetna,Middlesex Employees,,53.44,,,53.44,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Anthem,Commerical,,70.49,,,70.49,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Anthem,Indemnity,,,78.58,,78.58,30.17,86.57,percent of total billed charges,,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Anthem,State Preferred,,30.17,,,30.17,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Anthem,Individual Exchange,,56.4,,,56.4,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Cigna,Cigna,,81.05,,,81.05,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Connecticare,Commerical,,75.46,,,75.46,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Connecticare,Exchange,,75.46,,,75.46,30.17,86.57,other,Could be inpatient or outpatient,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,Multiplan,Multiplan,,,86.57,,86.57,30.17,86.57,percent of total billed charges,,
HC ALUMINUM BLOOD,82108,CPT,,,both,,,108.06,64.83,United Healthcare/Oxford,United Healthcare/Oxford,,65.83,,,65.83,30.17,86.57,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT  ,,,both,,,367.71,220.63,Aetna,Commerical,,202.25,,,202.25,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Aetna,Middlesex Employees,,182.02,,,182.02,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Anthem,Commerical,,240.14,,,240.14,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Anthem,Indemnity,,,267.67,,267.67,19.98,294.87,percent of total billed charges,,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Anthem,State Preferred,,19.98,,,19.98,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Anthem,Individual Exchange,,192.12,,,192.12,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Cigna,Cigna,,276.07,,,276.07,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Connecticare,Commerical,,257.01,,,257.01,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Connecticare,Exchange,,257.01,,,257.01,19.98,294.87,other,Could be inpatient or outpatient,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,Multiplan,Multiplan,,,294.87,,294.87,19.98,294.87,percent of total billed charges,,
HC PIPECOLIC ACID,82131,CPT,,,both,,,367.71,220.63,United Healthcare/Oxford,United Healthcare/Oxford,,224.21,,,224.21,19.98,294.87,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT  ,,,both,,,99.04,59.43,Aetna,Commerical,,54.42,,,54.42,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Aetna,Middlesex Employees,,48.98,,,48.98,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Anthem,Commerical,,64.63,,,64.63,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Anthem,Indemnity,,,72.03,,72.03,14.31,79.36,percent of total billed charges,,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Anthem,State Preferred,,14.31,,,14.31,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Anthem,Individual Exchange,,51.7,,,51.7,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Cigna,Cigna,,74.3,,,74.3,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Connecticare,Commerical,,69.16,,,69.16,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Connecticare,Exchange,,69.16,,,69.16,14.31,79.36,other,Could be inpatient or outpatient,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,Multiplan,Multiplan,,,79.36,,79.36,14.31,79.36,percent of total billed charges,,
HC DELTA-ALA URINE,82135,CPT,,,both,,,99.04,59.43,United Healthcare/Oxford,United Healthcare/Oxford,,60.34,,,60.34,14.31,79.36,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT  ,,,both,,,279.13,167.48,Aetna,Commerical,,19.56,,,19.56,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Anthem,Commerical,,31.08,,,31.08,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Anthem,Indemnity,,,203,,203,17.6,223.64,percent of total billed charges,,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Anthem,State Preferred,,19.98,,,19.98,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Anthem,Individual Exchange,,24.86,,,24.86,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Cigna,Cigna,,37.38,,,37.38,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Connecticare,Commerical,,18.88,,,18.88,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Connecticare,Exchange,,18.88,,,18.88,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,Multiplan,Multiplan,,,223.64,,223.64,17.6,223.64,percent of total billed charges,,
HC AMINO ACID QT PLSMSTOOL,82139,CPT,,,both,,,279.13,167.48,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,223.64,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT  ,,,both,,,68.65,41.19,Aetna,Commerical,,19.56,,,19.56,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Anthem,Commerical,,31.08,,,31.08,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Anthem,Indemnity,,,49.93,,49.93,17.6,55,percent of total billed charges,,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Anthem,State Preferred,,19.98,,,19.98,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Anthem,Individual Exchange,,24.86,,,24.86,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Cigna,Cigna,,37.38,,,37.38,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Connecticare,Commerical,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Connecticare,Exchange,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,Multiplan,Multiplan,,,55,,55,17.6,55,percent of total billed charges,,
HC AMINO ACIDS 6 OR MORE AA QUANTITATIVE EA SPEC - MAYO SEND OUT,82139,CPT,,,both,,,68.65,41.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT  ,,,both,,,68.65,41.19,Aetna,Commerical,,19.56,,,19.56,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Anthem,Commerical,,31.08,,,31.08,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Anthem,Indemnity,,,49.93,,49.93,17.6,55,percent of total billed charges,,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Anthem,State Preferred,,19.98,,,19.98,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Anthem,Individual Exchange,,24.86,,,24.86,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Cigna,Cigna,,37.38,,,37.38,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Connecticare,Commerical,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Connecticare,Exchange,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,Multiplan,Multiplan,,,55,,55,17.6,55,percent of total billed charges,,
HC AMINO ACIDS QUANT,82139,CPT,,,both,,,68.65,41.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,55,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT  ,,,both,,,664.05,398.43,Aetna,Commerical,,19.56,,,19.56,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Anthem,Commerical,,31.08,,,31.08,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Anthem,Indemnity,,,482.95,,482.95,17.6,532.04,percent of total billed charges,,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Anthem,State Preferred,,19.98,,,19.98,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Anthem,Individual Exchange,,24.86,,,24.86,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Cigna,Cigna,,37.38,,,37.38,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Connecticare,Commerical,,18.88,,,18.88,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Connecticare,Exchange,,18.88,,,18.88,17.6,532.04,other,Could be inpatient or outpatient,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,Multiplan,Multiplan,,,532.04,,532.04,17.6,532.04,percent of total billed charges,,
HC AMINO ACIDS URINE,82139,CPT,,,both,,,664.05,398.43,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,532.04,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT  ,,,both,,,68.65,41.19,Aetna,Commerical,,19.56,,,19.56,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Anthem,Commerical,,31.08,,,31.08,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Anthem,Indemnity,,,49.93,,49.93,17.6,55,percent of total billed charges,,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Anthem,State Preferred,,19.98,,,19.98,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Anthem,Individual Exchange,,24.86,,,24.86,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Cigna,Cigna,,37.38,,,37.38,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Connecticare,Commerical,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Connecticare,Exchange,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,Multiplan,Multiplan,,,55,,55,17.6,55,percent of total billed charges,,
HC AMNO ACID QT UR,82139,CPT,,,both,,,68.65,41.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT  ,,,both,,,68.65,41.19,Aetna,Commerical,,19.56,,,19.56,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Anthem,Commerical,,31.08,,,31.08,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Anthem,Indemnity,,,49.93,,49.93,17.6,55,percent of total billed charges,,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Anthem,State Preferred,,19.98,,,19.98,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Anthem,Individual Exchange,,24.86,,,24.86,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Cigna,Cigna,,37.38,,,37.38,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Connecticare,Commerical,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Connecticare,Exchange,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,Multiplan,Multiplan,,,55,,55,17.6,55,percent of total billed charges,,
HC CSF AMINO ACID,82139,CPT,,,both,,,68.65,41.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,55,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,16.89,,,16.89,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,15.2,,,15.2,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,26.86,,,26.86,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,15.2,46.44,percent of total billed charges,,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,17.25,,,17.25,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,21.49,,,21.49,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,32.64,,,32.64,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,16.31,,,16.31,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,16.31,,,16.31,15.2,46.44,other,Could be inpatient or outpatient,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,15.2,46.44,percent of total billed charges,,
HC AMMONIA BLOOD,82140,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,21.23,,,21.23,15.2,46.44,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT  ,,,both,,,244.24,146.55,Aetna,Commerical,,134.21,,,134.21,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Aetna,Middlesex Employees,,120.8,,,120.8,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Anthem,Commerical,,159.36,,,159.36,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Anthem,Indemnity,,,177.63,,177.63,11.35,195.69,percent of total billed charges,,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Anthem,State Preferred,,11.35,,,11.35,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Anthem,Individual Exchange,,127.49,,,127.49,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Cigna,Cigna,,183.21,,,183.21,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Connecticare,Commerical,,170.55,,,170.55,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Connecticare,Exchange,,170.55,,,170.55,11.35,195.69,other,Could be inpatient or outpatient,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,Multiplan,Multiplan,,,195.69,,195.69,11.35,195.69,percent of total billed charges,,
HC AMPHETAMINE CONFIRMATION URINE,82145,CPT,,,both,,,244.24,146.55,United Healthcare/Oxford,United Healthcare/Oxford,,148.79,,,148.79,11.35,195.69,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT  ,,,both,,,26.09,15.65,Aetna,Commerical,,7.51,,,7.51,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Aetna,Middlesex Employees,,6.76,,,6.76,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Anthem,Commerical,,11.94,,,11.94,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Anthem,Indemnity,,,18.97,,18.97,6.76,20.9,percent of total billed charges,,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Anthem,State Preferred,,7.68,,,7.68,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Anthem,Individual Exchange,,9.55,,,9.55,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Cigna,Cigna,,14.23,,,14.23,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Connecticare,Commerical,,7.26,,,7.26,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Connecticare,Exchange,,7.26,,,7.26,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,Multiplan,Multiplan,,,20.9,,20.9,6.76,20.9,percent of total billed charges,,
HC AMYLASE BLOOD,82150,CPT,,,both,,,26.09,15.65,United Healthcare/Oxford,United Healthcare/Oxford,,9.45,,,9.45,6.76,20.9,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,7.51,,,7.51,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,6.76,,,6.76,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,11.94,,,11.94,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,6.76,28.13,percent of total billed charges,,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,7.68,,,7.68,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,9.55,,,9.55,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,14.23,,,14.23,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,7.26,,,7.26,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,7.26,,,7.26,6.76,28.13,other,Could be inpatient or outpatient,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,6.76,28.13,percent of total billed charges,,
HC AMYLASE URINE,82150,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,9.45,,,9.45,6.76,28.13,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT  ,,,both,,,116.39,69.83,Aetna,Commerical,,33.95,,,33.95,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Aetna,Middlesex Employees,,30.56,,,30.56,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Anthem,Commerical,,53.95,,,53.95,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Anthem,Indemnity,,,85.13,,85.13,30.56,93.78,percent of total billed charges,,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Anthem,State Preferred,,34.66,,,34.66,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Anthem,Individual Exchange,,43.16,,,43.16,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Cigna,Cigna,,65.28,,,65.28,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Connecticare,Commerical,,32.76,,,32.76,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Connecticare,Exchange,,32.76,,,32.76,30.56,93.78,other,Could be inpatient or outpatient,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,Multiplan,Multiplan,,,93.78,,93.78,30.56,93.78,percent of total billed charges,,
HC ANDROSTENDIONE,82157,CPT,,,both,,,116.39,69.83,United Healthcare/Oxford,United Healthcare/Oxford,,42.66,,,42.66,30.56,93.78,other,Could be inpatient or outpatient,
HC ACE,82164,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,16.93,,,16.93,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.24,,,15.24,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,26.91,,,26.91,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.24,47.8,percent of total billed charges,,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.27,,,17.27,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,21.53,,,21.53,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.64,,,32.64,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.34,,,16.34,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.34,,,16.34,15.24,47.8,other,Could be inpatient or outpatient,
HC ACE,82164,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.24,47.8,percent of total billed charges,,
HC ACE,82164,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.27,,,21.27,15.24,47.8,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT  ,,,both,,,76.53,45.92,Aetna,Commerical,,42.06,,,42.06,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Aetna,Middlesex Employees,,37.86,,,37.86,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Anthem,Commerical,,49.94,,,49.94,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Anthem,Indemnity,,,55.66,,55.66,22.46,61.32,percent of total billed charges,,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Anthem,State Preferred,,22.46,,,22.46,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Anthem,Individual Exchange,,39.95,,,39.95,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Cigna,Cigna,,57.41,,,57.41,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Connecticare,Commerical,,53.44,,,53.44,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Connecticare,Exchange,,53.44,,,53.44,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,Multiplan,Multiplan,,,61.32,,61.32,22.46,61.32,percent of total billed charges,,
HC ARSENIC BLOOD Q,82175,CPT,,,both,,,76.53,45.92,United Healthcare/Oxford,United Healthcare/Oxford,,46.63,,,46.63,22.46,61.32,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT  ,,,both,,,106.92,64.15,Aetna,Commerical,,58.76,,,58.76,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Aetna,Middlesex Employees,,52.88,,,52.88,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Anthem,Commerical,,69.77,,,69.77,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Anthem,Indemnity,,,77.77,,77.77,22.46,85.67,percent of total billed charges,,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Anthem,State Preferred,,22.46,,,22.46,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Anthem,Individual Exchange,,55.82,,,55.82,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Cigna,Cigna,,80.2,,,80.2,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Connecticare,Commerical,,74.66,,,74.66,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Connecticare,Exchange,,74.66,,,74.66,22.46,85.67,other,Could be inpatient or outpatient,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,Multiplan,Multiplan,,,85.67,,85.67,22.46,85.67,percent of total billed charges,,
HC ARSENIC URINE,82175,CPT,,,both,,,106.92,64.15,United Healthcare/Oxford,United Healthcare/Oxford,,65.14,,,65.14,22.46,85.67,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT  ,,,both,,,150.38,90.23,Aetna,Commerical,,82.87,,,82.87,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Aetna,Middlesex Employees,,74.59,,,74.59,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Anthem,Commerical,,98.41,,,98.41,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Anthem,Indemnity,,,109.69,,109.69,11.71,120.84,percent of total billed charges,,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Anthem,State Preferred,,11.71,,,11.71,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Anthem,Individual Exchange,,78.72,,,78.72,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Cigna,Cigna,,113.13,,,113.13,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Connecticare,Commerical,,105.32,,,105.32,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Connecticare,Exchange,,105.32,,,105.32,11.71,120.84,other,Could be inpatient or outpatient,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,Multiplan,Multiplan,,,120.84,,120.84,11.71,120.84,percent of total billed charges,,
HC VITAMIN C SERUM,82180,CPT,,,both,,,150.38,90.23,United Healthcare/Oxford,United Healthcare/Oxford,,91.88,,,91.88,11.71,120.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT  ,,,both,,,101.29,60.77,Aetna,Commerical,,55.66,,,55.66,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Aetna,Middlesex Employees,,50.1,,,50.1,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Anthem,Commerical,,66.1,,,66.1,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Anthem,Indemnity,,,73.67,,73.67,19.16,81.16,percent of total billed charges,,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Anthem,State Preferred,,19.16,,,19.16,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Anthem,Individual Exchange,,52.88,,,52.88,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Cigna,Cigna,,75.98,,,75.98,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Connecticare,Commerical,,70.74,,,70.74,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Connecticare,Exchange,,70.74,,,70.74,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,Multiplan,Multiplan,,,81.16,,81.16,19.16,81.16,percent of total billed charges,,
HC B2 MICROGLOB CSF,82232,CPT,,,both,,,101.29,60.77,United Healthcare/Oxford,United Healthcare/Oxford,,61.71,,,61.71,19.16,81.16,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT  ,,,both,,,93.73,56.24,Aetna,Commerical,,51.34,,,51.34,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Aetna,Middlesex Employees,,46.2,,,46.2,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Anthem,Commerical,,60.95,,,60.95,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Anthem,Indemnity,,,67.94,,67.94,19.16,74.84,percent of total billed charges,,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Anthem,State Preferred,,19.16,,,19.16,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Anthem,Individual Exchange,,48.76,,,48.76,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Cigna,Cigna,,70.08,,,70.08,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Connecticare,Commerical,,65.24,,,65.24,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Connecticare,Exchange,,65.24,,,65.24,19.16,74.84,other,Could be inpatient or outpatient,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,Multiplan,Multiplan,,,74.84,,74.84,19.16,74.84,percent of total billed charges,,
HC B2 MICROGLOBULIN,82232,CPT,,,both,,,93.73,56.24,United Healthcare/Oxford,United Healthcare/Oxford,,56.91,,,56.91,19.16,74.84,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT  ,,,both,,,69.78,41.87,Aetna,Commerical,,19.85,,,19.85,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Aetna,Middlesex Employees,,17.86,,,17.86,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Anthem,Commerical,,31.58,,,31.58,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Anthem,Indemnity,,,50.75,,50.75,17.86,55.91,percent of total billed charges,,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Anthem,State Preferred,,20.3,,,20.3,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Anthem,Individual Exchange,,25.26,,,25.26,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Cigna,Cigna,,37.96,,,37.96,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Connecticare,Commerical,,19.16,,,19.16,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Connecticare,Exchange,,19.16,,,19.16,17.86,55.91,other,Could be inpatient or outpatient,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,Multiplan,Multiplan,,,55.91,,55.91,17.86,55.91,percent of total billed charges,,
HC BILE ACIDS TOTAL,82239,CPT,,,both,,,69.78,41.87,United Healthcare/Oxford,United Healthcare/Oxford,,24.96,,,24.96,17.86,55.91,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT  ,,,both,,,20.17,12.1,Aetna,Commerical,,5.82,,,5.82,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Aetna,Middlesex Employees,,5.24,,,5.24,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Anthem,Commerical,,9.25,,,9.25,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Anthem,Indemnity,,,14.67,,14.67,5.24,16.16,percent of total billed charges,,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Anthem,State Preferred,,5.95,,,5.95,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Anthem,Individual Exchange,,7.4,,,7.4,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Cigna,Cigna,,11.28,,,11.28,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Connecticare,Commerical,,5.61,,,5.61,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Connecticare,Exchange,,5.61,,,5.61,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,Multiplan,Multiplan,,,16.16,,16.16,5.24,16.16,percent of total billed charges,,
HC BILIRUBIN TOTAL,82247,CPT,,,both,,,20.17,12.1,United Healthcare/Oxford,United Healthcare/Oxford,,7.3,,,7.3,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT  ,,,both,,,20.17,12.1,Aetna,Commerical,,5.82,,,5.82,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Aetna,Middlesex Employees,,5.24,,,5.24,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Anthem,Commerical,,9.25,,,9.25,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Anthem,Indemnity,,,14.67,,14.67,5.24,16.16,percent of total billed charges,,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Anthem,State Preferred,,5.95,,,5.95,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Anthem,Individual Exchange,,7.4,,,7.4,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Cigna,Cigna,,11.28,,,11.28,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Connecticare,Commerical,,5.61,,,5.61,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Connecticare,Exchange,,5.61,,,5.61,5.24,16.16,other,Could be inpatient or outpatient,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,Multiplan,Multiplan,,,16.16,,16.16,5.24,16.16,percent of total billed charges,,
HC BILIRUBIN DIRECT,82248,CPT,,,both,,,20.17,12.1,United Healthcare/Oxford,United Healthcare/Oxford,,7.3,,,7.3,5.24,16.16,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,37.73,,,37.73,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,33.95,,,33.95,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,44.79,,,44.79,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,19.98,55,percent of total billed charges,,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,19.98,,,19.98,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,35.83,,,35.83,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,51.5,,,51.5,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,47.94,,,47.94,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,47.94,,,47.94,19.98,55,other,Could be inpatient or outpatient,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,19.98,55,percent of total billed charges,,
HC BIOTINIDASE,82261,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,19.98,55,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT  ,,,both,,,10.64,6.38,Aetna,Commerical,,5.85,,,5.85,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Aetna,Middlesex Employees,,5.26,,,5.26,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Anthem,Commerical,,6.94,,,6.94,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Anthem,Indemnity,,,7.75,,7.75,3.85,8.53,percent of total billed charges,,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Anthem,State Preferred,,3.85,,,3.85,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Anthem,Individual Exchange,,5.56,,,5.56,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Cigna,Cigna,,7.99,,,7.99,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Connecticare,Commerical,,7.43,,,7.43,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Connecticare,Exchange,,7.43,,,7.43,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,Multiplan,Multiplan,,,8.53,,8.53,3.85,8.53,percent of total billed charges,,
HC OCCULT BLOOD FECES CANCER SCREEN,82270,CPT,,,both,,,10.64,6.38,United Healthcare/Oxford,United Healthcare/Oxford,,6.49,,,6.49,3.85,8.53,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT  ,,,both,,,17.35,10.41,Aetna,Commerical,,9.53,,,9.53,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Aetna,Middlesex Employees,,8.58,,,8.58,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Anthem,Commerical,,11.31,,,11.31,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Anthem,Indemnity,,,12.62,,12.62,3.85,13.9,percent of total billed charges,,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Anthem,State Preferred,,3.85,,,3.85,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Anthem,Individual Exchange,,9.05,,,9.05,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Cigna,Cigna,,13.01,,,13.01,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Connecticare,Commerical,,12.12,,,12.12,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Connecticare,Exchange,,12.12,,,12.12,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,Multiplan,Multiplan,,,13.9,,13.9,3.85,13.9,percent of total billed charges,,
HC OCCULT BLOOD - FECES OTHER SOURCES,82271,CPT,,,both,,,17.35,10.41,United Healthcare/Oxford,United Healthcare/Oxford,,10.57,,,10.57,3.85,13.9,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT  ,,,both,,,13.79,8.28,Aetna,Commerical,,4.9,,,4.9,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Aetna,Middlesex Employees,,4.42,,,4.42,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Anthem,Commerical,,6,,,6,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Anthem,Indemnity,,,10.03,,10.03,3.85,11.89,percent of total billed charges,,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Anthem,State Preferred,,3.85,,,3.85,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Anthem,Individual Exchange,,4.8,,,4.8,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Cigna,Cigna,,11.89,,,11.89,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Connecticare,Commerical,,4.74,,,4.74,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Connecticare,Exchange,,4.74,,,4.74,3.85,11.89,other,Could be inpatient or outpatient,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,Multiplan,Multiplan,,,11.05,,11.05,3.85,11.89,percent of total billed charges,,
HC OCCULT BLOOD FECES NON CANCER SCREEN,82272,CPT,,,both,,,13.79,8.28,United Healthcare/Oxford,United Healthcare/Oxford,,5.55,,,5.55,3.85,11.89,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,17.18,82.06,percent of total billed charges,,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Anthem,State Preferred,,17.18,,,17.18,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,17.18,82.06,other,Could be inpatient or outpatient,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,17.18,82.06,percent of total billed charges,,
HC FECAL OCCULT BLD,82274,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,17.18,82.06,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,27.4,165.93,percent of total billed charges,,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,27.4,,,27.4,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,27.4,165.93,other,Could be inpatient or outpatient,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,27.4,165.93,percent of total billed charges,,
HC CADMIUM URINE,82300,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,27.4,165.93,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT  ,,,both,,,119.3,71.58,Aetna,Commerical,,34.32,,,34.32,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Aetna,Middlesex Employees,,30.89,,,30.89,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Anthem,Commerical,,54.57,,,54.57,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Anthem,Indemnity,,,86.77,,86.77,30.89,95.59,percent of total billed charges,,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Anthem,State Preferred,,35.05,,,35.05,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Anthem,Individual Exchange,,43.66,,,43.66,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Cigna,Cigna,,65.86,,,65.86,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Connecticare,Commerical,,33.12,,,33.12,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Connecticare,Exchange,,33.12,,,33.12,30.89,95.59,other,Could be inpatient or outpatient,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,Multiplan,Multiplan,,,95.59,,95.59,30.89,95.59,percent of total billed charges,,
HC VITAMIN D 25 HYD,82306,CPT,,,both,,,119.3,71.58,United Healthcare/Oxford,United Healthcare/Oxford,,43.13,,,43.13,30.89,95.59,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,59.38,,,59.38,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,53.44,,,53.44,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,70.49,,,70.49,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,31.7,86.57,percent of total billed charges,,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,31.7,,,31.7,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,56.4,,,56.4,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,81.05,,,81.05,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,75.46,,,75.46,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,75.46,,,75.46,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,31.7,86.57,percent of total billed charges,,
HC CALCITONIN,82308,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,65.83,,,65.83,31.7,86.57,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT  ,,,both,,,20.76,12.46,Aetna,Commerical,,5.98,,,5.98,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Aetna,Middlesex Employees,,5.38,,,5.38,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Anthem,Commerical,,9.5,,,9.5,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Anthem,Indemnity,,,15.1,,15.1,5.38,16.63,percent of total billed charges,,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Anthem,State Preferred,,6.1,,,6.1,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Anthem,Individual Exchange,,7.6,,,7.6,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Cigna,Cigna,,11.28,,,11.28,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Connecticare,Commerical,,5.77,,,5.77,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Connecticare,Exchange,,5.77,,,5.77,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,Multiplan,Multiplan,,,16.63,,16.63,5.38,16.63,percent of total billed charges,,
HC CALCIUM TOTAL BLD,82310,CPT,,,both,,,20.76,12.46,United Healthcare/Oxford,United Healthcare/Oxford,,7.52,,,7.52,5.38,16.63,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.86,,,15.86,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.28,,,14.28,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,21.46,,,21.46,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,13.79,44.58,percent of total billed charges,,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,13.79,,,13.79,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,17.16,,,17.16,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,13.79,44.58,percent of total billed charges,,
HC CALCIUM IONIZED,82330,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,19.93,,,19.93,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.86,,,15.86,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.28,,,14.28,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,21.46,,,21.46,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,13.79,44.58,percent of total billed charges,,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,13.79,,,13.79,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,17.16,,,17.16,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,13.79,44.58,percent of total billed charges,,
HC I-STAT IONIZD CAL,82330,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,19.93,,,19.93,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.86,,,15.86,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.28,,,14.28,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,21.46,,,21.46,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,13.79,44.58,percent of total billed charges,,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,13.79,,,13.79,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,17.16,,,17.16,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.31,,,15.31,13.79,44.58,other,Could be inpatient or outpatient,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,13.79,44.58,percent of total billed charges,,
HC I-STAT P FLTR ION,82330,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,19.93,,,19.93,13.79,44.58,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT  ,,,both,,,24.27,14.56,Aetna,Commerical,,6.99,,,6.99,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Aetna,Middlesex Employees,,6.29,,,6.29,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Anthem,Commerical,,11.12,,,11.12,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Anthem,Indemnity,,,17.64,,17.64,6.29,19.43,percent of total billed charges,,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Anthem,State Preferred,,7.14,,,7.14,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Anthem,Individual Exchange,,8.89,,,8.89,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Cigna,Cigna,,13.64,,,13.64,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Connecticare,Commerical,,6.75,,,6.75,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Connecticare,Exchange,,6.75,,,6.75,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,Multiplan,Multiplan,,,19.43,,19.43,6.29,19.43,percent of total billed charges,,
HC CALCIUM QUANT-UR,82340,CPT,,,both,,,24.27,14.56,United Healthcare/Oxford,United Healthcare/Oxford,,8.79,,,8.79,6.29,19.43,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,14.96,,,14.96,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.47,,,13.47,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.76,,,23.76,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.47,41.79,percent of total billed charges,,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.27,,,15.27,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.01,,,19.01,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,28.5,,,28.5,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.44,,,14.44,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.44,,,14.44,13.47,41.79,other,Could be inpatient or outpatient,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.47,41.79,percent of total billed charges,,
HC CALCULI ANALYSIS,82365,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.8,,,18.8,13.47,41.79,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,37.73,,,37.73,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,33.95,,,33.95,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,44.79,,,44.79,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,21.37,55,percent of total billed charges,,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,21.37,,,21.37,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,35.83,,,35.83,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,51.5,,,51.5,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,47.94,,,47.94,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,47.94,,,47.94,21.37,55,other,Could be inpatient or outpatient,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,21.37,55,percent of total billed charges,,
HC CARBOHYDRATE DEFICIENT TRANSFERRIN,82373,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,21.37,55,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT  ,,,both,,,19.66,11.8,Aetna,Commerical,,5.65,,,5.65,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Aetna,Middlesex Employees,,5.09,,,5.09,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Anthem,Commerical,,9.01,,,9.01,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Anthem,Indemnity,,,14.3,,14.3,5.09,15.75,percent of total billed charges,,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Anthem,State Preferred,,5.79,,,5.79,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Anthem,Individual Exchange,,7.21,,,7.21,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Cigna,Cigna,,10.68,,,10.68,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Connecticare,Commerical,,5.46,,,5.46,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Connecticare,Exchange,,5.46,,,5.46,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,Multiplan,Multiplan,,,15.75,,15.75,5.09,15.75,percent of total billed charges,,
HC CARBON DIOXIDE (BICARBINATE),82374,CPT,,,both,,,19.66,11.8,United Healthcare/Oxford,United Healthcare/Oxford,,7.13,,,7.13,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT  ,,,both,,,19.66,11.8,Aetna,Commerical,,5.65,,,5.65,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Aetna,Middlesex Employees,,5.09,,,5.09,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Anthem,Commerical,,9.01,,,9.01,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Anthem,Indemnity,,,14.3,,14.3,5.09,15.75,percent of total billed charges,,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Anthem,State Preferred,,5.79,,,5.79,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Anthem,Individual Exchange,,7.21,,,7.21,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Cigna,Cigna,,10.68,,,10.68,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Connecticare,Commerical,,5.46,,,5.46,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Connecticare,Exchange,,5.46,,,5.46,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,Multiplan,Multiplan,,,15.75,,15.75,5.09,15.75,percent of total billed charges,,
HC CARBON DIOXIDE BL,82374,CPT,,,both,,,19.66,11.8,United Healthcare/Oxford,United Healthcare/Oxford,,7.13,,,7.13,5.09,15.75,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT  ,,,both,,,48.7,29.22,Aetna,Commerical,,26.76,,,26.76,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Aetna,Middlesex Employees,,24.08,,,24.08,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Anthem,Commerical,,31.76,,,31.76,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Anthem,Indemnity,,,35.41,,35.41,14.59,39.01,percent of total billed charges,,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Anthem,State Preferred,,14.59,,,14.59,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Anthem,Individual Exchange,,25.41,,,25.41,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Cigna,Cigna,,36.52,,,36.52,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Connecticare,Commerical,,34,,,34,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Connecticare,Exchange,,34,,,34,14.59,39.01,other,Could be inpatient or outpatient,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,Multiplan,Multiplan,,,39.01,,39.01,14.59,39.01,percent of total billed charges,,
HC CARBOXYHGB QUANT,82375,CPT,,,both,,,48.7,29.22,United Healthcare/Oxford,United Healthcare/Oxford,,29.66,,,29.66,14.59,39.01,other,Could be inpatient or outpatient,
HC CEA,82378,CPT  ,,,both,,,76.22,45.73,Aetna,Commerical,,42.06,,,42.06,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Aetna,Middlesex Employees,,37.86,,,37.86,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Anthem,Commerical,,49.94,,,49.94,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Anthem,Indemnity,,,55.66,,55.66,22.46,61.32,percent of total billed charges,,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Anthem,State Preferred,,22.46,,,22.46,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Anthem,Individual Exchange,,39.95,,,39.95,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Cigna,Cigna,,57.41,,,57.41,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Connecticare,Commerical,,53.44,,,53.44,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Connecticare,Exchange,,53.44,,,53.44,22.46,61.32,other,Could be inpatient or outpatient,
HC CEA,82378,CPT,,,both,,,76.22,45.73,Multiplan,Multiplan,,,61.32,,61.32,22.46,61.32,percent of total billed charges,,
HC CEA,82378,CPT,,,both,,,76.22,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,46.63,,,46.63,22.46,61.32,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,19.56,,,19.56,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,17.6,,,17.6,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,31.08,,,31.08,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,17.6,55,percent of total billed charges,,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,19.98,,,19.98,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,24.86,,,24.86,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,37.38,,,37.38,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,18.88,,,18.88,17.6,55,other,Could be inpatient or outpatient,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,17.6,55,percent of total billed charges,,
HC CARNITINE SERUM QUANTITATIVE,82379,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,17.6,55,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT  ,,,both,,,101.29,60.77,Aetna,Commerical,,55.66,,,55.66,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Aetna,Middlesex Employees,,50.1,,,50.1,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Anthem,Commerical,,66.1,,,66.1,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Anthem,Indemnity,,,73.67,,73.67,29.89,81.16,percent of total billed charges,,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Anthem,State Preferred,,29.89,,,29.89,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Anthem,Individual Exchange,,52.88,,,52.88,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Cigna,Cigna,,75.98,,,75.98,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Connecticare,Commerical,,70.74,,,70.74,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Connecticare,Exchange,,70.74,,,70.74,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,Multiplan,Multiplan,,,81.16,,81.16,29.89,81.16,percent of total billed charges,,
HC CATECHOL FRAC PL,82384,CPT,,,both,,,101.29,60.77,United Healthcare/Oxford,United Healthcare/Oxford,,61.71,,,61.71,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT  ,,,both,,,101.97,61.18,Aetna,Commerical,,55.66,,,55.66,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Aetna,Middlesex Employees,,50.1,,,50.1,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Anthem,Commerical,,66.1,,,66.1,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Anthem,Indemnity,,,73.67,,73.67,29.89,81.16,percent of total billed charges,,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Anthem,State Preferred,,29.89,,,29.89,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Anthem,Individual Exchange,,52.88,,,52.88,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Cigna,Cigna,,75.98,,,75.98,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Connecticare,Commerical,,70.74,,,70.74,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Connecticare,Exchange,,70.74,,,70.74,29.89,81.16,other,Could be inpatient or outpatient,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,Multiplan,Multiplan,,,81.16,,81.16,29.89,81.16,percent of total billed charges,,
HC CATECHOLAMIN-FRUR,82384,CPT,,,both,,,101.97,61.18,United Healthcare/Oxford,United Healthcare/Oxford,,61.71,,,61.71,29.89,81.16,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,12.45,,,12.45,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,11.21,,,11.21,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,19.79,,,19.79,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,11.21,34.55,percent of total billed charges,,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,12.72,,,12.72,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,15.84,,,15.84,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,23.74,,,23.74,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,12.01,,,12.01,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,12.01,,,12.01,11.21,34.55,other,Could be inpatient or outpatient,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,11.21,34.55,percent of total billed charges,,
HC CERULOPLASMIN,82390,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,15.65,,,15.65,11.21,34.55,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,29.3,,,29.3,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,26.37,,,26.37,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,34.8,,,34.8,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,16.74,42.73,percent of total billed charges,,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,16.74,,,16.74,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,27.84,,,27.84,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,40,,,40,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,37.24,,,37.24,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,37.24,,,37.24,16.74,42.73,other,Could be inpatient or outpatient,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,16.74,42.73,percent of total billed charges,,
HC CHEMILUMINESCENT ASSAY,82397,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,32.49,,,32.49,16.74,42.73,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT  ,,,both,,,18.51,11.11,Aetna,Commerical,,5.33,,,5.33,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Aetna,Middlesex Employees,,4.8,,,4.8,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Anthem,Commerical,,8.48,,,8.48,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Anthem,Indemnity,,,13.46,,13.46,4.8,14.83,percent of total billed charges,,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Anthem,State Preferred,,5.44,,,5.44,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Anthem,Individual Exchange,,6.78,,,6.78,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Cigna,Cigna,,10.08,,,10.08,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Connecticare,Commerical,,5.15,,,5.15,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Connecticare,Exchange,,5.15,,,5.15,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,Multiplan,Multiplan,,,14.83,,14.83,4.8,14.83,percent of total billed charges,,
HC CHLORIDES BLOOD,82435,CPT,,,both,,,18.51,11.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT  ,,,both,,,18.51,11.11,Aetna,Commerical,,5.33,,,5.33,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Aetna,Middlesex Employees,,4.8,,,4.8,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Anthem,Commerical,,8.48,,,8.48,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Anthem,Indemnity,,,13.46,,13.46,4.8,14.83,percent of total billed charges,,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Anthem,State Preferred,,5.44,,,5.44,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Anthem,Individual Exchange,,6.78,,,6.78,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Cigna,Cigna,,10.08,,,10.08,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Connecticare,Commerical,,5.15,,,5.15,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Connecticare,Exchange,,5.15,,,5.15,4.8,14.83,other,Could be inpatient or outpatient,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,Multiplan,Multiplan,,,14.83,,14.83,4.8,14.83,percent of total billed charges,,
HC I-STAT CHLO BLD,82435,CPT,,,both,,,18.51,11.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,4.8,14.83,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT  ,,,both,,,20.23,12.14,Aetna,Commerical,,6.67,,,6.67,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Aetna,Middlesex Employees,,6,,,6,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Anthem,Commerical,,9.26,,,9.26,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Anthem,Indemnity,,,14.71,,14.71,5.95,16.21,percent of total billed charges,,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Anthem,State Preferred,,5.95,,,5.95,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Anthem,Individual Exchange,,7.41,,,7.41,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Cigna,Cigna,,11.28,,,11.28,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Connecticare,Commerical,,6.43,,,6.43,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Connecticare,Exchange,,6.43,,,6.43,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,Multiplan,Multiplan,,,16.21,,16.21,5.95,16.21,percent of total billed charges,,
HC CHLORIDE URINE,82436,CPT,,,both,,,20.23,12.14,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.95,16.21,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,14.33,,,14.33,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,12.9,,,12.9,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,17.03,,,17.03,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,5.62,20.9,percent of total billed charges,,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,5.62,,,5.62,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,13.62,,,13.62,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,19.57,,,19.57,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,18.22,,,18.22,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,18.22,,,18.22,5.62,20.9,other,Could be inpatient or outpatient,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,5.62,20.9,percent of total billed charges,,
HC CHLORIDE STOOL,82438,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,15.89,,,15.89,5.62,20.9,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT  ,,,both,,,19.75,11.85,Aetna,Commerical,,10.85,,,10.85,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Aetna,Middlesex Employees,,9.76,,,9.76,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Anthem,Commerical,,12.89,,,12.89,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Anthem,Indemnity,,,14.36,,14.36,5.62,15.82,percent of total billed charges,,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Anthem,State Preferred,,5.62,,,5.62,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Anthem,Individual Exchange,,10.31,,,10.31,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Cigna,Cigna,,14.81,,,14.81,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Connecticare,Commerical,,13.79,,,13.79,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Connecticare,Exchange,,13.79,,,13.79,5.62,15.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,Multiplan,Multiplan,,,15.82,,15.82,5.62,15.82,percent of total billed charges,,
HC CSF/BODY FL CL,82438,CPT,,,both,,,19.75,11.85,United Healthcare/Oxford,United Healthcare/Oxford,,12.03,,,12.03,5.62,15.82,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT  ,,,both,,,17.49,10.49,Aetna,Commerical,,5.04,,,5.04,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Aetna,Middlesex Employees,,4.54,,,4.54,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Anthem,Commerical,,8.02,,,8.02,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Anthem,Indemnity,,,12.72,,12.72,4.54,14.02,percent of total billed charges,,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Anthem,State Preferred,,5.15,,,5.15,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Anthem,Individual Exchange,,6.42,,,6.42,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Cigna,Cigna,,9.51,,,9.51,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Connecticare,Commerical,,4.87,,,4.87,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Connecticare,Exchange,,4.87,,,4.87,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,Multiplan,Multiplan,,,14.02,,14.02,4.54,14.02,percent of total billed charges,,
HC CHOLESTEROL TOTAL,82465,CPT,,,both,,,17.49,10.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.34,,,6.34,4.54,14.02,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT  ,,,both,,,81.03,48.62,Aetna,Commerical,,44.53,,,44.53,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Aetna,Middlesex Employees,,40.07,,,40.07,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Anthem,Commerical,,52.88,,,52.88,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Anthem,Indemnity,,,58.93,,58.93,9.34,64.92,percent of total billed charges,,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Anthem,State Preferred,,9.34,,,9.34,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Anthem,Individual Exchange,,42.3,,,42.3,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Cigna,Cigna,,60.79,,,60.79,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Connecticare,Commerical,,56.59,,,56.59,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Connecticare,Exchange,,56.59,,,56.59,9.34,64.92,other,Could be inpatient or outpatient,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,Multiplan,Multiplan,,,64.92,,64.92,9.34,64.92,percent of total billed charges,,
HC CHOLINESTERASE PS,82480,CPT,,,both,,,81.03,48.62,United Healthcare/Oxford,United Healthcare/Oxford,,49.37,,,49.37,9.34,64.92,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT  ,,,both,,,145.23,87.14,Aetna,Commerical,,79.79,,,79.79,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Aetna,Middlesex Employees,,71.81,,,71.81,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Anthem,Commerical,,94.73,,,94.73,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Anthem,Indemnity,,,105.6,,105.6,21.37,116.33,percent of total billed charges,,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Anthem,State Preferred,,21.37,,,21.37,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Anthem,Individual Exchange,,75.78,,,75.78,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Cigna,Cigna,,108.91,,,108.91,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Connecticare,Commerical,,101.39,,,101.39,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Connecticare,Exchange,,101.39,,,101.39,21.37,116.33,other,Could be inpatient or outpatient,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,Multiplan,Multiplan,,,116.33,,116.33,21.37,116.33,percent of total billed charges,,
HC OXAZEPAM,82491,CPT,,,both,,,145.23,87.14,United Healthcare/Oxford,United Healthcare/Oxford,,88.45,,,88.45,21.37,116.33,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT  ,,,both,,,112.27,67.36,Aetna,Commerical,,32.24,,,32.24,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Aetna,Middlesex Employees,,29.01,,,29.01,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Anthem,Commerical,,51.24,,,51.24,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Anthem,Indemnity,,,81.86,,81.86,29.01,90.18,percent of total billed charges,,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Anthem,State Preferred,,32.92,,,32.92,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Anthem,Individual Exchange,,41,,,41,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Cigna,Cigna,,61.72,,,61.72,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Connecticare,Commerical,,31.11,,,31.11,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Connecticare,Exchange,,31.11,,,31.11,29.01,90.18,other,Could be inpatient or outpatient,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,Multiplan,Multiplan,,,90.18,,90.18,29.01,90.18,percent of total billed charges,,
HC CITRATE,82507,CPT,,,both,,,112.27,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,40.51,,,40.51,29.01,90.18,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,21.66,,,21.66,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,19.5,,,19.5,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,34.44,,,34.44,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,19.5,60.42,percent of total billed charges,,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,22.12,,,22.12,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,27.55,,,27.55,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,41.53,,,41.53,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,20.9,,,20.9,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,20.9,,,20.9,19.5,60.42,other,Could be inpatient or outpatient,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,19.5,60.42,percent of total billed charges,,
HC COLLAGEN CROSS LINKS ANY METHOD,82523,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,27.22,,,27.22,19.5,60.42,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT  ,,,both,,,49.85,29.91,Aetna,Commerical,,27.39,,,27.39,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Aetna,Middlesex Employees,,24.65,,,24.65,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Anthem,Commerical,,32.53,,,32.53,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Anthem,Indemnity,,,36.26,,36.26,14.7,39.94,percent of total billed charges,,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Anthem,State Preferred,,14.7,,,14.7,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Anthem,Individual Exchange,,26.02,,,26.02,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Cigna,Cigna,,37.39,,,37.39,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Connecticare,Commerical,,34.81,,,34.81,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Connecticare,Exchange,,34.81,,,34.81,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,Multiplan,Multiplan,,,39.94,,39.94,14.7,39.94,percent of total billed charges,,
HC COPPER SERUM,82525,CPT,,,both,,,49.85,29.91,United Healthcare/Oxford,United Healthcare/Oxford,,30.36,,,30.36,14.7,39.94,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT  ,,,both,,,85.54,51.32,Aetna,Commerical,,47,,,47,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Aetna,Middlesex Employees,,42.31,,,42.31,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Anthem,Commerical,,55.81,,,55.81,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Anthem,Indemnity,,,62.21,,62.21,14.7,68.54,percent of total billed charges,,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Anthem,State Preferred,,14.7,,,14.7,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Anthem,Individual Exchange,,44.65,,,44.65,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Cigna,Cigna,,64.17,,,64.17,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Connecticare,Commerical,,59.74,,,59.74,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Connecticare,Exchange,,59.74,,,59.74,14.7,68.54,other,Could be inpatient or outpatient,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,Multiplan,Multiplan,,,68.54,,68.54,14.7,68.54,percent of total billed charges,,
HC COPPER URINE,82525,CPT,,,both,,,85.54,51.32,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,14.7,68.54,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT  ,,,both,,,67.53,40.52,Aetna,Commerical,,37.11,,,37.11,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Aetna,Middlesex Employees,,33.39,,,33.39,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Anthem,Commerical,,44.06,,,44.06,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Anthem,Indemnity,,,49.11,,49.11,19.78,54.1,percent of total billed charges,,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Anthem,State Preferred,,19.78,,,19.78,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Anthem,Individual Exchange,,35.25,,,35.25,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Cigna,Cigna,,50.66,,,50.66,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Connecticare,Commerical,,47.16,,,47.16,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Connecticare,Exchange,,47.16,,,47.16,19.78,54.1,other,Could be inpatient or outpatient,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,Multiplan,Multiplan,,,54.1,,54.1,19.78,54.1,percent of total billed charges,,
HC FREE CORTISOL UR,82530,CPT,,,both,,,67.53,40.52,United Healthcare/Oxford,United Healthcare/Oxford,,41.14,,,41.14,19.78,54.1,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,18.9,,,18.9,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,17.01,,,17.01,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,30.05,,,30.05,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,17.01,52.3,percent of total billed charges,,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,19.31,,,19.31,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,24.03,,,24.03,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,36.21,,,36.21,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,18.24,,,18.24,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,18.24,,,18.24,17.01,52.3,other,Could be inpatient or outpatient,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,17.01,52.3,percent of total billed charges,,
HC CORTISOL,82533,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,23.74,,,23.74,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,18.9,,,18.9,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,17.01,,,17.01,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,30.05,,,30.05,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,17.01,52.3,percent of total billed charges,,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,19.31,,,19.31,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,24.03,,,24.03,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,36.21,,,36.21,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,18.24,,,18.24,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,18.24,,,18.24,17.01,52.3,other,Could be inpatient or outpatient,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,17.01,52.3,percent of total billed charges,,
HC SPECIAL TEST CORTISOL,82533,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,23.74,,,23.74,17.01,52.3,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.93,,,27.93,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC ACYLGLYCINE,82542,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.93,,,27.93,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC CHROMATOGRAPHY QUAN COLUMN 1 ANALYTE NES - COENZYME Q10,82542,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,27.93,,,27.93,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC CHROMATOGRAPHY QUAN COLUMN MULTIPLE ANALYTES,82542,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,62.22,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT  ,,,both,,,201.47,120.88,Aetna,Commerical,,27.93,,,27.93,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Anthem,Commerical,,33.28,,,33.28,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Anthem,Indemnity,,,146.52,,146.52,21.37,161.42,percent of total billed charges,,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Anthem,State Preferred,,21.37,,,21.37,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Anthem,Individual Exchange,,26.62,,,26.62,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Cigna,Cigna,,40.34,,,40.34,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Connecticare,Commerical,,26.96,,,26.96,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Connecticare,Exchange,,26.96,,,26.96,21.37,161.42,other,Could be inpatient or outpatient,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,Multiplan,Multiplan,,,161.42,,161.42,21.37,161.42,percent of total billed charges,,
HC CLOZAPINE SERUM,82542,CPT,,,both,,,201.47,120.88,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,161.42,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.93,,,27.93,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC FATTY AC PROFILE,82542,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.93,,,27.93,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.96,,,26.96,21.37,62.22,other,Could be inpatient or outpatient,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC LAMOTRIGINE,82542,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,62.22,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT  ,,,both,,,184.37,110.62,Aetna,Commerical,,27.93,,,27.93,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Anthem,Commerical,,33.28,,,33.28,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Anthem,Indemnity,,,134.25,,134.25,21.37,147.89,percent of total billed charges,,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Anthem,State Preferred,,21.37,,,21.37,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Anthem,Individual Exchange,,26.62,,,26.62,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Cigna,Cigna,,40.34,,,40.34,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Connecticare,Commerical,,26.96,,,26.96,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Connecticare,Exchange,,26.96,,,26.96,21.37,147.89,other,Could be inpatient or outpatient,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,Multiplan,Multiplan,,,147.89,,147.89,21.37,147.89,percent of total billed charges,,
HC PROPRANOLOL,82542,CPT,,,both,,,184.37,110.62,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,147.89,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT  ,,,both,,,704.52,422.71,Aetna,Commerical,,27.93,,,27.93,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Aetna,Middlesex Employees,,25.14,,,25.14,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Anthem,Commerical,,33.28,,,33.28,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Anthem,Indemnity,,,512.42,,512.42,21.37,564.5,percent of total billed charges,,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Anthem,State Preferred,,21.37,,,21.37,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Anthem,Individual Exchange,,26.62,,,26.62,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Cigna,Cigna,,40.34,,,40.34,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Connecticare,Commerical,,26.96,,,26.96,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Connecticare,Exchange,,26.96,,,26.96,21.37,564.5,other,Could be inpatient or outpatient,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,Multiplan,Multiplan,,,564.5,,564.5,21.37,564.5,percent of total billed charges,,
HC PTN BD HOMOCYSTEI,82542,CPT,,,both,,,704.52,422.71,United Healthcare/Oxford,United Healthcare/Oxford,,31.59,,,31.59,21.37,564.5,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,7.55,,,7.55,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,6.8,,,6.8,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,12,,,12,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,6.8,20.9,percent of total billed charges,,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,7.72,,,7.72,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,9.59,,,9.59,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,14.23,,,14.23,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,7.29,,,7.29,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,7.29,,,7.29,6.8,20.9,other,Could be inpatient or outpatient,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,6.8,20.9,percent of total billed charges,,
HC CPK TOTAL,82550,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,9.49,,,9.49,6.8,20.9,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.39,,,13.39,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.05,,,12.05,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.28,,,21.28,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.05,36.97,percent of total billed charges,,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.67,,,13.67,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.03,,,17.03,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.92,,,12.92,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.92,,,12.92,12.05,36.97,other,Could be inpatient or outpatient,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.05,36.97,percent of total billed charges,,
HC CK-MB,82553,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.83,,,16.83,12.05,36.97,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT  ,,,both,,,20.63,12.38,Aetna,Commerical,,5.94,,,5.94,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Aetna,Middlesex Employees,,5.35,,,5.35,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Anthem,Commerical,,9.44,,,9.44,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Anthem,Indemnity,,,15.01,,15.01,5.35,16.53,percent of total billed charges,,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Anthem,State Preferred,,6.07,,,6.07,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Anthem,Individual Exchange,,7.56,,,7.56,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Cigna,Cigna,,11.28,,,11.28,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Connecticare,Commerical,,5.73,,,5.73,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Connecticare,Exchange,,5.73,,,5.73,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,Multiplan,Multiplan,,,16.53,,16.53,5.35,16.53,percent of total billed charges,,
HC CREATININE BLOOD,82565,CPT,,,both,,,20.63,12.38,United Healthcare/Oxford,United Healthcare/Oxford,,7.47,,,7.47,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT  ,,,both,,,20.63,12.38,Aetna,Commerical,,5.94,,,5.94,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Aetna,Middlesex Employees,,5.35,,,5.35,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Anthem,Commerical,,9.44,,,9.44,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Anthem,Indemnity,,,15.01,,15.01,5.35,16.53,percent of total billed charges,,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Anthem,State Preferred,,6.07,,,6.07,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Anthem,Individual Exchange,,7.56,,,7.56,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Cigna,Cigna,,11.28,,,11.28,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Connecticare,Commerical,,5.73,,,5.73,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Connecticare,Exchange,,5.73,,,5.73,5.35,16.53,other,Could be inpatient or outpatient,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,Multiplan,Multiplan,,,16.53,,16.53,5.35,16.53,percent of total billed charges,,
HC I-STAT CREATN BLD,82565,CPT,,,both,,,20.63,12.38,United Healthcare/Oxford,United Healthcare/Oxford,,7.47,,,7.47,5.35,16.53,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC SPECIAL TEST CREATININE URINE,82570,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,20.95,,,20.95,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,18.86,,,18.86,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,24.87,,,24.87,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,11.19,30.54,percent of total billed charges,,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.19,,,11.19,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,19.89,,,19.89,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,28.6,,,28.6,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,26.62,,,26.62,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,26.62,,,26.62,11.19,30.54,other,Could be inpatient or outpatient,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,11.19,30.54,percent of total billed charges,,
HC CREAT CLEARANCE,82575,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,23.23,,,23.23,11.19,30.54,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT  ,,,both,,,257.5,154.5,Aetna,Commerical,,141.63,,,141.63,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Aetna,Middlesex Employees,,127.47,,,127.47,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Anthem,Commerical,,168.17,,,168.17,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Anthem,Indemnity,,,187.45,,187.45,7.66,206.51,percent of total billed charges,,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Anthem,State Preferred,,7.66,,,7.66,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Anthem,Individual Exchange,,134.53,,,134.53,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Cigna,Cigna,,193.34,,,193.34,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Connecticare,Commerical,,179.99,,,179.99,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Connecticare,Exchange,,179.99,,,179.99,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,Multiplan,Multiplan,,,206.51,,206.51,7.66,206.51,percent of total billed charges,,
HC CRYOCRIT/CRYOGLOB,82595,CPT,,,both,,,257.5,154.5,United Healthcare/Oxford,United Healthcare/Oxford,,157.01,,,157.01,7.66,206.51,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,33.39,,,33.39,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,30.05,,,30.05,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.65,,,39.65,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,7.66,48.7,percent of total billed charges,,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,7.66,,,7.66,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.72,,,31.72,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,45.59,,,45.59,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,42.44,,,42.44,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,42.44,,,42.44,7.66,48.7,other,Could be inpatient or outpatient,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,7.66,48.7,percent of total billed charges,,
HC CRYOGLOBULIN,82595,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,37.03,,,37.03,7.66,48.7,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,22.97,101.9,percent of total billed charges,,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,22.97,,,22.97,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,22.97,101.9,other,Could be inpatient or outpatient,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,22.97,101.9,percent of total billed charges,,
HC CYANIDE,82600,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,22.97,101.9,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,17.49,,,17.49,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,15.74,,,15.74,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,27.78,,,27.78,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,15.74,48.7,percent of total billed charges,,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,17.85,,,17.85,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,22.22,,,22.22,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,33.23,,,33.23,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,16.87,,,16.87,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,16.87,,,16.87,15.74,48.7,other,Could be inpatient or outpatient,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,15.74,48.7,percent of total billed charges,,
HC B12 LEVEL,82607,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,21.96,,,21.96,15.74,48.7,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT  ,,,both,,,20.36,12.22,Aetna,Commerical,,21.48,,,21.48,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Aetna,Middlesex Employees,,19.33,,,19.33,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Anthem,Commerical,,25.06,,,25.06,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Anthem,Indemnity,,,14.81,,14.81,14.81,49.69,percent of total billed charges,,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Anthem,State Preferred,,28.39,,,28.39,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Anthem,Individual Exchange,,20.05,,,20.05,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Cigna,Cigna,,49.69,,,49.69,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Connecticare,Commerical,,20.72,,,20.72,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Connecticare,Exchange,,20.72,,,20.72,14.81,49.69,other,Could be inpatient or outpatient,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,Multiplan,Multiplan,,,16.31,,16.31,14.81,49.69,percent of total billed charges,,
HC CYSTATIN C,82610,CPT,,,both,,,20.36,12.22,United Healthcare/Oxford,United Healthcare/Oxford,,24.28,,,24.28,14.81,49.69,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT  ,,,both,,,182.31,109.39,Aetna,Commerical,,100.19,,,100.19,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Aetna,Middlesex Employees,,90.17,,,90.17,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Anthem,Commerical,,118.96,,,118.96,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Anthem,Indemnity,,,132.61,,132.61,29.92,146.09,percent of total billed charges,,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Anthem,State Preferred,,29.92,,,29.92,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Anthem,Individual Exchange,,95.17,,,95.17,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Cigna,Cigna,,136.77,,,136.77,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Connecticare,Commerical,,127.33,,,127.33,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Connecticare,Exchange,,127.33,,,127.33,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,Multiplan,Multiplan,,,146.09,,146.09,29.92,146.09,percent of total billed charges,,
HC DHEA,82626,CPT,,,both,,,182.31,109.39,United Healthcare/Oxford,United Healthcare/Oxford,,111.08,,,111.08,29.92,146.09,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT  ,,,both,,,87.55,52.53,Aetna,Commerical,,25.77,,,25.77,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Aetna,Middlesex Employees,,23.19,,,23.19,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Anthem,Commerical,,40.98,,,40.98,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Anthem,Indemnity,,,64.67,,64.67,23.19,71.24,percent of total billed charges,,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Anthem,State Preferred,,26.32,,,26.32,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Anthem,Individual Exchange,,32.78,,,32.78,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Cigna,Cigna,,49.24,,,49.24,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Connecticare,Commerical,,24.87,,,24.87,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Connecticare,Exchange,,24.87,,,24.87,23.19,71.24,other,Could be inpatient or outpatient,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,Multiplan,Multiplan,,,71.24,,71.24,23.19,71.24,percent of total billed charges,,
HC DHEA SULFATE,82627,CPT,,,both,,,87.55,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,32.4,,,32.4,23.19,71.24,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT  ,,,both,,,196.73,118.04,Aetna,Commerical,,108.24,,,108.24,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Aetna,Middlesex Employees,,97.42,,,97.42,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Anthem,Commerical,,128.52,,,128.52,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Anthem,Indemnity,,,143.25,,143.25,36.67,157.81,percent of total billed charges,,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Anthem,State Preferred,,36.67,,,36.67,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Anthem,Individual Exchange,,102.82,,,102.82,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Cigna,Cigna,,147.74,,,147.74,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Connecticare,Commerical,,137.55,,,137.55,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Connecticare,Exchange,,137.55,,,137.55,36.67,157.81,other,Could be inpatient or outpatient,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,Multiplan,Multiplan,,,157.81,,157.81,36.67,157.81,percent of total billed charges,,
HC DEOXYCORTICOSTERO,82633,CPT,,,both,,,196.73,118.04,United Healthcare/Oxford,United Healthcare/Oxford,,120,,,120,36.67,157.81,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT  ,,,both,,,299.73,179.84,Aetna,Commerical,,165.14,,,165.14,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Aetna,Middlesex Employees,,148.63,,,148.63,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Anthem,Commerical,,196.07,,,196.07,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Anthem,Indemnity,,,218.56,,218.56,34.66,240.77,percent of total billed charges,,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Anthem,State Preferred,,34.66,,,34.66,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Anthem,Individual Exchange,,156.85,,,156.85,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Cigna,Cigna,,225.42,,,225.42,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Connecticare,Commerical,,209.86,,,209.86,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Connecticare,Exchange,,209.86,,,209.86,34.66,240.77,other,Could be inpatient or outpatient,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,Multiplan,Multiplan,,,240.77,,240.77,34.66,240.77,percent of total billed charges,,
HC 11-DEOXYCORTISOL,82634,CPT,,,both,,,299.73,179.84,United Healthcare/Oxford,United Healthcare/Oxford,,183.07,,,183.07,34.66,240.77,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,144.73,,,144.73,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,130.25,,,130.25,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,171.84,,,171.84,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,30.56,211.01,percent of total billed charges,,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,30.56,,,30.56,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,137.47,,,137.47,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,197.56,,,197.56,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,183.92,,,183.92,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,183.92,,,183.92,30.56,211.01,other,Could be inpatient or outpatient,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,30.56,211.01,percent of total billed charges,,
HC DIHYDROTESTOSTERO,82651,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,160.44,,,160.44,30.56,211.01,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT  ,,,both,,,154.19,92.51,Aetna,Commerical,,44.64,,,44.64,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Aetna,Middlesex Employees,,40.17,,,40.17,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Anthem,Commerical,,70.95,,,70.95,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Anthem,Indemnity,,,112.14,,112.14,40.17,123.54,percent of total billed charges,,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Anthem,State Preferred,,45.58,,,45.58,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Anthem,Individual Exchange,,56.76,,,56.76,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Cigna,Cigna,,85.46,,,85.46,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Connecticare,Commerical,,43.08,,,43.08,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Connecticare,Exchange,,43.08,,,43.08,40.17,123.54,other,Could be inpatient or outpatient,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,Multiplan,Multiplan,,,123.54,,123.54,40.17,123.54,percent of total billed charges,,
HC VITAMIN D 1 25 DH,82652,CPT,,,both,,,154.19,92.51,United Healthcare/Oxford,United Healthcare/Oxford,,56.1,,,56.1,40.17,123.54,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,54.59,,,54.59,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,49.13,,,49.13,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,45.3,,,45.3,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.41,,59.41,36.25,65.45,percent of total billed charges,,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,45.3,,,45.3,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,36.25,,,36.25,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,48.09,,,48.09,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,49.32,,,49.32,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,49.32,,,49.32,36.25,65.45,other,Could be inpatient or outpatient,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.45,,65.45,36.25,65.45,percent of total billed charges,,
HC ELASTASE EL-1 PANCREATIC FECAL QUANTITATIVE,82653,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.57,,,50.57,36.25,65.45,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,21.41,,,21.41,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC PANCREATIC ELASTASE-1 STOOL,82656,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,25.7,,,25.7,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,23.13,,,23.13,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33.28,,,33.28,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.37,57.72,percent of total billed charges,,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.37,,,21.37,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.62,,,26.62,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,40.34,,,40.34,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,24.81,,,24.81,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,24.81,,,24.81,21.37,57.72,other,Could be inpatient or outpatient,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.37,57.72,percent of total billed charges,,
HC DISACCHARIDASE,82657,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,29.07,,,29.07,21.37,57.72,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,22.25,60.42,percent of total billed charges,,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,22.25,,,22.25,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,22.25,60.42,other,Could be inpatient or outpatient,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,22.25,60.42,percent of total billed charges,,
HC ERYTHROPOIETIN,82668,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,22.25,60.42,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT  ,,,both,,,112.27,67.36,Aetna,Commerical,,32.4,,,32.4,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Aetna,Middlesex Employees,,29.16,,,29.16,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Anthem,Commerical,,51.5,,,51.5,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Anthem,Indemnity,,,81.86,,81.86,29.16,90.18,percent of total billed charges,,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Anthem,State Preferred,,33.08,,,33.08,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Anthem,Individual Exchange,,41.2,,,41.2,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Cigna,Cigna,,62.32,,,62.32,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Connecticare,Commerical,,31.26,,,31.26,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Connecticare,Exchange,,31.26,,,31.26,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,Multiplan,Multiplan,,,90.18,,90.18,29.16,90.18,percent of total billed charges,,
HC ESTRADIOL,82670,CPT,,,both,,,112.27,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,40.71,,,40.71,29.16,90.18,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT  ,,,both,,,316.21,189.73,Aetna,Commerical,,173.8,,,173.8,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Aetna,Middlesex Employees,,156.42,,,156.42,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Anthem,Commerical,,206.36,,,206.36,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Anthem,Indemnity,,,230.01,,230.01,25.68,253.39,percent of total billed charges,,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Anthem,State Preferred,,25.68,,,25.68,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Anthem,Individual Exchange,,165.08,,,165.08,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Cigna,Cigna,,237.23,,,237.23,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Connecticare,Commerical,,220.86,,,220.86,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Connecticare,Exchange,,220.86,,,220.86,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,Multiplan,Multiplan,,,253.39,,253.39,25.68,253.39,percent of total billed charges,,
HC ESTRDIOL/ESTRONE,82672,CPT,,,both,,,316.21,189.73,United Healthcare/Oxford,United Healthcare/Oxford,,192.67,,,192.67,25.68,253.39,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT  ,,,both,,,85.49,51.29,Aetna,Commerical,,47.62,,,47.62,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Aetna,Middlesex Employees,,42.86,,,42.86,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Anthem,Commerical,,56.54,,,56.54,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Anthem,Indemnity,,,63.03,,63.03,25.68,69.44,percent of total billed charges,,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Anthem,State Preferred,,25.68,,,25.68,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Anthem,Individual Exchange,,45.23,,,45.23,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Cigna,Cigna,,65.01,,,65.01,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Connecticare,Commerical,,60.52,,,60.52,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Connecticare,Exchange,,60.52,,,60.52,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,Multiplan,Multiplan,,,69.44,,69.44,25.68,69.44,percent of total billed charges,,
HC ESTROGEN TOT-E1E2,82672,CPT,,,both,,,85.49,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,52.8,,,52.8,25.68,69.44,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT  ,,,both,,,325.48,195.29,Aetna,Commerical,,178.74,,,178.74,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Aetna,Middlesex Employees,,160.87,,,160.87,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Anthem,Commerical,,212.23,,,212.23,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Anthem,Indemnity,,,236.56,,235.56,29.56,260.61,percent of total billed charges,,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Anthem,State Preferred,,29.56,,,29.56,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Anthem,Individual Exchange,,169.78,,,169.78,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Cigna,Cigna,,243.99,,,243.99,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Connecticare,Commerical,,227.14,,,227.14,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Connecticare,Exchange,,227.14,,,227.14,29.56,260.61,other,Could be inpatient or outpatient,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,Multiplan,Multiplan,,,260.61,,260.61,29.56,260.61,percent of total billed charges,,
HC ESTRONE,82679,CPT,,,both,,,325.48,195.29,United Healthcare/Oxford,United Healthcare/Oxford,,198.16,,,198.16,29.56,260.61,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT  ,,,both,,,19.71,11.83,Aetna,Commerical,,10.83,,,10.83,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Aetna,Middlesex Employees,,9.74,,,9.74,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Anthem,Commerical,,12.85,,,12.85,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Anthem,Indemnity,,,14.34,,14.34,6.02,15.79,percent of total billed charges,,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Anthem,State Preferred,,6.02,,,6.02,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Anthem,Individual Exchange,,10.29,,,10.29,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Cigna,Cigna,,14.78,,,14.78,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Connecticare,Commerical,,13.76,,,13.76,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Connecticare,Exchange,,13.76,,,13.76,6.02,15.79,other,Could be inpatient or outpatient,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,Multiplan,Multiplan,,,15.79,,15.79,6.02,15.79,percent of total billed charges,,
HC FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,,both,,,19.71,11.83,United Healthcare/Oxford,United Healthcare/Oxford,,12.01,,,12.01,6.02,15.79,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,19.88,68.54,percent of total billed charges,,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,19.88,,,19.88,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,19.88,68.54,other,Could be inpatient or outpatient,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,19.88,68.54,percent of total billed charges,,
HC FECAL FATS:TL LIP,82710,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,19.88,68.54,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,34.01,,,34.01,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,30.61,,,30.61,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,40.39,,,40.39,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,15.76,49.6,percent of total billed charges,,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,15.76,,,15.76,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,32.31,,,32.31,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,46.44,,,46.44,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,43.22,,,43.22,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,43.22,,,43.22,15.76,49.6,other,Could be inpatient or outpatient,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,15.76,49.6,percent of total billed charges,,
HC FREE FATTY ACIDS,82725,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,15.76,49.6,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT  ,,,both,,,187.96,112.78,Aetna,Commerical,,22.9,,,22.9,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Aetna,Middlesex Employees,,20.6,,,20.6,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Anthem,Commerical,,33.28,,,33.28,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Anthem,Indemnity,,,136.7,,136.7,20.6,150.59,percent of total billed charges,,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Anthem,State Preferred,,21.37,,,21.37,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Anthem,Individual Exchange,,26.62,,,26.62,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Cigna,Cigna,,40.34,,,40.34,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Connecticare,Commerical,,22.1,,,22.1,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Connecticare,Exchange,,22.1,,,22.1,20.6,150.59,other,Could be inpatient or outpatient,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,Multiplan,Multiplan,,,150.59,,150.59,20.6,150.59,percent of total billed charges,,
HC FA PEROXISOMAL,82726,CPT,,,both,,,187.96,112.78,United Healthcare/Oxford,United Healthcare/Oxford,,26.31,,,26.31,20.6,150.59,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,22.9,,,22.9,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,20.6,,,20.6,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33.28,,,33.28,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,20.6,57.72,percent of total billed charges,,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.37,,,21.37,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.62,,,26.62,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,40.34,,,40.34,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,22.1,,,22.1,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,22.1,,,22.1,20.6,57.72,other,Could be inpatient or outpatient,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,20.6,57.72,percent of total billed charges,,
HC V LG CHAIN FAT AC,82726,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.31,,,26.31,20.6,57.72,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.8,,,15.8,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.22,,,14.22,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,25.11,,,25.11,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,14.22,44.58,percent of total billed charges,,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.13,,,16.13,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,20.09,,,20.09,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.25,,,15.25,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.25,,,15.25,14.22,44.58,other,Could be inpatient or outpatient,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,14.22,44.58,percent of total billed charges,,
HC FERRITIN,82728,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,19.87,,,19.87,14.22,44.58,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,17.04,,,17.04,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.34,,,15.34,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,27.1,,,27.1,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.34,47.8,percent of total billed charges,,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.41,,,17.41,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,21.67,,,21.67,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.64,,,32.64,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.45,,,16.45,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.45,,,16.45,15.34,47.8,other,Could be inpatient or outpatient,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.34,47.8,percent of total billed charges,,
HC FOLATE LEVEL,82746,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.42,,,21.42,15.34,47.8,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT  ,,,both,,,121.54,72.92,Aetna,Commerical,,67.42,,,67.42,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Aetna,Middlesex Employees,,60.68,,,60.68,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Anthem,Commerical,,80.05,,,80.05,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Anthem,Indemnity,,,89.22,,89.22,20.5,98.29,percent of total billed charges,,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Anthem,State Preferred,,20.5,,,20.5,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Anthem,Individual Exchange,,64.04,,,64.04,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Cigna,Cigna,,92.02,,,92.02,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Connecticare,Commerical,,85.67,,,85.67,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Connecticare,Exchange,,85.67,,,85.67,20.5,98.29,other,Could be inpatient or outpatient,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,Multiplan,Multiplan,,,98.29,,98.29,20.5,98.29,percent of total billed charges,,
HC RBC FOLATE,82747,CPT,,,both,,,121.54,72.92,United Healthcare/Oxford,United Healthcare/Oxford,,74.74,,,74.74,20.5,98.29,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,24.93,68.54,percent of total billed charges,,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,24.93,,,24.93,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,24.93,68.54,other,Could be inpatient or outpatient,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,24.93,68.54,percent of total billed charges,,
HC G-1-P URIDYLTRF,82775,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,24.93,68.54,other,Could be inpatient or outpatient,
HC IGD,82784,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,10.78,,,10.78,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,9.7,,,9.7,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,17.14,,,17.14,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,9.7,29.73,percent of total billed charges,,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,11,,,11,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,13.71,,,13.71,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,20.78,,,20.78,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,10.4,,,10.4,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,10.4,,,10.4,9.7,29.73,other,Could be inpatient or outpatient,
HC IGD,82784,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,9.7,29.73,percent of total billed charges,,
HC IGD,82784,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,13.57,,,13.57,9.7,29.73,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,10.78,,,10.78,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,9.7,,,9.7,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,17.14,,,17.14,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,9.7,32.94,percent of total billed charges,,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,11,,,11,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,13.71,,,13.71,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,20.78,,,20.78,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,10.4,,,10.4,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,10.4,,,10.4,9.7,32.94,other,Could be inpatient or outpatient,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,9.7,32.94,percent of total billed charges,,
HC IGG SERUM,82784,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,13.57,,,13.57,9.7,32.94,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,10.78,,,10.78,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,9.7,,,9.7,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,17.14,,,17.14,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,9.7,29.73,percent of total billed charges,,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,11,,,11,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,13.71,,,13.71,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,20.78,,,20.78,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,10.4,,,10.4,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,10.4,,,10.4,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,9.7,29.73,percent of total billed charges,,
HC IMMUNOGLOBULIN,82784,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,13.57,,,13.57,9.7,29.73,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,19.08,,,19.08,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,17.17,,,17.17,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,30.36,,,30.36,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,17.17,53.2,percent of total billed charges,,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,19.5,,,19.5,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,24.28,,,24.28,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,36.78,,,36.78,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,18.42,,,18.42,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,18.42,,,18.42,17.17,53.2,other,Could be inpatient or outpatient,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,17.17,53.2,percent of total billed charges,,
HC IMMUNOGLOBULIN E,82785,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,23.99,,,23.99,17.17,53.2,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT  ,,,both,,,13.57,8.14,Aetna,Commerical,,7.46,,,7.46,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Aetna,Middlesex Employees,,6.72,,,6.72,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Anthem,Commerical,,8.86,,,8.86,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Anthem,Indemnity,,,9.87,,9.87,6.72,10.87,percent of total billed charges,,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Anthem,State Preferred,,9.49,,,9.49,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Anthem,Individual Exchange,,7.09,,,7.09,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Cigna,Cigna,,10.18,,,10.18,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Connecticare,Commerical,,9.47,,,9.47,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Connecticare,Exchange,,9.47,,,9.47,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,Multiplan,Multiplan,,,10.87,,10.87,6.72,10.87,percent of total billed charges,,
HC IGG SBCLAS4(IGG4),82787,CPT,,,both,,,13.57,8.14,United Healthcare/Oxford,United Healthcare/Oxford,,8.27,,,8.27,6.72,10.87,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT  ,,,both,,,287.37,172.42,Aetna,Commerical,,157.71,,,157.71,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Aetna,Middlesex Employees,,141.94,,,141.94,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Anthem,Commerical,,187.26,,,187.26,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Anthem,Indemnity,,,208.73,,208.73,9.49,229.95,percent of total billed charges,,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Anthem,State Preferred,,9.49,,,9.49,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Anthem,Individual Exchange,,149.81,,,149.81,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Cigna,Cigna,,215.28,,,215.28,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Connecticare,Commerical,,200.42,,,200.42,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Connecticare,Exchange,,200.42,,,200.42,9.49,229.95,other,Could be inpatient or outpatient,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,Multiplan,Multiplan,,,229.95,,229.95,9.49,229.95,percent of total billed charges,,
HC IGG SUBCLASSES,82787,CPT,,,both,,,287.37,172.42,United Healthcare/Oxford,United Healthcare/Oxford,,174.84,,,174.84,9.49,229.95,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,28.66,,,28.66,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,25.8,,,25.8,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,34.04,,,34.04,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,10.02,41.79,percent of total billed charges,,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,10.02,,,10.02,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,27.23,,,27.23,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,39.14,,,39.14,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,36.43,,,36.43,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,36.43,,,36.43,10.02,41.79,other,Could be inpatient or outpatient,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.79,10.02,41.79,percent of total billed charges,,
HC PH BLOOD,82800,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,10.02,41.79,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,30.23,,,30.23,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,27.2,,,27.2,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,35.67,,,35.67,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,22.91,68.54,percent of total billed charges,,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,22.91,,,22.91,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,28.53,,,28.53,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,42.73,,,42.73,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,29.17,,,29.17,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,29.17,,,29.17,22.91,68.54,other,Could be inpatient or outpatient,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,22.91,68.54,percent of total billed charges,,
HC I-STAT BLOOD GAS,82803,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,34.18,,,34.18,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,30.23,,,30.23,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,27.2,,,27.2,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,35.67,,,35.67,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,22.91,68.54,percent of total billed charges,,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,22.91,,,22.91,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,28.53,,,28.53,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,42.73,,,42.73,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,29.17,,,29.17,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,29.17,,,29.17,22.91,68.54,other,Could be inpatient or outpatient,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,22.91,68.54,percent of total billed charges,,
HC PH/CO2/O2,82803,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,34.18,,,34.18,22.91,68.54,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,53.89,,,53.89,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,48.5,,,48.5,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,44.72,,,44.72,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.64,,58.64,10.34,64.6,percent of total billed charges,,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,10.34,,,10.34,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,35.78,,,35.78,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,47.47,,,47.47,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,48.68,,,48.68,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,48.68,,,48.68,10.34,64.6,other,Could be inpatient or outpatient,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.6,,64.6,10.34,64.6,percent of total billed charges,,
HC BLOOD GASES 02 SATURATION,82810,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,49.91,,,49.91,10.34,64.6,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,20.44,,,20.44,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,18.4,,,18.4,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,32.5,,,32.5,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,18.4,56.81,percent of total billed charges,,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,20.88,,,20.88,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,26,,,26,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,39.19,,,39.19,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,19.72,,,19.72,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,19.72,,,19.72,18.4,56.81,other,Could be inpatient or outpatient,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,18.4,56.81,percent of total billed charges,,
HC GASTRIN,82941,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,25.69,,,25.69,18.4,56.81,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,16.92,73.94,percent of total billed charges,,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,16.92,,,16.92,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,16.92,73.94,other,Could be inpatient or outpatient,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,16.92,73.94,percent of total billed charges,,
HC GLUCAGON,82943,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,16.92,73.94,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT  ,,,both,,,15.8,9.48,Aetna,Commerical,,4.56,,,4.56,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Aetna,Middlesex Employees,,4.1,,,4.1,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Anthem,Commerical,,7.22,,,7.22,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Anthem,Indemnity,,,11.5,,11.5,4.1,12.67,percent of total billed charges,,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Anthem,State Preferred,,4.65,,,4.65,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Anthem,Individual Exchange,,5.78,,,5.78,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Cigna,Cigna,,8.91,,,8.91,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Connecticare,Commerical,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Connecticare,Exchange,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,Multiplan,Multiplan,,,12.67,,12.67,4.1,12.67,percent of total billed charges,,
HC CSF/BODY FL GLUC,82945,CPT,,,both,,,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT  ,,,both,,,15.81,9.49,Aetna,Commerical,,4.56,,,4.56,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Aetna,Middlesex Employees,,4.1,,,4.1,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Anthem,Commerical,,7.22,,,7.22,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Anthem,Indemnity,,,11.5,,11.5,4.1,12.67,percent of total billed charges,,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Anthem,State Preferred,,4.65,,,4.65,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Anthem,Individual Exchange,,5.78,,,5.78,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Cigna,Cigna,,8.91,,,8.91,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Connecticare,Commerical,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Connecticare,Exchange,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,Multiplan,Multiplan,,,12.67,,12.67,4.1,12.67,percent of total billed charges,,
HC GLUCOSE URINE,82945,CPT,,,both,,,15.81,9.49,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT  ,,,both,,,15.81,9.49,Aetna,Commerical,,4.56,,,4.56,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Aetna,Middlesex Employees,,4.1,,,4.1,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Anthem,Commerical,,7.22,,,7.22,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Anthem,Indemnity,,,11.5,,11.5,4.1,12.67,percent of total billed charges,,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Anthem,State Preferred,,4.65,,,4.65,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Anthem,Individual Exchange,,5.78,,,5.78,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Cigna,Cigna,,8.91,,,8.91,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Connecticare,Commerical,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Connecticare,Exchange,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,Multiplan,Multiplan,,,12.67,,12.67,4.1,12.67,percent of total billed charges,,
HC GLUCOSE BLOOD,82947,CPT,,,both,,,15.81,9.49,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT  ,,,both,,,15.8,9.48,Aetna,Commerical,,4.56,,,4.56,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Aetna,Middlesex Employees,,4.1,,,4.1,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Anthem,Commerical,,7.22,,,7.22,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Anthem,Indemnity,,,11.5,,11.5,4.1,12.67,percent of total billed charges,,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Anthem,State Preferred,,4.65,,,4.65,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Anthem,Individual Exchange,,5.78,,,5.78,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Cigna,Cigna,,8.91,,,8.91,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Connecticare,Commerical,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Connecticare,Exchange,,4.4,,,4.4,4.1,12.67,other,Could be inpatient or outpatient,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,Multiplan,Multiplan,,,12.67,,12.67,4.1,12.67,percent of total billed charges,,
HC I-STAT GLUCOSE,82947,CPT,,,both,,,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.1,12.67,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT  ,,,both,,,19.38,11.63,Aetna,Commerical,,4.56,,,4.56,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Aetna,Middlesex Employees,,4.1,,,4.1,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Anthem,Commerical,,7.22,,,7.22,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Anthem,Indemnity,,,14.1,,14.1,4.1,15.53,percent of total billed charges,,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Anthem,State Preferred,,4.65,,,4.65,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Anthem,Individual Exchange,,5.78,,,5.78,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Cigna,Cigna,,8.91,,,8.91,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Connecticare,Commerical,,4.4,,,4.4,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Connecticare,Exchange,,4.4,,,4.4,4.1,15.53,other,Could be inpatient or outpatient,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,Multiplan,Multiplan,,,15.53,,15.53,4.1,15.53,percent of total billed charges,,
HC POCT YSI GLUCOSE BLOOD,82947,CPT,,,both,,,19.38,11.63,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.1,15.53,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,11.25,,,11.25,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,10.12,,,10.12,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,17.87,,,17.87,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,10.12,31.34,percent of total billed charges,,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,11.48,,,11.48,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,14.3,,,14.3,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,21.35,,,21.35,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,10.86,,,10.86,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,10.86,,,10.86,10.12,31.34,other,Could be inpatient or outpatient,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,10.12,31.34,percent of total billed charges,,
HC G6PD-QUANTITATIVE,82955,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,14.12,,,14.12,10.12,31.34,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT  ,,,both,,,44.14,26.48,Aetna,Commerical,,24.25,,,24.25,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Aetna,Middlesex Employees,,21.82,,,21.82,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Anthem,Commerical,,28.79,,,28.79,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Anthem,Indemnity,,,32.1,,32.1,7.17,35.36,percent of total billed charges,,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Anthem,State Preferred,,7.17,,,7.17,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Anthem,Individual Exchange,,23.04,,,23.04,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Cigna,Cigna,,33.1,,,33.1,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Connecticare,Commerical,,30.82,,,30.82,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Connecticare,Exchange,,30.82,,,30.82,7.17,35.36,other,Could be inpatient or outpatient,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,Multiplan,Multiplan,,,35.36,,35.36,7.17,35.36,percent of total billed charges,,
HC G-6-PD SCREENING,82960,CPT,,,both,,,44.14,26.48,United Healthcare/Oxford,United Healthcare/Oxford,,26.88,,,26.88,7.17,35.36,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT  ,,,both,,,21.28,12.77,Aetna,Commerical,,3.81,,,3.81,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Aetna,Middlesex Employees,,3.43,,,3.43,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Anthem,Commerical,,4.32,,,4.32,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Anthem,Indemnity,,,15.48,,15.48,2.76,17.05,percent of total billed charges,,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Anthem,State Preferred,,2.76,,,2.76,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Anthem,Individual Exchange,,3.46,,,3.46,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Cigna,Cigna,,5.31,,,5.31,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Connecticare,Commerical,,3.67,,,3.67,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Connecticare,Exchange,,3.67,,,3.67,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,Multiplan,Multiplan,,,17.05,,17.05,2.76,17.05,percent of total billed charges,,
HC GLUCOSE BLD TEST,82962,CPT,,,both,,,21.28,12.77,United Healthcare/Oxford,United Healthcare/Oxford,,4.31,,,4.31,2.76,17.05,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT  ,,,both,,,10.69,6.41,Aetna,Commerical,,3.81,,,3.81,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Aetna,Middlesex Employees,,3.43,,,3.43,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Anthem,Commerical,,4.32,,,4.32,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Anthem,Indemnity,,,7.78,,7.78,2.76,8.57,percent of total billed charges,,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Anthem,State Preferred,,2.76,,,2.76,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Anthem,Individual Exchange,,3.46,,,3.46,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Cigna,Cigna,,5.31,,,5.31,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Connecticare,Commerical,,3.67,,,3.67,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Connecticare,Exchange,,3.67,,,3.67,2.76,8.57,other,Could be inpatient or outpatient,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,Multiplan,Multiplan,,,8.57,,8.57,2.76,8.57,percent of total billed charges,,
HC GLUCOSE GLUCOMETR,82962,CPT,,,both,,,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,4.31,,,4.31,2.76,8.57,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT  ,,,both,,,20.98,12.59,Aetna,Commerical,,3.81,,,3.81,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Aetna,Middlesex Employees,,3.43,,,3.43,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Anthem,Commerical,,4.32,,,4.32,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Anthem,Indemnity,,,15.26,,15.26,2.76,16.81,percent of total billed charges,,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Anthem,State Preferred,,2.76,,,2.76,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Anthem,Individual Exchange,,3.46,,,3.46,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Cigna,Cigna,,5.31,,,5.31,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Connecticare,Commerical,,3.67,,,3.67,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Connecticare,Exchange,,3.67,,,3.67,2.76,16.81,other,Could be inpatient or outpatient,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,Multiplan,Multiplan,,,16.81,,16.81,2.76,16.81,percent of total billed charges,,
HC POS GLUCOSE SCREN,82962,CPT,,,both,,,20.98,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,4.31,,,4.31,2.76,16.81,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT  ,,,both,,,29.09,17.45,Aetna,Commerical,,8.34,,,8.34,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Aetna,Middlesex Employees,,7.51,,,7.51,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Anthem,Commerical,,12.89,,,12.89,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Anthem,Indemnity,,,21.15,,21.15,7.51,23.3,percent of total billed charges,,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Anthem,State Preferred,,8.28,,,8.28,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Anthem,Individual Exchange,,10.31,,,10.31,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Cigna,Cigna,,16.04,,,16.04,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Connecticare,Commerical,,8.06,,,8.06,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Connecticare,Exchange,,8.06,,,8.06,7.51,23.3,other,Could be inpatient or outpatient,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,Multiplan,Multiplan,,,23.3,,23.3,7.51,23.3,percent of total billed charges,,
HC GAMMA GT,82977,CPT,,,both,,,29.09,17.45,United Healthcare/Oxford,United Healthcare/Oxford,,10.49,,,10.49,7.51,23.3,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,19.43,,,19.43,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,17.49,,,17.49,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,27.78,,,27.78,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,17.49,48.7,percent of total billed charges,,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,17.85,,,17.85,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,22.22,,,22.22,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,33.23,,,33.23,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,18.75,,,18.75,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,18.75,,,18.75,17.49,48.7,other,Could be inpatient or outpatient,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,17.49,48.7,percent of total billed charges,,
HC FRUCTOSAMINE,82985,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,21.97,,,21.97,17.49,48.7,other,Could be inpatient or outpatient,
HC FSH,83001,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,21.54,,,21.54,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,19.39,,,19.39,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,34.25,,,34.25,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,19.39,60.42,percent of total billed charges,,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,22,,,22,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,27.4,,,27.4,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,41.53,,,41.53,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,20.79,,,20.79,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,20.79,,,20.79,19.39,60.42,other,Could be inpatient or outpatient,
HC FSH,83001,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,19.39,60.42,percent of total billed charges,,
HC FSH,83001,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,27.08,,,27.08,19.39,60.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,21.54,,,21.54,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,19.39,,,19.39,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,34.25,,,34.25,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,19.39,91.98,percent of total billed charges,,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,22,,,22,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,27.4,,,27.4,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,41.53,,,41.53,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,20.79,,,20.79,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,20.79,,,20.79,19.39,91.98,other,Could be inpatient or outpatient,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,19.39,91.98,percent of total billed charges,,
HC SPECIALITY TEST FSH,83001,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,27.08,,,27.08,19.39,91.98,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,21.48,,,21.48,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT  ,,,both,,,74.28,44.57,Aetna,Commerical,,21.48,,,21.48,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,19.33,,,19.33,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Aetna,Middlesex Employees,,19.33,,,19.33,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,34.13,,,34.13,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Anthem,Commerical,,34.13,,,34.13,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,19.33,104.6,percent of total billed charges,,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Anthem,Indemnity,,,54.03,,54.03,19.33,59.52,percent of total billed charges,,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,21.93,,,21.93,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Anthem,State Preferred,,21.93,,,21.93,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,27.3,,,27.3,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Anthem,Individual Exchange,,27.3,,,27.3,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,40.96,,,40.96,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Cigna,Cigna,,40.96,,,40.96,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,20.72,,,20.72,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Connecticare,Commerical,,20.72,,,20.72,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,20.72,,,20.72,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Connecticare,Exchange,,20.72,,,20.72,19.33,59.52,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,19.33,104.6,percent of total billed charges,,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,Multiplan,Multiplan,,,59.52,,59.52,19.33,59.52,percent of total billed charges,,
HC GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,26.97,,,26.97,19.33,104.6,other,Could be inpatient or outpatient,
HC GONADOTROPIN LUTEINIZING HORMONE-2,83002,CPT,,,both,,,74.28,44.57,United Healthcare/Oxford,United Healthcare/Oxford,,26.97,,,26.97,19.33,59.52,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT  ,,,both,,,67.98,40.79,Aetna,Commerical,,19.33,,,19.33,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Aetna,Middlesex Employees,,17.4,,,17.4,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Anthem,Commerical,,30.74,,,30.74,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Anthem,Indemnity,,,49.11,,49.11,17.4,54.1,percent of total billed charges,,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Anthem,State Preferred,,19.74,,,19.74,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Anthem,Individual Exchange,,24.59,,,24.59,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Cigna,Cigna,,36.78,,,36.78,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Connecticare,Commerical,,18.65,,,18.65,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Connecticare,Exchange,,18.65,,,18.65,17.4,54.1,other,Could be inpatient or outpatient,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,Multiplan,Multiplan,,,54.1,,54.1,17.4,54.1,percent of total billed charges,,
HC GROWTH HORMONE,83003,CPT,,,both,,,67.98,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,24.28,,,24.28,17.4,54.1,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT  ,,,both,,,49.85,29.91,Aetna,Commerical,,14.59,,,14.59,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Aetna,Middlesex Employees,,13.12,,,13.12,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Anthem,Commerical,,23.18,,,23.18,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Anthem,Indemnity,,,36.26,,36.26,13.12,39.94,percent of total billed charges,,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Anthem,State Preferred,,14.9,,,14.9,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Anthem,Individual Exchange,,18.55,,,18.55,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Cigna,Cigna,,27.89,,,27.89,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Connecticare,Commerical,,14.08,,,14.08,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Connecticare,Exchange,,14.08,,,14.08,13.12,39.94,other,Could be inpatient or outpatient,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,Multiplan,Multiplan,,,39.94,,39.94,13.12,39.94,percent of total billed charges,,
HC HAPTOGLOBIN QUANT,83010,CPT,,,both,,,49.85,29.91,United Healthcare/Oxford,United Healthcare/Oxford,,18.31,,,18.31,13.12,39.94,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT  ,,,both,,,213.85,128.31,Aetna,Commerical,,117.52,,,117.52,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Aetna,Middlesex Employees,,105.76,,,105.76,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Anthem,Commerical,,139.53,,,139.53,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Anthem,Indemnity,,,155.53,,155.53,22.29,171.33,percent of total billed charges,,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Anthem,State Preferred,,22.29,,,22.29,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Anthem,Individual Exchange,,111.62,,,111.62,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Cigna,Cigna,,160.41,,,160.41,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Connecticare,Commerical,,149.33,,,149.33,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Connecticare,Exchange,,149.33,,,149.33,22.29,171.33,other,Could be inpatient or outpatient,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,Multiplan,Multiplan,,,171.33,,171.33,22.29,171.33,percent of total billed charges,,
HC HEVY MTL UR RNDOM,83015,CPT,,,both,,,213.85,128.31,United Healthcare/Oxford,United Healthcare/Oxford,,130.27,,,130.27,22.29,171.33,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,14.92,,,14.92,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,13.43,,,13.43,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,23.72,,,23.72,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,13.43,51.4,percent of total billed charges,,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,15.25,,,15.25,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,18.98,,,18.98,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,28.5,,,28.5,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,14.4,,,14.4,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,14.4,,,14.4,13.43,51.4,other,Could be inpatient or outpatient,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,13.43,51.4,percent of total billed charges,,
HC HGB ELCTROPHORES,83020,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,18.76,,,18.76,13.43,51.4,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,20.94,,,20.94,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,18.85,,,18.85,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,33.28,,,33.28,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,18.85,40.34,percent of total billed charges,,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,21.37,,,21.37,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,26.62,,,26.62,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,40.34,,,40.34,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,20.21,,,20.21,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,20.21,,,20.21,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,18.85,40.34,percent of total billed charges,,
HC HEMOGLOBIN S (QUANTATIVE),83021,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,26.31,,,26.31,18.85,40.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,11.26,,,11.26,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,10.13,,,10.13,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,17.88,,,17.88,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,10.13,62.22,percent of total billed charges,,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,11.49,,,11.49,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,14.3,,,14.3,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,21.35,,,21.35,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,10.87,,,10.87,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,10.87,,,10.87,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,10.13,62.22,percent of total billed charges,,
HC HEMOGLOBIN A1CPOC,83036,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,14.15,,,14.15,10.13,62.22,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,11.26,,,11.26,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,10.13,,,10.13,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,17.88,,,17.88,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,10.13,31.34,percent of total billed charges,,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,11.49,,,11.49,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,14.3,,,14.3,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,21.35,,,21.35,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,10.87,,,10.87,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,10.87,,,10.87,10.13,31.34,other,Could be inpatient or outpatient,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,10.13,31.34,percent of total billed charges,,
HC HEMOGLOBIN AIC,83036,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,14.15,,,14.15,10.13,31.34,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT  ,,,both,,,29.09,17.45,Aetna,Commerical,,15.99,,,15.99,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Aetna,Middlesex Employees,,14.39,,,14.39,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Anthem,Commerical,,18.97,,,18.97,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Anthem,Indemnity,,,21.15,,21.15,6.55,23.3,percent of total billed charges,,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Anthem,State Preferred,,6.55,,,6.55,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Anthem,Individual Exchange,,15.17,,,15.17,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Cigna,Cigna,,21.82,,,21.82,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Connecticare,Commerical,,20.31,,,20.31,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Connecticare,Exchange,,20.31,,,20.31,6.55,23.3,other,Could be inpatient or outpatient,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,Multiplan,Multiplan,,,23.3,,23.3,6.55,23.3,percent of total billed charges,,
HC METHMOGLOBN QUANT,83050,CPT,,,both,,,29.09,17.45,United Healthcare/Oxford,United Healthcare/Oxford,,17.72,,,17.72,6.55,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT  ,,,both,,,29.09,17.45,Aetna,Commerical,,15.99,,,15.99,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Aetna,Middlesex Employees,,14.39,,,14.39,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Anthem,Commerical,,18.97,,,18.97,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Anthem,Indemnity,,,21.15,,21.15,8.65,23.3,percent of total billed charges,,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Anthem,State Preferred,,8.65,,,8.65,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Anthem,Individual Exchange,,15.17,,,15.17,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Cigna,Cigna,,21.82,,,21.82,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Connecticare,Commerical,,20.31,,,20.31,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Connecticare,Exchange,,20.31,,,20.31,8.65,23.3,other,Could be inpatient or outpatient,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,Multiplan,Multiplan,,,23.3,,23.3,8.65,23.3,percent of total billed charges,,
HC PLASMA HEMOGLOBIN,83051,CPT,,,both,,,29.09,17.45,United Healthcare/Oxford,United Healthcare/Oxford,,17.72,,,17.72,8.65,23.3,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT  ,,,both,,,17.39,10.43,Aetna,Commerical,,5.51,,,5.51,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Aetna,Middlesex Employees,,4.96,,,4.96,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Anthem,Commerical,,8.76,,,8.76,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Anthem,Indemnity,,,12.65,,12.65,4.96,13.93,percent of total billed charges,,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Anthem,State Preferred,,5.63,,,5.63,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Anthem,Individual Exchange,,7.01,,,7.01,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Cigna,Cigna,,10.68,,,10.68,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Connecticare,Commerical,,5.32,,,5.32,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Connecticare,Exchange,,5.32,,,5.32,4.96,13.93,other,Could be inpatient or outpatient,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,Multiplan,Multiplan,,,13.93,,13.93,4.96,13.93,percent of total billed charges,,
HC ASSAY OF HEMOSIDERIN QUALITATIVE,83070,CPT,,,both,,,17.39,10.43,United Healthcare/Oxford,United Healthcare/Oxford,,6.9,,,6.9,4.96,13.93,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT  ,,,both,,,170.98,102.59,Aetna,Commerical,,93.39,,,93.39,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Aetna,Middlesex Employees,,84.05,,,84.05,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Anthem,Commerical,,110.89,,,110.89,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Anthem,Indemnity,,,123.61,,123.61,19.98,136.17,percent of total billed charges,,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Anthem,State Preferred,,19.98,,,19.98,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Anthem,Individual Exchange,,88.71,,,88.71,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Cigna,Cigna,,127.48,,,127.48,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Connecticare,Commerical,,118.68,,,118.68,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Connecticare,Exchange,,118.68,,,118.68,19.98,136.17,other,Could be inpatient or outpatient,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,Multiplan,Multiplan,,,136.17,,136.17,19.98,136.17,percent of total billed charges,,
HC B-HEXOSAMINID A,83080,CPT,,,both,,,170.98,102.59,United Healthcare/Oxford,United Healthcare/Oxford,,103.54,,,103.54,19.98,136.17,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT  ,,,both,,,285.31,171.19,Aetna,Commerical,,156.48,,,156.48,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Aetna,Middlesex Employees,,140.83,,,140.83,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Anthem,Commerical,,185.79,,,185.79,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Anthem,Indemnity,,,207.1,,207.1,34.97,228.15,percent of total billed charges,,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Anthem,State Preferred,,34.97,,,34.97,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Anthem,Individual Exchange,,148.64,,,148.64,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Cigna,Cigna,,213.6,,,213.6,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Connecticare,Commerical,,198.85,,,198.85,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Connecticare,Exchange,,198.85,,,198.85,34.97,228.15,other,Could be inpatient or outpatient,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,Multiplan,Multiplan,,,228.15,,228.15,34.97,228.15,percent of total billed charges,,
HC HISTAMINE UR,83088,CPT,,,both,,,285.31,171.19,United Healthcare/Oxford,United Healthcare/Oxford,,173.47,,,173.47,34.97,228.15,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,20.78,,,20.78,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,18.7,,,18.7,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,31.09,,,31.09,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,18.7,55,percent of total billed charges,,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,19.98,,,19.98,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,24.87,,,24.87,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,37.38,,,37.38,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,20.05,,,20.05,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,20.05,,,20.05,18.7,55,other,Could be inpatient or outpatient,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,18.7,55,percent of total billed charges,,
HC HOMOCYSTEINE,83090,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,24.58,,,24.58,18.7,55,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,25.98,,,25.98,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,23.39,,,23.39,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,35.67,,,35.67,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,22.91,62.22,percent of total billed charges,,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,22.91,,,22.91,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.53,,,28.53,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,42.73,,,42.73,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,25.08,,,25.08,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,25.08,,,25.08,22.91,62.22,other,Could be inpatient or outpatient,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,22.91,62.22,percent of total billed charges,,
HC HVA(HOMOVANILLIC),83150,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,29.39,,,29.39,22.91,62.22,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT  ,,,both,,,48.7,29.22,Aetna,Commerical,,26.76,,,26.76,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Aetna,Middlesex Employees,,24.08,,,24.08,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Anthem,Commerical,,31.76,,,31.76,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Anthem,Indemnity,,,35.41,,35.41,12.79,39.01,percent of total billed charges,,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Anthem,State Preferred,,12.79,,,12.79,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Anthem,Individual Exchange,,25.41,,,25.41,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Cigna,Cigna,,36.52,,,36.52,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Connecticare,Commerical,,34,,,34,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Connecticare,Exchange,,34,,,34,12.79,39.01,other,Could be inpatient or outpatient,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,Multiplan,Multiplan,,,39.01,,39.01,12.79,39.01,percent of total billed charges,,
HC ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,83497,CPT,,,both,,,48.7,29.22,United Healthcare/Oxford,United Healthcare/Oxford,,29.66,,,29.66,12.79,39.01,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,31.51,,,31.51,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,28.36,,,28.36,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,50.07,,,50.07,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,28.36,87.47,percent of total billed charges,,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,32.16,,,32.16,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,40.05,,,40.05,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,60.54,,,60.54,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,30.41,,,30.41,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,30.41,,,30.41,28.36,87.47,other,Could be inpatient or outpatient,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,28.36,87.47,percent of total billed charges,,
HC PROGESTERONE 17HY,83498,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,39.59,,,39.59,28.36,87.47,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.27,,,21.27,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.66,,,13.66,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.02,,,17.02,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC GLIADIN ANTIBODY,83516,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.27,,,21.27,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.66,,,13.66,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.02,,,17.02,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC HISTONE ANTIBODY,83516,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT  ,,,both,,,153.07,91.84,Aetna,Commerical,,13.37,,,13.37,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Anthem,Commerical,,21.27,,,21.27,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Anthem,Indemnity,,,111.32,,111.32,12.03,122.64,percent of total billed charges,,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Anthem,State Preferred,,13.66,,,13.66,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Anthem,Individual Exchange,,17.02,,,17.02,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Cigna,Cigna,,25.51,,,25.51,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Connecticare,Commerical,,12.9,,,12.9,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Connecticare,Exchange,,12.9,,,12.9,12.03,122.64,other,Could be inpatient or outpatient,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,Multiplan,Multiplan,,,122.64,,122.64,12.03,122.64,percent of total billed charges,,
HC IMM ASSAY NON INF,83516,CPT,,,both,,,153.07,91.84,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,122.64,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.27,,,21.27,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.66,,,13.66,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.02,,,17.02,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC MYELOPEROXIDASE (MPO) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.27,,,21.27,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.66,,,13.66,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.02,,,17.02,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC PROTEINASE-3 (PR3) ANTIBODY,83516,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.27,,,21.27,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.66,,,13.66,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.02,,,17.02,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC TRANSGLUT TISSUE,83516,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT  ,,,both,,,204.97,122.98,Aetna,Commerical,,21.34,,,21.34,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Anthem,Commerical,,21.7,,,21.7,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Anthem,Indemnity,,,148.98,,148.98,13.95,164.12,percent of total billed charges,,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Anthem,State Preferred,,13.95,,,13.95,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Anthem,Individual Exchange,,17.37,,,17.37,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Cigna,Cigna,,30.25,,,30.25,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Connecticare,Commerical,,20.59,,,20.59,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Connecticare,Exchange,,20.59,,,20.59,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,Multiplan,Multiplan,,,164.12,,164.12,13.95,164.12,percent of total billed charges,,
HC ACETYLCH REC BIND,83519,CPT,,,both,,,204.97,122.98,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,164.12,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC ACETYLCHOL REC AB,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC CYSTRIC FIBROSIS,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC GAD ANTIBODY,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC IGFBP3,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT RIA - IGF BINDING PROTEIN-2,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT RIA -TSH ANTIBODY,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC PTH-RP,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,21.34,,,21.34,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,19.2,,,19.2,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.7,,,21.7,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.95,48.7,percent of total billed charges,,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.95,,,13.95,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.37,,,17.37,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,30.25,,,30.25,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,20.59,,,20.59,13.95,48.7,other,Could be inpatient or outpatient,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.95,48.7,percent of total billed charges,,
HC TBII-THYROTROP BD,83519,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,24.12,,,24.12,13.95,48.7,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC ANTI MULLERAN HRM,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC ANTI-MITOCHONDRIA,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT  ,,,both,,,153.47,92.08,Aetna,Commerical,,20.03,,,20.03,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Anthem,Commerical,,23.87,,,23.87,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Anthem,Indemnity,,,112.14,,112.14,15.33,123.54,percent of total billed charges,,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Anthem,State Preferred,,15.33,,,15.33,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Anthem,Individual Exchange,,19.1,,,19.1,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Cigna,Cigna,,28.5,,,28.5,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Connecticare,Commerical,,19.32,,,19.32,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Connecticare,Exchange,,19.32,,,19.32,15.33,123.54,other,Could be inpatient or outpatient,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,Multiplan,Multiplan,,,123.54,,123.54,15.33,123.54,percent of total billed charges,,
HC CAFFEINE SERUM,83520,CPT,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,123.54,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC GBM ANTIBODY,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT  ,,,both,,,55.64,33.38,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC GILADIN (DEAMIDATED PEPTIDE) AB IGA,83520,CPT,,,both,,,55.64,33.38,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT  ,,,both,,,55.64,33.38,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC IMMUNOASSAY ANALYTE QUANT NOS - MAG-SGPG AB IGM,83520,CPT,,,both,,,55.64,33.38,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC IMMUNOASSY BY RIA,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT  ,,,both,,,155.53,93.32,Aetna,Commerical,,20.03,,,20.03,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Anthem,Commerical,,23.87,,,23.87,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Anthem,Indemnity,,,113.78,,113.78,15.33,125.35,percent of total billed charges,,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Anthem,State Preferred,,15.33,,,15.33,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Anthem,Individual Exchange,,19.1,,,19.1,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Cigna,Cigna,,28.5,,,28.5,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Connecticare,Commerical,,19.32,,,19.32,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Connecticare,Exchange,,19.32,,,19.32,15.33,125.35,other,Could be inpatient or outpatient,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,Multiplan,Multiplan,,,125.35,,125.35,15.33,125.35,percent of total billed charges,,
HC INHIBIN B,83520,CPT,,,both,,,155.53,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,125.35,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC TRYPTASE,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,20.03,,,20.03,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,18.03,,,18.03,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,23.87,,,23.87,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,15.33,44.58,percent of total billed charges,,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,15.33,,,15.33,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,19.1,,,19.1,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,28.5,,,28.5,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,19.32,,,19.32,15.33,44.58,other,Could be inpatient or outpatient,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,15.33,44.58,percent of total billed charges,,
HC VWF COLGEN BD EIA,83520,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.64,,,22.64,15.33,44.58,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.26,,,13.26,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,11.93,,,11.93,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.06,,,21.06,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,11.93,36.97,percent of total billed charges,,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.55,,,13.55,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,16.85,,,16.85,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.79,,,12.79,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.79,,,12.79,11.93,36.97,other,Could be inpatient or outpatient,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,11.93,36.97,percent of total billed charges,,
HC INSULIN,83525,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.66,,,16.66,11.93,36.97,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,41.12,,,41.12,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,37.01,,,37.01,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,34.12,,,34.12,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.75,,44.75,27.3,49.3,percent of total billed charges,,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,34.12,,,34.12,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,27.3,,,27.3,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,36.22,,,36.22,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,37.16,,,37.16,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,37.16,,,37.16,27.3,49.3,other,Could be inpatient or outpatient,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,49.3,,49.3,27.3,49.3,percent of total billed charges,,
HC ASSAY OF INTERLEUKIN-6 (IL-6),83529,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,38.09,,,38.09,27.3,49.3,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT  ,,,both,,,258.87,155.32,Aetna,Commerical,,7.5,,,7.5,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Aetna,Middlesex Employees,,6.75,,,6.75,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Anthem,Commerical,,11.93,,,11.93,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Anthem,Indemnity,,,188.27,,188.27,6.75,207.41,percent of total billed charges,,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Anthem,State Preferred,,7.67,,,7.67,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Anthem,Individual Exchange,,9.54,,,9.54,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Cigna,Cigna,,14.23,,,14.23,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Connecticare,Commerical,,7.24,,,7.24,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Connecticare,Exchange,,7.24,,,7.24,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,Multiplan,Multiplan,,,207.41,,207.41,6.75,207.41,percent of total billed charges,,
HC IRON LIVER BX,83540,CPT,,,both,,,258.87,155.32,United Healthcare/Oxford,United Healthcare/Oxford,,9.43,,,9.43,6.75,207.41,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT  ,,,both,,,67.53,40.52,Aetna,Commerical,,7.5,,,7.5,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Aetna,Middlesex Employees,,6.75,,,6.75,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Anthem,Commerical,,11.93,,,11.93,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Anthem,Indemnity,,,49.11,,49.11,6.75,54.1,percent of total billed charges,,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Anthem,State Preferred,,7.67,,,7.67,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Anthem,Individual Exchange,,9.54,,,9.54,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Cigna,Cigna,,14.23,,,14.23,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Connecticare,Commerical,,7.24,,,7.24,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Connecticare,Exchange,,7.24,,,7.24,6.75,54.1,other,Could be inpatient or outpatient,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,Multiplan,Multiplan,,,54.1,,54.1,6.75,54.1,percent of total billed charges,,
HC IRON URINE,83540,CPT,,,both,,,67.53,40.52,United Healthcare/Oxford,United Healthcare/Oxford,,9.43,,,9.43,6.75,54.1,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,7.5,,,7.5,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,6.75,,,6.75,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,11.93,,,11.93,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,6.75,20.9,percent of total billed charges,,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,7.67,,,7.67,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,9.54,,,9.54,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,14.23,,,14.23,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,6.75,20.9,percent of total billed charges,,
HC SERUM IRON,83540,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,9.43,,,9.43,6.75,20.9,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10.13,,,10.13,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9.11,,,9.11,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,16.11,,,16.11,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,9.11,28.13,percent of total billed charges,,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,10.35,,,10.35,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,12.9,,,12.9,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19.58,,,19.58,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.78,,,9.78,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.78,,,9.78,9.11,28.13,other,Could be inpatient or outpatient,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,9.11,28.13,percent of total billed charges,,
HC TIBC,83550,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.73,,,12.73,9.11,28.13,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,13.42,,,13.42,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,12.08,,,12.08,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,19.69,,,19.69,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,12.08,152.4,percent of total billed charges,,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,12.65,,,12.65,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,15.75,,,15.75,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,23.74,,,23.74,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,12.94,,,12.94,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,12.94,,,12.94,12.08,152.4,other,Could be inpatient or outpatient,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,12.08,152.4,percent of total billed charges,,
HC D-LACTATE,83605,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,15.56,,,15.56,12.08,152.4,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,13.42,,,13.42,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,12.08,,,12.08,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,19.69,,,19.69,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,12.08,34.55,percent of total billed charges,,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,12.65,,,12.65,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,15.75,,,15.75,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,23.74,,,23.74,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,12.94,,,12.94,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,12.94,,,12.94,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,12.08,34.55,percent of total billed charges,,
HC LACTATE (LACTIC ACID),83605,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,15.56,,,15.56,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,13.42,,,13.42,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,12.08,,,12.08,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,19.69,,,19.69,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,12.08,34.55,percent of total billed charges,,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,12.65,,,12.65,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,15.75,,,15.75,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,23.74,,,23.74,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,12.94,,,12.94,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,12.94,,,12.94,12.08,34.55,other,Could be inpatient or outpatient,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,12.08,34.55,percent of total billed charges,,
HC LACTIC ACID,83605,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,15.56,,,15.56,12.08,34.55,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT  ,,,both,,,89.61,53.77,Aetna,Commerical,,13.42,,,13.42,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Aetna,Middlesex Employees,,12.08,,,12.08,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Anthem,Commerical,,19.69,,,19.69,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Anthem,Indemnity,,,65.48,,65.48,12.08,72.14,percent of total billed charges,,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Anthem,State Preferred,,12.65,,,12.65,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Anthem,Individual Exchange,,15.75,,,15.75,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Cigna,Cigna,,23.74,,,23.74,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Connecticare,Commerical,,12.94,,,12.94,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Connecticare,Exchange,,12.94,,,12.94,12.08,72.14,other,Could be inpatient or outpatient,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,Multiplan,Multiplan,,,72.14,,72.14,12.08,72.14,percent of total billed charges,,
HC POCT YSI LACTATE,83605,CPT,,,both,,,89.61,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,15.56,,,15.56,12.08,72.14,other,Could be inpatient or outpatient,
HC LDH,83615,CPT  ,,,both,,,24.3,14.58,Aetna,Commerical,,7,,,7,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Aetna,Middlesex Employees,,6.3,,,6.3,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Anthem,Commerical,,11.13,,,11.13,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Anthem,Indemnity,,,17.66,,17.66,6.3,19.46,percent of total billed charges,,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Anthem,State Preferred,,7.15,,,7.15,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Anthem,Individual Exchange,,8.9,,,8.9,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Cigna,Cigna,,13.64,,,13.64,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Connecticare,Commerical,,6.76,,,6.76,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Connecticare,Exchange,,6.76,,,6.76,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH,83615,CPT,,,both,,,24.3,14.58,Multiplan,Multiplan,,,19.46,,19.46,6.3,19.46,percent of total billed charges,,
HC LDH,83615,CPT,,,both,,,24.3,14.58,United Healthcare/Oxford,United Healthcare/Oxford,,8.8,,,8.8,6.3,19.46,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,15.15,56.81,percent of total billed charges,,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,15.15,,,15.15,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,15.15,56.81,other,Could be inpatient or outpatient,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,15.15,56.81,percent of total billed charges,,
HC LDH ISOENZYMES,83625,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,15.15,56.81,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,42.68,,,42.68,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,38.42,,,38.42,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.67,,,50.67,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,13.66,62.22,percent of total billed charges,,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,13.66,,,13.66,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.54,,,40.54,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,58.25,,,58.25,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,54.24,,,54.24,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,54.24,,,54.24,13.66,62.22,other,Could be inpatient or outpatient,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,13.66,62.22,percent of total billed charges,,
HC LACTOFERRIN FECAL; QUALITATIVE,83630,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,13.66,62.22,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT  ,,,both,,,78.78,47.27,Aetna,Commerical,,43.29,,,43.29,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Aetna,Middlesex Employees,,38.97,,,38.97,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Anthem,Commerical,,51.41,,,51.41,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Anthem,Indemnity,,,57.3,,57.3,23.24,63.12,percent of total billed charges,,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Anthem,State Preferred,,23.24,,,23.24,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Anthem,Individual Exchange,,41.13,,,41.13,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Cigna,Cigna,,59.09,,,59.09,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Connecticare,Commerical,,55.02,,,55.02,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Connecticare,Exchange,,55.02,,,55.02,23.24,63.12,other,Could be inpatient or outpatient,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,Multiplan,Multiplan,,,63.12,,63.12,23.24,63.12,percent of total billed charges,,
HC LCTOFRN STL QUANT,83631,CPT,,,both,,,78.78,47.27,United Healthcare/Oxford,United Healthcare/Oxford,,48,,,48,23.24,63.12,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT  ,,,both,,,48.69,29.21,Aetna,Commerical,,14.04,,,14.04,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT  ,,,both,,,29.08,17.45,Aetna,Commerical,,14.04,,,14.04,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Aetna,Middlesex Employees,,12.64,,,12.64,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Aetna,Middlesex Employees,,12.64,,,12.64,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Anthem,Commerical,,22.31,,,22.31,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Anthem,Commerical,,22.31,,,22.31,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Anthem,Indemnity,,,35.41,,35.41,12.64,39.01,percent of total billed charges,,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Anthem,Indemnity,,,21.15,,21.15,12.64,26.72,percent of total billed charges,,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Anthem,State Preferred,,14.32,,,14.32,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Anthem,State Preferred,,14.32,,,14.32,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Anthem,Individual Exchange,,17.85,,,17.85,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Anthem,Individual Exchange,,17.85,,,17.85,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Cigna,Cigna,,26.72,,,26.72,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Cigna,Cigna,,26.72,,,26.72,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Connecticare,Commerical,,13.55,,,13.55,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Connecticare,Commerical,,13.55,,,13.55,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Connecticare,Exchange,,13.55,,,13.55,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Connecticare,Exchange,,13.55,,,13.55,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,Multiplan,Multiplan,,,39.01,,39.01,12.64,39.01,percent of total billed charges,,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,Multiplan,Multiplan,,,23.3,,23.3,12.64,26.72,percent of total billed charges,,
HC LEAD BLOOD-2,83655,CPT,,,both,,,48.69,29.21,United Healthcare/Oxford,United Healthcare/Oxford,,17.63,,,17.63,12.64,39.01,other,Could be inpatient or outpatient,
HC LEAD BLOOD,83655,CPT,,,both,,,29.08,17.45,United Healthcare/Oxford,United Healthcare/Oxford,,17.63,,,17.63,12.64,26.72,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,14.04,,,14.04,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,12.64,,,12.64,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,22.31,,,22.31,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,12.64,64.02,percent of total billed charges,,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,14.32,,,14.32,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,17.85,,,17.85,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,26.72,,,26.72,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,13.55,,,13.55,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,13.55,,,13.55,12.64,64.02,other,Could be inpatient or outpatient,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,12.64,64.02,percent of total billed charges,,
HC LEAD URINE,83655,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,17.63,,,17.63,12.64,64.02,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,7.99,,,7.99,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,7.19,,,7.19,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,12.7,,,12.7,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,7.19,22.51,percent of total billed charges,,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.16,,,8.16,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,10.16,,,10.16,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,15.43,,,15.43,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,7.71,,,7.71,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,7.71,,,7.71,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,7.19,22.51,percent of total billed charges,,
HC LIPASE,83690,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,10.03,,,10.03,7.19,22.51,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,16.61,,,16.61,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,14.94,,,14.94,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.87,,,23.87,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,14.94,47.32,percent of total billed charges,,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.33,,,15.33,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.1,,,19.1,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,47.32,,,47.32,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,16.03,,,16.03,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,16.03,,,16.03,14.94,47.32,other,Could be inpatient or outpatient,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,14.94,47.32,percent of total billed charges,,
HC LIPOPTN A,83695,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.87,,,18.87,14.94,47.32,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT  ,,,both,,,33.1,19.86,Aetna,Commerical,,9.5,,,9.5,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Aetna,Middlesex Employees,,8.55,,,8.55,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Anthem,Commerical,,15.1,,,15.1,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Anthem,Indemnity,,,24.07,,24.07,8.55,26.52,percent of total billed charges,,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Anthem,State Preferred,,9.7,,,9.7,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Anthem,Individual Exchange,,12.08,,,12.08,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Cigna,Cigna,,18.41,,,18.41,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Connecticare,Commerical,,9.17,,,9.17,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Connecticare,Exchange,,9.17,,,9.17,8.55,26.52,other,Could be inpatient or outpatient,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,Multiplan,Multiplan,,,26.52,,26.52,8.55,26.52,percent of total billed charges,,
HC CHOLESTEROL-HDL,83718,CPT,,,both,,,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,11.94,,,11.94,8.55,26.52,other,Could be inpatient or outpatient,
HC LDL,83721,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,12.17,,,12.17,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,10.95,,,10.95,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.57,,,17.57,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,10.95,30.54,percent of total billed charges,,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.3,,,11.3,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,14.06,,,14.06,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,21.35,,,21.35,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,11.75,,,11.75,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,11.75,,,11.75,10.95,30.54,other,Could be inpatient or outpatient,
HC LDL,83721,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,10.95,30.54,percent of total billed charges,,
HC LDL,83721,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.89,,,13.89,10.95,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT  ,,,both,,,27.09,16.25,Aetna,Commerical,,7.76,,,7.76,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Aetna,Middlesex Employees,,6.99,,,6.99,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Anthem,Commerical,,12.35,,,12.35,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Anthem,Indemnity,,,19.7,,19.7,6.99,21.7,percent of total billed charges,,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Anthem,State Preferred,,7.93,,,7.93,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Anthem,Individual Exchange,,9.87,,,9.87,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Cigna,Cigna,,14.83,,,14.83,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Connecticare,Commerical,,7.49,,,7.49,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Connecticare,Exchange,,7.49,,,7.49,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.99,21.7,percent of total billed charges,,
HC MAGNESIUM BLOOD,83735,CPT,,,both,,,27.09,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.75,,,9.75,6.99,21.7,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,7.76,,,7.76,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,6.99,,,6.99,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,12.35,,,12.35,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,6.99,30.54,percent of total billed charges,,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,7.93,,,7.93,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,9.87,,,9.87,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,14.83,,,14.83,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,7.49,,,7.49,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,7.49,,,7.49,6.99,30.54,other,Could be inpatient or outpatient,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,6.99,30.54,percent of total billed charges,,
HC MAGNESIUM UR/FLD,83735,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,9.75,,,9.75,6.99,30.54,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT  ,,,both,,,182.31,109.39,Aetna,Commerical,,100.19,,,100.19,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Aetna,Middlesex Employees,,90.17,,,90.17,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Anthem,Commerical,,118.96,,,118.96,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Anthem,Indemnity,,,132.61,,132.61,29.11,146.09,percent of total billed charges,,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Anthem,State Preferred,,29.11,,,29.11,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Anthem,Individual Exchange,,95.17,,,95.17,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Cigna,Cigna,,136.77,,,136.77,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Connecticare,Commerical,,127.33,,,127.33,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Connecticare,Exchange,,127.33,,,127.33,29.11,146.09,other,Could be inpatient or outpatient,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,Multiplan,Multiplan,,,146.09,,146.09,29.11,146.09,percent of total billed charges,,
HC MANGANESE,83785,CPT,,,both,,,182.31,109.39,United Healthcare/Oxford,United Healthcare/Oxford,,111.08,,,111.08,29.11,146.09,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,27.95,,,27.95,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,25.16,,,25.16,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC BILE ACID FRAC,83789,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.61,,,31.61,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.95,,,27.95,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.16,,,25.16,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC MYCOPHENOLIC AC,83789,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.61,,,31.61,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,27.95,,,27.95,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,25.16,,,25.16,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,33.28,,,33.28,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,21.37,62.22,percent of total billed charges,,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,21.37,,,21.37,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,26.62,,,26.62,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,40.34,,,40.34,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,26.98,,,26.98,21.37,62.22,other,Could be inpatient or outpatient,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,21.37,62.22,percent of total billed charges,,
HC OXCARBAZEPINE MET,83789,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,31.61,,,31.61,21.37,62.22,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT  ,,,both,,,269.01,161.4,Aetna,Commerical,,27.95,,,27.95,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Aetna,Middlesex Employees,,25.16,,,25.16,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Anthem,Commerical,,33.28,,,33.28,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Anthem,Indemnity,,,195.64,,195.64,21.37,215.53,percent of total billed charges,,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Anthem,State Preferred,,21.37,,,21.37,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Anthem,Individual Exchange,,26.62,,,26.62,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Cigna,Cigna,,40.34,,,40.34,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Connecticare,Commerical,,26.98,,,26.98,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Connecticare,Exchange,,26.98,,,26.98,21.37,215.53,other,Could be inpatient or outpatient,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,Multiplan,Multiplan,,,215.53,,215.53,21.37,215.53,percent of total billed charges,,
HC TPMT RBC,83789,CPT,,,both,,,269.01,161.4,United Healthcare/Oxford,United Healthcare/Oxford,,31.61,,,31.61,21.37,215.53,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,35.87,,,35.87,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,32.29,,,32.29,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.59,,,42.59,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,19.25,52.3,percent of total billed charges,,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,19.25,,,19.25,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,34.07,,,34.07,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,48.96,,,48.96,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,45.59,,,45.59,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,45.59,,,45.59,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,19.25,52.3,percent of total billed charges,,
HC MERCURY BLOOD,83825,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,19.25,52.3,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT  ,,,both,,,93.73,56.24,Aetna,Commerical,,51.34,,,51.34,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Aetna,Middlesex Employees,,46.2,,,46.2,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Anthem,Commerical,,60.95,,,60.95,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Anthem,Indemnity,,,67.94,,67.94,19.25,74.84,percent of total billed charges,,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Anthem,State Preferred,,19.25,,,19.25,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Anthem,Individual Exchange,,48.76,,,48.76,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Cigna,Cigna,,70.08,,,70.08,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Connecticare,Commerical,,65.24,,,65.24,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Connecticare,Exchange,,65.24,,,65.24,19.25,74.84,other,Could be inpatient or outpatient,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,Multiplan,Multiplan,,,74.84,,74.84,19.25,74.84,percent of total billed charges,,
HC MERCURY-UR RANDOM,83825,CPT,,,both,,,93.73,56.24,United Healthcare/Oxford,United Healthcare/Oxford,,56.91,,,56.91,19.25,74.84,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,37.73,,,37.73,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,33.95,,,33.95,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,44.79,,,44.79,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,20.06,55,percent of total billed charges,,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,20.06,,,20.06,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,35.83,,,35.83,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,51.5,,,51.5,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,47.94,,,47.94,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,47.94,,,47.94,20.06,55,other,Could be inpatient or outpatient,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,20.06,55,percent of total billed charges,,
HC METANEPHRINES,83835,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,20.06,55,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,33.05,,,33.05,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,29.74,,,29.74,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,36.7,,,36.7,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,23.58,73.94,percent of total billed charges,,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,23.58,,,23.58,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,29.36,,,29.36,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,44.51,,,44.51,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,31.89,,,31.89,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,31.89,,,31.89,23.58,73.94,other,Could be inpatient or outpatient,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,23.58,73.94,percent of total billed charges,,
HC MUCOPOLYSACCH SCR,83864,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,37.37,,,37.37,23.58,73.94,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT  ,,,both,,,139.05,83.43,Aetna,Commerical,,76.07,,,76.07,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Aetna,Middlesex Employees,,68.47,,,68.47,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Anthem,Commerical,,90.32,,,90.32,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Anthem,Indemnity,,,100.68,,100.68,20.37,110.92,percent of total billed charges,,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Anthem,State Preferred,,20.37,,,20.37,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Anthem,Individual Exchange,,72.26,,,72.26,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Cigna,Cigna,,103.84,,,103.84,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Connecticare,Commerical,,96.68,,,96.68,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Connecticare,Exchange,,96.68,,,96.68,20.37,110.92,other,Could be inpatient or outpatient,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,Multiplan,Multiplan,,,110.92,,110.92,20.37,110.92,percent of total billed charges,,
HC MYELIN BASE PRT,83873,CPT,,,both,,,139.05,83.43,United Healthcare/Oxford,United Healthcare/Oxford,,84.34,,,84.34,20.37,110.92,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,14.98,,,14.98,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.48,,,13.48,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.79,,,23.79,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.48,41.79,percent of total billed charges,,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.29,,,15.29,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.03,,,19.03,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,28.5,,,28.5,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.46,,,14.46,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.46,,,14.46,13.48,41.79,other,Could be inpatient or outpatient,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.48,41.79,percent of total billed charges,,
HC MYOGLOBIN,83874,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.82,,,18.82,13.48,41.79,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,45.52,,,45.52,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,40.98,,,40.98,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,62.57,,,62.57,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,40.19,75.35,percent of total billed charges,,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,40.19,,,40.19,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,50.05,,,50.05,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,75.35,,,75.35,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,43.93,,,43.93,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,43.93,,,43.93,40.19,75.35,other,Could be inpatient or outpatient,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,40.19,75.35,percent of total billed charges,,
HC BINATRIURETIC PEP,83880,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,51.48,,,51.48,40.19,75.35,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT  ,,,both,,,51.01,30.6,Aetna,Commerical,,28.03,,,28.03,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Aetna,Middlesex Employees,,25.23,,,25.23,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Anthem,Commerical,,33.29,,,33.29,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Anthem,Indemnity,,,37.1,,37.1,16.1,40.87,percent of total billed charges,,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Anthem,State Preferred,,16.1,,,16.1,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Anthem,Individual Exchange,,26.63,,,26.63,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Cigna,Cigna,,38.26,,,38.26,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Connecticare,Commerical,,35.62,,,35.62,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Connecticare,Exchange,,35.62,,,35.62,16.1,40.87,other,Could be inpatient or outpatient,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,Multiplan,Multiplan,,,40.87,,40.87,16.1,40.87,percent of total billed charges,,
HC ASSAY OF NEPHELOMETRY EACH ANALYTE NES - RETINOL BINDING PROTEIN,83883,CPT,,,both,,,51.01,30.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.08,,,31.08,16.1,40.87,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT  ,,,both,,,368.74,221.24,Aetna,Commerical,,202.87,,,202.87,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Aetna,Middlesex Employees,,182.58,,,182.58,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Anthem,Commerical,,240.88,,,240.88,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Anthem,Indemnity,,,268.49,,268.49,29,295.78,percent of total billed charges,,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Anthem,State Preferred,,29,,,29,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Anthem,Individual Exchange,,192.7,,,192.7,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Cigna,Cigna,,276.92,,,276.92,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Connecticare,Commerical,,257.8,,,257.8,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Connecticare,Exchange,,257.8,,,257.8,29,295.78,other,Could be inpatient or outpatient,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,Multiplan,Multiplan,,,295.78,,295.78,29,295.78,percent of total billed charges,,
HC NICKEL URINE QN,83885,CPT,,,both,,,368.74,221.24,United Healthcare/Oxford,United Healthcare/Oxford,,224.9,,,224.9,29,295.78,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT  ,,,both,,,78.28,46.97,Aetna,Commerical,,43.29,,,43.29,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Aetna,Middlesex Employees,,38.97,,,38.97,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Anthem,Commerical,,51.41,,,51.41,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Anthem,Indemnity,,,57.3,,57.3,38.97,63.12,percent of total billed charges,,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Anthem,State Preferred,,51.41,,,51.41,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Anthem,Individual Exchange,,41.13,,,41.13,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Cigna,Cigna,,59.09,,,59.09,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Connecticare,Commerical,,55.02,,,55.02,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Connecticare,Exchange,,55.02,,,55.02,38.97,63.12,other,Could be inpatient or outpatient,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,Multiplan,Multiplan,,,63.12,,63.12,38.97,63.12,percent of total billed charges,,
HC MDLECULAR ISOLATE,83890,CPT,,,both,,,78.28,46.97,United Healthcare/Oxford,United Healthcare/Oxford,,48,,,48,38.97,63.12,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC MOLECULAR ISOLATE,83890,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT  ,,,both,,,19.87,11.92,Aetna,Commerical,,10.91,,,10.91,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Aetna,Middlesex Employees,,9.83,,,9.83,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Anthem,Commerical,,12.96,,,12.96,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Anthem,Indemnity,,,14.44,,14.44,9.83,15.91,percent of total billed charges,,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Anthem,State Preferred,,12.96,,,12.96,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Anthem,Individual Exchange,,10.37,,,10.37,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Cigna,Cigna,,14.9,,,14.9,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Connecticare,Commerical,,13.87,,,13.87,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Connecticare,Exchange,,13.87,,,13.87,9.83,15.91,other,Could be inpatient or outpatient,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,Multiplan,Multiplan,,,15.91,,15.91,9.83,15.91,percent of total billed charges,,
HC DNA EXTRACTION,83891,CPT,,,both,,,19.87,11.92,United Healthcare/Oxford,United Healthcare/Oxford,,12.1,,,12.1,9.83,15.91,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT  ,,,both,,,68.65,41.19,Aetna,Commerical,,37.73,,,37.73,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Aetna,Middlesex Employees,,33.95,,,33.95,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Anthem,Commerical,,44.79,,,44.79,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Anthem,Indemnity,,,49.93,,49.93,33.95,55,percent of total billed charges,,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Anthem,State Preferred,,44.79,,,44.79,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Anthem,Individual Exchange,,35.83,,,35.83,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Cigna,Cigna,,51.5,,,51.5,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Connecticare,Commerical,,47.94,,,47.94,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Connecticare,Exchange,,47.94,,,47.94,33.95,55,other,Could be inpatient or outpatient,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,Multiplan,Multiplan,,,55,,55,33.95,55,percent of total billed charges,,
HC FLT3 MUTATION,83891,CPT,,,both,,,68.65,41.19,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,33.95,55,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,15.44,,,15.44,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,13.9,,,13.9,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,18.33,,,18.33,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,13.9,22.51,percent of total billed charges,,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,18.33,,,18.33,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,14.67,,,14.67,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,21.07,,,21.07,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,19.62,,,19.62,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,19.62,,,19.62,13.9,22.51,other,Could be inpatient or outpatient,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,13.9,22.51,percent of total billed charges,,
HC ISOL EXTRACT,83891,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,17.12,,,17.12,13.9,22.51,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,44.53,,,44.53,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,40.07,,,40.07,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.88,,,52.88,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,40.07,64.92,percent of total billed charges,,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,52.88,,,52.88,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,42.3,,,42.3,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,60.79,,,60.79,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,56.59,,,56.59,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,56.59,,,56.59,40.07,64.92,other,Could be inpatient or outpatient,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,40.07,64.92,percent of total billed charges,,
HC SPECIAL ISOLATION,83891,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,49.37,,,49.37,40.07,64.92,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC ENZYMATIC DIGEST,83892,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,42.68,,,42.68,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,38.42,,,38.42,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,50.67,,,50.67,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,38.42,62.22,percent of total billed charges,,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,50.67,,,50.67,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,40.54,,,40.54,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,58.25,,,58.25,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,54.24,,,54.24,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,54.24,,,54.24,38.42,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,38.42,62.22,percent of total billed charges,,
HC SPECIALITY TEST ENZYMATIC DIGEST,83892,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,38.42,62.22,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC SEPARATION,83894,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT  ,,,both,,,115.36,69.22,Aetna,Commerical,,63.7,,,63.7,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Aetna,Middlesex Employees,,57.33,,,57.33,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Anthem,Commerical,,75.64,,,75.64,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Anthem,Indemnity,,,84.31,,84.31,57.33,92.88,percent of total billed charges,,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Anthem,State Preferred,,75.64,,,75.64,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Anthem,Individual Exchange,,60.51,,,60.51,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Cigna,Cigna,,86.95,,,86.95,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Connecticare,Commerical,,80.96,,,80.96,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Connecticare,Exchange,,80.96,,,80.96,57.33,92.88,other,Could be inpatient or outpatient,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,Multiplan,Multiplan,,,92.88,,92.88,57.33,92.88,percent of total billed charges,,
HC SPECIALITY TEST SEPARATION,83894,CPT,,,both,,,115.36,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,70.63,,,70.63,57.33,92.88,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT  ,,,both,,,21.99,13.19,Aetna,Commerical,,12.09,,,12.09,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Aetna,Middlesex Employees,,10.88,,,10.88,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Anthem,Commerical,,14.35,,,14.35,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Anthem,Indemnity,,,15.99,,15.99,10.88,17.62,percent of total billed charges,,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Anthem,State Preferred,,14.35,,,14.35,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Anthem,Individual Exchange,,11.48,,,11.48,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Cigna,Cigna,,16.49,,,16.49,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Connecticare,Commerical,,15.36,,,15.36,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Connecticare,Exchange,,15.36,,,15.36,10.88,17.62,other,Could be inpatient or outpatient,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,Multiplan,Multiplan,,,17.62,,17.62,10.88,17.62,percent of total billed charges,,
HC NUC ACID PROBE EA,83896,CPT,,,both,,,21.99,13.19,United Healthcare/Oxford,United Healthcare/Oxford,,13.4,,,13.4,10.88,17.62,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC NUCLEIC ACID PROB,83896,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,35.87,,,35.87,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,32.29,,,32.29,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.59,,,42.59,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,32.29,52.3,percent of total billed charges,,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,42.59,,,42.59,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,34.07,,,34.07,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,48.96,,,48.96,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,45.59,,,45.59,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,45.59,,,45.59,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,32.29,52.3,percent of total billed charges,,
HC NUCLEAR AC TRNSFR,83897,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,32.29,52.3,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.86,27.33,percent of total billed charges,,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,22.25,,,22.25,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.86,27.33,other,Could be inpatient or outpatient,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.86,27.33,percent of total billed charges,,
HC NUCLEIC ACID TNFR,83897,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.86,27.33,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT  ,,,both,,,82.4,49.44,Aetna,Commerical,,45.77,,,45.77,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Aetna,Middlesex Employees,,41.19,,,41.19,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Anthem,Commerical,,54.35,,,54.35,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Anthem,Indemnity,,,60.58,,60.58,41.19,66.73,percent of total billed charges,,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Anthem,State Preferred,,54.35,,,54.35,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Anthem,Individual Exchange,,43.48,,,43.48,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Cigna,Cigna,,62.47,,,62.47,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Connecticare,Commerical,,58.16,,,58.16,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Connecticare,Exchange,,58.16,,,58.16,41.19,66.73,other,Could be inpatient or outpatient,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,Multiplan,Multiplan,,,66.73,,66.73,41.19,66.73,percent of total billed charges,,
HC PCR TARGET AMP,83898,CPT,,,both,,,82.4,49.44,United Healthcare/Oxford,United Healthcare/Oxford,,50.74,,,50.74,41.19,66.73,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT  ,,,both,,,122.57,73.54,Aetna,Commerical,,68.04,,,68.04,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Aetna,Middlesex Employees,,61.23,,,61.23,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Anthem,Commerical,,80.78,,,80.78,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Anthem,Indemnity,,,90.04,,90.04,61.23,99.2,percent of total billed charges,,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Anthem,State Preferred,,80.78,,,80.78,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Anthem,Individual Exchange,,64.63,,,64.63,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Cigna,Cigna,,92.87,,,92.87,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Connecticare,Commerical,,86.46,,,86.46,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Connecticare,Exchange,,86.46,,,86.46,61.23,99.2,other,Could be inpatient or outpatient,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,Multiplan,Multiplan,,,99.2,,99.2,61.23,99.2,percent of total billed charges,,
HC PROBE AMPLIFICATE,83898,CPT,,,both,,,122.57,73.54,United Healthcare/Oxford,United Healthcare/Oxford,,75.43,,,75.43,61.23,99.2,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT  ,,,both,,,196.73,118.04,Aetna,Commerical,,108.24,,,108.24,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Aetna,Middlesex Employees,,97.42,,,97.42,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Anthem,Commerical,,128.52,,,128.52,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Anthem,Indemnity,,,143.25,,143.25,97.42,157.81,percent of total billed charges,,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Anthem,State Preferred,,128.52,,,128.52,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Anthem,Individual Exchange,,102.82,,,102.82,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Cigna,Cigna,,147.74,,,147.74,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Connecticare,Commerical,,137.55,,,137.55,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Connecticare,Exchange,,137.55,,,137.55,97.42,157.81,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,Multiplan,Multiplan,,,157.81,,157.81,97.42,157.81,percent of total billed charges,,
HC SPECIALITY TEST PROBE AMPLIFICATE,83898,CPT,,,both,,,196.73,118.04,United Healthcare/Oxford,United Healthcare/Oxford,,120,,,120,97.42,157.81,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT  ,,,both,,,90.64,54.38,Aetna,Commerical,,50.1,,,50.1,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Aetna,Middlesex Employees,,45.09,,,45.09,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Anthem,Commerical,,59.48,,,59.48,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Anthem,Indemnity,,,66.3,,66.3,45.09,73.04,percent of total billed charges,,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Anthem,State Preferred,,59.48,,,59.48,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Anthem,Individual Exchange,,47.59,,,47.59,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Cigna,Cigna,,68.38,,,68.38,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Connecticare,Commerical,,63.66,,,63.66,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Connecticare,Exchange,,63.66,,,63.66,45.09,73.04,other,Could be inpatient or outpatient,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,Multiplan,Multiplan,,,73.04,,73.04,45.09,73.04,percent of total billed charges,,
HC NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,90.64,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,55.54,,,55.54,45.09,73.04,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT  ,,,both,,,164.8,98.88,Aetna,Commerical,,90.29,,,90.29,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Aetna,Middlesex Employees,,81.26,,,81.26,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Anthem,Commerical,,107.22,,,107.22,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Anthem,Indemnity,,,119.51,,119.51,81.26,131.66,percent of total billed charges,,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Anthem,State Preferred,,107.22,,,107.22,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Anthem,Individual Exchange,,85.77,,,85.77,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Cigna,Cigna,,123.26,,,123.26,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Connecticare,Commerical,,114.75,,,114.75,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Connecticare,Exchange,,114.75,,,114.75,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,Multiplan,Multiplan,,,131.66,,131.66,81.26,131.66,percent of total billed charges,,
HC SPECIALITY TEST NUCLEIC AMP 2 SEQ,83900,CPT,,,both,,,164.8,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,81.26,131.66,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,21.49,,,21.49,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,19.34,,,19.34,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,25.52,,,25.52,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,19.34,31.34,percent of total billed charges,,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,25.52,,,25.52,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,20.42,,,20.42,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,29.34,,,29.34,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,27.31,,,27.31,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,27.31,,,27.31,19.34,31.34,other,Could be inpatient or outpatient,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,19.34,31.34,percent of total billed charges,,
HC MOL ISOL/EXTRACT,83901,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,23.82,,,23.82,19.34,31.34,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,25.35,,,25.35,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,22.82,,,22.82,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,30.1,,,30.1,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,22.82,36.97,percent of total billed charges,,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,30.1,,,30.1,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,24.07,,,24.07,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,34.61,,,34.61,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,32.21,,,32.21,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,32.21,,,32.21,22.82,36.97,other,Could be inpatient or outpatient,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,22.82,36.97,percent of total billed charges,,
HC NUCLEIC AMP ADDON,83901,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,28.11,,,28.11,22.82,36.97,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,35.07,56.81,percent of total billed charges,,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,35.07,56.81,percent of total billed charges,,
HC REVERSE TRANSCRIP,83902,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,35.07,56.81,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT  ,,,both,,,152.44,91.46,Aetna,Commerical,,84.11,,,84.11,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Aetna,Middlesex Employees,,75.7,,,75.7,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Anthem,Commerical,,99.88,,,99.88,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Anthem,Indemnity,,,111.32,,111.32,75.7,122.64,percent of total billed charges,,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Anthem,State Preferred,,99.88,,,99.88,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Anthem,Individual Exchange,,79.9,,,79.9,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Cigna,Cigna,,114.82,,,114.82,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Connecticare,Commerical,,106.89,,,106.89,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Connecticare,Exchange,,106.89,,,106.89,75.7,122.64,other,Could be inpatient or outpatient,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,Multiplan,Multiplan,,,122.64,,122.64,75.7,122.64,percent of total billed charges,,
HC CYTOGEN 125-99,83904,CPT,,,both,,,152.44,91.46,United Healthcare/Oxford,United Healthcare/Oxford,,93.25,,,93.25,75.7,122.64,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,45.64,73.94,percent of total billed charges,,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,60.22,,,60.22,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,45.64,73.94,other,Could be inpatient or outpatient,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,45.64,73.94,percent of total billed charges,,
HC ID BY SEQ S SEG,83904,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,45.64,73.94,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT  ,,,both,,,82.4,49.44,Aetna,Commerical,,45.77,,,45.77,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Aetna,Middlesex Employees,,41.19,,,41.19,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Anthem,Commerical,,54.35,,,54.35,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Anthem,Indemnity,,,60.58,,60.58,41.19,66.73,percent of total billed charges,,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Anthem,State Preferred,,54.35,,,54.35,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Anthem,Individual Exchange,,43.48,,,43.48,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Cigna,Cigna,,62.47,,,62.47,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Connecticare,Commerical,,58.16,,,58.16,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Connecticare,Exchange,,58.16,,,58.16,41.19,66.73,other,Could be inpatient or outpatient,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,Multiplan,Multiplan,,,66.73,,66.73,41.19,66.73,percent of total billed charges,,
HC SEQ MUTATION ID,83904,CPT,,,both,,,82.4,49.44,United Healthcare/Oxford,United Healthcare/Oxford,,50.74,,,50.74,41.19,66.73,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,19.84,,,19.84,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,17.86,,,17.86,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,23.56,,,23.56,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,17.86,28.93,percent of total billed charges,,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,23.56,,,23.56,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,18.85,,,18.85,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,27.08,,,27.08,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,25.21,,,25.21,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,25.21,,,25.21,17.86,28.93,other,Could be inpatient or outpatient,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,17.86,28.93,percent of total billed charges,,
HC LYSE NUCLEIC EXT,83907,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,22,,,22,17.86,28.93,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT  ,,,both,,,40.12,24.07,Aetna,Commerical,,22.05,,,22.05,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Aetna,Middlesex Employees,,19.84,,,19.84,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Anthem,Commerical,,26.18,,,26.18,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Anthem,Indemnity,,,29.18,,29.18,19.84,32.15,percent of total billed charges,,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Anthem,State Preferred,,26.18,,,26.18,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Anthem,Individual Exchange,,20.94,,,20.94,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Cigna,Cigna,,30.1,,,30.1,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Connecticare,Commerical,,28.02,,,28.02,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Connecticare,Exchange,,28.02,,,28.02,19.84,32.15,other,Could be inpatient or outpatient,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,Multiplan,Multiplan,,,32.15,,32.15,19.84,32.15,percent of total billed charges,,
HC AMP SIGNAL EA SEQ,83908,CPT,,,both,,,40.12,24.07,United Healthcare/Oxford,United Healthcare/Oxford,,24.44,,,24.44,19.84,32.15,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT  ,,,both,,,105.79,63.47,Aetna,Commerical,,58.14,,,58.14,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Aetna,Middlesex Employees,,52.32,,,52.32,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Anthem,Commerical,,69.03,,,69.03,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Anthem,Indemnity,,,76.94,,76.94,52.32,84.76,percent of total billed charges,,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Anthem,State Preferred,,69.03,,,69.03,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Anthem,Individual Exchange,,55.23,,,55.23,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Cigna,Cigna,,79.36,,,79.36,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Connecticare,Commerical,,73.88,,,73.88,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Connecticare,Exchange,,73.88,,,73.88,52.32,84.76,other,Could be inpatient or outpatient,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,Multiplan,Multiplan,,,84.76,,84.76,52.32,84.76,percent of total billed charges,,
HC NUCLEIC HIGH RESO,83909,CPT,,,both,,,105.79,63.47,United Healthcare/Oxford,United Healthcare/Oxford,,64.46,,,64.46,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT  ,,,both,,,106.09,63.65,Aetna,Commerical,,58.14,,,58.14,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Aetna,Middlesex Employees,,52.32,,,52.32,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Anthem,Commerical,,69.03,,,69.03,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Anthem,Indemnity,,,76.94,,76.94,52.32,84.76,percent of total billed charges,,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Anthem,State Preferred,,69.03,,,69.03,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Anthem,Individual Exchange,,55.23,,,55.23,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Cigna,Cigna,,79.36,,,79.36,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Connecticare,Commerical,,73.88,,,73.88,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Connecticare,Exchange,,73.88,,,73.88,52.32,84.76,other,Could be inpatient or outpatient,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,Multiplan,Multiplan,,,84.76,,84.76,52.32,84.76,percent of total billed charges,,
HC SEP & ID HIGH RES,83909,CPT,,,both,,,106.09,63.65,United Healthcare/Oxford,United Healthcare/Oxford,,64.46,,,64.46,52.32,84.76,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT  ,,,both,,,164.33,98.6,Aetna,Commerical,,90.29,,,90.29,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Aetna,Middlesex Employees,,81.26,,,81.26,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Anthem,Commerical,,107.22,,,107.22,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Anthem,Indemnity,,,119.51,,119.51,81.26,131.66,percent of total billed charges,,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Anthem,State Preferred,,107.22,,,107.22,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Anthem,Individual Exchange,,85.77,,,85.77,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Cigna,Cigna,,123.26,,,123.26,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Connecticare,Commerical,,114.75,,,114.75,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Connecticare,Exchange,,114.75,,,114.75,81.26,131.66,other,Could be inpatient or outpatient,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,Multiplan,Multiplan,,,131.66,,131.66,81.26,131.66,percent of total billed charges,,
HC SPECIALITY TEST NUCLEIC HIGH RESO,83909,CPT,,,both,,,164.33,98.6,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,81.26,131.66,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT  ,,,both,,,105.06,63.04,Aetna,Commerical,,57.52,,,57.52,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Aetna,Middlesex Employees,,51.77,,,51.77,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Anthem,Commerical,,68.3,,,68.3,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Anthem,Indemnity,,,76.12,,76.12,51.77,83.86,percent of total billed charges,,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Anthem,State Preferred,,68.3,,,68.3,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Anthem,Individual Exchange,,54.64,,,54.64,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Cigna,Cigna,,78.52,,,78.52,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Connecticare,Commerical,,73.09,,,73.09,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Connecticare,Exchange,,73.09,,,73.09,51.77,83.86,other,Could be inpatient or outpatient,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,Multiplan,Multiplan,,,83.86,,83.86,51.77,83.86,percent of total billed charges,,
HC INTERPRETATION,83912,CPT,,,both,,,105.06,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,63.77,,,63.77,51.77,83.86,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,20.33,32.94,percent of total billed charges,,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,26.83,,,26.83,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,20.33,32.94,percent of total billed charges,,
HC MOLEC DX PROF,83912,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,20.33,32.94,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,34.63,,,34.63,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,31.17,,,31.17,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,41.12,,,41.12,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,31.17,50.5,percent of total billed charges,,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,41.12,,,41.12,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,32.89,,,32.89,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,47.28,,,47.28,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,31.17,50.5,percent of total billed charges,,
HC MOLECR DX INT&RPT,83912,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,38.4,,,38.4,31.17,50.5,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT  ,,,both,,,19.87,11.92,Aetna,Commerical,,10.91,,,10.91,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Aetna,Middlesex Employees,,9.83,,,9.83,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Anthem,Commerical,,12.96,,,12.96,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Anthem,Indemnity,,,14.44,,14.44,9.83,15.91,percent of total billed charges,,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Anthem,State Preferred,,12.96,,,12.96,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Anthem,Individual Exchange,,10.37,,,10.37,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Cigna,Cigna,,14.9,,,14.9,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Connecticare,Commerical,,13.87,,,13.87,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Connecticare,Exchange,,13.87,,,13.87,9.83,15.91,other,Could be inpatient or outpatient,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,Multiplan,Multiplan,,,15.91,,15.91,9.83,15.91,percent of total billed charges,,
HC SEQ INTERP REPORT,83912,CPT,,,both,,,19.87,11.92,United Healthcare/Oxford,United Healthcare/Oxford,,12.1,,,12.1,9.83,15.91,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,35.07,56.81,percent of total billed charges,,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,35.07,56.81,percent of total billed charges,,
HC RNA STABILIZATION,83913,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,35.07,56.81,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,25.35,,,25.35,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,22.82,,,22.82,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,30.1,,,30.1,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,22.82,36.97,percent of total billed charges,,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,30.1,,,30.1,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,24.07,,,24.07,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,34.61,,,34.61,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,32.21,,,32.21,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,32.21,,,32.21,22.82,36.97,other,Could be inpatient or outpatient,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,22.82,36.97,percent of total billed charges,,
HC MUT ID SGL EA SEG,83914,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,28.11,,,28.11,22.82,36.97,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,12.93,,,12.93,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,11.64,,,11.64,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,20.56,,,20.56,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,11.64,45.51,percent of total billed charges,,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,13.21,,,13.21,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,16.45,,,16.45,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,24.93,,,24.93,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,12.48,,,12.48,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,12.48,,,12.48,11.64,45.51,other,Could be inpatient or outpatient,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,11.64,45.51,percent of total billed charges,,
HC 5' NUCLEOTIDASE,83915,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,16.25,,,16.25,11.64,45.51,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT  ,,,both,,,87.55,52.53,Aetna,Commerical,,31.76,,,31.76,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Aetna,Middlesex Employees,,28.58,,,28.58,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Anthem,Commerical,,37.06,,,37.06,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Anthem,Indemnity,,,64.67,,64.67,23.81,71.24,percent of total billed charges,,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Anthem,State Preferred,,23.81,,,23.81,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Anthem,Individual Exchange,,29.65,,,29.65,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Cigna,Cigna,,44.51,,,44.51,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Connecticare,Commerical,,30.65,,,30.65,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Connecticare,Exchange,,30.65,,,30.65,23.81,71.24,other,Could be inpatient or outpatient,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,Multiplan,Multiplan,,,71.24,,71.24,23.81,71.24,percent of total billed charges,,
HC CSF OLIGOCLONAL BANDS,83916,CPT,,,both,,,87.55,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,35.92,,,35.92,23.81,71.24,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,42.68,,,42.68,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,38.42,,,38.42,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,50.67,,,50.67,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,19.49,62.22,percent of total billed charges,,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,19.49,,,19.49,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,40.54,,,40.54,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,58.25,,,58.25,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,54.24,,,54.24,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,54.24,,,54.24,19.49,62.22,other,Could be inpatient or outpatient,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,19.49,62.22,percent of total billed charges,,
HC ORGANIC ACID:YALE,83918,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,47.31,,,47.31,19.49,62.22,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,19.07,,,19.07,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,17.16,,,17.16,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,30.33,,,30.33,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,17.16,53.2,percent of total billed charges,,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,19.49,,,19.49,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,24.26,,,24.26,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,36.78,,,36.78,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,18.4,,,18.4,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,18.4,,,18.4,17.16,53.2,other,Could be inpatient or outpatient,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,17.16,53.2,percent of total billed charges,,
HC ORG.ACIDS QUAL UR,83919,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,23.98,,,23.98,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,19.07,,,19.07,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,17.16,,,17.16,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,30.33,,,30.33,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,17.16,53.2,percent of total billed charges,,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,19.49,,,19.49,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,24.26,,,24.26,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,36.78,,,36.78,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,18.4,,,18.4,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,18.4,,,18.4,17.16,53.2,other,Could be inpatient or outpatient,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,17.16,53.2,percent of total billed charges,,
HC ORGANIC ACID QUALITATIVE EA SPECIMEN - MAYO SEND OUT,83919,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,23.98,,,23.98,17.16,53.2,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT  ,,,both,,,70.04,42.02,Aetna,Commerical,,24.59,,,24.59,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Aetna,Middlesex Employees,,22.14,,,22.14,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Anthem,Commerical,,30.33,,,30.33,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Anthem,Indemnity,,,50.75,,50.75,19.49,55.91,percent of total billed charges,,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Anthem,State Preferred,,19.49,,,19.49,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Anthem,Individual Exchange,,24.26,,,24.26,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Cigna,Cigna,,36.78,,,36.78,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Connecticare,Commerical,,23.74,,,23.74,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Connecticare,Exchange,,23.74,,,23.74,19.49,55.91,other,Could be inpatient or outpatient,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,Multiplan,Multiplan,,,55.91,,55.91,19.49,55.91,percent of total billed charges,,
HC METHYL MALONIC AC,83921,CPT,,,both,,,70.04,42.02,United Healthcare/Oxford,United Healthcare/Oxford,,27.81,,,27.81,19.49,55.91,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT  ,,,both,,,126.69,76.01,Aetna,Commerical,,69.89,,,69.89,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Aetna,Middlesex Employees,,62.9,,,62.9,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Anthem,Commerical,,82.99,,,82.99,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Anthem,Indemnity,,,92.5,,92.5,23.04,101.9,percent of total billed charges,,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Anthem,State Preferred,,23.04,,,23.04,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Anthem,Individual Exchange,,66.38,,,66.38,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Cigna,Cigna,,95.4,,,95.4,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Connecticare,Commerical,,88.81,,,88.81,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Connecticare,Exchange,,88.81,,,88.81,23.04,101.9,other,Could be inpatient or outpatient,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,Multiplan,Multiplan,,,101.9,,101.9,23.04,101.9,percent of total billed charges,,
HC OPIATE-BLOOD,83925,CPT,,,both,,,126.69,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,23.04,101.9,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT  ,,,both,,,27.09,16.25,Aetna,Commerical,,7.66,,,7.66,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Aetna,Middlesex Employees,,6.9,,,6.9,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Anthem,Commerical,,12.19,,,12.19,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Anthem,Indemnity,,,19.7,,19.7,6.9,21.7,percent of total billed charges,,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Anthem,State Preferred,,7.82,,,7.82,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Anthem,Individual Exchange,,9.75,,,9.75,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Cigna,Cigna,,14.83,,,14.83,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Connecticare,Commerical,,7.4,,,7.4,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Connecticare,Exchange,,7.4,,,7.4,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.9,21.7,percent of total billed charges,,
HC OSMOLALITY BLOOD,83930,CPT,,,both,,,27.09,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.64,,,9.64,6.9,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT  ,,,both,,,27.09,16.25,Aetna,Commerical,,7.91,,,7.91,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Aetna,Middlesex Employees,,7.12,,,7.12,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Anthem,Commerical,,12.56,,,12.56,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Anthem,Indemnity,,,19.7,,19.7,7.12,21.7,percent of total billed charges,,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Anthem,State Preferred,,8.06,,,8.06,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Anthem,Individual Exchange,,10.05,,,10.05,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Cigna,Cigna,,14.83,,,14.83,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Connecticare,Commerical,,7.63,,,7.63,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Connecticare,Exchange,,7.63,,,7.63,7.12,21.7,other,Could be inpatient or outpatient,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,Multiplan,Multiplan,,,21.7,,21.7,7.12,21.7,percent of total billed charges,,
HC OSMOLALITY URINE,83935,CPT,,,both,,,27.09,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,7.12,21.7,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,34.61,,,34.61,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,31.15,,,31.15,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,55.01,,,55.01,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,31.15,96.49,percent of total billed charges,,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,35.35,,,35.35,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,44.01,,,44.01,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,66.47,,,66.47,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,33.4,,,33.4,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,33.4,,,33.4,31.15,96.49,other,Could be inpatient or outpatient,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,31.15,96.49,percent of total billed charges,,
HC OSTEOCALCIN,83937,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,43.48,,,43.48,31.15,96.49,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,16.76,,,16.76,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,15.08,,,15.08,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,23.72,,,23.72,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,15.08,41.79,percent of total billed charges,,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,15.25,,,15.25,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,18.98,,,18.98,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,28.5,,,28.5,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,16.17,,,16.17,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,16.17,,,16.17,15.08,41.79,other,Could be inpatient or outpatient,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.78,15.08,41.79,percent of total billed charges,,
HC OXALATE URINE,83945,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,18.95,,,18.95,15.08,41.79,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT  ,,,both,,,166.86,100.12,Aetna,Commerical,,47.86,,,47.86,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Aetna,Middlesex Employees,,43.08,,,43.08,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Anthem,Commerical,,76.07,,,76.07,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Anthem,Indemnity,,,121.14,,121.14,43.08,133.46,percent of total billed charges,,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Anthem,State Preferred,,48.86,,,48.86,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Anthem,Individual Exchange,,60.86,,,60.86,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Cigna,Cigna,,91.37,,,91.37,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Connecticare,Commerical,,46.19,,,46.19,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Connecticare,Exchange,,46.19,,,46.19,43.08,133.46,other,Could be inpatient or outpatient,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,Multiplan,Multiplan,,,133.46,,133.46,43.08,133.46,percent of total billed charges,,
HC INTACT PTH,83970,CPT,,,both,,,166.86,100.12,United Healthcare/Oxford,United Healthcare/Oxford,,60.13,,,60.13,43.08,133.46,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,29.94,,,29.94,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,26.95,,,26.95,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,35.55,,,35.55,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,4.23,43.66,percent of total billed charges,,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,4.23,,,4.23,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,28.44,,,28.44,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,40.87,,,40.87,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,38.05,,,38.05,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,38.05,,,38.05,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,4.23,43.66,percent of total billed charges,,
HC BODY FLUID PH,83986,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,33.2,,,33.2,4.23,43.66,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT  ,,,both,,,14.41,8.65,Aetna,Commerical,,7.92,,,7.92,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Aetna,Middlesex Employees,,7.13,,,7.13,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Anthem,Commerical,,9.4,,,9.4,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Anthem,Indemnity,,,10.48,,10.48,4.23,11.54,percent of total billed charges,,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Anthem,State Preferred,,4.23,,,4.23,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Anthem,Individual Exchange,,7.51,,,7.51,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Cigna,Cigna,,10.81,,,10.81,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Connecticare,Commerical,,10.06,,,10.06,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Connecticare,Exchange,,10.06,,,10.06,4.23,11.54,other,Could be inpatient or outpatient,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,Multiplan,Multiplan,,,11.54,,11.54,4.23,11.54,percent of total billed charges,,
HC BODY FLUID PH - POCT,83986,CPT,,,both,,,14.41,8.65,United Healthcare/Oxford,United Healthcare/Oxford,,8.78,,,8.78,4.23,11.54,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT  ,,,both,,,60.78,36.47,Aetna,Commerical,,33.39,,,33.39,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Aetna,Middlesex Employees,,30.05,,,30.05,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Anthem,Commerical,,39.65,,,39.65,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Anthem,Indemnity,,,44.2,,44.2,17.41,48.7,percent of total billed charges,,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Anthem,State Preferred,,17.41,,,17.41,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Anthem,Individual Exchange,,31.72,,,31.72,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Cigna,Cigna,,45.59,,,45.59,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Connecticare,Commerical,,42.44,,,42.44,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Connecticare,Exchange,,42.44,,,42.44,17.41,48.7,other,Could be inpatient or outpatient,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,Multiplan,Multiplan,,,48.7,,48.7,17.41,48.7,percent of total billed charges,,
HC PHENCYCLIDINE PCP,83992,CPT,,,both,,,60.78,36.47,United Healthcare/Oxford,United Healthcare/Oxford,,37.03,,,37.03,17.41,48.7,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT  ,,,both,,,78.28,46.97,Aetna,Commerical,,22.76,,,22.76,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Aetna,Middlesex Employees,,20.48,,,20.48,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Anthem,Commerical,,36.17,,,36.17,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Anthem,Indemnity,,,57.3,,57.3,20.48,71.75,percent of total billed charges,,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Anthem,State Preferred,,40.55,,,40.55,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Anthem,Individual Exchange,,28.94,,,28.94,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Cigna,Cigna,,71.75,,,71.75,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Connecticare,Commerical,,21.96,,,21.96,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Connecticare,Exchange,,21.96,,,21.96,20.48,71.75,other,Could be inpatient or outpatient,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,Multiplan,Multiplan,,,63.12,,63.12,20.48,71.75,percent of total billed charges,,
HC CALPROTECTN FECAL,83993,CPT,,,both,,,78.28,46.97,United Healthcare/Oxford,United Healthcare/Oxford,,28.59,,,28.59,20.48,71.75,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,85.35,,,85.35,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,76.82,,,76.82,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,101.34,,,101.34,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,18.43,124.44,percent of total billed charges,,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,18.43,,,18.43,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,81.07,,,81.07,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,116.51,,,116.51,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,108.46,,,108.46,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,108.46,,,108.46,18.43,124.44,other,Could be inpatient or outpatient,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,18.43,124.44,percent of total billed charges,,
HC PERPHENAZINE,84022,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,94.63,,,94.63,18.43,124.44,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC PHOSPHATASE-ALKAL,84075,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,32.78,,,32.78,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,29.51,,,29.51,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,38.92,,,38.92,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,17.51,47.8,percent of total billed charges,,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.51,,,17.51,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,31.13,,,31.13,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,44.74,,,44.74,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,41.66,,,41.66,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,41.66,,,41.66,17.51,47.8,other,Could be inpatient or outpatient,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,17.51,47.8,percent of total billed charges,,
HC ALK PHOS ISO,84080,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,36.34,,,36.34,17.51,47.8,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT  ,,,both,,,19.07,11.44,Aetna,Commerical,,5.49,,,5.49,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Aetna,Middlesex Employees,,4.94,,,4.94,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Anthem,Commerical,,8.75,,,8.75,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Anthem,Indemnity,,,13.87,,13.87,4.94,15.27,percent of total billed charges,,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Anthem,State Preferred,,5.62,,,5.62,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Anthem,Individual Exchange,,7,,,7,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Cigna,Cigna,,10.68,,,10.68,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Connecticare,Commerical,,5.3,,,5.3,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Connecticare,Exchange,,5.3,,,5.3,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,Multiplan,Multiplan,,,15.27,,15.27,4.94,15.27,percent of total billed charges,,
HC PHOSPHORUS BLOOD,84100,CPT,,,both,,,19.07,11.44,United Healthcare/Oxford,United Healthcare/Oxford,,6.9,,,6.9,4.94,15.27,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.7,,,6.7,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,6.03,,,6.03,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,6.03,16.69,percent of total billed charges,,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,6.47,,,6.47,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,6.47,,,6.47,6.03,16.69,other,Could be inpatient or outpatient,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,6.03,16.69,percent of total billed charges,,
HC PHOSPHORUS URINE,84105,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.58,,,7.58,6.03,16.69,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,10,27.33,percent of total billed charges,,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,10,,,10,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,10,27.33,other,Could be inpatient or outpatient,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,10,27.33,percent of total billed charges,,
HC PORPHOBILINOGEN,84110,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,10,27.33,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT  ,,,both,,,138.43,83.06,Aetna,Commerical,,76.07,,,76.07,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Aetna,Middlesex Employees,,68.47,,,68.47,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Anthem,Commerical,,90.32,,,90.32,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Anthem,Indemnity,,,100.68,,100.68,17.41,110.92,percent of total billed charges,,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Anthem,State Preferred,,17.41,,,17.41,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Anthem,Individual Exchange,,72.26,,,72.26,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Cigna,Cigna,,103.84,,,103.84,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Connecticare,Commerical,,96.68,,,96.68,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Connecticare,Exchange,,96.68,,,96.68,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,Multiplan,Multiplan,,,110.92,,110.92,17.41,110.92,percent of total billed charges,,
HC PORPHYRIN FRACT24,84120,CPT,,,both,,,138.43,83.06,United Healthcare/Oxford,United Healthcare/Oxford,,84.34,,,84.34,17.41,110.92,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT  ,,,both,,,125.66,75.4,Aetna,Commerical,,69.27,,,69.27,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Aetna,Middlesex Employees,,62.35,,,62.35,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Anthem,Commerical,,82.25,,,82.25,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Anthem,Indemnity,,,91.68,,91.68,17.41,101,percent of total billed charges,,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Anthem,State Preferred,,17.41,,,17.41,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Anthem,Individual Exchange,,65.81,,,65.81,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Cigna,Cigna,,94.56,,,94.56,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Connecticare,Commerical,,88.03,,,88.03,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Connecticare,Exchange,,88.03,,,88.03,17.41,101,other,Could be inpatient or outpatient,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,Multiplan,Multiplan,,,101,,101,17.41,101,percent of total billed charges,,
HC PORPHYRINS,84120,CPT,,,both,,,125.66,75.4,United Healthcare/Oxford,United Healthcare/Oxford,,76.8,,,76.8,17.41,101,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT  ,,,both,,,18.51,11.11,Aetna,Commerical,,5.52,,,5.52,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Aetna,Middlesex Employees,,4.97,,,4.97,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Anthem,Commerical,,8.48,,,8.48,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Anthem,Indemnity,,,13.46,,13.46,4.97,14.83,percent of total billed charges,,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Anthem,State Preferred,,5.44,,,5.44,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Anthem,Individual Exchange,,6.78,,,6.78,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Cigna,Cigna,,10.08,,,10.08,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Connecticare,Commerical,,5.33,,,5.33,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Connecticare,Exchange,,5.33,,,5.33,4.97,14.83,other,Could be inpatient or outpatient,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,Multiplan,Multiplan,,,14.83,,14.83,4.97,14.83,percent of total billed charges,,
HC I-STAT POTASSIUM,84132,CPT,,,both,,,18.51,11.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT  ,,,both,,,18.51,11.11,Aetna,Commerical,,5.52,,,5.52,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Aetna,Middlesex Employees,,4.97,,,4.97,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Anthem,Commerical,,8.48,,,8.48,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Anthem,Indemnity,,,13.46,,13.46,4.97,14.83,percent of total billed charges,,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Anthem,State Preferred,,5.44,,,5.44,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Anthem,Individual Exchange,,6.78,,,6.78,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Cigna,Cigna,,10.08,,,10.08,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Connecticare,Commerical,,5.33,,,5.33,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Connecticare,Exchange,,5.33,,,5.33,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,Multiplan,Multiplan,,,14.83,,14.83,4.97,14.83,percent of total billed charges,,
HC POTASSIUM BLOOD,84132,CPT,,,both,,,18.51,11.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,4.97,14.83,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT  ,,,both,,,17.35,10.41,Aetna,Commerical,,5.48,,,5.48,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Aetna,Middlesex Employees,,4.93,,,4.93,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Anthem,Commerical,,7.93,,,7.93,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Anthem,Indemnity,,,12.62,,12.62,4.93,13.9,percent of total billed charges,,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Anthem,State Preferred,,5.09,,,5.09,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Anthem,Individual Exchange,,6.34,,,6.34,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Cigna,Cigna,,9.51,,,9.51,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Connecticare,Commerical,,5.29,,,5.29,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Connecticare,Exchange,,5.29,,,5.29,4.93,13.9,other,Could be inpatient or outpatient,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,Multiplan,Multiplan,,,13.9,,13.9,4.93,13.9,percent of total billed charges,,
HC POTASSIUM URINE,84133,CPT,,,both,,,17.35,10.41,United Healthcare/Oxford,United Healthcare/Oxford,,6.28,,,6.28,4.93,13.9,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,16.92,,,16.92,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.23,,,15.23,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,26.88,,,26.88,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.23,47.8,percent of total billed charges,,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.27,,,17.27,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,21.51,,,21.51,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.64,,,32.64,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.33,,,16.33,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.33,,,16.33,15.23,47.8,other,Could be inpatient or outpatient,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.23,47.8,percent of total billed charges,,
HC PREALBUMIN,84134,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.25,,,21.25,15.23,47.8,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT  ,,,both,,,234.84,140.9,Aetna,Commerical,,129.26,,,129.26,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Aetna,Middlesex Employees,,116.34,,,116.34,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Anthem,Commerical,,153.48,,,153.48,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Anthem,Indemnity,,,171.08,,171.08,24.48,188.47,percent of total billed charges,,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Anthem,State Preferred,,24.48,,,24.48,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Anthem,Individual Exchange,,122.78,,,122.78,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Cigna,Cigna,,176.45,,,176.45,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Connecticare,Commerical,,164.27,,,164.27,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Connecticare,Exchange,,164.27,,,164.27,24.48,188.47,other,Could be inpatient or outpatient,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,Multiplan,Multiplan,,,188.47,,188.47,24.48,188.47,percent of total billed charges,,
HC 17-OH PREGNENOLON,84140,CPT,,,both,,,234.84,140.9,United Healthcare/Oxford,United Healthcare/Oxford,,143.3,,,143.3,24.48,188.47,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT  ,,,both,,,179.22,107.53,Aetna,Commerical,,98.34,,,98.34,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Aetna,Middlesex Employees,,88.51,,,88.51,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Anthem,Commerical,,116.76,,,116.76,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Anthem,Indemnity,,,130.15,,130.15,24.7,143.38,percent of total billed charges,,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Anthem,State Preferred,,24.7,,,24.7,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Anthem,Individual Exchange,,93.41,,,93.41,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Cigna,Cigna,,134.23,,,134.23,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Connecticare,Commerical,,124.97,,,124.97,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Connecticare,Exchange,,124.97,,,124.97,24.7,143.38,other,Could be inpatient or outpatient,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,Multiplan,Multiplan,,,143.38,,143.38,24.7,143.38,percent of total billed charges,,
HC PROGESTERONE,84144,CPT,,,both,,,179.22,107.53,United Healthcare/Oxford,United Healthcare/Oxford,,109.03,,,109.03,24.7,143.38,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,31.56,,,31.56,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,28.4,,,28.4,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,49.37,,,49.37,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,23.53,97.97,percent of total billed charges,,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,23.53,,,23.53,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,39.5,,,39.5,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,97.97,,,97.97,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,30.46,,,30.46,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,30.46,,,30.46,23.53,97.97,other,Could be inpatient or outpatient,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,23.53,97.97,percent of total billed charges,,
HC PROCALCITONIN (PCT),84145,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,39.04,,,39.04,23.53,97.97,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,22.47,,,22.47,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,20.23,,,20.23,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,35.72,,,35.72,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,20.23,62.22,percent of total billed charges,,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,22.95,,,22.95,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.58,,,28.58,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,43.33,,,43.33,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,21.68,,,21.68,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,21.68,,,21.68,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,20.23,62.22,percent of total billed charges,,
HC PROLACTIN,84146,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,28.23,,,28.23,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,22.47,,,22.47,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,20.23,,,20.23,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,35.72,,,35.72,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,20.23,62.22,percent of total billed charges,,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,22.95,,,22.95,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,28.58,,,28.58,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,43.33,,,43.33,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,21.68,,,21.68,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,21.68,,,21.68,20.23,62.22,other,Could be inpatient or outpatient,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,20.23,62.22,percent of total billed charges,,
HC PROLACTIN PEDI,84146,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,28.23,,,28.23,20.23,62.22,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT  ,,,both,,,201.88,121.13,Aetna,Commerical,,22.47,,,22.47,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Aetna,Middlesex Employees,,20.23,,,20.23,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Anthem,Commerical,,35.72,,,35.72,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Anthem,Indemnity,,,146.52,,146.52,20.23,161.42,percent of total billed charges,,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Anthem,State Preferred,,22.95,,,22.95,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Anthem,Individual Exchange,,28.58,,,28.58,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Cigna,Cigna,,43.33,,,43.33,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Connecticare,Commerical,,21.68,,,21.68,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Connecticare,Exchange,,21.68,,,21.68,20.23,161.42,other,Could be inpatient or outpatient,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,Multiplan,Multiplan,,,161.42,,161.42,20.23,161.42,percent of total billed charges,,
HC SPECIALITY TEST PROLACTIN,84146,CPT,,,both,,,201.88,121.13,United Healthcare/Oxford,United Healthcare/Oxford,,28.23,,,28.23,20.23,161.42,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,48.43,,,48.43,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,43.58,,,43.58,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,46.01,,,46.01,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,29.56,110.02,percent of total billed charges,,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,29.56,,,29.56,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,36.8,,,36.8,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,55.17,,,55.17,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,46.74,,,46.74,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,46.74,,,46.74,29.56,110.02,other,Could be inpatient or outpatient,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,29.56,110.02,percent of total billed charges,,
HC PROSTAGLND D2 URN,84150,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,54.77,,,54.77,29.56,110.02,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT  ,,,both,,,14.76,8.86,Aetna,Commerical,,4.25,,,4.25,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Aetna,Middlesex Employees,,3.83,,,3.83,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Anthem,Commerical,,6.76,,,6.76,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Anthem,Indemnity,,,10.73,,10.73,3.83,11.82,percent of total billed charges,,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Anthem,State Preferred,,4.34,,,4.34,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Anthem,Individual Exchange,,5.4,,,5.4,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Cigna,Cigna,,8.31,,,8.31,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Connecticare,Commerical,,4.11,,,4.11,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Connecticare,Exchange,,4.11,,,4.11,3.83,11.82,other,Could be inpatient or outpatient,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,Multiplan,Multiplan,,,11.82,,11.82,3.83,11.82,percent of total billed charges,,
HC TOTAL PROTEIN,84155,CPT,,,both,,,14.76,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,5.34,,,5.34,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT  ,,,both,,,14.76,8.86,Aetna,Commerical,,4.25,,,4.25,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Aetna,Middlesex Employees,,3.83,,,3.83,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Anthem,Commerical,,6.76,,,6.76,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Anthem,Indemnity,,,10.73,,10.73,3.83,11.82,percent of total billed charges,,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Anthem,State Preferred,,4.34,,,4.34,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Anthem,Individual Exchange,,5.4,,,5.4,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Cigna,Cigna,,8.31,,,8.31,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Connecticare,Commerical,,4.11,,,4.11,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Connecticare,Exchange,,4.11,,,4.11,3.83,11.82,other,Could be inpatient or outpatient,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,Multiplan,Multiplan,,,11.82,,11.82,3.83,11.82,percent of total billed charges,,
HC PROTEIN-24 HR UR,84156,CPT,,,both,,,14.76,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,5.34,,,5.34,3.83,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT  ,,,both,,,14.76,8.86,Aetna,Commerical,,4.64,,,4.64,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Aetna,Middlesex Employees,,4.17,,,4.17,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Anthem,Commerical,,6.76,,,6.76,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Anthem,Indemnity,,,10.73,,10.73,4.17,11.82,percent of total billed charges,,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Anthem,State Preferred,,4.34,,,4.34,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Anthem,Individual Exchange,,5.4,,,5.4,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Cigna,Cigna,,8.31,,,8.31,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Connecticare,Commerical,,4.48,,,4.48,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Connecticare,Exchange,,4.48,,,4.48,4.17,11.82,other,Could be inpatient or outpatient,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,Multiplan,Multiplan,,,11.82,,11.82,4.17,11.82,percent of total billed charges,,
HC CSF/BODY FL PROT,84157,CPT,,,both,,,14.76,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,5.34,,,5.34,4.17,11.82,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.72,51.4,percent of total billed charges,,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,12.72,,,12.72,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.72,51.4,percent of total billed charges,,
HC ELECTRO PROTN SER,84165,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,12.72,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,21.11,51.4,percent of total billed charges,,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,21.11,,,21.11,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,21.11,51.4,other,Could be inpatient or outpatient,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,21.11,51.4,percent of total billed charges,,
HC ELECTRO PROTEN-UR,84166,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,21.11,51.4,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT  ,,,both,,,129.78,77.87,Aetna,Commerical,,71.13,,,71.13,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Aetna,Middlesex Employees,,64.02,,,64.02,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Anthem,Commerical,,84.46,,,84.46,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Anthem,Indemnity,,,94.13,,94.13,20.17,103.7,percent of total billed charges,,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Anthem,State Preferred,,20.17,,,20.17,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Anthem,Individual Exchange,,67.56,,,67.56,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Cigna,Cigna,,97.09,,,97.09,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Connecticare,Commerical,,90.39,,,90.39,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Connecticare,Exchange,,90.39,,,90.39,20.17,103.7,other,Could be inpatient or outpatient,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,Multiplan,Multiplan,,,103.7,,103.7,20.17,103.7,percent of total billed charges,,
HC WB INTERP/REPORT,84181,CPT,,,both,,,129.78,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,78.85,,,78.85,20.17,103.7,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT  ,,,both,,,261.12,156.67,Aetna,Commerical,,143.49,,,143.49,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Aetna,Middlesex Employees,,129.14,,,129.14,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Commerical,,170.37,,,170.37,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Indemnity,,,189.91,,189.91,21.31,209.21,percent of total billed charges,,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Anthem,State Preferred,,21.31,,,21.31,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Individual Exchange,,136.3,,,136.3,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Cigna,Cigna,,195.86,,,195.86,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Commerical,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Exchange,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,Multiplan,Multiplan,,,209.21,,209.21,21.31,209.21,percent of total billed charges,,
HC AMPHIPHYSIN WESTERN BLOT CSF HH,84182,CPT,,,both,,,261.12,156.67,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT  ,,,both,,,261.12,156.67,Aetna,Commerical,,143.49,,,143.49,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Aetna,Middlesex Employees,,129.14,,,129.14,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Commerical,,170.37,,,170.37,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Indemnity,,,189.91,,189.91,21.31,209.21,percent of total billed charges,,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,State Preferred,,21.31,,,21.31,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Individual Exchange,,136.3,,,136.3,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Cigna,Cigna,,195.86,,,195.86,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Commerical,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Exchange,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Multiplan,Multiplan,,,209.21,,209.21,21.31,209.21,percent of total billed charges,,
HC CRMP-5-IGG WESTERN BLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT  ,,,both,,,261.12,156.67,Aetna,Commerical,,143.49,,,143.49,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Aetna,Middlesex Employees,,129.14,,,129.14,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Commerical,,170.37,,,170.37,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Indemnity,,,189.91,,189.91,21.31,209.21,percent of total billed charges,,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,State Preferred,,21.31,,,21.31,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Anthem,Individual Exchange,,136.3,,,136.3,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Cigna,Cigna,,195.86,,,195.86,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Commerical,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Connecticare,Exchange,,182.34,,,182.34,21.31,209.21,other,Could be inpatient or outpatient,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,Multiplan,Multiplan,,,209.21,,209.21,21.31,209.21,percent of total billed charges,,
HC PARANEOPLAS AUTOANTBODY WBLOT CSF  HH,84182,CPT,,,both,,,261.12,156.67,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,21.31,209.21,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,31.85,,,31.85,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,28.66,,,28.66,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.82,,,37.82,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,16.99,46.44,percent of total billed charges,,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,16.99,,,16.99,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.25,,,30.25,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,43.48,,,43.48,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,40.48,,,40.48,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,40.48,,,40.48,16.99,46.44,other,Could be inpatient or outpatient,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,16.99,46.44,percent of total billed charges,,
HC ZZP,84202,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,16.99,46.44,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT  ,,,both,,,221.45,132.87,Aetna,Commerical,,121.84,,,121.84,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Aetna,Middlesex Employees,,109.66,,,109.66,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Anthem,Commerical,,144.67,,,144.67,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Anthem,Indemnity,,,161.26,,161.26,19.94,177.65,percent of total billed charges,,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Anthem,State Preferred,,19.94,,,19.94,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Anthem,Individual Exchange,,115.73,,,115.73,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Cigna,Cigna,,166.32,,,166.32,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Connecticare,Commerical,,154.84,,,154.84,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Connecticare,Exchange,,154.84,,,154.84,19.94,177.65,other,Could be inpatient or outpatient,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,Multiplan,Multiplan,,,177.65,,177.65,19.94,177.65,percent of total billed charges,,
HC PROINSULIN,84206,CPT,,,both,,,221.45,132.87,United Healthcare/Oxford,United Healthcare/Oxford,,135.07,,,135.07,19.94,177.65,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,32.58,,,32.58,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,29.32,,,29.32,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,45.25,,,45.25,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,29.08,91.08,percent of total billed charges,,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,29.08,,,29.08,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,36.2,,,36.2,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,62.32,,,62.32,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,31.44,,,31.44,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,31.44,,,31.44,29.08,91.08,other,Could be inpatient or outpatient,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,29.08,91.08,percent of total billed charges,,
HC VITAMIN B6,84207,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,40.93,,,40.93,29.08,91.08,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,16.79,,,16.79,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,15.11,,,15.11,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,20.01,,,20.01,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,12.85,37.77,percent of total billed charges,,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,12.85,,,12.85,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,16,,,16,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,24.34,,,24.34,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,16.2,,,16.2,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,16.2,,,16.2,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,12.85,37.77,percent of total billed charges,,
HC PYRUVATE,84210,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,18.99,,,18.99,12.85,37.77,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,20.95,,,20.95,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,18.86,,,18.86,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,24.87,,,24.87,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,11.18,30.54,percent of total billed charges,,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,19.89,,,19.89,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,28.6,,,28.6,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,26.62,,,26.62,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,26.62,,,26.62,11.18,30.54,other,Could be inpatient or outpatient,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,11.18,30.54,percent of total billed charges,,
HC PYRUVATE KINASE,84220,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,23.23,,,23.23,11.18,30.54,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT  ,,,both,,,147.44,88.47,Aetna,Commerical,,81.02,,,81.02,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Aetna,Middlesex Employees,,72.92,,,72.92,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Anthem,Commerical,,96.2,,,96.2,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Anthem,Indemnity,,,107.23,,107.23,43.29,118.13,percent of total billed charges,,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Anthem,State Preferred,,43.29,,,43.29,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Anthem,Individual Exchange,,76.96,,,76.96,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Cigna,Cigna,,110.59,,,110.59,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Connecticare,Commerical,,102.96,,,102.96,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Connecticare,Exchange,,102.96,,,102.96,43.29,118.13,other,Could be inpatient or outpatient,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,Multiplan,Multiplan,,,118.13,,118.13,43.29,118.13,percent of total billed charges,,
HC SOLBL TRNSF RCPT CodeR,84238,CPT,,,both,,,147.44,88.47,United Healthcare/Oxford,United Healthcare/Oxford,,89.83,,,89.83,43.29,118.13,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT  ,,,both,,,86.52,51.91,Aetna,Commerical,,48.24,,,48.24,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Aetna,Middlesex Employees,,43.42,,,43.42,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Anthem,Commerical,,57.28,,,57.28,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Anthem,Indemnity,,,63.85,,63.85,26.04,70.34,percent of total billed charges,,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Anthem,State Preferred,,26.04,,,26.04,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Anthem,Individual Exchange,,45.82,,,45.82,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Cigna,Cigna,,65.85,,,65.85,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Connecticare,Commerical,,61.31,,,61.31,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Connecticare,Exchange,,61.31,,,61.31,26.04,70.34,other,Could be inpatient or outpatient,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,Multiplan,Multiplan,,,70.34,,70.34,26.04,70.34,percent of total billed charges,,
HC RENIN,84244,CPT,,,both,,,86.52,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,53.48,,,53.48,26.04,70.34,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT  ,,,both,,,76.22,45.73,Aetna,Commerical,,42.06,,,42.06,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Aetna,Middlesex Employees,,37.86,,,37.86,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Anthem,Commerical,,49.94,,,49.94,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Anthem,Indemnity,,,55.66,,55.66,13.79,61.32,percent of total billed charges,,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Anthem,State Preferred,,13.79,,,13.79,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Anthem,Individual Exchange,,39.95,,,39.95,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Cigna,Cigna,,57.41,,,57.41,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Connecticare,Commerical,,53.44,,,53.44,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Connecticare,Exchange,,53.44,,,53.44,13.79,61.32,other,Could be inpatient or outpatient,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,Multiplan,Multiplan,,,61.32,,61.32,13.79,61.32,percent of total billed charges,,
HC ASSAY OF RIBOFLAVIN-VITAMIN B-2,84252,CPT,,,both,,,76.22,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,46.63,,,46.63,13.79,61.32,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,30.22,82.06,percent of total billed charges,,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Anthem,State Preferred,,30.22,,,30.22,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,30.22,82.06,other,Could be inpatient or outpatient,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,30.22,82.06,percent of total billed charges,,
HC SELENIUM,84255,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,30.22,82.06,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT  ,,,both,,,106.09,63.65,Aetna,Commerical,,40.96,,,40.96,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Aetna,Middlesex Employees,,36.9,,,36.9,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Anthem,Commerical,,30.02,,,30.02,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Anthem,Indemnity,,,77.16,,77.16,21.63,96.66,percent of total billed charges,,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Anthem,State Preferred,,21.63,,,21.63,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Anthem,Individual Exchange,,24.01,,,24.01,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Cigna,Cigna,,96.66,,,96.66,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Connecticare,Commerical,,36.68,,,36.68,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Connecticare,Exchange,,36.68,,,36.68,21.63,96.66,other,Could be inpatient or outpatient,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,Multiplan,Multiplan,,,85,,85,21.63,96.66,percent of total billed charges,,
HC SEROTONIN SERUM,84260,CPT,,,both,,,106.09,63.65,United Healthcare/Oxford,United Healthcare/Oxford,,38.3,,,38.3,21.63,96.66,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT  ,,,both,,,86.66,52,Aetna,Commerical,,25.19,,,25.19,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Aetna,Middlesex Employees,,22.68,,,22.68,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Anthem,Commerical,,40.04,,,40.04,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Anthem,Indemnity,,,63.03,,63.03,22.68,69.44,percent of total billed charges,,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Anthem,State Preferred,,25.73,,,25.73,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Anthem,Individual Exchange,,32.03,,,32.03,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Cigna,Cigna,,48.07,,,48.07,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Connecticare,Commerical,,24.32,,,24.32,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Connecticare,Exchange,,24.32,,,24.32,22.68,69.44,other,Could be inpatient or outpatient,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,Multiplan,Multiplan,,,69.44,,69.44,22.68,69.44,percent of total billed charges,,
HC SEX HORM BG GLOB,84270,CPT,,,both,,,86.66,52,United Healthcare/Oxford,United Healthcare/Oxford,,31.66,,,31.66,22.68,69.44,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT  ,,,both,,,19.37,11.62,Aetna,Commerical,,5.57,,,5.57,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Aetna,Middlesex Employees,,5.01,,,5.01,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Anthem,Commerical,,8.88,,,8.88,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Anthem,Indemnity,,,14.09,,14.09,5.01,15.52,percent of total billed charges,,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Anthem,State Preferred,,5.69,,,5.69,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Anthem,Individual Exchange,,7.1,,,7.1,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Cigna,Cigna,,10.68,,,10.68,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Connecticare,Commerical,,5.38,,,5.38,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Connecticare,Exchange,,5.38,,,5.38,5.01,15.52,other,Could be inpatient or outpatient,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,Multiplan,Multiplan,,,15.52,,15.52,5.01,15.52,percent of total billed charges,,
HC ISTAT SODIUM,84295,CPT,,,both,,,19.37,11.62,United Healthcare/Oxford,United Healthcare/Oxford,,7.01,,,7.01,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT  ,,,both,,,19.37,11.62,Aetna,Commerical,,5.57,,,5.57,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Aetna,Middlesex Employees,,5.01,,,5.01,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Anthem,Commerical,,8.88,,,8.88,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Anthem,Indemnity,,,14.09,,14.09,5.01,15.52,percent of total billed charges,,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Anthem,State Preferred,,5.69,,,5.69,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Anthem,Individual Exchange,,7.1,,,7.1,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Cigna,Cigna,,10.68,,,10.68,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Connecticare,Commerical,,5.38,,,5.38,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Connecticare,Exchange,,5.38,,,5.38,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,Multiplan,Multiplan,,,15.52,,15.52,5.01,15.52,percent of total billed charges,,
HC SODIUM BLOOD,84295,CPT,,,both,,,19.37,11.62,United Healthcare/Oxford,United Healthcare/Oxford,,7.01,,,7.01,5.01,15.52,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT  ,,,both,,,19.57,11.74,Aetna,Commerical,,5.87,,,5.87,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Aetna,Middlesex Employees,,5.28,,,5.28,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Anthem,Commerical,,8.97,,,8.97,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Anthem,Indemnity,,,14.24,,14.24,5.28,15.68,percent of total billed charges,,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Anthem,State Preferred,,5.75,,,5.75,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Anthem,Individual Exchange,,7.18,,,7.18,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Cigna,Cigna,,10.68,,,10.68,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Connecticare,Commerical,,5.67,,,5.67,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Connecticare,Exchange,,5.67,,,5.67,5.28,15.68,other,Could be inpatient or outpatient,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,Multiplan,Multiplan,,,15.68,,15.68,5.28,15.68,percent of total billed charges,,
HC SODIUM URINE,84300,CPT,,,both,,,19.57,11.74,United Healthcare/Oxford,United Healthcare/Oxford,,7.08,,,7.08,5.28,15.68,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT  ,,,both,,,23.67,14.2,Aetna,Commerical,,13,,,13,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Aetna,Middlesex Employees,,11.7,,,11.7,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Anthem,Commerical,,15.44,,,15.44,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Anthem,Indemnity,,,17.21,,17.21,5.75,18.96,percent of total billed charges,,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Anthem,State Preferred,,5.75,,,5.75,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Anthem,Individual Exchange,,12.36,,,12.36,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Cigna,Cigna,,17.75,,,17.75,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Connecticare,Commerical,,16.52,,,16.52,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Connecticare,Exchange,,16.52,,,16.52,5.75,18.96,other,Could be inpatient or outpatient,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,Multiplan,Multiplan,,,18.96,,18.96,5.75,18.96,percent of total billed charges,,
HC CSF/BODY FLD NA,84302,CPT,,,both,,,23.67,14.2,United Healthcare/Oxford,United Healthcare/Oxford,,14.42,,,14.42,5.75,18.96,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,14.33,,,14.33,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,12.9,,,12.9,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,17.03,,,17.03,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,5.75,20.9,percent of total billed charges,,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,5.75,,,5.75,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,13.62,,,13.62,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,19.57,,,19.57,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,18.22,,,18.22,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,18.22,,,18.22,5.75,20.9,other,Could be inpatient or outpatient,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,5.75,20.9,percent of total billed charges,,
HC SODIUM STOOL,84302,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,15.89,,,15.89,5.75,20.9,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,24.65,,,24.65,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,22.19,,,22.19,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,39.17,,,39.17,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,22.19,68.54,percent of total billed charges,,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,25.17,,,25.17,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,31.34,,,31.34,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,47.49,,,47.49,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,23.79,,,23.79,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,23.79,,,23.79,22.19,68.54,other,Could be inpatient or outpatient,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,22.19,68.54,percent of total billed charges,,
HC IGF1,84305,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,30.99,,,30.99,22.19,68.54,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,15.44,,,15.44,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,13.9,,,13.9,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,18.33,,,18.33,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,8.28,22.51,percent of total billed charges,,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.28,,,8.28,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,14.67,,,14.67,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,21.07,,,21.07,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,19.62,,,19.62,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,19.62,,,19.62,8.28,22.51,other,Could be inpatient or outpatient,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,8.28,22.51,percent of total billed charges,,
HC ADENOS DEAMINASE,84311,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,17.12,,,17.12,8.28,22.51,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,19.84,,,19.84,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,17.86,,,17.86,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,23.56,,,23.56,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,8.28,28.93,percent of total billed charges,,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,8.28,,,8.28,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,18.85,,,18.85,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,27.08,,,27.08,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,25.21,,,25.21,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,25.21,,,25.21,8.28,28.93,other,Could be inpatient or outpatient,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,8.28,28.93,percent of total billed charges,,
HC ARYLSULFATASE A,84311,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,22,,,22,8.28,28.93,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,15.44,,,15.44,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,13.9,,,13.9,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,18.33,,,18.33,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,8.28,22.51,percent of total billed charges,,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.28,,,8.28,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,14.67,,,14.67,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,21.07,,,21.07,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,19.62,,,19.62,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,19.62,,,19.62,8.28,22.51,other,Could be inpatient or outpatient,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,8.28,22.51,percent of total billed charges,,
HC FNGITEL R1-3 GLUC,84311,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,17.12,,,17.12,8.28,22.51,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT  ,,,both,,,19.54,11.72,Aetna,Commerical,,10.74,,,10.74,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Aetna,Middlesex Employees,,9.66,,,9.66,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Anthem,Commerical,,12.75,,,12.75,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Anthem,Indemnity,,,14.21,,14.21,8.28,15.66,percent of total billed charges,,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Anthem,State Preferred,,8.28,,,8.28,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Anthem,Individual Exchange,,10.21,,,10.21,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Cigna,Cigna,,14.65,,,14.65,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Connecticare,Commerical,,13.64,,,13.64,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Connecticare,Exchange,,13.64,,,13.64,8.28,15.66,other,Could be inpatient or outpatient,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,Multiplan,Multiplan,,,15.66,,15.66,8.28,15.66,percent of total billed charges,,
HC SPECTROPHOTOMETRY,84311,CPT,,,both,,,19.54,11.72,United Healthcare/Oxford,United Healthcare/Oxford,,11.91,,,11.91,8.28,15.66,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT  ,,,both,,,22.13,13.28,Aetna,Commerical,,6.37,,,6.37,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Aetna,Middlesex Employees,,5.73,,,5.73,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Anthem,Commerical,,10.13,,,10.13,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Anthem,Indemnity,,,16.1,,16.1,5.73,17.73,percent of total billed charges,,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Anthem,State Preferred,,6.52,,,6.52,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Anthem,Individual Exchange,,8.1,,,8.1,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Cigna,Cigna,,12.47,,,12.47,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Connecticare,Commerical,,6.15,,,6.15,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Connecticare,Exchange,,6.15,,,6.15,5.73,17.73,other,Could be inpatient or outpatient,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,Multiplan,Multiplan,,,17.73,,17.73,5.73,17.73,percent of total billed charges,,
HC REDUCING SUBSTANCES STOOL,84376,CPT,,,both,,,22.13,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,8.01,,,8.01,5.73,17.73,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT  ,,,both,,,375.92,225.55,Aetna,Commerical,,206.57,,,206.57,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Aetna,Middlesex Employees,,185.92,,,185.92,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Anthem,Commerical,,245.27,,,245.27,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Anthem,Indemnity,,,273.4,,273.4,30.14,301.19,percent of total billed charges,,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Anthem,State Preferred,,30.14,,,30.14,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Anthem,Individual Exchange,,196.22,,,196.22,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Cigna,Cigna,,281.99,,,281.99,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Connecticare,Commerical,,262.51,,,262.51,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Connecticare,Exchange,,262.51,,,262.51,30.14,301.19,other,Could be inpatient or outpatient,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,Multiplan,Multiplan,,,301.19,,301.19,30.14,301.19,percent of total billed charges,,
HC SPECIALITY TEST TESTOSTERONE FREE,84402,CPT,,,both,,,375.92,225.55,United Healthcare/Oxford,United Healthcare/Oxford,,229.01,,,229.01,30.14,301.19,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT  ,,,both,,,222.85,133.71,Aetna,Commerical,,122.46,,,122.46,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Aetna,Middlesex Employees,,110.22,,,110.22,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Anthem,Commerical,,145.41,,,145.41,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Anthem,Indemnity,,,162.08,,162.08,30.14,178.55,percent of total billed charges,,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Anthem,State Preferred,,30.14,,,30.14,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Anthem,Individual Exchange,,116.32,,,116.32,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Cigna,Cigna,,167.16,,,167.16,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Connecticare,Commerical,,155.62,,,155.62,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Connecticare,Exchange,,155.62,,,155.62,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,Multiplan,Multiplan,,,178.55,,178.55,30.14,178.55,percent of total billed charges,,
HC TESTOSTERONE FREE,84402,CPT,,,both,,,222.85,133.71,United Healthcare/Oxford,United Healthcare/Oxford,,135.76,,,135.76,30.14,178.55,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT  ,,,both,,,105.06,63.04,Aetna,Commerical,,29.92,,,29.92,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Aetna,Middlesex Employees,,26.93,,,26.93,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Anthem,Commerical,,47.59,,,47.59,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Anthem,Indemnity,,,76.12,,76.12,26.93,83.86,percent of total billed charges,,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Anthem,State Preferred,,30.57,,,30.57,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Anthem,Individual Exchange,,38.07,,,38.07,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Cigna,Cigna,,57.55,,,57.55,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Connecticare,Commerical,,28.88,,,28.88,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Connecticare,Exchange,,28.88,,,28.88,26.93,83.86,other,Could be inpatient or outpatient,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,Multiplan,Multiplan,,,83.86,,83.86,26.93,83.86,percent of total billed charges,,
HC TESTOSTERONE,84403,CPT,,,both,,,105.06,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,37.62,,,37.62,26.93,83.86,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT  ,,,both,,,278.1,166.86,Aetna,Commerical,,24.61,,,24.61,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Aetna,Middlesex Employees,,22.16,,,22.16,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Anthem,Commerical,,39.13,,,39.13,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Anthem,Indemnity,,,202.18,,202.18,22.16,222.73,percent of total billed charges,,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Anthem,State Preferred,,25.14,,,25.14,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Anthem,Individual Exchange,,31.31,,,31.31,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Cigna,Cigna,,46.87,,,46.87,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Connecticare,Commerical,,23.76,,,23.76,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Connecticare,Exchange,,23.76,,,23.76,22.16,222.73,other,Could be inpatient or outpatient,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,Multiplan,Multiplan,,,222.73,,222.73,22.16,222.73,percent of total billed charges,,
HC THIAMINE,84425,CPT,,,both,,,278.1,166.86,United Healthcare/Oxford,United Healthcare/Oxford,,30.93,,,30.93,22.16,222.73,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,24.61,,,24.61,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,22.16,,,22.16,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,39.13,,,39.13,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,22.16,68.54,percent of total billed charges,,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,25.14,,,25.14,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,31.31,,,31.31,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,46.87,,,46.87,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,23.76,,,23.76,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,23.76,,,23.76,22.16,68.54,other,Could be inpatient or outpatient,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,22.16,68.54,percent of total billed charges,,
HC VITAMIN B1,84425,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,30.93,,,30.93,22.16,68.54,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,25.9,,,25.9,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,23.31,,,23.31,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,30.76,,,30.76,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,13.79,37.77,percent of total billed charges,,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,13.79,,,13.79,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,24.61,,,24.61,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,35.36,,,35.36,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,32.91,,,32.91,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,32.91,,,32.91,13.79,37.77,other,Could be inpatient or outpatient,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,13.79,37.77,percent of total billed charges,,
HC THIOCYANATE,84430,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,28.72,,,28.72,13.79,37.77,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,19.01,51.4,percent of total billed charges,,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,19.01,,,19.01,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,19.01,51.4,other,Could be inpatient or outpatient,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,19.01,51.4,percent of total billed charges,,
HC THYROGLUBULIN,84432,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,19.01,51.4,other,Could be inpatient or outpatient,
HC T-4,84436,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,7.97,,,7.97,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,7.18,,,7.18,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,12.66,,,12.66,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,7.18,22.51,percent of total billed charges,,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.15,,,8.15,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,10.12,,,10.12,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,15.43,,,15.43,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,7.69,,,7.69,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,7.69,,,7.69,7.18,22.51,other,Could be inpatient or outpatient,
HC T-4,84436,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,7.18,22.51,percent of total billed charges,,
HC T-4,84436,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,10.01,,,10.01,7.18,22.51,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,10.45,,,10.45,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,9.41,,,9.41,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,16.62,,,16.62,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,9.41,28.93,percent of total billed charges,,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,10.68,,,10.68,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,13.3,,,13.3,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,20.19,,,20.19,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,10.09,,,10.09,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,10.09,,,10.09,9.41,28.93,other,Could be inpatient or outpatient,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,9.41,28.93,percent of total billed charges,,
HC FREE TH,84439,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.13,,,13.13,9.41,28.93,other,Could be inpatient or outpatient,
HC TSH,84443,CPT  ,,,both,,,67.98,40.79,Aetna,Commerical,,19.48,,,19.48,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Aetna,Middlesex Employees,,17.53,,,17.53,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Anthem,Commerical,,30.97,,,30.97,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Anthem,Indemnity,,,49.11,,49.11,17.53,54.1,percent of total billed charges,,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Anthem,State Preferred,,19.88,,,19.88,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Anthem,Individual Exchange,,24.78,,,24.78,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Cigna,Cigna,,37.38,,,37.38,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Connecticare,Commerical,,18.79,,,18.79,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Connecticare,Exchange,,18.79,,,18.79,17.53,54.1,other,Could be inpatient or outpatient,
HC TSH,84443,CPT,,,both,,,67.98,40.79,Multiplan,Multiplan,,,54.1,,54.1,17.53,54.1,percent of total billed charges,,
HC TSH,84443,CPT,,,both,,,67.98,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,24.47,,,24.47,17.53,54.1,other,Could be inpatient or outpatient,
HC TBII,84445,CPT  ,,,both,,,191.58,114.95,Aetna,Commerical,,58.97,,,58.97,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Aetna,Middlesex Employees,,53.07,,,53.07,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Anthem,Commerical,,93.72,,,93.72,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Anthem,Indemnity,,,139.97,,139.97,53.07,154.2,percent of total billed charges,,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Anthem,State Preferred,,60.21,,,60.21,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Anthem,Individual Exchange,,74.98,,,74.98,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Cigna,Cigna,,112.78,,,112.78,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Connecticare,Commerical,,56.91,,,56.91,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Connecticare,Exchange,,56.91,,,56.91,53.07,154.2,other,Could be inpatient or outpatient,
HC TBII,84445,CPT,,,both,,,191.58,114.95,Multiplan,Multiplan,,,154.2,,154.2,53.07,154.2,percent of total billed charges,,
HC TBII,84445,CPT,,,both,,,191.58,114.95,United Healthcare/Oxford,United Healthcare/Oxford,,74.1,,,74.1,53.07,154.2,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT  ,,,both,,,204.97,122.98,Aetna,Commerical,,58.97,,,58.97,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Aetna,Middlesex Employees,,53.07,,,53.07,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Anthem,Commerical,,93.72,,,93.72,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Anthem,Indemnity,,,148.98,,148.98,53.07,164.12,percent of total billed charges,,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Anthem,State Preferred,,60.21,,,60.21,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Anthem,Individual Exchange,,74.98,,,74.98,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Cigna,Cigna,,112.78,,,112.78,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Connecticare,Commerical,,56.91,,,56.91,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Connecticare,Exchange,,56.91,,,56.91,53.07,164.12,other,Could be inpatient or outpatient,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,Multiplan,Multiplan,,,164.12,,164.12,53.07,164.12,percent of total billed charges,,
HC TSI(THYROID STM),84445,CPT,,,both,,,204.97,122.98,United Healthcare/Oxford,United Healthcare/Oxford,,74.1,,,74.1,53.07,164.12,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,16.44,,,16.44,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,14.8,,,14.8,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,26.13,,,26.13,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,14.8,45.51,percent of total billed charges,,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,16.79,,,16.79,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,20.91,,,20.91,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,31.45,,,31.45,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,15.86,,,15.86,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,15.86,,,15.86,14.8,45.51,other,Could be inpatient or outpatient,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,14.8,45.51,percent of total billed charges,,
HC VITAMIN E,84446,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,20.65,,,20.65,14.8,45.51,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC AST (SGOT),84450,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT  ,,,both,,,21.33,12.8,Aetna,Commerical,,6.14,,,6.14,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Aetna,Middlesex Employees,,5.53,,,5.53,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Anthem,Commerical,,9.75,,,9.75,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Anthem,Indemnity,,,15.51,,15.51,5.53,17.09,percent of total billed charges,,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Anthem,State Preferred,,6.27,,,6.27,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Anthem,Individual Exchange,,7.8,,,7.8,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Cigna,Cigna,,11.86,,,11.86,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Connecticare,Commerical,,5.93,,,5.93,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Connecticare,Exchange,,5.93,,,5.93,5.53,17.09,other,Could be inpatient or outpatient,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,Multiplan,Multiplan,,,17.09,,17.09,5.53,17.09,percent of total billed charges,,
HC ALT (SGPT),84460,CPT,,,both,,,21.33,12.8,United Healthcare/Oxford,United Healthcare/Oxford,,7.73,,,7.73,5.53,17.09,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT  ,,,both,,,51.01,30.6,Aetna,Commerical,,14.8,,,14.8,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Aetna,Middlesex Employees,,13.32,,,13.32,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Anthem,Commerical,,23.53,,,23.53,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Anthem,Indemnity,,,37.1,,37.1,13.32,40.87,percent of total billed charges,,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Anthem,State Preferred,,15.12,,,15.12,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Anthem,Individual Exchange,,18.82,,,18.82,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Cigna,Cigna,,28.5,,,28.5,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Connecticare,Commerical,,14.27,,,14.27,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Connecticare,Exchange,,14.27,,,14.27,13.32,40.87,other,Could be inpatient or outpatient,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,Multiplan,Multiplan,,,40.87,,40.87,13.32,40.87,percent of total billed charges,,
HC TRANSFERRIN,84466,CPT,,,both,,,51.01,30.6,United Healthcare/Oxford,United Healthcare/Oxford,,18.6,,,18.6,13.32,40.87,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT  ,,,both,,,23.1,13.86,Aetna,Commerical,,6.66,,,6.66,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Aetna,Middlesex Employees,,5.99,,,5.99,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Anthem,Commerical,,10.59,,,10.59,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Anthem,Indemnity,,,16.8,,16.8,5.99,18.51,percent of total billed charges,,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Anthem,State Preferred,,6.81,,,6.81,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Anthem,Individual Exchange,,8.47,,,8.47,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Cigna,Cigna,,13.05,,,13.05,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Connecticare,Commerical,,6.42,,,6.42,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Connecticare,Exchange,,6.42,,,6.42,5.99,18.51,other,Could be inpatient or outpatient,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,Multiplan,Multiplan,,,18.51,,18.51,5.99,18.51,percent of total billed charges,,
HC TRIGLYCERIDES,84478,CPT,,,both,,,23.1,13.86,United Healthcare/Oxford,United Healthcare/Oxford,,8.37,,,8.37,5.99,18.51,other,Could be inpatient or outpatient,
HC T-3,84479,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,7.66,41.79,percent of total billed charges,,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,7.66,,,7.66,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,7.66,41.79,other,Could be inpatient or outpatient,
HC T-3,84479,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,7.66,41.79,percent of total billed charges,,
HC T-3,84479,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,7.66,41.79,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,16.44,,,16.44,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,14.8,,,14.8,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,26.13,,,26.13,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,14.8,45.51,percent of total billed charges,,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,16.79,,,16.79,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,20.91,,,20.91,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,31.45,,,31.45,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,15.86,,,15.86,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,15.86,,,15.86,14.8,45.51,other,Could be inpatient or outpatient,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,14.8,45.51,percent of total billed charges,,
HC TOTAL T3,84480,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,20.65,,,20.65,14.8,45.51,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,19.64,,,19.64,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,17.68,,,17.68,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,31.23,,,31.23,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,17.68,55,percent of total billed charges,,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,20.06,,,20.06,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,24.98,,,24.98,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,37.38,,,37.38,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,18.96,,,18.96,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,18.96,,,18.96,17.68,55,other,Could be inpatient or outpatient,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,17.68,55,percent of total billed charges,,
HC FREE T3,84481,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,24.68,,,24.68,17.68,55,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,18.66,51.4,percent of total billed charges,,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,18.66,,,18.66,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,18.66,51.4,other,Could be inpatient or outpatient,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,18.66,51.4,percent of total billed charges,,
HC REVERSE T3,84482,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,18.66,51.4,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,14.45,,,14.45,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,13.01,,,13.01,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,18.14,,,18.14,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,11.64,32.94,percent of total billed charges,,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,11.64,,,11.64,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,14.51,,,14.51,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,21.96,,,21.96,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,13.95,,,13.95,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,13.95,,,13.95,11.64,32.94,other,Could be inpatient or outpatient,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,11.64,32.94,percent of total billed charges,,
HC TROPONIN-T,84484,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,16.35,,,16.35,11.64,32.94,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT  ,,,both,,,234.11,140.47,Aetna,Commerical,,128.64,,,128.64,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Aetna,Middlesex Employees,,115.78,,,115.78,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Anthem,Commerical,,152.75,,,152.75,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Anthem,Indemnity,,,170.26,,170.26,4.64,187.57,percent of total billed charges,,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Anthem,State Preferred,,4.64,,,4.64,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Anthem,Individual Exchange,,122.19,,,122.19,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Cigna,Cigna,,175.6,,,175.6,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Connecticare,Commerical,,163.48,,,163.48,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Connecticare,Exchange,,163.48,,,163.48,4.64,187.57,other,Could be inpatient or outpatient,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,Multiplan,Multiplan,,,187.57,,187.57,4.64,187.57,percent of total billed charges,,
HC TRYPSIN FECES,84488,CPT,,,both,,,234.11,140.47,United Healthcare/Oxford,United Healthcare/Oxford,,142.61,,,142.61,4.64,187.57,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT  ,,,both,,,40.58,24.35,Aetna,Commerical,,22.3,,,22.3,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Aetna,Middlesex Employees,,20.07,,,20.07,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Anthem,Commerical,,26.48,,,26.48,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Anthem,Indemnity,,,29.51,,29.51,12.32,32.51,percent of total billed charges,,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Anthem,State Preferred,,12.32,,,12.32,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Anthem,Individual Exchange,,21.18,,,21.18,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Cigna,Cigna,,30.43,,,30.43,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Connecticare,Commerical,,28.33,,,28.33,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Connecticare,Exchange,,28.33,,,28.33,12.32,32.51,other,Could be inpatient or outpatient,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,Multiplan,Multiplan,,,32.51,,32.51,12.32,32.51,percent of total billed charges,,
HC ASSAY OF TYROSINE - PORPHYRINS FRACTIONATED URINE RANDOM QN,84510,CPT,,,both,,,40.58,24.35,United Healthcare/Oxford,United Healthcare/Oxford,,24.72,,,24.72,12.32,32.51,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT  ,,,both,,,15.91,9.55,Aetna,Commerical,,4.58,,,4.58,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Aetna,Middlesex Employees,,4.12,,,4.12,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Anthem,Commerical,,7.28,,,7.28,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Anthem,Indemnity,,,11.57,,11.57,4.12,12.75,percent of total billed charges,,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Anthem,State Preferred,,4.67,,,4.67,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Anthem,Individual Exchange,,5.82,,,5.82,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Cigna,Cigna,,8.91,,,8.91,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Connecticare,Commerical,,4.42,,,4.42,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Connecticare,Exchange,,4.42,,,4.42,4.12,12.75,other,Could be inpatient or outpatient,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,Multiplan,Multiplan,,,12.75,,12.75,4.12,12.75,percent of total billed charges,,
HC I-STAT BUN,84520,CPT,,,both,,,15.91,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,5.76,,,5.76,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT  ,,,both,,,15.91,9.55,Aetna,Commerical,,4.58,,,4.58,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Aetna,Middlesex Employees,,4.12,,,4.12,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Anthem,Commerical,,7.28,,,7.28,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Anthem,Indemnity,,,11.57,,11.57,4.12,12.75,percent of total billed charges,,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Anthem,State Preferred,,4.67,,,4.67,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Anthem,Individual Exchange,,5.82,,,5.82,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Cigna,Cigna,,8.91,,,8.91,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Connecticare,Commerical,,4.42,,,4.42,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Connecticare,Exchange,,4.42,,,4.42,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,Multiplan,Multiplan,,,12.75,,12.75,4.12,12.75,percent of total billed charges,,
HC UREA NITRO QNT-BL,84520,CPT,,,both,,,15.91,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,5.76,,,5.76,4.12,12.75,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT  ,,,both,,,25.08,15.05,Aetna,Commerical,,13.78,,,13.78,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Aetna,Middlesex Employees,,12.4,,,12.4,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Anthem,Commerical,,16.36,,,16.36,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Anthem,Indemnity,,,18.24,,18.24,5.63,20.09,percent of total billed charges,,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Anthem,State Preferred,,5.63,,,5.63,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Anthem,Individual Exchange,,13.09,,,13.09,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Cigna,Cigna,,18.81,,,18.81,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Connecticare,Commerical,,17.51,,,17.51,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Connecticare,Exchange,,17.51,,,17.51,5.63,20.09,other,Could be inpatient or outpatient,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,Multiplan,Multiplan,,,20.09,,20.09,5.63,20.09,percent of total billed charges,,
HC UREA NITROGEN UR,84540,CPT,,,both,,,25.08,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,15.27,,,15.27,5.63,20.09,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT  ,,,both,,,18.18,10.91,Aetna,Commerical,,5.24,,,5.24,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Aetna,Middlesex Employees,,4.71,,,4.71,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Anthem,Commerical,,8.32,,,8.32,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Anthem,Indemnity,,,13.22,,13.22,4.71,14.57,percent of total billed charges,,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Anthem,State Preferred,,5.34,,,5.34,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Anthem,Individual Exchange,,6.66,,,6.66,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Cigna,Cigna,,10.08,,,10.08,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Connecticare,Commerical,,5.06,,,5.06,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Connecticare,Exchange,,5.06,,,5.06,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,Multiplan,Multiplan,,,14.57,,14.57,4.71,14.57,percent of total billed charges,,
HC URIC ACID BLOOD,84550,CPT,,,both,,,18.18,10.91,United Healthcare/Oxford,United Healthcare/Oxford,,6.58,,,6.58,4.71,14.57,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT  ,,,both,,,19.1,11.46,Aetna,Commerical,,5.89,,,5.89,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Aetna,Middlesex Employees,,5.3,,,5.3,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Anthem,Commerical,,8.76,,,8.76,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Anthem,Indemnity,,,13.89,,13.89,5.3,15.3,percent of total billed charges,,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Anthem,State Preferred,,5.63,,,5.63,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Anthem,Individual Exchange,,7.01,,,7.01,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Cigna,Cigna,,10.68,,,10.68,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Connecticare,Commerical,,5.69,,,5.69,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Connecticare,Exchange,,5.69,,,5.69,5.3,15.3,other,Could be inpatient or outpatient,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,Multiplan,Multiplan,,,15.3,,15.3,5.3,15.3,percent of total billed charges,,
HC URIC ACID URINE,84560,CPT,,,both,,,19.1,11.46,United Healthcare/Oxford,United Healthcare/Oxford,,6.9,,,6.9,5.3,15.3,other,Could be inpatient or outpatient,
HC VMA,84585,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,17.98,,,17.98,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,16.18,,,16.18,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,28.56,,,28.56,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,16.18,50.5,percent of total billed charges,,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,18.36,,,18.36,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,22.84,,,22.84,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,34.41,,,34.41,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,17.34,,,17.34,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,17.34,,,17.34,16.18,50.5,other,Could be inpatient or outpatient,
HC VMA,84585,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,16.18,50.5,percent of total billed charges,,
HC VMA,84585,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,22.58,,,22.58,16.18,50.5,other,Could be inpatient or outpatient,
HC VIP,84586,CPT  ,,,both,,,219.39,131.63,Aetna,Commerical,,120.6,,,120.6,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Aetna,Middlesex Employees,,108.54,,,108.54,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Anthem,Commerical,,143.2,,,143.2,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Anthem,Indemnity,,,159.62,,159.62,41.83,175.85,percent of total billed charges,,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Anthem,State Preferred,,41.83,,,41.83,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Anthem,Individual Exchange,,114.56,,,114.56,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Cigna,Cigna,,164.63,,,164.63,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Connecticare,Commerical,,153.27,,,153.27,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Connecticare,Exchange,,153.27,,,153.27,41.83,175.85,other,Could be inpatient or outpatient,
HC VIP,84586,CPT,,,both,,,219.39,131.63,Multiplan,Multiplan,,,175.85,,175.85,41.83,175.85,percent of total billed charges,,
HC VIP,84586,CPT,,,both,,,219.39,131.63,United Healthcare/Oxford,United Healthcare/Oxford,,133.7,,,133.7,41.83,175.85,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT  ,,,both,,,137.31,82.39,Aetna,Commerical,,75.46,,,75.46,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Aetna,Middlesex Employees,,67.91,,,67.91,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Anthem,Commerical,,89.59,,,89.59,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Anthem,Indemnity,,,99.86,,99.86,40.19,110.02,percent of total billed charges,,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Anthem,State Preferred,,40.19,,,40.19,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Anthem,Individual Exchange,,71.67,,,71.67,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Cigna,Cigna,,103,,,103,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Connecticare,Commerical,,95.89,,,95.89,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Connecticare,Exchange,,95.89,,,95.89,40.19,110.02,other,Could be inpatient or outpatient,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,Multiplan,Multiplan,,,110.02,,110.02,40.19,110.02,percent of total billed charges,,
HC ADH PLASMA,84588,CPT,,,both,,,137.31,82.39,United Healthcare/Oxford,United Healthcare/Oxford,,83.65,,,83.65,40.19,110.02,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,13.46,,,13.46,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,12.11,,,12.11,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,19.83,,,19.83,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,12.11,37.77,percent of total billed charges,,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,12.73,,,12.73,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,15.87,,,15.87,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,25.51,,,25.51,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,12.99,,,12.99,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,12.99,,,12.99,12.11,37.77,other,Could be inpatient or outpatient,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,12.11,37.77,percent of total billed charges,,
HC VITAMIN A,84590,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,16.91,,,16.91,12.11,37.77,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT  ,,,both,,,111.24,66.74,Aetna,Commerical,,61.23,,,61.23,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Aetna,Middlesex Employees,,55.11,,,55.11,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Anthem,Commerical,,72.7,,,72.7,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Anthem,Indemnity,,,81.04,,81.04,12.73,89.28,percent of total billed charges,,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Anthem,State Preferred,,12.73,,,12.73,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Anthem,Individual Exchange,,58.16,,,58.16,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Cigna,Cigna,,83.58,,,83.58,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Connecticare,Commerical,,77.81,,,77.81,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Connecticare,Exchange,,77.81,,,77.81,12.73,89.28,other,Could be inpatient or outpatient,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,Multiplan,Multiplan,,,89.28,,89.28,12.73,89.28,percent of total billed charges,,
HC NIACIN (VIT B3),84591,CPT,,,both,,,111.24,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,67.88,,,67.88,12.73,89.28,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,30.58,,,30.58,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,27.53,,,27.53,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,11.01,44.58,percent of total billed charges,,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,11.01,,,11.01,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,11.01,44.58,other,Could be inpatient or outpatient,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,11.01,44.58,percent of total billed charges,,
HC VITAMIN K,84597,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,11.01,44.58,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.21,,,13.21,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,11.89,,,11.89,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,20.98,,,20.98,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,11.89,36.97,percent of total billed charges,,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.48,,,13.48,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,16.79,,,16.79,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.75,,,12.75,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.75,,,12.75,11.89,36.97,other,Could be inpatient or outpatient,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,11.89,36.97,percent of total billed charges,,
HC ZINC PLASMA,84630,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.58,,,16.58,11.89,36.97,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT  ,,,both,,,83.43,50.06,Aetna,Commerical,,46.39,,,46.39,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Aetna,Middlesex Employees,,41.75,,,41.75,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Anthem,Commerical,,55.07,,,55.07,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Anthem,Indemnity,,,61.39,,61.39,24.63,67.63,percent of total billed charges,,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Anthem,State Preferred,,24.63,,,24.63,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Anthem,Individual Exchange,,44.06,,,44.06,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Cigna,Cigna,,63.32,,,63.32,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Connecticare,Commerical,,58.94,,,58.94,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Connecticare,Exchange,,58.94,,,58.94,24.63,67.63,other,Could be inpatient or outpatient,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,Multiplan,Multiplan,,,67.63,,67.63,24.63,67.63,percent of total billed charges,,
HC C-PEPTIDE,84681,CPT,,,both,,,83.43,50.06,United Healthcare/Oxford,United Healthcare/Oxford,,51.43,,,51.43,24.63,67.63,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,17.45,,,17.45,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,15.7,,,15.7,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,21.5,,,21.5,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,13.81,48.7,percent of total billed charges,,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,13.81,,,13.81,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,17.2,,,17.2,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,33.23,,,33.23,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,16.84,,,16.84,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,16.84,,,16.84,13.81,48.7,other,Could be inpatient or outpatient,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,13.81,48.7,percent of total billed charges,,
HC BHCG-FLUID,84702,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,21.94,,,21.94,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT  ,,,both,,,60.78,36.47,Aetna,Commerical,,17.45,,,17.45,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Aetna,Middlesex Employees,,15.7,,,15.7,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Anthem,Commerical,,21.5,,,21.5,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Anthem,Indemnity,,,44.2,,44.2,13.81,48.7,percent of total billed charges,,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Anthem,State Preferred,,13.81,,,13.81,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Anthem,Individual Exchange,,17.2,,,17.2,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Cigna,Cigna,,33.23,,,33.23,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Connecticare,Commerical,,16.84,,,16.84,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Connecticare,Exchange,,16.84,,,16.84,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,Multiplan,Multiplan,,,48.7,,48.7,13.81,48.7,percent of total billed charges,,
HC HCG QUANTITATIVE,84702,CPT,,,both,,,60.78,36.47,United Healthcare/Oxford,United Healthcare/Oxford,,21.94,,,21.94,13.81,48.7,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT  ,,,both,,,30.1,18.06,Aetna,Commerical,,8.72,,,8.72,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Aetna,Middlesex Employees,,7.85,,,7.85,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Anthem,Commerical,,13.85,,,13.85,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Anthem,Indemnity,,,21.89,,21.89,7.85,24.11,percent of total billed charges,,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Anthem,State Preferred,,8.89,,,8.89,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Anthem,Individual Exchange,,11.07,,,11.07,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Cigna,Cigna,,16.6,,,16.6,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Connecticare,Commerical,,8.41,,,8.41,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Connecticare,Exchange,,8.41,,,8.41,7.85,24.11,other,Could be inpatient or outpatient,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,Multiplan,Multiplan,,,24.11,,24.11,7.85,24.11,percent of total billed charges,,
HC HCG QUAL,84703,CPT,,,both,,,30.1,18.06,United Healthcare/Oxford,United Healthcare/Oxford,,10.96,,,10.96,7.85,24.11,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT  ,,,both,,,67.53,40.52,Aetna,Commerical,,37.11,,,37.11,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Aetna,Middlesex Employees,,33.39,,,33.39,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Anthem,Commerical,,44.06,,,44.06,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Anthem,Indemnity,,,49.11,,49.11,33.39,54.1,percent of total billed charges,,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Anthem,State Preferred,,44.06,,,44.06,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Anthem,Individual Exchange,,35.25,,,35.25,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Cigna,Cigna,,50.66,,,50.66,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Connecticare,Commerical,,47.16,,,47.16,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Connecticare,Exchange,,47.16,,,47.16,33.39,54.1,other,Could be inpatient or outpatient,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,Multiplan,Multiplan,,,54.1,,54.1,33.39,54.1,percent of total billed charges,,
HC OSMOLALITY FECES,84999,CPT,,,both,,,67.53,40.52,United Healthcare/Oxford,United Healthcare/Oxford,,41.14,,,41.14,33.39,54.1,other,Could be inpatient or outpatient,
HC PKU,84999,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,31.85,,,31.85,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,28.66,,,28.66,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.82,,,37.82,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,28.66,46.44,percent of total billed charges,,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,37.82,,,37.82,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.25,,,30.25,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,43.48,,,43.48,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,40.48,,,40.48,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,40.48,,,40.48,28.66,46.44,other,Could be inpatient or outpatient,
HC PKU,84999,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,28.66,46.44,percent of total billed charges,,
HC PKU,84999,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,28.66,46.44,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,21.49,,,21.49,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,19.34,,,19.34,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,25.52,,,25.52,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,19.34,31.34,percent of total billed charges,,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,25.52,,,25.52,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,20.42,,,20.42,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,29.34,,,29.34,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,27.31,,,27.31,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,27.31,,,27.31,19.34,31.34,other,Could be inpatient or outpatient,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,19.34,31.34,percent of total billed charges,,
HC POTASSIUM STOOL,84999,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,23.82,,,23.82,19.34,31.34,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,7.5,,,7.5,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,6.75,,,6.75,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,11.92,,,11.92,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,6.75,20.9,percent of total billed charges,,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,7.66,,,7.66,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,9.54,,,9.54,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,14.23,,,14.23,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,6.75,20.9,percent of total billed charges,,
HC AUTO WBC DIFF,85004,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,9.41,,,9.41,6.75,20.9,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT  ,,,both,,,13.82,8.29,Aetna,Commerical,,4.41,,,4.41,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Aetna,Middlesex Employees,,3.97,,,3.97,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Anthem,Commerical,,6.34,,,6.34,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Anthem,Indemnity,,,10.05,,10.05,3.97,11.08,percent of total billed charges,,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Anthem,State Preferred,,4.08,,,4.08,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Anthem,Individual Exchange,,5.07,,,5.07,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Cigna,Cigna,,7.72,,,7.72,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Connecticare,Commerical,,4.25,,,4.25,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Connecticare,Exchange,,4.25,,,4.25,3.97,11.08,other,Could be inpatient or outpatient,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,Multiplan,Multiplan,,,11.08,,11.08,3.97,11.08,percent of total billed charges,,
HC MANUAL WBC DIFF,85007,CPT,,,both,,,13.82,8.29,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,3.97,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT  ,,,both,,,13.82,8.29,Aetna,Commerical,,3.98,,,3.98,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Aetna,Middlesex Employees,,3.58,,,3.58,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Anthem,Commerical,,5.82,,,5.82,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Anthem,Indemnity,,,10.05,,10.05,3.58,11.08,percent of total billed charges,,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Anthem,State Preferred,,3.74,,,3.74,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Anthem,Individual Exchange,,4.66,,,4.66,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Cigna,Cigna,,7.72,,,7.72,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Connecticare,Commerical,,3.84,,,3.84,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Connecticare,Exchange,,3.84,,,3.84,3.58,11.08,other,Could be inpatient or outpatient,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,Multiplan,Multiplan,,,11.08,,11.08,3.58,11.08,percent of total billed charges,,
HC RBC MORPHOLOGY,85008,CPT,,,both,,,13.82,8.29,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,3.58,11.08,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT  ,,,both,,,7.79,4.67,Aetna,Commerical,,2.75,,,2.75,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Aetna,Middlesex Employees,,2.48,,,2.48,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Anthem,Commerical,,4.37,,,4.37,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Anthem,Indemnity,,,5.66,,5.66,2.48,6.24,percent of total billed charges,,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Anthem,State Preferred,,2.8,,,2.8,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Anthem,Individual Exchange,,3.5,,,3.5,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Cigna,Cigna,,5.31,,,5.31,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Connecticare,Commerical,,2.65,,,2.65,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Connecticare,Exchange,,2.65,,,2.65,2.48,6.24,other,Could be inpatient or outpatient,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,Multiplan,Multiplan,,,6.24,,6.24,2.48,6.24,percent of total billed charges,,
HC HCT-FLUID,85014,CPT,,,both,,,7.79,4.67,United Healthcare/Oxford,United Healthcare/Oxford,,3.45,,,3.45,2.48,6.24,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT  ,,,both,,,9.55,5.73,Aetna,Commerical,,2.75,,,2.75,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Aetna,Middlesex Employees,,2.48,,,2.48,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Commerical,,4.37,,,4.37,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Indemnity,,,6.95,,6.95,2.48,7.66,percent of total billed charges,,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,State Preferred,,2.8,,,2.8,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Individual Exchange,,3.5,,,3.5,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Cigna,Cigna,,5.31,,,5.31,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Connecticare,Commerical,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Connecticare,Exchange,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Multiplan,Multiplan,,,7.66,,7.66,2.48,7.66,percent of total billed charges,,
HC HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.45,,,3.45,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT  ,,,both,,,9.55,5.73,Aetna,Commerical,,2.75,,,2.75,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Aetna,Middlesex Employees,,2.48,,,2.48,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Commerical,,4.37,,,4.37,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Indemnity,,,6.95,,6.95,2.48,7.66,percent of total billed charges,,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,State Preferred,,2.8,,,2.8,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Anthem,Individual Exchange,,3.5,,,3.5,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Cigna,Cigna,,5.31,,,5.31,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Connecticare,Commerical,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Connecticare,Exchange,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,Multiplan,Multiplan,,,7.66,,7.66,2.48,7.66,percent of total billed charges,,
HC I-STAT HEMATOCRIT,85014,CPT,,,both,,,9.55,5.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.45,,,3.45,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT  ,,,both,,,9.55,5.73,Aetna,Commerical,,2.75,,,2.75,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Aetna,Middlesex Employees,,2.48,,,2.48,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Anthem,Commerical,,4.37,,,4.37,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Anthem,Indemnity,,,6.95,,6.95,2.48,7.66,percent of total billed charges,,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Anthem,State Preferred,,2.8,,,2.8,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Anthem,Individual Exchange,,3.5,,,3.5,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Cigna,Cigna,,5.31,,,5.31,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Connecticare,Commerical,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Connecticare,Exchange,,2.65,,,2.65,2.48,7.66,other,Could be inpatient or outpatient,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,Multiplan,Multiplan,,,7.66,,7.66,2.48,7.66,percent of total billed charges,,
HC TOTAL HEMOGLOBIN,85018,CPT,,,both,,,9.55,5.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.45,,,3.45,2.48,7.66,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT  ,,,both,,,31.09,18.65,Aetna,Commerical,,9.01,,,9.01,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Aetna,Middlesex Employees,,8.11,,,8.11,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Anthem,Commerical,,14.33,,,14.33,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Anthem,Indemnity,,,22.61,,22.61,8.11,24.91,percent of total billed charges,,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Anthem,State Preferred,,9.21,,,9.21,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Anthem,Individual Exchange,,11.47,,,11.47,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Cigna,Cigna,,17.21,,,17.21,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Connecticare,Commerical,,8.69,,,8.69,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Connecticare,Exchange,,8.69,,,8.69,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,Multiplan,Multiplan,,,24.91,,24.91,8.11,24.91,percent of total billed charges,,
HC CBC AUTODIFF POCT,85025,CPT,,,both,,,31.09,18.65,United Healthcare/Oxford,United Healthcare/Oxford,,11.32,,,11.32,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT  ,,,both,,,31.09,18.65,Aetna,Commerical,,9.01,,,9.01,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Aetna,Middlesex Employees,,8.11,,,8.11,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Anthem,Commerical,,14.33,,,14.33,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Anthem,Indemnity,,,22.61,,22.61,8.11,24.91,percent of total billed charges,,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Anthem,State Preferred,,9.21,,,9.21,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Anthem,Individual Exchange,,11.47,,,11.47,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Cigna,Cigna,,17.21,,,17.21,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Connecticare,Commerical,,8.69,,,8.69,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Connecticare,Exchange,,8.69,,,8.69,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,Multiplan,Multiplan,,,24.91,,24.91,8.11,24.91,percent of total billed charges,,
HC CBC WITH AUTODIFF,85025,CPT,,,both,,,31.09,18.65,United Healthcare/Oxford,United Healthcare/Oxford,,11.32,,,11.32,8.11,24.91,other,Could be inpatient or outpatient,
HC CBC,85027,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,7.5,,,7.5,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,6.75,,,6.75,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,11.92,,,11.92,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,6.75,20.9,percent of total billed charges,,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,7.66,,,7.66,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,9.54,,,9.54,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,14.23,,,14.23,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,7.24,,,7.24,6.75,20.9,other,Could be inpatient or outpatient,
HC CBC,85027,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,6.75,20.9,percent of total billed charges,,
HC CBC,85027,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,9.41,,,9.41,6.75,20.9,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT  ,,,both,,,17.77,10.66,Aetna,Commerical,,3.5,,,3.5,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Aetna,Middlesex Employees,,3.16,,,3.16,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Anthem,Commerical,,5.31,,,5.31,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Anthem,Indemnity,,,12.92,,12.92,3.16,14.24,percent of total billed charges,,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Anthem,State Preferred,,3.42,,,3.42,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Anthem,Individual Exchange,,4.24,,,4.24,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Cigna,Cigna,,6.54,,,6.54,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Connecticare,Commerical,,3.37,,,3.37,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Connecticare,Exchange,,3.37,,,3.37,3.16,14.24,other,Could be inpatient or outpatient,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,Multiplan,Multiplan,,,14.24,,14.24,3.16,14.24,percent of total billed charges,,
HC RBC PROFILE AUTO,85041,CPT,,,both,,,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,4.39,,,4.39,3.16,14.24,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT  ,,,both,,,16.07,9.64,Aetna,Commerical,,4.63,,,4.63,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Aetna,Middlesex Employees,,4.16,,,4.16,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Anthem,Commerical,,7.37,,,7.37,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Anthem,Indemnity,,,11.69,,11.69,4.16,12.88,percent of total billed charges,,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Anthem,State Preferred,,4.73,,,4.73,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Anthem,Individual Exchange,,5.9,,,5.9,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Cigna,Cigna,,8.91,,,8.91,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Connecticare,Commerical,,4.47,,,4.47,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Connecticare,Exchange,,4.47,,,4.47,4.16,12.88,other,Could be inpatient or outpatient,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,Multiplan,Multiplan,,,12.88,,12.88,4.16,12.88,percent of total billed charges,,
HC RETIC COUNT AUTO,85045,CPT,,,both,,,16.07,9.64,United Healthcare/Oxford,United Healthcare/Oxford,,5.82,,,5.82,4.16,12.88,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,6.46,,,6.46,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,5.81,,,5.81,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,10.29,,,10.29,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,5.81,43.66,percent of total billed charges,,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,6.61,,,6.61,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,8.23,,,8.23,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,12.47,,,12.47,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,6.23,,,6.23,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,6.23,,,6.23,5.81,43.66,other,Could be inpatient or outpatient,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,5.81,43.66,percent of total billed charges,,
HC IMMATR RETICULOCT,85046,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,8.12,,,8.12,5.81,43.66,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT  ,,,both,,,22.43,13.46,Aetna,Commerical,,6.46,,,6.46,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Aetna,Middlesex Employees,,5.81,,,5.81,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Anthem,Commerical,,10.29,,,10.29,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Anthem,Indemnity,,,16.31,,16.31,5.81,17.97,percent of total billed charges,,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Anthem,State Preferred,,6.61,,,6.61,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Anthem,Individual Exchange,,8.23,,,8.23,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Cigna,Cigna,,12.47,,,12.47,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Connecticare,Commerical,,6.23,,,6.23,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Connecticare,Exchange,,6.23,,,6.23,5.81,17.97,other,Could be inpatient or outpatient,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,Multiplan,Multiplan,,,17.97,,17.97,5.81,17.97,percent of total billed charges,,
HC RETICUL HEMOGLB C,85046,CPT,,,both,,,22.43,13.46,United Healthcare/Oxford,United Healthcare/Oxford,,8.12,,,8.12,5.81,17.97,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT  ,,,both,,,10.2,6.12,Aetna,Commerical,,2.94,,,2.94,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Aetna,Middlesex Employees,,2.65,,,2.65,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Anthem,Commerical,,4.68,,,4.68,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Anthem,Indemnity,,,7.41,,7.41,2.65,8.17,percent of total billed charges,,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Anthem,State Preferred,,3,,,3,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Anthem,Individual Exchange,,3.75,,,3.75,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Cigna,Cigna,,5.93,,,5.93,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Connecticare,Commerical,,2.84,,,2.84,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Connecticare,Exchange,,2.84,,,2.84,2.65,8.17,other,Could be inpatient or outpatient,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,Multiplan,Multiplan,,,8.17,,8.17,2.65,8.17,percent of total billed charges,,
HC WBC AUTOMATED,85048,CPT,,,both,,,10.2,6.12,United Healthcare/Oxford,United Healthcare/Oxford,,3.7,,,3.7,2.65,8.17,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT  ,,,both,,,18.04,10.82,Aetna,Commerical,,5.2,,,5.2,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Aetna,Middlesex Employees,,4.68,,,4.68,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Anthem,Commerical,,7.22,,,7.22,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Anthem,Indemnity,,,13.12,,13.12,4.64,14.45,percent of total billed charges,,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Anthem,State Preferred,,4.64,,,4.64,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Anthem,Individual Exchange,,5.78,,,5.78,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Cigna,Cigna,,10.08,,,10.08,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Connecticare,Commerical,,5.02,,,5.02,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Connecticare,Exchange,,5.02,,,5.02,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,Multiplan,Multiplan,,,14.45,,14.45,4.64,14.45,percent of total billed charges,,
HC PLATELET CNT CITR,85049,CPT,,,both,,,18.04,10.82,United Healthcare/Oxford,United Healthcare/Oxford,,6.51,,,6.51,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT  ,,,both,,,18.04,10.82,Aetna,Commerical,,5.2,,,5.2,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Aetna,Middlesex Employees,,4.68,,,4.68,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Anthem,Commerical,,7.22,,,7.22,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Anthem,Indemnity,,,13.12,,13.12,4.64,14.45,percent of total billed charges,,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Anthem,State Preferred,,4.64,,,4.64,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Anthem,Individual Exchange,,5.78,,,5.78,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Cigna,Cigna,,10.08,,,10.08,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Connecticare,Commerical,,5.02,,,5.02,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Connecticare,Exchange,,5.02,,,5.02,4.64,14.45,other,Could be inpatient or outpatient,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,Multiplan,Multiplan,,,14.45,,14.45,4.64,14.45,percent of total billed charges,,
HC PLATELET COUNT,85049,CPT,,,both,,,18.04,10.82,United Healthcare/Oxford,United Healthcare/Oxford,,6.51,,,6.51,4.64,14.45,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT  ,,,both,,,76.22,45.73,Aetna,Commerical,,42.06,,,42.06,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Aetna,Middlesex Employees,,37.86,,,37.86,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Anthem,Commerical,,49.94,,,49.94,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Anthem,Indemnity,,,55.66,,55.66,31.7,61.32,percent of total billed charges,,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Anthem,State Preferred,,31.7,,,31.7,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Anthem,Individual Exchange,,39.95,,,39.95,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Cigna,Cigna,,57.41,,,57.41,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Connecticare,Commerical,,53.44,,,53.44,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Connecticare,Exchange,,53.44,,,53.44,31.7,61.32,other,Could be inpatient or outpatient,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,Multiplan,Multiplan,,,61.32,,61.32,31.7,61.32,percent of total billed charges,,
HC IMMATR PLATLET FR,85055,CPT,,,both,,,76.22,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,46.63,,,46.63,31.7,61.32,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT  ,,,both,,,1929.19,1157.51,Aetna,Commerical,,62.79,,,62.79,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Aetna,Middlesex Employees,,56.51,,,56.51,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Anthem,Commerical,,124.71,,,124.71,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Anthem,Indemnity,,,1403.01,,1403.01,56.51,1545.62,percent of total billed charges,,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Anthem,State Preferred,,91.11,,,91.11,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Anthem,Individual Exchange,,99.76,,,99.76,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Cigna,Cigna,,76.91,,,76.91,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Connecticare,Commerical,,64.12,,,64.12,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Connecticare,Exchange,,64.12,,,64.12,56.51,1545.62,other,Could be inpatient or outpatient,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,Multiplan,Multiplan,,,1545.62,,1545.62,56.51,1545.62,percent of total billed charges,,
HC BINE MARROW SPEAR,85097,CPT,,,both,,,1929.19,1157.51,United Healthcare/Oxford,United Healthcare/Oxford,,731.85,,,731.85,56.51,1545.62,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,15.05,,,15.05,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.55,,,13.55,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.93,,,23.93,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.55,41.79,percent of total billed charges,,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.38,,,15.38,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.15,,,19.15,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,29.08,,,29.08,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.52,,,14.52,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.52,,,14.52,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.55,41.79,percent of total billed charges,,
HC FACTOR II,85210,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.92,,,18.92,13.55,41.79,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,20.46,,,20.46,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,18.41,,,18.41,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,32.53,,,32.53,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,18.41,56.81,percent of total billed charges,,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,20.9,,,20.9,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,26.02,,,26.02,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,39.19,,,39.19,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,19.75,,,19.75,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,19.75,,,19.75,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,18.41,56.81,percent of total billed charges,,
HC FACTOR V,85220,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,25.71,,,25.71,18.41,56.81,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.76,,,20.76,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.69,,,18.69,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33,,,33,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,18.69,57.72,percent of total billed charges,,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.21,,,21.21,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.39,,,26.39,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,39.75,,,39.75,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,18.69,57.72,percent of total billed charges,,
HC FACTOR VII,85230,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.08,,,26.08,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.76,,,20.76,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.69,,,18.69,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33,,,33,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,18.69,57.72,percent of total billed charges,,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.21,,,21.21,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.39,,,26.39,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,39.75,,,39.75,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,18.69,57.72,percent of total billed charges,,
HC FACTOR VIII,85240,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.08,,,26.08,18.69,57.72,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,26.59,,,26.59,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,23.93,,,23.93,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,42.29,,,42.29,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,23.93,73.94,percent of total billed charges,,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,27.17,,,27.17,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,33.83,,,33.83,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,51.03,,,51.03,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,23.93,73.94,percent of total billed charges,,
HC RISTOCETIN COFAC,85245,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,33.42,,,33.42,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT  ,,,both,,,165.83,99.5,Aetna,Commerical,,26.59,,,26.59,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Aetna,Middlesex Employees,,23.93,,,23.93,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Anthem,Commerical,,42.29,,,42.29,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Anthem,Indemnity,,,120.33,,120.33,23.93,132.56,percent of total billed charges,,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Anthem,State Preferred,,27.17,,,27.17,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Anthem,Individual Exchange,,33.83,,,33.83,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Cigna,Cigna,,51.03,,,51.03,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Connecticare,Commerical,,25.67,,,25.67,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Connecticare,Exchange,,25.67,,,25.67,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,Multiplan,Multiplan,,,132.56,,132.56,23.93,132.56,percent of total billed charges,,
HC FACTOR 8-AG SEND,85246,CPT,,,both,,,165.83,99.5,United Healthcare/Oxford,United Healthcare/Oxford,,33.42,,,33.42,23.93,132.56,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT  ,,,both,,,92.29,55.37,Aetna,Commerical,,26.59,,,26.59,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Aetna,Middlesex Employees,,23.93,,,23.93,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Anthem,Commerical,,42.29,,,42.29,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Anthem,Indemnity,,,67.12,,67.12,23.93,73.94,percent of total billed charges,,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Anthem,State Preferred,,27.17,,,27.17,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Anthem,Individual Exchange,,33.83,,,33.83,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Cigna,Cigna,,51.03,,,51.03,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Connecticare,Commerical,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Connecticare,Exchange,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,Multiplan,Multiplan,,,73.94,,73.94,23.93,73.94,percent of total billed charges,,
HC FACTOR ANTIGEN VW,85246,CPT,,,both,,,92.29,55.37,United Healthcare/Oxford,United Healthcare/Oxford,,33.42,,,33.42,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,26.59,,,26.59,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,23.93,,,23.93,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,42.29,,,42.29,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,23.93,73.94,percent of total billed charges,,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,27.17,,,27.17,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,33.83,,,33.83,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,51.03,,,51.03,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,23.93,73.94,percent of total billed charges,,
HC V WILBRND FAC ACT,85246,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,33.42,,,33.42,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,26.59,,,26.59,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,23.93,,,23.93,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,42.29,,,42.29,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,23.93,73.94,percent of total billed charges,,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,27.17,,,27.17,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,33.83,,,33.83,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,51.03,,,51.03,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,25.67,,,25.67,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,23.93,73.94,percent of total billed charges,,
HC FACTOR 8 MULTIMER,85247,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,33.42,,,33.42,23.93,73.94,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT  ,,,both,,,76.22,45.73,Aetna,Commerical,,22.08,,,22.08,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Aetna,Middlesex Employees,,19.87,,,19.87,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Anthem,Commerical,,35.09,,,35.09,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Anthem,Indemnity,,,55.66,,55.66,19.87,61.32,percent of total billed charges,,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Anthem,State Preferred,,22.54,,,22.54,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Anthem,Individual Exchange,,28.07,,,28.07,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Cigna,Cigna,,42.13,,,42.13,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Connecticare,Commerical,,21.3,,,21.3,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Connecticare,Exchange,,21.3,,,21.3,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,Multiplan,Multiplan,,,61.32,,61.32,19.87,61.32,percent of total billed charges,,
HC FACTOR IX,85250,CPT,,,both,,,76.22,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,27.75,,,27.75,19.87,61.32,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.76,,,20.76,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.69,,,18.69,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33,,,33,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,18.69,57.72,percent of total billed charges,,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.21,,,21.21,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.39,,,26.39,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,39.75,,,39.75,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,18.69,57.72,percent of total billed charges,,
HC FACTOR X,85260,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.08,,,26.08,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.76,,,20.76,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.69,,,18.69,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,33,,,33,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,18.69,57.72,percent of total billed charges,,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.21,,,21.21,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,26.39,,,26.39,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,39.75,,,39.75,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.03,,,20.03,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.7,18.69,57.72,percent of total billed charges,,
HC FACTOR XI,85270,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.08,,,26.08,18.69,57.72,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,22.43,,,22.43,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,20.19,,,20.19,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,35.67,,,35.67,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,20.19,62.22,percent of total billed charges,,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,22.91,,,22.91,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.53,,,28.53,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,42.73,,,42.73,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,20.19,62.22,percent of total billed charges,,
HC FACTOR XII,85280,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,28.19,,,28.19,20.19,62.22,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT  ,,,both,,,89.61,53.77,Aetna,Commerical,,18.95,,,18.95,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Aetna,Middlesex Employees,,17.05,,,17.05,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Anthem,Commerical,,30.13,,,30.13,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Anthem,Indemnity,,,65.48,,65.48,17.05,72.14,percent of total billed charges,,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Anthem,State Preferred,,19.34,,,19.34,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Anthem,Individual Exchange,,24.11,,,24.11,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Cigna,Cigna,,36.21,,,36.21,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Connecticare,Commerical,,18.29,,,18.29,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Connecticare,Exchange,,18.29,,,18.29,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,Multiplan,Multiplan,,,72.14,,72.14,17.05,72.14,percent of total billed charges,,
HC FACTOR XII ANTIGEN,85290,CPT,,,both,,,89.61,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,23.8,,,23.8,17.05,72.14,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT  ,,,both,,,66.4,39.84,Aetna,Commerical,,18.95,,,18.95,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Aetna,Middlesex Employees,,17.05,,,17.05,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Anthem,Commerical,,30.13,,,30.13,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Anthem,Indemnity,,,48.29,,48.29,17.05,53.2,percent of total billed charges,,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Anthem,State Preferred,,19.34,,,19.34,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Anthem,Individual Exchange,,24.11,,,24.11,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Cigna,Cigna,,36.21,,,36.21,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Connecticare,Commerical,,18.29,,,18.29,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Connecticare,Exchange,,18.29,,,18.29,17.05,53.2,other,Could be inpatient or outpatient,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,Multiplan,Multiplan,,,53.2,,53.2,17.05,53.2,percent of total billed charges,,
HC FACTOR XIII ACTIVITY,85290,CPT,,,both,,,66.4,39.84,United Healthcare/Oxford,United Healthcare/Oxford,,23.8,,,23.8,17.05,53.2,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,25.9,,,25.9,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,23.31,,,23.31,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,30.76,,,30.76,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,10.53,37.77,percent of total billed charges,,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,10.53,,,10.53,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,24.61,,,24.61,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,35.36,,,35.36,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,32.91,,,32.91,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,32.91,,,32.91,10.53,37.77,other,Could be inpatient or outpatient,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,10.53,37.77,percent of total billed charges,,
HC FIBN STABL FACTOR,85291,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,28.72,,,28.72,10.53,37.77,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.74,,,13.74,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.37,,,12.37,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,20.24,,,20.24,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.37,38.58,percent of total billed charges,,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,13,,,13,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,16.2,,,16.2,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.1,,,26.1,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.26,,,13.26,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.26,,,13.26,12.37,38.58,other,Could be inpatient or outpatient,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.37,38.58,percent of total billed charges,,
HC ANTITHROMBIN-3,85300,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.26,,,17.26,12.37,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.23,38.58,percent of total billed charges,,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.23,,,14.23,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.23,38.58,percent of total billed charges,,
HC PROTEIN C ANTIGEN,85302,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.23,38.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,30.58,,,30.58,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,27.53,,,27.53,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,16.37,44.58,percent of total billed charges,,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.37,,,16.37,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,16.37,44.58,other,Could be inpatient or outpatient,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,16.37,44.58,percent of total billed charges,,
HC PROTEIN C (ACTIV),85303,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,16.37,44.58,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT  ,,,both,,,44.05,26.43,Aetna,Commerical,,24.21,,,24.21,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Aetna,Middlesex Employees,,21.79,,,21.79,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Anthem,Commerical,,28.74,,,28.74,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Anthem,Indemnity,,,32.04,,32.04,13.72,35.29,percent of total billed charges,,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Anthem,State Preferred,,13.72,,,13.72,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Anthem,Individual Exchange,,23,,,23,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Cigna,Cigna,,33.04,,,33.04,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Connecticare,Commerical,,30.77,,,30.77,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Connecticare,Exchange,,30.77,,,30.77,13.72,35.29,other,Could be inpatient or outpatient,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,Multiplan,Multiplan,,,35.29,,35.29,13.72,35.29,percent of total billed charges,,
HC SQ PROTEIN S TOTAL ANTIGEN CLOTTING INHIBITOR,85305,CPT,,,both,,,44.05,26.43,United Healthcare/Oxford,United Healthcare/Oxford,,26.84,,,26.84,13.72,35.29,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,34.01,,,34.01,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,30.61,,,30.61,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,40.39,,,40.39,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,18.14,49.6,percent of total billed charges,,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,18.14,,,18.14,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,32.31,,,32.31,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,46.44,,,46.44,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,43.22,,,43.22,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,43.22,,,43.22,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,18.14,49.6,percent of total billed charges,,
HC PROTEIN S (ACTIV),85306,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,18.14,49.6,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT  ,,,both,,,146.26,87.76,Aetna,Commerical,,80.41,,,80.41,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Aetna,Middlesex Employees,,72.37,,,72.37,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Anthem,Commerical,,95.47,,,95.47,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Anthem,Indemnity,,,106.42,,106.42,18.14,117.23,percent of total billed charges,,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Anthem,State Preferred,,18.14,,,18.14,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Anthem,Individual Exchange,,76.37,,,76.37,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Cigna,Cigna,,109.75,,,109.75,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Connecticare,Commerical,,102.18,,,102.18,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Connecticare,Exchange,,102.18,,,102.18,18.14,117.23,other,Could be inpatient or outpatient,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,Multiplan,Multiplan,,,117.23,,117.23,18.14,117.23,percent of total billed charges,,
HC PROTEIN S AG FREE,85306,CPT,,,both,,,146.26,87.76,United Healthcare/Oxford,United Healthcare/Oxford,,89.14,,,89.14,18.14,117.23,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT  ,,,both,,,185.4,111.24,Aetna,Commerical,,102.05,,,102.05,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Aetna,Middlesex Employees,,91.85,,,91.85,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Anthem,Commerical,,121.17,,,121.17,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Anthem,Indemnity,,,135.06,,135.06,15.25,148.79,percent of total billed charges,,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Anthem,State Preferred,,15.25,,,15.25,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Anthem,Individual Exchange,,96.94,,,96.94,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Cigna,Cigna,,139.3,,,139.3,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Connecticare,Commerical,,129.68,,,129.68,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Connecticare,Exchange,,129.68,,,129.68,15.25,148.79,other,Could be inpatient or outpatient,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,Multiplan,Multiplan,,,148.79,,148.79,15.25,148.79,percent of total billed charges,,
HC FCTR VIII INHIB,85335,CPT,,,both,,,185.4,111.24,United Healthcare/Oxford,United Healthcare/Oxford,,113.14,,,113.14,15.25,148.79,other,Could be inpatient or outpatient,
HC ACT,85347,CPT  ,,,both,,,17.14,10.28,Aetna,Commerical,,4.96,,,4.96,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Aetna,Middlesex Employees,,4.47,,,4.47,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Anthem,Commerical,,7.85,,,7.85,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Anthem,Indemnity,,,12.47,,12.47,4.47,13.74,percent of total billed charges,,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Anthem,State Preferred,,5.04,,,5.04,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Anthem,Individual Exchange,,6.27,,,6.27,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Cigna,Cigna,,9.51,,,9.51,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Connecticare,Commerical,,4.79,,,4.79,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Connecticare,Exchange,,4.79,,,4.79,4.47,13.74,other,Could be inpatient or outpatient,
HC ACT,85347,CPT,,,both,,,17.14,10.28,Multiplan,Multiplan,,,13.74,,13.74,4.47,13.74,percent of total billed charges,,
HC ACT,85347,CPT,,,both,,,17.14,10.28,United Healthcare/Oxford,United Healthcare/Oxford,,6.21,,,6.21,4.47,13.74,other,Could be inpatient or outpatient,
HC FSP,85362,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,15.44,,,15.44,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,13.9,,,13.9,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,18.33,,,18.33,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,8.16,22.51,percent of total billed charges,,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.16,,,8.16,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,14.67,,,14.67,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,21.07,,,21.07,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,19.62,,,19.62,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,19.62,,,19.62,8.16,22.51,other,Could be inpatient or outpatient,
HC FSP,85362,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,8.16,22.51,percent of total billed charges,,
HC FSP,85362,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,17.12,,,17.12,8.16,22.51,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT  ,,,both,,,112.27,67.36,Aetna,Commerical,,61.84,,,61.84,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Aetna,Middlesex Employees,,55.66,,,55.66,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Anthem,Commerical,,73.43,,,73.43,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Anthem,Indemnity,,,81.86,,81.86,8.46,90.18,percent of total billed charges,,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Anthem,State Preferred,,8.46,,,8.46,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Anthem,Individual Exchange,,58.75,,,58.75,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Cigna,Cigna,,84.43,,,84.43,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Connecticare,Commerical,,78.59,,,78.59,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Connecticare,Exchange,,78.59,,,78.59,8.46,90.18,other,Could be inpatient or outpatient,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,Multiplan,Multiplan,,,90.18,,90.18,8.46,90.18,percent of total billed charges,,
HC D-DIMER,85378,CPT,,,both,,,112.27,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,68.57,,,68.57,8.46,90.18,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT  ,,,both,,,38.25,22.95,Aetna,Commerical,,11.8,,,11.8,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Aetna,Middlesex Employees,,10.63,,,10.63,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Anthem,Commerical,,18.75,,,18.75,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Anthem,Indemnity,,,27.82,,27.82,10.63,30.65,percent of total billed charges,,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Anthem,State Preferred,,12.06,,,12.06,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Anthem,Individual Exchange,,15.01,,,15.01,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Cigna,Cigna,,22.53,,,22.53,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Connecticare,Commerical,,11.39,,,11.39,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Connecticare,Exchange,,11.39,,,11.39,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,Multiplan,Multiplan,,,30.65,,30.65,10.63,30.65,percent of total billed charges,,
HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,85379,CPT,,,both,,,38.25,22.95,United Healthcare/Oxford,United Healthcare/Oxford,,14.83,,,14.83,10.63,30.65,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,11.27,,,11.27,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,10.14,,,10.14,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,15.66,,,15.66,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,10.06,27.33,percent of total billed charges,,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,10.06,,,10.06,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,12.52,,,12.52,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,19,,,19,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,10.88,,,10.88,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,10.88,,,10.88,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,10.06,27.33,percent of total billed charges,,
HC FIBRINOGEN LEVEL,85384,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,12.74,,,12.74,10.06,27.33,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT  ,,,both,,,25.02,15.01,Aetna,Commerical,,13.75,,,13.75,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Aetna,Middlesex Employees,,12.38,,,12.38,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Anthem,Commerical,,16.32,,,16.32,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Anthem,Indemnity,,,18.19,,18.19,10.06,20.04,percent of total billed charges,,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Anthem,State Preferred,,10.06,,,10.06,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Anthem,Individual Exchange,,13.06,,,13.06,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Cigna,Cigna,,18.77,,,18.77,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Connecticare,Commerical,,17.47,,,17.47,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Connecticare,Exchange,,17.47,,,17.47,10.06,20.04,other,Could be inpatient or outpatient,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,Multiplan,Multiplan,,,20.04,,20.04,10.06,20.04,percent of total billed charges,,
HC FIBRINOGEN ANTIGEN NEPHELOMETRY,85385,CPT,,,both,,,25.02,15.01,United Healthcare/Oxford,United Healthcare/Oxford,,15.24,,,15.24,10.06,20.04,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT  ,,,both,,,73.13,43.88,Aetna,Commerical,,40.2,,,40.2,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Aetna,Middlesex Employees,,36.18,,,36.18,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Anthem,Commerical,,47.73,,,47.73,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Anthem,Indemnity,,,53.21,,53.21,19.54,58.62,percent of total billed charges,,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Anthem,State Preferred,,19.54,,,19.54,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Anthem,Individual Exchange,,38.19,,,38.19,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Cigna,Cigna,,54.88,,,54.88,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Connecticare,Commerical,,51.09,,,51.09,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Connecticare,Exchange,,51.09,,,51.09,19.54,58.62,other,Could be inpatient or outpatient,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,Multiplan,Multiplan,,,58.62,,58.62,19.54,58.62,percent of total billed charges,,
HC THROMBOELASTOGRAM,85396,CPT,,,both,,,73.13,43.88,United Healthcare/Oxford,United Healthcare/Oxford,,44.57,,,44.57,19.54,58.62,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT  ,,,both,,,166.86,100.12,Aetna,Commerical,,91.53,,,91.53,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Aetna,Middlesex Employees,,82.38,,,82.38,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Anthem,Commerical,,108.69,,,108.69,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Anthem,Indemnity,,,121.14,,121.14,9.13,133.46,percent of total billed charges,,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Anthem,State Preferred,,9.13,,,9.13,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Anthem,Individual Exchange,,86.95,,,86.95,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Cigna,Cigna,,124.95,,,124.95,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Connecticare,Commerical,,116.33,,,116.33,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Connecticare,Exchange,,116.33,,,116.33,9.13,133.46,other,Could be inpatient or outpatient,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,Multiplan,Multiplan,,,133.46,,133.46,9.13,133.46,percent of total billed charges,,
HC ALPHA ANTIPLASMA,85410,CPT,,,both,,,166.86,100.12,United Healthcare/Oxford,United Healthcare/Oxford,,101.48,,,101.48,9.13,133.46,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT  ,,,both,,,70.04,42.02,Aetna,Commerical,,38.35,,,38.35,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Aetna,Middlesex Employees,,34.51,,,34.51,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Anthem,Commerical,,45.53,,,45.53,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Anthem,Indemnity,,,50.75,,50.75,20.36,55.91,percent of total billed charges,,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Anthem,State Preferred,,20.36,,,20.36,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Anthem,Individual Exchange,,36.42,,,36.42,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Cigna,Cigna,,52.34,,,52.34,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Connecticare,Commerical,,48.73,,,48.73,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Connecticare,Exchange,,48.73,,,48.73,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,Multiplan,Multiplan,,,55.91,,55.91,20.36,55.91,percent of total billed charges,,
HC PLASMIN ACT INHIB,85415,CPT,,,both,,,70.04,42.02,United Healthcare/Oxford,United Healthcare/Oxford,,42.51,,,42.51,20.36,55.91,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,14.33,,,14.33,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,12.9,,,12.9,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,17.03,,,17.03,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,7.74,20.9,percent of total billed charges,,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,7.74,,,7.74,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,13.62,,,13.62,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,19.57,,,19.57,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,18.22,,,18.22,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,18.22,,,18.22,7.74,20.9,other,Could be inpatient or outpatient,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,7.74,20.9,percent of total billed charges,,
HC PLASMINOGEN,85420,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,15.89,,,15.89,7.74,20.9,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,9.16,60.42,percent of total billed charges,,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,9.16,,,9.16,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,9.16,60.42,other,Could be inpatient or outpatient,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,9.16,60.42,percent of total billed charges,,
HC KIEIHAUER-BETKE STAIN,85460,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,9.16,60.42,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.17,,,15.17,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.66,,,13.66,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,16.11,,,16.11,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,10.36,42.73,percent of total billed charges,,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,10.36,,,10.36,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,12.9,,,12.9,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,29.08,,,29.08,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.65,,,14.65,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.65,,,14.65,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,10.36,42.73,percent of total billed charges,,
HC HEPARIN ASSAY,85520,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.08,,,19.08,10.36,42.73,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.72,,,13.72,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.35,,,12.35,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,21.83,,,21.83,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.35,38.58,percent of total billed charges,,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.02,,,14.02,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.46,,,17.46,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.1,,,26.1,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.25,,,13.25,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.25,,,13.25,12.35,38.58,other,Could be inpatient or outpatient,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.35,38.58,percent of total billed charges,,
HC HEPARIN NEUTRALZN,85525,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.24,,,17.24,12.35,38.58,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT  ,,,both,,,184.37,110.62,Aetna,Commerical,,101.43,,,101.43,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Aetna,Middlesex Employees,,91.29,,,91.29,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Anthem,Commerical,,120.43,,,120.43,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Anthem,Indemnity,,,134.25,,134.25,22.21,147.89,percent of total billed charges,,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Anthem,State Preferred,,22.21,,,22.21,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Anthem,Individual Exchange,,96.35,,,96.35,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Cigna,Cigna,,138.46,,,138.46,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Connecticare,Commerical,,128.9,,,128.9,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Connecticare,Exchange,,128.9,,,128.9,22.21,147.89,other,Could be inpatient or outpatient,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,Multiplan,Multiplan,,,147.89,,147.89,22.21,147.89,percent of total billed charges,,
HC LYSOZYME,85549,CPT,,,both,,,184.37,110.62,United Healthcare/Oxford,United Healthcare/Oxford,,112.45,,,112.45,22.21,147.89,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT  ,,,both,,,54.59,32.75,Aetna,Commerical,,29.94,,,29.94,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Aetna,Middlesex Employees,,26.95,,,26.95,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Anthem,Commerical,,35.55,,,35.55,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Anthem,Indemnity,,,39.63,,39.63,15.81,43.66,percent of total billed charges,,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Anthem,State Preferred,,15.81,,,15.81,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Anthem,Individual Exchange,,28.44,,,28.44,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Cigna,Cigna,,40.87,,,40.87,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Connecticare,Commerical,,38.05,,,38.05,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Connecticare,Exchange,,38.05,,,38.05,15.81,43.66,other,Could be inpatient or outpatient,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,Multiplan,Multiplan,,,43.66,,43.66,15.81,43.66,percent of total billed charges,,
HC RBC FRAGILIGY,85557,CPT,,,both,,,54.59,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,33.2,,,33.2,15.81,43.66,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT  ,,,both,,,145.2,87.12,Aetna,Commerical,,79.79,,,79.79,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Aetna,Middlesex Employees,,71.81,,,71.81,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Anthem,Commerical,,94.73,,,94.73,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Anthem,Indemnity,,,105.6,,105.6,25.43,116.33,percent of total billed charges,,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Anthem,State Preferred,,25.43,,,25.43,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Anthem,Individual Exchange,,75.78,,,75.78,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Cigna,Cigna,,108.91,,,108.91,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Connecticare,Commerical,,101.39,,,101.39,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Connecticare,Exchange,,101.39,,,101.39,25.43,116.33,other,Could be inpatient or outpatient,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,Multiplan,Multiplan,,,116.33,,116.33,25.43,116.33,percent of total billed charges,,
HC PLAVIX-PLT AGG,85576,CPT,,,both,,,145.2,87.12,United Healthcare/Oxford,United Healthcare/Oxford,,88.45,,,88.45,25.43,116.33,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT  ,,,both,,,83.43,50.06,Aetna,Commerical,,46.39,,,46.39,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Aetna,Middlesex Employees,,41.75,,,41.75,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Anthem,Commerical,,55.07,,,55.07,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Anthem,Indemnity,,,61.39,,61.39,21.29,67.63,percent of total billed charges,,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Anthem,State Preferred,,21.29,,,21.29,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Anthem,Individual Exchange,,44.06,,,44.06,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Cigna,Cigna,,63.32,,,63.32,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Connecticare,Commerical,,58.94,,,58.94,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Connecticare,Exchange,,58.94,,,58.94,21.29,67.63,other,Could be inpatient or outpatient,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,Multiplan,Multiplan,,,67.63,,67.63,21.29,67.63,percent of total billed charges,,
HC DRVVT CONFIRMATING,85597,CPT,,,both,,,83.43,50.06,United Healthcare/Oxford,United Healthcare/Oxford,,51.43,,,51.43,21.29,67.63,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.29,57.72,percent of total billed charges,,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.29,,,21.29,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.29,57.72,other,Could be inpatient or outpatient,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.29,57.72,percent of total billed charges,,
HC PLT NEUTRALIZN,85597,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.29,57.72,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT  ,,,both,,,42.13,25.28,Aetna,Commerical,,4.97,,,4.97,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Aetna,Middlesex Employees,,4.48,,,4.48,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Anthem,Commerical,,7.25,,,7.25,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Anthem,Indemnity,,,30.64,,30.64,4.48,33.75,percent of total billed charges,,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Anthem,State Preferred,,4.66,,,4.66,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Anthem,Individual Exchange,,5.8,,,5.8,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Cigna,Cigna,,8.91,,,8.91,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Connecticare,Commerical,,4.8,,,4.8,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Connecticare,Exchange,,4.8,,,4.8,4.48,33.75,other,Could be inpatient or outpatient,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,Multiplan,Multiplan,,,33.75,,33.75,4.48,33.75,percent of total billed charges,,
HC I-STAT INR,85610,CPT,,,both,,,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.48,33.75,other,Could be inpatient or outpatient,
HC PT,85610,CPT  ,,,both,,,15.8,9.48,Aetna,Commerical,,4.97,,,4.97,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Aetna,Middlesex Employees,,4.48,,,4.48,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Anthem,Commerical,,7.25,,,7.25,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Anthem,Indemnity,,,11.5,,11.5,4.48,12.67,percent of total billed charges,,
HC PT,85610,CPT,,,both,,,15.8,9.48,Anthem,State Preferred,,4.66,,,4.66,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Anthem,Individual Exchange,,5.8,,,5.8,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Cigna,Cigna,,8.91,,,8.91,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Connecticare,Commerical,,4.8,,,4.8,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Connecticare,Exchange,,4.8,,,4.8,4.48,12.67,other,Could be inpatient or outpatient,
HC PT,85610,CPT,,,both,,,15.8,9.48,Multiplan,Multiplan,,,12.67,,12.67,4.48,12.67,percent of total billed charges,,
HC PT,85610,CPT,,,both,,,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,5.73,,,5.73,4.48,12.67,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT  ,,,both,,,21.88,13.13,Aetna,Commerical,,12.03,,,12.03,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Aetna,Middlesex Employees,,10.83,,,10.83,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Anthem,Commerical,,14.27,,,14.27,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Anthem,Indemnity,,,15.91,,15.91,4.67,17.53,percent of total billed charges,,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Anthem,State Preferred,,4.67,,,4.67,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Anthem,Individual Exchange,,11.42,,,11.42,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Cigna,Cigna,,16.41,,,16.41,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Connecticare,Commerical,,15.28,,,15.28,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Connecticare,Exchange,,15.28,,,15.28,4.67,17.53,other,Could be inpatient or outpatient,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,Multiplan,Multiplan,,,17.53,,17.53,4.67,17.53,percent of total billed charges,,
HC PROTHROMBIN TIME SUB PLASMA FRACTIONS EA,85611,CPT,,,both,,,21.88,13.13,United Healthcare/Oxford,United Healthcare/Oxford,,13.33,,,13.33,4.67,17.53,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,11.1,,,11.1,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,10,,,10,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.65,,,17.65,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,10,30.54,percent of total billed charges,,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.33,,,11.33,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,14.12,,,14.12,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,21.35,,,21.35,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.72,,,10.72,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.72,,,10.72,10,30.54,other,Could be inpatient or outpatient,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,10,30.54,percent of total billed charges,,
HC DRVVT,85613,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.96,,,13.96,10,30.54,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT  ,,,both,,,79.31,47.59,Aetna,Commerical,,11.1,,,11.1,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Aetna,Middlesex Employees,,10,,,10,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Anthem,Commerical,,17.65,,,17.65,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Anthem,Indemnity,,,58.11,,58.11,10,64.02,percent of total billed charges,,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Anthem,State Preferred,,11.33,,,11.33,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Anthem,Individual Exchange,,14.12,,,14.12,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Cigna,Cigna,,21.35,,,21.35,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Connecticare,Commerical,,10.72,,,10.72,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Connecticare,Exchange,,10.72,,,10.72,10,64.02,other,Could be inpatient or outpatient,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,Multiplan,Multiplan,,,64.02,,64.02,10,64.02,percent of total billed charges,,
HC SILICA CLT T SCREEN,85613,CPT,,,both,,,79.31,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,13.96,,,13.96,10,64.02,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT  ,,,both,,,10.86,6.51,Aetna,Commerical,,3.13,,,3.13,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Aetna,Middlesex Employees,,2.81,,,2.81,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Anthem,Commerical,,4.98,,,4.98,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Anthem,Indemnity,,,7.89,,7.89,2.81,8.7,percent of total billed charges,,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Anthem,State Preferred,,3.2,,,3.2,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Anthem,Individual Exchange,,3.98,,,3.98,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Cigna,Cigna,,5.93,,,5.93,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Connecticare,Commerical,,3.02,,,3.02,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Connecticare,Exchange,,3.02,,,3.02,2.81,8.7,other,Could be inpatient or outpatient,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,Multiplan,Multiplan,,,8.7,,8.7,2.81,8.7,percent of total billed charges,,
HC SED RATE (ESR) A,85652,CPT,,,both,,,10.86,6.51,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,2.81,8.7,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT  ,,,both,,,22.17,13.3,Aetna,Commerical,,6.38,,,6.38,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Aetna,Middlesex Employees,,5.74,,,5.74,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Anthem,Commerical,,9.58,,,9.58,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Anthem,Indemnity,,,16.12,,16.12,5.74,17.76,percent of total billed charges,,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Anthem,State Preferred,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Anthem,Individual Exchange,,7.67,,,7.67,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Cigna,Cigna,,12.47,,,12.47,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Connecticare,Commerical,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Connecticare,Exchange,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,Multiplan,Multiplan,,,17.76,,17.76,5.74,17.76,percent of total billed charges,,
HC SICKLE TEST DONOR,85660,CPT,,,both,,,22.17,13.3,United Healthcare/Oxford,United Healthcare/Oxford,,8.02,,,8.02,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT  ,,,both,,,22.17,13.3,Aetna,Commerical,,6.38,,,6.38,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Aetna,Middlesex Employees,,5.74,,,5.74,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Anthem,Commerical,,9.58,,,9.58,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Anthem,Indemnity,,,16.12,,16.12,5.74,17.76,percent of total billed charges,,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Anthem,State Preferred,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Anthem,Individual Exchange,,7.67,,,7.67,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Cigna,Cigna,,12.47,,,12.47,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Connecticare,Commerical,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Connecticare,Exchange,,6.16,,,6.16,5.74,17.76,other,Could be inpatient or outpatient,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,Multiplan,Multiplan,,,17.76,,17.76,5.74,17.76,percent of total billed charges,,
HC SICKLNG RBC RED,85660,CPT,,,both,,,22.17,13.3,United Healthcare/Oxford,United Healthcare/Oxford,,8.02,,,8.02,5.74,17.76,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT  ,,,both,,,23.22,13.93,Aetna,Commerical,,6.69,,,6.69,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Aetna,Middlesex Employees,,6.02,,,6.02,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Anthem,Commerical,,10.63,,,10.63,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Anthem,Indemnity,,,16.88,,16.88,6.02,18.6,percent of total billed charges,,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Anthem,State Preferred,,6.83,,,6.83,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Anthem,Individual Exchange,,8.51,,,8.51,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Cigna,Cigna,,13.05,,,13.05,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Connecticare,Commerical,,6.46,,,6.46,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Connecticare,Exchange,,6.46,,,6.46,6.02,18.6,other,Could be inpatient or outpatient,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,Multiplan,Multiplan,,,18.6,,18.6,6.02,18.6,percent of total billed charges,,
HC THROMBIN TIME,85670,CPT,,,both,,,23.22,13.93,United Healthcare/Oxford,United Healthcare/Oxford,,8.4,,,8.4,6.02,18.6,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT  ,,,both,,,70.04,42.02,Aetna,Commerical,,6.97,,,6.97,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Aetna,Middlesex Employees,,6.27,,,6.27,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Anthem,Commerical,,11.06,,,11.06,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Anthem,Indemnity,,,50.75,,50.75,6.27,55.91,percent of total billed charges,,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Anthem,State Preferred,,7.11,,,7.11,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Anthem,Individual Exchange,,8.85,,,8.85,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Cigna,Cigna,,13.05,,,13.05,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Connecticare,Commerical,,6.73,,,6.73,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Connecticare,Exchange,,6.73,,,6.73,6.27,55.91,other,Could be inpatient or outpatient,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,Multiplan,Multiplan,,,55.91,,55.91,6.27,55.91,percent of total billed charges,,
HC DRVVT (PTT-LA) SCREEN,85730,CPT,,,both,,,70.04,42.02,United Healthcare/Oxford,United Healthcare/Oxford,,8.74,,,8.74,6.27,55.91,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT  ,,,both,,,24.19,14.52,Aetna,Commerical,,6.97,,,6.97,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Aetna,Middlesex Employees,,6.27,,,6.27,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Anthem,Commerical,,11.06,,,11.06,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Anthem,Indemnity,,,17.6,,17.6,6.27,19.39,percent of total billed charges,,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Anthem,State Preferred,,7.11,,,7.11,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Anthem,Individual Exchange,,8.85,,,8.85,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Cigna,Cigna,,13.05,,,13.05,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Connecticare,Commerical,,6.73,,,6.73,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Connecticare,Exchange,,6.73,,,6.73,6.27,19.39,other,Could be inpatient or outpatient,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,Multiplan,Multiplan,,,19.39,,19.39,6.27,19.39,percent of total billed charges,,
HC PPT - LA,85730,CPT,,,both,,,24.19,14.52,United Healthcare/Oxford,United Healthcare/Oxford,,8.74,,,8.74,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT  ,,,both,,,24.19,14.52,Aetna,Commerical,,6.97,,,6.97,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Aetna,Middlesex Employees,,6.27,,,6.27,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Anthem,Commerical,,11.06,,,11.06,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Anthem,Indemnity,,,17.6,,17.6,6.27,19.39,percent of total billed charges,,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Anthem,State Preferred,,7.11,,,7.11,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Anthem,Individual Exchange,,8.85,,,8.85,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Cigna,Cigna,,13.05,,,13.05,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Connecticare,Commerical,,6.73,,,6.73,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Connecticare,Exchange,,6.73,,,6.73,6.27,19.39,other,Could be inpatient or outpatient,
HC PTT,85730,CPT,,,both,,,24.19,14.52,Multiplan,Multiplan,,,19.39,,19.39,6.27,19.39,percent of total billed charges,,
HC PTT,85730,CPT,,,both,,,24.19,14.52,United Healthcare/Oxford,United Healthcare/Oxford,,8.74,,,8.74,6.27,19.39,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT  ,,,both,,,259.56,155.74,Aetna,Commerical,,6.97,,,6.97,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Aetna,Middlesex Employees,,6.27,,,6.27,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Anthem,Commerical,,11.06,,,11.06,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Anthem,Indemnity,,,189.09,,189.09,6.27,208.31,percent of total billed charges,,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Anthem,State Preferred,,7.11,,,7.11,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Anthem,Individual Exchange,,8.85,,,8.85,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Cigna,Cigna,,13.05,,,13.05,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Connecticare,Commerical,,6.73,,,6.73,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Connecticare,Exchange,,6.73,,,6.73,6.27,208.31,other,Could be inpatient or outpatient,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,Multiplan,Multiplan,,,208.31,,208.31,6.27,208.31,percent of total billed charges,,
HC SEROTONIN,85730,CPT,,,both,,,259.56,155.74,United Healthcare/Oxford,United Healthcare/Oxford,,8.74,,,8.74,6.27,208.31,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,25.9,,,25.9,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,23.31,,,23.31,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,30.76,,,30.76,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,7.66,37.77,percent of total billed charges,,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,7.66,,,7.66,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,24.61,,,24.61,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,35.36,,,35.36,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,32.91,,,32.91,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,32.91,,,32.91,7.66,37.77,other,Could be inpatient or outpatient,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,7.66,37.77,percent of total billed charges,,
HC MIXING STUDY,85732,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,28.72,,,28.72,7.66,37.77,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT  ,,,both,,,25.08,15.05,Aetna,Commerical,,9.06,,,9.06,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Aetna,Middlesex Employees,,8.16,,,8.16,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Anthem,Commerical,,9.62,,,9.62,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Anthem,Indemnity,,,18.24,,18.24,6.19,20.09,percent of total billed charges,,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Anthem,State Preferred,,6.19,,,6.19,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Anthem,Individual Exchange,,7.69,,,7.69,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Cigna,Cigna,,11.86,,,11.86,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Connecticare,Commerical,,8.75,,,8.75,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Connecticare,Exchange,,8.75,,,8.75,6.19,20.09,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,Multiplan,Multiplan,,,20.09,,20.09,6.19,20.09,percent of total billed charges,,
HC ASPRG. FUMIG IGG,86001,CPT,,,both,,,25.08,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,10.25,,,10.25,6.19,20.09,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC A. ALERNATA (M6). IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ALDER (T2) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC ALMOND IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC APPLE (F49) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ASPER NIGER (M207) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC ASPRG. FUMIG IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC AUSTRALIAN PINE (T73) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BANANA (F92) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BARLEY (F6) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BEECH (T5) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BEEF (F27) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC BERMUDA GRASS (G2) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BIRCH (T3) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BLUE MUSSEL (F37) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC BRAZIL NUT (F18) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CALTRN,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC CARROT (F31) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC CASEIN (F78) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CASHEW NUT (F202) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CAT DANDER (E1) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CBIRCH,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CCEDAR,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CCLADO,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CCOTTN,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CDERMP,86003,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CELERY (F85) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CELM,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CELM,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CELM,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CFUMIG,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CHESTNUT SWEET (F299) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CHICKEN MEAT (F83) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CJUNE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CLADOSPORIUM HERBARUM (M2) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CLAM (F207) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CLMBFT,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CMAPLE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CMUGWT,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC COCKROACH (I6) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC COCOA (CHOCOLATE) (F93) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC COCONUT (F36) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CODFISH (F3) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC COMMON RAGWEED (W1) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CPENCL,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC CRAB (F23) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CRAGWD,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CSHPSR,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CSYCAM,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CWHASH,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CWHOAK,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC CWLTRE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC D PTERONYSSINUS (D1) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC D. FARINAE (D2) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC DOG DANDER (E5) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC EGG WHITE (F1) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC EGG YOLK (F75) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ELM (T8) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC GARLIC (F47) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC GLUTEN (F79) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC GRAPE (F259) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC GRAPEFRUIT (F209) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC HAZEL NUT TREE (T4) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC HAZELNUT (F17) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC HORSE DANDER (E3) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC JUNE GRASS (G8) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC KIWI FRUIT (F84) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LAMB (F88) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LAMB'S QUARTERS (W10) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LATEX (HEVEA BRAZILIENSIS) (K82) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LEMON (F208) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LENTILS (F235) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC LOBSTER (F80) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC MAIZE/CORN (F8) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC MAPLE (BOX ELDER) (T1) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC MEADOW FESCUE (G4) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC MILK (F2) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC MOSQUITO (I71) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC MPIGWD,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC OAK (T7) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC OAT (F7) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ONION (F48) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ORANGE (F33) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ORCHARD GRASS (G3) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC OYSTER (F290) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PARROT/PARAKEET DROPPINGS (E77) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PARROT/PARAKEET FEATHERS (E78) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC PEA (F12) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PEACH (F95) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PEANUT (F13) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PEAR (F94) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PECAN NUT (F201) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PEN. CHRYSOGENUM (M1) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PERENNIAL RYE (G5) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PINE NUT (RF253) IGE,86003,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PINEAPPLE (F210) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PISTACHIO (F203) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PLUM (F255) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC PORK (F26) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC POTATO (F35) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC RABBIT EPITHELIA (E82) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC RASPBERRY IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT  ,,,both,,,456.29,273.77,Aetna,Commerical,,250.49,,,250.49,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Aetna,Middlesex Employees,,225.44,,,225.44,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Anthem,Commerical,,297.42,,,297.42,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Anthem,Indemnity,,,331.51,,331.51,6.19,365.21,percent of total billed charges,,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Anthem,State Preferred,,6.19,,,6.19,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Anthem,Individual Exchange,,237.94,,,237.94,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Cigna,Cigna,,341.92,,,341.92,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Connecticare,Commerical,,318.32,,,318.32,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Connecticare,Exchange,,318.32,,,318.32,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,Multiplan,Multiplan,,,365.21,,365.21,6.19,365.21,percent of total billed charges,,
HC RAST PANEL-NE,86003,CPT,,,both,,,456.29,273.77,United Healthcare/Oxford,United Healthcare/Oxford,,277.7,,,277.7,6.19,365.21,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT  ,,,both,,,101.29,60.77,Aetna,Commerical,,55.66,,,55.66,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Aetna,Middlesex Employees,,50.1,,,50.1,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Anthem,Commerical,,66.1,,,66.1,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Anthem,Indemnity,,,73.67,,73.67,6.19,81.16,percent of total billed charges,,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Anthem,State Preferred,,6.19,,,6.19,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Anthem,Individual Exchange,,52.88,,,52.88,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Cigna,Cigna,,75.98,,,75.98,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Connecticare,Commerical,,70.74,,,70.74,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Connecticare,Exchange,,70.74,,,70.74,6.19,81.16,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,Multiplan,Multiplan,,,81.16,,81.16,6.19,81.16,percent of total billed charges,,
HC RAST-1,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC RAST-1,86003,CPT,,,both,,,101.29,60.77,United Healthcare/Oxford,United Healthcare/Oxford,,61.71,,,61.71,6.19,81.16,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,6.19,29.73,percent of total billed charges,,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,6.19,,,6.19,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,6.19,29.73,other,Could be inpatient or outpatient,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,6.19,29.73,percent of total billed charges,,
HC RICE (F9) IGE,86003,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,6.19,29.73,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC ROUGH PIGWEED (W14) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC RUSSIAN THISTLE (W11) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC RYE (F5) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SALMON (F41) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SCALLOP (R338) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SESAME SEED (F10) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SHRIMP (F24) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SILK (K74) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC SMULBY,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC SOYBEAN (F14) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC STRAWBERRY (F44) IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC SUNFLOWER SEED (K84) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC TIMOTHY GRASS (G6) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC TOMATO (F25) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC TROUT (F204) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC TUNA (F40) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC WALNUT (F256) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT  ,,,both,,,20.99,12.59,Aetna,Commerical,,11.53,,,11.53,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Aetna,Middlesex Employees,,10.37,,,10.37,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Commerical,,13.69,,,13.69,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Indemnity,,,15.27,,15.27,6.19,16.82,percent of total billed charges,,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,State Preferred,,6.19,,,6.19,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Anthem,Individual Exchange,,10.95,,,10.95,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Cigna,Cigna,,15.75,,,15.75,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Commerical,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Connecticare,Exchange,,14.66,,,14.66,6.19,16.82,other,Could be inpatient or outpatient,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,Multiplan,Multiplan,,,16.82,,16.82,6.19,16.82,percent of total billed charges,,
HC WHEAT IGE,86003,CPT,,,both,,,20.99,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,6.19,16.82,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC WHITE ASH (T15) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC WHITE MULBERRY (T70) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC WHITE PINE (T16) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC WHOLE EGG (F245) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT  ,,,both,,,41.11,24.66,Aetna,Commerical,,22.59,,,22.59,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Aetna,Middlesex Employees,,20.33,,,20.33,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Commerical,,26.83,,,26.83,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Indemnity,,,29.9,,29.9,6.19,32.94,percent of total billed charges,,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,State Preferred,,6.19,,,6.19,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Anthem,Individual Exchange,,21.47,,,21.47,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Cigna,Cigna,,30.84,,,30.84,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Commerical,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Connecticare,Exchange,,28.71,,,28.71,6.19,32.94,other,Could be inpatient or outpatient,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,Multiplan,Multiplan,,,32.94,,32.94,6.19,32.94,percent of total billed charges,,
HC YEAST (F45) IGE,86003,CPT,,,both,,,41.11,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,6.19,32.94,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,17.45,,,17.45,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,15.7,,,15.7,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,27.76,,,27.76,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,15.7,48.7,percent of total billed charges,,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,17.81,,,17.81,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,22.21,,,22.21,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,33.23,,,33.23,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,16.84,,,16.84,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,16.84,,,16.84,15.7,48.7,other,Could be inpatient or outpatient,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,15.7,48.7,percent of total billed charges,,
HC ANCA,86021,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,21.94,,,21.94,15.7,48.7,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT  ,,,both,,,228.66,137.2,Aetna,Commerical,,17.45,,,17.45,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Aetna,Middlesex Employees,,15.7,,,15.7,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Anthem,Commerical,,27.76,,,27.76,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Anthem,Indemnity,,,166.98,,166.98,15.7,183.96,percent of total billed charges,,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Anthem,State Preferred,,17.81,,,17.81,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Anthem,Individual Exchange,,22.21,,,22.21,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Cigna,Cigna,,33.23,,,33.23,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Connecticare,Commerical,,16.84,,,16.84,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Connecticare,Exchange,,16.84,,,16.84,15.7,183.96,other,Could be inpatient or outpatient,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,Multiplan,Multiplan,,,183.96,,183.96,15.7,183.96,percent of total billed charges,,
HC ANTI-NEUTROPHL AB,86021,CPT,,,both,,,228.66,137.2,United Healthcare/Oxford,United Healthcare/Oxford,,21.94,,,21.94,15.7,183.96,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,17.45,,,17.45,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,15.7,,,15.7,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,27.76,,,27.76,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,15.7,45.51,percent of total billed charges,,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,17.81,,,17.81,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,22.21,,,22.21,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,33.23,,,33.23,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,16.84,,,16.84,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,16.84,,,16.84,15.7,45.51,other,Could be inpatient or outpatient,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,15.7,45.51,percent of total billed charges,,
HC REF PROTEINASE 3 ANTIBODY (LEUKOCYTE AB),86021,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,21.94,,,21.94,15.7,45.51,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,21.75,73.94,percent of total billed charges,,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,21.75,,,21.75,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,21.75,73.94,other,Could be inpatient or outpatient,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,21.75,73.94,percent of total billed charges,,
HC HEPARIN/PF4 AB,86022,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,21.75,73.94,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT  ,,,both,,,23.49,14.1,Aetna,Commerical,,12.91,,,12.91,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Aetna,Middlesex Employees,,11.62,,,11.62,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Anthem,Commerical,,15.33,,,15.33,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Anthem,Indemnity,,,17.08,,17.08,11.62,21.75,percent of total billed charges,,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Anthem,State Preferred,,21.75,,,21.75,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Anthem,Individual Exchange,,12.26,,,12.26,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Cigna,Cigna,,17.62,,,17.62,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Connecticare,Commerical,,16.4,,,16.4,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Connecticare,Exchange,,16.4,,,16.4,11.62,21.75,other,Could be inpatient or outpatient,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,Multiplan,Multiplan,,,18.82,,18.82,11.62,21.75,percent of total billed charges,,
HC HPA ANTIBODY INDIRECT PLATELET SCREEN,86022,CPT,,,both,,,23.49,14.1,United Healthcare/Oxford,United Healthcare/Oxford,,14.31,,,14.31,11.62,21.75,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,40.82,,,40.82,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,36.74,,,36.74,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,48.47,,,48.47,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.03,,54.03,21.75,59.52,percent of total billed charges,,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,21.75,,,21.75,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,38.77,,,38.77,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,55.72,,,55.72,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,51.87,,,51.87,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,51.87,,,51.87,21.75,59.52,other,Could be inpatient or outpatient,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.52,,59.52,21.75,59.52,percent of total billed charges,,
HC PLATELET AB-RC,86022,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,45.26,,,45.26,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,40.82,,,40.82,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,36.74,,,36.74,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,48.47,,,48.47,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.03,,54.03,21.75,59.52,percent of total billed charges,,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,21.75,,,21.75,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,38.77,,,38.77,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,55.72,,,55.72,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,51.87,,,51.87,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,51.87,,,51.87,21.75,59.52,other,Could be inpatient or outpatient,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.52,,59.52,21.75,59.52,percent of total billed charges,,
HC PLT ALLOSCREEN-RC,86022,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,45.26,,,45.26,21.75,59.52,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT  ,,,both,,,265.74,159.44,Aetna,Commerical,,145.97,,,145.97,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Aetna,Middlesex Employees,,131.37,,,131.37,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Anthem,Commerical,,173.31,,,173.31,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Anthem,Indemnity,,,193.18,,193.18,21.75,212.81,percent of total billed charges,,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Anthem,State Preferred,,21.75,,,21.75,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Anthem,Individual Exchange,,138.65,,,138.65,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Cigna,Cigna,,199.24,,,199.24,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Connecticare,Commerical,,185.49,,,185.49,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Connecticare,Exchange,,185.49,,,185.49,21.75,212.81,other,Could be inpatient or outpatient,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,Multiplan,Multiplan,,,212.81,,212.81,21.75,212.81,percent of total billed charges,,
HC REF PLA-1 TYPING,86022,CPT,,,both,,,265.74,159.44,United Healthcare/Oxford,United Healthcare/Oxford,,161.81,,,161.81,21.75,212.81,other,Could be inpatient or outpatient,
HC SRA,86022,CPT  ,,,both,,,231.75,139.05,Aetna,Commerical,,127.41,,,127.41,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Aetna,Middlesex Employees,,114.67,,,114.67,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Anthem,Commerical,,151.28,,,151.28,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Anthem,Indemnity,,,168.63,,168.63,21.75,185.77,percent of total billed charges,,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Anthem,State Preferred,,21.75,,,21.75,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Anthem,Individual Exchange,,121.02,,,121.02,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Cigna,Cigna,,173.92,,,173.92,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Connecticare,Commerical,,161.91,,,161.91,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Connecticare,Exchange,,161.91,,,161.91,21.75,185.77,other,Could be inpatient or outpatient,
HC SRA,86022,CPT,,,both,,,231.75,139.05,Multiplan,Multiplan,,,185.77,,185.77,21.75,185.77,percent of total billed charges,,
HC SRA,86022,CPT,,,both,,,231.75,139.05,United Healthcare/Oxford,United Healthcare/Oxford,,141.24,,,141.24,21.75,185.77,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT  ,,,both,,,42.62,25.57,Aetna,Commerical,,28.48,,,28.48,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Aetna,Middlesex Employees,,25.63,,,25.63,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Anthem,Commerical,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Anthem,Indemnity,,,30.99,,30.99,18.91,34.14,percent of total billed charges,,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Anthem,State Preferred,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Anthem,Individual Exchange,,18.91,,,18.91,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Cigna,Cigna,,25.08,,,25.08,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Connecticare,Commerical,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Connecticare,Exchange,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,Multiplan,Multiplan,,,34.14,,34.14,18.91,34.14,percent of total billed charges,,
HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,,both,,,42.62,25.57,United Healthcare/Oxford,United Healthcare/Oxford,,26.38,,,26.38,18.91,34.14,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,14.02,,,14.02,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.62,,,12.62,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.28,,,22.28,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.62,38.58,percent of total billed charges,,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.31,,,14.31,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.82,,,17.82,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.53,,,13.53,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.53,,,13.53,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.62,38.58,percent of total billed charges,,
HC ANA SCREEN,86038,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.61,,,17.61,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,14.02,,,14.02,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.62,,,12.62,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.28,,,22.28,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.62,38.58,percent of total billed charges,,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.31,,,14.31,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.82,,,17.82,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.53,,,13.53,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.53,,,13.53,12.62,38.58,other,Could be inpatient or outpatient,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.62,38.58,percent of total billed charges,,
HC CENTROMERE ANTIBODY,86038,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.61,,,17.61,12.62,38.58,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT  ,,,both,,,45.13,27.08,Aetna,Commerical,,24.8,,,24.8,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Aetna,Middlesex Employees,,22.32,,,22.32,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Anthem,Commerical,,29.45,,,29.45,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Anthem,Indemnity,,,32.82,,32.82,13.22,36.16,percent of total billed charges,,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Anthem,State Preferred,,13.22,,,13.22,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Anthem,Individual Exchange,,23.56,,,23.56,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Cigna,Cigna,,33.85,,,33.85,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Connecticare,Commerical,,31.52,,,31.52,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Connecticare,Exchange,,31.52,,,31.52,13.22,36.16,other,Could be inpatient or outpatient,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,Multiplan,Multiplan,,,36.16,,36.16,13.22,36.16,percent of total billed charges,,
HC ANA TITER,86039,CPT,,,both,,,45.13,27.08,United Healthcare/Oxford,United Healthcare/Oxford,,27.49,,,27.49,13.22,36.16,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT  ,,,both,,,42.62,25.57,Aetna,Commerical,,28.48,,,28.48,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Aetna,Middlesex Employees,,25.63,,,25.63,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Anthem,Commerical,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Anthem,Indemnity,,,30.99,,30.99,18.91,34.14,percent of total billed charges,,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Anthem,State Preferred,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Anthem,Individual Exchange,,18.91,,,18.91,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Cigna,Cigna,,25.08,,,25.08,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Connecticare,Commerical,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Connecticare,Exchange,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,Multiplan,Multiplan,,,34.14,,34.14,18.91,34.14,percent of total billed charges,,
HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,86052,CPT,,,both,,,42.62,25.57,United Healthcare/Oxford,United Healthcare/Oxford,,26.38,,,26.38,18.91,34.14,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT  ,,,both,,,29.09,17.45,Aetna,Commerical,,8.47,,,8.47,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Aetna,Middlesex Employees,,7.62,,,7.62,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Anthem,Commerical,,13.44,,,13.44,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Anthem,Indemnity,,,21.15,,21.15,7.62,23.3,percent of total billed charges,,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Anthem,State Preferred,,8.64,,,8.64,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Anthem,Individual Exchange,,10.75,,,10.75,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Cigna,Cigna,,16.04,,,16.04,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Connecticare,Commerical,,8.16,,,8.16,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Connecticare,Exchange,,8.16,,,8.16,7.62,23.3,other,Could be inpatient or outpatient,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,Multiplan,Multiplan,,,23.3,,23.3,7.62,23.3,percent of total billed charges,,
HC A.S.O. TITER,86060,CPT,,,both,,,29.09,17.45,United Healthcare/Oxford,United Healthcare/Oxford,,10.63,,,10.63,7.62,23.3,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,8.47,,,8.47,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,7.62,,,7.62,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,13.44,,,13.44,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,7.62,137.97,percent of total billed charges,,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,8.64,,,8.64,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,10.75,,,10.75,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,16.04,,,16.04,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,8.16,,,8.16,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,8.16,,,8.16,7.62,137.97,other,Could be inpatient or outpatient,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,7.62,137.97,percent of total billed charges,,
HC ANTI-HYALURON,86060,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,10.63,,,10.63,7.62,137.97,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT  ,,,both,,,23.22,13.93,Aetna,Commerical,,6.69,,,6.69,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Aetna,Middlesex Employees,,6.02,,,6.02,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Anthem,Commerical,,10.63,,,10.63,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Anthem,Indemnity,,,16.88,,16.88,6.02,18.6,percent of total billed charges,,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Anthem,State Preferred,,6.83,,,6.83,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Anthem,Individual Exchange,,8.51,,,8.51,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Cigna,Cigna,,13.05,,,13.05,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Connecticare,Commerical,,6.46,,,6.46,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Connecticare,Exchange,,6.46,,,6.46,6.02,18.6,other,Could be inpatient or outpatient,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,Multiplan,Multiplan,,,18.6,,18.6,6.02,18.6,percent of total billed charges,,
HC A.S.O. SCREENING,86063,CPT,,,both,,,23.22,13.93,United Healthcare/Oxford,United Healthcare/Oxford,,8.4,,,8.4,6.02,18.6,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT  ,,,both,,,63.03,37.82,Aetna,Commerical,,34.63,,,34.63,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Aetna,Middlesex Employees,,31.17,,,31.17,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Anthem,Commerical,,41.12,,,41.12,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Anthem,Indemnity,,,45.84,,45.84,31.17,50.5,percent of total billed charges,,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Anthem,State Preferred,,45.72,,,45.72,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Anthem,Individual Exchange,,32.89,,,32.89,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Cigna,Cigna,,47.28,,,47.28,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Connecticare,Commerical,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Connecticare,Exchange,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,Multiplan,Multiplan,,,50.5,,50.5,31.17,50.5,percent of total billed charges,,
HC MD CONSULT GEN,86077,CPT,,,both,,,63.03,37.82,United Healthcare/Oxford,United Healthcare/Oxford,,38.4,,,38.4,31.17,50.5,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT  ,,,both,,,460.34,276.2,Aetna,Commerical,,64.65,,,64.65,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Aetna,Middlesex Employees,,58.18,,,58.18,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Anthem,Commerical,,76.6,,,76.6,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Anthem,Indemnity,,,334.79,,334.79,47.07,368.82,percent of total billed charges,,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Anthem,State Preferred,,47.07,,,47.07,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Anthem,Individual Exchange,,61.28,,,61.28,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Cigna,Cigna,,76.33,,,76.33,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Connecticare,Commerical,,66.03,,,66.03,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Connecticare,Exchange,,66.03,,,66.03,47.07,368.82,other,Could be inpatient or outpatient,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,Multiplan,Multiplan,,,368.82,,368.82,47.07,368.82,percent of total billed charges,,
HC MD CONSULT TRANSFUSION RX,86078,CPT,,,both,,,460.34,276.2,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,47.07,368.82,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT  ,,,both,,,390.37,234.22,Aetna,Commerical,,214.61,,,214.61,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Aetna,Middlesex Employees,,193.15,,,193.15,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Anthem,Commerical,,254.83,,,254.83,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Anthem,Indemnity,,,284.04,,284.04,46.73,312.91,percent of total billed charges,,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Anthem,State Preferred,,46.73,,,46.73,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Anthem,Individual Exchange,,203.86,,,203.86,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Cigna,Cigna,,292.96,,,292.96,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Connecticare,Commerical,,272.73,,,272.73,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Connecticare,Exchange,,272.73,,,272.73,46.73,312.91,other,Could be inpatient or outpatient,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,Multiplan,Multiplan,,,312.91,,312.91,46.73,312.91,percent of total billed charges,,
HC MD AUTH DIV FROM SOP,86079,CPT,,,both,,,390.37,234.22,United Healthcare/Oxford,United Healthcare/Oxford,,237.93,,,237.93,46.73,312.91,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC C-REACTIVE PROTEI,86140,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT  ,,,both,,,94.54,56.73,Aetna,Commerical,,51.96,,,51.96,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Aetna,Middlesex Employees,,46.76,,,46.76,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Anthem,Commerical,,61.69,,,61.69,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Anthem,Indemnity,,,68.76,,68.76,15.33,75.75,percent of total billed charges,,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Anthem,State Preferred,,15.33,,,15.33,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Anthem,Individual Exchange,,49.35,,,49.35,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Cigna,Cigna,,70.92,,,70.92,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Connecticare,Commerical,,66.02,,,66.02,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Connecticare,Exchange,,66.02,,,66.02,15.33,75.75,other,Could be inpatient or outpatient,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,Multiplan,Multiplan,,,75.75,,75.75,15.33,75.75,percent of total billed charges,,
HC CRP HIGH SENS,86141,CPT,,,both,,,94.54,56.73,United Healthcare/Oxford,United Healthcare/Oxford,,57.6,,,57.6,15.33,75.75,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Anthem,State Preferred,,30.12,,,30.12,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA,86146,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Anthem,State Preferred,,30.12,,,30.12,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA - IGG,86146,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Anthem,State Preferred,,30.12,,,30.12,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,30.12,82.06,percent of total billed charges,,
HC BETA 2 GLYCOPROTEIN I AB EA - IGM,86146,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,30.12,82.06,percent of total billed charges,,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Anthem,State Preferred,,30.12,,,30.12,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,30.12,82.06,other,Could be inpatient or outpatient,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,30.12,82.06,percent of total billed charges,,
HC CARDIOLIPIN AB EA IG CLASS,86147,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,30.12,82.06,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT  ,,,both,,,123.81,74.28,Aetna,Commerical,,68.04,,,68.04,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Aetna,Middlesex Employees,,61.23,,,61.23,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Anthem,Commerical,,80.78,,,80.78,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Anthem,Indemnity,,,90.04,,90.04,19.01,99.2,percent of total billed charges,,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Anthem,State Preferred,,19.01,,,19.01,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Anthem,Individual Exchange,,64.63,,,64.63,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Cigna,Cigna,,92.87,,,92.87,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Connecticare,Commerical,,86.46,,,86.46,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Connecticare,Exchange,,86.46,,,86.46,19.01,99.2,other,Could be inpatient or outpatient,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,Multiplan,Multiplan,,,99.2,,99.2,19.01,99.2,percent of total billed charges,,
HC PHSPHTDYL IFF M A,86148,CPT,,,both,,,123.81,74.28,United Healthcare/Oxford,United Healthcare/Oxford,,75.43,,,75.43,19.01,99.2,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,9.36,,,9.36,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,8.42,,,8.42,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.35,,,12.35,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,7.93,21.7,percent of total billed charges,,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.93,,,7.93,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.87,,,9.87,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,9.03,,,9.03,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,9.03,,,9.03,7.93,21.7,other,Could be inpatient or outpatient,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,7.93,21.7,percent of total billed charges,,
HC COLD ANTIBODY SCREEN,86156,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,10.58,,,10.58,7.93,21.7,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT  ,,,both,,,32.11,19.26,Aetna,Commerical,,17.64,,,17.64,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Aetna,Middlesex Employees,,15.87,,,15.87,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Anthem,Commerical,,20.95,,,20.95,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Anthem,Indemnity,,,23.35,,23.35,9.54,25.72,percent of total billed charges,,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Anthem,State Preferred,,9.54,,,9.54,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Anthem,Individual Exchange,,16.76,,,16.76,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Cigna,Cigna,,24.08,,,24.08,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Connecticare,Commerical,,22.42,,,22.42,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Connecticare,Exchange,,22.42,,,22.42,9.54,25.72,other,Could be inpatient or outpatient,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,Multiplan,Multiplan,,,25.72,,25.72,9.54,25.72,percent of total billed charges,,
HC AGGLUTININS-COLD,86157,CPT,,,both,,,32.11,19.26,United Healthcare/Oxford,United Healthcare/Oxford,,19.56,,,19.56,9.54,25.72,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT  ,,,both,,,48.15,28.89,Aetna,Commerical,,13.92,,,13.92,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Anthem,Commerical,,22.12,,,22.12,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Anthem,Indemnity,,,35.02,,35.02,12.53,38.58,percent of total billed charges,,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Anthem,State Preferred,,14.22,,,14.22,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Anthem,Individual Exchange,,17.7,,,17.7,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Cigna,Cigna,,26.72,,,26.72,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Connecticare,Commerical,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Connecticare,Exchange,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.53,38.58,percent of total billed charges,,
HC C1 EST INHIB QT,86160,CPT,,,both,,,48.15,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.92,,,13.92,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.12,,,22.12,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.22,,,14.22,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.7,,,17.7,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C2,86160,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.92,,,13.92,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.12,,,22.12,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.22,,,14.22,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.7,,,17.7,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C-3,86160,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.92,,,13.92,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.12,,,22.12,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.22,,,14.22,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.7,,,17.7,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT C4,86160,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT  ,,,both,,,218.36,131.02,Aetna,Commerical,,13.92,,,13.92,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Anthem,Commerical,,22.12,,,22.12,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Anthem,Indemnity,,,158.8,,158.8,12.53,174.94,percent of total billed charges,,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Anthem,State Preferred,,14.22,,,14.22,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Anthem,Individual Exchange,,17.7,,,17.7,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Cigna,Cigna,,26.72,,,26.72,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Connecticare,Commerical,,13.43,,,13.43,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Connecticare,Exchange,,13.43,,,13.43,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,Multiplan,Multiplan,,,174.94,,174.94,12.53,174.94,percent of total billed charges,,
HC COMPLEMENT C5,86160,CPT,,,both,,,218.36,131.02,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,174.94,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,13.92,,,13.92,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,22.12,,,22.12,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,12.53,91.98,percent of total billed charges,,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,14.22,,,14.22,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,17.7,,,17.7,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,26.72,,,26.72,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,13.43,,,13.43,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,13.43,,,13.43,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,12.53,91.98,percent of total billed charges,,
HC COMPLEMENT C6,86160,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,91.98,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.92,,,13.92,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.53,,,12.53,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.12,,,22.12,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.22,,,14.22,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.7,,,17.7,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.43,,,13.43,12.53,38.58,other,Could be inpatient or outpatient,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.53,38.58,percent of total billed charges,,
HC COMPLEMENT; FCN ACTIVITY EA,86161,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.48,,,17.48,12.53,38.58,other,Could be inpatient or outpatient,
HC CH50,86162,CPT  ,,,both,,,81.37,48.82,Aetna,Commerical,,23.56,,,23.56,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,21.2,,,21.2,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Anthem,Commerical,,37.45,,,37.45,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Anthem,Indemnity,,,59.76,,59.76,21.2,65.83,percent of total billed charges,,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Anthem,State Preferred,,24.05,,,24.05,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Anthem,Individual Exchange,,29.95,,,29.95,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Cigna,Cigna,,45.12,,,45.12,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Connecticare,Commerical,,22.74,,,22.74,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Connecticare,Exchange,,22.74,,,22.74,21.2,65.83,other,Could be inpatient or outpatient,
HC CH50,86162,CPT,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.83,,65.83,21.2,65.83,percent of total billed charges,,
HC CH50,86162,CPT,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,29.61,,,29.61,21.2,65.83,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT  ,,,both,,,51.01,30.6,Aetna,Commerical,,28.03,,,28.03,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Aetna,Middlesex Employees,,25.23,,,25.23,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Anthem,Commerical,,33.29,,,33.29,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Anthem,Indemnity,,,37.1,,37.1,11.46,40.87,percent of total billed charges,,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Anthem,State Preferred,,11.46,,,11.46,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Anthem,Individual Exchange,,26.63,,,26.63,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Cigna,Cigna,,38.26,,,38.26,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Connecticare,Commerical,,35.62,,,35.62,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Connecticare,Exchange,,35.62,,,35.62,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,Multiplan,Multiplan,,,40.87,,40.87,11.46,40.87,percent of total billed charges,,
HC COMPLEMENT FIXATION EA AG - SGL VIRAL STDY,86171,CPT,,,both,,,51.01,30.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.08,,,31.08,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT  ,,,both,,,51.01,30.6,Aetna,Commerical,,28.03,,,28.03,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Aetna,Middlesex Employees,,25.23,,,25.23,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Anthem,Commerical,,33.29,,,33.29,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Anthem,Indemnity,,,37.1,,37.1,11.46,40.87,percent of total billed charges,,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Anthem,State Preferred,,11.46,,,11.46,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Anthem,Individual Exchange,,26.63,,,26.63,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Cigna,Cigna,,38.26,,,38.26,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Connecticare,Commerical,,35.62,,,35.62,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Connecticare,Exchange,,35.62,,,35.62,11.46,40.87,other,Could be inpatient or outpatient,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,Multiplan,Multiplan,,,40.87,,40.87,11.46,40.87,percent of total billed charges,,
HC COMPLEMENT FIXATION EA AG - VAR,86171,CPT,,,both,,,51.01,30.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.08,,,31.08,11.46,40.87,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,15.33,41.79,percent of total billed charges,,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.33,,,15.33,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,15.33,41.79,other,Could be inpatient or outpatient,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,15.33,41.79,percent of total billed charges,,
HC CCP ANTIBODY,86200,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.33,41.79,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.37,,,15.37,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.83,,,13.83,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,24.42,,,24.42,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,13.83,42.73,percent of total billed charges,,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.68,,,15.68,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,19.53,,,19.53,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,29.67,,,29.67,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.83,,,14.83,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.83,,,14.83,13.83,42.73,other,Could be inpatient or outpatient,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,13.83,42.73,percent of total billed charges,,
HC ANTISTREP DNASE B,86215,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.3,,,19.3,13.83,42.73,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,15.94,,,15.94,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,14.34,,,14.34,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,25.32,,,25.32,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,14.34,44.58,percent of total billed charges,,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.27,,,16.27,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,20.25,,,20.25,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,30.25,,,30.25,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,15.38,,,15.38,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,15.38,,,15.38,14.34,44.58,other,Could be inpatient or outpatient,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,14.34,44.58,percent of total billed charges,,
HC DNA DS AB,86225,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,20.02,,,20.02,14.34,44.58,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT  ,,,both,,,42.62,25.57,Aetna,Commerical,,28.48,,,28.48,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Aetna,Middlesex Employees,,25.63,,,25.63,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Anthem,Commerical,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Anthem,Indemnity,,,30.99,,30.99,18.91,34.14,percent of total billed charges,,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Anthem,State Preferred,,23.64,,,23.64,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Anthem,Individual Exchange,,18.91,,,18.91,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Cigna,Cigna,,25.08,,,25.08,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Connecticare,Commerical,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Connecticare,Exchange,,25.73,,,25.73,18.91,34.14,other,Could be inpatient or outpatient,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,Multiplan,Multiplan,,,34.14,,34.14,18.91,34.14,percent of total billed charges,,
HC ENDOMYSIAL EMA ANTIBODY EACH IMMUNOGLOBULIN CLASS,86231,CPT,,,both,,,42.62,25.57,United Healthcare/Oxford,United Healthcare/Oxford,,26.38,,,26.38,18.91,34.14,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC ANTI-JO-1,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC ANTI-SCL 70 AB,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC NUCLEAR AG ANTBY,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT  ,,,both,,,72.04,43.22,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC REF CENTROMERE B ANTIBODY ENA ANY METHOD,86235,CPT,,,both,,,72.04,43.22,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC RNP/SM AB'S,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC SM ANTIBODY,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC SSA ANTIBODY,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT  ,,,both,,,172.01,103.21,Aetna,Commerical,,94.01,,,94.01,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Aetna,Middlesex Employees,,84.61,,,84.61,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Anthem,Commerical,,111.62,,,111.62,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Anthem,Indemnity,,,124.42,,124.42,21.24,137.07,percent of total billed charges,,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Anthem,State Preferred,,21.24,,,21.24,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Anthem,Individual Exchange,,89.3,,,89.3,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Cigna,Cigna,,128.33,,,128.33,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Connecticare,Commerical,,119.47,,,119.47,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Connecticare,Exchange,,119.47,,,119.47,21.24,137.07,other,Could be inpatient or outpatient,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,Multiplan,Multiplan,,,137.07,,137.07,21.24,137.07,percent of total billed charges,,
HC SS-A/SS/B AB'S,86235,CPT,,,both,,,172.01,103.21,United Healthcare/Oxford,United Healthcare/Oxford,,104.23,,,104.23,21.24,137.07,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,21.24,57.72,percent of total billed charges,,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,21.24,,,21.24,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,21.24,57.72,other,Could be inpatient or outpatient,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,21.24,57.72,percent of total billed charges,,
HC SSB ANTIBODY,86235,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,21.24,57.72,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,13.97,,,13.97,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,22.22,,,22.22,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.57,51.4,percent of total billed charges,,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,17.78,,,17.78,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,26.72,,,26.72,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.57,51.4,percent of total billed charges,,
HC ANTI-ADRENAL AB,86255,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,13.97,,,13.97,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,22.22,,,22.22,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.57,51.4,percent of total billed charges,,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,17.78,,,17.78,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,26.72,,,26.72,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.57,51.4,percent of total billed charges,,
HC ANTI-ENDOMISIAL,86255,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,13.97,,,13.97,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Anthem,Commerical,,22.22,,,22.22,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,12.57,82.06,percent of total billed charges,,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Anthem,State Preferred,,14.27,,,14.27,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,17.78,,,17.78,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Cigna,Cigna,,26.72,,,26.72,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Connecticare,Commerical,,13.48,,,13.48,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Connecticare,Exchange,,13.48,,,13.48,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,12.57,82.06,percent of total billed charges,,
HC ANTI-RETICULIN,86255,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,82.06,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,13.97,,,13.97,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,22.22,,,22.22,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.57,51.4,percent of total billed charges,,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,17.78,,,17.78,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,26.72,,,26.72,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.57,51.4,percent of total billed charges,,
HC ANTI-SM MUSCLE,86255,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,13.97,,,13.97,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,22.22,,,22.22,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.57,51.4,percent of total billed charges,,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,17.78,,,17.78,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,26.72,,,26.72,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.57,51.4,percent of total billed charges,,
HC CMV-NEG PROD,86255,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,51.4,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT  ,,,both,,,249.87,149.92,Aetna,Commerical,,13.97,,,13.97,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Commerical,,22.22,,,22.22,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Indemnity,,,181.72,,181.72,12.57,200.19,percent of total billed charges,,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,State Preferred,,14.27,,,14.27,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Individual Exchange,,17.78,,,17.78,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Cigna,Cigna,,26.72,,,26.72,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Commerical,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Exchange,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Multiplan,Multiplan,,,200.19,,200.19,12.57,200.19,percent of total billed charges,,
HC DPPX AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,200.19,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT  ,,,both,,,1414.77,848.86,Aetna,Commerical,,13.97,,,13.97,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Anthem,Commerical,,22.22,,,22.22,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Anthem,Indemnity,,,1028.93,,1028.93,12.57,1133.52,percent of total billed charges,,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Anthem,State Preferred,,14.27,,,14.27,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Anthem,Individual Exchange,,17.78,,,17.78,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Cigna,Cigna,,26.72,,,26.72,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Connecticare,Commerical,,13.48,,,13.48,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Connecticare,Exchange,,13.48,,,13.48,12.57,1133.52,other,Could be inpatient or outpatient,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,Multiplan,Multiplan,,,1133.52,,1133.52,12.57,1133.52,percent of total billed charges,,
HC ENCEPHALOPATHY-AUTOIMMUNE EVAL CSF  HH,86255,CPT,,,both,,,1414.77,848.86,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,1133.52,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT  ,,,both,,,87.55,52.53,Aetna,Commerical,,13.97,,,13.97,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Anthem,Commerical,,22.22,,,22.22,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Anthem,Indemnity,,,64.67,,64.67,12.57,71.24,percent of total billed charges,,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Anthem,State Preferred,,14.27,,,14.27,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Anthem,Individual Exchange,,17.78,,,17.78,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Cigna,Cigna,,26.72,,,26.72,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Connecticare,Commerical,,13.48,,,13.48,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Connecticare,Exchange,,13.48,,,13.48,12.57,71.24,other,Could be inpatient or outpatient,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,Multiplan,Multiplan,,,71.24,,71.24,12.57,71.24,percent of total billed charges,,
HC FLUORESCNT AB SCR,86255,CPT,,,both,,,87.55,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,71.24,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT  ,,,both,,,249.87,149.92,Aetna,Commerical,,13.97,,,13.97,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Commerical,,22.22,,,22.22,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Indemnity,,,181.72,,181.72,12.57,200.19,percent of total billed charges,,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,State Preferred,,14.27,,,14.27,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Individual Exchange,,17.78,,,17.78,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Cigna,Cigna,,26.72,,,26.72,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Commerical,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Exchange,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Multiplan,Multiplan,,,200.19,,200.19,12.57,200.19,percent of total billed charges,,
HC GFAP CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,200.19,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,13.97,,,13.97,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,22.22,,,22.22,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,12.57,124.44,percent of total billed charges,,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,14.27,,,14.27,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,17.78,,,17.78,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,26.72,,,26.72,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,13.48,,,13.48,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,13.48,,,13.48,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,12.57,124.44,percent of total billed charges,,
HC HU YO RI AB SCREEN REFLEX,86255,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT  ,,,both,,,154.5,92.7,Aetna,Commerical,,13.97,,,13.97,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Commerical,,22.22,,,22.22,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Indemnity,,,112.96,,112.96,12.57,124.44,percent of total billed charges,,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,State Preferred,,14.27,,,14.27,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Anthem,Individual Exchange,,17.78,,,17.78,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Cigna,Cigna,,26.72,,,26.72,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Connecticare,Commerical,,13.48,,,13.48,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Connecticare,Exchange,,13.48,,,13.48,12.57,124.44,other,Could be inpatient or outpatient,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,Multiplan,Multiplan,,,124.44,,124.44,12.57,124.44,percent of total billed charges,,
HC HU YO RI REFLEX,86255,CPT,,,both,,,154.5,92.7,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,124.44,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT  ,,,both,,,249.87,149.92,Aetna,Commerical,,13.97,,,13.97,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Commerical,,22.22,,,22.22,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Indemnity,,,181.72,,181.72,12.57,200.19,percent of total billed charges,,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,State Preferred,,14.27,,,14.27,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Anthem,Individual Exchange,,17.78,,,17.78,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Cigna,Cigna,,26.72,,,26.72,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Commerical,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Connecticare,Exchange,,13.48,,,13.48,12.57,200.19,other,Could be inpatient or outpatient,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,Multiplan,Multiplan,,,200.19,,200.19,12.57,200.19,percent of total billed charges,,
HC MGLUR1 AB CBA CSF  HH,86255,CPT,,,both,,,249.87,149.92,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,200.19,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,13.97,,,13.97,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,22.22,,,22.22,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,12.57,51.4,percent of total billed charges,,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,17.78,,,17.78,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,26.72,,,26.72,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,13.48,,,13.48,12.57,51.4,other,Could be inpatient or outpatient,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,12.57,51.4,percent of total billed charges,,
HC NEUROMYELITIS OPT,86255,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,51.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,13.97,,,13.97,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,22.22,,,22.22,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,12.57,152.4,percent of total billed charges,,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,14.27,,,14.27,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,17.78,,,17.78,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,26.72,,,26.72,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,13.48,,,13.48,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,13.48,,,13.48,12.57,152.4,other,Could be inpatient or outpatient,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,12.57,152.4,percent of total billed charges,,
HC STR MUSCLE AB SCR,86255,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,152.4,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC AMPA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC DPPX AB IFA TITER CSF  HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT  ,,,both,,,157.59,94.55,Aetna,Commerical,,87.21,,,87.21,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Aetna,Middlesex Employees,,78.49,,,78.49,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Anthem,Commerical,,103.54,,,103.54,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Anthem,Indemnity,,,115.42,,115.42,14.27,127.15,percent of total billed charges,,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Anthem,State Preferred,,14.27,,,14.27,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Anthem,Individual Exchange,,82.83,,,82.83,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Cigna,Cigna,,119.04,,,119.04,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Connecticare,Commerical,,110.82,,,110.82,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Connecticare,Exchange,,110.82,,,110.82,14.27,127.15,other,Could be inpatient or outpatient,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,Multiplan,Multiplan,,,127.15,,127.15,14.27,127.15,percent of total billed charges,,
HC ENDOMYSIAL AB,86256,CPT,,,both,,,157.59,94.55,United Healthcare/Oxford,United Healthcare/Oxford,,96.68,,,96.68,14.27,127.15,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC GABA-B-R AB IF TITER ASSAY CSF HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC GFPAP IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC MGLUR1 AB IFA TITER CSF HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT  ,,,both,,,82.16,49.3,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC NMDA-R AB IF TITER ASSAY CSF  HH,86256,CPT,,,both,,,82.16,49.3,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT  ,,,both,,,79.31,47.59,Aetna,Commerical,,45.15,,,45.15,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Aetna,Middlesex Employees,,40.63,,,40.63,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Anthem,Commerical,,53.61,,,53.61,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Anthem,Indemnity,,,59.76,,59.76,14.27,65.83,percent of total billed charges,,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Anthem,State Preferred,,14.27,,,14.27,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Anthem,Individual Exchange,,42.89,,,42.89,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Cigna,Cigna,,61.63,,,61.63,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Connecticare,Commerical,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Connecticare,Exchange,,57.37,,,57.37,14.27,65.83,other,Could be inpatient or outpatient,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,Multiplan,Multiplan,,,65.83,,65.83,14.27,65.83,percent of total billed charges,,
HC NMO/AQP4-IGG CBA HH,86256,CPT,,,both,,,79.31,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,50.06,,,50.06,14.27,65.83,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,14.27,51.4,percent of total billed charges,,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,14.27,,,14.27,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,14.27,51.4,other,Could be inpatient or outpatient,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,14.27,51.4,percent of total billed charges,,
HC SM MUSCLE TITER,86256,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,14.27,51.4,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT  ,,,both,,,40.43,24.26,Aetna,Commerical,,27.02,,,27.02,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Aetna,Middlesex Employees,,24.32,,,24.32,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Anthem,Commerical,,22.43,,,22.43,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Anthem,Indemnity,,,29.4,,29.4,17.95,32.39,percent of total billed charges,,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Anthem,State Preferred,,22.43,,,22.43,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Anthem,Individual Exchange,,17.95,,,17.95,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Cigna,Cigna,,23.81,,,23.81,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Connecticare,Commerical,,24.41,,,24.41,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Connecticare,Exchange,,24.41,,,24.41,17.95,32.39,other,Could be inpatient or outpatient,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,Multiplan,Multiplan,,,32.39,,32.39,17.95,32.39,percent of total billed charges,,
HC GLIADIN DGP ANTIBODY EACH IMMUNOGLOBULIN CLASS,86258,CPT,,,both,,,40.43,24.26,United Healthcare/Oxford,United Healthcare/Oxford,,25.03,,,25.03,17.95,32.39,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT  ,,,both,,,76.38,45.83,Aetna,Commerical,,51.04,,,51.04,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Aetna,Middlesex Employees,,45.94,,,45.94,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Anthem,Commerical,,42.36,,,42.36,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Anthem,Indemnity,,,55.55,,55.55,24.63,61.2,percent of total billed charges,,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Anthem,State Preferred,,24.63,,,24.63,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Anthem,Individual Exchange,,33.89,,,33.89,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Cigna,Cigna,,44.97,,,44.97,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Connecticare,Commerical,,46.12,,,46.12,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Connecticare,Exchange,,46.12,,,46.12,24.63,61.2,other,Could be inpatient or outpatient,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,Multiplan,Multiplan,,,61.2,,61.2,24.63,61.2,percent of total billed charges,,
HC IA QUANT CA 19-9,86301,CPT,,,both,,,76.38,45.83,United Healthcare/Oxford,United Healthcare/Oxford,,47.29,,,47.29,24.63,61.2,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT  ,,,both,,,83.43,50.06,Aetna,Commerical,,24.13,,,24.13,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Aetna,Middlesex Employees,,21.71,,,21.71,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Anthem,Commerical,,38.36,,,38.36,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Anthem,Indemnity,,,61.39,,61.39,21.71,67.63,percent of total billed charges,,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Anthem,State Preferred,,24.63,,,24.63,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Anthem,Individual Exchange,,30.69,,,30.69,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Cigna,Cigna,,46.29,,,46.29,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Connecticare,Commerical,,23.28,,,23.28,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Connecticare,Exchange,,23.28,,,23.28,21.71,67.63,other,Could be inpatient or outpatient,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,Multiplan,Multiplan,,,67.63,,67.63,21.71,67.63,percent of total billed charges,,
HC CA-125,86304,CPT,,,both,,,83.43,50.06,United Healthcare/Oxford,United Healthcare/Oxford,,30.33,,,30.33,21.71,67.63,other,Could be inpatient or outpatient,
HC MONO,86308,CPT  ,,,both,,,20.84,12.5,Aetna,Commerical,,6.01,,,6.01,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Aetna,Middlesex Employees,,5.41,,,5.41,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Anthem,Commerical,,9.53,,,9.53,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Anthem,Indemnity,,,15.15,,15.15,5.41,16.69,percent of total billed charges,,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Anthem,State Preferred,,6.13,,,6.13,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Anthem,Individual Exchange,,7.63,,,7.63,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Cigna,Cigna,,11.28,,,11.28,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Connecticare,Commerical,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Connecticare,Exchange,,5.8,,,5.8,5.41,16.69,other,Could be inpatient or outpatient,
HC MONO,86308,CPT,,,both,,,20.84,12.5,Multiplan,Multiplan,,,16.69,,16.69,5.41,16.69,percent of total billed charges,,
HC MONO,86308,CPT,,,both,,,20.84,12.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.54,,,7.54,5.41,16.69,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT  ,,,both,,,164.8,98.88,Aetna,Commerical,,90.29,,,90.29,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Aetna,Middlesex Employees,,81.26,,,81.26,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Anthem,Commerical,,107.22,,,107.22,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Anthem,Indemnity,,,119.51,,119.51,24.63,131.66,percent of total billed charges,,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Anthem,State Preferred,,24.63,,,24.63,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Anthem,Individual Exchange,,85.77,,,85.77,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Cigna,Cigna,,123.26,,,123.26,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Connecticare,Commerical,,114.75,,,114.75,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Connecticare,Exchange,,114.75,,,114.75,24.63,131.66,other,Could be inpatient or outpatient,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,Multiplan,Multiplan,,,131.66,,131.66,24.63,131.66,percent of total billed charges,,
HC CHROMOGRANIN A,86316,CPT,,,both,,,164.8,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,24.63,131.66,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,20.97,,,20.97,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,18.87,,,18.87,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,23.87,,,23.87,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.33,47.8,percent of total billed charges,,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,15.33,,,15.33,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,19.1,,,19.1,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,28.5,,,28.5,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,20.24,,,20.24,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,20.24,,,20.24,15.33,47.8,other,Could be inpatient or outpatient,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.33,47.8,percent of total billed charges,,
HC SYPHILIS EIA,86318,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,23.72,,,23.72,15.33,47.8,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,39.59,,,39.59,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,35.63,,,35.63,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,47,,,47,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,28.86,57.72,percent of total billed charges,,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,28.86,,,28.86,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.6,,,37.6,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,54.03,,,54.03,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,50.3,,,50.3,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,50.3,,,50.3,28.86,57.72,other,Could be inpatient or outpatient,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,28.86,57.72,percent of total billed charges,,
HC C1Q BIND IMM CPLX,86332,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,43.88,,,43.88,28.86,57.72,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT  ,,,both,,,166.86,100.12,Aetna,Commerical,,91.53,,,91.53,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Aetna,Middlesex Employees,,82.38,,,82.38,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Anthem,Commerical,,108.69,,,108.69,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Anthem,Indemnity,,,121.14,,121.14,26.44,133.46,percent of total billed charges,,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Anthem,State Preferred,,26.44,,,26.44,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Anthem,Individual Exchange,,86.95,,,86.95,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Cigna,Cigna,,124.95,,,124.95,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Connecticare,Commerical,,116.33,,,116.33,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Connecticare,Exchange,,116.33,,,116.33,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,Multiplan,Multiplan,,,133.46,,133.46,26.44,133.46,percent of total billed charges,,
HC IMMUNOFIX SERUM,86334,CPT,,,both,,,166.86,100.12,United Healthcare/Oxford,United Healthcare/Oxford,,101.48,,,101.48,26.44,133.46,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,66.18,,,66.18,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,59.56,,,59.56,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,78.58,,,78.58,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,34.74,96.49,percent of total billed charges,,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,34.74,,,34.74,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,62.87,,,62.87,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,90.33,,,90.33,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,84.1,,,84.1,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,84.1,,,84.1,34.74,96.49,other,Could be inpatient or outpatient,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,34.74,96.49,percent of total billed charges,,
HC IMMUNOFIX FLUID,86335,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,73.37,,,73.37,34.74,96.49,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT  ,,,both,,,82.4,49.44,Aetna,Commerical,,45.77,,,45.77,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Aetna,Middlesex Employees,,41.19,,,41.19,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Anthem,Commerical,,54.35,,,54.35,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Anthem,Indemnity,,,60.58,,60.58,18.45,66.73,percent of total billed charges,,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Anthem,State Preferred,,18.45,,,18.45,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Anthem,Individual Exchange,,43.48,,,43.48,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Cigna,Cigna,,62.47,,,62.47,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Connecticare,Commerical,,58.16,,,58.16,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Connecticare,Exchange,,58.16,,,58.16,18.45,66.73,other,Could be inpatient or outpatient,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,Multiplan,Multiplan,,,66.73,,66.73,18.45,66.73,percent of total billed charges,,
HC INHIBIN-A,86336,CPT,,,both,,,82.4,49.44,United Healthcare/Oxford,United Healthcare/Oxford,,50.74,,,50.74,18.45,66.73,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,24.83,,,24.83,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,22.34,,,22.34,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,30.59,,,30.59,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,19.65,68.54,percent of total billed charges,,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,19.65,,,19.65,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,24.48,,,24.48,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,47.49,,,47.49,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,23.96,,,23.96,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,23.96,,,23.96,19.65,68.54,other,Could be inpatient or outpatient,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,19.65,68.54,percent of total billed charges,,
HC INSULIN AB,86337,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,31.2,,,31.2,19.65,68.54,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT  ,,,both,,,90.64,54.38,Aetna,Commerical,,50.1,,,50.1,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Aetna,Middlesex Employees,,45.09,,,45.09,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Anthem,Commerical,,59.48,,,59.48,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Anthem,Indemnity,,,66.3,,66.3,17.85,73.04,percent of total billed charges,,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Anthem,State Preferred,,17.85,,,17.85,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Anthem,Individual Exchange,,47.59,,,47.59,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Cigna,Cigna,,68.38,,,68.38,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Connecticare,Commerical,,63.66,,,63.66,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Connecticare,Exchange,,63.66,,,63.66,17.85,73.04,other,Could be inpatient or outpatient,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,Multiplan,Multiplan,,,73.04,,73.04,17.85,73.04,percent of total billed charges,,
HC INTRINSIC FACTOR BLOCKING ANTIBODY,86340,CPT,,,both,,,90.64,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,55.54,,,55.54,17.85,73.04,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT  ,,,both,,,78.78,47.27,Aetna,Commerical,,27.32,,,27.32,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Aetna,Middlesex Employees,,24.59,,,24.59,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Anthem,Commerical,,36.47,,,36.47,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Anthem,Indemnity,,,57.3,,57.3,23.43,63.12,percent of total billed charges,,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Anthem,State Preferred,,23.43,,,23.43,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Anthem,Individual Exchange,,29.18,,,29.18,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Cigna,Cigna,,43.92,,,43.92,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Connecticare,Commerical,,26.37,,,26.37,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Connecticare,Exchange,,26.37,,,26.37,23.43,63.12,other,Could be inpatient or outpatient,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,Multiplan,Multiplan,,,63.12,,63.12,23.43,63.12,percent of total billed charges,,
HC ISLET CELL AUTOAB,86341,CPT,,,both,,,78.78,47.27,United Healthcare/Oxford,United Healthcare/Oxford,,30.9,,,30.9,23.43,63.12,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT  ,,,both,,,375.95,225.57,Aetna,Commerical,,206.57,,,206.57,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Aetna,Middlesex Employees,,185.92,,,185.92,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Anthem,Commerical,,245.27,,,245.27,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Anthem,Indemnity,,,273.4,,273.4,58.04,301.19,percent of total billed charges,,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Anthem,State Preferred,,58.04,,,58.04,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Anthem,Individual Exchange,,196.22,,,196.22,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Cigna,Cigna,,281.99,,,281.99,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Connecticare,Commerical,,262.51,,,262.51,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Connecticare,Exchange,,262.51,,,262.51,58.04,301.19,other,Could be inpatient or outpatient,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,Multiplan,Multiplan,,,301.19,,301.19,58.04,301.19,percent of total billed charges,,
HC LYMPH TRANSFORM,86353,CPT,,,both,,,375.95,225.57,United Healthcare/Oxford,United Healthcare/Oxford,,229.01,,,229.01,58.04,301.19,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT  ,,,both,,,151.41,90.85,Aetna,Commerical,,43.75,,,43.75,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Aetna,Middlesex Employees,,39.37,,,39.37,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Anthem,Commerical,,26.33,,,26.33,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Anthem,Indemnity,,,110.5,,110.5,16.92,137.95,percent of total billed charges,,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Anthem,State Preferred,,16.92,,,16.92,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Anthem,Individual Exchange,,21.06,,,21.06,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Cigna,Cigna,,137.95,,,137.95,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Connecticare,Commerical,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Connecticare,Exchange,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,Multiplan,Multiplan,,,121.74,,121.74,16.92,137.95,percent of total billed charges,,
HC B CELLS TOTAL CT,86355,CPT,,,both,,,151.41,90.85,United Healthcare/Oxford,United Healthcare/Oxford,,54.96,,,54.96,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT  ,,,both,,,137.31,82.39,Aetna,Commerical,,43.75,,,43.75,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Aetna,Middlesex Employees,,39.37,,,39.37,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Anthem,Commerical,,26.33,,,26.33,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Anthem,Indemnity,,,99.86,,99.86,16.92,137.95,percent of total billed charges,,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Anthem,State Preferred,,16.92,,,16.92,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Anthem,Individual Exchange,,21.06,,,21.06,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Cigna,Cigna,,137.95,,,137.95,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Connecticare,Commerical,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Connecticare,Exchange,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,Multiplan,Multiplan,,,110.02,,110.02,16.92,137.95,percent of total billed charges,,
HC BETA-2 TRANSFERRIN BODY FLUID,86355,CPT,,,both,,,137.31,82.39,United Healthcare/Oxford,United Healthcare/Oxford,,54.96,,,54.96,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT  ,,,both,,,151.41,90.85,Aetna,Commerical,,43.75,,,43.75,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Aetna,Middlesex Employees,,39.37,,,39.37,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Anthem,Commerical,,26.33,,,26.33,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Anthem,Indemnity,,,110.5,,110.5,16.92,137.95,percent of total billed charges,,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Anthem,State Preferred,,16.92,,,16.92,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Anthem,Individual Exchange,,21.06,,,21.06,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Cigna,Cigna,,137.95,,,137.95,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Connecticare,Commerical,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Connecticare,Exchange,,42.22,,,42.22,16.92,137.95,other,Could be inpatient or outpatient,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,Multiplan,Multiplan,,,121.74,,121.74,16.92,137.95,percent of total billed charges,,
HC NK CELLS TOTAL CT,86357,CPT,,,both,,,151.41,90.85,United Healthcare/Oxford,United Healthcare/Oxford,,54.96,,,54.96,16.92,137.95,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT  ,,,both,,,151.95,91.17,Aetna,Commerical,,43.75,,,43.75,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Aetna,Middlesex Employees,,39.37,,,39.37,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Anthem,Commerical,,26.33,,,26.33,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Anthem,Indemnity,,,110.5,,110.5,16.92,121.74,percent of total billed charges,,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Anthem,State Preferred,,16.92,,,16.92,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Anthem,Individual Exchange,,21.06,,,21.06,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Cigna,Cigna,,83.66,,,83.66,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Connecticare,Commerical,,42.22,,,42.22,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Connecticare,Exchange,,42.22,,,42.22,16.92,121.74,other,Could be inpatient or outpatient,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,Multiplan,Multiplan,,,121.74,,121.74,16.92,121.74,percent of total billed charges,,
HC T CELLS TOTAL,86359,CPT,,,both,,,151.95,91.17,United Healthcare/Oxford,United Healthcare/Oxford,,54.96,,,54.96,16.92,121.74,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,54.48,,,54.48,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,49.02,,,49.02,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,86.6,,,86.6,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,49.02,152.4,percent of total billed charges,,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,55.63,,,55.63,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,69.28,,,69.28,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,104.43,,,104.43,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,52.56,,,52.56,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,52.56,,,52.56,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,49.02,152.4,percent of total billed charges,,
HC CD4CD8 WUTH RATIO,86360,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,68.44,,,68.44,49.02,152.4,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,59.38,,,59.38,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,53.44,,,53.44,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,70.49,,,70.49,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,31.7,86.57,percent of total billed charges,,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,31.7,,,31.7,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,56.4,,,56.4,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,81.05,,,81.05,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,75.46,,,75.46,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,75.46,,,75.46,31.7,86.57,other,Could be inpatient or outpatient,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,31.7,86.57,percent of total billed charges,,
HC CD4 CT ONLY,86361,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,65.83,,,65.83,31.7,86.57,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT  ,,,both,,,40.43,24.26,Aetna,Commerical,,27.02,,,27.02,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Aetna,Middlesex Employees,,24.32,,,24.32,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Anthem,Commerical,,22.43,,,22.43,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Anthem,Indemnity,,,29.4,,29.4,17.95,32.39,percent of total billed charges,,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Anthem,State Preferred,,22.43,,,22.43,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Anthem,Individual Exchange,,17.95,,,17.95,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Cigna,Cigna,,23.81,,,23.81,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Connecticare,Commerical,,24.41,,,24.41,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Connecticare,Exchange,,24.41,,,24.41,17.95,32.39,other,Could be inpatient or outpatient,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,Multiplan,Multiplan,,,32.39,,32.39,17.95,32.39,percent of total billed charges,,
HC TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS,86364,CPT,,,both,,,40.43,24.26,United Healthcare/Oxford,United Healthcare/Oxford,,25.03,,,25.03,17.95,32.39,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT  ,,,both,,,175.1,105.06,Aetna,Commerical,,95.87,,,95.87,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Aetna,Middlesex Employees,,86.29,,,86.29,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Anthem,Commerical,,113.83,,,113.83,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Anthem,Indemnity,,,126.88,,126.88,16.92,139.77,percent of total billed charges,,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Anthem,State Preferred,,16.92,,,16.92,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Anthem,Individual Exchange,,91.06,,,91.06,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Cigna,Cigna,,130.86,,,130.86,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Connecticare,Commerical,,121.83,,,121.83,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Connecticare,Exchange,,121.83,,,121.83,16.92,139.77,other,Could be inpatient or outpatient,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,Multiplan,Multiplan,,,139.77,,139.77,16.92,139.77,percent of total billed charges,,
HC STEM CELLS TOT CT,86367,CPT,,,both,,,175.1,105.06,United Healthcare/Oxford,United Healthcare/Oxford,,106.28,,,106.28,16.92,139.77,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT  ,,,both,,,95.68,57.41,Aetna,Commerical,,16.87,,,16.87,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Aetna,Middlesex Employees,,15.18,,,15.18,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Anthem,Commerical,,23.14,,,23.14,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Anthem,Indemnity,,,69.58,,69.58,14.87,76.65,percent of total billed charges,,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Anthem,State Preferred,,14.87,,,14.87,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Anthem,Individual Exchange,,18.52,,,18.52,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Cigna,Cigna,,32.03,,,32.03,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Connecticare,Commerical,,16.28,,,16.28,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Connecticare,Exchange,,16.28,,,16.28,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,Multiplan,Multiplan,,,76.65,,76.65,14.87,76.65,percent of total billed charges,,
HC ANTI-MICROSOMAL ANTIBODY TITER,86376,CPT,,,both,,,95.68,57.41,United Healthcare/Oxford,United Healthcare/Oxford,,21.2,,,21.2,14.87,76.65,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,16.87,,,16.87,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.18,,,15.18,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,23.14,,,23.14,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,14.87,47.8,percent of total billed charges,,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,14.87,,,14.87,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,18.52,,,18.52,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.03,,,32.03,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.28,,,16.28,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.28,,,16.28,14.87,47.8,other,Could be inpatient or outpatient,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,14.87,47.8,percent of total billed charges,,
HC ANTI-THYROID AB,86376,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.2,,,21.2,14.87,47.8,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT  ,,,both,,,57.97,34.78,Aetna,Commerical,,16.87,,,16.87,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Aetna,Middlesex Employees,,15.18,,,15.18,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Anthem,Commerical,,23.14,,,23.14,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Anthem,Indemnity,,,42.16,,42.16,14.87,46.44,percent of total billed charges,,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Anthem,State Preferred,,14.87,,,14.87,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Anthem,Individual Exchange,,18.52,,,18.52,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Cigna,Cigna,,32.03,,,32.03,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Connecticare,Commerical,,16.28,,,16.28,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Connecticare,Exchange,,16.28,,,16.28,14.87,46.44,other,Could be inpatient or outpatient,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,Multiplan,Multiplan,,,46.44,,46.44,14.87,46.44,percent of total billed charges,,
HC LIV/KID MICRO AB,86376,CPT,,,both,,,57.97,34.78,United Healthcare/Oxford,United Healthcare/Oxford,,21.2,,,21.2,14.87,46.44,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT  ,,,both,,,84.42,50.65,Aetna,Commerical,,16.87,,,16.87,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Aetna,Middlesex Employees,,15.18,,,15.18,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Anthem,Commerical,,23.14,,,23.14,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Anthem,Indemnity,,,61.39,,61.39,14.87,67.63,percent of total billed charges,,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Anthem,State Preferred,,14.87,,,14.87,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Anthem,Individual Exchange,,18.52,,,18.52,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Cigna,Cigna,,32.03,,,32.03,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Connecticare,Commerical,,16.28,,,16.28,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Connecticare,Exchange,,16.28,,,16.28,14.87,67.63,other,Could be inpatient or outpatient,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,Multiplan,Multiplan,,,67.63,,67.63,14.87,67.63,percent of total billed charges,,
HC THYR PEROX AB,86376,CPT,,,both,,,84.42,50.65,United Healthcare/Oxford,United Healthcare/Oxford,,21.2,,,21.2,14.87,67.63,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT  ,,,both,,,90.64,54.38,Aetna,Commerical,,60.26,,,60.26,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Aetna,Middlesex Employees,,54.23,,,54.23,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Anthem,Commerical,,50.01,,,50.01,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Anthem,Indemnity,,,65.58,,65.58,40.01,72.25,percent of total billed charges,,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Anthem,State Preferred,,50.01,,,50.01,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Anthem,Individual Exchange,,40.01,,,40.01,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Cigna,Cigna,,53.08,,,53.08,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Connecticare,Commerical,,54.45,,,54.45,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Connecticare,Exchange,,54.45,,,54.45,40.01,72.25,other,Could be inpatient or outpatient,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,Multiplan,Multiplan,,,72.25,,72.25,40.01,72.25,percent of total billed charges,,
HC MITOCHONDRIAL ANTIBODY EACH,86381,CPT,,,both,,,90.64,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,55.83,,,55.83,40.01,72.25,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,25.35,,,25.35,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,22.82,,,22.82,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,30.1,,,30.1,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,13.48,36.97,percent of total billed charges,,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.48,,,13.48,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,24.07,,,24.07,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,34.61,,,34.61,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,32.21,,,32.21,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,32.21,,,32.21,13.48,36.97,other,Could be inpatient or outpatient,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,13.48,36.97,percent of total billed charges,,
HC LEUKO LOCOMOTION,86384,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,28.11,,,28.11,13.48,36.97,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT  ,,,both,,,185.4,111.24,Aetna,Commerical,,102.05,,,102.05,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Aetna,Middlesex Employees,,91.85,,,91.85,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Anthem,Commerical,,121.17,,,121.17,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Anthem,Indemnity,,,135.06,,135.06,12.07,148.79,percent of total billed charges,,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Anthem,State Preferred,,12.07,,,12.07,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Anthem,Individual Exchange,,96.94,,,96.94,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Cigna,Cigna,,139.3,,,139.3,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Connecticare,Commerical,,129.68,,,129.68,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Connecticare,Exchange,,129.68,,,129.68,12.07,148.79,other,Could be inpatient or outpatient,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,Multiplan,Multiplan,,,148.79,,148.79,12.07,148.79,percent of total billed charges,,
HC CANDIDA ANTIGEN,86403,CPT,,,both,,,185.4,111.24,United Healthcare/Oxford,United Healthcare/Oxford,,113.14,,,113.14,12.07,148.79,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,22.59,,,22.59,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,20.33,,,20.33,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,26.83,,,26.83,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,12.07,32.94,percent of total billed charges,,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.07,,,12.07,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,21.47,,,21.47,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,30.84,,,30.84,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,28.71,,,28.71,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,28.71,,,28.71,12.07,32.94,other,Could be inpatient or outpatient,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,12.07,32.94,percent of total billed charges,,
HC CRYPTOCOC AG SCRN,86403,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,12.07,32.94,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,31.21,,,31.21,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,28.1,,,28.1,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,37.06,,,37.06,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,12.07,45.51,percent of total billed charges,,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,12.07,,,12.07,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,29.65,,,29.65,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,42.61,,,42.61,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,39.66,,,39.66,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,39.66,,,39.66,12.07,45.51,other,Could be inpatient or outpatient,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,12.07,45.51,percent of total billed charges,,
HC STREP EXOENZYME,86403,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,34.61,,,34.61,12.07,45.51,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,34.01,,,34.01,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,30.61,,,30.61,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,40.39,,,40.39,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,12.6,49.6,percent of total billed charges,,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,12.6,,,12.6,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,32.31,,,32.31,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,46.44,,,46.44,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,43.22,,,43.22,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,43.22,,,43.22,12.6,49.6,other,Could be inpatient or outpatient,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,12.6,49.6,percent of total billed charges,,
HC STREPTOZYME TITER,86406,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,12.6,49.6,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT  ,,,both,,,22.82,13.69,Aetna,Commerical,,6.58,,,6.58,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Aetna,Middlesex Employees,,5.92,,,5.92,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Anthem,Commerical,,10.45,,,10.45,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Anthem,Indemnity,,,16.59,,16.59,5.92,18.28,percent of total billed charges,,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Anthem,State Preferred,,6.73,,,6.73,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Anthem,Individual Exchange,,8.36,,,8.36,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Cigna,Cigna,,12.47,,,12.47,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Connecticare,Commerical,,6.35,,,6.35,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Connecticare,Exchange,,6.35,,,6.35,5.92,18.28,other,Could be inpatient or outpatient,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,Multiplan,Multiplan,,,18.28,,18.28,5.92,18.28,percent of total billed charges,,
HC RHEUMATOID FACTOR,86431,CPT,,,both,,,22.82,13.69,United Healthcare/Oxford,United Healthcare/Oxford,,8.26,,,8.26,5.92,18.28,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT  ,,,both,,,249.26,149.56,Aetna,Commerical,,71.86,,,71.86,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Aetna,Middlesex Employees,,64.68,,,64.68,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Anthem,Commerical,,114.23,,,114.23,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Anthem,Indemnity,,,180.9,,180.9,64.68,226.58,percent of total billed charges,,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Anthem,State Preferred,,73.37,,,73.37,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Anthem,Individual Exchange,,91.39,,,91.39,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Cigna,Cigna,,226.58,,,226.58,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Connecticare,Commerical,,69.36,,,69.36,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Connecticare,Exchange,,69.36,,,69.36,64.68,226.58,other,Could be inpatient or outpatient,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,Multiplan,Multiplan,,,199.29,,199.29,64.68,226.58,percent of total billed charges,,
HC QUANTIFERON TB,86480,CPT,,,both,,,249.26,149.56,United Healthcare/Oxford,United Healthcare/Oxford,,90.3,,,90.3,64.68,226.58,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,35.87,,,35.87,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,32.29,,,32.29,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.59,,,42.59,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,10.56,52.3,percent of total billed charges,,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,10.56,,,10.56,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,34.07,,,34.07,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,48.96,,,48.96,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,45.59,,,45.59,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,45.59,,,45.59,10.56,52.3,other,Could be inpatient or outpatient,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,10.56,52.3,percent of total billed charges,,
HC CANDIDA SKIN,86485,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,10.56,52.3,other,Could be inpatient or outpatient,
HC RPR,86592,CPT  ,,,both,,,25.08,15.05,Aetna,Commerical,,13.78,,,13.78,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Aetna,Middlesex Employees,,12.4,,,12.4,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Anthem,Commerical,,16.36,,,16.36,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Anthem,Indemnity,,,18.24,,18.24,5.05,20.09,percent of total billed charges,,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Anthem,State Preferred,,5.05,,,5.05,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Anthem,Individual Exchange,,13.09,,,13.09,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Cigna,Cigna,,18.81,,,18.81,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Connecticare,Commerical,,17.51,,,17.51,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Connecticare,Exchange,,17.51,,,17.51,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR,86592,CPT,,,both,,,25.08,15.05,Multiplan,Multiplan,,,20.09,,20.09,5.05,20.09,percent of total billed charges,,
HC RPR,86592,CPT,,,both,,,25.08,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,15.27,,,15.27,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT  ,,,both,,,25.08,15.05,Aetna,Commerical,,13.78,,,13.78,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Aetna,Middlesex Employees,,12.4,,,12.4,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Anthem,Commerical,,16.36,,,16.36,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Anthem,Indemnity,,,18.24,,18.24,5.05,20.09,percent of total billed charges,,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Anthem,State Preferred,,5.05,,,5.05,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Anthem,Individual Exchange,,13.09,,,13.09,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Cigna,Cigna,,18.81,,,18.81,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Connecticare,Commerical,,17.51,,,17.51,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Connecticare,Exchange,,17.51,,,17.51,5.05,20.09,other,Could be inpatient or outpatient,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,Multiplan,Multiplan,,,20.09,,20.09,5.05,20.09,percent of total billed charges,,
HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,86592,CPT,,,both,,,25.08,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,15.27,,,15.27,5.05,20.09,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT  ,,,both,,,17.74,10.64,Aetna,Commerical,,5.11,,,5.11,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Aetna,Middlesex Employees,,4.6,,,4.6,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Anthem,Commerical,,8.11,,,8.11,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Anthem,Indemnity,,,12.9,,12.9,4.6,14.21,percent of total billed charges,,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Anthem,State Preferred,,5.22,,,5.22,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Anthem,Individual Exchange,,6.49,,,6.49,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Cigna,Cigna,,9.51,,,9.51,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Connecticare,Commerical,,4.92,,,4.92,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Connecticare,Exchange,,4.92,,,4.92,4.6,14.21,other,Could be inpatient or outpatient,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,Multiplan,Multiplan,,,14.21,,14.21,4.6,14.21,percent of total billed charges,,
HC RPR TITER,86593,CPT,,,both,,,17.74,10.64,United Healthcare/Oxford,United Healthcare/Oxford,,6.42,,,6.42,4.6,14.21,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,5.11,,,5.11,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,4.6,,,4.6,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,8.11,,,8.11,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,4.6,34.55,percent of total billed charges,,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,5.22,,,5.22,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,6.49,,,6.49,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,9.51,,,9.51,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,4.92,,,4.92,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,4.92,,,4.92,4.6,34.55,other,Could be inpatient or outpatient,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,4.6,34.55,percent of total billed charges,,
HC VDRL (SRM/CSF):CS,86593,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,6.42,,,6.42,4.6,34.55,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,43.96,,,43.96,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,39.56,,,39.56,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.84,,47.84,29.19,52.7,percent of total billed charges,,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,29.19,,,29.19,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,38.72,,,38.72,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.7,,52.7,29.19,52.7,percent of total billed charges,,
HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH - QUEST,86596,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,40.72,,,40.72,29.19,52.7,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,15.25,27.33,percent of total billed charges,,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,15.25,,,15.25,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,15.25,27.33,other,Could be inpatient or outpatient,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,15.25,27.33,percent of total billed charges,,
HC ADENOVIRUS AB,86603,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,15.25,27.33,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,31.21,,,31.21,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,28.1,,,28.1,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,37.06,,,37.06,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,17.81,45.51,percent of total billed charges,,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,17.81,,,17.81,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,29.65,,,29.65,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,42.61,,,42.61,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,39.66,,,39.66,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,39.66,,,39.66,17.81,45.51,other,Could be inpatient or outpatient,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,17.81,45.51,percent of total billed charges,,
HC ANTIBODY ASPERGILLUS,86606,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,34.61,,,34.61,17.81,45.51,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,14.93,,,14.93,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.44,,,13.44,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.74,,,23.74,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.44,41.79,percent of total billed charges,,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.26,,,15.26,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,18.99,,,18.99,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,28.5,,,28.5,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.41,,,14.41,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.41,,,14.41,13.44,41.79,other,Could be inpatient or outpatient,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.44,41.79,percent of total billed charges,,
HC PNEUMOCOCCAL AB.,86609,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.77,,,18.77,13.44,41.79,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.8,,,11.8,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.63,,,10.63,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,18.75,,,18.75,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.63,32.94,percent of total billed charges,,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.06,,,12.06,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,15.01,,,15.01,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,22.53,,,22.53,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.63,32.94,percent of total billed charges,,
HC BARNTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,14.83,,,14.83,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.8,,,11.8,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.63,,,10.63,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,18.75,,,18.75,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.63,32.94,percent of total billed charges,,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.06,,,12.06,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,15.01,,,15.01,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,22.53,,,22.53,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.63,32.94,percent of total billed charges,,
HC BARTONELA IGG IGM,86611,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,14.83,,,14.83,10.63,32.94,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT  ,,,both,,,204.97,122.98,Aetna,Commerical,,112.56,,,112.56,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Aetna,Middlesex Employees,,101.31,,,101.31,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Anthem,Commerical,,133.65,,,133.65,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Anthem,Indemnity,,,148.98,,148.98,15.28,164.12,percent of total billed charges,,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Anthem,State Preferred,,15.28,,,15.28,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Anthem,Individual Exchange,,106.92,,,106.92,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Cigna,Cigna,,153.65,,,153.65,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Connecticare,Commerical,,143.05,,,143.05,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Connecticare,Exchange,,143.05,,,143.05,15.28,164.12,other,Could be inpatient or outpatient,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,Multiplan,Multiplan,,,164.12,,164.12,15.28,164.12,percent of total billed charges,,
HC BLASTOMYCOSIS AB,86612,CPT,,,both,,,204.97,122.98,United Healthcare/Oxford,United Healthcare/Oxford,,124.79,,,124.79,15.28,164.12,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,29.3,,,29.3,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,26.37,,,26.37,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,34.8,,,34.8,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,15.62,42.73,percent of total billed charges,,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.62,,,15.62,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,27.84,,,27.84,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,40,,,40,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,37.24,,,37.24,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,37.24,,,37.24,15.62,42.73,other,Could be inpatient or outpatient,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,15.62,42.73,percent of total billed charges,,
HC B PERTUSSIS AB,86615,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,32.49,,,32.49,15.62,42.73,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,17.96,,,17.96,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,16.16,,,16.16,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,28.56,,,28.56,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,16.16,50.5,percent of total billed charges,,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,18.34,,,18.34,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,22.84,,,22.84,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,34.41,,,34.41,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,17.33,,,17.33,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,17.33,,,17.33,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,16.16,50.5,percent of total billed charges,,
HC LYME WESTERN BLOT,86617,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,22.57,,,22.57,16.16,50.5,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT  ,,,both,,,211.59,126.96,Aetna,Commerical,,19.74,,,19.74,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT  ,,,both,,,213.85,128.31,Aetna,Commerical,,19.74,,,19.74,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Anthem,Commerical,,31.39,,,31.39,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Anthem,Commerical,,31.39,,,31.39,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Anthem,Indemnity,,,153.89,,153.89,17.77,169.53,percent of total billed charges,,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Anthem,Indemnity,,,155.53,,155.53,17.77,171.33,percent of total billed charges,,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Anthem,State Preferred,,20.17,,,20.17,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Anthem,State Preferred,,20.17,,,20.17,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Anthem,Individual Exchange,,25.11,,,25.11,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Anthem,Individual Exchange,,25.11,,,25.11,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Cigna,Cigna,,37.96,,,37.96,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Cigna,Cigna,,37.96,,,37.96,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Connecticare,Commerical,,19.05,,,19.05,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Connecticare,Commerical,,19.05,,,19.05,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Connecticare,Exchange,,19.05,,,19.05,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Connecticare,Exchange,,19.05,,,19.05,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,Multiplan,Multiplan,,,169.53,,169.53,17.77,169.53,percent of total billed charges,,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,Multiplan,Multiplan,,,171.33,,171.33,17.77,171.33,percent of total billed charges,,
HC LYME INDEX,86618,CPT,,,both,,,211.59,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,169.53,other,Could be inpatient or outpatient,
HC LYME INDEX-2,86618,CPT,,,both,,,213.85,128.31,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,171.33,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,19.74,,,19.74,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,31.39,,,31.39,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,17.77,55,percent of total billed charges,,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,20.17,,,20.17,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,25.11,,,25.11,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,37.96,,,37.96,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,19.05,,,19.05,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,19.05,,,19.05,17.77,55,other,Could be inpatient or outpatient,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,17.77,55,percent of total billed charges,,
HC LYME REFLEX WB,86618,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,55,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,19.74,,,19.74,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,31.39,,,31.39,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,17.77,68.54,percent of total billed charges,,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,20.17,,,20.17,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,25.11,,,25.11,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,37.96,,,37.96,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,19.05,,,19.05,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,19.05,,,19.05,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,17.77,68.54,percent of total billed charges,,
HC LYME TITER IGG,86618,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,19.74,,,19.74,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,31.39,,,31.39,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,17.77,68.54,percent of total billed charges,,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,20.17,,,20.17,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,25.11,,,25.11,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,37.96,,,37.96,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,19.05,,,19.05,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,19.05,,,19.05,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,17.77,68.54,percent of total billed charges,,
HC LYME TITER IGM,86618,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,68.54,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT  ,,,both,,,285.31,171.19,Aetna,Commerical,,19.74,,,19.74,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Aetna,Middlesex Employees,,17.77,,,17.77,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Anthem,Commerical,,31.39,,,31.39,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Anthem,Indemnity,,,207.1,,207.1,17.77,228.15,percent of total billed charges,,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Anthem,State Preferred,,20.17,,,20.17,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Anthem,Individual Exchange,,25.11,,,25.11,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Cigna,Cigna,,37.96,,,37.96,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Connecticare,Commerical,,19.05,,,19.05,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Connecticare,Exchange,,19.05,,,19.05,17.77,228.15,other,Could be inpatient or outpatient,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,Multiplan,Multiplan,,,228.15,,228.15,17.77,228.15,percent of total billed charges,,
HC LYME W-B UCONN,86618,CPT,,,both,,,285.31,171.19,United Healthcare/Oxford,United Healthcare/Oxford,,24.8,,,24.8,17.77,228.15,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,19.84,,,19.84,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,17.86,,,17.86,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,23.56,,,23.56,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,10.58,28.93,percent of total billed charges,,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,10.58,,,10.58,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,18.85,,,18.85,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,27.08,,,27.08,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,25.21,,,25.21,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,25.21,,,25.21,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,10.58,28.93,percent of total billed charges,,
HC BRUCELLA ABY IGG,86622,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,22,,,22,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,19.84,,,19.84,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,17.86,,,17.86,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,23.56,,,23.56,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,10.58,28.93,percent of total billed charges,,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,10.58,,,10.58,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,18.85,,,18.85,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,27.08,,,27.08,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,25.21,,,25.21,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,25.21,,,25.21,10.58,28.93,other,Could be inpatient or outpatient,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,10.58,28.93,percent of total billed charges,,
HC BRUCELLA ABY IGM,86622,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,22,,,22,10.58,28.93,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,29.3,,,29.3,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,26.37,,,26.37,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,34.8,,,34.8,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,15.54,42.73,percent of total billed charges,,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.54,,,15.54,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,27.84,,,27.84,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,40,,,40,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,37.24,,,37.24,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,37.24,,,37.24,15.54,42.73,other,Could be inpatient or outpatient,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,15.54,42.73,percent of total billed charges,,
HC CAMPYLOCTR JEJUNI,86625,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,32.49,,,32.49,15.54,42.73,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT  ,,,both,,,92.7,55.62,Aetna,Commerical,,50.72,,,50.72,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Aetna,Middlesex Employees,,45.64,,,45.64,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Anthem,Commerical,,60.22,,,60.22,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Anthem,Indemnity,,,67.12,,67.12,14.22,73.94,percent of total billed charges,,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Anthem,State Preferred,,14.22,,,14.22,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Anthem,Individual Exchange,,48.17,,,48.17,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Cigna,Cigna,,69.23,,,69.23,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Connecticare,Commerical,,64.44,,,64.44,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Connecticare,Exchange,,64.44,,,64.44,14.22,73.94,other,Could be inpatient or outpatient,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,Multiplan,Multiplan,,,73.94,,73.94,14.22,73.94,percent of total billed charges,,
HC CANDIDA ANTIBODY,86628,CPT,,,both,,,92.7,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,56.23,,,56.23,14.22,73.94,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,13.99,51.4,percent of total billed charges,,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,13.99,,,13.99,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,13.99,51.4,other,Could be inpatient or outpatient,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,13.99,51.4,percent of total billed charges,,
HC C PNEUMON AB IGG,86631,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,13.99,51.4,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT  ,,,both,,,112.27,67.36,Aetna,Commerical,,61.84,,,61.84,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Aetna,Middlesex Employees,,55.66,,,55.66,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Anthem,Commerical,,73.43,,,73.43,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Anthem,Indemnity,,,81.86,,81.86,13.99,90.18,percent of total billed charges,,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Anthem,State Preferred,,13.99,,,13.99,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Anthem,Individual Exchange,,58.75,,,58.75,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Cigna,Cigna,,84.43,,,84.43,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Connecticare,Commerical,,78.59,,,78.59,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Connecticare,Exchange,,78.59,,,78.59,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,Multiplan,Multiplan,,,90.18,,90.18,13.99,90.18,percent of total billed charges,,
HC CHLAMYDIA TITER,86631,CPT,,,both,,,112.27,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,68.57,,,68.57,13.99,90.18,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT  ,,,both,,,140.08,84.05,Aetna,Commerical,,76.69,,,76.69,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Aetna,Middlesex Employees,,69.02,,,69.02,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Anthem,Commerical,,91.06,,,91.06,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Anthem,Indemnity,,,101.5,,101.5,15.04,111.82,percent of total billed charges,,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Anthem,State Preferred,,15.04,,,15.04,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Anthem,Individual Exchange,,72.84,,,72.84,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Cigna,Cigna,,104.69,,,104.69,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Connecticare,Commerical,,97.46,,,97.46,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Connecticare,Exchange,,97.46,,,97.46,15.04,111.82,other,Could be inpatient or outpatient,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,Multiplan,Multiplan,,,111.82,,111.82,15.04,111.82,percent of total billed charges,,
HC CHLAMYDIA IGM AB,86632,CPT,,,both,,,140.08,84.05,United Healthcare/Oxford,United Healthcare/Oxford,,85.03,,,85.03,15.04,111.82,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT  ,,,both,,,42.89,25.73,Aetna,Commerical,,23.57,,,23.57,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Aetna,Middlesex Employees,,21.21,,,21.21,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Anthem,Commerical,,27.99,,,27.99,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Anthem,Indemnity,,,31.19,,31.19,13.58,34.37,percent of total billed charges,,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Anthem,State Preferred,,13.58,,,13.58,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Anthem,Individual Exchange,,22.39,,,22.39,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Cigna,Cigna,,32.18,,,32.18,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Connecticare,Commerical,,29.95,,,29.95,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Connecticare,Exchange,,29.95,,,29.95,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,Multiplan,Multiplan,,,34.37,,34.37,13.58,34.37,percent of total billed charges,,
HC ANTIBODY COCCIDIOIDES,86635,CPT,,,both,,,42.89,25.73,United Healthcare/Oxford,United Healthcare/Oxford,,26.13,,,26.13,13.58,34.37,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT  ,,,both,,,45.22,27.13,Aetna,Commerical,,24.85,,,24.85,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Aetna,Middlesex Employees,,22.36,,,22.36,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Anthem,Commerical,,29.5,,,29.5,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Anthem,Indemnity,,,32.88,,32.88,14.36,36.23,percent of total billed charges,,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Anthem,State Preferred,,14.36,,,14.36,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Anthem,Individual Exchange,,23.6,,,23.6,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Cigna,Cigna,,33.91,,,33.91,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Connecticare,Commerical,,31.57,,,31.57,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Connecticare,Exchange,,31.57,,,31.57,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,Multiplan,Multiplan,,,36.23,,36.23,14.36,36.23,percent of total billed charges,,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGG,86638,CPT,,,both,,,45.22,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,27.54,,,27.54,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT  ,,,both,,,45.22,27.13,Aetna,Commerical,,24.85,,,24.85,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Aetna,Middlesex Employees,,22.36,,,22.36,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Anthem,Commerical,,29.5,,,29.5,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Anthem,Indemnity,,,32.88,,32.88,14.36,36.23,percent of total billed charges,,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Anthem,State Preferred,,14.36,,,14.36,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Anthem,Individual Exchange,,23.6,,,23.6,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Cigna,Cigna,,33.91,,,33.91,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Connecticare,Commerical,,31.57,,,31.57,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Connecticare,Exchange,,31.57,,,31.57,14.36,36.23,other,Could be inpatient or outpatient,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,Multiplan,Multiplan,,,36.23,,36.23,14.36,36.23,percent of total billed charges,,
HC ANTIBODY COXIELLA BURNETII Q FEVER - IGM,86638,CPT,,,both,,,45.22,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,27.54,,,27.54,14.36,36.23,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,16.69,,,16.69,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,15.02,,,15.02,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,26.54,,,26.54,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,15.02,32.03,percent of total billed charges,,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,17.04,,,17.04,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,21.23,,,21.23,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,32.03,,,32.03,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,16.1,,,16.1,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,16.1,,,16.1,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,15.02,32.03,percent of total billed charges,,
HC CMV AB,86644,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,15.02,32.03,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT  ,,,both,,,57.97,34.78,Aetna,Commerical,,16.69,,,16.69,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Aetna,Middlesex Employees,,15.02,,,15.02,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Anthem,Commerical,,26.54,,,26.54,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Anthem,Indemnity,,,42.16,,42.16,15.02,46.44,percent of total billed charges,,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Anthem,State Preferred,,17.04,,,17.04,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Anthem,Individual Exchange,,21.23,,,21.23,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Cigna,Cigna,,32.03,,,32.03,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Connecticare,Commerical,,16.1,,,16.1,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Connecticare,Exchange,,16.1,,,16.1,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,Multiplan,Multiplan,,,46.44,,46.44,15.02,46.44,percent of total billed charges,,
HC CMV IGG,86644,CPT,,,both,,,57.97,34.78,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,15.02,46.44,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,19.54,,,19.54,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,17.59,,,17.59,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,31.04,,,31.04,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,17.59,55,percent of total billed charges,,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,19.95,,,19.95,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,24.83,,,24.83,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,37.38,,,37.38,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,18.86,,,18.86,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,18.86,,,18.86,17.59,55,other,Could be inpatient or outpatient,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,17.59,55,percent of total billed charges,,
HC CMV IGM,86645,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,24.54,,,24.54,17.59,55,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,17.63,,,17.63,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,15.86,,,15.86,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,28.04,,,28.04,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,15.86,49.6,percent of total billed charges,,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,18.01,,,18.01,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,22.43,,,22.43,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,33.81,,,33.81,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,17.02,,,17.02,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,17.02,,,17.02,15.86,49.6,other,Could be inpatient or outpatient,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,15.86,49.6,percent of total billed charges,,
HC DIPTHERIA AB.,86648,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,22.17,,,22.17,15.86,49.6,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,15.42,41.79,percent of total billed charges,,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.42,,,15.42,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,15.42,41.79,other,Could be inpatient or outpatient,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,15.42,41.79,percent of total billed charges,,
HC COXSACKIE AB,86658,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,15.42,41.79,percent of total billed charges,,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.42,,,15.42,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,15.42,41.79,other,Could be inpatient or outpatient,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,15.42,41.79,percent of total billed charges,,
HC ECHOVIRUS AB,86658,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.42,41.79,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT  ,,,both,,,53.33,32,Aetna,Commerical,,15.21,,,15.21,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Aetna,Middlesex Employees,,13.69,,,13.69,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Anthem,Commerical,,24.18,,,24.18,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Anthem,Indemnity,,,38.79,,38.79,13.69,42.73,percent of total billed charges,,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Anthem,State Preferred,,15.54,,,15.54,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Anthem,Individual Exchange,,19.34,,,19.34,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Cigna,Cigna,,29.08,,,29.08,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Connecticare,Commerical,,14.68,,,14.68,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Connecticare,Exchange,,14.68,,,14.68,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,Multiplan,Multiplan,,,42.73,,42.73,13.69,42.73,percent of total billed charges,,
HC EBV-EA IGG,86663,CPT,,,both,,,53.33,32,United Healthcare/Oxford,United Healthcare/Oxford,,19.13,,,19.13,13.69,42.73,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT  ,,,both,,,62.83,37.7,Aetna,Commerical,,17.73,,,17.73,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Aetna,Middlesex Employees,,15.96,,,15.96,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Anthem,Commerical,,28.19,,,28.19,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Anthem,Indemnity,,,45.02,,45.02,15.96,49.6,percent of total billed charges,,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Anthem,State Preferred,,18.12,,,18.12,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Anthem,Individual Exchange,,22.55,,,22.55,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Cigna,Cigna,,33.81,,,33.81,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Connecticare,Commerical,,17.11,,,17.11,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Connecticare,Exchange,,17.11,,,17.11,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,Multiplan,Multiplan,,,49.6,,49.6,15.96,49.6,percent of total billed charges,,
HC EBV-EBNA,86664,CPT,,,both,,,62.83,37.7,United Healthcare/Oxford,United Healthcare/Oxford,,22.28,,,22.28,15.96,49.6,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT  ,,,both,,,73.16,43.9,Aetna,Commerical,,21.03,,,21.03,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Aetna,Middlesex Employees,,18.93,,,18.93,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Anthem,Commerical,,33.44,,,33.44,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Anthem,Indemnity,,,53.21,,53.21,18.93,58.62,percent of total billed charges,,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Anthem,State Preferred,,21.48,,,21.48,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Anthem,Individual Exchange,,26.75,,,26.75,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Cigna,Cigna,,40.34,,,40.34,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Connecticare,Commerical,,20.3,,,20.3,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Connecticare,Exchange,,20.3,,,20.3,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,Multiplan,Multiplan,,,58.62,,58.62,18.93,58.62,percent of total billed charges,,
HC EBV-VCA IGG,86665,CPT,,,both,,,73.16,43.9,United Healthcare/Oxford,United Healthcare/Oxford,,26.43,,,26.43,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT  ,,,both,,,73.13,43.88,Aetna,Commerical,,21.03,,,21.03,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Aetna,Middlesex Employees,,18.93,,,18.93,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Anthem,Commerical,,33.44,,,33.44,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Anthem,Indemnity,,,53.21,,53.21,18.93,58.62,percent of total billed charges,,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Anthem,State Preferred,,21.48,,,21.48,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Anthem,Individual Exchange,,26.75,,,26.75,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Cigna,Cigna,,40.34,,,40.34,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Connecticare,Commerical,,20.3,,,20.3,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Connecticare,Exchange,,20.3,,,20.3,18.93,58.62,other,Could be inpatient or outpatient,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,Multiplan,Multiplan,,,58.62,,58.62,18.93,58.62,percent of total billed charges,,
HC EBV-VCA IGM,86665,CPT,,,both,,,73.13,43.88,United Healthcare/Oxford,United Healthcare/Oxford,,26.43,,,26.43,18.93,58.62,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,11.8,,,11.8,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,10.63,,,10.63,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,18.75,,,18.75,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,10.63,45.51,percent of total billed charges,,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,12.06,,,12.06,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,15.01,,,15.01,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,22.53,,,22.53,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,11.39,,,11.39,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,11.39,,,11.39,10.63,45.51,other,Could be inpatient or outpatient,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,10.63,45.51,percent of total billed charges,,
HC ANAPLASMA,86666,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,14.83,,,14.83,10.63,45.51,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.8,,,11.8,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.63,,,10.63,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,18.75,,,18.75,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.63,32.94,percent of total billed charges,,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.06,,,12.06,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,15.01,,,15.01,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,22.53,,,22.53,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.39,,,11.39,10.63,32.94,other,Could be inpatient or outpatient,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.63,32.94,percent of total billed charges,,
HC EHRLICHIA ANTIBODY,86666,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,14.83,,,14.83,10.63,32.94,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT  ,,,both,,,128.31,76.98,Aetna,Commerical,,70.51,,,70.51,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Aetna,Middlesex Employees,,63.46,,,63.46,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Anthem,Commerical,,83.72,,,83.72,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Anthem,Indemnity,,,93.31,,93.31,14.52,102.8,percent of total billed charges,,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Anthem,State Preferred,,14.52,,,14.52,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Anthem,Individual Exchange,,66.97,,,66.97,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Cigna,Cigna,,96.24,,,96.24,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Connecticare,Commerical,,89.6,,,89.6,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Connecticare,Exchange,,89.6,,,89.6,14.52,102.8,other,Could be inpatient or outpatient,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,Multiplan,Multiplan,,,102.8,,102.8,14.52,102.8,percent of total billed charges,,
HC FUNGAL AB NOS,86671,CPT,,,both,,,128.31,76.98,United Healthcare/Oxford,United Healthcare/Oxford,,78.17,,,78.17,14.52,102.8,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,19.54,,,19.54,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,17.59,,,17.59,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,26.74,,,26.74,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,17.18,46.44,percent of total billed charges,,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,17.18,,,17.18,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,21.39,,,21.39,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,32.03,,,32.03,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,18.86,,,18.86,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,18.86,,,18.86,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,17.18,46.44,percent of total billed charges,,
HC H PYLORI,86677,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,22.09,,,22.09,17.18,46.44,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,19.54,,,19.54,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,17.59,,,17.59,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,26.74,,,26.74,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,17.18,44.58,percent of total billed charges,,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,17.18,,,17.18,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,21.39,,,21.39,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,32.03,,,32.03,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,18.86,,,18.86,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,18.86,,,18.86,17.18,44.58,other,Could be inpatient or outpatient,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,17.18,44.58,percent of total billed charges,,
HC H PYLORI AR,86677,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,22.09,,,22.09,17.18,44.58,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT  ,,,both,,,82.4,49.44,Aetna,Commerical,,19.54,,,19.54,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Aetna,Middlesex Employees,,17.59,,,17.59,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Anthem,Commerical,,26.74,,,26.74,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Anthem,Indemnity,,,60.58,,60.58,17.18,66.73,percent of total billed charges,,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Anthem,State Preferred,,17.18,,,17.18,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Anthem,Individual Exchange,,21.39,,,21.39,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Cigna,Cigna,,32.03,,,32.03,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Connecticare,Commerical,,18.86,,,18.86,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Connecticare,Exchange,,18.86,,,18.86,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,Multiplan,Multiplan,,,66.73,,66.73,17.18,66.73,percent of total billed charges,,
HC H.PYLORI IGA AB,86677,CPT,,,both,,,82.4,49.44,United Healthcare/Oxford,United Healthcare/Oxford,,22.09,,,22.09,17.18,66.73,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,19.54,,,19.54,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,17.59,,,17.59,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,26.74,,,26.74,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.03,,54.03,17.18,59.52,percent of total billed charges,,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,17.18,,,17.18,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,21.39,,,21.39,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,32.03,,,32.03,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,18.86,,,18.86,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,18.86,,,18.86,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.52,,59.52,17.18,59.52,percent of total billed charges,,
HC H.PYLORI IGG AB,86677,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,22.09,,,22.09,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,19.54,,,19.54,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,17.59,,,17.59,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,26.74,,,26.74,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.03,,54.03,17.18,59.52,percent of total billed charges,,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,17.18,,,17.18,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,21.39,,,21.39,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,32.03,,,32.03,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,18.86,,,18.86,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,18.86,,,18.86,17.18,59.52,other,Could be inpatient or outpatient,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.52,,59.52,17.18,59.52,percent of total billed charges,,
HC H.PYLORI OGM AB,86677,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,22.09,,,22.09,17.18,59.52,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT  ,,,both,,,217.33,130.4,Aetna,Commerical,,119.36,,,119.36,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Aetna,Middlesex Employees,,107.43,,,107.43,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Anthem,Commerical,,141.73,,,141.73,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Anthem,Indemnity,,,157.98,,157.98,15.4,174.04,percent of total billed charges,,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Anthem,State Preferred,,15.4,,,15.4,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Anthem,Individual Exchange,,113.38,,,113.38,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Cigna,Cigna,,162.94,,,162.94,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Connecticare,Commerical,,151.69,,,151.69,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Connecticare,Exchange,,151.69,,,151.69,15.4,174.04,other,Could be inpatient or outpatient,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,Multiplan,Multiplan,,,174.04,,174.04,15.4,174.04,percent of total billed charges,,
HC CYSTERCERCOSIS AB,86682,CPT,,,both,,,217.33,130.4,United Healthcare/Oxford,United Healthcare/Oxford,,132.33,,,132.33,15.4,174.04,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT  ,,,both,,,279.13,167.48,Aetna,Commerical,,153.39,,,153.39,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Aetna,Middlesex Employees,,138.05,,,138.05,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Anthem,Commerical,,182.12,,,182.12,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Anthem,Indemnity,,,203,,203,15.4,223.64,percent of total billed charges,,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Anthem,State Preferred,,15.4,,,15.4,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Anthem,Individual Exchange,,145.7,,,145.7,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Cigna,Cigna,,209.37,,,209.37,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Connecticare,Commerical,,194.92,,,194.92,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Connecticare,Exchange,,194.92,,,194.92,15.4,223.64,other,Could be inpatient or outpatient,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,Multiplan,Multiplan,,,223.64,,223.64,15.4,223.64,percent of total billed charges,,
HC ECHINOCOCCOSIS AB,86682,CPT,,,both,,,279.13,167.48,United Healthcare/Oxford,United Healthcare/Oxford,,170.04,,,170.04,15.4,223.64,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,15.4,165.93,percent of total billed charges,,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,15.4,,,15.4,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,15.4,165.93,other,Could be inpatient or outpatient,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,15.4,165.93,percent of total billed charges,,
HC SCHISTOSOMA AB,86682,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,15.4,165.93,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,18.36,,,18.36,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,16.52,,,16.52,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,29.2,,,29.2,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,16.52,51.4,percent of total billed charges,,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,18.76,,,18.76,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,23.36,,,23.36,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,35.02,,,35.02,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,17.72,,,17.72,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,17.72,,,17.72,16.52,51.4,other,Could be inpatient or outpatient,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,16.52,51.4,percent of total billed charges,,
HC H INFLUENZA B AB,86684,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,23.08,,,23.08,16.52,51.4,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,44.53,,,44.53,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,40.07,,,40.07,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.88,,,52.88,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,17.04,64.92,percent of total billed charges,,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,17.04,,,17.04,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,42.3,,,42.3,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,60.79,,,60.79,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,56.59,,,56.59,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,56.59,,,56.59,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,17.04,64.92,percent of total billed charges,,
HC HSV 1/2 IGM,86694,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,49.37,,,49.37,17.04,64.92,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,17.04,82.06,percent of total billed charges,,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Anthem,State Preferred,,17.04,,,17.04,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV AB,86694,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,17.04,82.06,percent of total billed charges,,
HC HSV AB,86694,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,17.04,82.06,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT  ,,,both,,,53.33,32,Aetna,Commerical,,15.3,,,15.3,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Aetna,Middlesex Employees,,13.76,,,13.76,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Anthem,Commerical,,24.31,,,24.31,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Anthem,Indemnity,,,38.79,,38.79,13.76,42.73,percent of total billed charges,,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Anthem,State Preferred,,15.62,,,15.62,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Anthem,Individual Exchange,,19.45,,,19.45,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Cigna,Cigna,,29.08,,,29.08,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Connecticare,Commerical,,14.76,,,14.76,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Connecticare,Exchange,,14.76,,,14.76,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,Multiplan,Multiplan,,,42.73,,42.73,13.76,42.73,percent of total billed charges,,
HC HSV 1 IGG EIA,86695,CPT,,,both,,,53.33,32,United Healthcare/Oxford,United Healthcare/Oxford,,19.21,,,19.21,13.76,42.73,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,22.43,,,22.43,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,20.19,,,20.19,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,35.67,,,35.67,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,20.19,62.22,percent of total billed charges,,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,22.93,,,22.93,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,28.53,,,28.53,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,42.73,,,42.73,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,20.19,62.22,percent of total billed charges,,
HC HSV 2 IGG EIA,86696,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,28.2,,,28.2,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,22.43,,,22.43,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,20.19,,,20.19,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,35.67,,,35.67,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,20.19,62.22,percent of total billed charges,,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,22.93,,,22.93,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.53,,,28.53,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,42.73,,,42.73,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,20.19,62.22,percent of total billed charges,,
HC HSV TYPE 1/2 AB,86696,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,28.2,,,28.2,20.19,62.22,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT  ,,,both,,,49.85,29.91,Aetna,Commerical,,27.39,,,27.39,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Aetna,Middlesex Employees,,24.65,,,24.65,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Anthem,Commerical,,32.53,,,32.53,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Anthem,Indemnity,,,36.26,,36.26,14.8,39.94,percent of total billed charges,,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Anthem,State Preferred,,14.8,,,14.8,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Anthem,Individual Exchange,,26.02,,,26.02,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Cigna,Cigna,,37.39,,,37.39,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Connecticare,Commerical,,34.81,,,34.81,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Connecticare,Exchange,,34.81,,,34.81,14.8,39.94,other,Could be inpatient or outpatient,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,Multiplan,Multiplan,,,39.94,,39.94,14.8,39.94,percent of total billed charges,,
HC HISTOPLASMA AB,86698,CPT,,,both,,,49.85,29.91,United Healthcare/Oxford,United Healthcare/Oxford,,30.36,,,30.36,14.8,39.94,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT  ,,,both,,,20.56,12.34,Aetna,Commerical,,11.3,,,11.3,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Aetna,Middlesex Employees,,10.17,,,10.17,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Anthem,Commerical,,13.41,,,13.41,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Anthem,Indemnity,,,14.95,,14.95,10.17,16.47,percent of total billed charges,,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Anthem,State Preferred,,10.52,,,10.52,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Anthem,Individual Exchange,,10.73,,,10.73,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Cigna,Cigna,,15.42,,,15.42,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Connecticare,Commerical,,14.36,,,14.36,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Connecticare,Exchange,,14.36,,,14.36,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,Multiplan,Multiplan,,,16.47,,16.47,10.17,16.47,percent of total billed charges,,
HC HIV 1 AB,86701,CPT,,,both,,,20.56,12.34,United Healthcare/Oxford,United Healthcare/Oxford,,12.52,,,12.52,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT  ,,,both,,,20.56,12.34,Aetna,Commerical,,11.3,,,11.3,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Aetna,Middlesex Employees,,10.17,,,10.17,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Anthem,Commerical,,13.41,,,13.41,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Anthem,Indemnity,,,14.95,,14.95,10.17,16.47,percent of total billed charges,,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Anthem,State Preferred,,16,,,16,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Anthem,Individual Exchange,,10.73,,,10.73,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Cigna,Cigna,,15.42,,,15.42,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Connecticare,Commerical,,14.36,,,14.36,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Connecticare,Exchange,,14.36,,,14.36,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,Multiplan,Multiplan,,,16.47,,16.47,10.17,16.47,percent of total billed charges,,
HC HIV 2 AB,86702,CPT,,,both,,,20.56,12.34,United Healthcare/Oxford,United Healthcare/Oxford,,12.52,,,12.52,10.17,16.47,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,30.58,,,30.58,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,27.53,,,27.53,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,16.25,44.58,percent of total billed charges,,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,16.25,,,16.25,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,16.25,44.58,other,Could be inpatient or outpatient,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,16.25,44.58,percent of total billed charges,,
HC HIV 1/2 AB RFWB,86703,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,16.25,44.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.97,,,13.97,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.57,,,12.57,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.22,,,22.22,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.57,38.58,percent of total billed charges,,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.27,,,14.27,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.78,,,17.78,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.48,,,13.48,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.48,,,13.48,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.57,38.58,percent of total billed charges,,
HC HEP B CORE TOT-AB,86704,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.56,,,17.56,12.57,38.58,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT  ,,,both,,,47.13,28.28,Aetna,Commerical,,13.64,,,13.64,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Aetna,Middlesex Employees,,12.28,,,12.28,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Anthem,Commerical,,21.69,,,21.69,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Anthem,Indemnity,,,34.28,,34.28,12.28,37.77,percent of total billed charges,,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Anthem,State Preferred,,13.93,,,13.93,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Anthem,Individual Exchange,,17.36,,,17.36,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Cigna,Cigna,,26.1,,,26.1,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Connecticare,Commerical,,13.17,,,13.17,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Connecticare,Exchange,,13.17,,,13.17,12.28,37.77,other,Could be inpatient or outpatient,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,Multiplan,Multiplan,,,37.77,,37.77,12.28,37.77,percent of total billed charges,,
HC HEP. B-CORE IGM,86705,CPT,,,both,,,47.13,28.28,United Healthcare/Oxford,United Healthcare/Oxford,,17.16,,,17.16,12.28,37.77,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,12.45,,,12.45,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,11.21,,,11.21,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,19.79,,,19.79,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,11.21,34.55,percent of total billed charges,,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,12.72,,,12.72,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,15.84,,,15.84,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,23.74,,,23.74,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,12.01,,,12.01,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,12.01,,,12.01,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,11.21,34.55,percent of total billed charges,,
HC HEPATITIS BS ABDY,86706,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,15.65,,,15.65,11.21,34.55,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.42,,,13.42,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.08,,,12.08,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.32,,,21.32,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.08,36.97,percent of total billed charges,,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.69,,,13.69,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,17.06,,,17.06,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.94,,,12.94,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.94,,,12.94,12.08,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.08,36.97,percent of total billed charges,,
HC HEPATITIS BE AB,86707,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.85,,,16.85,12.08,36.97,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,34.63,,,34.63,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,31.17,,,31.17,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,41.12,,,41.12,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,14.67,50.5,percent of total billed charges,,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,14.67,,,14.67,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,32.89,,,32.89,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,47.28,,,47.28,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,44.02,,,44.02,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,44.02,,,44.02,14.67,50.5,other,Could be inpatient or outpatient,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,14.67,50.5,percent of total billed charges,,
HC HEP A TOT-AB,86708,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,38.4,,,38.4,14.67,50.5,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT  ,,,both,,,45.13,27.08,Aetna,Commerical,,13.05,,,13.05,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Aetna,Middlesex Employees,,11.74,,,11.74,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Anthem,Commerical,,20.74,,,20.74,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Anthem,Indemnity,,,32.82,,32.82,11.74,36.16,percent of total billed charges,,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Anthem,State Preferred,,13.33,,,13.33,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Anthem,Individual Exchange,,16.59,,,16.59,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Cigna,Cigna,,24.93,,,24.93,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Connecticare,Commerical,,12.6,,,12.6,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Connecticare,Exchange,,12.6,,,12.6,11.74,36.16,other,Could be inpatient or outpatient,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,Multiplan,Multiplan,,,36.16,,36.16,11.74,36.16,percent of total billed charges,,
HC HEPATITIS A-IGM,86709,CPT,,,both,,,45.13,27.08,United Healthcare/Oxford,United Healthcare/Oxford,,16.4,,,16.4,11.74,36.16,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,32.78,,,32.78,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,29.51,,,29.51,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,38.92,,,38.92,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,16.05,47.8,percent of total billed charges,,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,16.05,,,16.05,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,31.13,,,31.13,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,44.74,,,44.74,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,41.66,,,41.66,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,41.66,,,41.66,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,16.05,47.8,percent of total billed charges,,
HC INFLUENZA A AB,86710,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,36.34,,,36.34,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,16.05,27.33,percent of total billed charges,,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,16.05,,,16.05,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,16.05,27.33,percent of total billed charges,,
HC INFLUENZA AB,86710,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,16.05,27.33,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,32.78,,,32.78,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,29.51,,,29.51,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,38.92,,,38.92,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,16.05,47.8,percent of total billed charges,,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,16.05,,,16.05,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,31.13,,,31.13,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,44.74,,,44.74,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,41.66,,,41.66,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,41.66,,,41.66,16.05,47.8,other,Could be inpatient or outpatient,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,16.05,47.8,percent of total billed charges,,
HC INFLUENZA B AB,86710,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,36.34,,,36.34,16.05,47.8,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT  ,,,both,,,90.64,54.38,Aetna,Commerical,,50.1,,,50.1,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Aetna,Middlesex Employees,,45.09,,,45.09,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Anthem,Commerical,,59.48,,,59.48,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Anthem,Indemnity,,,66.3,,66.3,18.12,73.04,percent of total billed charges,,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Anthem,State Preferred,,18.12,,,18.12,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Anthem,Individual Exchange,,47.59,,,47.59,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Cigna,Cigna,,68.38,,,68.38,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Connecticare,Commerical,,63.66,,,63.66,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Connecticare,Exchange,,63.66,,,63.66,18.12,73.04,other,Could be inpatient or outpatient,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,Multiplan,Multiplan,,,73.04,,73.04,18.12,73.04,percent of total billed charges,,
HC LEGIONELLA-AB,86713,CPT,,,both,,,90.64,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,55.54,,,55.54,18.12,73.04,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,15.13,,,15.13,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.62,,,13.62,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,24.05,,,24.05,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.62,41.79,percent of total billed charges,,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.44,,,15.44,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.24,,,19.24,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,29.08,,,29.08,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.6,,,14.6,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.6,,,14.6,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.62,41.79,percent of total billed charges,,
HC MUMPS,86735,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,19.01,,,19.01,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,15.13,,,15.13,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.62,,,13.62,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,24.05,,,24.05,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.62,41.79,percent of total billed charges,,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.44,,,15.44,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,19.24,,,19.24,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,29.08,,,29.08,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.6,,,14.6,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.6,,,14.6,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.62,41.79,percent of total billed charges,,
HC MUMPS AB,86735,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,19.01,,,19.01,13.62,41.79,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT  ,,,both,,,136.99,82.19,Aetna,Commerical,,15.13,,,15.13,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Aetna,Middlesex Employees,,13.62,,,13.62,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Anthem,Commerical,,24.05,,,24.05,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Anthem,Indemnity,,,99.05,,99.05,13.62,109.11,percent of total billed charges,,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Anthem,State Preferred,,15.44,,,15.44,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Anthem,Individual Exchange,,19.24,,,19.24,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Cigna,Cigna,,29.08,,,29.08,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Connecticare,Commerical,,14.6,,,14.6,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Connecticare,Exchange,,14.6,,,14.6,13.62,109.11,other,Could be inpatient or outpatient,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,Multiplan,Multiplan,,,109.11,,109.11,13.62,109.11,percent of total billed charges,,
HC MUMPS ANTIBODY,86735,CPT,,,both,,,136.99,82.19,United Healthcare/Oxford,United Healthcare/Oxford,,19.01,,,19.01,13.62,109.11,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.35,,,15.35,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.81,,,13.81,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,24.41,,,24.41,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,13.81,42.73,percent of total billed charges,,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,15.68,,,15.68,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,19.52,,,19.52,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,29.67,,,29.67,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.81,,,14.81,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.81,,,14.81,13.81,42.73,other,Could be inpatient or outpatient,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,13.81,42.73,percent of total billed charges,,
HC MYCOPLASMA AB,86738,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.28,,,19.28,13.81,42.73,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,33.39,,,33.39,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,30.05,,,30.05,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.65,,,39.65,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,17.79,48.7,percent of total billed charges,,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,17.79,,,17.79,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.72,,,31.72,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,45.59,,,45.59,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,42.44,,,42.44,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,42.44,,,42.44,17.79,48.7,other,Could be inpatient or outpatient,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,17.79,48.7,percent of total billed charges,,
HC PARVOVIRUS B19,86747,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,37.03,,,37.03,17.79,48.7,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,14.68,56.81,percent of total billed charges,,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,14.68,,,14.68,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,14.68,56.81,other,Could be inpatient or outpatient,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,14.68,56.81,percent of total billed charges,,
HC BAESIA IFA,86753,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,14.68,56.81,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT  ,,,both,,,297.67,178.6,Aetna,Commerical,,163.9,,,163.9,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Aetna,Middlesex Employees,,147.51,,,147.51,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Anthem,Commerical,,194.6,,,194.6,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Anthem,Indemnity,,,216.92,,216.92,14.68,238.97,percent of total billed charges,,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Anthem,State Preferred,,14.68,,,14.68,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Anthem,Individual Exchange,,155.68,,,155.68,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Cigna,Cigna,,223.72,,,223.72,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Connecticare,Commerical,,208.28,,,208.28,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Connecticare,Exchange,,208.28,,,208.28,14.68,238.97,other,Could be inpatient or outpatient,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,Multiplan,Multiplan,,,238.97,,238.97,14.68,238.97,percent of total billed charges,,
HC ENTAMOEBA AB,86753,CPT,,,both,,,297.67,178.6,United Healthcare/Oxford,United Healthcare/Oxford,,181.7,,,181.7,14.68,238.97,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,15.27,27.33,percent of total billed charges,,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,15.27,,,15.27,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,15.27,27.33,other,Could be inpatient or outpatient,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,15.27,27.33,percent of total billed charges,,
HC RSV AB,86756,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,15.27,27.33,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,22.43,,,22.43,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,20.19,,,20.19,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,35.67,,,35.67,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,20.19,62.22,percent of total billed charges,,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,22.93,,,22.93,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,28.53,,,28.53,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,42.73,,,42.73,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,21.65,,,21.65,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,20.19,62.22,percent of total billed charges,,
HC RCKY M SPT AB IGG,86757,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,28.2,,,28.2,20.19,62.22,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT  ,,,both,,,74.28,44.57,Aetna,Commerical,,22.43,,,22.43,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Aetna,Middlesex Employees,,20.19,,,20.19,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Anthem,Commerical,,35.67,,,35.67,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Anthem,Indemnity,,,54.03,,54.03,20.19,59.52,percent of total billed charges,,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Anthem,State Preferred,,22.93,,,22.93,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Anthem,Individual Exchange,,28.53,,,28.53,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Cigna,Cigna,,42.73,,,42.73,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Connecticare,Commerical,,21.65,,,21.65,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Connecticare,Exchange,,21.65,,,21.65,20.19,59.52,other,Could be inpatient or outpatient,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,Multiplan,Multiplan,,,59.52,,59.52,20.19,59.52,percent of total billed charges,,
HC RCKY M SPT AB IGM,86757,CPT,,,both,,,74.28,44.57,United Healthcare/Oxford,United Healthcare/Oxford,,28.2,,,28.2,20.19,59.52,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,31.85,,,31.85,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,28.66,,,28.66,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.82,,,37.82,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,17.04,46.44,percent of total billed charges,,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,17.04,,,17.04,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.25,,,30.25,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,43.48,,,43.48,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,40.48,,,40.48,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,40.48,,,40.48,17.04,46.44,other,Could be inpatient or outpatient,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,17.04,46.44,percent of total billed charges,,
HC RUBELLA,86762,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,17.04,46.44,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC MEASLES AB,86765,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC RUBEOLA,86765,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,31.85,,,31.85,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,28.66,,,28.66,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,37.82,,,37.82,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,42.16,,42.16,28.66,47.6,percent of total billed charges,,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,47.6,,,47.6,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,30.25,,,30.25,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,43.48,,,43.48,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,40.48,,,40.48,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,40.48,,,40.48,28.66,47.6,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,46.44,,46.44,28.66,47.6,percent of total billed charges,,
HC SARS-COV-2/2019 COVID-19 IGG ANTIBODY,86769,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,28.66,47.6,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT  ,,,both,,,58.35,35.01,Aetna,Commerical,,50.07,,,50.07,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Aetna,Middlesex Employees,,45.07,,,45.07,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Anthem,Commerical,,57.05,,,57.05,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Anthem,Indemnity,,,42.44,,42.44,42.44,74.19,percent of total billed charges,,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Anthem,State Preferred,,47.6,,,47.6,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Anthem,Individual Exchange,,45.64,,,45.64,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Cigna,Cigna,,74.19,,,74.19,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Connecticare,Commerical,,49.74,,,49.74,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Connecticare,Exchange,,49.74,,,49.74,42.44,74.19,other,Could be inpatient or outpatient,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,Multiplan,Multiplan,,,46.75,,46.75,42.44,74.19,percent of total billed charges,,
SARS-COV-2 COVID-19 ANTIBODY,86769,CPT,,,both,,,58.35,35.01,United Healthcare/Oxford,United Healthcare/Oxford,,53.64,,,53.64,42.44,74.19,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,17.16,,,17.16,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,15.45,,,15.45,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,27.27,,,27.27,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,15.45,96.49,percent of total billed charges,,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,17.52,,,17.52,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,21.82,,,21.82,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,32.64,,,32.64,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,16.57,,,16.57,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,16.57,,,16.57,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,15.45,96.49,percent of total billed charges,,
HC TETANUS AB,86774,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,21.56,,,21.56,15.45,96.49,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT  ,,,both,,,60.77,36.46,Aetna,Commerical,,17.16,,,17.16,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Aetna,Middlesex Employees,,15.45,,,15.45,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Anthem,Commerical,,27.27,,,27.27,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Anthem,Indemnity,,,43.39,,43.39,15.45,47.8,percent of total billed charges,,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Anthem,State Preferred,,17.52,,,17.52,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Anthem,Individual Exchange,,21.82,,,21.82,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Cigna,Cigna,,32.64,,,32.64,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Connecticare,Commerical,,16.57,,,16.57,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Connecticare,Exchange,,16.57,,,16.57,15.45,47.8,other,Could be inpatient or outpatient,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,Multiplan,Multiplan,,,47.8,,47.8,15.45,47.8,percent of total billed charges,,
HC TETANUS ANTITOXOID ANTIBODY,86774,CPT,,,both,,,60.77,36.46,United Healthcare/Oxford,United Healthcare/Oxford,,21.56,,,21.56,15.45,47.8,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT  ,,,both,,,57.97,34.78,Aetna,Commerical,,31.85,,,31.85,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Aetna,Middlesex Employees,,28.66,,,28.66,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Anthem,Commerical,,37.82,,,37.82,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Anthem,Indemnity,,,42.16,,42.16,17.04,46.44,percent of total billed charges,,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Anthem,State Preferred,,17.04,,,17.04,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Anthem,Individual Exchange,,30.25,,,30.25,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Cigna,Cigna,,43.48,,,43.48,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Connecticare,Commerical,,40.48,,,40.48,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Connecticare,Exchange,,40.48,,,40.48,17.04,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,Multiplan,Multiplan,,,46.44,,46.44,17.04,46.44,percent of total billed charges,,
HC TOXOPLASMA IGG,86777,CPT,,,both,,,57.97,34.78,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,17.04,46.44,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT  ,,,both,,,290.38,174.23,Aetna,Commerical,,159.57,,,159.57,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Aetna,Middlesex Employees,,143.61,,,143.61,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Anthem,Commerical,,189.47,,,189.47,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Anthem,Indemnity,,,211.19,,211.19,17.05,232.65,percent of total billed charges,,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Anthem,State Preferred,,17.05,,,17.05,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Anthem,Individual Exchange,,151.58,,,151.58,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Cigna,Cigna,,217.82,,,217.82,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Connecticare,Commerical,,202.78,,,202.78,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Connecticare,Exchange,,202.78,,,202.78,17.05,232.65,other,Could be inpatient or outpatient,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,Multiplan,Multiplan,,,232.65,,232.65,17.05,232.65,percent of total billed charges,,
HC SPECIAL TEST TOXOPLASMA IGM,86778,CPT,,,both,,,290.38,174.23,United Healthcare/Oxford,United Healthcare/Oxford,,176.9,,,176.9,17.05,232.65,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT  ,,,both,,,57.97,34.78,Aetna,Commerical,,31.85,,,31.85,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Aetna,Middlesex Employees,,28.66,,,28.66,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Anthem,Commerical,,37.82,,,37.82,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Anthem,Indemnity,,,42.16,,42.16,17.05,46.44,percent of total billed charges,,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Anthem,State Preferred,,17.05,,,17.05,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Anthem,Individual Exchange,,30.25,,,30.25,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Cigna,Cigna,,43.48,,,43.48,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Connecticare,Commerical,,40.48,,,40.48,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Connecticare,Exchange,,40.48,,,40.48,17.05,46.44,other,Could be inpatient or outpatient,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,Multiplan,Multiplan,,,46.44,,46.44,17.05,46.44,percent of total billed charges,,
HC TOXOPLASMA IGM,86778,CPT,,,both,,,57.97,34.78,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,17.05,46.44,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT  ,,,both,,,53.56,32.14,Aetna,Commerical,,15.35,,,15.35,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Aetna,Middlesex Employees,,13.81,,,13.81,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Anthem,Commerical,,24.41,,,24.41,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Anthem,Indemnity,,,38.79,,38.79,13.81,48.38,percent of total billed charges,,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Anthem,State Preferred,,16.07,,,16.07,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Anthem,Individual Exchange,,19.52,,,19.52,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Cigna,Cigna,,48.38,,,48.38,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Connecticare,Commerical,,14.81,,,14.81,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Connecticare,Exchange,,14.81,,,14.81,13.81,48.38,other,Could be inpatient or outpatient,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,Multiplan,Multiplan,,,42.73,,42.73,13.81,48.38,percent of total billed charges,,
HC TPPA,86780,CPT,,,both,,,53.56,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,19.28,,,19.28,13.81,48.38,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT  ,,,both,,,85.49,51.29,Aetna,Commerical,,47.62,,,47.62,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Aetna,Middlesex Employees,,42.86,,,42.86,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Anthem,Commerical,,56.54,,,56.54,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Anthem,Indemnity,,,63.03,,63.03,15.68,69.44,percent of total billed charges,,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Anthem,State Preferred,,15.68,,,15.68,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Anthem,Individual Exchange,,45.23,,,45.23,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Cigna,Cigna,,65.01,,,65.01,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Connecticare,Commerical,,60.52,,,60.52,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Connecticare,Exchange,,60.52,,,60.52,15.68,69.44,other,Could be inpatient or outpatient,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,Multiplan,Multiplan,,,69.44,,69.44,15.68,69.44,percent of total billed charges,,
HC FTA/ABS: CS,86781,CPT,,,both,,,85.49,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,52.8,,,52.8,15.68,69.44,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT  ,,,both,,,294.58,176.75,Aetna,Commerical,,162.04,,,162.04,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Aetna,Middlesex Employees,,145.85,,,145.85,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Anthem,Commerical,,192.41,,,192.41,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Anthem,Indemnity,,,214.47,,214.47,14.87,236.27,percent of total billed charges,,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Anthem,State Preferred,,14.87,,,14.87,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Anthem,Individual Exchange,,153.93,,,153.93,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Cigna,Cigna,,221.2,,,221.2,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Connecticare,Commerical,,205.92,,,205.92,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Connecticare,Exchange,,205.92,,,205.92,14.87,236.27,other,Could be inpatient or outpatient,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,Multiplan,Multiplan,,,236.27,,236.27,14.87,236.27,percent of total billed charges,,
HC TRICHINOSIS AB,86784,CPT,,,both,,,294.58,176.75,United Healthcare/Oxford,United Healthcare/Oxford,,179.64,,,179.64,14.87,236.27,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,14.93,,,14.93,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,13.44,,,13.44,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,23.74,,,23.74,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,13.44,41.79,percent of total billed charges,,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,15.26,,,15.26,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,18.99,,,18.99,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,28.5,,,28.5,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,14.41,,,14.41,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,14.41,,,14.41,13.44,41.79,other,Could be inpatient or outpatient,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,13.44,41.79,percent of total billed charges,,
HC VARICELLA AB,86787,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,18.77,,,18.77,13.44,41.79,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,14.93,,,14.93,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,13.44,,,13.44,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,23.74,,,23.74,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,13.44,31.34,percent of total billed charges,,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,15.26,,,15.26,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,18.99,,,18.99,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,28.5,,,28.5,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,14.41,,,14.41,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,14.41,,,14.41,13.44,31.34,other,Could be inpatient or outpatient,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,13.44,31.34,percent of total billed charges,,
HC VZN AB,86787,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,18.77,,,18.77,13.44,31.34,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,59.38,,,59.38,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,53.44,,,53.44,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,70.49,,,70.49,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,53.44,86.57,percent of total billed charges,,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,72.79,,,72.79,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,56.4,,,56.4,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,81.05,,,81.05,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,75.46,,,75.46,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,75.46,,,75.46,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,53.44,86.57,percent of total billed charges,,
HC WEST NILE IGM-AB,86788,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,65.83,,,65.83,53.44,86.57,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,31.85,,,31.85,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,28.66,,,28.66,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.82,,,37.82,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,28.66,55.66,percent of total billed charges,,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,55.66,,,55.66,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.25,,,30.25,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,43.48,,,43.48,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,40.48,,,40.48,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,40.48,,,40.48,28.66,55.66,other,Could be inpatient or outpatient,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,28.66,55.66,percent of total billed charges,,
HC WEST NILE IGG-AB,86789,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,35.31,,,35.31,28.66,55.66,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGG,86790,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC ANTIBODY VIRUS NOS - DENGUE FEVER ANTIBODY IGM,86790,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC HERPESVIRUS 6 AB IGG IGM,86790,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT  ,,,both,,,52.17,31.3,Aetna,Commerical,,28.66,,,28.66,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Aetna,Middlesex Employees,,25.8,,,25.8,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Anthem,Commerical,,34.04,,,34.04,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Anthem,Indemnity,,,37.94,,37.94,15.26,41.79,percent of total billed charges,,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Anthem,State Preferred,,15.26,,,15.26,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Anthem,Individual Exchange,,27.23,,,27.23,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Cigna,Cigna,,39.14,,,39.14,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Connecticare,Commerical,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Connecticare,Exchange,,36.43,,,36.43,15.26,41.79,other,Could be inpatient or outpatient,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,Multiplan,Multiplan,,,41.79,,41.79,15.26,41.79,percent of total billed charges,,
HC HTLVI/II IGG CSF,86790,CPT,,,both,,,52.17,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,15.26,41.79,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,15.26,,,15.26,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 1,86790,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,15.26,,,15.26,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 2,86790,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,15.26,,,15.26,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,15.26,68.54,percent of total billed charges,,
HC PARAINF AB TYPE 3,86790,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,15.26,68.54,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT  ,,,both,,,12.02,7.21,Aetna,Commerical,,6.61,,,6.61,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Aetna,Middlesex Employees,,5.95,,,5.95,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Anthem,Commerical,,7.85,,,7.85,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Anthem,Indemnity,,,8.74,,8.74,5.95,15.26,percent of total billed charges,,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Anthem,State Preferred,,15.26,,,15.26,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Anthem,Individual Exchange,,6.27,,,6.27,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Cigna,Cigna,,9.02,,,9.02,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Connecticare,Commerical,,8.39,,,8.39,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Connecticare,Exchange,,8.39,,,8.39,5.95,15.26,other,Could be inpatient or outpatient,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,Multiplan,Multiplan,,,9.63,,9.63,5.95,15.26,percent of total billed charges,,
HC PARAINFLUENZA AB,86790,CPT,,,both,,,12.02,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,7.32,,,7.32,5.95,15.26,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT  ,,,both,,,93.73,56.24,Aetna,Commerical,,18.44,,,18.44,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Aetna,Middlesex Employees,,16.6,,,16.6,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Anthem,Commerical,,26.74,,,26.74,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Anthem,Indemnity,,,67.94,,67.94,16.6,74.84,percent of total billed charges,,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Anthem,State Preferred,,17.18,,,17.18,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Anthem,Individual Exchange,,21.39,,,21.39,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Cigna,Cigna,,35.6,,,35.6,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Connecticare,Commerical,,17.8,,,17.8,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Connecticare,Exchange,,17.8,,,17.8,16.6,74.84,other,Could be inpatient or outpatient,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,Multiplan,Multiplan,,,74.84,,74.84,16.6,74.84,percent of total billed charges,,
HC ANTI-THYROGLOBULN,86800,CPT,,,both,,,93.73,56.24,United Healthcare/Oxford,United Healthcare/Oxford,,23.16,,,23.16,16.6,74.84,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,16.54,,,16.54,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,14.89,,,14.89,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,26.31,,,26.31,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,14.89,45.51,percent of total billed charges,,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,16.9,,,16.9,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,21.05,,,21.05,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,31.45,,,31.45,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,15.97,,,15.97,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,15.97,,,15.97,14.89,45.51,other,Could be inpatient or outpatient,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,14.89,45.51,percent of total billed charges,,
HC HEPATITIS C,86803,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,20.79,,,20.79,14.89,45.51,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,66.18,,,66.18,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,59.56,,,59.56,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,78.58,,,78.58,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,46.85,96.49,percent of total billed charges,,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,46.85,,,46.85,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,62.87,,,62.87,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,90.33,,,90.33,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,84.1,,,84.1,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,84.1,,,84.1,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,46.85,96.49,percent of total billed charges,,
HC HLA AB SCREEN,86807,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,73.37,,,73.37,46.85,96.49,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT  ,,,both,,,692.16,415.3,Aetna,Commerical,,380.37,,,380.37,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Aetna,Middlesex Employees,,342.34,,,342.34,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Anthem,Commerical,,451.63,,,451.63,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Anthem,Indemnity,,,503.41,,503.41,68.66,554.58,percent of total billed charges,,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Anthem,State Preferred,,68.66,,,68.66,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Anthem,Individual Exchange,,361.31,,,361.31,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Cigna,Cigna,,519.22,,,519.22,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Connecticare,Commerical,,483.37,,,483.37,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Connecticare,Exchange,,483.37,,,483.37,68.66,554.58,other,Could be inpatient or outpatient,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,Multiplan,Multiplan,,,554.58,,554.58,68.66,554.58,percent of total billed charges,,
HC HLA ABC TYPING,86813,CPT,,,both,,,692.16,415.3,United Healthcare/Oxford,United Healthcare/Oxford,,421.68,,,421.68,68.66,554.58,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT  ,,,both,,,352.26,211.36,Aetna,Commerical,,193.59,,,193.59,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Aetna,Middlesex Employees,,174.23,,,174.23,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Anthem,Commerical,,229.85,,,229.85,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Anthem,Indemnity,,,256.21,,256.21,76.22,282.25,percent of total billed charges,,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Anthem,State Preferred,,76.22,,,76.22,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Anthem,Individual Exchange,,183.88,,,183.88,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Cigna,Cigna,,264.25,,,264.25,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Connecticare,Commerical,,246.01,,,246.01,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Connecticare,Exchange,,246.01,,,246.01,76.22,282.25,other,Could be inpatient or outpatient,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,Multiplan,Multiplan,,,282.25,,282.25,76.22,282.25,percent of total billed charges,,
HC DR TYPING,86817,CPT,,,both,,,352.26,211.36,United Healthcare/Oxford,United Healthcare/Oxford,,214.61,,,214.61,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT  ,,,both,,,352.28,211.37,Aetna,Commerical,,193.59,,,193.59,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Aetna,Middlesex Employees,,174.23,,,174.23,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Anthem,Commerical,,229.85,,,229.85,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Anthem,Indemnity,,,256.21,,256.21,76.22,282.25,percent of total billed charges,,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Anthem,State Preferred,,76.22,,,76.22,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Anthem,Individual Exchange,,183.88,,,183.88,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Cigna,Cigna,,264.25,,,264.25,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Connecticare,Commerical,,246.01,,,246.01,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Connecticare,Exchange,,246.01,,,246.01,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,Multiplan,Multiplan,,,282.25,,282.25,76.22,282.25,percent of total billed charges,,
HC HLA DR TYPING RED CROSS,86817,CPT,,,both,,,352.28,211.37,United Healthcare/Oxford,United Healthcare/Oxford,,214.61,,,214.61,76.22,282.25,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,36.49,,,36.49,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,32.85,,,32.85,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,43.33,,,43.33,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,32.85,53.2,percent of total billed charges,,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,46.1,,,46.1,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.66,,,34.66,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,49.82,,,49.82,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,46.37,,,46.37,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,46.37,,,46.37,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,32.85,53.2,percent of total billed charges,,
HC HLA ANTIBODY SCREEN,86828,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,40.46,,,40.46,32.85,53.2,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT  ,,,both,,,424.36,254.62,Aetna,Commerical,,184.31,,,184.31,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Aetna,Middlesex Employees,,165.88,,,165.88,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Anthem,Commerical,,218.84,,,218.84,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Anthem,Indemnity,,,243.93,,243.93,147.78,268.73,percent of total billed charges,,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Anthem,State Preferred,,147.78,,,147.78,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Anthem,Individual Exchange,,175.07,,,175.07,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Cigna,Cigna,,251.59,,,251.59,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Connecticare,Commerical,,234.21,,,234.21,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Connecticare,Exchange,,234.21,,,234.21,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,Multiplan,Multiplan,,,268.73,,268.73,147.78,268.73,percent of total billed charges,,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS I,86832,CPT,,,both,,,424.36,254.62,United Healthcare/Oxford,United Healthcare/Oxford,,204.33,,,204.33,147.78,268.73,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT  ,,,both,,,424.36,254.62,Aetna,Commerical,,185.54,,,185.54,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Aetna,Middlesex Employees,,166.99,,,166.99,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Anthem,Commerical,,220.31,,,220.31,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Anthem,Indemnity,,,245.57,,245.57,134.34,270.53,percent of total billed charges,,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Anthem,State Preferred,,134.34,,,134.34,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Anthem,Individual Exchange,,176.25,,,176.25,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Cigna,Cigna,,253.28,,,253.28,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Connecticare,Commerical,,235.79,,,235.79,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Connecticare,Exchange,,235.79,,,235.79,134.34,270.53,other,Could be inpatient or outpatient,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,Multiplan,Multiplan,,,270.53,,270.53,134.34,270.53,percent of total billed charges,,
HC HLA ANTIBODY SCREEN IDENTIFICATION CLASS II,86833,CPT,,,both,,,424.36,254.62,United Healthcare/Oxford,United Healthcare/Oxford,,205.7,,,205.7,134.34,270.53,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,11.33,,,11.33,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,10.19,,,10.19,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,22.81,,,22.81,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,10.19,128.05,percent of total billed charges,,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,13.79,,,13.79,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,18.25,,,18.25,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,27.89,,,27.89,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,10.93,,,10.93,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,10.93,,,10.93,10.19,128.05,other,Could be inpatient or outpatient,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,10.19,128.05,percent of total billed charges,,
HC COOMBS AB SCREEN,86850,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,12.8,,,12.8,10.19,128.05,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,,,,,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,,,,,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,29.19,,,29.19,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,13.79,368.82,percent of total billed charges,,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,13.79,,,13.79,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,23.35,,,23.35,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,27.89,,,27.89,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,45.08,,,45.08,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,45.08,,,45.08,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,13.79,368.82,percent of total billed charges,,
HC ANTIBODY ELUTION,86860,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,13.79,368.82,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,,,,,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,,,,,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,40.15,,,40.15,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,32.12,615.9,percent of total billed charges,,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,33.47,,,33.47,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,32.12,,,32.12,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,49.24,,,49.24,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,61.39,,,61.39,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,61.39,,,61.39,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,32.12,615.9,percent of total billed charges,,
HC ANTIBODY IDENT,86870,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,32.12,615.9,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT  ,,,both,,,329.6,197.76,Aetna,Commerical,,,,,,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Aetna,Middlesex Employees,,,,,,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Anthem,Commerical,,40.15,,,40.15,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Anthem,Indemnity,,,239.84,,239.84,32.12,359.57,percent of total billed charges,,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Anthem,State Preferred,,33.47,,,33.47,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Anthem,Individual Exchange,,32.12,,,32.12,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Cigna,Cigna,,49.24,,,49.24,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Connecticare,Commerical,,61.39,,,61.39,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Connecticare,Exchange,,61.39,,,61.39,32.12,359.57,other,Could be inpatient or outpatient,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,Multiplan,Multiplan,,,264.21,,264.21,32.12,359.57,percent of total billed charges,,
HC ANTIBODY IDENT-RC,86870,CPT,,,both,,,329.6,197.76,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,32.12,359.57,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,6.25,,,6.25,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,5.62,,,5.62,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,9.9,,,9.9,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,5.62,91.08,percent of total billed charges,,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,6.37,,,6.37,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,7.93,,,7.93,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,11.86,,,11.86,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,6.03,,,6.03,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,6.03,,,6.03,5.62,91.08,other,Could be inpatient or outpatient,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,5.62,91.08,percent of total billed charges,,
HC COOMBS-DIRECT,86880,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,7.86,,,7.86,5.62,91.08,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT  ,,,both,,,265.62,159.37,Aetna,Commerical,,145.97,,,145.97,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Aetna,Middlesex Employees,,131.37,,,131.37,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Anthem,Commerical,,173.31,,,173.31,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Anthem,Indemnity,,,193.18,,193.18,6.77,212.81,percent of total billed charges,,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Anthem,State Preferred,,6.77,,,6.77,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Anthem,Individual Exchange,,138.65,,,138.65,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Cigna,Cigna,,199.24,,,199.24,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Connecticare,Commerical,,185.49,,,185.49,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Connecticare,Exchange,,185.49,,,185.49,6.77,212.81,other,Could be inpatient or outpatient,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,Multiplan,Multiplan,,,212.81,,212.81,6.77,212.81,percent of total billed charges,,
HC REF ABID CELL EA,86885,CPT,,,both,,,265.62,159.37,United Healthcare/Oxford,United Healthcare/Oxford,,161.81,,,161.81,6.77,212.81,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,252.96,,,252.96,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,227.66,,,227.66,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,300.36,,,300.36,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,6.13,368.82,percent of total billed charges,,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,6.13,,,6.13,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,240.29,,,240.29,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,345.3,,,345.3,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,321.46,,,321.46,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,321.46,,,321.46,6.13,368.82,other,Could be inpatient or outpatient,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,6.13,368.82,percent of total billed charges,,
HC COOMBS-AB TITER,86886,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,280.44,,,280.44,6.13,368.82,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT  ,,,both,,,184.37,110.62,Aetna,Commerical,,101.43,,,101.43,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Aetna,Middlesex Employees,,91.29,,,91.29,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Anthem,Commerical,,120.43,,,120.43,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Anthem,Indemnity,,,134.25,,134.25,6.13,147.89,percent of total billed charges,,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Anthem,State Preferred,,6.13,,,6.13,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Anthem,Individual Exchange,,96.35,,,96.35,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Cigna,Cigna,,138.46,,,138.46,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Connecticare,Commerical,,128.9,,,128.9,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Connecticare,Exchange,,128.9,,,128.9,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,Multiplan,Multiplan,,,147.89,,147.89,6.13,147.89,percent of total billed charges,,
HC ISOAGGLUTININ,86886,CPT,,,both,,,184.37,110.62,United Healthcare/Oxford,United Healthcare/Oxford,,112.45,,,112.45,6.13,147.89,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT  ,,,both,,,156.56,93.94,Aetna,Commerical,,86.59,,,86.59,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Aetna,Middlesex Employees,,77.93,,,77.93,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Anthem,Commerical,,102.81,,,102.81,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Anthem,Indemnity,,,114.6,,114.6,6.13,126.25,percent of total billed charges,,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Anthem,State Preferred,,6.13,,,6.13,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Anthem,Individual Exchange,,82.24,,,82.24,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Cigna,Cigna,,118.2,,,118.2,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Connecticare,Commerical,,110.03,,,110.03,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Connecticare,Exchange,,110.03,,,110.03,6.13,126.25,other,Could be inpatient or outpatient,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,Multiplan,Multiplan,,,126.25,,126.25,6.13,126.25,percent of total billed charges,,
HC ISOHEMAGGLUTININ,86886,CPT,,,both,,,156.56,93.94,United Healthcare/Oxford,United Healthcare/Oxford,,96,,,96,6.13,126.25,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT  ,,,both,,,125.66,75.4,Aetna,Commerical,,69.27,,,69.27,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Aetna,Middlesex Employees,,62.35,,,62.35,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Anthem,Commerical,,82.25,,,82.25,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Anthem,Indemnity,,,91.68,,91.68,62.35,101,percent of total billed charges,,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Anthem,State Preferred,,91.63,,,91.63,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Anthem,Individual Exchange,,65.81,,,65.81,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Cigna,Cigna,,94.56,,,94.56,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Connecticare,Commerical,,88.03,,,88.03,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Connecticare,Exchange,,88.03,,,88.03,62.35,101,other,Could be inpatient or outpatient,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,Multiplan,Multiplan,,,101,,101,62.35,101,percent of total billed charges,,
HC AUTO BLD STORAGE,86890,CPT,,,both,,,125.66,75.4,United Healthcare/Oxford,United Healthcare/Oxford,,76.8,,,76.8,62.35,101,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT  ,,,both,,,374.92,224.95,Aetna,Commerical,,3.47,,,3.47,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Aetna,Middlesex Employees,,3.13,,,3.13,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Anthem,Commerical,,5.5,,,5.5,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Anthem,Indemnity,,,272.58,,272.58,3.13,300.29,percent of total billed charges,,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Anthem,State Preferred,,3.54,,,3.54,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Anthem,Individual Exchange,,4.4,,,4.4,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Cigna,Cigna,,6.54,,,6.54,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Connecticare,Commerical,,3.34,,,3.34,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Connecticare,Exchange,,3.34,,,3.34,3.13,300.29,other,Could be inpatient or outpatient,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,Multiplan,Multiplan,,,300.29,,300.29,3.13,300.29,percent of total billed charges,,
HC GROUPING,86900,CPT,,,both,,,374.92,224.95,United Healthcare/Oxford,United Healthcare/Oxford,,4.35,,,4.35,3.13,300.29,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,3.47,,,3.47,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,3.13,,,3.13,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,5.5,,,5.5,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,3.13,91.08,percent of total billed charges,,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,7.05,,,7.05,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,4.4,,,4.4,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,14.23,,,14.23,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,3.34,,,3.34,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,3.34,,,3.34,3.13,91.08,other,Could be inpatient or outpatient,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,3.13,91.08,percent of total billed charges,,
HC R H FACTOR,86901,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,4.35,,,4.35,3.13,91.08,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC AG TYPING DONOR,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-1,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-2,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-3,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-4,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,7.36,,,7.36,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,7.04,,,7.04,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,4.56,,,4.56,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,5.63,,,5.63,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,13.98,,,13.98,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,7.1,,,7.1,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,4.56,615.9,percent of total billed charges,,
HC PHENOTYPED PROD-5,86902,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,615.9,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT  ,,,both,,,664.35,398.61,Aetna,Commerical,,7.36,,,7.36,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Anthem,Commerical,,7.04,,,7.04,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Anthem,Indemnity,,,482.95,,482.95,4.56,532.04,percent of total billed charges,,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Anthem,State Preferred,,4.56,,,4.56,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Anthem,Individual Exchange,,5.63,,,5.63,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Cigna,Cigna,,13.98,,,13.98,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Connecticare,Commerical,,7.1,,,7.1,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Connecticare,Exchange,,7.1,,,7.1,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,Multiplan,Multiplan,,,532.04,,532.04,4.56,532.04,percent of total billed charges,,
HC PHENOTYPED PROD-6,86902,CPT,,,both,,,664.35,398.61,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,532.04,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT  ,,,both,,,780.74,468.44,Aetna,Commerical,,7.36,,,7.36,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Anthem,Commerical,,7.04,,,7.04,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Anthem,Indemnity,,,568.08,,568.08,4.56,625.82,percent of total billed charges,,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Anthem,State Preferred,,4.56,,,4.56,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Anthem,Individual Exchange,,5.63,,,5.63,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Cigna,Cigna,,13.98,,,13.98,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Connecticare,Commerical,,7.1,,,7.1,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Connecticare,Exchange,,7.1,,,7.1,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,Multiplan,Multiplan,,,625.82,,625.82,4.56,625.82,percent of total billed charges,,
HC PHENOTYPED PROD-7,86902,CPT,,,both,,,780.74,468.44,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,625.82,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT  ,,,both,,,879.62,527.77,Aetna,Commerical,,7.36,,,7.36,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Anthem,Commerical,,7.04,,,7.04,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Anthem,Indemnity,,,640.11,,640.11,4.56,705.18,percent of total billed charges,,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Anthem,State Preferred,,4.56,,,4.56,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Anthem,Individual Exchange,,5.63,,,5.63,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Cigna,Cigna,,13.98,,,13.98,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Connecticare,Commerical,,7.1,,,7.1,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Connecticare,Exchange,,7.1,,,7.1,4.56,705.18,other,Could be inpatient or outpatient,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,Multiplan,Multiplan,,,705.18,,705.18,4.56,705.18,percent of total billed charges,,
HC PHENOTYPED PROD-8,86902,CPT,,,both,,,879.62,527.77,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,705.18,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT  ,,,both,,,344.02,206.41,Aetna,Commerical,,7.36,,,7.36,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Anthem,Commerical,,7.04,,,7.04,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Anthem,Indemnity,,,250.48,,250.48,4.56,275.94,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Anthem,State Preferred,,4.56,,,4.56,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Anthem,Individual Exchange,,5.63,,,5.63,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Cigna,Cigna,,13.98,,,13.98,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Connecticare,Commerical,,7.1,,,7.1,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Connecticare,Exchange,,7.1,,,7.1,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,Multiplan,Multiplan,,,275.94,,275.94,4.56,275.94,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH COMBINATION,86902,CPT,,,both,,,344.02,206.41,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,275.94,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT  ,,,both,,,282.22,169.33,Aetna,Commerical,,7.36,,,7.36,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Anthem,Commerical,,7.04,,,7.04,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Anthem,Indemnity,,,204.64,,204.64,4.56,225.45,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Anthem,State Preferred,,4.56,,,4.56,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Anthem,Individual Exchange,,5.63,,,5.63,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Cigna,Cigna,,13.98,,,13.98,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Connecticare,Commerical,,7.1,,,7.1,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Connecticare,Exchange,,7.1,,,7.1,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,Multiplan,Multiplan,,,225.45,,225.45,4.56,225.45,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH HIGH FREQUENCY,86902,CPT,,,both,,,282.22,169.33,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,225.45,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT  ,,,both,,,42.13,25.28,Aetna,Commerical,,7.36,,,7.36,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Anthem,Commerical,,7.04,,,7.04,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Anthem,Indemnity,,,30.64,,30.64,4.56,33.75,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Anthem,State Preferred,,4.56,,,4.56,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Anthem,Individual Exchange,,5.63,,,5.63,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Cigna,Cigna,,13.98,,,13.98,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Connecticare,Commerical,,7.1,,,7.1,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Connecticare,Exchange,,7.1,,,7.1,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,Multiplan,Multiplan,,,33.75,,33.75,4.56,33.75,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING- HH STANDING ORDER,86902,CPT,,,both,,,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,33.75,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT  ,,,both,,,93.73,56.24,Aetna,Commerical,,7.36,,,7.36,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Aetna,Middlesex Employees,,6.63,,,6.63,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Anthem,Commerical,,7.04,,,7.04,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Anthem,Indemnity,,,67.94,,67.94,4.56,74.84,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Anthem,State Preferred,,4.56,,,4.56,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Anthem,Individual Exchange,,5.63,,,5.63,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Cigna,Cigna,,13.98,,,13.98,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Connecticare,Commerical,,7.1,,,7.1,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Connecticare,Exchange,,7.1,,,7.1,4.56,74.84,other,Could be inpatient or outpatient,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,Multiplan,Multiplan,,,74.84,,74.84,4.56,74.84,percent of total billed charges,,
HC REF IRL ANTIGEN TYPING-HH ROUTINE,86902,CPT,,,both,,,93.73,56.24,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,4.56,74.84,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT  ,,,both,,,48.7,29.22,Aetna,Commerical,,4.45,,,4.45,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Aetna,Middlesex Employees,,4,,,4,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Anthem,Commerical,,7.04,,,7.04,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Anthem,Indemnity,,,35.41,,35.41,4,39.01,percent of total billed charges,,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Anthem,State Preferred,,4.53,,,4.53,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Anthem,Individual Exchange,,5.63,,,5.63,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Cigna,Cigna,,8.31,,,8.31,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Connecticare,Commerical,,4.28,,,4.28,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Connecticare,Exchange,,4.28,,,4.28,4,39.01,other,Could be inpatient or outpatient,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,Multiplan,Multiplan,,,39.01,,39.01,4,39.01,percent of total billed charges,,
HC ANTIGEN TYPING,86905,CPT,,,both,,,48.7,29.22,United Healthcare/Oxford,United Healthcare/Oxford,,5.57,,,5.57,4,39.01,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,41.93,,,41.93,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,37.74,,,37.74,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,37.52,,,37.52,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,4.53,46.44,percent of total billed charges,,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,4.53,,,4.53,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,30.02,,,30.02,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,36.64,,,36.64,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,39.19,,,39.19,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,39.19,,,39.19,4.53,46.44,other,Could be inpatient or outpatient,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,4.53,46.44,percent of total billed charges,,
HC REF ANTIGEN TYPING,86905,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,4.53,46.44,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,62.46,,,62.46,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,56.22,,,56.22,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,74.17,,,74.17,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,9.17,91.08,percent of total billed charges,,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,9.17,,,9.17,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,59.34,,,59.34,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,85.27,,,85.27,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,79.38,,,79.38,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,79.38,,,79.38,9.17,91.08,other,Could be inpatient or outpatient,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,9.17,91.08,percent of total billed charges,,
HC REF RH PHENOTYPE COMPLETE,86906,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,69.26,,,69.26,9.17,91.08,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT  ,,,both,,,23.42,14.05,Aetna,Commerical,,,,,,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Aetna,Middlesex Employees,,,,,,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Anthem,Commerical,,32.4,,,32.4,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Anthem,Indemnity,,,17.04,,17.04,8.04,189.79,percent of total billed charges,,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Anthem,State Preferred,,8.04,,,8.04,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Anthem,Individual Exchange,,25.92,,,25.92,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Cigna,Cigna,,30.83,,,30.83,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Connecticare,Commerical,,49.89,,,49.89,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Connecticare,Exchange,,49.89,,,49.89,8.04,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,Multiplan,Multiplan,,,18.78,,18.78,8.04,189.79,percent of total billed charges,,
HC CROSSMATCH,86920,CPT,,,both,,,23.42,14.05,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,8.04,189.79,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,,,,,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,,,,,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,32.4,,,32.4,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,8.04,368.82,percent of total billed charges,,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,8.04,,,8.04,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,25.92,,,25.92,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,30.83,,,30.83,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,49.89,,,49.89,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,49.89,,,49.89,8.04,368.82,other,Could be inpatient or outpatient,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,8.04,368.82,percent of total billed charges,,
HC IMMEDIATE SPIN XM,86920,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,8.04,368.82,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT  ,,,both,,,17.38,10.43,Aetna,Commerical,,,,,,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Aetna,Middlesex Employees,,,,,,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Anthem,Commerical,,32.4,,,32.4,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Anthem,Indemnity,,,12.64,,12.64,8.04,189.79,percent of total billed charges,,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Anthem,State Preferred,,8.04,,,8.04,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Anthem,Individual Exchange,,25.92,,,25.92,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Cigna,Cigna,,30.83,,,30.83,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Connecticare,Commerical,,49.89,,,49.89,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Connecticare,Exchange,,49.89,,,49.89,8.04,189.79,other,Could be inpatient or outpatient,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,Multiplan,Multiplan,,,13.92,,13.92,8.04,189.79,percent of total billed charges,,
HC TYPE SPEC PROCESS,86920,CPT,,,both,,,17.38,10.43,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,8.04,189.79,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,,,,,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,,,,,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,34.67,,,34.67,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,16.6,368.82,percent of total billed charges,,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,34.67,,,34.67,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,27.74,,,27.74,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,16.6,,,16.6,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,53.25,,,53.25,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,53.25,,,53.25,16.6,368.82,other,Could be inpatient or outpatient,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,16.6,368.82,percent of total billed charges,,
HC AGH XM EACH UNIT,86922,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,16.6,368.82,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT  ,,,both,,,30.1,18.06,Aetna,Commerical,,,,,,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Aetna,Middlesex Employees,,,,,,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Anthem,Commerical,,34.67,,,34.67,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Anthem,Indemnity,,,21.89,,21.89,16.6,189.79,percent of total billed charges,,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Anthem,State Preferred,,34.67,,,34.67,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Anthem,Individual Exchange,,27.74,,,27.74,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Cigna,Cigna,,16.6,,,16.6,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Connecticare,Commerical,,53.25,,,53.25,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Connecticare,Exchange,,53.25,,,53.25,16.6,189.79,other,Could be inpatient or outpatient,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,Multiplan,Multiplan,,,24.11,,24.11,16.6,189.79,percent of total billed charges,,
HC CROSSMATCH AHG,86922,CPT,,,both,,,30.1,18.06,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,16.6,189.79,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT  ,,,both,,,22.19,13.31,Aetna,Commerical,,16.05,,,16.05,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Aetna,Middlesex Employees,,14.44,,,14.44,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Anthem,Commerical,,14.36,,,14.36,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Anthem,Indemnity,,,16.13,,16.13,11.49,29.06,percent of total billed charges,,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Anthem,State Preferred,,29.06,,,29.06,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Anthem,Individual Exchange,,11.49,,,11.49,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Cigna,Cigna,,14.02,,,14.02,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Connecticare,Commerical,,15,,,15,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Connecticare,Exchange,,15,,,15,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,Multiplan,Multiplan,,,17.77,,17.77,11.49,29.06,percent of total billed charges,,
HC ELECTRONIC CROSSMATCH,86923,CPT,,,both,,,22.19,13.31,United Healthcare/Oxford,United Healthcare/Oxford,,14.43,,,14.43,11.49,29.06,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,,,,,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,,,,,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,26,,,26,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,20.8,368.82,percent of total billed charges,,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,29.06,,,29.06,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,20.8,,,20.8,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,73.64,,,73.64,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,39.81,,,39.81,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,39.81,,,39.81,20.8,368.82,other,Could be inpatient or outpatient,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,20.8,368.82,percent of total billed charges,,
HC ELECTRONIC XM,86923,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,20.8,368.82,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,88.45,,,88.45,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,79.61,,,79.61,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,79.61,128.95,percent of total billed charges,,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,84.01,,,84.01,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,120.73,,,120.73,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,128.95,79.61,128.95,percent of total billed charges,,
HC FROZEN BLOOD THAW EACH UNIT,86931,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,98.05,,,98.05,79.61,128.95,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT  ,,,both,,,260.59,156.35,Aetna,Commerical,,143.49,,,143.49,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Aetna,Middlesex Employees,,129.14,,,129.14,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Anthem,Commerical,,170.37,,,170.37,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Anthem,Indemnity,,,189.91,,189.91,129.14,209.21,percent of total billed charges,,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Anthem,State Preferred,,170.37,,,170.37,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Anthem,Individual Exchange,,136.3,,,136.3,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Cigna,Cigna,,195.86,,,195.86,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Connecticare,Commerical,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Connecticare,Exchange,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,Multiplan,Multiplan,,,209.21,,209.21,129.14,209.21,percent of total billed charges,,
HC RED CELLS DEGLYC,86931,CPT,,,both,,,260.59,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,129.14,209.21,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,,,,,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,,,,,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,27.37,,,27.37,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,21.89,91.08,percent of total billed charges,,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,29.95,,,29.95,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,21.89,,,21.89,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,42.13,,,42.13,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,41.73,,,41.73,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,41.73,,,41.73,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,21.89,91.08,percent of total billed charges,,
HC IRRADIATE BLD PRODUCT EA UNIT,86945,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,21.89,91.08,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT  ,,,both,,,951.72,571.03,Aetna,Commerical,,,,,,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Aetna,Middlesex Employees,,,,,,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Anthem,Commerical,,27.37,,,27.37,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Anthem,Indemnity,,,692.5,,692.5,21.89,762.89,percent of total billed charges,,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Anthem,State Preferred,,29.95,,,29.95,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Anthem,Individual Exchange,,21.89,,,21.89,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Cigna,Cigna,,42.13,,,42.13,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Connecticare,Commerical,,41.73,,,41.73,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Connecticare,Exchange,,41.73,,,41.73,21.89,762.89,other,Could be inpatient or outpatient,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,Multiplan,Multiplan,,,762.89,,762.89,21.89,762.89,percent of total billed charges,,
HC IRRADIATE BLD PRODUCT EA UNIT - PHENOTYPYPE PROD-9,86945,CPT,,,both,,,951.72,571.03,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,21.89,762.89,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,,,,,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,,,,,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,30.57,,,30.57,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,24.46,368.82,percent of total billed charges,,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,30.57,,,30.57,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,24.46,,,24.46,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,86.08,,,86.08,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,46.52,,,46.52,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,46.52,,,46.52,24.46,368.82,other,Could be inpatient or outpatient,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,24.46,368.82,percent of total billed charges,,
HC VOL REDUCTION OF BLOOD/PROD EACH UNIT,86960,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,24.46,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,252.96,,,252.96,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,227.66,,,227.66,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,300.36,,,300.36,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,227.66,368.82,percent of total billed charges,,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,300.36,,,300.36,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,240.29,,,240.29,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,345.3,,,345.3,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,321.46,,,321.46,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,321.46,,,321.46,227.66,368.82,other,Could be inpatient or outpatient,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,227.66,368.82,percent of total billed charges,,
HC POOL PLATELETS OR BLD PRODUCT,86965,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,280.44,,,280.44,227.66,368.82,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,34.63,,,34.63,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,31.17,,,31.17,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,41.12,,,41.12,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,31.17,50.5,percent of total billed charges,,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,41.12,,,41.12,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,32.89,,,32.89,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,47.28,,,47.28,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,44.02,,,44.02,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,31.17,50.5,percent of total billed charges,,
HC PRETREAT RBC; CHEM OR DRUGS EACH,86970,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,38.4,,,38.4,31.17,50.5,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT  ,,,both,,,265.74,159.44,Aetna,Commerical,,145.97,,,145.97,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Aetna,Middlesex Employees,,131.37,,,131.37,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Anthem,Commerical,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Anthem,Indemnity,,,193.18,,193.18,131.37,212.81,percent of total billed charges,,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Anthem,State Preferred,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Anthem,Individual Exchange,,138.65,,,138.65,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Cigna,Cigna,,199.24,,,199.24,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Connecticare,Commerical,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Connecticare,Exchange,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,Multiplan,Multiplan,,,212.81,,212.81,131.37,212.81,percent of total billed charges,,
HC PRETREAT RBC; ENZYMES EACH,86971,CPT,,,both,,,265.74,159.44,United Healthcare/Oxford,United Healthcare/Oxford,,161.81,,,161.81,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT  ,,,both,,,265.74,159.44,Aetna,Commerical,,145.97,,,145.97,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Aetna,Middlesex Employees,,131.37,,,131.37,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Anthem,Commerical,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Anthem,Indemnity,,,193.18,,193.18,131.37,212.81,percent of total billed charges,,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Anthem,State Preferred,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Anthem,Individual Exchange,,138.65,,,138.65,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Cigna,Cigna,,199.24,,,199.24,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Connecticare,Commerical,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Connecticare,Exchange,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,Multiplan,Multiplan,,,212.81,,212.81,131.37,212.81,percent of total billed charges,,
HC PRETREAT RBC; DGS,86972,CPT,,,both,,,265.74,159.44,United Healthcare/Oxford,United Healthcare/Oxford,,161.81,,,161.81,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT  ,,,both,,,265.74,159.44,Aetna,Commerical,,145.97,,,145.97,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Aetna,Middlesex Employees,,131.37,,,131.37,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Anthem,Commerical,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Anthem,Indemnity,,,193.18,,193.18,131.37,212.81,percent of total billed charges,,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Anthem,State Preferred,,173.31,,,173.31,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Anthem,Individual Exchange,,138.65,,,138.65,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Cigna,Cigna,,199.24,,,199.24,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Connecticare,Commerical,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Connecticare,Exchange,,185.49,,,185.49,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,Multiplan,Multiplan,,,212.81,,212.81,131.37,212.81,percent of total billed charges,,
HC SERUM PRETX; DRUG INCUBATE EACH,86975,CPT,,,both,,,265.74,159.44,United Healthcare/Oxford,United Healthcare/Oxford,,161.81,,,161.81,131.37,212.81,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,88.45,,,88.45,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,79.61,,,79.61,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,79.61,128.95,percent of total billed charges,,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,84.01,,,84.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,120.73,,,120.73,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,128.95,79.61,128.95,percent of total billed charges,,
HC SERUM PRETX; DILUTION,86976,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,98.05,,,98.05,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,88.45,,,88.45,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,79.61,,,79.61,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,79.61,128.95,percent of total billed charges,,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,84.01,,,84.01,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,120.73,,,120.73,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,128.95,79.61,128.95,percent of total billed charges,,
HC SERUM PRETX; INHIBITOR INCUBATE,86977,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,98.05,,,98.05,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,88.45,,,88.45,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,79.61,,,79.61,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,79.61,128.95,percent of total billed charges,,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,105.01,,,105.01,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,84.01,,,84.01,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,120.73,,,120.73,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,112.4,,,112.4,79.61,128.95,other,Could be inpatient or outpatient,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,129.85,79.61,128.95,percent of total billed charges,,
HC REF DIFF ADSORPTION,86978,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,98.05,,,98.05,79.61,128.95,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,37.3,60.42,percent of total billed charges,,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,49.2,,,49.2,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,37.3,60.42,other,Could be inpatient or outpatient,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,37.3,60.42,percent of total billed charges,,
HC WARM AUTO ADSORPTION,86978,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,37.3,60.42,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT  ,,,both,,,144.07,86.44,Aetna,Commerical,,,,,,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT  ,,,both,,,460.34,276.2,Aetna,Commerical,,,,,,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Aetna,Middlesex Employees,,,,,,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Aetna,Middlesex Employees,,,,,,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Anthem,Commerical,,23.72,,,23.72,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Anthem,Commerical,,23.72,,,23.72,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Anthem,Indemnity,,,104.78,,104.78,18.98,189.79,percent of total billed charges,,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Anthem,Indemnity,,,334.79,,334.79,18.98,368.82,percent of total billed charges,,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Anthem,State Preferred,,23.72,,,23.72,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Anthem,State Preferred,,23.72,,,23.72,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Anthem,Individual Exchange,,18.98,,,18.98,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Anthem,Individual Exchange,,18.98,,,18.98,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Cigna,Cigna,,29.67,,,29.67,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Cigna,Cigna,,29.67,,,29.67,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Connecticare,Commerical,,36.45,,,36.45,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Connecticare,Commerical,,36.45,,,36.45,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Connecticare,Exchange,,36.45,,,36.45,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Connecticare,Exchange,,36.45,,,36.45,18.98,368.82,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,Multiplan,Multiplan,,,115.43,,115.43,18.98,189.79,percent of total billed charges,,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,Multiplan,Multiplan,,,368.82,,368.82,18.98,368.82,percent of total billed charges,,
HC SPLIT BLD PRODUCT EA UNIT,86985,CPT,,,both,,,144.07,86.44,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,18.98,189.79,other,Could be inpatient or outpatient,
HC SPLIT BLD PRODUCT EA UNIT-2,86985,CPT,,,both,,,460.34,276.2,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,18.98,368.82,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT  ,,,both,,,37.11,22.27,Aetna,Commerical,,20.39,,,20.39,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Aetna,Middlesex Employees,,18.35,,,18.35,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Anthem,Commerical,,24.21,,,24.21,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Anthem,Indemnity,,,26.99,,26.99,18.35,29.73,percent of total billed charges,,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Anthem,State Preferred,,24.21,,,24.21,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Anthem,Individual Exchange,,19.36,,,19.36,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Cigna,Cigna,,27.83,,,27.83,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Connecticare,Commerical,,25.92,,,25.92,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Connecticare,Exchange,,25.92,,,25.92,18.35,29.73,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,Multiplan,Multiplan,,,29.73,,29.73,18.35,29.73,percent of total billed charges,,
HC COMMERCIAL TRANS,86999,CPT,,,both,,,37.11,22.27,United Healthcare/Oxford,United Healthcare/Oxford,,22.61,,,22.61,18.35,29.73,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT  ,,,both,,,336.81,202.09,Aetna,Commerical,,184.93,,,184.93,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Aetna,Middlesex Employees,,166.44,,,166.44,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Anthem,Commerical,,219.58,,,219.58,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Anthem,Indemnity,,,244.75,,244.75,166.44,269.63,percent of total billed charges,,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Anthem,State Preferred,,219.58,,,219.58,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Anthem,Individual Exchange,,175.66,,,175.66,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Cigna,Cigna,,252.43,,,252.43,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Connecticare,Commerical,,235.01,,,235.01,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Connecticare,Exchange,,235.01,,,235.01,166.44,269.63,other,Could be inpatient or outpatient,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,Multiplan,Multiplan,,,269.63,,269.63,166.44,269.63,percent of total billed charges,,
HC DEGLYCEROLIZATION,86999,CPT,,,both,,,336.81,202.09,United Healthcare/Oxford,United Healthcare/Oxford,,205.01,,,205.01,166.44,269.63,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT  ,,,both,,,260.59,156.35,Aetna,Commerical,,143.49,,,143.49,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Aetna,Middlesex Employees,,129.14,,,129.14,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Anthem,Commerical,,170.37,,,170.37,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Anthem,Indemnity,,,189.91,,189.91,129.14,209.21,percent of total billed charges,,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Anthem,State Preferred,,170.37,,,170.37,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Anthem,Individual Exchange,,136.3,,,136.3,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Cigna,Cigna,,195.86,,,195.86,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Connecticare,Commerical,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Connecticare,Exchange,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,Multiplan,Multiplan,,,209.21,,209.21,129.14,209.21,percent of total billed charges,,
HC WASHING OF RBC,86999,CPT,,,both,,,260.59,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,129.14,209.21,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.74,,,7.74,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.97,,,6.97,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.31,,,12.31,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.97,21.7,percent of total billed charges,,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.91,,,7.91,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.84,,,9.84,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.47,,,7.47,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.47,,,7.47,6.97,21.7,other,Could be inpatient or outpatient,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.97,21.7,percent of total billed charges,,
HC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.72,,,9.72,6.97,21.7,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT  ,,,both,,,24.35,14.61,Aetna,Commerical,,7.74,,,7.74,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Aetna,Middlesex Employees,,6.97,,,6.97,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Anthem,Commerical,,12.31,,,12.31,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Anthem,Indemnity,,,17.71,,17.71,6.97,19.51,percent of total billed charges,,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Anthem,State Preferred,,7.91,,,7.91,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Anthem,Individual Exchange,,9.84,,,9.84,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Cigna,Cigna,,14.83,,,14.83,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Connecticare,Commerical,,7.47,,,7.47,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Connecticare,Exchange,,7.47,,,7.47,6.97,19.51,other,Could be inpatient or outpatient,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,Multiplan,Multiplan,,,19.51,,19.51,6.97,19.51,percent of total billed charges,,
HC SPEC CONCENTRATION FOR INFECT AGNT,87015,CPT,,,both,,,24.35,14.61,United Healthcare/Oxford,United Healthcare/Oxford,,9.72,,,9.72,6.97,19.51,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.97,,,11.97,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.77,,,10.77,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,17.16,,,17.16,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.77,32.94,percent of total billed charges,,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,11.01,,,11.01,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,13.72,,,13.72,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,23.14,,,23.14,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.55,,,11.55,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.55,,,11.55,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.77,32.94,percent of total billed charges,,
HC AEROB BACTERIAL BLOOD CULTURE,87040,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,15.04,,,15.04,10.77,32.94,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,10.94,,,10.94,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.39,,,17.39,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,9.85,30.54,percent of total billed charges,,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.91,,,13.91,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,9.85,30.54,percent of total billed charges,,
HC AEROB BACTERIA CULTURE STOOL,87045,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,30.54,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT  ,,,both,,,35.95,21.57,Aetna,Commerical,,10.94,,,10.94,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Anthem,Commerical,,17.39,,,17.39,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Anthem,Indemnity,,,26.13,,26.13,9.85,28.79,percent of total billed charges,,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Anthem,State Preferred,,11.18,,,11.18,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Anthem,Individual Exchange,,13.91,,,13.91,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Cigna,Cigna,,20.78,,,20.78,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Connecticare,Commerical,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Connecticare,Exchange,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,Multiplan,Multiplan,,,28.79,,28.79,9.85,28.79,percent of total billed charges,,
HC AEROBIC BACTERIA CULTURE STOOL - QUEST,87045,CPT,,,both,,,35.95,21.57,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT  ,,,both,,,35.95,21.57,Aetna,Commerical,,10.94,,,10.94,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Commerical,,17.39,,,17.39,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Indemnity,,,26.13,,26.13,9.85,28.79,percent of total billed charges,,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,State Preferred,,11.18,,,11.18,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Individual Exchange,,13.91,,,13.91,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Cigna,Cigna,,20.78,,,20.78,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Connecticare,Commerical,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Connecticare,Exchange,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,Multiplan,Multiplan,,,28.79,,28.79,9.85,28.79,percent of total billed charges,,
HC AEROBIC STOOL CLT ADDTL: E COLI EA PLATE -QUEST,87046,CPT,,,both,,,35.95,21.57,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT  ,,,both,,,35.95,21.57,Aetna,Commerical,,10.94,,,10.94,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Commerical,,17.39,,,17.39,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Indemnity,,,26.13,,26.13,9.85,28.79,percent of total billed charges,,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,State Preferred,,11.18,,,11.18,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Anthem,Individual Exchange,,13.91,,,13.91,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Cigna,Cigna,,20.78,,,20.78,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Connecticare,Commerical,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Connecticare,Exchange,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,Multiplan,Multiplan,,,28.79,,28.79,9.85,28.79,percent of total billed charges,,
HC AEROBIC STOOL CLT ADDTL: SHIGA TOXIN EA PLATE - QUEST,87046,CPT,,,both,,,35.95,21.57,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT  ,,,both,,,35.94,21.56,Aetna,Commerical,,10.94,,,10.94,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Anthem,Commerical,,17.39,,,17.39,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Anthem,Indemnity,,,26.13,,26.13,9.85,28.79,percent of total billed charges,,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Anthem,State Preferred,,11.18,,,11.18,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Anthem,Individual Exchange,,13.91,,,13.91,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Cigna,Cigna,,20.78,,,20.78,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Connecticare,Commerical,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Connecticare,Exchange,,10.56,,,10.56,9.85,28.79,other,Could be inpatient or outpatient,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,Multiplan,Multiplan,,,28.79,,28.79,9.85,28.79,percent of total billed charges,,
HC ARBIC STOOL CLT ADDTL: SALMONELLA/SHIGELLA/CAMPYLOBACTER EA PLATE - QUEST,87046,CPT,,,both,,,35.94,21.56,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,28.79,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,10.94,,,10.94,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.39,,,17.39,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,9.85,30.54,percent of total billed charges,,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.91,,,13.91,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,9.85,30.54,percent of total billed charges,,
HC STL CLT / CAMPY EACH PLATE,87046,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,10.94,,,10.94,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,17.39,,,17.39,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,9.85,53.2,percent of total billed charges,,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,11.18,,,11.18,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,13.91,,,13.91,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,20.78,,,20.78,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,10.56,,,10.56,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,10.56,,,10.56,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,9.85,53.2,percent of total billed charges,,
HC STL CLT: E. COLI EACH PLATE,87046,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,53.2,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,10.94,,,10.94,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.39,,,17.39,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,9.85,30.54,percent of total billed charges,,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.91,,,13.91,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,9.85,30.54,percent of total billed charges,,
HC STL CLT: VIBRIO EACH PLATE,87046,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,10.94,,,10.94,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,9.85,,,9.85,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.39,,,17.39,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,9.85,30.54,percent of total billed charges,,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.91,,,13.91,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.56,,,10.56,9.85,30.54,other,Could be inpatient or outpatient,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,9.85,30.54,percent of total billed charges,,
HC STL CLT: YERSINIA EACH PLATE,87046,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,9.85,30.54,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10,,,10,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9,,,9,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,13.89,,,13.89,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,8.92,28.13,percent of total billed charges,,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,8.92,,,8.92,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,11.12,,,11.12,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,8.92,28.13,percent of total billed charges,,
HC CULT-LOWER RESP,87070,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.55,,,12.55,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10,,,10,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9,,,9,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,13.89,,,13.89,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,8.92,28.13,percent of total billed charges,,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,8.92,,,8.92,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,11.12,,,11.12,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,8.92,28.13,percent of total billed charges,,
HC CULTURE-FLUID,87070,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.55,,,12.55,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10,,,10,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9,,,9,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,13.89,,,13.89,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,8.92,28.13,percent of total billed charges,,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,8.92,,,8.92,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,11.12,,,11.12,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,8.92,28.13,percent of total billed charges,,
HC CULTURE-GENITAL,87070,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.55,,,12.55,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10,,,10,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9,,,9,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,13.89,,,13.89,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,8.92,28.13,percent of total billed charges,,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,8.92,,,8.92,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,11.12,,,11.12,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.65,,,9.65,8.92,28.13,other,Could be inpatient or outpatient,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,8.92,28.13,percent of total billed charges,,
HC CULTURE-WOUND,87070,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.55,,,12.55,8.92,28.13,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,11.47,,,11.47,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,10.32,,,10.32,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.39,,,17.39,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,10.32,30.54,percent of total billed charges,,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.18,,,11.18,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.91,,,13.91,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,11.06,,,11.06,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,11.06,,,11.06,10.32,30.54,other,Could be inpatient or outpatient,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,10.32,30.54,percent of total billed charges,,
HC CULT QUANT BAL,87071,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.76,,,13.76,10.32,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,10.98,,,10.98,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,9.89,,,9.89,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,17.44,,,17.44,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,9.89,30.54,percent of total billed charges,,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,11.21,,,11.21,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,13.95,,,13.95,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,20.78,,,20.78,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,10.6,,,10.6,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,10.6,,,10.6,9.89,30.54,other,Could be inpatient or outpatient,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,9.89,30.54,percent of total billed charges,,
HC ANAEROBIC CULTURE,87075,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,13.79,,,13.79,9.89,30.54,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT  ,,,both,,,45.13,27.08,Aetna,Commerical,,9.37,,,9.37,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Aetna,Middlesex Employees,,8.43,,,8.43,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Anthem,Commerical,,14.89,,,14.89,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Anthem,Indemnity,,,32.82,,32.82,8.43,36.16,percent of total billed charges,,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Anthem,State Preferred,,9.57,,,9.57,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Anthem,Individual Exchange,,11.91,,,11.91,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Cigna,Cigna,,17.79,,,17.79,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Connecticare,Commerical,,9.04,,,9.04,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Connecticare,Exchange,,9.04,,,9.04,8.43,36.16,other,Could be inpatient or outpatient,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,Multiplan,Multiplan,,,36.16,,36.16,8.43,36.16,percent of total billed charges,,
HC BC - ANAEROBE - ADDTL ID EACH ISOLATE,87076,CPT,,,both,,,45.13,27.08,United Healthcare/Oxford,United Healthcare/Oxford,,11.76,,,11.76,8.43,36.16,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT  ,,,both,,,30.14,18.08,Aetna,Commerical,,9.37,,,9.37,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Aetna,Middlesex Employees,,8.43,,,8.43,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Anthem,Commerical,,14.89,,,14.89,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Anthem,Indemnity,,,21.92,,21.92,8.43,24.15,percent of total billed charges,,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Anthem,State Preferred,,9.57,,,9.57,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Anthem,Individual Exchange,,11.91,,,11.91,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Cigna,Cigna,,17.79,,,17.79,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Connecticare,Commerical,,9.04,,,9.04,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Connecticare,Exchange,,9.04,,,9.04,8.43,24.15,other,Could be inpatient or outpatient,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,Multiplan,Multiplan,,,24.15,,24.15,8.43,24.15,percent of total billed charges,,
HC BAC CLT AEROBIC  EA ISOLATE - QUEST,87077,CPT,,,both,,,30.14,18.08,United Healthcare/Oxford,United Healthcare/Oxford,,11.76,,,11.76,8.43,24.15,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT  ,,,both,,,32.11,19.26,Aetna,Commerical,,9.37,,,9.37,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Aetna,Middlesex Employees,,8.43,,,8.43,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Anthem,Commerical,,14.89,,,14.89,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Anthem,Indemnity,,,23.35,,23.35,8.43,25.72,percent of total billed charges,,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Anthem,State Preferred,,9.57,,,9.57,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Anthem,Individual Exchange,,11.91,,,11.91,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Cigna,Cigna,,17.79,,,17.79,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Connecticare,Commerical,,9.04,,,9.04,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Connecticare,Exchange,,9.04,,,9.04,8.43,25.72,other,Could be inpatient or outpatient,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,Multiplan,Multiplan,,,25.72,,25.72,8.43,25.72,percent of total billed charges,,
HC BC - AEROBIC - ADDTL ID  EACH ISOLATE,87077,CPT,,,both,,,32.11,19.26,United Healthcare/Oxford,United Healthcare/Oxford,,11.76,,,11.76,8.43,25.72,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,7.68,,,7.68,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,12.22,,,12.22,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,6.91,87.47,percent of total billed charges,,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,7.86,,,7.86,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,9.78,,,9.78,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,14.83,,,14.83,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,7.42,,,7.42,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,7.42,,,7.42,6.91,87.47,other,Could be inpatient or outpatient,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,6.91,87.47,percent of total billed charges,,
HC BARTONELLA CULTUR SCREEN,87081,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,87.47,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.68,,,7.68,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.22,,,12.22,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.91,21.7,percent of total billed charges,,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.86,,,7.86,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.78,,,9.78,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.91,21.7,percent of total billed charges,,
HC CLO TEST SCREEN,87081,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.68,,,7.68,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.22,,,12.22,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.91,21.7,percent of total billed charges,,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.86,,,7.86,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.78,,,9.78,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.91,21.7,percent of total billed charges,,
HC GENITAL SCREENING,87081,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,21.7,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,7.68,,,7.68,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,12.22,,,12.22,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,6.91,87.47,percent of total billed charges,,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,7.86,,,7.86,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,9.78,,,9.78,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,14.83,,,14.83,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,7.42,,,7.42,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,7.42,,,7.42,6.91,87.47,other,Could be inpatient or outpatient,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,6.91,87.47,percent of total billed charges,,
HC LEGIONELLA CULTRE SCREEN,87081,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,87.47,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.68,,,7.68,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.22,,,12.22,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.91,21.7,percent of total billed charges,,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.86,,,7.86,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.78,,,9.78,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.91,21.7,percent of total billed charges,,
HC PERTUSS CULT&DFA SCREENING ONLY,87081,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT  ,,,both,,,27.08,16.25,Aetna,Commerical,,7.68,,,7.68,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Commerical,,12.22,,,12.22,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Indemnity,,,19.7,,19.7,6.91,21.7,percent of total billed charges,,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,State Preferred,,7.86,,,7.86,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Anthem,Individual Exchange,,9.78,,,9.78,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Cigna,Cigna,,14.83,,,14.83,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Connecticare,Commerical,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Connecticare,Exchange,,7.42,,,7.42,6.91,21.7,other,Could be inpatient or outpatient,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,Multiplan,Multiplan,,,21.7,,21.7,6.91,21.7,percent of total billed charges,,
HC THROAT SCREEN,87081,CPT,,,both,,,27.08,16.25,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,21.7,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,7.68,,,7.68,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,6.91,,,6.91,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,12.22,,,12.22,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,6.91,34.55,percent of total billed charges,,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,7.86,,,7.86,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,9.78,,,9.78,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,14.83,,,14.83,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,7.42,,,7.42,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,7.42,,,7.42,6.91,34.55,other,Could be inpatient or outpatient,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,6.91,34.55,percent of total billed charges,,
HC VRE SCREEN CULT,87081,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,9.65,,,9.65,6.91,34.55,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT  ,,,both,,,32.11,19.26,Aetna,Commerical,,9.36,,,9.36,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Aetna,Middlesex Employees,,8.42,,,8.42,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Anthem,Commerical,,14.88,,,14.88,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Anthem,Indemnity,,,23.35,,23.35,8.42,25.72,percent of total billed charges,,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Anthem,State Preferred,,9.55,,,9.55,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Anthem,Individual Exchange,,11.9,,,11.9,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Cigna,Cigna,,17.79,,,17.79,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Connecticare,Commerical,,9.03,,,9.03,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Connecticare,Exchange,,9.03,,,9.03,8.42,25.72,other,Could be inpatient or outpatient,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,Multiplan,Multiplan,,,25.72,,25.72,8.42,25.72,percent of total billed charges,,
HC BACT CULTURE - URINE; QUAN COUNT,87086,CPT,,,both,,,32.11,19.26,United Healthcare/Oxford,United Healthcare/Oxford,,11.76,,,11.76,8.42,25.72,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT  ,,,both,,,21.85,13.11,Aetna,Commerical,,9.38,,,9.38,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Aetna,Middlesex Employees,,8.44,,,8.44,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Anthem,Commerical,,14.92,,,14.92,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Anthem,Indemnity,,,15.89,,15.89,8.44,17.79,percent of total billed charges,,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Anthem,State Preferred,,9.58,,,9.58,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Anthem,Individual Exchange,,11.94,,,11.94,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Cigna,Cigna,,17.79,,,17.79,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Connecticare,Commerical,,9.05,,,9.05,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Connecticare,Exchange,,9.05,,,9.05,8.44,17.79,other,Could be inpatient or outpatient,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,Multiplan,Multiplan,,,17.5,,17.5,8.44,17.79,percent of total billed charges,,
HC URINE BACTERIA CULTURE,87088,CPT,,,both,,,21.85,13.11,United Healthcare/Oxford,United Healthcare/Oxford,,11.79,,,11.79,8.44,17.79,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT  ,,,both,,,31.09,18.65,Aetna,Commerical,,17.08,,,17.08,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Aetna,Middlesex Employees,,15.38,,,15.38,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Anthem,Commerical,,20.29,,,20.29,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Anthem,Indemnity,,,22.61,,22.61,9.13,24.91,percent of total billed charges,,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Anthem,State Preferred,,9.13,,,9.13,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Anthem,Individual Exchange,,16.23,,,16.23,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Cigna,Cigna,,23.32,,,23.32,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Connecticare,Commerical,,21.71,,,21.71,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Connecticare,Exchange,,21.71,,,21.71,9.13,24.91,other,Could be inpatient or outpatient,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,Multiplan,Multiplan,,,24.91,,24.91,9.13,24.91,percent of total billed charges,,
HC CULT FUNGUS W P ID; SKIN HR NL,87101,CPT,,,both,,,31.09,18.65,United Healthcare/Oxford,United Healthcare/Oxford,,18.94,,,18.94,9.13,24.91,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,9.75,,,9.75,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,8.78,,,8.78,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,15.48,,,15.48,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,8.78,27.33,percent of total billed charges,,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,9.96,,,9.96,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,12.39,,,12.39,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,18.41,,,18.41,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,9.41,,,9.41,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,9.41,,,9.41,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,8.78,27.33,percent of total billed charges,,
HC FUNGUS CULTURE NOT BLOOD,87102,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,12.25,,,12.25,8.78,27.33,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,23.72,,,23.72,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,21.35,,,21.35,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,16.62,,,16.62,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,10.68,53.2,percent of total billed charges,,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,10.68,,,10.68,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,13.3,,,13.3,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,20.19,,,20.19,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,22.89,,,22.89,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,22.89,,,22.89,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,10.68,53.2,percent of total billed charges,,
HC FUNGUS BLOOD CLTR,87103,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,26.83,,,26.83,10.68,53.2,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.97,,,11.97,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.77,,,10.77,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,19.02,,,19.02,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.77,32.94,percent of total billed charges,,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.22,,,12.22,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,15.21,,,15.21,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,23.14,,,23.14,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.55,,,11.55,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.55,,,11.55,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.77,32.94,percent of total billed charges,,
HC FUNGUS CULTURE DEF I.D YEAST,87106,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,15.04,,,15.04,10.77,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,22.59,,,22.59,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,20.33,,,20.33,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,26.83,,,26.83,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,12.22,32.94,percent of total billed charges,,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.22,,,12.22,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,21.47,,,21.47,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,30.84,,,30.84,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,28.71,,,28.71,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,28.71,,,28.71,12.22,32.94,other,Could be inpatient or outpatient,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,12.22,32.94,percent of total billed charges,,
HC FUNGUS CULTURE DEF ID MOLD,87107,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,25.05,,,25.05,12.22,32.94,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,87.83,,,87.83,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,79.05,,,79.05,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,104.28,,,104.28,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,18.23,128.05,percent of total billed charges,,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,18.23,,,18.23,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,83.42,,,83.42,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,119.88,,,119.88,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,111.61,,,111.61,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,111.61,,,111.61,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,18.23,128.05,percent of total billed charges,,
HC MYCOPLAS CLT-RESP,87109,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,97.37,,,97.37,18.23,128.05,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,60,,,60,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,54,,,54,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,71.23,,,71.23,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,18.23,87.47,percent of total billed charges,,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,18.23,,,18.23,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,56.99,,,56.99,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,81.89,,,81.89,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,76.24,,,76.24,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,76.24,,,76.24,18.23,87.47,other,Could be inpatient or outpatient,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,18.23,87.47,percent of total billed charges,,
HC MYCOPLASMA-GENITL,87109,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,66.51,,,66.51,18.23,87.47,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT  ,,,both,,,78.28,46.97,Aetna,Commerical,,43.29,,,43.29,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Aetna,Middlesex Employees,,38.97,,,38.97,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Anthem,Commerical,,51.41,,,51.41,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Anthem,Indemnity,,,57.3,,57.3,23.19,63.12,percent of total billed charges,,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Anthem,State Preferred,,23.19,,,23.19,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Anthem,Individual Exchange,,41.13,,,41.13,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Cigna,Cigna,,59.09,,,59.09,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Connecticare,Commerical,,55.02,,,55.02,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Connecticare,Exchange,,55.02,,,55.02,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,Multiplan,Multiplan,,,63.12,,63.12,23.19,63.12,percent of total billed charges,,
HC CHLAMYDIA CULTURE,87110,CPT,,,both,,,78.28,46.97,United Healthcare/Oxford,United Healthcare/Oxford,,48,,,48,23.19,63.12,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,40.82,,,40.82,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,36.74,,,36.74,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,48.47,,,48.47,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.03,,54.03,23.19,59.52,percent of total billed charges,,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,23.19,,,23.19,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,38.77,,,38.77,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,55.72,,,55.72,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,51.87,,,51.87,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,51.87,,,51.87,23.19,59.52,other,Could be inpatient or outpatient,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.52,,59.52,23.19,59.52,percent of total billed charges,,
HC CHLAMYDIA SPECIES CULTURE - QUEST,87110,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,45.26,,,45.26,23.19,59.52,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT  ,,,both,,,43.13,25.88,Aetna,Commerical,,12.53,,,12.53,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Aetna,Middlesex Employees,,11.28,,,11.28,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Anthem,Commerical,,19.91,,,19.91,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Anthem,Indemnity,,,31.36,,31.36,11.28,34.55,percent of total billed charges,,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Anthem,State Preferred,,12.8,,,12.8,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Anthem,Individual Exchange,,15.93,,,15.93,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Cigna,Cigna,,23.74,,,23.74,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Connecticare,Commerical,,12.09,,,12.09,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Connecticare,Exchange,,12.09,,,12.09,11.28,34.55,other,Could be inpatient or outpatient,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,Multiplan,Multiplan,,,34.55,,34.55,11.28,34.55,percent of total billed charges,,
HC TB CULTURE,87116,CPT,,,both,,,43.13,25.88,United Healthcare/Oxford,United Healthcare/Oxford,,15.74,,,15.74,11.28,34.55,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT  ,,,both,,,50.92,30.55,Aetna,Commerical,,37.59,,,37.59,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Aetna,Middlesex Employees,,17.4,,,17.4,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Anthem,Commerical,,18.88,,,18.88,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Anthem,Indemnity,,,37.04,,37.04,13.61,45.58,percent of total billed charges,,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Anthem,State Preferred,,13.61,,,13.61,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Anthem,Individual Exchange,,15.1,,,15.1,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Cigna,Cigna,,45.58,,,45.58,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Connecticare,Commerical,,17.3,,,17.3,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Connecticare,Exchange,,17.3,,,17.3,13.61,45.58,other,Could be inpatient or outpatient,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,Multiplan,Multiplan,,,40.8,,40.8,13.61,45.58,percent of total billed charges,,
HC DEFINITIVE MYCOBACTERIC IDENTIFICATION,87118,CPT,,,both,,,50.92,30.55,United Healthcare/Oxford,United Healthcare/Oxford,,18.06,,,18.06,13.61,45.58,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT  ,,,both,,,20.87,12.52,Aetna,Commerical,,11.47,,,11.47,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Aetna,Middlesex Employees,,10.32,,,10.32,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Anthem,Commerical,,13.61,,,13.61,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Anthem,Indemnity,,,15.18,,15.18,6.59,16.72,percent of total billed charges,,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Anthem,State Preferred,,6.59,,,6.59,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Anthem,Individual Exchange,,10.89,,,10.89,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Cigna,Cigna,,15.65,,,15.65,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Connecticare,Commerical,,14.57,,,14.57,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Connecticare,Exchange,,14.57,,,14.57,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,Multiplan,Multiplan,,,16.72,,16.72,6.59,16.72,percent of total billed charges,,
HC CULTURE TYPE;  IF EA ANTISERUM - QUEST,87140,CPT,,,both,,,20.87,12.52,United Healthcare/Oxford,United Healthcare/Oxford,,12.71,,,12.71,6.59,16.72,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT  ,,,both,,,47.53,28.52,Aetna,Commerical,,26.12,,,26.12,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Aetna,Middlesex Employees,,23.51,,,23.51,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Anthem,Commerical,,31.01,,,31.01,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Anthem,Indemnity,,,34.57,,34.57,14.83,38.08,percent of total billed charges,,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Anthem,State Preferred,,14.83,,,14.83,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Anthem,Individual Exchange,,24.81,,,24.81,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Cigna,Cigna,,35.65,,,35.65,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Connecticare,Commerical,,33.19,,,33.19,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Connecticare,Exchange,,33.19,,,33.19,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,Multiplan,Multiplan,,,38.08,,38.08,14.83,38.08,percent of total billed charges,,
HC CULTURE TYPE; GLC/HPLC - QUEST,87143,CPT,,,both,,,47.53,28.52,United Healthcare/Oxford,United Healthcare/Oxford,,28.95,,,28.95,14.83,38.08,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT  ,,,both,,,14.02,8.41,Aetna,Commerical,,7.7,,,7.7,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Aetna,Middlesex Employees,,6.93,,,6.93,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Anthem,Commerical,,9.15,,,9.15,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Anthem,Indemnity,,,10.2,,10.2,6.13,11.24,percent of total billed charges,,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Anthem,State Preferred,,6.13,,,6.13,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Anthem,Individual Exchange,,7.32,,,7.32,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Cigna,Cigna,,10.51,,,10.51,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Connecticare,Commerical,,9.79,,,9.79,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Connecticare,Exchange,,9.79,,,9.79,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,Multiplan,Multiplan,,,11.24,,11.24,6.13,11.24,percent of total billed charges,,
HC CULTURE TYPE IMMUNOLOGIC,87147,CPT,,,both,,,14.02,8.41,United Healthcare/Oxford,United Healthcare/Oxford,,8.54,,,8.54,6.13,11.24,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT  ,,,both,,,19.71,11.83,Aetna,Commerical,,10.83,,,10.83,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Aetna,Middlesex Employees,,9.74,,,9.74,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Anthem,Commerical,,12.85,,,12.85,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Anthem,Indemnity,,,14.34,,14.34,6.13,15.79,percent of total billed charges,,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Anthem,State Preferred,,6.13,,,6.13,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Anthem,Individual Exchange,,10.29,,,10.29,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Cigna,Cigna,,14.78,,,14.78,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Connecticare,Commerical,,13.76,,,13.76,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Connecticare,Exchange,,13.76,,,13.76,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,Multiplan,Multiplan,,,15.79,,15.79,6.13,15.79,percent of total billed charges,,
HC CULTURE TYPE IMMUNOLOGIC - QUEST,87147,CPT,,,both,,,19.71,11.83,United Healthcare/Oxford,United Healthcare/Oxford,,12.01,,,12.01,6.13,15.79,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT  ,,,both,,,75.19,45.11,Aetna,Commerical,,41.44,,,41.44,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Aetna,Middlesex Employees,,37.3,,,37.3,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Anthem,Commerical,,49.2,,,49.2,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Anthem,Indemnity,,,54.84,,54.84,23.75,60.42,percent of total billed charges,,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Anthem,State Preferred,,23.75,,,23.75,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Anthem,Individual Exchange,,39.36,,,39.36,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Cigna,Cigna,,56.57,,,56.57,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Connecticare,Commerical,,52.66,,,52.66,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Connecticare,Exchange,,52.66,,,52.66,23.75,60.42,other,Could be inpatient or outpatient,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,Multiplan,Multiplan,,,60.42,,60.42,23.75,60.42,percent of total billed charges,,
HC CULTURE TYPE; DNA/RNA DIRECT PROBE - QUEST,87149,CPT,,,both,,,75.19,45.11,United Healthcare/Oxford,United Healthcare/Oxford,,45.94,,,45.94,23.75,60.42,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT  ,,,both,,,128.37,77.02,Aetna,Commerical,,85.79,,,85.79,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Aetna,Middlesex Employees,,77.21,,,77.21,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Anthem,Commerical,,71.2,,,71.2,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Anthem,Indemnity,,,93.36,,93.36,42.59,102.85,percent of total billed charges,,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Anthem,State Preferred,,42.59,,,42.59,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Anthem,Individual Exchange,,56.96,,,56.96,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Cigna,Cigna,,75.57,,,75.57,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Connecticare,Commerical,,77.51,,,77.51,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Connecticare,Exchange,,77.51,,,77.51,42.59,102.85,other,Could be inpatient or outpatient,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,Multiplan,Multiplan,,,102.85,,102.85,42.59,102.85,percent of total billed charges,,
HC BLOOD CULT INDENTIFICATION PANEL  EA ORGANISM,87150,CPT,,,both,,,128.37,77.02,United Healthcare/Oxford,United Healthcare/Oxford,,79.46,,,79.46,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT  ,,,both,,,128.37,77.02,Aetna,Commerical,,85.79,,,85.79,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Aetna,Middlesex Employees,,77.21,,,77.21,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Anthem,Commerical,,71.2,,,71.2,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Anthem,Indemnity,,,93.36,,93.36,42.59,102.85,percent of total billed charges,,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Anthem,State Preferred,,42.59,,,42.59,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Anthem,Individual Exchange,,56.96,,,56.96,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Cigna,Cigna,,75.57,,,75.57,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Connecticare,Commerical,,77.51,,,77.51,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Connecticare,Exchange,,77.51,,,77.51,42.59,102.85,other,Could be inpatient or outpatient,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,Multiplan,Multiplan,,,102.85,,102.85,42.59,102.85,percent of total billed charges,,
HC CARBAR PCR CULTURE TYPING EA ORGAN,87150,CPT,,,both,,,128.37,77.02,United Healthcare/Oxford,United Healthcare/Oxford,,79.46,,,79.46,42.59,102.85,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT  ,,,both,,,353.29,211.97,Aetna,Commerical,,194.21,,,194.21,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Aetna,Middlesex Employees,,174.79,,,174.79,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Anthem,Commerical,,230.59,,,230.59,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Anthem,Indemnity,,,257.03,,257.03,140,283.15,percent of total billed charges,,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Anthem,State Preferred,,140,,,140,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Anthem,Individual Exchange,,184.47,,,184.47,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Cigna,Cigna,,265.1,,,265.1,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Connecticare,Commerical,,246.8,,,246.8,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Connecticare,Exchange,,246.8,,,246.8,140,283.15,other,Could be inpatient or outpatient,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,Multiplan,Multiplan,,,283.15,,283.15,140,283.15,percent of total billed charges,,
HC DNA/RNA SEQUENCING,87153,CPT,,,both,,,353.29,211.97,United Healthcare/Oxford,United Healthcare/Oxford,,215.3,,,215.3,140,283.15,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT  ,,,both,,,774.56,464.74,Aetna,Commerical,,517.56,,,517.56,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Aetna,Middlesex Employees,,465.8,,,465.8,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Anthem,Commerical,,429.54,,,429.54,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Anthem,Indemnity,,,563.25,,563.25,343.63,620.5,percent of total billed charges,,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Anthem,State Preferred,,429.54,,,429.54,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Anthem,Individual Exchange,,343.63,,,343.63,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Cigna,Cigna,,455.9,,,455.9,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Connecticare,Commerical,,467.65,,,467.65,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Connecticare,Exchange,,467.65,,,467.65,343.63,620.5,other,Could be inpatient or outpatient,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,Multiplan,Multiplan,,,620.5,,620.5,343.63,620.5,percent of total billed charges,,
HC CULTURE TYPING ID BLD PTHGN&RESIST TYPING 6+TRGT,87154,CPT,,,both,,,774.56,464.74,United Healthcare/Oxford,United Healthcare/Oxford,,479.41,,,479.41,343.63,620.5,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT  ,,,both,,,22.43,13.46,Aetna,Commerical,,12.32,,,12.32,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Aetna,Middlesex Employees,,11.09,,,11.09,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Anthem,Commerical,,14.63,,,14.63,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Anthem,Indemnity,,,16.31,,16.31,5.05,17.97,percent of total billed charges,,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Anthem,State Preferred,,5.05,,,5.05,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Anthem,Individual Exchange,,11.71,,,11.71,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Cigna,Cigna,,16.83,,,16.83,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Connecticare,Commerical,,15.67,,,15.67,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Connecticare,Exchange,,15.67,,,15.67,5.05,17.97,other,Could be inpatient or outpatient,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,Multiplan,Multiplan,,,17.97,,17.97,5.05,17.97,percent of total billed charges,,
HC ARTHROPOD ID,87168,CPT,,,both,,,22.43,13.46,United Healthcare/Oxford,United Healthcare/Oxford,,13.67,,,13.67,5.05,17.97,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT  ,,,both,,,17.18,10.31,Aetna,Commerical,,9.44,,,9.44,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Aetna,Middlesex Employees,,8.5,,,8.5,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Anthem,Commerical,,11.21,,,11.21,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Anthem,Indemnity,,,12.49,,12.49,5.05,13.76,percent of total billed charges,,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Anthem,State Preferred,,5.05,,,5.05,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Anthem,Individual Exchange,,8.96,,,8.96,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Cigna,Cigna,,12.89,,,12.89,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Connecticare,Commerical,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Connecticare,Exchange,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,Multiplan,Multiplan,,,13.76,,13.76,5.05,13.76,percent of total billed charges,,
HC PARASITE IDENT,87169,CPT,,,both,,,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,10.46,,,10.46,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT  ,,,both,,,17.18,10.31,Aetna,Commerical,,9.44,,,9.44,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Aetna,Middlesex Employees,,8.5,,,8.5,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Anthem,Commerical,,11.21,,,11.21,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Anthem,Indemnity,,,12.49,,12.49,5.05,13.76,percent of total billed charges,,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Anthem,State Preferred,,5.05,,,5.05,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Anthem,Individual Exchange,,8.96,,,8.96,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Cigna,Cigna,,12.89,,,12.89,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Connecticare,Commerical,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Connecticare,Exchange,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,Multiplan,Multiplan,,,13.76,,13.76,5.05,13.76,percent of total billed charges,,
HC PINWORM,87172,CPT,,,both,,,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,10.46,,,10.46,5.05,13.76,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT  ,,,both,,,21.38,12.83,Aetna,Commerical,,14.29,,,14.29,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Aetna,Middlesex Employees,,12.86,,,12.86,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Anthem,Commerical,,11.86,,,11.86,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Anthem,Indemnity,,,15.55,,15.55,6.98,17.14,percent of total billed charges,,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Anthem,State Preferred,,6.98,,,6.98,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Anthem,Individual Exchange,,9.49,,,9.49,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Cigna,Cigna,,12.59,,,12.59,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Connecticare,Commerical,,12.91,,,12.91,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Connecticare,Exchange,,12.91,,,12.91,6.98,17.14,other,Could be inpatient or outpatient,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,Multiplan,Multiplan,,,17.14,,17.14,6.98,17.14,percent of total billed charges,,
HC HOMOGENIZATION TISSUE CULTURE,87176,CPT,,,both,,,21.38,12.83,United Healthcare/Oxford,United Healthcare/Oxford,,13.24,,,13.24,6.98,17.14,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT  ,,,both,,,36.1,21.66,Aetna,Commerical,,10.32,,,10.32,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Aetna,Middlesex Employees,,9.29,,,9.29,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Anthem,Commerical,,16.39,,,16.39,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Anthem,Indemnity,,,26.26,,26.26,9.29,28.93,percent of total billed charges,,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Anthem,State Preferred,,10.53,,,10.53,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Anthem,Individual Exchange,,13.11,,,13.11,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Cigna,Cigna,,19.58,,,19.58,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Connecticare,Commerical,,9.96,,,9.96,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Connecticare,Exchange,,9.96,,,9.96,9.29,28.93,other,Could be inpatient or outpatient,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,Multiplan,Multiplan,,,28.93,,28.93,9.29,28.93,percent of total billed charges,,
HC OVA AND PARASITES,87177,CPT,,,both,,,36.1,21.66,United Healthcare/Oxford,United Healthcare/Oxford,,12.97,,,12.97,9.29,28.93,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT  ,,,both,,,19.1,11.46,Aetna,Commerical,,5.51,,,5.51,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Aetna,Middlesex Employees,,4.96,,,4.96,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Anthem,Commerical,,1.68,,,1.68,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Anthem,Indemnity,,,13.89,,13.89,1.08,15.3,percent of total billed charges,,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Anthem,State Preferred,,1.08,,,1.08,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Anthem,Individual Exchange,,1.35,,,1.35,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Cigna,Cigna,,10.68,,,10.68,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Connecticare,Commerical,,5.32,,,5.32,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Connecticare,Exchange,,5.32,,,5.32,1.08,15.3,other,Could be inpatient or outpatient,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,Multiplan,Multiplan,,,15.3,,15.3,1.08,15.3,percent of total billed charges,,
HC ETEST SUSCEPT,87181,CPT,,,both,,,19.1,11.46,United Healthcare/Oxford,United Healthcare/Oxford,,6.9,,,6.9,1.08,15.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT  ,,,both,,,17.39,10.43,Aetna,Commerical,,5.51,,,5.51,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Aetna,Middlesex Employees,,4.96,,,4.96,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Anthem,Commerical,,1.68,,,1.68,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Anthem,Indemnity,,,12.65,,12.65,1.08,13.93,percent of total billed charges,,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Anthem,State Preferred,,1.08,,,1.08,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Anthem,Individual Exchange,,1.35,,,1.35,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Cigna,Cigna,,10.68,,,10.68,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Connecticare,Commerical,,5.32,,,5.32,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Connecticare,Exchange,,5.32,,,5.32,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,Multiplan,Multiplan,,,13.93,,13.93,1.08,13.93,percent of total billed charges,,
HC SENSITIVITY - AGAR DILUTION/AGENT - QUEST,87181,CPT,,,both,,,17.39,10.43,United Healthcare/Oxford,United Healthcare/Oxford,,6.9,,,6.9,1.08,13.93,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT  ,,,both,,,28.09,16.85,Aetna,Commerical,,8.67,,,8.67,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Aetna,Middlesex Employees,,7.81,,,7.81,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Anthem,Commerical,,12.72,,,12.72,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Anthem,Indemnity,,,20.43,,20.43,7.81,22.51,percent of total billed charges,,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Anthem,State Preferred,,8.16,,,8.16,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Anthem,Individual Exchange,,10.17,,,10.17,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Cigna,Cigna,,15.43,,,15.43,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Connecticare,Commerical,,8.37,,,8.37,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Connecticare,Exchange,,8.37,,,8.37,7.81,22.51,other,Could be inpatient or outpatient,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,Multiplan,Multiplan,,,22.51,,22.51,7.81,22.51,percent of total billed charges,,
HC DISK SUSCEPT,87184,CPT,,,both,,,28.09,16.85,United Healthcare/Oxford,United Healthcare/Oxford,,10.04,,,10.04,7.81,22.51,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT  ,,,both,,,27.82,16.69,Aetna,Commerical,,8.67,,,8.67,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Aetna,Middlesex Employees,,7.81,,,7.81,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Anthem,Commerical,,12.72,,,12.72,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Anthem,Indemnity,,,20.24,,20.24,7.81,22.3,percent of total billed charges,,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Anthem,State Preferred,,8.16,,,8.16,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Anthem,Individual Exchange,,10.17,,,10.17,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Cigna,Cigna,,15.43,,,15.43,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Connecticare,Commerical,,8.37,,,8.37,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Connecticare,Exchange,,8.37,,,8.37,7.81,22.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,Multiplan,Multiplan,,,22.3,,22.3,7.81,22.3,percent of total billed charges,,
HC SENSITIVITY - DISK PER PLATE - QUEST,87184,CPT,,,both,,,27.82,16.69,United Healthcare/Oxford,United Healthcare/Oxford,,10.04,,,10.04,7.81,22.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT  ,,,both,,,19.1,11.46,Aetna,Commerical,,10.5,,,10.5,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Aetna,Middlesex Employees,,9.45,,,9.45,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Anthem,Commerical,,12.46,,,12.46,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Anthem,Indemnity,,,13.89,,13.89,1.08,15.3,percent of total billed charges,,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Anthem,State Preferred,,1.08,,,1.08,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Anthem,Individual Exchange,,9.97,,,9.97,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Cigna,Cigna,,14.33,,,14.33,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Connecticare,Commerical,,13.33,,,13.33,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Connecticare,Exchange,,13.33,,,13.33,1.08,15.3,other,Could be inpatient or outpatient,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,Multiplan,Multiplan,,,15.3,,15.3,1.08,15.3,percent of total billed charges,,
HC BETA LACTAMASE,87185,CPT,,,both,,,19.1,11.46,United Healthcare/Oxford,United Healthcare/Oxford,,11.64,,,11.64,1.08,15.3,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT  ,,,both,,,17.39,10.43,Aetna,Commerical,,9.55,,,9.55,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Aetna,Middlesex Employees,,8.6,,,8.6,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Anthem,Commerical,,11.34,,,11.34,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Anthem,Indemnity,,,12.65,,12.65,1.08,13.93,percent of total billed charges,,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Anthem,State Preferred,,1.08,,,1.08,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Anthem,Individual Exchange,,9.08,,,9.08,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Cigna,Cigna,,13.04,,,13.04,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Connecticare,Commerical,,12.15,,,12.15,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Connecticare,Exchange,,12.15,,,12.15,1.08,13.93,other,Could be inpatient or outpatient,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,Multiplan,Multiplan,,,13.93,,13.93,1.08,13.93,percent of total billed charges,,
HC SENSITIVITY - ENZYME DETECT - QUEST,87185,CPT,,,both,,,17.39,10.43,United Healthcare/Oxford,United Healthcare/Oxford,,10.59,,,10.59,1.08,13.93,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,10.03,,,10.03,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,9.02,,,9.02,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,15.93,,,15.93,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,9.02,28.13,percent of total billed charges,,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,10.24,,,10.24,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,12.74,,,12.74,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,19,,,19,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,9.68,,,9.68,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,9.68,,,9.68,9.02,28.13,other,Could be inpatient or outpatient,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,9.02,28.13,percent of total billed charges,,
HC ANTIMICROBIAL MIC,87186,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,12.6,,,12.6,9.02,28.13,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT  ,,,both,,,32.47,19.48,Aetna,Commerical,,10.03,,,10.03,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Aetna,Middlesex Employees,,9.02,,,9.02,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Anthem,Commerical,,15.93,,,15.93,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Anthem,Indemnity,,,23.61,,23.61,9.02,26.01,percent of total billed charges,,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Anthem,State Preferred,,10.24,,,10.24,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Anthem,Individual Exchange,,12.74,,,12.74,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Cigna,Cigna,,19,,,19,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Connecticare,Commerical,,9.68,,,9.68,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Connecticare,Exchange,,9.68,,,9.68,9.02,26.01,other,Could be inpatient or outpatient,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,Multiplan,Multiplan,,,26.01,,26.01,9.02,26.01,percent of total billed charges,,
HC MICROBE SUSCEPTIBLE MIC - QUEST,87186,CPT,,,both,,,32.47,19.48,United Healthcare/Oxford,United Healthcare/Oxford,,12.6,,,12.6,9.02,26.01,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT  ,,,both,,,17.18,10.31,Aetna,Commerical,,4.95,,,4.95,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Aetna,Middlesex Employees,,4.46,,,4.46,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Anthem,Commerical,,7.87,,,7.87,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Anthem,Indemnity,,,12.49,,12.49,4.46,13.76,percent of total billed charges,,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Anthem,State Preferred,,5.05,,,5.05,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Anthem,Individual Exchange,,6.29,,,6.29,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Cigna,Cigna,,9.51,,,9.51,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Connecticare,Commerical,,4.78,,,4.78,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Connecticare,Exchange,,4.78,,,4.78,4.46,13.76,other,Could be inpatient or outpatient,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,Multiplan,Multiplan,,,13.76,,13.76,4.46,13.76,percent of total billed charges,,
HC GRAM STAIN,87205,CPT,,,both,,,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,6.23,,,6.23,4.46,13.76,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT  ,,,both,,,21.68,13.01,Aetna,Commerical,,6.25,,,6.25,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Aetna,Middlesex Employees,,5.62,,,5.62,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Anthem,Commerical,,9.9,,,9.9,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Anthem,Indemnity,,,15.76,,15.76,5.62,17.37,percent of total billed charges,,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Anthem,State Preferred,,6.37,,,6.37,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Anthem,Individual Exchange,,7.93,,,7.93,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Cigna,Cigna,,11.86,,,11.86,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Connecticare,Commerical,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Connecticare,Exchange,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,Multiplan,Multiplan,,,17.37,,17.37,5.62,17.37,percent of total billed charges,,
HC CRYPTOSPORIDIUM,87206,CPT,,,both,,,21.68,13.01,United Healthcare/Oxford,United Healthcare/Oxford,,7.86,,,7.86,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT  ,,,both,,,21.68,13.01,Aetna,Commerical,,6.25,,,6.25,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Aetna,Middlesex Employees,,5.62,,,5.62,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Commerical,,9.9,,,9.9,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Indemnity,,,15.76,,15.76,5.62,17.37,percent of total billed charges,,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,State Preferred,,6.37,,,6.37,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Individual Exchange,,7.93,,,7.93,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Cigna,Cigna,,11.86,,,11.86,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Connecticare,Commerical,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Connecticare,Exchange,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,Multiplan,Multiplan,,,17.37,,17.37,5.62,17.37,percent of total billed charges,,
HC FUNGAL SMEAR,87206,CPT,,,both,,,21.68,13.01,United Healthcare/Oxford,United Healthcare/Oxford,,7.86,,,7.86,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT  ,,,both,,,21.68,13.01,Aetna,Commerical,,6.25,,,6.25,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Aetna,Middlesex Employees,,5.62,,,5.62,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Commerical,,9.9,,,9.9,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Indemnity,,,15.76,,15.76,5.62,17.37,percent of total billed charges,,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,State Preferred,,6.37,,,6.37,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Anthem,Individual Exchange,,7.93,,,7.93,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Cigna,Cigna,,11.86,,,11.86,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Connecticare,Commerical,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Connecticare,Exchange,,6.03,,,6.03,5.62,17.37,other,Could be inpatient or outpatient,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,Multiplan,Multiplan,,,17.37,,17.37,5.62,17.37,percent of total billed charges,,
HC TB SMEAR,87206,CPT,,,both,,,21.68,13.01,United Healthcare/Oxford,United Healthcare/Oxford,,7.86,,,7.86,5.62,17.37,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,6.94,,,6.94,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,6.25,,,6.25,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,7.58,,,7.58,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,4.85,51.4,percent of total billed charges,,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,4.85,,,4.85,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,6.07,,,6.07,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,13.05,,,13.05,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,6.7,,,6.7,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,6.7,,,6.7,4.85,51.4,other,Could be inpatient or outpatient,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,4.85,51.4,percent of total billed charges,,
HC BLOOD PARASITES,87207,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,8.73,,,8.73,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,6.94,,,6.94,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,6.25,,,6.25,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,7.58,,,7.58,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,4.85,51.4,percent of total billed charges,,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,4.85,,,4.85,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,6.07,,,6.07,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,13.05,,,13.05,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,6.7,,,6.7,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,6.7,,,6.7,4.85,51.4,other,Could be inpatient or outpatient,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,4.85,51.4,percent of total billed charges,,
HC EHRLICHIA BLD SMR,87207,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,8.73,,,8.73,4.85,51.4,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT  ,,,both,,,24.35,14.61,Aetna,Commerical,,6.94,,,6.94,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Aetna,Middlesex Employees,,6.25,,,6.25,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Anthem,Commerical,,7.58,,,7.58,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Anthem,Indemnity,,,17.71,,17.71,4.85,19.51,percent of total billed charges,,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Anthem,State Preferred,,4.85,,,4.85,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Anthem,Individual Exchange,,6.07,,,6.07,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Cigna,Cigna,,13.05,,,13.05,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Connecticare,Commerical,,6.7,,,6.7,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Connecticare,Exchange,,6.7,,,6.7,4.85,19.51,other,Could be inpatient or outpatient,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,Multiplan,Multiplan,,,19.51,,19.51,4.85,19.51,percent of total billed charges,,
HC SMEAR SP STAIN,87207,CPT,,,both,,,24.35,14.61,United Healthcare/Oxford,United Healthcare/Oxford,,8.73,,,8.73,4.85,19.51,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,20.85,,,20.85,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,18.77,,,18.77,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,22.68,,,22.68,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,14.56,65.74,percent of total billed charges,,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,14.56,,,14.56,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,18.14,,,18.14,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,65.74,,,65.74,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,20.12,,,20.12,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,20.12,,,20.12,14.56,65.74,other,Could be inpatient or outpatient,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,14.56,65.74,percent of total billed charges,,
HC TRICHRONE STAIN,87209,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,26.18,,,26.18,14.56,65.74,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT  ,,,both,,,18.98,11.39,Aetna,Commerical,,6.75,,,6.75,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Aetna,Middlesex Employees,,6.08,,,6.08,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Anthem,Commerical,,7.87,,,7.87,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Anthem,Indemnity,,,13.8,,13.8,5.05,15.21,percent of total billed charges,,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Anthem,State Preferred,,5.05,,,5.05,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Anthem,Individual Exchange,,6.29,,,6.29,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Cigna,Cigna,,9.51,,,9.51,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Connecticare,Commerical,,6.51,,,6.51,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Connecticare,Exchange,,6.51,,,6.51,5.05,15.21,other,Could be inpatient or outpatient,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,Multiplan,Multiplan,,,15.21,,15.21,5.05,15.21,percent of total billed charges,,
HC DIRECT WET PREP,87210,CPT,,,both,,,18.98,11.39,United Healthcare/Oxford,United Healthcare/Oxford,,7.63,,,7.63,5.05,15.21,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT  ,,,both,,,35.1,21.06,Aetna,Commerical,,6.75,,,6.75,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Aetna,Middlesex Employees,,6.08,,,6.08,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Anthem,Commerical,,7.87,,,7.87,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Anthem,Indemnity,,,25.53,,25.53,5.05,28.13,percent of total billed charges,,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Anthem,State Preferred,,5.05,,,5.05,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Anthem,Individual Exchange,,6.29,,,6.29,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Cigna,Cigna,,9.51,,,9.51,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Connecticare,Commerical,,6.51,,,6.51,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Connecticare,Exchange,,6.51,,,6.51,5.05,28.13,other,Could be inpatient or outpatient,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,Multiplan,Multiplan,,,28.13,,28.13,5.05,28.13,percent of total billed charges,,
HC INDIA INK,87210,CPT,,,both,,,35.1,21.06,United Healthcare/Oxford,United Healthcare/Oxford,,7.63,,,7.63,5.05,28.13,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT  ,,,both,,,104.03,62.42,Aetna,Commerical,,56.9,,,56.9,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Aetna,Middlesex Employees,,51.21,,,51.21,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Anthem,Commerical,,67.56,,,67.56,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Anthem,Indemnity,,,75.31,,75.31,23.38,82.96,percent of total billed charges,,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Anthem,State Preferred,,23.38,,,23.38,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Anthem,Individual Exchange,,54.05,,,54.05,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Cigna,Cigna,,77.67,,,77.67,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Connecticare,Commerical,,72.31,,,72.31,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Connecticare,Exchange,,72.31,,,72.31,23.38,82.96,other,Could be inpatient or outpatient,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,Multiplan,Multiplan,,,82.96,,82.96,23.38,82.96,percent of total billed charges,,
HC C DIFFICILE TOXIN,87230,CPT,,,both,,,104.03,62.42,United Healthcare/Oxford,United Healthcare/Oxford,,63.08,,,63.08,23.38,82.96,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT  ,,,both,,,106.09,63.65,Aetna,Commerical,,30.23,,,30.23,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Aetna,Middlesex Employees,,27.2,,,27.2,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Anthem,Commerical,,48.04,,,48.04,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Anthem,Indemnity,,,76.94,,76.94,27.2,84.76,percent of total billed charges,,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Anthem,State Preferred,,30.86,,,30.86,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Anthem,Individual Exchange,,38.44,,,38.44,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Cigna,Cigna,,58.15,,,58.15,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Connecticare,Commerical,,29.17,,,29.17,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Connecticare,Exchange,,29.17,,,29.17,27.2,84.76,other,Could be inpatient or outpatient,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,Multiplan,Multiplan,,,84.76,,84.76,27.2,84.76,percent of total billed charges,,
HC CMV TUBE CULTURE,87252,CPT,,,both,,,106.09,63.65,United Healthcare/Oxford,United Healthcare/Oxford,,37.99,,,37.99,27.2,84.76,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT  ,,,both,,,79.91,47.94,Aetna,Commerical,,22.68,,,22.68,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Anthem,Commerical,,36.04,,,36.04,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Anthem,Indemnity,,,58.11,,58.11,20.41,64.02,percent of total billed charges,,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Anthem,State Preferred,,23.15,,,23.15,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Anthem,Individual Exchange,,28.84,,,28.84,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Cigna,Cigna,,43.33,,,43.33,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Connecticare,Commerical,,21.89,,,21.89,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Connecticare,Exchange,,21.89,,,21.89,20.41,64.02,other,Could be inpatient or outpatient,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,Multiplan,Multiplan,,,64.02,,64.02,20.41,64.02,percent of total billed charges,,
HC CULTURE VIRAL ENTEROVIRUS,87254,CPT,,,both,,,79.91,47.94,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,64.02,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT  ,,,both,,,106.92,64.15,Aetna,Commerical,,22.68,,,22.68,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Anthem,Commerical,,36.04,,,36.04,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Anthem,Indemnity,,,77.77,,77.77,20.41,85.67,percent of total billed charges,,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Anthem,State Preferred,,23.15,,,23.15,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Anthem,Individual Exchange,,28.84,,,28.84,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Cigna,Cigna,,43.33,,,43.33,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Connecticare,Commerical,,21.89,,,21.89,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Connecticare,Exchange,,21.89,,,21.89,20.41,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,Multiplan,Multiplan,,,85.67,,85.67,20.41,85.67,percent of total billed charges,,
HC HPV DNA TYPE 16 18 INCL 45,87254,CPT,,,both,,,106.92,64.15,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,85.67,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,22.68,,,22.68,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,36.04,,,36.04,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,20.41,62.22,percent of total billed charges,,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,23.15,,,23.15,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.84,,,28.84,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,43.33,,,43.33,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,20.41,62.22,percent of total billed charges,,
HC RESPIRATORY SV,87254,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,22.68,,,22.68,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,36.04,,,36.04,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,20.41,62.22,percent of total billed charges,,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,23.15,,,23.15,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,28.84,,,28.84,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,43.33,,,43.33,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,20.41,62.22,percent of total billed charges,,
HC SHELL VIAL ID X1,87254,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,22.68,,,22.68,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,36.04,,,36.04,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,20.41,62.22,percent of total billed charges,,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,23.15,,,23.15,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,28.84,,,28.84,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,43.33,,,43.33,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,20.41,62.22,percent of total billed charges,,
HC VIRUS ISOL ADENOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,22.68,,,22.68,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,36.04,,,36.04,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,20.41,62.22,percent of total billed charges,,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,23.15,,,23.15,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,28.84,,,28.84,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,43.33,,,43.33,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,21.89,,,21.89,20.41,62.22,other,Could be inpatient or outpatient,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,20.41,62.22,percent of total billed charges,,
HC VIRUS ISOL CYTOMEGALOVIRUS CULTURE - QUEST,87254,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,62.22,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT  ,,,both,,,39.11,23.47,Aetna,Commerical,,22.68,,,22.68,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Aetna,Middlesex Employees,,20.41,,,20.41,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Anthem,Commerical,,36.04,,,36.04,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Anthem,Indemnity,,,28.45,,28.45,20.41,43.33,percent of total billed charges,,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Anthem,State Preferred,,23.15,,,23.15,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Anthem,Individual Exchange,,28.84,,,28.84,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Cigna,Cigna,,43.33,,,43.33,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Connecticare,Commerical,,21.89,,,21.89,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Connecticare,Exchange,,21.89,,,21.89,20.41,43.33,other,Could be inpatient or outpatient,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,Multiplan,Multiplan,,,31.34,,31.34,20.41,43.33,percent of total billed charges,,
HC VZV SHELL VIAL,87254,CPT,,,both,,,39.11,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,20.41,43.33,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,34.63,,,34.63,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,31.17,,,31.17,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,41.12,,,41.12,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,14.2,50.5,percent of total billed charges,,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,14.2,,,14.2,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,32.89,,,32.89,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,47.28,,,47.28,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,44.02,,,44.02,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,44.02,,,44.02,14.2,50.5,other,Could be inpatient or outpatient,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,14.2,50.5,percent of total billed charges,,
HC PERTUSSIS DFA,87265,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,38.4,,,38.4,14.2,50.5,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC HSV RAPID TYPE 2,87273,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC HSV RAPID TYPE 1,87274,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.2,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,15.56,,,15.56,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,14.01,,,14.01,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.01,38.58,percent of total billed charges,,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,15.02,,,15.02,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,15.02,,,15.02,14.01,38.58,other,Could be inpatient or outpatient,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.01,38.58,percent of total billed charges,,
HC RSV RAPID DFA,87280,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.59,,,17.59,14.01,38.58,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,35.87,,,35.87,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,32.29,,,32.29,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.59,,,42.59,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,14.2,52.3,percent of total billed charges,,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,14.2,,,14.2,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,34.07,,,34.07,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,48.96,,,48.96,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,45.59,,,45.59,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,45.59,,,45.59,14.2,52.3,other,Could be inpatient or outpatient,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,14.2,52.3,percent of total billed charges,,
HC PNEUMOCYSTIS,87281,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,14.2,52.3,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC VARICELLA RAPID,87290,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.2,38.58,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT  ,,,both,,,52.53,31.52,Aetna,Commerical,,28.66,,,28.66,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Aetna,Middlesex Employees,,25.8,,,25.8,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Anthem,Commerical,,34.04,,,34.04,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Anthem,Indemnity,,,37.94,,37.94,14.2,41.79,percent of total billed charges,,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Anthem,State Preferred,,14.2,,,14.2,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Anthem,Individual Exchange,,27.23,,,27.23,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Cigna,Cigna,,39.14,,,39.14,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Connecticare,Commerical,,36.43,,,36.43,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Connecticare,Exchange,,36.43,,,36.43,14.2,41.79,other,Could be inpatient or outpatient,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,Multiplan,Multiplan,,,41.79,,41.79,14.2,41.79,percent of total billed charges,,
HC METAPNEUMO DFA,87299,CPT,,,both,,,52.53,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,31.78,,,31.78,14.2,41.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,23.81,72.79,percent of total billed charges,,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,72.79,,,72.79,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,23.81,72.79,other,Could be inpatient or outpatient,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,23.81,72.79,percent of total billed charges,,
HC ASPERGILLUS AG IA,87305,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,23.81,72.79,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.89,,,13.89,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.49,38.58,percent of total billed charges,,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.49,38.58,percent of total billed charges,,
HC IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,87324,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT  ,,,both,,,59.66,35.79,Aetna,Commerical,,16.03,,,16.03,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT  ,,,both,,,48.15,28.89,Aetna,Commerical,,16.03,,,16.03,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Aetna,Middlesex Employees,,14.42,,,14.42,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Aetna,Middlesex Employees,,14.42,,,14.42,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Anthem,Commerical,,22.11,,,22.11,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Anthem,Commerical,,22.11,,,22.11,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Anthem,Indemnity,,,43.39,,43.39,14.2,47.8,percent of total billed charges,,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Anthem,State Preferred,,14.2,,,14.2,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Anthem,Individual Exchange,,17.69,,,17.69,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Anthem,Individual Exchange,,17.69,,,17.69,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Cigna,Cigna,,26.72,,,26.72,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Cigna,Cigna,,26.72,,,26.72,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Connecticare,Commerical,,15.46,,,15.46,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Connecticare,Commerical,,15.46,,,15.46,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Connecticare,Exchange,,15.46,,,15.46,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Connecticare,Exchange,,15.46,,,15.46,14.2,38.58,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,Multiplan,Multiplan,,,47.8,,47.8,14.2,47.8,percent of total billed charges,,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC CRYPTOSPORIDIUM AG IA - Lab Chemistry,87328,CPT,,,both,,,59.66,35.79,United Healthcare/Oxford,United Healthcare/Oxford,,18.12,,,18.12,14.2,47.8,other,Could be inpatient or outpatient,
HC CRYPTOSPORIDIUM AG IA - Lab Other,87328,CPT,,,both,,,48.15,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,18.12,,,18.12,14.2,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.89,,,13.89,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.49,38.58,percent of total billed charges,,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.49,38.58,percent of total billed charges,,
HC GIARDIA AG IA,87329,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC ENTAMOEB HIST GROUP AG IA - STOOL,87337,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.2,38.58,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,16.68,,,16.68,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,15.01,,,15.01,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,26.51,,,26.51,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,42.16,,42.16,15.01,46.44,percent of total billed charges,,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,17.04,,,17.04,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,21.21,,,21.21,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,32.03,,,32.03,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,16.09,,,16.09,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,16.09,,,16.09,15.01,46.44,other,Could be inpatient or outpatient,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,46.44,,46.44,15.01,46.44,percent of total billed charges,,
HC H HPYLORI STOOL IA,87338,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,20.96,,,20.96,15.01,46.44,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT  ,,,both,,,41.12,24.67,Aetna,Commerical,,11.98,,,11.98,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Aetna,Middlesex Employees,,10.78,,,10.78,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Anthem,Commerical,,19.04,,,19.04,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Anthem,Indemnity,,,29.9,,29.9,10.78,32.94,percent of total billed charges,,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Anthem,State Preferred,,12.22,,,12.22,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Anthem,Individual Exchange,,15.24,,,15.24,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Cigna,Cigna,,23.14,,,23.14,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Connecticare,Commerical,,11.56,,,11.56,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Connecticare,Exchange,,11.56,,,11.56,10.78,32.94,other,Could be inpatient or outpatient,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,Multiplan,Multiplan,,,32.94,,32.94,10.78,32.94,percent of total billed charges,,
HC HBSAG,87340,CPT,,,both,,,41.12,24.67,United Healthcare/Oxford,United Healthcare/Oxford,,15.06,,,15.06,10.78,32.94,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT  ,,,both,,,39.41,23.64,Aetna,Commerical,,21.66,,,21.66,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Aetna,Middlesex Employees,,19.5,,,19.5,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Anthem,Commerical,,25.72,,,25.72,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Anthem,Indemnity,,,28.66,,28.66,12.22,31.58,percent of total billed charges,,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Anthem,State Preferred,,12.22,,,12.22,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Anthem,Individual Exchange,,20.58,,,20.58,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Cigna,Cigna,,29.57,,,29.57,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Connecticare,Commerical,,27.53,,,27.53,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Connecticare,Exchange,,27.53,,,27.53,12.22,31.58,other,Could be inpatient or outpatient,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,Multiplan,Multiplan,,,31.58,,31.58,12.22,31.58,percent of total billed charges,,
HC IAAD EIA HEPATITIS B SURFACE AG NEUTRALIZATION,87341,CPT,,,both,,,39.41,23.64,United Healthcare/Oxford,United Healthcare/Oxford,,24.01,,,24.01,12.22,31.58,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT  ,,,both,,,46.13,27.68,Aetna,Commerical,,13.37,,,13.37,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Aetna,Middlesex Employees,,12.03,,,12.03,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Anthem,Commerical,,21.24,,,21.24,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Anthem,Indemnity,,,33.56,,33.56,12.03,36.97,percent of total billed charges,,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Anthem,State Preferred,,13.65,,,13.65,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Anthem,Individual Exchange,,16.99,,,16.99,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Cigna,Cigna,,25.51,,,25.51,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Connecticare,Commerical,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Connecticare,Exchange,,12.9,,,12.9,12.03,36.97,other,Could be inpatient or outpatient,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,Multiplan,Multiplan,,,36.97,,36.97,12.03,36.97,percent of total billed charges,,
HC HEPATITIS BE AG IA,87350,CPT,,,both,,,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,16.8,,,16.8,12.03,36.97,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,87.83,,,87.83,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,79.05,,,79.05,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,104.28,,,104.28,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,14.2,128.05,percent of total billed charges,,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,14.2,,,14.2,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,83.42,,,83.42,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,119.88,,,119.88,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,111.61,,,111.61,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,111.61,,,111.61,14.2,128.05,other,Could be inpatient or outpatient,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,14.2,128.05,percent of total billed charges,,
HC HISTOPLASMA CAPSUL AG IA,87385,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,97.37,,,97.37,14.2,128.05,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,27.92,,,27.92,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,25.13,,,25.13,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,44.39,,,44.39,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,25.13,88.04,percent of total billed charges,,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,28.91,,,28.91,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,35.51,,,35.51,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,88.04,,,88.04,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,26.95,,,26.95,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,26.95,,,26.95,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,25.13,88.04,percent of total billed charges,,
HC HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,35.07,,,35.07,25.13,88.04,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT  ,,,both,,,147.29,88.37,Aetna,Commerical,,81.02,,,81.02,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Aetna,Middlesex Employees,,72.92,,,72.92,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Anthem,Commerical,,96.2,,,96.2,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Anthem,Indemnity,,,107.23,,107.23,20.89,118.13,percent of total billed charges,,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Anthem,State Preferred,,20.89,,,20.89,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Anthem,Individual Exchange,,76.96,,,76.96,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Cigna,Cigna,,110.59,,,110.59,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Connecticare,Commerical,,102.96,,,102.96,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Connecticare,Exchange,,102.96,,,102.96,20.89,118.13,other,Could be inpatient or outpatient,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,Multiplan,Multiplan,,,118.13,,118.13,20.89,118.13,percent of total billed charges,,
HC HIV-1 AG IA - DIRECT,87390,CPT,,,both,,,147.29,88.37,United Healthcare/Oxford,United Healthcare/Oxford,,89.83,,,89.83,20.89,118.13,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,16.38,,,16.38,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,14.75,,,14.75,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,15.81,,,15.81,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,15.81,,,15.81,14.2,38.58,other,Could be inpatient or outpatient,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC INFLUENZA A/B AG IA - RAPID,87400,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,18.53,,,18.53,14.2,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.89,,,13.89,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.49,38.58,percent of total billed charges,,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.49,38.58,percent of total billed charges,,
HC ROTAVIRUS AG IA,87425,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,38.58,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT  ,,,both,,,45.22,27.13,Aetna,Commerical,,13.89,,,13.89,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Anthem,Commerical,,22.11,,,22.11,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Anthem,Indemnity,,,32.88,,32.88,12.49,36.23,percent of total billed charges,,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Anthem,State Preferred,,14.2,,,14.2,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Anthem,Individual Exchange,,17.69,,,17.69,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Cigna,Cigna,,26.72,,,26.72,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Connecticare,Commerical,,13.41,,,13.41,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Connecticare,Exchange,,13.41,,,13.41,12.49,36.23,other,Could be inpatient or outpatient,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,Multiplan,Multiplan,,,36.23,,36.23,12.49,36.23,percent of total billed charges,,
HC ROTAVIRUS ANTIGEN DET; EIA -QUEST,87425,CPT,,,both,,,45.22,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,13.89,,,13.89,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,12.49,38.58,percent of total billed charges,,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,26.72,,,26.72,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,13.41,,,13.41,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,12.49,38.58,percent of total billed charges,,
HC SHIGA-LIKE TOXIN AG IA,87427,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,38.58,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT  ,,,both,,,45.22,27.13,Aetna,Commerical,,13.89,,,13.89,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Aetna,Middlesex Employees,,12.49,,,12.49,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Anthem,Commerical,,22.11,,,22.11,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Anthem,Indemnity,,,32.88,,32.88,12.49,36.23,percent of total billed charges,,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Anthem,State Preferred,,14.2,,,14.2,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Anthem,Individual Exchange,,17.69,,,17.69,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Cigna,Cigna,,26.72,,,26.72,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Connecticare,Commerical,,13.41,,,13.41,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Connecticare,Exchange,,13.41,,,13.41,12.49,36.23,other,Could be inpatient or outpatient,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,Multiplan,Multiplan,,,36.23,,36.23,12.49,36.23,percent of total billed charges,,
HC SHIGA-LIKE TOXIN AG IA -QUEST,87427,CPT,,,both,,,45.22,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,12.49,36.23,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,73.6,,,73.6,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,66.24,,,66.24,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,87.39,,,87.39,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,14.2,107.31,percent of total billed charges,,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,14.2,,,14.2,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,69.9,,,69.9,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,100.46,,,100.46,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,93.53,,,93.53,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,93.53,,,93.53,14.2,107.31,other,Could be inpatient or outpatient,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,14.2,107.31,percent of total billed charges,,
HC C.DIFFICILE AG,87449,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,81.6,,,81.6,14.2,107.31,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,26.46,,,26.46,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,23.81,,,23.81,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,31.41,,,31.41,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,14.2,38.58,percent of total billed charges,,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,25.13,,,25.13,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,36.12,,,36.12,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,33.63,,,33.63,14.2,38.58,other,Could be inpatient or outpatient,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,14.2,38.58,percent of total billed charges,,
HC LEGIONELLA UR AG,87449,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,14.2,38.58,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT  ,,,both,,,170.98,102.59,Aetna,Commerical,,93.39,,,93.39,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Aetna,Middlesex Employees,,84.05,,,84.05,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Anthem,Commerical,,110.89,,,110.89,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Anthem,Indemnity,,,123.61,,123.61,14.2,136.17,percent of total billed charges,,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Anthem,State Preferred,,14.2,,,14.2,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Anthem,Individual Exchange,,88.71,,,88.71,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Cigna,Cigna,,127.48,,,127.48,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Connecticare,Commerical,,118.68,,,118.68,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Connecticare,Exchange,,118.68,,,118.68,14.2,136.17,other,Could be inpatient or outpatient,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,Multiplan,Multiplan,,,136.17,,136.17,14.2,136.17,percent of total billed charges,,
HC NOROVIRUS AG,87449,CPT,,,both,,,170.98,102.59,United Healthcare/Oxford,United Healthcare/Oxford,,103.54,,,103.54,14.2,136.17,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT  ,,,both,,,120.51,72.31,Aetna,Commerical,,89.28,,,89.28,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Aetna,Middlesex Employees,,85.61,,,85.61,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Anthem,Commerical,,44.05,,,44.05,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Anthem,Indemnity,,,87.96,,87.96,31.23,100.33,percent of total billed charges,,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Anthem,State Preferred,,31.23,,,31.23,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Anthem,Individual Exchange,,35.24,,,35.24,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Cigna,Cigna,,100.33,,,100.33,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Connecticare,Commerical,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Connecticare,Exchange,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,Multiplan,Multiplan,,,96.9,,96.9,31.23,100.33,percent of total billed charges,,
HC ANAPLSMA PHGCYTOPHLM AMPLIFIED PROBE TECH,87468,CPT,,,both,,,120.51,72.31,United Healthcare/Oxford,United Healthcare/Oxford,,43.37,,,43.37,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT  ,,,both,,,120.51,72.31,Aetna,Commerical,,89.28,,,89.28,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Aetna,Middlesex Employees,,85.61,,,85.61,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Anthem,Commerical,,44.05,,,44.05,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Anthem,Indemnity,,,87.96,,87.96,31.23,100.33,percent of total billed charges,,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Anthem,State Preferred,,31.23,,,31.23,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Anthem,Individual Exchange,,35.24,,,35.24,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Cigna,Cigna,,100.33,,,100.33,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Connecticare,Commerical,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Connecticare,Exchange,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,Multiplan,Multiplan,,,96.9,,96.9,31.23,100.33,percent of total billed charges,,
HC BABESIA MICROTI AMPLIFIED PROBE TECH,87469,CPT,,,both,,,120.51,72.31,United Healthcare/Oxford,United Healthcare/Oxford,,43.37,,,43.37,31.23,100.33,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC B BURGDORFERI DNA,87476,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC LYME AMPLF PROBE,87476,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT  ,,,both,,,1525.43,915.26,Aetna,Commerical,,1019.51,,,1019.51,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Aetna,Middlesex Employees,,917.56,,,917.56,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Anthem,Commerical,,846.11,,,846.11,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Anthem,Indemnity,,,1109.52,,1109.52,484.45,1222.3,percent of total billed charges,,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Anthem,State Preferred,,484.45,,,484.45,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Anthem,Individual Exchange,,676.89,,,676.89,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Cigna,Cigna,,898.06,,,898.06,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Connecticare,Commerical,,921.22,,,921.22,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Connecticare,Exchange,,921.22,,,921.22,484.45,1222.3,other,Could be inpatient or outpatient,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,Multiplan,Multiplan,,,1222.3,,1222.3,484.45,1222.3,percent of total billed charges,,
HC MENINGITIS/TNCEPHALITIS PCR PANEL,87483,CPT,,,both,,,1525.43,915.26,United Healthcare/Oxford,United Healthcare/Oxford,,944.38,,,944.38,484.45,1222.3,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT  ,,,both,,,120.51,72.31,Aetna,Commerical,,89.28,,,89.28,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Aetna,Middlesex Employees,,85.61,,,85.61,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Anthem,Commerical,,44.05,,,44.05,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Anthem,Indemnity,,,87.96,,87.96,31.23,100.33,percent of total billed charges,,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Anthem,State Preferred,,31.23,,,31.23,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Anthem,Individual Exchange,,35.24,,,35.24,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Cigna,Cigna,,100.33,,,100.33,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Connecticare,Commerical,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Connecticare,Exchange,,60.58,,,60.58,31.23,100.33,other,Could be inpatient or outpatient,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,Multiplan,Multiplan,,,96.9,,96.9,31.23,100.33,percent of total billed charges,,
HC EHRLICHA CHAFFEENSIS AMPLIFIED PROBE TECH,87484,CPT,,,both,,,120.51,72.31,United Healthcare/Oxford,United Healthcare/Oxford,,43.37,,,43.37,31.23,100.33,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA P AMPLIF NA PROBE PCR,87486,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA PNEUMONIAE AMP PROBE TECH,87486,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC CHLAMYDIA T AMPLIF NA PROBE,87491,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,43.21,,,43.21,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,38.88,,,38.88,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,38.88,128.29,percent of total billed charges,,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,42.59,,,42.59,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,128.29,,,128.29,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,41.71,,,41.71,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,41.71,,,41.71,38.88,128.29,other,Could be inpatient or outpatient,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,38.88,128.29,percent of total billed charges,,
HC C DIFF AMPLIFIED PROBE,87493,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,38.88,128.29,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC CMV PCR,87496,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,49.67,,,49.67,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,44.71,,,44.71,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,78.95,,,78.95,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,44.71,137.97,percent of total billed charges,,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,50.72,,,50.72,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,63.16,,,63.16,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,94.94,,,94.94,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,44.71,137.97,percent of total billed charges,,
HC CMV QUANT PCR,87497,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,62.42,,,62.42,44.71,137.97,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,188.39,percent of total billed charges,,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,188.39,,,188.39,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,128.29,,,128.29,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,188.39,percent of total billed charges,,
HC ENTEROVIRUS PCR,87498,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,188.39,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT  ,,,both,,,341.96,205.18,Aetna,Commerical,,111.07,,,111.07,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Aetna,Middlesex Employees,,99.97,,,99.97,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Anthem,Commerical,,156.81,,,156.81,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Anthem,Indemnity,,,248.84,,248.84,99.97,311.11,percent of total billed charges,,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Anthem,State Preferred,,101.47,,,101.47,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Anthem,Individual Exchange,,125.45,,,125.45,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Cigna,Cigna,,311.11,,,311.11,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Connecticare,Commerical,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Connecticare,Exchange,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,Multiplan,Multiplan,,,274.13,,274.13,99.97,311.11,percent of total billed charges,,
HC INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,,both,,,341.96,205.18,United Healthcare/Oxford,United Healthcare/Oxford,,125.62,,,125.62,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT  ,,,both,,,341.96,205.18,Aetna,Commerical,,111.07,,,111.07,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Aetna,Middlesex Employees,,99.97,,,99.97,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Anthem,Commerical,,156.81,,,156.81,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Anthem,Indemnity,,,248.84,,248.84,99.97,311.11,percent of total billed charges,,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Anthem,State Preferred,,101.47,,,101.47,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Anthem,Individual Exchange,,125.45,,,125.45,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Cigna,Cigna,,311.11,,,311.11,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Connecticare,Commerical,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Connecticare,Exchange,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,Multiplan,Multiplan,,,274.13,,274.13,99.97,311.11,percent of total billed charges,,
HC INFLUENZA A/B (LIAT),87502,CPT,,,both,,,341.96,205.18,United Healthcare/Oxford,United Healthcare/Oxford,,125.62,,,125.62,99.97,311.11,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT  ,,,both,,,438.78,263.27,Aetna,Commerical,,111.07,,,111.07,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Aetna,Middlesex Employees,,99.97,,,99.97,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Commerical,,156.81,,,156.81,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Indemnity,,,319.24,,319.24,99.97,351.69,percent of total billed charges,,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,State Preferred,,101.47,,,101.47,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Individual Exchange,,125.45,,,125.45,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Cigna,Cigna,,311.11,,,311.11,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Connecticare,Commerical,,107.19,,,107.19,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Connecticare,Exchange,,107.19,,,107.19,99.97,351.69,other,Could be inpatient or outpatient,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,Multiplan,Multiplan,,,351.69,,351.69,99.97,351.69,percent of total billed charges,,
HC INFLUENZA PCR,87502,CPT,,,both,,,438.78,263.27,United Healthcare/Oxford,United Healthcare/Oxford,,125.62,,,125.62,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT  ,,,both,,,438.78,263.27,Aetna,Commerical,,111.07,,,111.07,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Aetna,Middlesex Employees,,99.97,,,99.97,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Commerical,,156.81,,,156.81,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Indemnity,,,319.24,,319.24,99.97,351.69,percent of total billed charges,,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,State Preferred,,101.47,,,101.47,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Anthem,Individual Exchange,,125.45,,,125.45,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Cigna,Cigna,,311.11,,,311.11,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Connecticare,Commerical,,107.19,,,107.19,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Connecticare,Exchange,,107.19,,,107.19,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,Multiplan,Multiplan,,,351.69,,351.69,99.97,351.69,percent of total billed charges,,
HC SWINE FLU PCR,87502,CPT,,,both,,,438.78,263.27,United Healthcare/Oxford,United Healthcare/Oxford,,125.62,,,125.62,99.97,351.69,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT  ,,,both,,,341.96,205.18,Aetna,Commerical,,111.07,,,111.07,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Aetna,Middlesex Employees,,99.97,,,99.97,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Anthem,Commerical,,156.81,,,156.81,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Anthem,Indemnity,,,248.84,,248.84,99.97,311.11,percent of total billed charges,,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Anthem,State Preferred,,101.47,,,101.47,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Anthem,Individual Exchange,,125.45,,,125.45,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Cigna,Cigna,,311.11,,,311.11,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Connecticare,Commerical,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Connecticare,Exchange,,107.19,,,107.19,99.97,311.11,other,Could be inpatient or outpatient,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,Multiplan,Multiplan,,,274.13,,274.13,99.97,311.11,percent of total billed charges,,
HC SWINE FLUE PCR,87502,CPT,,,both,,,341.96,205.18,United Healthcare/Oxford,United Healthcare/Oxford,,125.62,,,125.62,99.97,311.11,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT  ,,,both,,,95.79,57.47,Aetna,Commerical,,51.96,,,51.96,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Aetna,Middlesex Employees,,46.76,,,46.76,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Anthem,Commerical,,61.69,,,61.69,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Anthem,Indemnity,,,68.76,,68.76,24.77,75.75,percent of total billed charges,,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Anthem,State Preferred,,24.77,,,24.77,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Anthem,Individual Exchange,,49.35,,,49.35,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Cigna,Cigna,,70.92,,,70.92,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Connecticare,Commerical,,66.02,,,66.02,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Connecticare,Exchange,,66.02,,,66.02,24.77,75.75,other,Could be inpatient or outpatient,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,Multiplan,Multiplan,,,75.75,,75.75,24.77,75.75,percent of total billed charges,,
HC FLU TYPING PCR,87503,CPT,,,both,,,95.79,57.47,United Healthcare/Oxford,United Healthcare/Oxford,,57.6,,,57.6,24.77,75.75,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT  ,,,both,,,4972.84,2983.7,Aetna,Commerical,,2731.86,,,2731.86,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Aetna,Middlesex Employees,,2458.68,,,2458.68,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Anthem,Commerical,,3243.68,,,3243.68,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Anthem,Indemnity,,,3615.59,,3615.59,480.61,3983.1,percent of total billed charges,,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Anthem,State Preferred,,480.61,,,480.61,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Anthem,Individual Exchange,,2594.94,,,2594.94,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Cigna,Cigna,,3729.08,,,3729.08,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Connecticare,Commerical,,3471.62,,,3471.62,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Connecticare,Exchange,,3471.62,,,3471.62,480.61,3983.1,other,Could be inpatient or outpatient,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,Multiplan,Multiplan,,,3983.1,,3983.1,480.61,3983.1,percent of total billed charges,,
HC IADNA-DNA/RNA PROBE TQ 12-25; BIOFIRE GI PCR PANEL,87507,CPT,,,both,,,4972.84,2983.7,United Healthcare/Oxford,United Healthcare/Oxford,,3028.58,,,3028.58,480.61,3983.1,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT  ,,,both,,,164.8,98.88,Aetna,Commerical,,90.29,,,90.29,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Aetna,Middlesex Employees,,81.26,,,81.26,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Anthem,Commerical,,107.22,,,107.22,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Anthem,Indemnity,,,119.51,,119.51,41.56,131.66,percent of total billed charges,,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Anthem,State Preferred,,41.56,,,41.56,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Anthem,Individual Exchange,,85.77,,,85.77,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Cigna,Cigna,,123.26,,,123.26,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Connecticare,Commerical,,114.75,,,114.75,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Connecticare,Exchange,,114.75,,,114.75,41.56,131.66,other,Could be inpatient or outpatient,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,Multiplan,Multiplan,,,131.66,,131.66,41.56,131.66,percent of total billed charges,,
HC HEPB DNA QUAL PCR,87516,CPT,,,both,,,164.8,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,100.11,,,100.11,41.56,131.66,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT  ,,,both,,,1822.07,1093.24,Aetna,Commerical,,1000.72,,,1000.72,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Aetna,Middlesex Employees,,900.65,,,900.65,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Anthem,Commerical,,1188.2,,,1188.2,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Anthem,Indemnity,,,1324.44,,1324.44,50.72,1459.06,percent of total billed charges,,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Anthem,State Preferred,,50.72,,,50.72,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Anthem,Individual Exchange,,950.56,,,950.56,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Cigna,Cigna,,1366.01,,,1366.01,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Connecticare,Commerical,,1271.69,,,1271.69,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Connecticare,Exchange,,1271.69,,,1271.69,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,Multiplan,Multiplan,,,1459.06,,1459.06,50.72,1459.06,percent of total billed charges,,
HC HEP B VIRAL LOAD,87517,CPT,,,both,,,1822.07,1093.24,United Healthcare/Oxford,United Healthcare/Oxford,,1109.4,,,1109.4,50.72,1459.06,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,94.63,,,94.63,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,85.17,,,85.17,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,112.36,,,112.36,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,50.72,137.97,percent of total billed charges,,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,50.72,,,50.72,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,89.89,,,89.89,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,129.17,,,129.17,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,120.25,,,120.25,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,120.25,,,120.25,50.72,137.97,other,Could be inpatient or outpatient,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,50.72,137.97,percent of total billed charges,,
HC HEPB DNA QUAN PCR,87517,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,104.91,,,104.91,50.72,137.97,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT  ,,,both,,,196.73,118.04,Aetna,Commerical,,108.24,,,108.24,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Aetna,Middlesex Employees,,97.42,,,97.42,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Anthem,Commerical,,128.52,,,128.52,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Anthem,Indemnity,,,143.25,,143.25,41.56,157.81,percent of total billed charges,,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Anthem,State Preferred,,41.56,,,41.56,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Anthem,Individual Exchange,,102.82,,,102.82,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Cigna,Cigna,,147.74,,,147.74,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Connecticare,Commerical,,137.55,,,137.55,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Connecticare,Exchange,,137.55,,,137.55,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,Multiplan,Multiplan,,,157.81,,157.81,41.56,157.81,percent of total billed charges,,
HC HCV RNA TMA,87521,CPT,,,both,,,196.73,118.04,United Healthcare/Oxford,United Healthcare/Oxford,,120,,,120,41.56,157.81,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,49.67,,,49.67,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,44.71,,,44.71,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,78.95,,,78.95,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,44.71,137.97,percent of total billed charges,,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,50.72,,,50.72,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,63.16,,,63.16,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,94.94,,,94.94,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,44.71,137.97,percent of total billed charges,,
HC HCV RNA PCR QN,87522,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,62.42,,,62.42,44.71,137.97,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC HSV PCR,87529,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC YALE IADNA HSV AMPLIFIED PROBE TQ,87529,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT  ,,,both,,,167.89,100.73,Aetna,Commerical,,92.15,,,92.15,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Aetna,Middlesex Employees,,82.94,,,82.94,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Anthem,Commerical,,109.42,,,109.42,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Anthem,Indemnity,,,121.96,,121.96,49.43,134.36,percent of total billed charges,,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Anthem,State Preferred,,49.43,,,49.43,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Anthem,Individual Exchange,,87.54,,,87.54,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Cigna,Cigna,,125.8,,,125.8,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Connecticare,Commerical,,117.11,,,117.11,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Connecticare,Exchange,,117.11,,,117.11,49.43,134.36,other,Could be inpatient or outpatient,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,Multiplan,Multiplan,,,134.36,,134.36,49.43,134.36,percent of total billed charges,,
HC HERPES V6 DNA PCR,87533,CPT,,,both,,,167.89,100.73,United Healthcare/Oxford,United Healthcare/Oxford,,102.17,,,102.17,49.43,134.36,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,77.93,,,77.93,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,70.14,,,70.14,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,92.53,,,92.53,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,41.56,113.62,percent of total billed charges,,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,74.02,,,74.02,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,106.37,,,106.37,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,99.03,,,99.03,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,99.03,,,99.03,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,41.56,113.62,percent of total billed charges,,
HC HIV-1 DNA,87535,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,86.4,,,86.4,41.56,113.62,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT  ,,,both,,,341.96,205.18,Aetna,Commerical,,188.02,,,188.02,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Aetna,Middlesex Employees,,169.22,,,169.22,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Anthem,Commerical,,223.25,,,223.25,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Anthem,Indemnity,,,248.84,,248.84,100.75,274.13,percent of total billed charges,,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Anthem,State Preferred,,100.75,,,100.75,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Anthem,Individual Exchange,,178.6,,,178.6,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Cigna,Cigna,,256.65,,,256.65,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Connecticare,Commerical,,238.93,,,238.93,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Connecticare,Exchange,,238.93,,,238.93,100.75,274.13,other,Could be inpatient or outpatient,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,Multiplan,Multiplan,,,274.13,,274.13,100.75,274.13,percent of total billed charges,,
HC HIV VIRAL PCR,87536,CPT,,,both,,,341.96,205.18,United Healthcare/Oxford,United Healthcare/Oxford,,208.44,,,208.44,100.75,274.13,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,62.46,,,62.46,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,56.22,,,56.22,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,74.17,,,74.17,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,23.75,91.08,percent of total billed charges,,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,23.75,,,23.75,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,59.34,,,59.34,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,85.27,,,85.27,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,79.38,,,79.38,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,79.38,,,79.38,23.75,91.08,other,Could be inpatient or outpatient,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,23.75,91.08,percent of total billed charges,,
HC M TUBERCULOSIS ID,87555,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,69.26,,,69.26,23.75,91.08,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,77.93,,,77.93,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,70.14,,,70.14,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,92.53,,,92.53,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,41.56,113.62,percent of total billed charges,,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,74.02,,,74.02,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,106.37,,,106.37,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,99.03,,,99.03,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,99.03,,,99.03,41.56,113.62,other,Could be inpatient or outpatient,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,41.56,113.62,percent of total billed charges,,
HC TB PCR,87556,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,86.4,,,86.4,41.56,113.62,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,62.46,,,62.46,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,56.22,,,56.22,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,74.17,,,74.17,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,23.75,91.08,percent of total billed charges,,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,23.75,,,23.75,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,59.34,,,59.34,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,85.27,,,85.27,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,79.38,,,79.38,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,79.38,,,79.38,23.75,91.08,other,Could be inpatient or outpatient,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,23.75,91.08,percent of total billed charges,,
HC M AVIUM-INTRA ID,87560,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,69.26,,,69.26,23.75,91.08,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT  ,,,both,,,124.63,74.78,Aetna,Commerical,,82.95,,,82.95,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Aetna,Middlesex Employees,,74.65,,,74.65,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Anthem,Commerical,,68.84,,,68.84,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Anthem,Indemnity,,,90.27,,90.27,29.74,99.45,percent of total billed charges,,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Anthem,State Preferred,,29.74,,,29.74,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Anthem,Individual Exchange,,55.07,,,55.07,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Cigna,Cigna,,73.07,,,73.07,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Connecticare,Commerical,,74.95,,,74.95,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Connecticare,Exchange,,74.95,,,74.95,29.74,99.45,other,Could be inpatient or outpatient,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,Multiplan,Multiplan,,,99.45,,99.45,29.74,99.45,percent of total billed charges,,
HC INF ADNA MYCOPLASMA GENITALIUM AMP PROBE TECH,87563,CPT,,,both,,,124.63,74.78,United Healthcare/Oxford,United Healthcare/Oxford,,76.84,,,76.84,29.74,99.45,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC MYCOPLASMA PNEUMONIAE QUANTIFICATION,87581,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC N. GONORRHEAE DNA,87591,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT  ,,,both,,,103,61.8,Aetna,Commerical,,56.28,,,56.28,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Aetna,Middlesex Employees,,50.66,,,50.66,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Anthem,Commerical,,66.83,,,66.83,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Anthem,Indemnity,,,74.49,,74.49,41.56,82.06,percent of total billed charges,,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Anthem,State Preferred,,41.56,,,41.56,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Anthem,Individual Exchange,,53.47,,,53.47,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Cigna,Cigna,,76.82,,,76.82,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Connecticare,Commerical,,71.52,,,71.52,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Connecticare,Exchange,,71.52,,,71.52,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,Multiplan,Multiplan,,,82.06,,82.06,41.56,82.06,percent of total billed charges,,
HC HPV DNA,87621,CPT,,,both,,,103,61.8,United Healthcare/Oxford,United Healthcare/Oxford,,62.4,,,62.4,41.56,82.06,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT  ,,,both,,,106.92,64.15,Aetna,Commerical,,58.76,,,58.76,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Aetna,Middlesex Employees,,52.88,,,52.88,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Anthem,Commerical,,69.77,,,69.77,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Anthem,Indemnity,,,77.77,,77.77,40.47,85.67,percent of total billed charges,,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Anthem,State Preferred,,40.47,,,40.47,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Anthem,Individual Exchange,,55.82,,,55.82,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Cigna,Cigna,,80.2,,,80.2,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Connecticare,Commerical,,74.66,,,74.66,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Connecticare,Exchange,,74.66,,,74.66,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,Multiplan,Multiplan,,,85.67,,85.67,40.47,85.67,percent of total billed charges,,
HC HPV DNA LOW RISK,87623,CPT,,,both,,,106.92,64.15,United Healthcare/Oxford,United Healthcare/Oxford,,65.14,,,65.14,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT  ,,,both,,,106.92,64.15,Aetna,Commerical,,58.76,,,58.76,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Aetna,Middlesex Employees,,52.88,,,52.88,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Anthem,Commerical,,69.77,,,69.77,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Anthem,Indemnity,,,77.77,,77.77,40.47,85.67,percent of total billed charges,,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Anthem,State Preferred,,40.47,,,40.47,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Anthem,Individual Exchange,,55.82,,,55.82,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Cigna,Cigna,,80.2,,,80.2,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Connecticare,Commerical,,74.66,,,74.66,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Connecticare,Exchange,,74.66,,,74.66,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,Multiplan,Multiplan,,,85.67,,85.67,40.47,85.67,percent of total billed charges,,
HC HPV DNA HIGH RISK,87624,CPT,,,both,,,106.92,64.15,United Healthcare/Oxford,United Healthcare/Oxford,,65.14,,,65.14,40.47,85.67,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,77.93,,,77.93,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,70.14,,,70.14,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,92.53,,,92.53,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,40.47,113.62,percent of total billed charges,,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,40.47,,,40.47,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,74.02,,,74.02,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,106.37,,,106.37,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,99.03,,,99.03,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,99.03,,,99.03,40.47,113.62,other,Could be inpatient or outpatient,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,40.47,113.62,percent of total billed charges,,
HC HPV DNA TYPE 16 18 INCL 45,87625,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,86.4,,,86.4,40.47,113.62,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT  ,,,both,,,517.06,310.24,Aetna,Commerical,,165.37,,,165.37,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Aetna,Middlesex Employees,,148.84,,,148.84,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Anthem,Commerical,,236.44,,,236.44,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Anthem,Indemnity,,,375.72,,375.72,148.84,469.04,percent of total billed charges,,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Anthem,State Preferred,,149.43,,,149.43,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Anthem,Individual Exchange,,189.15,,,189.15,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Cigna,Cigna,,469.04,,,469.04,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Connecticare,Commerical,,159.59,,,159.59,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Connecticare,Exchange,,159.59,,,159.59,148.84,469.04,other,Could be inpatient or outpatient,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,Multiplan,Multiplan,,,413.91,,413.91,148.84,469.04,percent of total billed charges,,
HC RSV AND INFLUENZA A/B (LIAT),87631,CPT,,,both,,,517.06,310.24,United Healthcare/Oxford,United Healthcare/Oxford,,187.03,,,187.03,148.84,469.04,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT  ,,,both,,,1677,1006.2,Aetna,Commerical,,483.23,,,483.23,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Aetna,Middlesex Employees,,434.91,,,434.91,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Anthem,Commerical,,768.15,,,768.15,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Anthem,Indemnity,,,1219.66,,1219.66,434.91,1523.79,percent of total billed charges,,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Anthem,State Preferred,,485.46,,,485.46,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Anthem,Individual Exchange,,614.52,,,614.52,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Cigna,Cigna,,1523.79,,,1523.79,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Connecticare,Commerical,,466.36,,,466.36,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Connecticare,Exchange,,466.36,,,466.36,434.91,1523.79,other,Could be inpatient or outpatient,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,Multiplan,Multiplan,,,1343.63,,1343.63,434.91,1523.79,percent of total billed charges,,
HC RESPIRATORY VIRUS PCR PANEL MULT TYPES OR SUBTYPES 12-25 TARGETS,87633,CPT,,,both,,,1677,1006.2,United Healthcare/Oxford,United Healthcare/Oxford,,607.24,,,607.24,434.91,1523.79,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT  ,,,both,,,172.01,103.21,Aetna,Commerical,,130.79,,,130.79,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Aetna,Middlesex Employees,,125.42,,,125.42,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Anthem,Commerical,,64.42,,,64.42,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Anthem,Indemnity,,,128.85,,128.85,51.53,146.97,percent of total billed charges,,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Anthem,State Preferred,,60.87,,,60.87,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Anthem,Individual Exchange,,51.53,,,51.53,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Cigna,Cigna,,146.97,,,146.97,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Connecticare,Commerical,,60.76,,,60.76,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Connecticare,Exchange,,60.76,,,60.76,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,Multiplan,Multiplan,,,141.95,,141.95,51.53,146.97,percent of total billed charges,,
HC SARS COVID-19 AMP PROBE XPERT XPRESS,87635,CPT,,,both,,,172.01,103.21,United Healthcare/Oxford,United Healthcare/Oxford,,63.42,,,63.42,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT  ,,,both,,,172.01,103.21,Aetna,Commerical,,130.79,,,130.79,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Aetna,Middlesex Employees,,125.42,,,125.42,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Anthem,Commerical,,64.42,,,64.42,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Anthem,Indemnity,,,128.85,,128.85,51.53,146.97,percent of total billed charges,,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Anthem,State Preferred,,60.87,,,60.87,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Anthem,Individual Exchange,,51.53,,,51.53,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Cigna,Cigna,,146.97,,,146.97,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Connecticare,Commerical,,60.76,,,60.76,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Connecticare,Exchange,,60.76,,,60.76,51.53,146.97,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,Multiplan,Multiplan,,,141.95,,141.95,51.53,146.97,percent of total billed charges,,
HC SARS-COVID-19 NUCL ACID AMP PROBE (LIAT),87635,CPT,,,both,,,172.01,103.21,United Healthcare/Oxford,United Healthcare/Oxford,,63.42,,,63.42,51.53,146.97,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT  ,,,both,,,516.66,309.99,Aetna,Commerical,,169.52,,,169.52,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Aetna,Middlesex Employees,,152.56,,,152.56,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Anthem,Commerical,,238.75,,,238.75,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Anthem,Indemnity,,,375.76,,375.76,149.43,413.95,percent of total billed charges,,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Anthem,State Preferred,,149.43,,,149.43,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Anthem,Individual Exchange,,191,,,191,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Cigna,Cigna,,251.16,,,251.16,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Connecticare,Commerical,,168.38,,,168.38,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Connecticare,Exchange,,168.38,,,168.38,149.43,413.95,other,Could be inpatient or outpatient,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,Multiplan,Multiplan,,,413.95,,413.95,149.43,413.95,percent of total billed charges,,
SARSCOV2 & INF A&B AMP PRB,87636,CPT,,,both,,,516.66,309.99,United Healthcare/Oxford,United Healthcare/Oxford,,181.54,,,181.54,149.43,413.95,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT  ,,,both,,,501.61,300.97,Aetna,Commerical,,381.41,,,381.41,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Aetna,Middlesex Employees,,365.74,,,365.74,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Anthem,Commerical,,220.46,,,220.46,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Anthem,Indemnity,,,375.76,,375.76,156.91,428.58,percent of total billed charges,,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Anthem,State Preferred,,156.91,,,156.91,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Anthem,Individual Exchange,,176.36,,,176.36,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Cigna,Cigna,,428.58,,,428.58,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Connecticare,Commerical,,168.89,,,168.89,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Connecticare,Exchange,,168.89,,,168.89,156.91,428.58,other,Could be inpatient or outpatient,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,Multiplan,Multiplan,,,413.95,,413.95,156.91,428.58,percent of total billed charges,,
HC SARS COV2 & INF A&B&RSV XPERT XPRESS,87637,CPT,,,both,,,501.61,300.97,United Healthcare/Oxford,United Healthcare/Oxford,,176.29,,,176.29,156.91,428.58,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT  ,,,both,,,196.73,118.04,Aetna,Commerical,,108.24,,,108.24,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Aetna,Middlesex Employees,,97.42,,,97.42,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Anthem,Commerical,,128.52,,,128.52,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Anthem,Indemnity,,,143.25,,143.25,97.42,188.39,percent of total billed charges,,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Anthem,State Preferred,,188.39,,,188.39,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Anthem,Individual Exchange,,102.82,,,102.82,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Cigna,Cigna,,147.74,,,147.74,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Connecticare,Commerical,,137.55,,,137.55,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Connecticare,Exchange,,137.55,,,137.55,97.42,188.39,other,Could be inpatient or outpatient,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,Multiplan,Multiplan,,,157.81,,157.81,97.42,188.39,percent of total billed charges,,
HC SA PCR CHARGE,87640,CPT,,,both,,,196.73,118.04,United Healthcare/Oxford,United Healthcare/Oxford,,120,,,120,97.42,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT  ,,,both,,,196.73,118.04,Aetna,Commerical,,40.68,,,40.68,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Anthem,Commerical,,64.68,,,64.68,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Anthem,Indemnity,,,143.25,,143.25,36.61,188.39,percent of total billed charges,,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Anthem,State Preferred,,188.39,,,188.39,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Anthem,Individual Exchange,,51.74,,,51.74,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Cigna,Cigna,,128.29,,,128.29,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Connecticare,Commerical,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Connecticare,Exchange,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,Multiplan,Multiplan,,,157.81,,157.81,36.61,188.39,percent of total billed charges,,
HC MRSA RE PCR,87641,CPT,,,both,,,196.73,118.04,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,188.39,percent of total billed charges,,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,188.39,,,188.39,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,128.29,,,128.29,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,188.39,other,Could be inpatient or outpatient,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,188.39,percent of total billed charges,,
HC MRSA TP PCR,87641,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,188.39,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC STREP A DNA,87651,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC ADENVRS DNA Q PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC ANAPLASMA PHAGOCYTOPHILUM DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC B PERTUSSIS PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC BABESIA MICROTI REAL-TIME DNA PCR - HH/LABCORP,87798,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC BABESIA PCR,87798,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT  ,,,both,,,372.54,223.52,Aetna,Commerical,,40.68,,,40.68,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Anthem,Commerical,,64.68,,,64.68,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Anthem,Indemnity,,,270.95,,270.95,36.61,298.49,percent of total billed charges,,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Anthem,State Preferred,,41.56,,,41.56,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Anthem,Individual Exchange,,51.74,,,51.74,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Cigna,Cigna,,77.76,,,77.76,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Connecticare,Commerical,,39.26,,,39.26,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Connecticare,Exchange,,39.26,,,39.26,36.61,298.49,other,Could be inpatient or outpatient,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,Multiplan,Multiplan,,,298.49,,298.49,36.61,298.49,percent of total billed charges,,
HC DETECT AGENT NOS DNA AMP-ZIKA VIRUS TMA,87798,CPT,,,both,,,372.54,223.52,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,298.49,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT  ,,,both,,,108.15,64.89,Aetna,Commerical,,40.68,,,40.68,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Anthem,Commerical,,64.68,,,64.68,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Anthem,Indemnity,,,78.58,,78.58,36.61,86.57,percent of total billed charges,,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Anthem,State Preferred,,41.56,,,41.56,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Anthem,Individual Exchange,,51.74,,,51.74,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Cigna,Cigna,,77.76,,,77.76,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Connecticare,Commerical,,39.26,,,39.26,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Connecticare,Exchange,,39.26,,,39.26,36.61,86.57,other,Could be inpatient or outpatient,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,Multiplan,Multiplan,,,86.57,,86.57,36.61,86.57,percent of total billed charges,,
HC DNA AMPLIFICATION,87798,CPT,,,both,,,108.15,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,86.57,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC EBV DNA PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - A. PHAGOCYTOPHILUM DNA RT-PCR Q1,87798,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT  ,,,both,,,141.81,85.09,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC IADNA NOS AMPLIF PROBE TQ EA ORGAN - E. CHAFFEENSIS DNA RT-PCR QUAL,87798,CPT,,,both,,,141.81,85.09,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC INFECTIOUS AGNT DET NUC ACID (DNA OR RNA) AMP PROBE TECH EA ORGAN,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC JC VIRUS PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC MUMPS VIRUS RNA PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC NOROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC PARVOVIRUS Q PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC SPECIALITY TEST ENTEROVIRUS PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,40.68,,,40.68,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,36.61,,,36.61,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,64.68,,,64.68,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,36.61,113.62,percent of total billed charges,,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,41.56,,,41.56,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,51.74,,,51.74,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,77.76,,,77.76,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,39.26,,,39.26,36.61,113.62,other,Could be inpatient or outpatient,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,36.61,113.62,percent of total billed charges,,
HC VZV PCR,87798,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,51.13,,,51.13,36.61,113.62,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,49.67,,,49.67,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,44.71,,,44.71,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,78.95,,,78.95,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,44.71,137.97,percent of total billed charges,,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,50.72,,,50.72,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,63.16,,,63.16,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,94.94,,,94.94,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,44.71,137.97,percent of total billed charges,,
HC BK VIRUS,87799,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,62.42,,,62.42,44.71,137.97,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT  ,,,both,,,342.16,205.29,Aetna,Commerical,,49.67,,,49.67,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Aetna,Middlesex Employees,,44.71,,,44.71,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Anthem,Commerical,,78.95,,,78.95,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Anthem,Indemnity,,,248.84,,248.84,44.71,274.13,percent of total billed charges,,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Anthem,State Preferred,,50.72,,,50.72,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Anthem,Individual Exchange,,63.16,,,63.16,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Cigna,Cigna,,94.94,,,94.94,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Connecticare,Commerical,,47.94,,,47.94,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Connecticare,Exchange,,47.94,,,47.94,44.71,274.13,other,Could be inpatient or outpatient,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,Multiplan,Multiplan,,,274.13,,274.13,44.71,274.13,percent of total billed charges,,
HC EBV DNA QUANT,87799,CPT,,,both,,,342.16,205.29,United Healthcare/Oxford,United Healthcare/Oxford,,62.42,,,62.42,44.71,274.13,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,49.67,,,49.67,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,44.71,,,44.71,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,78.95,,,78.95,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,44.71,137.97,percent of total billed charges,,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,50.72,,,50.72,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,63.16,,,63.16,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,94.94,,,94.94,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,47.94,,,47.94,44.71,137.97,other,Could be inpatient or outpatient,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,44.71,137.97,percent of total billed charges,,
HC IADNA NOS QUANTIFICATION EA ORGANISM,87799,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,62.42,,,62.42,44.71,137.97,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT  ,,,both,,,241.89,145.13,Aetna,Commerical,,161.65,,,161.65,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Aetna,Middlesex Employees,,145.48,,,145.48,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Anthem,Commerical,,134.16,,,134.16,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Anthem,Indemnity,,,175.92,,175.92,83.1,193.8,percent of total billed charges,,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Anthem,State Preferred,,83.1,,,83.1,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Anthem,Individual Exchange,,107.33,,,107.33,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Cigna,Cigna,,142.39,,,142.39,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Connecticare,Commerical,,146.06,,,146.06,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Connecticare,Exchange,,146.06,,,146.06,83.1,193.8,other,Could be inpatient or outpatient,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,Multiplan,Multiplan,,,193.8,,193.8,83.1,193.8,percent of total billed charges,,
HC BORRELIA SPECIES DNA QUAL,87801,CPT,,,both,,,241.89,145.13,United Healthcare/Oxford,United Healthcare/Oxford,,149.73,,,149.73,83.1,193.8,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT  ,,,both,,,48.14,28.89,Aetna,Commerical,,15.18,,,15.18,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Aetna,Middlesex Employees,,13.66,,,13.66,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Anthem,Commerical,,22.11,,,22.11,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Anthem,Indemnity,,,35.02,,35.02,13.66,43.85,percent of total billed charges,,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Anthem,State Preferred,,14.2,,,14.2,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Anthem,Individual Exchange,,17.69,,,17.69,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Cigna,Cigna,,43.85,,,43.85,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Connecticare,Commerical,,14.66,,,14.66,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Connecticare,Exchange,,14.66,,,14.66,13.66,43.85,other,Could be inpatient or outpatient,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,Multiplan,Multiplan,,,38.58,,38.58,13.66,43.85,percent of total billed charges,,
HC RESP SYNCYTI VIRS,87807,CPT,,,both,,,48.14,28.89,United Healthcare/Oxford,United Healthcare/Oxford,,17.46,,,17.46,13.66,43.85,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT  ,,,both,,,54.49,32.69,Aetna,Commerical,,19.16,,,19.16,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Aetna,Middlesex Employees,,17.24,,,17.24,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Anthem,Commerical,,22.11,,,22.11,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Anthem,Indemnity,,,39.63,,39.63,14.2,43.66,percent of total billed charges,,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Anthem,State Preferred,,14.2,,,14.2,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Anthem,Individual Exchange,,17.69,,,17.69,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Cigna,Cigna,,26.72,,,26.72,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Connecticare,Commerical,,18.5,,,18.5,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Connecticare,Exchange,,18.5,,,18.5,14.2,43.66,other,Could be inpatient or outpatient,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,Multiplan,Multiplan,,,43.66,,43.66,14.2,43.66,percent of total billed charges,,
HC STREP A ASSAY W/OPTIC,87880,CPT,,,both,,,54.49,32.69,United Healthcare/Oxford,United Healthcare/Oxford,,21.68,,,21.68,14.2,43.66,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT  ,,,both,,,69.01,41.41,Aetna,Commerical,,37.73,,,37.73,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,33.95,,,33.95,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,44.79,,,44.79,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,14.2,55,percent of total billed charges,,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,14.2,,,14.2,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,35.83,,,35.83,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,51.5,,,51.5,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,47.94,,,47.94,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,47.94,,,47.94,14.2,55,other,Could be inpatient or outpatient,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,14.2,55,percent of total billed charges,,
HC LATEX AGGLUTIN EA,87899,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,14.2,55,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT  ,,,both,,,450.11,270.07,Aetna,Commerical,,332.07,,,332.07,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Aetna,Middlesex Employees,,155.23,,,155.23,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Anthem,Commerical,,224.94,,,224.94,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Anthem,Indemnity,,,327.15,,327.15,154.35,406.57,percent of total billed charges,,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Anthem,State Preferred,,320.75,,,320.75,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Anthem,Individual Exchange,,179.95,,,179.95,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Cigna,Cigna,,406.57,,,406.57,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Connecticare,Commerical,,154.35,,,154.35,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Connecticare,Exchange,,154.35,,,154.35,154.35,406.57,other,Could be inpatient or outpatient,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,Multiplan,Multiplan,,,360.4,,360.4,154.35,406.57,percent of total billed charges,,
"HC HIV GENOTYPING RTI, QUEST",87900,CPT,,,both,,,450.11,270.07,United Healthcare/Oxford,United Healthcare/Oxford,,161.11,,,161.11,154.35,406.57,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT  ,,,both,,,1036.18,621.71,Aetna,Commerical,,569.63,,,569.63,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Aetna,Middlesex Employees,,512.67,,,512.67,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Anthem,Commerical,,676.35,,,676.35,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Anthem,Indemnity,,,753.9,,753.9,304.79,830.53,percent of total billed charges,,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Anthem,State Preferred,,304.79,,,304.79,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Anthem,Individual Exchange,,541.08,,,541.08,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Cigna,Cigna,,777.56,,,777.56,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Connecticare,Commerical,,723.87,,,723.87,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Connecticare,Exchange,,723.87,,,723.87,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,Multiplan,Multiplan,,,830.53,,830.53,304.79,830.53,percent of total billed charges,,
HC HIV GENOTYPE,87901,CPT,,,both,,,1036.18,621.71,United Healthcare/Oxford,United Healthcare/Oxford,,631.49,,,631.49,304.79,830.53,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT  ,,,both,,,1453.33,872,Aetna,Commerical,,798.47,,,798.47,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Aetna,Middlesex Employees,,718.62,,,718.62,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Anthem,Commerical,,948.06,,,948.06,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Anthem,Indemnity,,,1056.76,,1056.76,304.79,1164.18,percent of total billed charges,,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Anthem,State Preferred,,304.79,,,304.79,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Anthem,Individual Exchange,,758.45,,,758.45,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Cigna,Cigna,,1089.93,,,1089.93,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Connecticare,Commerical,,1014.69,,,1014.69,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Connecticare,Exchange,,1014.69,,,1014.69,304.79,1164.18,other,Could be inpatient or outpatient,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,Multiplan,Multiplan,,,1164.18,,1164.18,304.79,1164.18,percent of total billed charges,,
HC HIV GENOTYPING,87901,CPT,,,both,,,1453.33,872,United Healthcare/Oxford,United Healthcare/Oxford,,885.19,,,885.19,304.79,1164.18,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT  ,,,both,,,814.73,488.84,Aetna,Commerical,,447.79,,,447.79,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Aetna,Middlesex Employees,,403.01,,,403.01,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Anthem,Commerical,,531.68,,,531.68,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Anthem,Indemnity,,,592.64,,592.64,304.79,652.88,percent of total billed charges,,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Anthem,State Preferred,,304.79,,,304.79,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Anthem,Individual Exchange,,425.34,,,425.34,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Cigna,Cigna,,611.24,,,611.24,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Connecticare,Commerical,,569.04,,,569.04,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Connecticare,Exchange,,569.04,,,569.04,304.79,652.88,other,Could be inpatient or outpatient,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,Multiplan,Multiplan,,,652.88,,652.88,304.79,652.88,percent of total billed charges,,
HC HCV GENOTYPING,87902,CPT,,,both,,,814.73,488.84,United Healthcare/Oxford,United Healthcare/Oxford,,496.42,,,496.42,304.79,652.88,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT  ,,,both,,,485.13,291.08,Aetna,Commerical,,266.57,,,266.57,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Aetna,Middlesex Employees,,239.92,,,239.92,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Anthem,Commerical,,316.51,,,316.51,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Anthem,Indemnity,,,352.8,,352.8,153.49,388.66,percent of total billed charges,,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Anthem,State Preferred,,153.49,,,153.49,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Anthem,Individual Exchange,,253.21,,,253.21,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Cigna,Cigna,,363.88,,,363.88,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Connecticare,Commerical,,338.76,,,338.76,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Connecticare,Exchange,,338.76,,,338.76,153.49,388.66,other,Could be inpatient or outpatient,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,Multiplan,Multiplan,,,388.66,,388.66,153.49,388.66,percent of total billed charges,,
HC NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,87906,CPT,,,both,,,485.13,291.08,United Healthcare/Oxford,United Healthcare/Oxford,,295.52,,,295.52,153.49,388.66,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT  ,,,both,,,117.42,70.45,Aetna,Commerical,,86.93,,,86.93,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Aetna,Middlesex Employees,,83.36,,,83.36,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Anthem,Commerical,,83.97,,,83.97,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Anthem,Indemnity,,,85.64,,85.64,57.17,110.32,percent of total billed charges,,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Anthem,State Preferred,,83.97,,,83.97,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Anthem,Individual Exchange,,67.18,,,67.18,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Cigna,Cigna,,110.32,,,110.32,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Connecticare,Commerical,,58.99,,,58.99,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Connecticare,Exchange,,58.99,,,58.99,57.17,110.32,other,Could be inpatient or outpatient,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,Multiplan,Multiplan,,,94.35,,94.35,57.17,110.32,percent of total billed charges,,
HC BIOFIRE JOINT INFCTION PCR PANEL,87999,CPT,,,both,,,117.42,70.45,United Healthcare/Oxford,United Healthcare/Oxford,,57.17,,,57.17,57.17,110.32,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT  ,,,both,,,84.46,50.68,Aetna,Commerical,,47,,,47,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Aetna,Middlesex Employees,,42.31,,,42.31,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Anthem,Commerical,,55.81,,,55.81,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Anthem,Indemnity,,,62.21,,62.21,42.31,68.54,percent of total billed charges,,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Anthem,State Preferred,,45.14,,,45.14,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Anthem,Individual Exchange,,44.65,,,44.65,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Cigna,Cigna,,64.17,,,64.17,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Connecticare,Commerical,,59.74,,,59.74,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Connecticare,Exchange,,59.74,,,59.74,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,Multiplan,Multiplan,,,68.54,,68.54,42.31,68.54,percent of total billed charges,,
HC NON-GYN DIR SMEAR,88104,CPT,,,both,,,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,42.31,68.54,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT  ,,,both,,,79.31,47.59,Aetna,Commerical,,59.14,,,59.14,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Aetna,Middlesex Employees,,53.23,,,53.23,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Anthem,Commerical,,98.8,,,98.8,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Anthem,Indemnity,,,58.11,,58.11,22.51,98.8,percent of total billed charges,,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Anthem,State Preferred,,39.37,,,39.37,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Anthem,Individual Exchange,,79.04,,,79.04,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Cigna,Cigna,,22.93,,,22.93,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Connecticare,Commerical,,65.15,,,65.15,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Connecticare,Exchange,,65.15,,,65.15,22.51,98.8,other,Could be inpatient or outpatient,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,Multiplan,Multiplan,,,64.02,,64.02,22.51,98.8,percent of total billed charges,,
HC NON-GYN FILTER,88106,CPT,,,both,,,79.31,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,22.51,,,22.51,22.51,98.8,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT  ,,,both,,,105.06,63.04,Aetna,Commerical,,57.52,,,57.52,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Aetna,Middlesex Employees,,51.77,,,51.77,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Anthem,Commerical,,68.3,,,68.3,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Anthem,Indemnity,,,76.12,,76.12,23.98,83.86,percent of total billed charges,,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Anthem,State Preferred,,23.98,,,23.98,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Anthem,Individual Exchange,,54.64,,,54.64,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Cigna,Cigna,,78.52,,,78.52,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Connecticare,Commerical,,73.09,,,73.09,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Connecticare,Exchange,,73.09,,,73.09,23.98,83.86,other,Could be inpatient or outpatient,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,Multiplan,Multiplan,,,83.86,,83.86,23.98,83.86,percent of total billed charges,,
HC CP CERV/VAG; ATL; MANUAL SCRN - THIN PRE,88142,CPT,,,both,,,105.06,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,63.77,,,63.77,23.98,83.86,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT  ,,,both,,,71.07,42.64,Aetna,Commerical,,38.97,,,38.97,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Aetna,Middlesex Employees,,35.07,,,35.07,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Anthem,Commerical,,46.26,,,46.26,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Anthem,Indemnity,,,51.57,,51.57,35.07,56.81,percent of total billed charges,,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Anthem,State Preferred,,48.03,,,48.03,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Anthem,Individual Exchange,,37.01,,,37.01,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Cigna,Cigna,,53.19,,,53.19,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Connecticare,Commerical,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Connecticare,Exchange,,49.52,,,49.52,35.07,56.81,other,Could be inpatient or outpatient,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,Multiplan,Multiplan,,,56.81,,56.81,35.07,56.81,percent of total billed charges,,
HC CP SMR OTHR; PREP SCRN INT,88161,CPT,,,both,,,71.07,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,35.07,56.81,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,25.14,,,25.14,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,22.62,,,22.62,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,28.92,,,28.92,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,22.62,368.82,percent of total billed charges,,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,42.97,,,42.97,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,23.13,,,23.13,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,24.1,,,24.1,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,27.26,,,27.26,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,27.26,,,27.26,22.62,368.82,other,Could be inpatient or outpatient,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,22.62,368.82,percent of total billed charges,,
HC CYTP DX EVAL FNA 1ST EA SITE,88172,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,22.62,368.82,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,107.56,,,107.56,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,96.8,,,96.8,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,119.05,,,119.05,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,66.86,128.05,percent of total billed charges,,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,106.77,,,106.77,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,95.24,,,95.24,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,69.2,,,69.2,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,117.36,,,117.36,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,117.36,,,117.36,66.86,128.05,other,Could be inpatient or outpatient,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,66.86,128.05,percent of total billed charges,,
HC EVAL OF FNA; INT & REP,88173,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,66.86,128.05,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,75.46,,,75.46,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,67.91,,,67.91,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,89.59,,,89.59,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,31.36,110.02,percent of total billed charges,,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,31.36,,,31.36,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.67,,,71.67,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,103,,,103,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,95.89,,,95.89,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,95.89,,,95.89,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,31.36,110.02,percent of total billed charges,,
HC CYTOPATH C/V AUTO FLUID REDO,88175,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,83.65,,,83.65,31.36,110.02,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT  ,,,both,,,116.39,69.83,Aetna,Commerical,,64.32,,,64.32,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Aetna,Middlesex Employees,,57.89,,,57.89,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Anthem,Commerical,,76.37,,,76.37,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Anthem,Indemnity,,,85.13,,85.13,6.32,93.78,percent of total billed charges,,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Anthem,State Preferred,,6.32,,,6.32,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Anthem,Individual Exchange,,61.1,,,61.1,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Cigna,Cigna,,87.81,,,87.81,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Connecticare,Commerical,,81.74,,,81.74,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Connecticare,Exchange,,81.74,,,81.74,6.32,93.78,other,Could be inpatient or outpatient,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,Multiplan,Multiplan,,,93.78,,93.78,6.32,93.78,percent of total billed charges,,
HC CYTP FNA EVAL EA ADDL,88177,CPT,,,both,,,116.39,69.83,United Healthcare/Oxford,United Healthcare/Oxford,,71.31,,,71.31,6.32,93.78,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT  ,,,both,,,219.39,131.63,Aetna,Commerical,,120.6,,,120.6,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Aetna,Middlesex Employees,,108.54,,,108.54,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Anthem,Commerical,,143.2,,,143.2,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Anthem,Indemnity,,,159.62,,159.62,78.25,175.85,percent of total billed charges,,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Anthem,State Preferred,,78.25,,,78.25,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Anthem,Individual Exchange,,114.56,,,114.56,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Cigna,Cigna,,164.63,,,164.63,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Connecticare,Commerical,,153.27,,,153.27,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Connecticare,Exchange,,153.27,,,153.27,78.25,175.85,other,Could be inpatient or outpatient,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,Multiplan,Multiplan,,,175.85,,175.85,78.25,175.85,percent of total billed charges,,
HC CELL MARKER STUDY - DNA ANALYSIS,88182,CPT,,,both,,,219.39,131.63,United Healthcare/Oxford,United Healthcare/Oxford,,133.7,,,133.7,78.25,175.85,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,88,,,88,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,79.2,,,79.2,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,132.21,,,132.21,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,50.18,615.9,percent of total billed charges,,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,50.18,,,50.18,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,105.77,,,105.77,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,164.51,,,164.51,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,95.78,,,95.78,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,95.78,,,95.78,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,50.18,615.9,percent of total billed charges,,
HC FLOW CYTO 1ST MRK,88184,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,88,,,88,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,79.2,,,79.2,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,132.21,,,132.21,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,50.18,615.9,percent of total billed charges,,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,50.18,,,50.18,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,105.77,,,105.77,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,164.51,,,164.51,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,95.78,,,95.78,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,95.78,,,95.78,50.18,615.9,other,Could be inpatient or outpatient,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,50.18,615.9,percent of total billed charges,,
HC JHU FLOW CYTOMETRY 1ST MKR,88184,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,50.18,615.9,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT  ,,,both,,,111.24,66.74,Aetna,Commerical,,28.87,,,28.87,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Aetna,Middlesex Employees,,25.98,,,25.98,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Anthem,Commerical,,80.56,,,80.56,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Anthem,Indemnity,,,81.04,,81.04,24.48,100.43,percent of total billed charges,,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Anthem,State Preferred,,24.48,,,24.48,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Anthem,Individual Exchange,,64.45,,,64.45,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Cigna,Cigna,,100.43,,,100.43,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Connecticare,Commerical,,31.65,,,31.65,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Connecticare,Exchange,,31.65,,,31.65,24.48,100.43,other,Could be inpatient or outpatient,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,Multiplan,Multiplan,,,89.28,,89.28,24.48,100.43,percent of total billed charges,,
HC FLOW CYTO EA ADDL MARKERS,88185,CPT,,,both,,,111.24,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,32.61,,,32.61,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT  ,,,both,,,111.24,66.74,Aetna,Commerical,,28.87,,,28.87,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Aetna,Middlesex Employees,,25.98,,,25.98,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Anthem,Commerical,,80.56,,,80.56,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Anthem,Indemnity,,,81.04,,81.04,24.48,100.43,percent of total billed charges,,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Anthem,State Preferred,,24.48,,,24.48,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Anthem,Individual Exchange,,64.45,,,64.45,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Cigna,Cigna,,100.43,,,100.43,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Connecticare,Commerical,,31.65,,,31.65,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Connecticare,Exchange,,31.65,,,31.65,24.48,100.43,other,Could be inpatient or outpatient,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,Multiplan,Multiplan,,,89.28,,89.28,24.48,100.43,percent of total billed charges,,
HC JHU FLOW CYTO EA ADDL,88185,CPT,,,both,,,111.24,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,32.61,,,32.61,24.48,100.43,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT  ,,,both,,,468.21,280.92,Aetna,Commerical,,135.07,,,135.07,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Aetna,Middlesex Employees,,121.56,,,121.56,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Anthem,Commerical,,214.71,,,214.71,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Anthem,Indemnity,,,340.52,,340.52,121.56,375.13,percent of total billed charges,,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Anthem,State Preferred,,137.92,,,137.92,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Anthem,Individual Exchange,,171.77,,,171.77,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Cigna,Cigna,,258.73,,,258.73,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Connecticare,Commerical,,130.34,,,130.34,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Connecticare,Exchange,,130.34,,,130.34,121.56,375.13,other,Could be inpatient or outpatient,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,Multiplan,Multiplan,,,375.13,,375.13,121.56,375.13,percent of total billed charges,,
HC TISCUL NON LYMPH,88230,CPT,,,both,,,468.21,280.92,United Healthcare/Oxford,United Healthcare/Oxford,,169.73,,,169.73,121.56,375.13,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT  ,,,both,,,1202.01,721.21,Aetna,Commerical,,660.54,,,660.54,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Aetna,Middlesex Employees,,594.49,,,594.49,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Anthem,Commerical,,784.3,,,784.3,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Anthem,Indemnity,,,874.22,,874.22,166.61,963.08,percent of total billed charges,,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Anthem,State Preferred,,166.61,,,166.61,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Anthem,Individual Exchange,,627.44,,,627.44,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Cigna,Cigna,,901.67,,,901.67,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Connecticare,Commerical,,839.42,,,839.42,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Connecticare,Exchange,,839.42,,,839.42,166.61,963.08,other,Could be inpatient or outpatient,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,Multiplan,Multiplan,,,963.08,,963.08,166.61,963.08,percent of total billed charges,,
HC KAROTYPE-SOL TUMR,88233,CPT,,,both,,,1202.01,721.21,United Healthcare/Oxford,United Healthcare/Oxford,,732.29,,,732.29,166.61,963.08,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT  ,,,both,,,680.93,408.56,Aetna,Commerical,,374.19,,,374.19,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Aetna,Middlesex Employees,,336.77,,,336.77,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Anthem,Commerical,,444.28,,,444.28,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Anthem,Indemnity,,,495.23,,495.23,166.61,545.56,percent of total billed charges,,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Anthem,State Preferred,,166.61,,,166.61,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Anthem,Individual Exchange,,355.43,,,355.43,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Cigna,Cigna,,510.78,,,510.78,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Connecticare,Commerical,,475.51,,,475.51,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Connecticare,Exchange,,475.51,,,475.51,166.61,545.56,other,Could be inpatient or outpatient,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,Multiplan,Multiplan,,,545.56,,545.56,166.61,545.56,percent of total billed charges,,
HC TISCUL NON SK B,88233,CPT,,,both,,,680.93,408.56,United Healthcare/Oxford,United Healthcare/Oxford,,414.82,,,414.82,166.61,545.56,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT  ,,,both,,,586.39,351.83,Aetna,Commerical,,166.67,,,166.67,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Aetna,Middlesex Employees,,150.01,,,150.01,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Anthem,Commerical,,232.78,,,232.78,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Anthem,Indemnity,,,426.47,,426.47,149.53,469.82,percent of total billed charges,,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Anthem,State Preferred,,149.53,,,149.53,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Anthem,Individual Exchange,,186.23,,,186.23,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Cigna,Cigna,,280.7,,,280.7,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Connecticare,Commerical,,160.85,,,160.85,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Connecticare,Exchange,,160.85,,,160.85,149.53,469.82,other,Could be inpatient or outpatient,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,Multiplan,Multiplan,,,469.82,,469.82,149.53,469.82,percent of total billed charges,,
HC CHROM CULTURE BM,88237,CPT,,,both,,,586.39,351.83,United Healthcare/Oxford,United Healthcare/Oxford,,188.5,,,188.5,149.53,469.82,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT  ,,,both,,,508.74,305.24,Aetna,Commerical,,166.67,,,166.67,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Aetna,Middlesex Employees,,150.01,,,150.01,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Anthem,Commerical,,232.78,,,232.78,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Anthem,Indemnity,,,369.99,,369.99,149.53,407.6,percent of total billed charges,,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Anthem,State Preferred,,149.53,,,149.53,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Anthem,Individual Exchange,,186.23,,,186.23,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Cigna,Cigna,,280.7,,,280.7,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Connecticare,Commerical,,160.85,,,160.85,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Connecticare,Exchange,,160.85,,,160.85,149.53,407.6,other,Could be inpatient or outpatient,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,Multiplan,Multiplan,,,407.6,,407.6,149.53,407.6,percent of total billed charges,,
HC TIS CULT BM&BP,88237,CPT,,,both,,,508.74,305.24,United Healthcare/Oxford,United Healthcare/Oxford,,188.5,,,188.5,149.53,407.6,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT  ,,,both,,,593.14,355.88,Aetna,Commerical,,171.04,,,171.04,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Aetna,Middlesex Employees,,153.93,,,153.93,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Anthem,Commerical,,271.88,,,271.88,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Anthem,Indemnity,,,431.38,,431.38,153.93,475.23,percent of total billed charges,,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Anthem,State Preferred,,174.66,,,174.66,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Anthem,Individual Exchange,,217.51,,,217.51,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Cigna,Cigna,,327.57,,,327.57,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Connecticare,Commerical,,165.07,,,165.07,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Connecticare,Exchange,,165.07,,,165.07,153.93,475.23,other,Could be inpatient or outpatient,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,Multiplan,Multiplan,,,475.23,,472.23,153.93,475.23,percent of total billed charges,,
HC TISCUL NEO TUMO,88239,CPT,,,both,,,593.14,355.88,United Healthcare/Oxford,United Healthcare/Oxford,,214.93,,,214.93,153.93,475.23,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT  ,,,both,,,740.58,444.35,Aetna,Commerical,,406.96,,,406.96,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Aetna,Middlesex Employees,,366.27,,,366.27,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Anthem,Commerical,,483.21,,,483.21,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Anthem,Indemnity,,,538.61,,538.61,209.24,593.36,percent of total billed charges,,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Anthem,State Preferred,,209.24,,,209.24,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Anthem,Individual Exchange,,386.57,,,386.57,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Cigna,Cigna,,555.52,,,555.52,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Connecticare,Commerical,,517.16,,,517.16,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Connecticare,Exchange,,517.16,,,517.16,209.24,593.36,other,Could be inpatient or outpatient,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,Multiplan,Multiplan,,,593.36,,593.36,209.24,593.36,percent of total billed charges,,
HC CHR ALYS 1 KARYO,88261,CPT,,,both,,,740.58,444.35,United Healthcare/Oxford,United Healthcare/Oxford,,451.17,,,451.17,209.24,593.36,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT  ,,,both,,,501.97,301.18,Aetna,Commerical,,145.5,,,145.5,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Aetna,Middlesex Employees,,130.96,,,130.96,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Anthem,Commerical,,229.72,,,229.72,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Anthem,Indemnity,,,365.08,,365.08,130.96,402.19,percent of total billed charges,,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Anthem,State Preferred,,147.56,,,147.56,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Anthem,Individual Exchange,,183.77,,,183.77,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Cigna,Cigna,,276.53,,,276.53,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Connecticare,Commerical,,140.42,,,140.42,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Connecticare,Exchange,,140.42,,,140.42,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,Multiplan,Multiplan,,,402.19,,402.19,130.96,402.19,percent of total billed charges,,
HC CHROMOSOME 15-20 CELLS 2KA,88262,CPT,,,both,,,501.97,301.18,United Healthcare/Oxford,United Healthcare/Oxford,,181.6,,,181.6,130.96,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT  ,,,both,,,605.64,363.38,Aetna,Commerical,,332.75,,,332.75,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Aetna,Middlesex Employees,,299.48,,,299.48,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Anthem,Commerical,,395.09,,,395.09,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Anthem,Indemnity,,,440.38,,440.38,177.93,485.15,percent of total billed charges,,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Anthem,State Preferred,,177.93,,,177.93,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Anthem,Individual Exchange,,316.07,,,316.07,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Cigna,Cigna,,454.21,,,454.21,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Connecticare,Commerical,,422.85,,,422.85,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Connecticare,Exchange,,422.85,,,422.85,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,Multiplan,Multiplan,,,485.15,,485.15,177.93,485.15,percent of total billed charges,,
HC CHROM ANALY; 45 CELLS; 2KA - MOSA,88263,CPT,,,both,,,605.64,363.38,United Healthcare/Oxford,United Healthcare/Oxford,,368.88,,,368.88,177.93,485.15,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT  ,,,both,,,501.97,301.18,Aetna,Commerical,,167.67,,,167.67,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Aetna,Middlesex Employees,,150.9,,,150.9,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Anthem,Commerical,,229.72,,,229.72,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Anthem,Indemnity,,,365.08,,365.08,147.56,402.19,percent of total billed charges,,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Anthem,State Preferred,,147.56,,,147.56,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Anthem,Individual Exchange,,183.77,,,183.77,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Cigna,Cigna,,276.53,,,276.53,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Connecticare,Commerical,,161.81,,,161.81,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Connecticare,Exchange,,161.81,,,161.81,147.56,402.19,other,Could be inpatient or outpatient,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,Multiplan,Multiplan,,,402.19,,402.19,147.56,402.19,percent of total billed charges,,
HC CHROM ANALY; 20-25 CELLS,88264,CPT,,,both,,,501.97,301.18,United Healthcare/Oxford,United Healthcare/Oxford,,189.62,,,189.62,147.56,402.19,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT  ,,,both,,,85.54,51.32,Aetna,Commerical,,24.84,,,24.84,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,24.84,,,24.84,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Aetna,Middlesex Employees,,22.35,,,22.35,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,22.35,,,22.35,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Anthem,Commerical,,39.47,,,39.47,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,39.47,,,39.47,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Anthem,Indemnity,,,62.21,,62.21,22.35,68.54,percent of total billed charges,,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,22.35,62.22,percent of total billed charges,,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Anthem,State Preferred,,25.37,,,25.37,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,25.37,,,25.37,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Anthem,Individual Exchange,,31.58,,,31.58,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,31.58,,,31.58,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Cigna,Cigna,,47.49,,,47.49,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,47.49,,,47.49,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Connecticare,Commerical,,23.97,,,23.97,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,23.97,,,23.97,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Connecticare,Exchange,,23.97,,,23.97,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,23.97,,,23.97,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,Multiplan,Multiplan,,,68.54,,68.54,22.35,68.54,percent of total billed charges,,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,22.35,62.22,percent of total billed charges,,
HC MCG; DNA PROBE EA - CYTOGEN-2,88271,CPT,,,both,,,85.54,51.32,United Healthcare/Oxford,United Healthcare/Oxford,,31.21,,,31.21,22.35,68.54,other,Could be inpatient or outpatient,
HC MCG; DNA PROBE EA - CYTOGEN,88271,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,31.21,,,31.21,22.35,62.22,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT  ,,,both,,,129.78,77.87,Aetna,Commerical,,40.36,,,40.36,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Aetna,Middlesex Employees,,36.32,,,36.32,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Anthem,Commerical,,40.01,,,40.01,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Anthem,Indemnity,,,94.13,,94.13,25.7,103.7,percent of total billed charges,,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Anthem,State Preferred,,25.7,,,25.7,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Anthem,Individual Exchange,,32.01,,,32.01,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Cigna,Cigna,,71.22,,,71.22,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Connecticare,Commerical,,38.95,,,38.95,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Connecticare,Exchange,,38.95,,,38.95,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,Multiplan,Multiplan,,,103.7,,103.7,25.7,103.7,percent of total billed charges,,
HC MCG; SITU HYBRID 10-30 CELLS - CYTOGEN ISH,88273,CPT,,,both,,,129.78,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,46.81,,,46.81,25.7,103.7,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT  ,,,both,,,141.11,84.67,Aetna,Commerical,,49.14,,,49.14,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Aetna,Middlesex Employees,,44.22,,,44.22,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Anthem,Commerical,,40.01,,,40.01,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Anthem,Indemnity,,,102.32,,102.32,25.7,112.72,percent of total billed charges,,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Anthem,State Preferred,,25.7,,,25.7,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Anthem,Individual Exchange,,32.01,,,32.01,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Cigna,Cigna,,77.15,,,77.15,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Connecticare,Commerical,,47.42,,,47.42,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Connecticare,Exchange,,47.42,,,47.42,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,Multiplan,Multiplan,,,112.72,,112.72,25.7,112.72,percent of total billed charges,,
HC MCG; IP SITU 25-99 CELLS - CYTOGEN,88274,CPT,,,both,,,141.11,84.67,United Healthcare/Oxford,United Healthcare/Oxford,,55.58,,,55.58,25.7,112.72,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT  ,,,both,,,166.86,100.12,Aetna,Commerical,,59.35,,,59.35,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Aetna,Middlesex Employees,,53.41,,,53.41,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Anthem,Commerical,,40.01,,,40.01,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Anthem,Indemnity,,,121.14,,121.14,25.7,133.46,percent of total billed charges,,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Anthem,State Preferred,,25.7,,,25.7,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Anthem,Individual Exchange,,32.01,,,32.01,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Cigna,Cigna,,89,,,89,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Connecticare,Commerical,,57.28,,,57.28,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Connecticare,Exchange,,57.28,,,57.28,25.7,133.46,other,Could be inpatient or outpatient,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,Multiplan,Multiplan,,,133.46,,133.46,25.7,133.46,percent of total billed charges,,
HC MCG; IP SITU 100-300 CELLS - CYTOGEN,88275,CPT,,,both,,,166.86,100.12,United Healthcare/Oxford,United Healthcare/Oxford,,67.13,,,67.13,25.7,133.46,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT  ,,,both,,,109.18,65.51,Aetna,Commerical,,38.8,,,38.8,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Aetna,Middlesex Employees,,34.93,,,34.93,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Anthem,Commerical,,46.25,,,46.25,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Anthem,Indemnity,,,79.4,,79.4,29.71,87.47,percent of total billed charges,,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Anthem,State Preferred,,29.71,,,29.71,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Anthem,Individual Exchange,,37,,,37,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Cigna,Cigna,,55.79,,,55.79,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Connecticare,Commerical,,37.45,,,37.45,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Connecticare,Exchange,,37.45,,,37.45,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,Multiplan,Multiplan,,,87.47,,87.47,29.71,87.47,percent of total billed charges,,
HC CHROM ANALY; ADDTL KARYOT EA STUDY,88280,CPT,,,both,,,109.18,65.51,United Healthcare/Oxford,United Healthcare/Oxford,,43.89,,,43.89,29.71,87.47,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT  ,,,both,,,188.49,113.09,Aetna,Commerical,,103.91,,,103.91,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Aetna,Middlesex Employees,,93.51,,,93.51,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Anthem,Commerical,,123.37,,,123.37,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Anthem,Indemnity,,,137.52,,137.52,22.49,151.5,percent of total billed charges,,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Anthem,State Preferred,,22.49,,,22.49,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Anthem,Individual Exchange,,98.7,,,98.7,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Cigna,Cigna,,141.84,,,141.84,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Connecticare,Commerical,,132.05,,,132.05,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Connecticare,Exchange,,132.05,,,132.05,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,Multiplan,Multiplan,,,151.5,,151.5,22.49,151.5,percent of total billed charges,,
HC CHROM ANALY; ADDTL CELL COUNTED;EA STUDY,88285,CPT,,,both,,,188.49,113.09,United Healthcare/Oxford,United Healthcare/Oxford,,115.2,,,115.2,22.49,151.5,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT  ,,,both,,,139.05,83.43,Aetna,Commerical,,39.92,,,39.92,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Aetna,Middlesex Employees,,35.93,,,35.93,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Anthem,Commerical,,63.48,,,63.48,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Anthem,Indemnity,,,100.68,,100.68,35.93,110.92,percent of total billed charges,,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Anthem,State Preferred,,40.76,,,40.76,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Anthem,Individual Exchange,,50.78,,,50.78,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Cigna,Cigna,,76.55,,,76.55,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Connecticare,Commerical,,38.53,,,38.53,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Connecticare,Exchange,,38.53,,,38.53,35.93,110.92,other,Could be inpatient or outpatient,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,Multiplan,Multiplan,,,110.92,,110.92,35.93,110.92,percent of total billed charges,,
HC CHROM ANALY; ADDTL HI RESOLN,88289,CPT,,,both,,,139.05,83.43,United Healthcare/Oxford,United Healthcare/Oxford,,50.17,,,50.17,35.93,110.92,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT  ,,,both,,,89.61,53.77,Aetna,Commerical,,49.48,,,49.48,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Aetna,Middlesex Employees,,44.54,,,44.54,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Anthem,Commerical,,58.75,,,58.75,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Anthem,Indemnity,,,65.48,,65.48,26.73,72.14,percent of total billed charges,,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Anthem,State Preferred,,26.73,,,26.73,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Anthem,Individual Exchange,,47,,,47,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Cigna,Cigna,,67.54,,,67.54,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Connecticare,Commerical,,62.88,,,62.88,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Connecticare,Exchange,,62.88,,,62.88,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,Multiplan,Multiplan,,,72.14,,72.14,26.73,72.14,percent of total billed charges,,
HC CYTOGENETICS INT,88291,CPT,,,both,,,89.61,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,54.86,,,54.86,26.73,72.14,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT  ,,,both,,,65.28,39.17,Aetna,Commerical,,35.87,,,35.87,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Aetna,Middlesex Employees,,32.29,,,32.29,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Anthem,Commerical,,42.59,,,42.59,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Anthem,Indemnity,,,47.47,,47.47,26.73,52.3,percent of total billed charges,,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Anthem,State Preferred,,26.73,,,26.73,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Anthem,Individual Exchange,,34.07,,,34.07,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Cigna,Cigna,,48.96,,,48.96,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Connecticare,Commerical,,45.59,,,45.59,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Connecticare,Exchange,,45.59,,,45.59,26.73,52.3,other,Could be inpatient or outpatient,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,Multiplan,Multiplan,,,52.3,,52.3,26.73,52.3,percent of total billed charges,,
HC CYTOGN INTERP/RPT,88291,CPT,,,both,,,65.28,39.17,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,26.73,52.3,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,14.43,,,14.43,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,12.99,,,12.99,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,15.25,,,15.25,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,12.19,50.5,percent of total billed charges,,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,13.2,,,13.2,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,12.19,,,12.19,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,14.72,,,14.72,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,15.28,,,15.28,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,15.28,,,15.28,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,12.19,50.5,percent of total billed charges,,
HC SURG PATH G 1,88300,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,22.51,,,22.51,12.19,50.5,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,31.2,,,31.2,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,28.09,,,28.09,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,36.02,,,36.02,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,28.09,91.08,percent of total billed charges,,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,29.59,,,29.59,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,28.81,,,28.81,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,38.34,,,38.34,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,34.45,,,34.45,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,34.45,,,34.45,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,28.09,91.08,percent of total billed charges,,
HC SURG PATH G&M 2,88302,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,28.09,91.08,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,38.64,,,38.64,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,34.77,,,34.77,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,49.68,,,49.68,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,34.77,128.05,percent of total billed charges,,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,38.12,,,38.12,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,39.74,,,39.74,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,46.66,,,46.66,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,42.13,,,42.13,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,42.13,,,42.13,34.77,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,34.77,128.05,percent of total billed charges,,
HC SURG PATH G&M 3,88304,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,34.77,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,41.44,,,41.44,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,37.3,,,37.3,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,49.68,,,49.68,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,37.3,128.05,percent of total billed charges,,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,84.48,,,84.48,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,39.74,,,39.74,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,85.01,,,85.01,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,46.44,,,46.44,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,46.44,,,46.44,37.3,128.05,other,Could be inpatient or outpatient,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,37.3,128.05,percent of total billed charges,,
HC CPP LEVEL IV SURG,88305,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,41.44,,,41.44,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,37.3,,,37.3,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,49.68,,,49.68,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,37.3,128.05,percent of total billed charges,,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,84.48,,,84.48,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,39.74,,,39.74,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,85.01,,,85.01,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,46.44,,,46.44,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,46.44,,,46.44,37.3,128.05,other,Could be inpatient or outpatient,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,37.3,128.05,percent of total billed charges,,
HC SURG PATH G&M 4,88305,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,37.3,128.05,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,41.44,,,41.44,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,37.3,,,37.3,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,49.68,,,49.68,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,37.3,107.31,percent of total billed charges,,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,84.48,,,84.48,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,39.74,,,39.74,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,85.01,,,85.01,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,46.44,,,46.44,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,46.44,,,46.44,37.3,107.31,other,Could be inpatient or outpatient,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,37.3,107.31,percent of total billed charges,,
HC UC LEVEL IV SURG,88305,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,37.3,107.31,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,251.47,,,251.47,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,226.32,,,226.32,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,320.58,,,320.58,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,119.18,615.9,percent of total billed charges,,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,144.22,,,144.22,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,256.46,,,256.46,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,119.18,,,119.18,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,284.11,,,284.11,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,284.11,,,284.11,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,119.18,615.9,percent of total billed charges,,
HC SURG PATH G&M 5,88307,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,119.18,615.9,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT  ,,,both,,,1929.19,1157.51,Aetna,Commerical,,354.85,,,354.85,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Aetna,Middlesex Employees,,319.37,,,319.37,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Anthem,Commerical,,453.36,,,453.36,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Anthem,Indemnity,,,1403.01,,1403.01,136.4,1545.62,percent of total billed charges,,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Anthem,State Preferred,,186.69,,,186.69,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Anthem,Individual Exchange,,362.68,,,362.68,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Cigna,Cigna,,136.4,,,136.4,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Connecticare,Commerical,,404.98,,,404.98,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Connecticare,Exchange,,404.98,,,404.98,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,Multiplan,Multiplan,,,1545.62,,1545.62,136.4,1545.62,percent of total billed charges,,
HC SURG PATH G&M 6,88309,CPT,,,both,,,1929.19,1157.51,United Healthcare/Oxford,United Healthcare/Oxford,,731.85,,,731.85,136.4,1545.62,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,11.64,,,11.64,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,10.47,,,10.47,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,12.21,,,12.21,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,5.81,27.33,percent of total billed charges,,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,14.73,,,14.73,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,9.77,,,9.77,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,5.81,,,5.81,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,11.91,,,11.91,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,11.91,,,11.91,5.81,27.33,other,Could be inpatient or outpatient,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,5.81,27.33,percent of total billed charges,,
HC SURG.PATH.DECAL-J,88311,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,11.81,,,11.81,5.81,27.33,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT  ,,,both,,,112.27,67.36,Aetna,Commerical,,102.44,,,102.44,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Aetna,Middlesex Employees,,92.2,,,92.2,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Anthem,Commerical,,105.88,,,105.88,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Anthem,Indemnity,,,81.86,,81.86,66.35,118.39,percent of total billed charges,,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Anthem,State Preferred,,72.03,,,72.03,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Anthem,Individual Exchange,,84.7,,,84.7,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Cigna,Cigna,,66.35,,,66.35,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Connecticare,Commerical,,118.39,,,118.39,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Connecticare,Exchange,,118.39,,,118.39,66.35,118.39,other,Could be inpatient or outpatient,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,Multiplan,Multiplan,,,90.18,,90.18,66.35,118.39,percent of total billed charges,,
HC CPP SP ST GR1 ORG,88312,CPT,,,both,,,112.27,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,66.35,118.39,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT  ,,,both,,,159.65,95.79,Aetna,Commerical,,102.44,,,102.44,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Aetna,Middlesex Employees,,92.2,,,92.2,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Anthem,Commerical,,105.88,,,105.88,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Anthem,Indemnity,,,116.24,,116.24,66.35,128.05,percent of total billed charges,,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Anthem,State Preferred,,72.03,,,72.03,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Anthem,Individual Exchange,,84.7,,,84.7,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Cigna,Cigna,,66.35,,,66.35,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Connecticare,Commerical,,118.39,,,118.39,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Connecticare,Exchange,,118.39,,,118.39,66.35,128.05,other,Could be inpatient or outpatient,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,Multiplan,Multiplan,,,128.05,,128.05,66.35,128.05,percent of total billed charges,,
HC SP STAIN GRP1-K,88312,CPT,,,both,,,159.65,95.79,United Healthcare/Oxford,United Healthcare/Oxford,,66.86,,,66.86,66.35,128.05,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,83.35,,,83.35,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,75.02,,,75.02,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,83.1,,,83.1,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,42.12,95.37,percent of total billed charges,,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,48.27,,,48.27,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,66.48,,,66.48,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,58.65,,,58.65,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,42.12,95.37,percent of total billed charges,,
HC IRON STAIN GRP II,88313,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,83.35,,,83.35,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,75.02,,,75.02,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,83.1,,,83.1,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,42.12,95.37,percent of total billed charges,,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,48.27,,,48.27,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,66.48,,,66.48,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,58.65,,,58.65,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,42.12,95.37,percent of total billed charges,,
HC SPECIAL STAINS GROUP 2,88313,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,83.35,,,83.35,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,75.02,,,75.02,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,83.1,,,83.1,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,42.12,95.37,percent of total billed charges,,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,48.27,,,48.27,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,66.48,,,66.48,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,58.65,,,58.65,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,95.37,,,95.37,42.12,95.37,other,Could be inpatient or outpatient,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,42.12,95.37,percent of total billed charges,,
HC SPECIAL STAINS GROUP 2 - CPP,88313,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,42.12,95.37,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT  ,,,both,,,161.71,97.03,Aetna,Commerical,,83.35,,,83.35,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Aetna,Middlesex Employees,,75.02,,,75.02,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Anthem,Commerical,,83.1,,,83.1,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Anthem,Indemnity,,,117.87,,117.87,42.12,129.85,percent of total billed charges,,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Anthem,State Preferred,,48.27,,,48.27,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Anthem,Individual Exchange,,66.48,,,66.48,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Cigna,Cigna,,58.65,,,58.65,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Connecticare,Commerical,,95.37,,,95.37,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Connecticare,Exchange,,95.37,,,95.37,42.12,129.85,other,Could be inpatient or outpatient,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,Multiplan,Multiplan,,,129.85,,129.85,42.12,129.85,percent of total billed charges,,
HC UC GP 2 SPECIALS,88313,CPT,,,both,,,161.71,97.03,United Healthcare/Oxford,United Healthcare/Oxford,,42.12,,,42.12,42.12,129.85,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT  ,,,both,,,327.54,196.52,Aetna,Commerical,,179.98,,,179.98,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Aetna,Middlesex Employees,,161.98,,,161.98,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Anthem,Commerical,,213.7,,,213.7,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Anthem,Indemnity,,,238.2,,238.2,43.44,262.41,percent of total billed charges,,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Anthem,State Preferred,,43.44,,,43.44,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Anthem,Individual Exchange,,170.96,,,170.96,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Cigna,Cigna,,245.68,,,245.68,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Connecticare,Commerical,,228.71,,,228.71,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Connecticare,Exchange,,228.71,,,228.71,43.44,262.41,other,Could be inpatient or outpatient,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,Multiplan,Multiplan,,,262.41,,262.41,43.44,262.41,percent of total billed charges,,
HC HISTOCHEMICAL STAINS ADD-ON - 314,88314,CPT,,,both,,,327.54,196.52,United Healthcare/Oxford,United Healthcare/Oxford,,199.53,,,199.53,43.44,262.41,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT  ,,,both,,,321.36,192.82,Aetna,Commerical,,176.26,,,176.26,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Aetna,Middlesex Employees,,158.63,,,158.63,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Anthem,Commerical,,209.3,,,209.3,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Anthem,Indemnity,,,233.29,,233.29,43.44,257.01,percent of total billed charges,,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Anthem,State Preferred,,43.44,,,43.44,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Anthem,Individual Exchange,,167.44,,,167.44,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Cigna,Cigna,,240.61,,,240.61,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Connecticare,Commerical,,224,,,224,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Connecticare,Exchange,,224,,,224,43.44,257.01,other,Could be inpatient or outpatient,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,Multiplan,Multiplan,,,257.01,,257.01,43.44,257.01,percent of total billed charges,,
HC UC HISTOCHEM FRZN,88314,CPT,,,both,,,321.36,192.82,United Healthcare/Oxford,United Healthcare/Oxford,,195.41,,,195.41,43.44,257.01,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT  ,,,both,,,307.97,184.78,Aetna,Commerical,,169.46,,,169.46,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Aetna,Middlesex Employees,,152.51,,,152.51,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Anthem,Commerical,,201.21,,,201.21,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Anthem,Indemnity,,,224.29,,224.29,91.31,247.09,percent of total billed charges,,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Anthem,State Preferred,,91.31,,,91.31,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Anthem,Individual Exchange,,160.97,,,160.97,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Cigna,Cigna,,231.33,,,231.33,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Connecticare,Commerical,,215.36,,,215.36,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Connecticare,Exchange,,215.36,,,215.36,91.31,247.09,other,Could be inpatient or outpatient,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,Multiplan,Multiplan,,,247.09,,247.09,91.31,247.09,percent of total billed charges,,
HC UC H/C ENZY88319,88319,CPT,,,both,,,307.97,184.78,United Healthcare/Oxford,United Healthcare/Oxford,,187.87,,,187.87,91.31,247.09,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT  ,,,both,,,301.79,181.07,Aetna,Commerical,,165.76,,,165.76,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Aetna,Middlesex Employees,,149.18,,,149.18,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Anthem,Commerical,,196.81,,,196.81,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Anthem,Indemnity,,,219.37,,219.37,91.31,241.67,percent of total billed charges,,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Anthem,State Preferred,,91.31,,,91.31,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Anthem,Individual Exchange,,157.44,,,157.44,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Cigna,Cigna,,226.26,,,226.26,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Connecticare,Commerical,,210.64,,,210.64,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Connecticare,Exchange,,210.64,,,210.64,91.31,241.67,other,Could be inpatient or outpatient,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,Multiplan,Multiplan,,,241.67,,241.67,91.31,241.67,percent of total billed charges,,
HC UC HISCYTO CHEM,88319,CPT,,,both,,,301.79,181.07,United Healthcare/Oxford,United Healthcare/Oxford,,183.76,,,183.76,91.31,241.67,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT  ,,,both,,,86.52,51.91,Aetna,Commerical,,48.24,,,48.24,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Aetna,Middlesex Employees,,43.42,,,43.42,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Anthem,Commerical,,57.28,,,57.28,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Anthem,Indemnity,,,63.85,,63.85,43.42,91.65,percent of total billed charges,,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Anthem,State Preferred,,91.65,,,91.65,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Anthem,Individual Exchange,,45.82,,,45.82,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Cigna,Cigna,,65.85,,,65.85,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Connecticare,Commerical,,61.31,,,61.31,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Connecticare,Exchange,,61.31,,,61.31,43.42,91.65,other,Could be inpatient or outpatient,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,Multiplan,Multiplan,,,70.34,,70.34,43.42,91.65,percent of total billed charges,,
HC CPP SLIDE PREP,88323,CPT,,,both,,,86.52,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,53.48,,,53.48,43.42,91.65,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,31.21,,,31.21,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,28.1,,,28.1,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,37.06,,,37.06,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Anthem,Indemnity,,,41.31,,41.31,28.1,45.51,percent of total billed charges,,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,43.55,,,43.55,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,29.65,,,29.65,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,42.61,,,42.61,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,39.66,,,39.66,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,39.66,,,39.66,28.1,45.51,other,Could be inpatient or outpatient,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,Multiplan,Multiplan,,,45.51,,45.51,28.1,45.51,percent of total billed charges,,
HC PATH CONSULT DURING SURGERY,88329,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,34.61,,,34.61,28.1,45.51,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,45.17,,,45.17,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,40.65,,,40.65,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,57.28,,,57.28,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,29.22,368.82,percent of total billed charges,,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,73.51,,,73.51,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,45.82,,,45.82,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,29.22,,,29.22,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,57.95,,,57.95,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,57.95,,,57.95,29.22,368.82,other,Could be inpatient or outpatient,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,29.22,368.82,percent of total billed charges,,
HC SP CONSULT; 1ST TB W FS SGL SP,88331,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,29.22,368.82,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT  ,,,both,,,187.46,112.48,Aetna,Commerical,,103.29,,,103.29,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Aetna,Middlesex Employees,,92.95,,,92.95,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Anthem,Commerical,,122.64,,,122.64,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Anthem,Indemnity,,,136.7,,136.7,92.95,859.1,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Anthem,State Preferred,,859.1,,,859.1,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Anthem,Individual Exchange,,98.11,,,98.11,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Cigna,Cigna,,140.99,,,140.99,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Connecticare,Commerical,,131.25,,,131.25,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Connecticare,Exchange,,131.25,,,131.25,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,Multiplan,Multiplan,,,150.59,,150.59,92.95,859.1,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE,88333,CPT,,,both,,,187.46,112.48,United Healthcare/Oxford,United Healthcare/Oxford,,114.51,,,114.51,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT  ,,,both,,,1929.19,1157.51,Aetna,Commerical,,1060.09,,,1060.09,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Aetna,Middlesex Employees,,954.08,,,954.08,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Anthem,Commerical,,1258.69,,,1258.69,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Anthem,Indemnity,,,1403.01,,1403.01,859.1,1545.62,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Anthem,State Preferred,,859.1,,,859.1,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Anthem,Individual Exchange,,1006.95,,,1006.95,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Cigna,Cigna,,1447.06,,,1447.06,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Connecticare,Commerical,,1347.15,,,1347.15,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Connecticare,Exchange,,1347.15,,,1347.15,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,Multiplan,Multiplan,,,1545.62,,1545.62,859.1,1545.62,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - JHU FLOW,88333,CPT,,,both,,,1929.19,1157.51,United Healthcare/Oxford,United Healthcare/Oxford,,1175.23,,,1175.23,859.1,1545.62,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT  ,,,both,,,187.46,112.48,Aetna,Commerical,,103.29,,,103.29,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Aetna,Middlesex Employees,,92.95,,,92.95,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Anthem,Commerical,,122.64,,,122.64,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Anthem,Indemnity,,,136.7,,136.7,92.95,859.1,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Anthem,State Preferred,,859.1,,,859.1,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Anthem,Individual Exchange,,98.11,,,98.11,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Cigna,Cigna,,140.99,,,140.99,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Connecticare,Commerical,,131.25,,,131.25,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Connecticare,Exchange,,131.25,,,131.25,92.95,859.1,other,Could be inpatient or outpatient,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,Multiplan,Multiplan,,,150.59,,150.59,92.95,859.1,percent of total billed charges,,
HC INTRAOP CYTO PATH CONSULT INITIAL SITE - PREP TECH,88333,CPT,,,both,,,187.46,112.48,United Healthcare/Oxford,United Healthcare/Oxford,,114.51,,,114.51,92.95,859.1,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT  ,,,both,,,233.81,140.29,Aetna,Commerical,,83.36,,,83.36,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Aetna,Middlesex Employees,,75.03,,,75.03,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Anthem,Commerical,,68.84,,,68.84,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Anthem,Indemnity,,,170.26,,170.26,55.07,187.57,percent of total billed charges,,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Anthem,State Preferred,,63.03,,,63.03,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Anthem,Individual Exchange,,55.07,,,55.07,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Cigna,Cigna,,166.43,,,166.43,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Connecticare,Commerical,,89.69,,,89.69,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Connecticare,Exchange,,89.69,,,89.69,55.07,187.57,other,Could be inpatient or outpatient,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,Multiplan,Multiplan,,,187.57,,187.57,55.07,187.57,percent of total billed charges,,
HC CPP ICC PER SPECIMEN EA ADDL SGNL STAIN,88341,CPT,,,both,,,233.81,140.29,United Healthcare/Oxford,United Healthcare/Oxford,,84.58,,,84.58,55.07,187.57,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT  ,,,both,,,121.54,72.92,Aetna,Commerical,,83.36,,,83.36,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Aetna,Middlesex Employees,,75.03,,,75.03,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Anthem,Commerical,,68.84,,,68.84,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Anthem,Indemnity,,,89.22,,89.22,55.07,166.43,percent of total billed charges,,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Anthem,State Preferred,,63.03,,,63.03,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Anthem,Individual Exchange,,55.07,,,55.07,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Cigna,Cigna,,166.43,,,166.43,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Connecticare,Commerical,,89.69,,,89.69,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Connecticare,Exchange,,89.69,,,89.69,55.07,166.43,other,Could be inpatient or outpatient,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,Multiplan,Multiplan,,,98.29,,98.29,55.07,166.43,percent of total billed charges,,
HC ICH AB PER SPECIMEN; EA ADDL SGL STAIN,88341,CPT,,,both,,,121.54,72.92,United Healthcare/Oxford,United Healthcare/Oxford,,84.58,,,84.58,55.07,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT  ,,,both,,,233.81,140.29,Aetna,Commerical,,83.36,,,83.36,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Aetna,Middlesex Employees,,75.03,,,75.03,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Anthem,Commerical,,68.84,,,68.84,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Anthem,Indemnity,,,170.26,,170.26,55.07,187.57,percent of total billed charges,,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Anthem,State Preferred,,63.03,,,63.03,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Anthem,Individual Exchange,,55.07,,,55.07,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Cigna,Cigna,,166.43,,,166.43,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Connecticare,Commerical,,89.69,,,89.69,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Connecticare,Exchange,,89.69,,,89.69,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,Multiplan,Multiplan,,,187.57,,187.57,55.07,187.57,percent of total billed charges,,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - CPP,88341,CPT,,,both,,,233.81,140.29,United Healthcare/Oxford,United Healthcare/Oxford,,84.58,,,84.58,55.07,187.57,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT  ,,,both,,,38.13,22.88,Aetna,Commerical,,83.36,,,83.36,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Aetna,Middlesex Employees,,75.03,,,75.03,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Anthem,Commerical,,68.84,,,68.84,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Anthem,Indemnity,,,27.72,,27.72,27.72,166.43,percent of total billed charges,,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Anthem,State Preferred,,63.03,,,63.03,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Anthem,Individual Exchange,,55.07,,,55.07,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Cigna,Cigna,,166.43,,,166.43,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Connecticare,Commerical,,89.69,,,89.69,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Connecticare,Exchange,,89.69,,,89.69,27.72,166.43,other,Could be inpatient or outpatient,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,Multiplan,Multiplan,,,30.54,,30.54,27.72,166.43,percent of total billed charges,,
HC IMHISTOCHE/CYTCHM EA ADD SG AB STAIN - UCONN,88341,CPT,,,both,,,38.13,22.88,United Healthcare/Oxford,United Healthcare/Oxford,,84.58,,,84.58,27.72,166.43,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT  ,,,both,,,153.47,92.08,Aetna,Commerical,,90.8,,,90.8,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,81.72,,,81.72,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Anthem,Commerical,,108.92,,,108.92,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Anthem,Indemnity,,,112.14,,112.14,59.12,189.79,percent of total billed charges,,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Anthem,State Preferred,,71.96,,,71.96,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Anthem,Individual Exchange,,87.14,,,87.14,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Cigna,Cigna,,59.12,,,59.12,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Connecticare,Commerical,,97.3,,,97.3,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Connecticare,Exchange,,97.3,,,97.3,59.12,189.79,other,Could be inpatient or outpatient,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,Multiplan,Multiplan,,,123.54,,123.54,59.12,189.79,percent of total billed charges,,
HC CPP ICC 1ST AB,88342,CPT,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,59.12,189.79,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,90.8,,,90.8,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,81.72,,,81.72,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,108.92,,,108.92,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,59.12,615.9,percent of total billed charges,,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,71.96,,,71.96,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,87.14,,,87.14,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,59.12,,,59.12,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,97.3,,,97.3,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,97.3,,,97.3,59.12,615.9,other,Could be inpatient or outpatient,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,59.12,615.9,percent of total billed charges,,
HC IMMUNOHISTO ANTB PER SPECIMEN 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,90.8,,,90.8,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,81.72,,,81.72,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,108.92,,,108.92,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,59.12,615.9,percent of total billed charges,,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,71.96,,,71.96,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,87.14,,,87.14,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,59.12,,,59.12,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,97.3,,,97.3,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,97.3,,,97.3,59.12,615.9,other,Could be inpatient or outpatient,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,59.12,615.9,percent of total billed charges,,
HC IMPEROX EA AB; PER SPEC 1ST STAIN,88342,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,59.12,615.9,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT  ,,,both,,,211.15,126.69,Aetna,Commerical,,90.8,,,90.8,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Aetna,Middlesex Employees,,81.72,,,81.72,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Anthem,Commerical,,108.92,,,108.92,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Anthem,Indemnity,,,153.07,,153.07,59.12,189.79,percent of total billed charges,,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Anthem,State Preferred,,71.96,,,71.96,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Anthem,Individual Exchange,,87.14,,,87.14,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Cigna,Cigna,,59.12,,,59.12,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Connecticare,Commerical,,97.3,,,97.3,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Connecticare,Exchange,,97.3,,,97.3,59.12,189.79,other,Could be inpatient or outpatient,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,Multiplan,Multiplan,,,168.63,,168.53,59.12,189.79,percent of total billed charges,,
HC UC IC PER SPECI. ANTB 1ST STAIN - IHC,88342,CPT,,,both,,,211.15,126.69,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,59.12,189.79,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT  ,,,both,,,211.59,126.96,Aetna,Commerical,,116.28,,,116.28,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Aetna,Middlesex Employees,,104.65,,,104.65,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Anthem,Commerical,,138.06,,,138.06,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Anthem,Indemnity,,,153.89,,153.89,104.65,169.53,percent of total billed charges,,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Anthem,State Preferred,,108.86,,,108.86,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Anthem,Individual Exchange,,110.44,,,110.44,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Cigna,Cigna,,158.72,,,158.72,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Connecticare,Commerical,,147.77,,,147.77,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Connecticare,Exchange,,147.77,,,147.77,104.65,169.53,other,Could be inpatient or outpatient,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,Multiplan,Multiplan,,,169.53,,169.53,104.65,169.53,percent of total billed charges,,
HC IHC MPLX AB PER SPEC EA MULTPX STAIN,88344,CPT,,,both,,,211.59,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,128.9,,,128.9,104.65,169.53,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,117.35,,,117.35,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,105.62,,,105.62,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,100.31,,,100.31,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,64.46,615.9,percent of total billed charges,,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,77.36,,,77.36,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,80.25,,,80.25,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,64.46,,,64.46,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,150.52,,,150.52,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,150.52,,,150.52,64.46,615.9,other,Could be inpatient or outpatient,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,64.46,615.9,percent of total billed charges,,
HC DIRECT IF PER SPECIMEN 1ST STATIN EA AB,88346,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,64.46,615.9,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,117.35,,,117.35,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,105.62,,,105.62,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,100.31,,,100.31,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,64.46,359.57,percent of total billed charges,,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,77.36,,,77.36,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,80.25,,,80.25,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,64.46,,,64.46,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,150.52,,,150.52,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,150.52,,,150.52,64.46,359.57,other,Could be inpatient or outpatient,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,64.46,359.57,percent of total billed charges,,
HC IF STUDY-TDT PER SPECI 1ST STAIN,88346,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,64.46,359.57,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,117.35,,,117.35,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,105.62,,,105.62,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,100.31,,,100.31,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,64.46,615.9,percent of total billed charges,,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,77.36,,,77.36,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,80.25,,,80.25,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,64.46,,,64.46,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,150.52,,,150.52,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,150.52,,,150.52,64.46,615.9,other,Could be inpatient or outpatient,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,64.46,615.9,percent of total billed charges,,
HC IMMUNOFLUOR ANTB 1ST STAIN - CPP,88346,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,359.57,,,359.57,64.46,615.9,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT  ,,,both,,,1929.19,1157.51,Aetna,Commerical,,405.59,,,405.59,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Aetna,Middlesex Employees,,365.03,,,365.03,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Anthem,Commerical,,969.61,,,969.61,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Anthem,Indemnity,,,1403.01,,1403.01,323.72,1545.62,percent of total billed charges,,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Anthem,State Preferred,,323.72,,,323.72,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Anthem,Individual Exchange,,775.69,,,775.69,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Cigna,Cigna,,467.41,,,467.41,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Connecticare,Commerical,,486.91,,,486.91,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Connecticare,Exchange,,486.91,,,486.91,323.72,1545.62,other,Could be inpatient or outpatient,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,Multiplan,Multiplan,,,1545.62,,1545.62,323.72,1545.62,percent of total billed charges,,
HC CPP ELECTRON MIC,88348,CPT,,,both,,,1929.19,1157.51,United Healthcare/Oxford,United Healthcare/Oxford,,731.85,,,731.85,323.72,1545.62,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT  ,,,both,,,1242.18,745.31,Aetna,Commerical,,405.59,,,405.59,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Aetna,Middlesex Employees,,365.03,,,365.03,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Anthem,Commerical,,969.61,,,969.61,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Anthem,Indemnity,,,903.69,,903.69,323.72,995.55,percent of total billed charges,,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Anthem,State Preferred,,323.72,,,323.72,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Anthem,Individual Exchange,,775.69,,,775.69,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Cigna,Cigna,,467.41,,,467.41,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Connecticare,Commerical,,486.91,,,486.91,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Connecticare,Exchange,,486.91,,,486.91,323.72,995.55,other,Could be inpatient or outpatient,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,Multiplan,Multiplan,,,995.55,,995.55,323.72,995.55,percent of total billed charges,,
HC ELECTRON MICROSCOPY,88348,CPT,,,both,,,1242.18,745.31,United Healthcare/Oxford,United Healthcare/Oxford,,731.85,,,731.85,323.72,995.55,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT  ,,,both,,,1245.27,747.16,Aetna,Commerical,,405.59,,,405.59,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Aetna,Middlesex Employees,,365.03,,,365.03,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Anthem,Commerical,,969.61,,,969.61,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Anthem,Indemnity,,,906.15,,906.15,323.72,998.26,percent of total billed charges,,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Anthem,State Preferred,,323.72,,,323.72,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Anthem,Individual Exchange,,775.69,,,775.69,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Cigna,Cigna,,467.41,,,467.41,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Connecticare,Commerical,,486.91,,,486.91,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Connecticare,Exchange,,486.91,,,486.91,323.72,998.26,other,Could be inpatient or outpatient,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,Multiplan,Multiplan,,,998.26,,998.26,323.72,998.26,percent of total billed charges,,
HC UC ELECTRON MIC,88348,CPT,,,both,,,1245.27,747.16,United Healthcare/Oxford,United Healthcare/Oxford,,731.85,,,731.85,323.72,998.26,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT  ,,,both,,,156.56,93.94,Aetna,Commerical,,82.43,,,82.43,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Aetna,Middlesex Employees,,74.19,,,74.19,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Anthem,Commerical,,65.7,,,65.7,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Anthem,Indemnity,,,114.6,,114.6,41.52,126.25,percent of total billed charges,,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Anthem,State Preferred,,41.52,,,41.52,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Anthem,Individual Exchange,,52.56,,,52.56,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Cigna,Cigna,,117.66,,,117.66,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Connecticare,Commerical,,111.68,,,111.68,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Connecticare,Exchange,,111.68,,,111.68,41.52,126.25,other,Could be inpatient or outpatient,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,Multiplan,Multiplan,,,126.25,,126.25,41.52,126.25,percent of total billed charges,,
HC CPP IF EA ADDL AB,88350,CPT,,,both,,,156.56,93.94,United Healthcare/Oxford,United Healthcare/Oxford,,63.8,,,63.8,41.52,126.25,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT  ,,,both,,,927,556.2,Aetna,Commerical,,509.63,,,509.63,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Aetna,Middlesex Employees,,458.67,,,458.67,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Anthem,Commerical,,605.11,,,605.11,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Anthem,Indemnity,,,674.49,,674.49,146.75,743.05,percent of total billed charges,,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Anthem,State Preferred,,146.75,,,146.75,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Anthem,Individual Exchange,,484.09,,,484.09,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Cigna,Cigna,,695.67,,,695.67,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Connecticare,Commerical,,647.64,,,647.64,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Connecticare,Exchange,,647.64,,,647.64,146.75,743.05,other,Could be inpatient or outpatient,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,Multiplan,Multiplan,,,743.05,,743.05,146.75,743.05,percent of total billed charges,,
HC MORPHOMETRICS; SKEL MSCL - MSCL BX,88355,CPT,,,both,,,927,556.2,United Healthcare/Oxford,United Healthcare/Oxford,,564.99,,,564.99,146.75,743.05,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT  ,,,both,,,152.44,91.46,Aetna,Commerical,,134.59,,,134.59,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Aetna,Middlesex Employees,,121.13,,,121.13,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Anthem,Commerical,,105.38,,,105.38,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Anthem,Indemnity,,,111.32,,111.32,84.31,257.31,percent of total billed charges,,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Anthem,State Preferred,,90.89,,,90.89,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Anthem,Individual Exchange,,84.31,,,84.31,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Cigna,Cigna,,257.31,,,257.31,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Connecticare,Commerical,,150.52,,,150.52,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Connecticare,Exchange,,150.52,,,150.52,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,Multiplan,Multiplan,,,122.64,,122.64,84.31,257.31,percent of total billed charges,,
HC CPP IN SITU HYB EA ADDL,88364,CPT,,,both,,,152.44,91.46,United Healthcare/Oxford,United Healthcare/Oxford,,129.02,,,129.02,84.31,257.31,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,178.36,,,178.36,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,160.52,,,160.52,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,179.3,,,179.3,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,98.82,368.82,percent of total billed charges,,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,98.82,,,98.82,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,143.44,,,143.44,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,107.79,,,107.79,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,195.06,,,195.06,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,195.06,,,195.06,98.82,368.82,other,Could be inpatient or outpatient,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,98.82,368.82,percent of total billed charges,,
HC CPP IN SITU HYB,88365,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT  ,,,both,,,460.34,276.2,Aetna,Commerical,,178.36,,,178.36,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Aetna,Middlesex Employees,,160.52,,,160.52,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Anthem,Commerical,,179.3,,,179.3,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Anthem,Indemnity,,,334.79,,334.79,98.82,368.82,percent of total billed charges,,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Anthem,State Preferred,,98.82,,,98.82,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Anthem,Individual Exchange,,143.44,,,143.44,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Cigna,Cigna,,107.79,,,107.79,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Connecticare,Commerical,,195.06,,,195.06,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Connecticare,Exchange,,195.06,,,195.06,98.82,368.82,other,Could be inpatient or outpatient,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,Multiplan,Multiplan,,,368.82,,368.82,98.82,368.82,percent of total billed charges,,
HC INSITU DNA HYB,88365,CPT,,,both,,,460.34,276.2,United Healthcare/Oxford,United Healthcare/Oxford,,189.79,,,189.79,98.82,368.82,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT  ,,,both,,,260.59,156.35,Aetna,Commerical,,143.49,,,143.49,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Aetna,Middlesex Employees,,129.14,,,129.14,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Anthem,Commerical,,170.37,,,170.37,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Anthem,Indemnity,,,189.91,,189.91,129.14,209.21,percent of total billed charges,,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Anthem,State Preferred,,180.08,,,180.08,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Anthem,Individual Exchange,,136.3,,,136.3,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Cigna,Cigna,,195.86,,,195.86,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Connecticare,Commerical,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Connecticare,Exchange,,182.34,,,182.34,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,Multiplan,Multiplan,,,209.21,,209.21,129.14,209.21,percent of total billed charges,,
HC MORPHO ANALY AUTO,88367,CPT,,,both,,,260.59,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,159.07,,,159.07,129.14,209.21,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT  ,,,both,,,768.38,461.03,Aetna,Commerical,,422.42,,,422.42,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Aetna,Middlesex Employees,,380.18,,,380.18,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Anthem,Commerical,,501.57,,,501.57,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Anthem,Indemnity,,,559.07,,559.07,146.72,615.9,percent of total billed charges,,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Anthem,State Preferred,,146.72,,,146.72,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Anthem,Individual Exchange,,401.26,,,401.26,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Cigna,Cigna,,576.63,,,576.63,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Connecticare,Commerical,,536.82,,,536.82,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Connecticare,Exchange,,536.82,,,536.82,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,Multiplan,Multiplan,,,615.9,,615.9,146.72,615.9,percent of total billed charges,,
HC MORPHO ANALY MANUAL,88368,CPT,,,both,,,768.38,461.03,United Healthcare/Oxford,United Healthcare/Oxford,,468.31,,,468.31,146.72,615.9,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT  ,,,both,,,562.38,337.43,Aetna,Commerical,,309.24,,,309.24,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Aetna,Middlesex Employees,,278.31,,,278.31,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Anthem,Commerical,,367.18,,,367.18,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Anthem,Indemnity,,,409.28,,409.28,199.05,450.88,percent of total billed charges,,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Anthem,State Preferred,,199.05,,,199.05,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Anthem,Individual Exchange,,293.74,,,293.74,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Cigna,Cigna,,422.13,,,422.13,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Connecticare,Commerical,,392.98,,,392.98,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Connecticare,Exchange,,392.98,,,392.98,199.05,450.88,other,Could be inpatient or outpatient,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,Multiplan,Multiplan,,,450.88,,450.88,199.05,450.88,percent of total billed charges,,
HC MORPHOLOGIC ANALYSIS MULTIPLEX PROBE STAIN,88377,CPT,,,both,,,562.38,337.43,United Healthcare/Oxford,United Healthcare/Oxford,,342.84,,,342.84,199.05,450.88,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT  ,,,both,,,226.6,135.96,Aetna,Commerical,,124.94,,,124.94,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Aetna,Middlesex Employees,,112.44,,,112.44,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Anthem,Commerical,,148.34,,,148.34,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Anthem,Indemnity,,,165.35,,165.35,112.44,211.16,percent of total billed charges,,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Anthem,State Preferred,,211.16,,,211.16,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Anthem,Individual Exchange,,118.67,,,118.67,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Cigna,Cigna,,170.54,,,170.54,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Connecticare,Commerical,,158.77,,,158.77,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Connecticare,Exchange,,158.77,,,158.77,112.44,211.16,other,Could be inpatient or outpatient,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,Multiplan,Multiplan,,,182.16,,182.16,112.44,211.16,percent of total billed charges,,
HC MICRODISCT MANUAL,88381,CPT,,,both,,,226.6,135.96,United Healthcare/Oxford,United Healthcare/Oxford,,138.5,,,138.5,112.44,211.16,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT  ,,,both,,,237.93,142.76,Aetna,Commerical,,130.5,,,130.5,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Aetna,Middlesex Employees,,117.45,,,117.45,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Anthem,Commerical,,154.95,,,154.95,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Anthem,Indemnity,,,172.72,,172.72,117.45,190.27,percent of total billed charges,,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Anthem,State Preferred,,154.95,,,154.95,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Anthem,Individual Exchange,,123.96,,,123.96,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Cigna,Cigna,,178.14,,,178.14,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Connecticare,Commerical,,165.84,,,165.84,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Connecticare,Exchange,,165.84,,,165.84,117.45,190.27,other,Could be inpatient or outpatient,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,Multiplan,Multiplan,,,190.27,,190.27,117.45,190.27,percent of total billed charges,,
HC ARRAY251-500 PRBS,88386,CPT,,,both,,,237.93,142.76,United Healthcare/Oxford,United Healthcare/Oxford,,144.67,,,144.67,117.45,190.27,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT  ,,,both,,,19.01,11.41,Aetna,Commerical,,5.47,,,5.47,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Aetna,Middlesex Employees,,4.92,,,4.92,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Anthem,Commerical,,8.71,,,8.71,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Anthem,Indemnity,,,13.83,,13.83,4.92,15.23,percent of total billed charges,,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Anthem,State Preferred,,5.6,,,5.6,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Anthem,Individual Exchange,,6.98,,,6.98,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Cigna,Cigna,,10.68,,,10.68,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Connecticare,Commerical,,5.28,,,5.28,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Connecticare,Exchange,,5.28,,,5.28,4.92,15.23,other,Could be inpatient or outpatient,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,Multiplan,Multiplan,,,15.23,,15.23,4.92,15.23,percent of total billed charges,,
HC CELL CT BODY FLD,89050,CPT,,,both,,,19.01,11.41,United Healthcare/Oxford,United Healthcare/Oxford,,6.88,,,6.88,4.92,15.23,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT  ,,,both,,,22.17,13.3,Aetna,Commerical,,6.5,,,6.5,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Aetna,Middlesex Employees,,5.85,,,5.85,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Anthem,Commerical,,10.15,,,10.15,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Anthem,Indemnity,,,16.12,,16.12,5.85,17.76,percent of total billed charges,,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Anthem,State Preferred,,6.53,,,6.53,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Anthem,Individual Exchange,,8.12,,,8.12,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Cigna,Cigna,,12.47,,,12.47,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Connecticare,Commerical,,6.26,,,6.26,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Connecticare,Exchange,,6.26,,,6.26,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,Multiplan,Multiplan,,,17.76,,17.76,5.85,17.76,percent of total billed charges,,
HC WBC DIFF-FLUID,89051,CPT,,,both,,,22.17,13.3,United Healthcare/Oxford,United Healthcare/Oxford,,8.02,,,8.02,5.85,17.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT  ,,,both,,,17.18,10.31,Aetna,Commerical,,9.44,,,9.44,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Aetna,Middlesex Employees,,8.5,,,8.5,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Anthem,Commerical,,11.21,,,11.21,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Anthem,Indemnity,,,12.49,,12.49,5.05,13.76,percent of total billed charges,,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Anthem,State Preferred,,5.05,,,5.05,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Anthem,Individual Exchange,,8.96,,,8.96,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Cigna,Cigna,,12.89,,,12.89,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Connecticare,Commerical,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Connecticare,Exchange,,11.99,,,11.99,5.05,13.76,other,Could be inpatient or outpatient,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,Multiplan,Multiplan,,,13.76,,13.76,5.05,13.76,percent of total billed charges,,
HC WBC STOOL,89055,CPT,,,both,,,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,10.46,,,10.46,5.05,13.76,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,35.25,,,35.25,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,31.73,,,31.73,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.86,,,41.86,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,8.47,51.4,percent of total billed charges,,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,8.47,,,8.47,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.48,,,33.48,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,48.12,,,48.12,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,44.8,,,44.8,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,44.8,,,44.8,8.47,51.4,other,Could be inpatient or outpatient,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,8.47,51.4,percent of total billed charges,,
HC CRYSTAL ID SYNOVL,89060,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,8.47,51.4,other,Could be inpatient or outpatient,
HC FATS,89125,CPT  ,,,both,,,26.1,15.66,Aetna,Commerical,,14.33,,,14.33,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Aetna,Middlesex Employees,,12.9,,,12.9,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Anthem,Commerical,,17.03,,,17.03,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Anthem,Indemnity,,,18.97,,18.97,5.1,20.9,percent of total billed charges,,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Anthem,State Preferred,,5.1,,,5.1,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Anthem,Individual Exchange,,13.62,,,13.62,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Cigna,Cigna,,19.57,,,19.57,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Connecticare,Commerical,,18.22,,,18.22,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Connecticare,Exchange,,18.22,,,18.22,5.1,20.9,other,Could be inpatient or outpatient,
HC FATS,89125,CPT,,,both,,,26.1,15.66,Multiplan,Multiplan,,,20.9,,20.9,5.1,20.9,percent of total billed charges,,
HC FATS,89125,CPT,,,both,,,26.1,15.66,United Healthcare/Oxford,United Healthcare/Oxford,,15.89,,,15.89,5.1,20.9,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT  ,,,both,,,19.1,11.46,Aetna,Commerical,,10.5,,,10.5,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Aetna,Middlesex Employees,,9.45,,,9.45,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Anthem,Commerical,,12.46,,,12.46,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Anthem,Indemnity,,,13.89,,13.89,5.63,15.3,percent of total billed charges,,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Anthem,State Preferred,,5.63,,,5.63,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Anthem,Individual Exchange,,9.97,,,9.97,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Cigna,Cigna,,14.33,,,14.33,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Connecticare,Commerical,,13.33,,,13.33,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Connecticare,Exchange,,13.33,,,13.33,5.63,15.3,other,Could be inpatient or outpatient,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,Multiplan,Multiplan,,,15.3,,15.3,5.63,15.3,percent of total billed charges,,
HC EO SMEAR,89190,CPT,,,both,,,19.1,11.46,United Healthcare/Oxford,United Healthcare/Oxford,,11.64,,,11.64,5.63,15.3,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT  ,,,both,,,526.33,315.8,Aetna,Commerical,,289.45,,,289.45,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Aetna,Middlesex Employees,,260.5,,,260.5,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Anthem,Commerical,,343.68,,,343.68,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Anthem,Indemnity,,,383.09,,383.09,66.5,422.03,percent of total billed charges,,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Anthem,State Preferred,,66.5,,,66.5,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Anthem,Individual Exchange,,274.95,,,274.95,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Cigna,Cigna,,395.11,,,395.11,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Connecticare,Commerical,,367.83,,,367.83,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Connecticare,Exchange,,367.83,,,367.83,66.5,422.03,other,Could be inpatient or outpatient,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,Multiplan,Multiplan,,,422.03,,422.03,66.5,422.03,percent of total billed charges,,
HC SWEAT TEST ANALYS,89230,CPT,,,both,,,526.33,315.8,United Healthcare/Oxford,United Healthcare/Oxford,,320.89,,,320.89,66.5,422.03,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT  ,,,both,,,12.82,7.69,Aetna,Commerical,,9.28,,,9.28,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Aetna,Middlesex Employees,,8.35,,,8.35,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Anthem,Commerical,,8.3,,,8.3,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Anthem,Indemnity,,,9.33,,9.33,6.64,10.28,percent of total billed charges,,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Anthem,State Preferred,,8.3,,,8.3,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Anthem,Individual Exchange,,6.64,,,6.64,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Cigna,Cigna,,8.11,,,8.11,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Connecticare,Commerical,,8.67,,,8.67,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Connecticare,Exchange,,8.67,,,8.67,6.64,10.28,other,Could be inpatient or outpatient,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,Multiplan,Multiplan,,,10.28,,10.28,6.64,10.28,percent of total billed charges,,
HC RHIGIV HUMAN FOR IV USE,90386,CPT,,,both,,,12.82,7.69,United Healthcare/Oxford,United Healthcare/Oxford,,8.34,,,8.34,6.64,10.28,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT  ,,,both,,,21.63,12.98,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,90460,CPT,,,both,,,21.63,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT  ,,,both,,,21.63,12.98,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,90461,CPT,,,both,,,21.63,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT  ,,,both,,,77.66,46.6,Aetna,Commerical,,56.17,,,56.17,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Aetna,Middlesex Employees,,50.56,,,50.56,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Anthem,Commerical,,50.26,,,50.26,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,outpatient,,,77.66,46.6,Anthem,Indemnity,,,56.48,,56.48,40.21,62.22,percent of total billed charges,,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Anthem,State Preferred,,50.26,,,50.26,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Anthem,Individual Exchange,,40.21,,,40.21,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Cigna,Cigna,,49.09,,,49.09,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Connecticare,Commerical,,52.5,,,52.5,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,Connecticare,Exchange,,52.5,,,52.5,40.21,62.22,other,Could be inpatient or outpatient,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,outpatient,,,77.66,46.6,Multiplan,Multiplan,,,62.22,,62.22,40.21,62.22,percent of total billed charges,,
HC IM IMM INITIAL  ADMINISTRATION 1 VACCINE,90471,CPT,,,both,,,77.66,46.6,United Healthcare/Oxford,United Healthcare/Oxford,,50.52,,,50.52,40.21,62.22,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT  ,,,both,,,247.2,148.32,Aetna,Commerical,,178.28,,,178.28,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Aetna,Middlesex Employees,,160.46,,,160.46,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Anthem,Commerical,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,outpatient,,,247.2,148.32,Anthem,Indemnity,,,179.27,,179.27,127.62,197.49,percent of total billed charges,,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Anthem,State Preferred,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Anthem,Individual Exchange,,127.62,,,127.62,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Cigna,Cigna,,155.79,,,155.79,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Connecticare,Commerical,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,Connecticare,Exchange,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,outpatient,,,247.2,148.32,Multiplan,Multiplan,,,197.49,,197.49,127.62,197.49,percent of total billed charges,,
HC IM/SQ/ID IMMUN ADMIN INITIAL 1 VACCINE,90471,CPT,,,both,,,247.2,148.32,United Healthcare/Oxford,United Healthcare/Oxford,,160.34,,,160.34,127.62,197.49,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT  ,,,both,,,57.68,34.61,Aetna,Commerical,,41.19,,,41.19,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Aetna,Middlesex Employees,,37.07,,,37.07,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Anthem,Commerical,,36.86,,,36.86,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,outpatient,,,57.68,34.61,Anthem,Indemnity,,,41.42,,41.42,29.49,45.63,percent of total billed charges,,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Anthem,State Preferred,,36.86,,,36.86,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Anthem,Individual Exchange,,29.49,,,29.49,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Cigna,Cigna,,35.99,,,35.99,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Connecticare,Commerical,,38.5,,,38.5,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,Connecticare,Exchange,,38.5,,,38.5,29.49,45.63,other,Could be inpatient or outpatient,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,outpatient,,,57.68,34.61,Multiplan,Multiplan,,,45.63,,45.63,29.49,45.63,percent of total billed charges,,
HC IM/SQ/ID IMMUN ADMIN EA ADDL VACCINE,90472,CPT,,,both,,,57.68,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,37.05,,,37.05,29.49,45.63,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT  ,,,both,,,21.63,12.98,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC IIV3 VACC NO PRSV 0.25 ML IM 6-35MO,90655,CPT,,,both,,,21.63,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT  ,,,both,,,21.63,12.98,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC IIV3 VACC NO PRSV 0.5 ML IM  3YO+,90656,CPT,,,both,,,21.63,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT  ,,,both,,,21.63,12.98,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC HEPB VACC 3 DOSE PED/ADOL IM,90744,CPT,,,both,,,21.63,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT  ,,,both,,,554.14,332.48,Aetna,Commerical,,400.53,,,400.53,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Aetna,Middlesex Employees,,360.48,,,360.48,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Anthem,Commerical,,358.39,,,358.39,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,outpatient,,,554.14,332.48,Anthem,Indemnity,,,402.73,,402.73,286.72,443.67,percent of total billed charges,,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Anthem,State Preferred,,358.39,,,358.39,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Anthem,Individual Exchange,,286.72,,,286.72,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Cigna,Cigna,,350,,,350,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Connecticare,Commerical,,374.36,,,374.36,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,Connecticare,Exchange,,374.36,,,374.36,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSESSMENT,90791,CPT,,,outpatient,,,554.14,332.48,Multiplan,Multiplan,,,443.67,,443.67,286.72,443.67,percent of total billed charges,,
HC PSY DX ASSESSMENT,90791,CPT,,,both,,,554.14,332.48,United Healthcare/Oxford,United Healthcare/Oxford,,360.21,,,360.21,286.72,443.67,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT  ,,,both,,,529.42,317.65,Aetna,Commerical,,382.62,,,382.62,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Aetna,Middlesex Employees,,344.36,,,344.36,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Anthem,Commerical,,342.36,,,342.36,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,outpatient,,,529.42,317.65,Anthem,Indemnity,,,384.72,,384.72,273.88,423.83,percent of total billed charges,,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Anthem,State Preferred,,342.36,,,342.36,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Anthem,Individual Exchange,,273.88,,,273.88,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Cigna,Cigna,,334.35,,,334.35,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Connecticare,Commerical,,357.62,,,357.62,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,Connecticare,Exchange,,357.62,,,357.62,273.88,423.83,other,Could be inpatient or outpatient,
HC PSY DX ASSES MED,90792,CPT,,,outpatient,,,529.42,317.65,Multiplan,Multiplan,,,423.83,,423.83,273.88,423.83,percent of total billed charges,,
HC PSY DX ASSES MED,90792,CPT,,,both,,,529.42,317.65,United Healthcare/Oxford,United Healthcare/Oxford,,344.1,,,344.1,273.88,423.83,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT  ,,,both,,,611.82,367.09,Aetna,Commerical,,442.86,,,442.86,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Aetna,Middlesex Employees,,398.58,,,398.58,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Anthem,Commerical,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Anthem,Indemnity,,,445.3,,445.3,317.02,490.56,percent of total billed charges,,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Anthem,State Preferred,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Anthem,Individual Exchange,,317.02,,,317.02,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Cigna,Cigna,,386.99,,,386.99,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Connecticare,Commerical,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Connecticare,Exchange,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,Multiplan,Multiplan,,,490.56,,490.56,317.02,490.56,percent of total billed charges,,
HC BIOFEEDBACK TRAINING ANY MODALITY,90901,CPT,,,both,,,611.82,367.09,United Healthcare/Oxford,United Healthcare/Oxford,,398.28,,,398.28,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT  ,,,both,,,611.82,367.09,Aetna,Commerical,,442.86,,,442.86,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Aetna,Middlesex Employees,,398.58,,,398.58,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Anthem,Commerical,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Anthem,Indemnity,,,445.3,,445.3,317.02,490.56,percent of total billed charges,,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Anthem,State Preferred,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Anthem,Individual Exchange,,317.02,,,317.02,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Cigna,Cigna,,386.99,,,386.99,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Connecticare,Commerical,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Connecticare,Exchange,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,Multiplan,Multiplan,,,490.56,,490.56,317.02,490.56,percent of total billed charges,,
HC BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,90911,CPT,,,both,,,611.82,367.09,United Healthcare/Oxford,United Healthcare/Oxford,,398.28,,,398.28,317.02,490.56,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT  ,,,both,,,619.04,371.42,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BIOFEEDBACK TRAINING INITIAL 15 MIN,90912,CPT,,,both,,,619.04,371.42,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT  ,,,both,,,343.28,205.97,Aetna,Commerical,,248.3,,,248.3,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Aetna,Middlesex Employees,,223.47,,,223.47,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Anthem,Commerical,,222.17,,,222.17,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Anthem,Indemnity,,,249.66,,249.66,177.74,275.03,percent of total billed charges,,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Anthem,State Preferred,,222.17,,,222.17,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Anthem,Individual Exchange,,177.74,,,177.74,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Cigna,Cigna,,216.98,,,216.98,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Connecticare,Commerical,,232.08,,,232.08,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Connecticare,Exchange,,232.08,,,232.08,177.74,275.03,other,Could be inpatient or outpatient,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,Multiplan,Multiplan,,,275.03,,275.03,177.74,275.03,percent of total billed charges,,
HC BIOFEEDBACK TRAINING EA ADD'L  15 MIN,90913,CPT,,,both,,,343.28,205.97,United Healthcare/Oxford,United Healthcare/Oxford,,223.29,,,223.29,177.74,275.03,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT  ,,,both,,,2304.11,1382.47,Aetna,Commerical,,1701.05,,,1701.05,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Aetna,Middlesex Employees,,1631.17,,,1631.17,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Anthem,Commerical,,1643.08,,,1643.08,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Anthem,Indemnity,,,1675.86,,1675.86,757.05,1846.2,percent of total billed charges,,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Anthem,State Preferred,,1643.08,,,1643.08,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Anthem,Individual Exchange,,1314.46,,,1314.46,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Cigna,Cigna,,847.6,,,847.6,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Connecticare,Commerical,,1813.1,,,1813.1,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Connecticare,Exchange,,1813.1,,,1813.1,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,Multiplan,Multiplan,,,1846.2,,1846.2,757.05,1846.2,percent of total billed charges,,
HC OUTPATIENT/HOME HEMODIALYSIS,90935,CPT,,,both,,,2304.11,1382.47,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT  ,,,both,,,1356.51,813.91,Aetna,Commerical,,1001.68,,,1001.68,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Aetna,Middlesex Employees,,960.53,,,960.53,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Anthem,Commerical,,967.54,,,967.54,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Anthem,Indemnity,,,986.84,,986.84,333.72,1087.15,percent of total billed charges,,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Anthem,State Preferred,,967.54,,,967.54,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Anthem,Individual Exchange,,774.03,,,774.03,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Cigna,Cigna,,717.6,,,717.6,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Connecticare,Commerical,,1067.66,,,1067.66,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Connecticare,Exchange,,1067.66,,,1067.66,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,Multiplan,Multiplan,,,1087.15,,1087.15,333.72,1087.15,percent of total billed charges,,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS,90945,CPT,,,both,,,1356.51,813.91,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,1087.15,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT  ,,,both,,,875.5,525.3,Aetna,Commerical,,665.7,,,665.7,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Aetna,Middlesex Employees,,638.35,,,638.35,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Commerical,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Indemnity,,,655.84,,655.84,333.72,722.5,percent of total billed charges,,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,State Preferred,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Individual Exchange,,514.41,,,514.41,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Cigna,Cigna,,717.6,,,717.6,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Commerical,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Exchange,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Multiplan,Multiplan,,,722.5,,722.5,333.72,722.5,percent of total billed charges,,
HC CAPD PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT  ,,,both,,,875.5,525.3,Aetna,Commerical,,665.7,,,665.7,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Aetna,Middlesex Employees,,638.35,,,638.35,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Commerical,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Indemnity,,,655.84,,655.84,333.72,722.5,percent of total billed charges,,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,State Preferred,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Individual Exchange,,514.41,,,514.41,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Cigna,Cigna,,717.6,,,717.6,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Commerical,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Exchange,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,Multiplan,Multiplan,,,722.5,,722.5,333.72,722.5,percent of total billed charges,,
HC CCPD PERI DIALYSIS TRAINING COMPLETE,90989,CPT,,,both,,,875.5,525.3,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,722.5,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT  ,,,both,,,1310.16,786.1,Aetna,Commerical,,967.22,,,967.22,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Aetna,Middlesex Employees,,927.48,,,927.48,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Anthem,Commerical,,934.25,,,934.25,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Anthem,Indemnity,,,952.89,,952.89,747.4,1049.75,percent of total billed charges,,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Anthem,State Preferred,,934.25,,,934.25,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Anthem,Individual Exchange,,747.4,,,747.4,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Cigna,Cigna,,847.6,,,847.6,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Connecticare,Commerical,,1030.93,,,1030.93,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Connecticare,Exchange,,1030.93,,,1030.93,747.4,1049.75,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,Multiplan,Multiplan,,,1049.75,,1049.75,747.4,1049.75,percent of total billed charges,,
HC HEMO DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,1310.16,786.1,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,747.4,1049.75,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT  ,,,both,,,875.5,525.3,Aetna,Commerical,,665.7,,,665.7,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Aetna,Middlesex Employees,,638.35,,,638.35,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Commerical,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Indemnity,,,655.84,,655.84,333.72,722.5,percent of total billed charges,,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,State Preferred,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Anthem,Individual Exchange,,514.41,,,514.41,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Cigna,Cigna,,717.6,,,717.6,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Commerical,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Connecticare,Exchange,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,Multiplan,Multiplan,,,722.5,,722.5,333.72,722.5,percent of total billed charges,,
HC PERI DIALYSIS TRAINING  COMPLETE,90989,CPT,,,both,,,875.5,525.3,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,722.5,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,44.64,,,44.64,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,42.81,,,42.81,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,43.98,,43.98,34.5,717.6,percent of total billed charges,,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,34.5,,,34.5,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,717.6,,,717.6,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,48.45,,48.45,34.5,717.6,percent of total billed charges,,
HC CAPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,44.64,,,44.64,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,42.81,,,42.81,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,43.98,,43.98,34.5,717.6,percent of total billed charges,,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,34.5,,,34.5,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,717.6,,,717.6,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,48.45,,48.45,34.5,717.6,percent of total billed charges,,
HC CCPD PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,34.5,717.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT  ,,,both,,,220.42,132.25,Aetna,Commerical,,162.9,,,162.9,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Aetna,Middlesex Employees,,156.21,,,156.21,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Anthem,Commerical,,157.35,,,157.35,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Anthem,Indemnity,,,160.49,,160.49,125.88,847.6,percent of total billed charges,,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Anthem,State Preferred,,157.35,,,157.35,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Anthem,Individual Exchange,,125.88,,,125.88,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Cigna,Cigna,,847.6,,,847.6,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Connecticare,Commerical,,173.63,,,173.63,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Connecticare,Exchange,,173.63,,,173.63,125.88,847.6,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,Multiplan,Multiplan,,,176.8,,176.8,125.88,847.6,percent of total billed charges,,
HC HEMO DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,220.42,132.25,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,125.88,847.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT  ,,,both,,,58.71,35.23,Aetna,Commerical,,44.64,,,44.64,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Aetna,Middlesex Employees,,42.81,,,42.81,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Commerical,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Indemnity,,,43.98,,43.98,34.5,717.6,percent of total billed charges,,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,State Preferred,,43.12,,,43.12,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Anthem,Individual Exchange,,34.5,,,34.5,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Cigna,Cigna,,717.6,,,717.6,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Commerical,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Connecticare,Exchange,,47.58,,,47.58,34.5,717.6,other,Could be inpatient or outpatient,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,Multiplan,Multiplan,,,48.45,,48.45,34.5,717.6,percent of total billed charges,,
HC PERI DIALYSIS TRAINING INCOMPLETE,90993,CPT,,,both,,,58.71,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,34.5,717.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT  ,,,both,,,902.28,541.37,Aetna,Commerical,,665.7,,,665.7,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Aetna,Middlesex Employees,,638.35,,,638.35,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Commerical,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Indemnity,,,655.84,,655.84,333.72,722.5,percent of total billed charges,,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,State Preferred,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Individual Exchange,,514.41,,,514.41,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Cigna,Cigna,,717.6,,,717.6,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Commerical,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Exchange,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Multiplan,Multiplan,,,722.5,,722.5,333.72,722.5,percent of total billed charges,,
HC UNLISTED OUTPATIENT CAPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT  ,,,both,,,902.28,541.37,Aetna,Commerical,,665.7,,,665.7,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Aetna,Middlesex Employees,,638.35,,,638.35,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Commerical,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Indemnity,,,655.84,,655.84,333.72,722.5,percent of total billed charges,,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,State Preferred,,643.01,,,643.01,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Anthem,Individual Exchange,,514.41,,,514.41,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Cigna,Cigna,,717.6,,,717.6,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Commerical,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Exchange,,709.55,,,709.55,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,Multiplan,Multiplan,,,722.5,,722.5,333.72,722.5,percent of total billed charges,,
HC UNLISTED OUTPATIENT CCPD PERI DIALYSIS PROC COMPOSITE,90999,CPT,,,both,,,902.28,541.37,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,722.5,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT  ,,,both,,,902.28,541.37,Aetna,Commerical,,665.7,,,665.7,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Aetna,Middlesex Employees,,638.35,,,638.35,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Anthem,Commerical,,643.01,,,643.01,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Anthem,Indemnity,,,655.84,,655.84,514.41,847.6,percent of total billed charges,,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Anthem,State Preferred,,643.01,,,643.01,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Anthem,Individual Exchange,,514.41,,,514.41,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Cigna,Cigna,,847.6,,,847.6,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Commerical,,709.55,,,709.55,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Connecticare,Exchange,,709.55,,,709.55,514.41,847.6,other,Could be inpatient or outpatient,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,Multiplan,Multiplan,,,722.5,,722.5,514.41,847.6,percent of total billed charges,,
HC UNLISTED OUTPATIENT HEMO/OP DIALYSIS PROCEDURE,90999,CPT,,,both,,,902.28,541.37,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,514.41,847.6,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1482.46,,,1482.46,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1334.22,,,1334.22,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1061.18,,,1061.18,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1295.44,,,1295.44,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGEAL MOTILITY STUDY W/INTERP & RPT,91010,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1333.2,,,1333.2,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1482.46,,,1482.46,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1334.22,,,1334.22,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1061.18,,,1061.18,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1295.44,,,1295.44,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,91013,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1333.2,,,1333.2,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1482.46,,,1482.46,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1334.22,,,1334.22,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1061.18,,,1061.18,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1295.44,,,1295.44,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1061.18,1642.12,percent of total billed charges,,
HC ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,91030,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1333.2,,,1333.2,1061.18,1642.12,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT  ,,,both,,,882.71,529.63,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Anthem,Indemnity,,,641.76,,641.76,456.87,706.99,percent of total billed charges,,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC PH MONITORING,91034,CPT,,,both,,,882.71,529.63,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1482.46,,,1482.46,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1334.22,,,1334.22,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1061.18,1642.12,percent of total billed charges,,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1061.18,,,1061.18,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1295.44,,,1295.44,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1061.18,1642.12,percent of total billed charges,,
HC GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,91035,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1333.2,,,1333.2,1061.18,1642.12,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT  ,,,both,,,1135.06,681.04,Aetna,Commerical,,821.42,,,821.42,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Aetna,Middlesex Employees,,739.28,,,739.28,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Anthem,Commerical,,734.98,,,734.98,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Anthem,Indemnity,,,825.93,,825.93,587.98,909.88,percent of total billed charges,,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Anthem,State Preferred,,734.98,,,734.98,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Anthem,Individual Exchange,,587.98,,,587.98,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Cigna,Cigna,,717.8,,,717.8,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Connecticare,Commerical,,767.75,,,767.75,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Connecticare,Exchange,,767.75,,,767.75,587.98,909.88,other,Could be inpatient or outpatient,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,Multiplan,Multiplan,,,909.88,,909.88,587.98,909.88,percent of total billed charges,,
HC GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,91037,CPT,,,both,,,1135.06,681.04,United Healthcare/Oxford,United Healthcare/Oxford,,738.72,,,738.72,587.98,909.88,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT  ,,,both,,,2049.7,1229.82,Aetna,Commerical,,1482.46,,,1482.46,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Aetna,Middlesex Employees,,1334.22,,,1334.22,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Anthem,Commerical,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Anthem,Indemnity,,,1490.6,,1490.6,1061.18,1642.12,percent of total billed charges,,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Anthem,State Preferred,,1326.47,,,1326.47,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Anthem,Individual Exchange,,1061.18,,,1061.18,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Cigna,Cigna,,1295.44,,,1295.44,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Connecticare,Commerical,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Connecticare,Exchange,,1385.59,,,1385.59,1061.18,1642.12,other,Could be inpatient or outpatient,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,Multiplan,Multiplan,,,1642.12,,1642.12,1061.18,1642.12,percent of total billed charges,,
HC ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG 1-24 HRS,91038,CPT,,,both,,,2049.7,1229.82,United Healthcare/Oxford,United Healthcare/Oxford,,1333.2,,,1333.2,1061.18,1642.12,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT  ,,,both,,,630.36,378.22,Aetna,Commerical,,455.89,,,455.89,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Aetna,Middlesex Employees,,410.3,,,410.3,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Anthem,Commerical,,407.92,,,407.92,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Anthem,Indemnity,,,458.39,,458.39,326.34,504.99,percent of total billed charges,,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Anthem,State Preferred,,407.92,,,407.92,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Anthem,Individual Exchange,,326.34,,,326.34,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Cigna,Cigna,,398.38,,,398.38,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Connecticare,Commerical,,426.1,,,426.1,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Connecticare,Exchange,,426.1,,,426.1,326.34,504.99,other,Could be inpatient or outpatient,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,Multiplan,Multiplan,,,504.99,,504.99,326.34,504.99,percent of total billed charges,,
HC BREATH HYDROGEN/METHANE TEST,91065,CPT,,,both,,,630.36,378.22,United Healthcare/Oxford,United Healthcare/Oxford,,409.99,,,409.99,326.34,504.99,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT  ,,,both,,,3529.81,2117.89,Aetna,Commerical,,2552.99,,,2552.99,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Aetna,Middlesex Employees,,2297.69,,,2297.69,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Anthem,Commerical,,2284.36,,,2284.36,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Anthem,Indemnity,,,2567.01,,2567.01,1827.49,2827.93,percent of total billed charges,,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Anthem,State Preferred,,2284.36,,,2284.36,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Anthem,Individual Exchange,,1827.49,,,1827.49,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Cigna,Cigna,,2230.92,,,2230.92,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Connecticare,Commerical,,2386.16,,,2386.16,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Connecticare,Exchange,,2386.16,,,2386.16,1827.49,2827.93,other,Could be inpatient or outpatient,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,Multiplan,Multiplan,,,2827.93,,2827.93,1827.49,2827.93,percent of total billed charges,,
HC GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,91110,CPT,,,both,,,3529.81,2117.89,United Healthcare/Oxford,United Healthcare/Oxford,,2295.95,,,2295.95,1827.49,2827.93,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT  ,,,both,,,611.82,367.09,Aetna,Commerical,,442.86,,,442.86,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Aetna,Middlesex Employees,,398.58,,,398.58,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Anthem,Commerical,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Anthem,Indemnity,,,445.3,,445.3,317.02,490.56,percent of total billed charges,,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Anthem,State Preferred,,396.27,,,396.27,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Anthem,Individual Exchange,,317.02,,,317.02,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Cigna,Cigna,,386.99,,,386.99,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Connecticare,Commerical,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Connecticare,Exchange,,413.92,,,413.92,317.02,490.56,other,Could be inpatient or outpatient,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,Multiplan,Multiplan,,,490.56,,490.56,317.02,490.56,percent of total billed charges,,
HC RECTAL SESATION TONE & COMPLIANCE TEST,91120,CPT,,,both,,,611.82,367.09,United Healthcare/Oxford,United Healthcare/Oxford,,398.28,,,398.28,317.02,490.56,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT  ,,,both,,,1103.13,661.88,Aetna,Commerical,,798.62,,,798.62,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Aetna,Middlesex Employees,,718.76,,,718.76,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Anthem,Commerical,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Anthem,Indemnity,,,803.01,,803.01,571.67,884.63,percent of total billed charges,,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Anthem,State Preferred,,714.58,,,714.58,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Anthem,Individual Exchange,,571.67,,,571.67,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Cigna,Cigna,,697.87,,,697.87,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Connecticare,Commerical,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Connecticare,Exchange,,746.44,,,746.44,571.67,884.63,other,Could be inpatient or outpatient,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,Multiplan,Multiplan,,,884.63,,884.63,571.67,884.63,percent of total billed charges,,
HC ANORECTAL MANOMETRY,91122,CPT,,,both,,,1103.13,661.88,United Healthcare/Oxford,United Healthcare/Oxford,,718.22,,,718.22,571.67,884.63,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT  ,,,both,,,647.87,388.72,Aetna,Commerical,,468.92,,,468.92,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Aetna,Middlesex Employees,,422.03,,,422.03,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Anthem,Commerical,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Anthem,Indemnity,,,471.49,,471.49,335.66,519.42,percent of total billed charges,,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Anthem,State Preferred,,419.58,,,419.58,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Anthem,Individual Exchange,,335.66,,,335.66,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Cigna,Cigna,,409.76,,,409.76,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Connecticare,Commerical,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Connecticare,Exchange,,438.27,,,438.27,335.66,519.42,other,Could be inpatient or outpatient,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,Multiplan,Multiplan,,,519.42,,519.42,335.66,519.42,percent of total billed charges,,
HC UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,91299,CPT,,,both,,,647.87,388.72,United Healthcare/Oxford,United Healthcare/Oxford,,421.7,,,421.7,335.66,519.42,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT  ,,,both,,,137.92,82.75,Aetna,Commerical,,92.17,,,92.17,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Aetna,Middlesex Employees,,82.96,,,82.96,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Anthem,Commerical,,76.5,,,76.5,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Anthem,Indemnity,,,100.3,,100.3,61.2,110.5,percent of total billed charges,,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Anthem,State Preferred,,76.5,,,76.5,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Anthem,Individual Exchange,,61.2,,,61.2,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Cigna,Cigna,,81.19,,,81.19,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Connecticare,Commerical,,83.28,,,83.28,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Connecticare,Exchange,,83.28,,,83.28,61.2,110.5,other,Could be inpatient or outpatient,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,Multiplan,Multiplan,,,110.5,,110.54,61.2,110.5,percent of total billed charges,,
HC IMG RETINA DETC/MNTR OF DISEASE UNI/BI,92228,CPT,,,both,,,137.92,82.75,United Healthcare/Oxford,United Healthcare/Oxford,,85.38,,,85.38,61.2,110.5,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT  ,,,both,,,2908.72,1745.23,Aetna,Commerical,,2103.61,,,2103.61,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Aetna,Middlesex Employees,,1893.25,,,1893.25,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Anthem,Commerical,,1882.26,,,1882.26,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,outpatient,,,2908.72,1745.23,Anthem,Indemnity,,,2115.17,,2115.17,1505.81,2330.16,percent of total billed charges,,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Anthem,State Preferred,,1882.26,,,1882.26,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Anthem,Individual Exchange,,1505.81,,,1505.81,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Cigna,Cigna,,1838.24,,,1838.24,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Connecticare,Commerical,,1966.15,,,1966.15,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,Connecticare,Exchange,,1966.15,,,1966.15,1505.81,2330.16,other,Could be inpatient or outpatient,
HC EYE EXAM W/PHOTO,92230,CPT,,,outpatient,,,2908.72,1745.23,Multiplan,Multiplan,,,2330.16,,2330.16,1505.81,2330.16,percent of total billed charges,,
HC EYE EXAM W/PHOTO,92230,CPT,,,both,,,2908.72,1745.23,United Healthcare/Oxford,United Healthcare/Oxford,,1891.81,,,1891.81,1505.81,2330.16,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT  ,,,both,,,962.02,577.21,Aetna,Commerical,,643.04,,,643.04,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Aetna,Middlesex Employees,,578.74,,,578.74,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Anthem,Commerical,,533.68,,,533.68,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Anthem,Indemnity,,,699.82,,699.82,426.94,770.95,percent of total billed charges,,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Anthem,State Preferred,,533.68,,,533.68,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Anthem,Individual Exchange,,426.94,,,426.94,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Cigna,Cigna,,566.44,,,566.44,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Connecticare,Commerical,,581.04,,,581.04,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Connecticare,Exchange,,581.04,,,581.04,426.94,770.95,other,Could be inpatient or outpatient,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,Multiplan,Multiplan,,,770.95,,770.95,426.94,770.95,percent of total billed charges,,
HC FLUORESCEIN ANGIOGRAM UNI/BI,92235,CPT,,,both,,,962.02,577.21,United Healthcare/Oxford,United Healthcare/Oxford,,595.65,,,595.65,426.94,770.95,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT  ,,,both,,,478.95,287.37,Aetna,Commerical,,345.99,,,345.99,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Aetna,Middlesex Employees,,311.39,,,311.39,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Anthem,Commerical,,309.58,,,309.58,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Anthem,Indemnity,,,347.89,,347.89,247.67,383.25,percent of total billed charges,,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Anthem,State Preferred,,309.58,,,309.58,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Anthem,Individual Exchange,,247.67,,,247.67,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Cigna,Cigna,,302.34,,,302.34,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Connecticare,Commerical,,323.38,,,323.38,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Connecticare,Exchange,,323.38,,,323.38,247.67,383.25,other,Could be inpatient or outpatient,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,Multiplan,Multiplan,,,383.25,,383.25,247.67,383.25,percent of total billed charges,,
HC FUNDUS PHOTOGRPY W/ INTERP & REPORT,92250,CPT,,,both,,,478.95,287.37,United Healthcare/Oxford,United Healthcare/Oxford,,311.15,,,311.15,247.67,383.25,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT  ,,,both,,,74.16,44.5,Aetna,Commerical,,49.63,,,49.63,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Aetna,Middlesex Employees,,44.67,,,44.67,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Anthem,Commerical,,41.19,,,41.19,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Anthem,Indemnity,,,54.01,,54.01,32.95,59.5,percent of total billed charges,,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Anthem,State Preferred,,41.19,,,41.19,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Anthem,Individual Exchange,,32.95,,,32.95,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Cigna,Cigna,,43.72,,,43.72,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Connecticare,Commerical,,44.84,,,44.84,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Connecticare,Exchange,,44.84,,,44.84,32.95,59.5,other,Could be inpatient or outpatient,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,Multiplan,Multiplan,,,59.5,,59.5,32.95,59.5,percent of total billed charges,,
HB EAR MICROSCOPY EXAM,92504,CPT,,,both,,,74.16,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,45.97,,,45.97,32.95,59.5,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC SPEECH LNG VOICE EVAL,92506,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC SPEECH THERAPY IND 1/2HR,92507,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC SPEECH THERAPY IND HOUR,92507,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC SPEECH/HEARING THERAPY INDIV 1/2HR,92507,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT  ,,,both,,,263.37,158.02,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC SPEECH/HEARING THERAPY INDIV 1HR,92507,CPT,,,both,,,263.37,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT  ,,,both,,,95.79,57.47,Aetna,Commerical,,68.38,,,68.38,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Aetna,Middlesex Employees,,61.54,,,61.54,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Anthem,Commerical,,61.19,,,61.19,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Anthem,Indemnity,,,68.76,,68.76,48.96,75.75,percent of total billed charges,,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Anthem,State Preferred,,61.19,,,61.19,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Anthem,Individual Exchange,,48.96,,,48.96,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Cigna,Cigna,,59.76,,,59.76,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Connecticare,Commerical,,63.92,,,63.92,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Connecticare,Exchange,,63.92,,,63.92,48.96,75.75,other,Could be inpatient or outpatient,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,Multiplan,Multiplan,,,75.75,,75.75,48.96,75.75,percent of total billed charges,,
HC SPEECH THERPY GRP,92508,CPT,,,both,,,95.79,57.47,United Healthcare/Oxford,United Healthcare/Oxford,,61.5,,,61.5,48.96,75.75,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT  ,,,both,,,705.69,423.42,Aetna,Commerical,,510.43,,,510.43,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT  ,,,both,,,666.3,399.78,Aetna,Commerical,,481.94,,,481.94,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Aetna,Middlesex Employees,,459.39,,,459.39,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Aetna,Middlesex Employees,,433.75,,,433.75,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Anthem,Commerical,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Anthem,Commerical,,431.23,,,431.23,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,outpatient,,,705.69,423.42,Anthem,Indemnity,,,513.23,,513.23,365.38,565.4,percent of total billed charges,,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,outpatient,,,666.3,399.78,Anthem,Indemnity,,,484.59,,484.59,344.99,533.84,percent of total billed charges,,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Anthem,State Preferred,,456.72,,,456.72,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Anthem,State Preferred,,431.23,,,431.23,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Anthem,Individual Exchange,,365.38,,,365.38,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Anthem,Individual Exchange,,344.99,,,344.99,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Cigna,Cigna,,446.05,,,446.05,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Cigna,Cigna,,421.15,,,421.15,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Connecticare,Commerical,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Connecticare,Commerical,,450.45,,,450.45,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,Connecticare,Exchange,,477.08,,,477.08,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,Connecticare,Exchange,,450.45,,,450.45,344.99,533.84,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,outpatient,,,705.69,423.42,Multiplan,Multiplan,,,565.4,,565.4,365.38,565.4,percent of total billed charges,,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,outpatient,,,666.3,399.78,Multiplan,Multiplan,,,533.84,,533.84,344.99,533.84,percent of total billed charges,,
HC NASOPHARYNGOSCOPY W ENDOSCOPE-ED,92511,CPT,,,both,,,705.69,423.42,United Healthcare/Oxford,United Healthcare/Oxford,,459.04,,,459.04,365.38,565.4,other,Could be inpatient or outpatient,
HC NASOPHARYNGOSCOPY W ENDOSCOPE,92511,CPT,,,both,,,666.3,399.78,United Healthcare/Oxford,United Healthcare/Oxford,,433.42,,,433.42,344.99,533.84,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,126.91,,,126.91,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,114.22,,,114.22,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,105.32,,,105.32,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.11,,138.11,84.26,152.15,percent of total billed charges,,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,105.32,,,105.32,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,84.26,,,84.26,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,111.79,,,111.79,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,114.68,,,114.68,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,114.68,,,114.68,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.15,,152.15,84.26,152.15,percent of total billed charges,,
HC VEMP TESTING CERVICAL (CVEMP),92517,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,117.55,,,117.55,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,126.91,,,126.91,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,114.22,,,114.22,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,105.32,,,105.32,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.11,,138.11,84.26,152.15,percent of total billed charges,,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,105.32,,,105.32,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,84.26,,,84.26,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,111.79,,,111.79,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,114.68,,,114.68,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,114.68,,,114.68,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.15,,152.15,84.26,152.15,percent of total billed charges,,
HC VEMP TESTING OCULAR (OVEMP),92518,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,117.55,,,117.55,84.26,152.15,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT  ,,,both,,,337.84,202.7,Aetna,Commerical,,225.45,,,225.45,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Aetna,Middlesex Employees,,202.91,,,202.91,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Anthem,Commerical,,187.11,,,187.11,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Anthem,Indemnity,,,245.36,,245.36,149.68,270.3,percent of total billed charges,,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Anthem,State Preferred,,187.11,,,187.11,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Anthem,Individual Exchange,,149.68,,,149.68,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Cigna,Cigna,,198.6,,,198.6,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Connecticare,Commerical,,203.72,,,203.72,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Connecticare,Exchange,,203.72,,,203.72,149.68,270.3,other,Could be inpatient or outpatient,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,Multiplan,Multiplan,,,270.3,,270.3,149.68,270.3,percent of total billed charges,,
HC VEMP TESTING CERVICAL & OCULAR (CVEMP + OVEMP),92519,CPT,,,both,,,337.84,202.7,United Healthcare/Oxford,United Healthcare/Oxford,,208.84,,,208.84,149.68,270.3,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT  ,,,both,,,263.37,158.02,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC LARYNGEAL FUNCTN,92520,CPT,,,both,,,263.37,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT  ,,,both,,,536.63,321.98,Aetna,Commerical,,388.32,,,388.32,388.32,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Aetna,Middlesex Employees,,349.48,,,349.48,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Anthem,Commerical,,347.46,,,347.46,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Anthem,Indemnity,,,390.45,,390.45,277.97,430.14,percent of total billed charges,,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Anthem,State Preferred,,347.46,,,347.46,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Anthem,Individual Exchange,,277.97,,,277.97,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Cigna,Cigna,,339.33,,,339.33,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Connecticare,Commerical,,362.95,,,362.95,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Connecticare,Exchange,,362.95,,,362.95,277.97,430.14,other,Could be inpatient or outpatient,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,Multiplan,Multiplan,,,430.14,,430.14,277.97,430.14,percent of total billed charges,,
HC PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT,92520,CPT,,,both,,,536.63,321.98,United Healthcare/Oxford,United Healthcare/Oxford,,349.22,,,349.22,277.97,430.14,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC FLUENCY EVAL,92521,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC SP EVAL SOUNDPROD,92522,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT  ,,,both,,,787.95,472.77,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC SPCH LNG VOIC EVL,92523,CPT,,,both,,,787.95,472.77,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT  ,,,both,,,919.79,551.87,Aetna,Commerical,,665.11,,,665.11,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Aetna,Middlesex Employees,,598.6,,,598.6,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Anthem,Commerical,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Anthem,Indemnity,,,668.77,,668.77,476.1,736.75,percent of total billed charges,,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Anthem,State Preferred,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Anthem,Individual Exchange,,476.1,,,476.1,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Cigna,Cigna,,581.2,,,581.2,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Connecticare,Commerical,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Connecticare,Exchange,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,Multiplan,Multiplan,,,736.75,,736.75,476.1,736.75,percent of total billed charges,,
HC SPL V EVL-ADA/NAU,92523,CPT,,,both,,,919.79,551.87,United Healthcare/Oxford,United Healthcare/Oxford,,598.15,,,598.15,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT  ,,,both,,,919.79,551.87,Aetna,Commerical,,665.11,,,665.11,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Aetna,Middlesex Employees,,598.6,,,598.6,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Anthem,Commerical,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Anthem,Indemnity,,,668.77,,668.77,476.1,736.75,percent of total billed charges,,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Anthem,State Preferred,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Anthem,Individual Exchange,,476.1,,,476.1,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Cigna,Cigna,,581.2,,,581.2,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Connecticare,Commerical,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Connecticare,Exchange,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,Multiplan,Multiplan,,,736.75,,736.75,476.1,736.75,percent of total billed charges,,
HC SPL VOICE EVL-SLE,92523,CPT,,,both,,,919.79,551.87,United Healthcare/Oxford,United Healthcare/Oxford,,598.15,,,598.15,476.1,736.75,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC BEHAVRAL QUALIT ANALYS VOICE,92524,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW - FEEDING TEAM SLP,92526,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW 1/2HR,92526,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT  ,,,both,,,263.37,158.02,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC TRT FEED SWALLOW HOUR,92526,CPT,,,both,,,263.37,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT  ,,,both,,,379.04,227.42,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
HC BITHERMAL BILATERAL CALORICS,92537,CPT,,,both,,,379.04,227.42,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,137.58,,,137.58,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,123.83,,,123.83,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,98.48,152.4,percent of total billed charges,,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,98.48,,,98.48,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,120.22,,,120.22,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,98.48,152.4,percent of total billed charges,,
HC MONOTHERMAL BILATERAL CALORICS,92538,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,123.73,,,123.73,98.48,152.4,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT  ,,,both,,,947.6,568.56,Aetna,Commerical,,685.46,,,685.46,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Aetna,Middlesex Employees,,616.92,,,616.92,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Anthem,Commerical,,613.34,,,613.34,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Anthem,Indemnity,,,689.23,,689.23,490.67,759.29,percent of total billed charges,,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Anthem,State Preferred,,613.34,,,613.34,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Anthem,Individual Exchange,,490.67,,,490.67,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Cigna,Cigna,,598.99,,,598.99,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Connecticare,Commerical,,640.68,,,640.68,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Connecticare,Exchange,,640.68,,,640.68,490.67,759.29,other,Could be inpatient or outpatient,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,Multiplan,Multiplan,,,759.29,,759.29,490.67,759.29,percent of total billed charges,,
HC BASIC VESTIBULAR EVAL,92540,CPT,,,both,,,947.6,568.56,United Healthcare/Oxford,United Healthcare/Oxford,,616.46,,,616.46,490.67,759.29,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT  ,,,both,,,243.08,145.85,Aetna,Commerical,,175.85,,,175.85,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Aetna,Middlesex Employees,,158.27,,,158.27,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Anthem,Commerical,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Anthem,Indemnity,,,176.81,,176.81,125.88,194.78,percent of total billed charges,,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Anthem,State Preferred,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Anthem,Individual Exchange,,125.88,,,125.88,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Cigna,Cigna,,153.66,,,153.66,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Connecticare,Commerical,,164.35,,,164.35,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Connecticare,Exchange,,164.35,,,164.35,125.88,194.78,other,Could be inpatient or outpatient,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,Multiplan,Multiplan,,,194.78,,194.78,125.88,194.78,percent of total billed charges,,
HC SPONTANEOUS NYSTAGMUS TEST,92541,CPT,,,both,,,243.08,145.85,United Healthcare/Oxford,United Healthcare/Oxford,,158.14,,,158.14,125.88,194.78,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT  ,,,both,,,438.78,263.27,Aetna,Commerical,,317.49,,,317.49,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Aetna,Middlesex Employees,,285.74,,,285.74,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Anthem,Commerical,,284.09,,,284.09,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Anthem,Indemnity,,,319.24,,319.24,227.27,351.69,percent of total billed charges,,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Anthem,State Preferred,,284.09,,,284.09,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Anthem,Individual Exchange,,227.27,,,227.27,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Cigna,Cigna,,277.44,,,277.44,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Connecticare,Commerical,,296.75,,,296.75,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Connecticare,Exchange,,296.75,,,296.75,227.27,351.69,other,Could be inpatient or outpatient,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,Multiplan,Multiplan,,,351.69,,351.69,227.27,351.69,percent of total billed charges,,
HC POSITIONAL NYSTAGMUS MIN 4 POS W/RECORDING,92542,CPT,,,both,,,438.78,263.27,United Healthcare/Oxford,United Healthcare/Oxford,,285.53,,,285.53,227.27,351.69,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT  ,,,both,,,147.29,88.37,Aetna,Commerical,,106.65,,,106.65,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Aetna,Middlesex Employees,,95.98,,,95.98,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Anthem,Commerical,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Anthem,Indemnity,,,107.23,,107.23,76.34,118.13,percent of total billed charges,,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Anthem,State Preferred,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Anthem,Individual Exchange,,76.34,,,76.34,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Cigna,Cigna,,93.19,,,93.19,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Connecticare,Commerical,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Connecticare,Exchange,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,Multiplan,Multiplan,,,118.13,,118.13,76.34,118.13,percent of total billed charges,,
HC OPTOKINETIC NYSTAGMUS W RECORD,92544,CPT,,,both,,,147.29,88.37,United Healthcare/Oxford,United Healthcare/Oxford,,95.91,,,95.91,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT  ,,,both,,,147.29,88.37,Aetna,Commerical,,106.65,,,106.65,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Aetna,Middlesex Employees,,95.98,,,95.98,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Anthem,Commerical,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Anthem,Indemnity,,,107.23,,107.23,76.34,118.13,percent of total billed charges,,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Anthem,State Preferred,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Anthem,Individual Exchange,,76.34,,,76.34,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Cigna,Cigna,,93.19,,,93.19,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Connecticare,Commerical,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Connecticare,Exchange,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,Multiplan,Multiplan,,,118.13,,118.13,76.34,118.13,percent of total billed charges,,
HC OSCILLATING TRACKING W RECORDING,92545,CPT,,,both,,,147.29,88.37,United Healthcare/Oxford,United Healthcare/Oxford,,95.91,,,95.91,76.34,118.13,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT  ,,,both,,,164.8,98.88,Aetna,Commerical,,118.86,,,118.86,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Aetna,Middlesex Employees,,106.97,,,106.97,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Anthem,Commerical,,106.35,,,106.35,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Anthem,Indemnity,,,119.51,,119.51,85.08,131.66,percent of total billed charges,,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Anthem,State Preferred,,106.35,,,106.35,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Anthem,Individual Exchange,,85.08,,,85.08,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Cigna,Cigna,,103.86,,,103.86,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Connecticare,Commerical,,111.1,,,111.1,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Connecticare,Exchange,,111.1,,,111.1,85.08,131.66,other,Could be inpatient or outpatient,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,Multiplan,Multiplan,,,131.66,,131.55,85.08,131.66,percent of total billed charges,,
HC USE VERTICAL ELECTRODES,92547,CPT,,,both,,,164.8,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,106.89,,,106.89,85.08,131.66,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT  ,,,both,,,230.72,138.43,Aetna,Commerical,,166.89,,,166.89,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Aetna,Middlesex Employees,,150.2,,,150.2,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Anthem,Commerical,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Anthem,Indemnity,,,167.8,,167.8,119.46,184.86,percent of total billed charges,,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Anthem,State Preferred,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Anthem,Individual Exchange,,119.46,,,119.46,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Cigna,Cigna,,145.84,,,145.84,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Connecticare,Commerical,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Connecticare,Exchange,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,Multiplan,Multiplan,,,184.86,,184.86,119.46,184.86,percent of total billed charges,,
HC TYMPANOMETRY & REFLEX THRESH,92550,CPT,,,both,,,230.72,138.43,United Healthcare/Oxford,United Healthcare/Oxford,,150.08,,,150.08,119.46,184.86,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,83.04,,,83.04,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,74.73,,,74.73,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,59.44,91.98,percent of total billed charges,,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,59.44,,,59.44,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,72.56,,,72.56,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,59.44,91.98,percent of total billed charges,,
HC SCREENING PURE TONE AIR ONLY,92551,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,74.68,,,74.68,59.44,91.98,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT  ,,,both,,,252.35,151.41,Aetna,Commerical,,182.35,,,182.35,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Aetna,Middlesex Employees,,164.12,,,164.12,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Anthem,Commerical,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Anthem,Indemnity,,,183.36,,183.36,130.53,201.99,percent of total billed charges,,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Anthem,State Preferred,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Anthem,Individual Exchange,,130.53,,,130.53,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Cigna,Cigna,,159.35,,,159.35,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Connecticare,Commerical,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Connecticare,Exchange,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,Multiplan,Multiplan,,,201.99,,201.99,130.53,201.99,percent of total billed charges,,
HC PTA THRESHOLD-AIR ONLY,92552,CPT,,,both,,,252.35,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,164,,,164,130.53,201.99,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT  ,,,both,,,315.18,189.11,Aetna,Commerical,,227.95,,,227.95,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Aetna,Middlesex Employees,,205.15,,,205.15,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Anthem,Commerical,,203.96,,,203.96,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Anthem,Indemnity,,,229.2,,229.2,163.17,252.49,percent of total billed charges,,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Anthem,State Preferred,,203.96,,,203.96,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Anthem,Individual Exchange,,163.17,,,163.17,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Cigna,Cigna,,199.19,,,199.19,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Connecticare,Commerical,,213.05,,,213.05,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Connecticare,Exchange,,213.05,,,213.05,163.17,252.49,other,Could be inpatient or outpatient,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,Multiplan,Multiplan,,,252.49,,252.49,163.17,252.49,percent of total billed charges,,
HC PTA THRESHOLD; AIR AND BONE,92553,CPT,,,both,,,315.18,189.11,United Healthcare/Oxford,United Healthcare/Oxford,,204.99,,,204.99,163.17,252.49,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,83.04,,,83.04,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,74.73,,,74.73,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,59.44,91.98,percent of total billed charges,,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,59.44,,,59.44,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,72.56,,,72.56,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,59.44,91.98,percent of total billed charges,,
HC SPEECH AUDIOMETRY THRESHOLD,92555,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,74.68,,,74.68,59.44,91.98,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT  ,,,both,,,144.2,86.52,Aetna,Commerical,,104.2,,,104.2,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Aetna,Middlesex Employees,,93.78,,,93.78,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Anthem,Commerical,,93.24,,,93.24,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Anthem,Indemnity,,,104.78,,104.78,74.59,115.43,percent of total billed charges,,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Anthem,State Preferred,,93.24,,,93.24,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Anthem,Individual Exchange,,74.59,,,74.59,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Cigna,Cigna,,91.06,,,91.06,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Connecticare,Commerical,,97.4,,,97.4,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Connecticare,Exchange,,97.4,,,97.4,74.59,115.43,other,Could be inpatient or outpatient,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,Multiplan,Multiplan,,,115.43,,115.43,74.59,115.43,percent of total billed charges,,
HC SA THRESHOLD; W SR,92556,CPT,,,both,,,144.2,86.52,United Healthcare/Oxford,United Healthcare/Oxford,,93.71,,,93.71,74.59,115.43,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT  ,,,both,,,400.67,240.4,Aetna,Commerical,,289.81,,,289.81,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Aetna,Middlesex Employees,,260.83,,,260.83,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Anthem,Commerical,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Anthem,Indemnity,,,291.41,,291.41,207.46,321.03,percent of total billed charges,,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Anthem,State Preferred,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Anthem,Individual Exchange,,207.46,,,207.46,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Cigna,Cigna,,253.26,,,253.26,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Connecticare,Commerical,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Connecticare,Exchange,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,Multiplan,Multiplan,,,321.03,,321.03,207.46,321.03,percent of total billed charges,,
HC COMP AUD EVAL,92557,CPT,,,both,,,400.67,240.4,United Healthcare/Oxford,United Healthcare/Oxford,,260.64,,,260.64,207.46,321.03,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT  ,,,both,,,117.42,70.45,Aetna,Commerical,,85.48,,,85.48,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Aetna,Middlesex Employees,,76.94,,,76.94,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Anthem,Commerical,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Anthem,Indemnity,,,85.95,,85.95,61.19,94.68,percent of total billed charges,,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Anthem,State Preferred,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Anthem,Individual Exchange,,61.19,,,61.19,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Cigna,Cigna,,74.69,,,74.69,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Connecticare,Commerical,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Connecticare,Exchange,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,Multiplan,Multiplan,,,94.68,,94.68,61.19,94.68,percent of total billed charges,,
HC TONE DECAY TEST,92563,CPT,,,both,,,117.42,70.45,United Healthcare/Oxford,United Healthcare/Oxford,,76.87,,,76.87,61.19,94.68,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,83.04,,,83.04,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,74.73,,,74.73,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,59.44,91.98,percent of total billed charges,,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,59.44,,,59.44,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,72.56,,,72.56,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,59.44,91.98,percent of total billed charges,,
HC STENGER PURE TONE,92565,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,74.68,,,74.68,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,83.04,,,83.04,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,74.73,,,74.73,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,59.44,91.98,percent of total billed charges,,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,59.44,,,59.44,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,72.56,,,72.56,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,59.44,91.98,percent of total billed charges,,
HC TYMPANOMETRY,92567,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,74.68,,,74.68,59.44,91.98,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT  ,,,both,,,345.05,207.03,Aetna,Commerical,,249.92,,,249.92,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Aetna,Middlesex Employees,,224.93,,,224.93,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Anthem,Commerical,,223.63,,,223.63,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Anthem,Indemnity,,,251.3,,251.3,178.91,276.85,percent of total billed charges,,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Anthem,State Preferred,,223.63,,,223.63,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Anthem,Individual Exchange,,178.91,,,178.91,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Cigna,Cigna,,218.4,,,218.4,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Connecticare,Commerical,,233.6,,,233.6,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Connecticare,Exchange,,233.6,,,233.6,178.91,276.85,other,Could be inpatient or outpatient,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,Multiplan,Multiplan,,,276.85,,276.85,178.91,276.85,percent of total billed charges,,
HC ACOUSTIC IMMITTANCE TESTING,92570,CPT,,,both,,,345.05,207.03,United Healthcare/Oxford,United Healthcare/Oxford,,224.77,,,224.77,178.91,276.85,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT  ,,,both,,,237.93,142.76,Aetna,Commerical,,171.77,,,171.77,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Aetna,Middlesex Employees,,154.59,,,154.59,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Anthem,Commerical,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Anthem,Indemnity,,,172.72,,172.72,122.96,190.27,percent of total billed charges,,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Anthem,State Preferred,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Anthem,Individual Exchange,,122.96,,,122.96,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Cigna,Cigna,,150.1,,,150.1,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Connecticare,Commerical,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Connecticare,Exchange,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,Multiplan,Multiplan,,,190.27,,190.27,122.96,190.27,percent of total billed charges,,
HC STENGER SPEECH TEST,92577,CPT,,,both,,,237.93,142.76,United Healthcare/Oxford,United Healthcare/Oxford,,154.48,,,154.48,122.96,190.27,other,Could be inpatient or outpatient,
HC VRA,92579,CPT  ,,,both,,,360.5,216.3,Aetna,Commerical,,260.51,,,260.51,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Aetna,Middlesex Employees,,234.45,,,234.45,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Anthem,Commerical,,233.1,,,233.1,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Anthem,Indemnity,,,261.94,,261.94,186.49,288.57,percent of total billed charges,,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Anthem,State Preferred,,233.1,,,233.1,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Anthem,Individual Exchange,,186.49,,,186.49,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Cigna,Cigna,,227.65,,,227.65,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Connecticare,Commerical,,243.48,,,243.48,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Connecticare,Exchange,,243.48,,,243.48,186.49,288.57,other,Could be inpatient or outpatient,
HC VRA,92579,CPT,,,both,,,360.5,216.3,Multiplan,Multiplan,,,288.57,,288.57,186.49,288.57,percent of total billed charges,,
HC VRA,92579,CPT,,,both,,,360.5,216.3,United Healthcare/Oxford,United Healthcare/Oxford,,234.28,,,234.28,186.49,288.57,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT  ,,,both,,,371.42,222.85,Aetna,Commerical,,268.65,,,268.65,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT  ,,,both,,,400.68,240.41,Aetna,Commerical,,289.81,,,289.81,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Aetna,Middlesex Employees,,241.78,,,241.78,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Aetna,Middlesex Employees,,260.83,,,260.83,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Anthem,Commerical,,240.38,,,240.38,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Anthem,Commerical,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Anthem,Indemnity,,,270.13,,270.13,192.3,297.59,percent of total billed charges,,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Anthem,Indemnity,,,291.41,,291.41,207.46,321.03,percent of total billed charges,,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Anthem,State Preferred,,240.38,,,240.38,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Anthem,State Preferred,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Anthem,Individual Exchange,,192.3,,,192.3,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Anthem,Individual Exchange,,207.46,,,207.46,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Cigna,Cigna,,234.76,,,234.76,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Cigna,Cigna,,253.26,,,253.26,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Connecticare,Commerical,,251.1,,,251.1,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Connecticare,Commerical,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Connecticare,Exchange,,251.1,,,251.1,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Connecticare,Exchange,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,Multiplan,Multiplan,,,297.59,,297.59,192.3,297.59,percent of total billed charges,,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,Multiplan,Multiplan,,,321.03,,321.03,207.46,321.03,percent of total billed charges,,
HC CONDITIONING PLAY AUDIOMETRY INPT,92582,CPT,,,both,,,371.42,222.85,United Healthcare/Oxford,United Healthcare/Oxford,,241.6,,,241.6,192.3,297.59,other,Could be inpatient or outpatient,
HC CONDITIONING PLAY AUDIOMETRY,92582,CPT,,,both,,,400.68,240.41,United Healthcare/Oxford,United Healthcare/Oxford,,260.64,,,260.64,207.46,321.03,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT  ,,,both,,,79.31,47.59,Aetna,Commerical,,57.8,,,57.8,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Aetna,Middlesex Employees,,52.03,,,52.03,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Anthem,Commerical,,51.72,,,51.72,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Anthem,Indemnity,,,58.11,,58.11,41.38,64.02,percent of total billed charges,,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Anthem,State Preferred,,51.72,,,51.72,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Anthem,Individual Exchange,,41.38,,,41.38,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Cigna,Cigna,,50.51,,,50.51,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Connecticare,Commerical,,54.02,,,54.02,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Connecticare,Exchange,,54.02,,,54.02,41.38,64.02,other,Could be inpatient or outpatient,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,Multiplan,Multiplan,,,64.02,,64.02,41.38,64.02,percent of total billed charges,,
HC SELECT PICTURE AUDIOMETRY,92583,CPT,,,both,,,79.31,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,51.98,,,51.98,41.38,64.02,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT  ,,,both,,,354.32,212.59,Aetna,Commerical,,256.44,,,256.44,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Aetna,Middlesex Employees,,230.8,,,230.8,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Anthem,Commerical,,229.46,,,229.46,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Anthem,Indemnity,,,257.84,,257.84,183.57,284.05,percent of total billed charges,,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Anthem,State Preferred,,229.46,,,229.46,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Anthem,Individual Exchange,,183.57,,,183.57,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Cigna,Cigna,,224.09,,,224.09,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Connecticare,Commerical,,239.68,,,239.68,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Connecticare,Exchange,,239.68,,,239.68,183.57,284.05,other,Could be inpatient or outpatient,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,Multiplan,Multiplan,,,284.05,,284.05,183.57,284.05,percent of total billed charges,,
HC ELECTROCOCHLEOGRAPHY,92584,CPT,,,both,,,354.32,212.59,United Healthcare/Oxford,United Healthcare/Oxford,,230.62,,,230.62,183.57,284.05,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT  ,,,both,,,1429.64,857.78,Aetna,Commerical,,1034.71,,,1034.71,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Aetna,Middlesex Employees,,931.24,,,931.24,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Anthem,Commerical,,925.84,,,925.84,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Anthem,Indemnity,,,1040.39,,1040.39,740.67,1146.14,percent of total billed charges,,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Anthem,State Preferred,,925.84,,,925.84,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Anthem,Individual Exchange,,740.67,,,740.67,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Cigna,Cigna,,904.18,,,904.18,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Connecticare,Commerical,,967.1,,,967.1,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Connecticare,Exchange,,967.1,,,967.1,740.67,1146.14,other,Could be inpatient or outpatient,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,Multiplan,Multiplan,,,1146.14,,1146.14,740.67,1146.14,percent of total billed charges,,
HC AUDIO EVOKED POTENTIAL,92585,CPT,,,both,,,1429.64,857.78,United Healthcare/Oxford,United Healthcare/Oxford,,930.53,,,930.53,740.67,1146.14,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT  ,,,both,,,1501.74,901.04,Aetna,Commerical,,1086.81,,,1086.81,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Aetna,Middlesex Employees,,978.14,,,978.14,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Anthem,Commerical,,972.45,,,972.45,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Anthem,Indemnity,,,1092.78,,1092.78,777.97,1203.86,percent of total billed charges,,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Anthem,State Preferred,,972.45,,,972.45,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Anthem,Individual Exchange,,777.97,,,777.97,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Cigna,Cigna,,949.71,,,949.71,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Connecticare,Commerical,,1015.79,,,1015.79,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Connecticare,Exchange,,1015.79,,,1015.79,777.97,1203.86,other,Could be inpatient or outpatient,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,Multiplan,Multiplan,,,1203.86,,1203.86,777.97,1203.86,percent of total billed charges,,
HC BAER SEDATED,92585,CPT,,,both,,,1501.74,901.04,United Healthcare/Oxford,United Healthcare/Oxford,,977.39,,,977.39,777.97,1203.86,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT  ,,,both,,,475.86,285.52,Aetna,Commerical,,344.36,,,344.36,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Aetna,Middlesex Employees,,309.92,,,309.92,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Anthem,Commerical,,308.13,,,308.13,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Anthem,Indemnity,,,346.25,,346.25,246.51,381.45,percent of total billed charges,,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Anthem,State Preferred,,308.13,,,308.13,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Anthem,Individual Exchange,,246.51,,,246.51,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Cigna,Cigna,,300.92,,,300.92,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Connecticare,Commerical,,321.86,,,321.86,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Connecticare,Exchange,,321.86,,,321.86,246.51,381.45,other,Could be inpatient or outpatient,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,Multiplan,Multiplan,,,381.45,,381.45,246.51,381.45,percent of total billed charges,,
HC NEWBORN BAER LIMITED,92586,CPT,,,both,,,475.86,285.52,United Healthcare/Oxford,United Healthcare/Oxford,,309.69,,,309.69,246.51,381.45,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT  ,,,both,,,252.35,151.41,Aetna,Commerical,,182.35,,,182.35,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Aetna,Middlesex Employees,,164.12,,,164.12,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Anthem,Commerical,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Anthem,Indemnity,,,183.36,,183.36,130.53,201.99,percent of total billed charges,,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Anthem,State Preferred,,163.17,,,163.17,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Anthem,Individual Exchange,,130.53,,,130.53,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Cigna,Cigna,,159.35,,,159.35,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Connecticare,Commerical,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Connecticare,Exchange,,170.44,,,170.44,130.53,201.99,other,Could be inpatient or outpatient,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,Multiplan,Multiplan,,,201.99,,201.99,130.53,201.99,percent of total billed charges,,
HC EVOKED AUDITORY TEST LIMITED - OTO,92587,CPT,,,both,,,252.35,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,164,,,164,130.53,201.99,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT  ,,,both,,,629.33,377.6,Aetna,Commerical,,455.08,,,455.08,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Aetna,Middlesex Employees,,409.57,,,409.57,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Anthem,Commerical,,407.19,,,407.19,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Anthem,Indemnity,,,457.57,,457.57,325.76,504.08,percent of total billed charges,,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Anthem,State Preferred,,407.19,,,407.19,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Anthem,Individual Exchange,,325.76,,,325.76,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Cigna,Cigna,,397.66,,,397.66,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Connecticare,Commerical,,425.34,,,425.34,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Connecticare,Exchange,,425.34,,,425.34,325.76,504.08,other,Could be inpatient or outpatient,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,Multiplan,Multiplan,,,504.08,,504.08,325.76,504.08,percent of total billed charges,,
HC DISTORTION PRODUCT EVOKED TST COMPLETE,92588,CPT,,,both,,,629.33,377.6,United Healthcare/Oxford,United Healthcare/Oxford,,409.26,,,409.26,325.76,504.08,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT  ,,,both,,,379.04,227.42,Aetna,Commerical,,274.34,,,274.34,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Aetna,Middlesex Employees,,246.91,,,246.91,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Anthem,Commerical,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Anthem,Indemnity,,,275.85,,275.85,196.38,303.89,percent of total billed charges,,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Anthem,State Preferred,,245.48,,,245.48,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Anthem,Individual Exchange,,196.38,,,196.38,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Cigna,Cigna,,239.74,,,239.74,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Connecticare,Commerical,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Connecticare,Exchange,,256.43,,,256.43,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,Multiplan,Multiplan,,,303.89,,303.89,196.38,303.89,percent of total billed charges,,
HC HEARING AID EXAM ONE EAR,92590,CPT,,,both,,,379.04,227.42,United Healthcare/Oxford,United Healthcare/Oxford,,246.73,,,246.73,196.38,303.89,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT  ,,,both,,,471.74,283.04,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Anthem,Indemnity,,,342.98,,342.98,244.17,377.84,percent of total billed charges,,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,Multiplan,Multiplan,,,377.84,,377.84,244.17,377.84,percent of total billed charges,,
HC HEARING AID EXAM BOTH EARS,92591,CPT,,,both,,,471.74,283.04,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT  ,,,both,,,79.31,47.59,Aetna,Commerical,,57.8,,,57.8,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Aetna,Middlesex Employees,,52.03,,,52.03,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Anthem,Commerical,,51.72,,,51.72,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Anthem,Indemnity,,,58.11,,58.11,41.38,64.02,percent of total billed charges,,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Anthem,State Preferred,,51.72,,,51.72,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Anthem,Individual Exchange,,41.38,,,41.38,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Cigna,Cigna,,50.51,,,50.51,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Connecticare,Commerical,,54.02,,,54.02,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Connecticare,Exchange,,54.02,,,54.02,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,Multiplan,Multiplan,,,64.02,,64.02,41.38,64.02,percent of total billed charges,,
HC HEARING AID CHECK ONE EAR,92592,CPT,,,both,,,79.31,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,51.98,,,51.98,41.38,64.02,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,69.35,107.31,percent of total billed charges,,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC HEARING AID CHECK BOTH EARS,92593,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT  ,,,both,,,114.33,68.6,Aetna,Commerical,,83.04,,,83.04,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Aetna,Middlesex Employees,,74.73,,,74.73,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Anthem,Commerical,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Anthem,Indemnity,,,83.49,,83.49,59.44,91.98,percent of total billed charges,,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Anthem,State Preferred,,74.3,,,74.3,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Anthem,Individual Exchange,,59.44,,,59.44,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Cigna,Cigna,,72.56,,,72.56,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Connecticare,Commerical,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Connecticare,Exchange,,77.61,,,77.61,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,Multiplan,Multiplan,,,91.98,,91.98,59.44,91.98,percent of total billed charges,,
HC ELECTRO HEARING AID TEST MONAURAL,92594,CPT,,,both,,,114.33,68.6,United Healthcare/Oxford,United Healthcare/Oxford,,74.68,,,74.68,59.44,91.98,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT  ,,,both,,,230.72,138.43,Aetna,Commerical,,166.89,,,166.89,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Aetna,Middlesex Employees,,150.2,,,150.2,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Anthem,Commerical,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Anthem,Indemnity,,,167.8,,167.8,119.46,184.86,percent of total billed charges,,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Anthem,State Preferred,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Anthem,Individual Exchange,,119.46,,,119.46,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Cigna,Cigna,,145.84,,,145.84,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Connecticare,Commerical,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Connecticare,Exchange,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,Multiplan,Multiplan,,,184.86,,184.86,119.46,184.86,percent of total billed charges,,
HC ELECTRO HEARING AID TEST BINAURAL,92595,CPT,,,both,,,230.72,138.43,United Healthcare/Oxford,United Healthcare/Oxford,,150.08,,,150.08,119.46,184.86,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT  ,,,both,,,920.82,552.49,Aetna,Commerical,,665.93,,,665.93,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Aetna,Middlesex Employees,,599.34,,,599.34,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Anthem,Commerical,,595.86,,,595.86,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Anthem,Indemnity,,,669.59,,669.59,476.69,737.65,percent of total billed charges,,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Anthem,State Preferred,,595.86,,,595.86,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Anthem,Individual Exchange,,476.69,,,476.69,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Cigna,Cigna,,581.92,,,581.92,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Connecticare,Commerical,,622.41,,,622.41,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Connecticare,Exchange,,622.41,,,622.41,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,Multiplan,Multiplan,,,737.65,,737.65,476.69,737.65,percent of total billed charges,,
HC COCHLEAR IMPLT F/UP EXAM < 7 YRS W PROG,92601,CPT,,,both,,,920.82,552.49,United Healthcare/Oxford,United Healthcare/Oxford,,598.88,,,598.88,476.69,737.65,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,332.96,,,332.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,299.67,,,299.67,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,238.34,368.82,percent of total billed charges,,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,238.34,,,238.34,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,290.96,,,290.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,238.34,368.82,percent of total billed charges,,
HC REPROGRAM COCHLEAR IMPLT < 7 YRS,92602,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,299.44,,,299.44,238.34,368.82,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT  ,,,both,,,920.82,552.49,Aetna,Commerical,,665.93,,,665.93,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Aetna,Middlesex Employees,,599.34,,,599.34,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Anthem,Commerical,,595.86,,,595.86,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Anthem,Indemnity,,,669.59,,669.59,476.69,737.65,percent of total billed charges,,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Anthem,State Preferred,,595.86,,,595.86,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Anthem,Individual Exchange,,476.69,,,476.69,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Cigna,Cigna,,581.92,,,581.92,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Connecticare,Commerical,,622.41,,,622.41,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Connecticare,Exchange,,622.41,,,622.41,476.69,737.65,other,Could be inpatient or outpatient,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,Multiplan,Multiplan,,,737.65,,737.65,476.69,737.65,percent of total billed charges,,
HC COCHLEAR IMPLT F/UP EXAM >=7 W PROG,92603,CPT,,,both,,,920.82,552.49,United Healthcare/Oxford,United Healthcare/Oxford,,598.88,,,598.88,476.69,737.65,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT  ,,,both,,,460.41,276.25,Aetna,Commerical,,332.96,,,332.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Aetna,Middlesex Employees,,299.67,,,299.67,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Anthem,Commerical,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Anthem,Indemnity,,,334.79,,334.79,238.34,368.82,percent of total billed charges,,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Anthem,State Preferred,,297.92,,,297.92,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Anthem,Individual Exchange,,238.34,,,238.34,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Cigna,Cigna,,290.96,,,290.96,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Connecticare,Commerical,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Connecticare,Exchange,,311.21,,,311.21,238.34,368.82,other,Could be inpatient or outpatient,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,Multiplan,Multiplan,,,368.82,,368.82,238.34,368.82,percent of total billed charges,,
HC REPROGRAM COCHLEAR IMPLT >7 YRS,92604,CPT,,,both,,,460.41,276.25,United Healthcare/Oxford,United Healthcare/Oxford,,299.44,,,299.44,238.34,368.82,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC TX NON-SP ACC,92606,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC AAC EVAL FIRST HR,92607,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC AAC EVAL ADDL 30MIN,92608,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC AAC TX PRGRM DEV,92609,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC BED/CHAIR SWAL EV,92610,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC BED/CHAIR SWAL EV - FEEDING TEAM SLP,92610,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC MOD BARIUM SWAL,92611,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT  ,,,both,,,1182.44,709.46,Aetna,Commerical,,855.61,,,855.61,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Aetna,Middlesex Employees,,770.05,,,770.05,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Anthem,Commerical,,765.58,,,765.58,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Anthem,Indemnity,,,860.31,,860.31,612.46,947.76,percent of total billed charges,,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Anthem,State Preferred,,765.58,,,765.58,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Anthem,Individual Exchange,,612.46,,,612.46,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Cigna,Cigna,,747.68,,,747.68,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Connecticare,Commerical,,799.7,,,799.7,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Connecticare,Exchange,,799.7,,,799.7,612.46,947.76,other,Could be inpatient or outpatient,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,Multiplan,Multiplan,,,947.76,,947.76,612.46,947.76,percent of total billed charges,,
HC VELOPHARYN STUDY,92611,CPT,,,both,,,1182.44,709.46,United Healthcare/Oxford,United Healthcare/Oxford,,769.46,,,769.46,612.46,947.76,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC FLEX ENDOSCOPIC EVAL OF SWALLOW,92612,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT  ,,,both,,,558.26,334.96,Aetna,Commerical,,411.95,,,411.95,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Aetna,Middlesex Employees,,395.03,,,395.03,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Anthem,Commerical,,397.91,,,397.91,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Anthem,Indemnity,,,405.85,,405.85,318.33,447.1,percent of total billed charges,,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Anthem,State Preferred,,397.91,,,397.91,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Anthem,Individual Exchange,,318.33,,,318.33,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Cigna,Cigna,,386,,,386,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Connecticare,Commerical,,439.09,,,439.09,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Connecticare,Exchange,,439.09,,,439.09,318.33,447.1,other,Could be inpatient or outpatient,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,Multiplan,Multiplan,,,447.1,,447.1,318.33,447.1,percent of total billed charges,,
HC TINNITUS ASSESSMENT,92625,CPT,,,both,,,558.26,334.96,United Healthcare/Oxford,United Healthcare/Oxford,,430.72,,,430.72,318.33,447.1,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC EVAL AUD REHAB STATUS 1ST HR,92626,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC EVAL AUD STATUS REHAB EA ADDL 15 MIN,92627,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT  ,,,both,,,518.85,311.31,Aetna,Commerical,,375.3,,,375.3,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Aetna,Middlesex Employees,,337.77,,,337.77,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Anthem,Commerical,,335.81,,,335.81,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Anthem,Indemnity,,,377.35,,377.35,268.64,415.71,percent of total billed charges,,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Anthem,State Preferred,,335.81,,,335.81,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Anthem,Individual Exchange,,268.64,,,268.64,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Cigna,Cigna,,327.95,,,327.95,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Connecticare,Commerical,,350.77,,,350.77,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Connecticare,Exchange,,350.77,,,350.77,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,Multiplan,Multiplan,,,415.71,,415.71,268.64,415.71,percent of total billed charges,,
HC AURAL REHAB PRE,92630,CPT,,,both,,,518.85,311.31,United Healthcare/Oxford,United Healthcare/Oxford,,337.51,,,337.51,268.64,415.71,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT  ,,,both,,,393.93,236.36,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC AURAL REHAB POST,92633,CPT,,,both,,,393.93,236.36,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT  ,,,both,,,476.34,285.81,Aetna,Commerical,,318.33,,,318.33,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Aetna,Middlesex Employees,,286.5,,,286.5,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Anthem,Commerical,,264.19,,,264.19,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Anthem,Indemnity,,,346.44,,346.44,211.36,381.65,percent of total billed charges,,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Anthem,State Preferred,,264.19,,,264.19,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Anthem,Individual Exchange,,211.36,,,211.36,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Cigna,Cigna,,280.4,,,280.4,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Connecticare,Commerical,,287.64,,,287.64,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Connecticare,Exchange,,287.64,,,287.64,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,Multiplan,Multiplan,,,381.65,,381.65,211.36,381.65,percent of total billed charges,,
HC AEP POST SCREENING W/ BROADBAND STIMULI I&R,92651,CPT,,,both,,,476.34,285.81,United Healthcare/Oxford,United Healthcare/Oxford,,294.87,,,294.87,211.36,381.65,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT  ,,,both,,,1501.74,901.04,Aetna,Commerical,,1003.92,,,1003.92,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Aetna,Middlesex Employees,,903.52,,,903.52,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Anthem,Commerical,,833.18,,,833.18,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Anthem,Indemnity,,,1092.55,,1092.55,666.54,1203.6,percent of total billed charges,,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Anthem,State Preferred,,833.18,,,833.18,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Anthem,Individual Exchange,,666.54,,,666.54,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Cigna,Cigna,,884.32,,,884.32,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Connecticare,Commerical,,907.12,,,907.12,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Connecticare,Exchange,,907.12,,,907.12,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,Multiplan,Multiplan,,,1203.6,,1203.6,666.54,1203.6,percent of total billed charges,,
HC AEP SED BAER THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1501.74,901.04,United Healthcare/Oxford,United Healthcare/Oxford,,929.93,,,929.93,666.54,1203.6,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT  ,,,both,,,1429.64,857.78,Aetna,Commerical,,955.7,,,955.7,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Aetna,Middlesex Employees,,860.13,,,860.13,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Anthem,Commerical,,793.16,,,793.16,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Anthem,Indemnity,,,1040.08,,1040.08,634.53,1145.8,percent of total billed charges,,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Anthem,State Preferred,,793.16,,,793.16,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Anthem,Individual Exchange,,634.53,,,634.53,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Cigna,Cigna,,841.85,,,841.85,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Connecticare,Commerical,,863.56,,,863.56,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Connecticare,Exchange,,863.56,,,863.56,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,Multiplan,Multiplan,,,1145.8,,1145.8,634.53,1145.8,percent of total billed charges,,
HC AEP THRESHOLD ESTIMATION AT MULT FREQ,92652,CPT,,,both,,,1429.64,857.78,United Healthcare/Oxford,United Healthcare/Oxford,,885.26,,,885.26,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT  ,,,both,,,1430.09,858.06,Aetna,Commerical,,955.7,,,955.7,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Aetna,Middlesex Employees,,860.13,,,860.13,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Anthem,Commerical,,793.16,,,793.16,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Anthem,Indemnity,,,1040.08,,1040.08,634.53,1145.8,percent of total billed charges,,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Anthem,State Preferred,,793.16,,,793.16,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Anthem,Individual Exchange,,634.53,,,634.53,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Cigna,Cigna,,841.85,,,841.85,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Connecticare,Commerical,,863.56,,,863.56,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Connecticare,Exchange,,863.56,,,863.56,634.53,1145.8,other,Could be inpatient or outpatient,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,Multiplan,Multiplan,,,1145.8,,1145.8,634.53,1145.8,percent of total billed charges,,
HC AEP NEURODIAGNOSTIC W/ INTERP & REPORT,92653,CPT,,,both,,,1430.09,858.06,United Healthcare/Oxford,United Healthcare/Oxford,,885.26,,,885.26,634.53,1145.8,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,137.58,,,137.58,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,123.83,,,123.83,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,98.48,152.4,percent of total billed charges,,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,98.48,,,98.48,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,120.22,,,120.22,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,98.48,152.4,percent of total billed charges,,
HC DVAT - DYNAMIC VISUAL ACUITY TEST,92700,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,123.73,,,123.73,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,137.58,,,137.58,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,123.83,,,123.83,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,98.48,152.4,percent of total billed charges,,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,98.48,,,98.48,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,120.22,,,120.22,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,98.48,152.4,percent of total billed charges,,
HC VEMP - VESTIBULAR EVOKED MYOGENIC POTENTIAL,92700,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,123.73,,,123.73,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT  ,,,both,,,189.52,113.71,Aetna,Commerical,,137.58,,,137.58,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Aetna,Middlesex Employees,,123.83,,,123.83,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Commerical,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Indemnity,,,138.34,,138.34,98.48,152.4,percent of total billed charges,,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,State Preferred,,123.1,,,123.1,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Anthem,Individual Exchange,,98.48,,,98.48,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Cigna,Cigna,,120.22,,,120.22,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Connecticare,Commerical,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Connecticare,Exchange,,128.59,,,128.59,98.48,152.4,other,Could be inpatient or outpatient,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,Multiplan,Multiplan,,,152.4,,152.4,98.48,152.4,percent of total billed charges,,
HC VHIT - VIDEO HEAD IMPULSE TEST,92700,CPT,,,both,,,189.52,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,123.73,,,123.73,98.48,152.4,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT  ,,,both,,,1056.86,634.12,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,outpatient,,,1056.86,634.12,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CODE BLUE (CPT CodeR),92950,CPT,,,outpatient,,,1056.86,634.12,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC CODE BLUE (CPT CodeR),92950,CPT,,,both,,,1056.86,634.12,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC CPR,92950,CPT  ,,,both,,,1089.74,653.84,Aetna,Commerical,,788.04,,,788.04,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Aetna,Middlesex Employees,,709.23,,,709.23,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Anthem,Commerical,,705.12,,,705.12,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,outpatient,,,1089.74,653.84,Anthem,Indemnity,,,792.37,,792.37,564.1,872.91,percent of total billed charges,,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Anthem,State Preferred,,705.12,,,705.12,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Anthem,Individual Exchange,,564.1,,,564.1,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Cigna,Cigna,,688.63,,,688.63,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Connecticare,Commerical,,736.55,,,736.55,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,Connecticare,Exchange,,736.55,,,736.55,564.1,872.91,other,Could be inpatient or outpatient,
HC CPR,92950,CPT,,,outpatient,,,1089.74,653.84,Multiplan,Multiplan,,,872.91,,872.91,564.1,872.91,percent of total billed charges,,
HC CPR,92950,CPT,,,both,,,1089.74,653.84,United Healthcare/Oxford,United Healthcare/Oxford,,708.7,,,708.7,564.1,872.91,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,outpatient,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC INTUBATE ASSIST (CPR),92950,CPT,,,outpatient,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC INTUBATE ASSIST (CPR),92950,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT  ,,,both,,,1089.74,653.84,Aetna,Commerical,,788.04,,,788.04,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Aetna,Middlesex Employees,,709.23,,,709.23,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Anthem,Commerical,,705.12,,,705.12,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,outpatient,,,1089.74,653.84,Anthem,Indemnity,,,792.37,,792.37,564.1,872.91,percent of total billed charges,,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Anthem,State Preferred,,705.12,,,705.12,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Anthem,Individual Exchange,,564.1,,,564.1,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Cigna,Cigna,,688.63,,,688.63,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Connecticare,Commerical,,736.55,,,736.55,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,Connecticare,Exchange,,736.55,,,736.55,564.1,872.91,other,Could be inpatient or outpatient,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,outpatient,,,1089.74,653.84,Multiplan,Multiplan,,,872.91,,872.91,564.1,872.91,percent of total billed charges,,
HC TEMP TRANSCUTAN PACING,92953,CPT,,,both,,,1089.74,653.84,United Healthcare/Oxford,United Healthcare/Oxford,,708.7,,,708.7,564.1,872.91,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT  ,,,both,,,1556.33,933.8,Aetna,Commerical,,1125.89,,,1125.89,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Aetna,Middlesex Employees,,1013.3,,,1013.3,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Anthem,Commerical,,1007.42,,,1007.42,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,outpatient,,,1556.33,933.8,Anthem,Indemnity,,,1132.07,,1132.07,805.93,1247.14,percent of total billed charges,,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Anthem,State Preferred,,1007.42,,,1007.42,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Anthem,Individual Exchange,,805.93,,,805.93,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Cigna,Cigna,,983.86,,,983.86,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Connecticare,Commerical,,1052.32,,,1052.32,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,Connecticare,Exchange,,1052.32,,,1052.32,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,outpatient,,,1556.33,933.8,Multiplan,Multiplan,,,1247.14,,1247.14,805.93,1247.14,percent of total billed charges,,
HC CARDIOVERSION ELECTRIC EXT,92960,CPT,,,both,,,1556.33,933.8,United Healthcare/Oxford,United Healthcare/Oxford,,1012.53,,,1012.53,805.93,1247.14,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT  ,,,both,,,2263.94,1358.36,Aetna,Commerical,,1637.96,,,1637.96,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Aetna,Middlesex Employees,,1474.17,,,1474.17,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Anthem,Commerical,,1465.6,,,1465.6,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,outpatient,,,2263.94,1358.36,Anthem,Indemnity,,,1646.95,,1646.95,1172.48,1814.35,percent of total billed charges,,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Anthem,State Preferred,,1465.6,,,1465.6,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Anthem,Individual Exchange,,1172.48,,,1172.48,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Cigna,Cigna,,1431.32,,,1431.32,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Connecticare,Commerical,,1530.92,,,1530.92,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,Connecticare,Exchange,,1530.92,,,1530.92,1172.48,1814.35,other,Could be inpatient or outpatient,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,outpatient,,,2263.94,1358.36,Multiplan,Multiplan,,,1814.35,,1814.35,1172.48,1814.35,percent of total billed charges,,
HC CARDIOVERSION ELECTIVE; INT,92961,CPT,,,both,,,2263.94,1358.36,United Healthcare/Oxford,United Healthcare/Oxford,,1473.04,,,1473.04,1172.48,1814.35,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT  ,,,both,,,198.79,119.27,Aetna,Commerical,,144.09,,,144.09,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Aetna,Middlesex Employees,,129.68,,,129.68,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Anthem,Commerical,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,outpatient,,,198.79,119.27,Anthem,Indemnity,,,144.89,,144.89,103.15,159.61,percent of total billed charges,,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Anthem,State Preferred,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Anthem,Individual Exchange,,103.15,,,103.15,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Cigna,Cigna,,125.91,,,125.91,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Connecticare,Commerical,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,Connecticare,Exchange,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,outpatient,,,198.79,119.27,Multiplan,Multiplan,,,159.61,,159.61,103.15,159.61,percent of total billed charges,,
HC 12 LEAD EKG; TRACING ONLY,93005,CPT,,,both,,,198.79,119.27,United Healthcare/Oxford,United Healthcare/Oxford,,129.58,,,129.58,103.15,159.61,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT  ,,,both,,,137.31,82.39,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,outpatient,,,137.31,82.39,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC EKG TRACING,93005,CPT,,,outpatient,,,137.31,82.39,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC EKG TRACING,93005,CPT,,,both,,,137.31,82.39,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC CVSLR STRESS TEST; TRACING,93017,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT  ,,,both,,,119.48,71.69,Aetna,Commerical,,87.11,,,87.11,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Aetna,Middlesex Employees,,78.4,,,78.4,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Anthem,Commerical,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Anthem,Indemnity,,,87.59,,87.59,62.36,96.49,percent of total billed charges,,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Anthem,State Preferred,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Anthem,Individual Exchange,,62.36,,,62.36,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Cigna,Cigna,,76.12,,,76.12,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Connecticare,Commerical,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Connecticare,Exchange,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,Multiplan,Multiplan,,,96.49,,96.49,62.36,96.49,percent of total billed charges,,
HC RHYTHM ECG 1-3 LEADS TRACING,93041,CPT,,,both,,,119.48,71.69,United Healthcare/Oxford,United Healthcare/Oxford,,78.34,,,78.34,62.36,96.49,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT  ,,,both,,,219.39,131.63,Aetna,Commerical,,146.76,,,146.76,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Aetna,Middlesex Employees,,132.08,,,132.08,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Anthem,Commerical,,121.8,,,121.8,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Anthem,Indemnity,,,159.72,,159.72,97.43,175.95,percent of total billed charges,,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Anthem,State Preferred,,121.8,,,121.8,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Anthem,Individual Exchange,,97.43,,,97.43,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Cigna,Cigna,,129.27,,,129.27,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Connecticare,Commerical,,132.6,,,132.6,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Connecticare,Exchange,,132.6,,,132.6,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,Multiplan,Multiplan,,,175.95,,175.95,97.43,175.95,percent of total billed charges,,
HB EXT ECG (HOLTER MONT)  >48HR <7D REC,93242,CPT,,,both,,,219.39,131.63,United Healthcare/Oxford,United Healthcare/Oxford,,135.94,,,135.94,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT  ,,,both,,,219.39,131.63,Aetna,Commerical,,146.76,,,146.76,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Aetna,Middlesex Employees,,132.08,,,132.08,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Anthem,Commerical,,121.8,,,121.8,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Anthem,Indemnity,,,159.72,,159.72,97.43,175.95,percent of total billed charges,,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Anthem,State Preferred,,121.8,,,121.8,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Anthem,Individual Exchange,,97.43,,,97.43,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Cigna,Cigna,,129.27,,,129.27,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Connecticare,Commerical,,132.6,,,132.6,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Connecticare,Exchange,,132.6,,,132.6,97.43,175.95,other,Could be inpatient or outpatient,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,Multiplan,Multiplan,,,175.95,,175.95,97.43,175.95,percent of total billed charges,,
HB EXT ECG (HOLTER MONT)  >7D <15D REC,93246,CPT,,,both,,,219.39,131.63,United Healthcare/Oxford,United Healthcare/Oxford,,135.94,,,135.94,97.43,175.95,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT  ,,,both,,,2065.15,1239.09,Aetna,Commerical,,1493.86,,,1493.86,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Aetna,Middlesex Employees,,1344.47,,,1344.47,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Anthem,Commerical,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Anthem,Indemnity,,,1502.06,,1502.06,1069.34,1654.74,percent of total billed charges,,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Anthem,State Preferred,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Anthem,Individual Exchange,,1069.34,,,1069.34,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Cigna,Cigna,,1305.41,,,1305.41,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Connecticare,Commerical,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Connecticare,Exchange,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,Multiplan,Multiplan,,,1654.74,,1654.74,1069.34,1654.74,percent of total billed charges,,
HC TTE CONG ABN; COMPLETE,93303,CPT,,,both,,,2065.15,1239.09,United Healthcare/Oxford,United Healthcare/Oxford,,1343.45,,,1343.45,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT  ,,,both,,,2065.15,1239.09,Aetna,Commerical,,1493.86,,,1493.86,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Aetna,Middlesex Employees,,1344.47,,,1344.47,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Anthem,Commerical,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Anthem,Indemnity,,,1502.06,,1502.06,1069.34,1654.74,percent of total billed charges,,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Anthem,State Preferred,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Anthem,Individual Exchange,,1069.34,,,1069.34,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Cigna,Cigna,,1305.41,,,1305.41,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Connecticare,Commerical,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Connecticare,Exchange,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,Multiplan,Multiplan,,,1654.74,,1654.74,1069.34,1654.74,percent of total billed charges,,
HC TTE CONG ABN; LIMITED/F-UP,93304,CPT,,,both,,,2065.15,1239.09,United Healthcare/Oxford,United Healthcare/Oxford,,1343.45,,,1343.45,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT  ,,,both,,,2065.15,1239.09,Aetna,Commerical,,1493.86,,,1493.86,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Aetna,Middlesex Employees,,1344.47,,,1344.47,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Anthem,Commerical,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Anthem,Indemnity,,,1502.06,,1502.06,1069.34,1654.74,percent of total billed charges,,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Anthem,State Preferred,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Anthem,Individual Exchange,,1069.34,,,1069.34,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Cigna,Cigna,,1305.41,,,1305.41,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Connecticare,Commerical,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Connecticare,Exchange,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,Multiplan,Multiplan,,,1654.74,,1654.74,1069.34,1654.74,percent of total billed charges,,
HC TTE W DOP COMPLTE,93306,CPT,,,both,,,2065.15,1239.09,United Healthcare/Oxford,United Healthcare/Oxford,,1343.45,,,1343.45,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT  ,,,both,,,932.15,559.29,Aetna,Commerical,,674.07,,,674.07,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Aetna,Middlesex Employees,,606.67,,,606.67,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Anthem,Commerical,,603.14,,,603.14,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Anthem,Indemnity,,,677.77,,677.77,482.51,746.67,percent of total billed charges,,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Anthem,State Preferred,,603.14,,,603.14,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Anthem,Individual Exchange,,482.51,,,482.51,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Cigna,Cigna,,589.04,,,589.04,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Connecticare,Commerical,,630.02,,,630.02,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Connecticare,Exchange,,630.02,,,630.02,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,Multiplan,Multiplan,,,746.67,,746.67,482.51,746.67,percent of total billed charges,,
HC TTE W/O DOP CMPLT,93307,CPT,,,both,,,932.15,559.29,United Healthcare/Oxford,United Healthcare/Oxford,,606.2,,,606.2,482.51,746.67,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT  ,,,both,,,987.07,592.24,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC TTE F-UP OR LMTD,93308,CPT,,,both,,,987.07,592.24,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT  ,,,both,,,2065.15,1239.09,Aetna,Commerical,,1493.86,,,1493.86,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Aetna,Middlesex Employees,,1344.47,,,1344.47,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Anthem,Commerical,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Anthem,Indemnity,,,1502.06,,1502.06,1069.34,1654.74,percent of total billed charges,,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Anthem,State Preferred,,1336.67,,,1336.67,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Anthem,Individual Exchange,,1069.34,,,1069.34,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Cigna,Cigna,,1305.41,,,1305.41,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Connecticare,Commerical,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Connecticare,Exchange,,1396.25,,,1396.25,1069.34,1654.74,other,Could be inpatient or outpatient,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,Multiplan,Multiplan,,,1654.74,,1654.74,1069.34,1654.74,percent of total billed charges,,
HC ECHO TRANSESOPHAGEAL COMPLETE,93312,CPT,,,both,,,2065.15,1239.09,United Healthcare/Oxford,United Healthcare/Oxford,,1343.45,,,1343.45,1069.34,1654.74,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT  ,,,both,,,1385.5,831.3,Aetna,Commerical,,1002.15,,,1002.15,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT  ,,,both,,,1648.88,989.33,Aetna,Commerical,,1192.65,,,1192.65,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Aetna,Middlesex Employees,,901.94,,,901.94,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Aetna,Middlesex Employees,,1073.38,,,1073.38,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Anthem,Commerical,,896.69,,,896.69,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Anthem,Commerical,,1067.15,,,1067.15,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Anthem,Indemnity,,,1007.65,,1007.65,717.36,1110.07,percent of total billed charges,,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Anthem,Indemnity,,,1199.19,,1199.19,853.72,1321.09,percent of total billed charges,,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Anthem,State Preferred,,896.69,,,896.69,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Anthem,State Preferred,,1067.15,,,1067.15,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Anthem,Individual Exchange,,717.36,,,717.36,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Anthem,Individual Exchange,,853.72,,,853.72,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Cigna,Cigna,,875.72,,,875.72,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Cigna,Cigna,,1042.19,,,1042.19,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Connecticare,Commerical,,936.66,,,936.66,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Connecticare,Commerical,,1114.71,,,1114.71,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Connecticare,Exchange,,936.66,,,936.66,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Connecticare,Exchange,,1114.71,,,1114.71,853.72,1321.09,other,Could be inpatient or outpatient,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,Multiplan,Multiplan,,,1110.07,,1110.07,717.36,1110.07,percent of total billed charges,,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,Multiplan,Multiplan,,,1321.09,,1321.09,853.72,1321.09,percent of total billed charges,,
HC TEE CONGENITAL-OTHER IMAGING SERVICES,93315,CPT,,,both,,,1385.5,831.3,United Healthcare/Oxford,United Healthcare/Oxford,,901.25,,,901.25,717.36,1110.07,other,Could be inpatient or outpatient,
HC TEE CONGENITAL,93315,CPT,,,both,,,1648.88,989.33,United Healthcare/Oxford,United Healthcare/Oxford,,1072.57,,,1072.57,853.72,1321.09,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT  ,,,both,,,157.59,94.55,Aetna,Commerical,,114.79,,,114.79,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Aetna,Middlesex Employees,,103.31,,,103.31,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Anthem,Commerical,,102.71,,,102.71,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Anthem,Indemnity,,,115.42,,115.42,82.17,127.15,percent of total billed charges,,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Anthem,State Preferred,,102.71,,,102.71,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Anthem,Individual Exchange,,82.17,,,82.17,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Cigna,Cigna,,100.31,,,100.31,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Connecticare,Commerical,,107.29,,,107.29,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Connecticare,Exchange,,107.29,,,107.29,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,Multiplan,Multiplan,,,127.15,,127.15,82.17,127.15,percent of total billed charges,,
HC DOPPLER ECHO; COMPLETE ADD ON,93320,CPT,,,both,,,157.59,94.55,United Healthcare/Oxford,United Healthcare/Oxford,,103.23,,,103.23,82.17,127.15,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT  ,,,both,,,86.52,51.91,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Anthem,Indemnity,,,63.85,,63.85,45.46,70.34,percent of total billed charges,,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC DOPPLER ECHO; LIMITED/ F-UP ADD ON,93321,CPT,,,both,,,86.52,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT  ,,,both,,,99.91,59.95,Aetna,Commerical,,71.64,,,71.64,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Aetna,Middlesex Employees,,64.47,,,64.47,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Anthem,Commerical,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Anthem,Indemnity,,,72.03,,72.03,51.27,79.36,percent of total billed charges,,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Anthem,State Preferred,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Anthem,Individual Exchange,,51.27,,,51.27,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Cigna,Cigna,,62.6,,,62.6,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Connecticare,Commerical,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Connecticare,Exchange,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,Multiplan,Multiplan,,,79.36,,79.36,51.27,79.36,percent of total billed charges,,
HC DOPPLER COLOR FLOW ADD ON,93325,CPT,,,both,,,99.91,59.95,United Healthcare/Oxford,United Healthcare/Oxford,,64.43,,,64.43,51.27,79.36,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT  ,,,both,,,1813.83,1088.3,Aetna,Commerical,,1212.36,,,1212.36,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Aetna,Middlesex Employees,,1091.13,,,1091.13,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Anthem,Commerical,,1006.16,,,1006.16,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Anthem,Indemnity,,,1319.39,,1319.39,804.93,1453.5,percent of total billed charges,,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Anthem,State Preferred,,1006.16,,,1006.16,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Anthem,Individual Exchange,,804.93,,,804.93,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Cigna,Cigna,,1067.93,,,1067.93,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Connecticare,Commerical,,1095.47,,,1095.47,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Connecticare,Exchange,,1095.47,,,1095.47,804.93,1453.5,other,Could be inpatient or outpatient,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,Multiplan,Multiplan,,,1453.5,,1453.5,804.93,1453.5,percent of total billed charges,,
HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,,both,,,1813.83,1088.3,United Healthcare/Oxford,United Healthcare/Oxford,,1123.01,,,1123.01,804.93,1453.5,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT  ,,,both,,,4214.76,2528.86,Aetna,Commerical,,2316.24,,,2316.24,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Aetna,Middlesex Employees,,2084.62,,,2084.62,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Anthem,Commerical,,2750.18,,,2750.18,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Anthem,Indemnity,,,3065.51,,3065.51,2084.62,3377.11,percent of total billed charges,,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Anthem,State Preferred,,2750.18,,,2750.18,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Anthem,Individual Exchange,,2200.14,,,2200.14,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Cigna,Cigna,,3161.74,,,3161.74,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Connecticare,Commerical,,2943.46,,,2943.46,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Connecticare,Exchange,,2943.46,,,2943.46,2084.62,3377.11,other,Could be inpatient or outpatient,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,Multiplan,Multiplan,,,3377.11,,3377.11,2084.62,3377.11,percent of total billed charges,,
HC HH PULMANGIOBIIR,93568,CPT,,,both,,,4214.76,2528.86,United Healthcare/Oxford,United Healthcare/Oxford,,2567.81,,,2567.81,2084.62,3377.11,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT  ,,,both,,,986.74,592.04,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC CAROTID DUPLEX SCAN; BILAT,93880,CPT,,,both,,,986.74,592.04,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT  ,,,both,,,1831.2,1098.72,Aetna,Commerical,,1324.52,,,1324.52,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT  ,,,both,,,486.22,291.73,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Aetna,Middlesex Employees,,1192.08,,,1192.08,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Anthem,Commerical,,1185.16,,,1185.16,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Anthem,Indemnity,,,1331.8,,1331.8,948.12,1467.17,percent of total billed charges,,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Anthem,State Preferred,,1185.16,,,1185.16,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Anthem,Individual Exchange,,948.12,,,948.12,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Cigna,Cigna,,1157.44,,,1157.44,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Connecticare,Commerical,,1237.97,,,1237.97,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Connecticare,Exchange,,1237.97,,,1237.97,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,Multiplan,Multiplan,,,1467.17,,1467.17,948.12,1467.17,percent of total billed charges,,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC US TCD COMPLETE,93886,CPT,,,both,,,1831.2,1098.72,United Healthcare/Oxford,United Healthcare/Oxford,,1191.17,,,1191.17,948.12,1467.17,other,Could be inpatient or outpatient,
HC US TCD COMPLETE-OTHER DIAGNOSTIC SERVICES,93886,CPT,,,both,,,486.22,291.73,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT  ,,,both,,,1133.39,680.03,Aetna,Commerical,,819.79,,,819.79,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT  ,,,both,,,486.22,291.73,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Aetna,Middlesex Employees,,737.8,,,737.8,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Anthem,Commerical,,733.53,,,733.53,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Anthem,Indemnity,,,824.29,,824.29,586.82,908.08,percent of total billed charges,,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Anthem,State Preferred,,733.53,,,733.53,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Anthem,Individual Exchange,,586.82,,,586.82,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Cigna,Cigna,,716.37,,,716.37,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Connecticare,Commerical,,766.22,,,766.22,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Connecticare,Exchange,,766.22,,,766.22,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,Multiplan,Multiplan,,,908.08,,908.08,586.82,908.08,percent of total billed charges,,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC US TCD LIMITED,93888,CPT,,,both,,,1133.39,680.03,United Healthcare/Oxford,United Healthcare/Oxford,,737.25,,,737.25,586.82,908.08,other,Could be inpatient or outpatient,
HC US TCD LIMITED-OTHER DIAGNOSTIC SERVICES,93888,CPT,,,both,,,486.22,291.73,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT  ,,,both,,,1552.08,931.25,Aetna,Commerical,,1122.63,,,1122.63,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT  ,,,both,,,1903.23,1141.94,Aetna,Commerical,,1376.62,,,1376.62,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Aetna,Middlesex Employees,,1010.37,,,1010.37,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Aetna,Middlesex Employees,,1238.96,,,1238.96,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Anthem,Commerical,,1004.51,,,1004.51,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Anthem,Commerical,,1231.77,,,1231.77,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Anthem,Indemnity,,,1128.8,,1128.8,803.61,1243.53,percent of total billed charges,,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Anthem,Indemnity,,,1384.19,,1384.19,985.42,1524.88,percent of total billed charges,,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Anthem,State Preferred,,1004.51,,,1004.51,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Anthem,State Preferred,,1231.77,,,1231.77,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Anthem,Individual Exchange,,803.61,,,803.61,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Anthem,Individual Exchange,,985.42,,,985.42,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Cigna,Cigna,,981.01,,,981.01,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Cigna,Cigna,,1202.97,,,1202.97,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Connecticare,Commerical,,1049.27,,,1049.27,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Connecticare,Commerical,,1286.68,,,1286.68,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Connecticare,Exchange,,1049.27,,,1049.27,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Connecticare,Exchange,,1286.68,,,1286.68,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,Multiplan,Multiplan,,,1243.53,,1243.53,803.61,1243.53,percent of total billed charges,,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,Multiplan,Multiplan,,,1524.88,,1524.88,985.42,1524.88,percent of total billed charges,,
HC US TCD VASOREACTIVITY,93890,CPT,,,both,,,1552.08,931.25,United Healthcare/Oxford,United Healthcare/Oxford,,1009.61,,,1009.61,803.61,1243.53,other,Could be inpatient or outpatient,
HC US TCD VASOREACTIVITY-OTHER DIAGNOSTIC SERVICES,93890,CPT,,,both,,,1903.23,1141.94,United Healthcare/Oxford,United Healthcare/Oxford,,1238.03,,,1238.03,985.42,1524.88,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT  ,,,both,,,2025.92,1215.55,Aetna,Commerical,,1465.37,,,1465.37,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT  ,,,both,,,2484,1490.4,Aetna,Commerical,,1796.7,,,1796.7,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Aetna,Middlesex Employees,,1318.83,,,1318.83,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Aetna,Middlesex Employees,,1617.04,,,1617.04,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Anthem,Commerical,,1311.17,,,1311.17,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Anthem,Commerical,,1607.64,,,1607.64,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Anthem,Indemnity,,,1473.41,,1473.41,1048.93,1623.18,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Anthem,Indemnity,,,1806.57,,1806.57,1286.11,1990.2,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Anthem,State Preferred,,1311.17,,,1311.17,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Anthem,State Preferred,,1607.64,,,1607.64,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Anthem,Individual Exchange,,1048.93,,,1048.93,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Anthem,Individual Exchange,,1286.11,,,1286.11,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Cigna,Cigna,,1280.51,,,1280.51,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Cigna,Cigna,,1570.05,,,1570.05,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Connecticare,Commerical,,1369.61,,,1369.61,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Connecticare,Commerical,,1679.3,,,1679.3,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Connecticare,Exchange,,1369.61,,,1369.61,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Connecticare,Exchange,,1679.3,,,1679.3,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,Multiplan,Multiplan,,,1623.18,,1623.18,1048.93,1623.18,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,Multiplan,Multiplan,,,1990.2,,1990.2,1286.11,1990.2,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION,93892,CPT,,,both,,,2025.92,1215.55,United Healthcare/Oxford,United Healthcare/Oxford,,1317.83,,,1317.83,1048.93,1623.18,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITHOUT INJECTION-OTHER DIAGNOSTIC SERVICES,93892,CPT,,,both,,,2484,1490.4,United Healthcare/Oxford,United Healthcare/Oxford,,1615.8,,,1615.8,1286.11,1990.2,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT  ,,,both,,,1860.47,1116.28,Aetna,Commerical,,1345.7,,,1345.7,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT  ,,,both,,,2281.4,1368.84,Aetna,Commerical,,1650.17,,,1650.17,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Aetna,Middlesex Employees,,1211.13,,,1211.13,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Aetna,Middlesex Employees,,1485.15,,,1485.15,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Anthem,Commerical,,1204.1,,,1204.1,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Anthem,Commerical,,1476.53,,,1476.53,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Anthem,Indemnity,,,1353.08,,1353.08,963.27,1490.62,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Anthem,Indemnity,,,1659.22,,1659.22,1181.22,1827.87,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Anthem,State Preferred,,1204.1,,,1204.1,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Anthem,State Preferred,,1476.53,,,1476.53,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Anthem,Individual Exchange,,963.27,,,963.27,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Anthem,Individual Exchange,,1181.22,,,1181.22,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Cigna,Cigna,,1175.93,,,1175.93,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Cigna,Cigna,,1441.99,,,1441.99,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Connecticare,Commerical,,1257.76,,,1257.76,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Connecticare,Commerical,,1542.34,,,1542.34,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Connecticare,Exchange,,1257.76,,,1257.76,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Connecticare,Exchange,,1542.34,,,1542.34,1181.22,1827.87,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,Multiplan,Multiplan,,,1490.62,,1490.62,963.27,1490.62,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,Multiplan,Multiplan,,,1827.87,,1827.87,1181.22,1827.87,percent of total billed charges,,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION,93893,CPT,,,both,,,1860.47,1116.28,United Healthcare/Oxford,United Healthcare/Oxford,,1210.21,,,1210.21,963.27,1490.62,other,Could be inpatient or outpatient,
HC US TCD EMBOLIZATION DETECTION WITH INJECTION-OTHER DIAGNOSTIC SERVICES,93893,CPT,,,both,,,2281.4,1368.84,United Healthcare/Oxford,United Healthcare/Oxford,,1484.02,,,1484.02,1181.22,1827.87,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT  ,,,both,,,986.74,592.04,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC DUPLEX LE ART/BPG; BILAT,93925,CPT,,,both,,,986.74,592.04,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT  ,,,both,,,486.16,291.7,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC DUPLEX LE ART/BPG; UNIL/LIMIT,93926,CPT,,,both,,,486.16,291.7,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT  ,,,both,,,1440.97,864.58,Aetna,Commerical,,1042.04,,,1042.04,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Aetna,Middlesex Employees,,937.84,,,937.84,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Anthem,Commerical,,932.39,,,932.39,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Anthem,Indemnity,,,1047.76,,1047.76,745.91,1154.26,percent of total billed charges,,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Anthem,State Preferred,,932.39,,,932.39,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Anthem,Individual Exchange,,745.91,,,745.91,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Cigna,Cigna,,910.58,,,910.58,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Connecticare,Commerical,,973.95,,,973.95,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Connecticare,Exchange,,973.95,,,973.95,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,Multiplan,Multiplan,,,1154.26,,1154.26,745.91,1154.26,percent of total billed charges,,
HC DUPLEX UE ART/BPG; BILAT,93930,CPT,,,both,,,1440.97,864.58,United Healthcare/Oxford,United Healthcare/Oxford,,937.12,,,937.12,745.91,1154.26,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT  ,,,both,,,486.16,291.7,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC DUPLEX UE ART/BPG; UNIL/LIMIT,93931,CPT,,,both,,,486.16,291.7,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT  ,,,both,,,986.74,592.04,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC US DUPLEX EXTREMITY VENOUS BILAT,93970,CPT,,,both,,,986.74,592.04,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT  ,,,both,,,1574.87,944.92,Aetna,Commerical,,1138.91,,,1138.91,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Aetna,Middlesex Employees,,1025.02,,,1025.02,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Anthem,Commerical,,1019.07,,,1019.07,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Anthem,Indemnity,,,1145.17,,1145.17,815.26,1261.57,percent of total billed charges,,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Anthem,State Preferred,,1019.07,,,1019.07,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Anthem,Individual Exchange,,815.26,,,815.26,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Cigna,Cigna,,995.24,,,995.24,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Connecticare,Commerical,,1064.5,,,1064.5,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Connecticare,Exchange,,1064.5,,,1064.5,815.26,1261.57,other,Could be inpatient or outpatient,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,Multiplan,Multiplan,,,1261.57,,1261.57,815.26,1261.57,percent of total billed charges,,
HC DUPLEX EXT VEINS; UNIL/LIMIT,93971,CPT,,,both,,,1574.87,944.92,United Healthcare/Oxford,United Healthcare/Oxford,,1024.24,,,1024.24,815.26,1261.57,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT  ,,,both,,,1224.56,734.73,Aetna,Commerical,,885.73,,,885.73,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT  ,,,both,,,486.22,291.73,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Aetna,Middlesex Employees,,797.16,,,797.16,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Anthem,Commerical,,792.53,,,792.53,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Anthem,Indemnity,,,890.6,,890.6,634.02,981.12,percent of total billed charges,,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Anthem,State Preferred,,792.53,,,792.53,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Anthem,Individual Exchange,,634.02,,,634.02,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Cigna,Cigna,,774,,,774,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Connecticare,Commerical,,827.86,,,827.86,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Connecticare,Exchange,,827.86,,,827.86,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,Multiplan,Multiplan,,,981.12,,981.12,634.02,981.12,percent of total billed charges,,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER,93971,CPT,,,both,,,1224.56,734.73,United Healthcare/Oxford,United Healthcare/Oxford,,796.55,,,796.55,634.02,981.12,other,Could be inpatient or outpatient,
HC US UNI OR LTD EXTREMITY VENOUS DOPPLER-OTHER DIAGNOSTIC SERVICES,93971,CPT,,,both,,,486.22,291.73,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT  ,,,both,,,987.07,592.24,Aetna,Commerical,,713.96,,,713.96,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Aetna,Middlesex Employees,,642.57,,,642.57,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Anthem,Commerical,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Anthem,Indemnity,,,717.88,,717.88,511.06,790.85,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Anthem,State Preferred,,638.83,,,638.83,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Anthem,Individual Exchange,,511.06,,,511.06,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Cigna,Cigna,,623.9,,,623.9,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Connecticare,Commerical,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Connecticare,Exchange,,667.3,,,667.3,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,Multiplan,Multiplan,,,790.85,,790.85,511.06,790.85,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASC STUDY COMPLETE,93975,CPT,,,both,,,987.07,592.24,United Healthcare/Oxford,United Healthcare/Oxford,,642.07,,,642.07,511.06,790.85,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT  ,,,both,,,408.56,245.14,Aetna,Commerical,,295.52,,,295.52,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT  ,,,both,,,486.22,291.73,Aetna,Commerical,,351.69,,,351.69,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Aetna,Middlesex Employees,,265.97,,,265.97,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Aetna,Middlesex Employees,,316.52,,,316.52,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Anthem,Commerical,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Anthem,Commerical,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Anthem,Indemnity,,,297.14,,297.14,211.53,327.34,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Anthem,Indemnity,,,353.62,,353.62,251.74,389.56,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Anthem,State Preferred,,264.42,,,264.42,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Anthem,State Preferred,,314.68,,,314.68,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Anthem,Individual Exchange,,211.53,,,211.53,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Anthem,Individual Exchange,,251.74,,,251.74,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Cigna,Cigna,,258.23,,,258.23,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Cigna,Cigna,,307.32,,,307.32,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Connecticare,Commerical,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Connecticare,Commerical,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Connecticare,Exchange,,276.2,,,276.2,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Connecticare,Exchange,,328.7,,,328.7,251.74,389.56,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,Multiplan,Multiplan,,,327.34,,327.34,211.53,327.34,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,Multiplan,Multiplan,,,389.56,,389.56,251.74,389.56,percent of total billed charges,,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED,93976,CPT,,,both,,,408.56,245.14,United Healthcare/Oxford,United Healthcare/Oxford,,265.76,,,265.76,211.53,327.34,other,Could be inpatient or outpatient,
HC US DOPPLER ABD/PEL VASCULAR STUDY LIMITED-OTHER DIAGNOSTIC SERVICES,93976,CPT,,,both,,,486.22,291.73,United Healthcare/Oxford,United Healthcare/Oxford,,316.28,,,316.28,251.74,389.56,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT  ,,,both,,,1955.97,1173.58,Aetna,Commerical,,1414.89,,,1414.89,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Aetna,Middlesex Employees,,1273.4,,,1273.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Commerical,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Indemnity,,,1422.66,,1422.66,1012.81,1567.26,percent of total billed charges,,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,State Preferred,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Individual Exchange,,1012.81,,,1012.81,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Cigna,Cigna,,1236.4,,,1236.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Commerical,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Exchange,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Multiplan,Multiplan,,,1567.26,,1567.26,1012.81,1567.26,percent of total billed charges,,
HC HIGH FREQ OSCILL VENT MGMT INPAT INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,United Healthcare/Oxford,United Healthcare/Oxford,,1272.44,,,1272.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT  ,,,both,,,1955.97,1173.58,Aetna,Commerical,,1414.89,,,1414.89,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Aetna,Middlesex Employees,,1273.4,,,1273.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Commerical,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Indemnity,,,1422.66,,1422.66,1012.81,1567.26,percent of total billed charges,,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Anthem,State Preferred,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Individual Exchange,,1012.81,,,1012.81,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Cigna,Cigna,,1236.4,,,1236.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Commerical,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Exchange,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,Multiplan,Multiplan,,,1567.26,,1567.26,1012.81,1567.26,percent of total billed charges,,
HC HOME VENT CHECK,94002,CPT,,,both,,,1955.97,1173.58,United Healthcare/Oxford,United Healthcare/Oxford,,1272.44,,,1272.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT  ,,,both,,,1955.97,1173.58,Aetna,Commerical,,1414.89,,,1414.89,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Aetna,Middlesex Employees,,1273.4,,,1273.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Commerical,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Indemnity,,,1422.66,,1422.66,1012.81,1567.26,percent of total billed charges,,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,State Preferred,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Anthem,Individual Exchange,,1012.81,,,1012.81,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Cigna,Cigna,,1236.4,,,1236.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Commerical,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Connecticare,Exchange,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,Multiplan,Multiplan,,,1567.26,,1567.26,1012.81,1567.26,percent of total billed charges,,
HC VENT MGMT INPAT/OBS INIT DAY,94002,CPT,,,both,,,1955.97,1173.58,United Healthcare/Oxford,United Healthcare/Oxford,,1272.44,,,1272.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT  ,,,both,,,1955.97,1173.58,Aetna,Commerical,,1414.89,,,1414.89,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Aetna,Middlesex Employees,,1273.4,,,1273.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Commerical,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Indemnity,,,1422.66,,1422.66,1012.81,1567.26,percent of total billed charges,,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,State Preferred,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Individual Exchange,,1012.81,,,1012.81,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Cigna,Cigna,,1236.4,,,1236.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Connecticare,Commerical,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Connecticare,Exchange,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Multiplan,Multiplan,,,1567.26,,1567.26,1012.81,1567.26,percent of total billed charges,,
HC HIGH FREQ OSCILL VENT MGMT INPAT EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,United Healthcare/Oxford,United Healthcare/Oxford,,1272.44,,,1272.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT  ,,,both,,,1955.97,1173.58,Aetna,Commerical,,1414.89,,,1414.89,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Aetna,Middlesex Employees,,1273.4,,,1273.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Commerical,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Indemnity,,,1422.66,,1422.66,1012.81,1567.26,percent of total billed charges,,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,State Preferred,,1266.01,,,1266.01,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Anthem,Individual Exchange,,1012.81,,,1012.81,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Cigna,Cigna,,1236.4,,,1236.4,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Connecticare,Commerical,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Connecticare,Exchange,,1322.44,,,1322.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,Multiplan,Multiplan,,,1567.26,,1567.26,1012.81,1567.26,percent of total billed charges,,
HC VENT MGMT INPAT/OBS EA SUBSQ DAY,94003,CPT,,,both,,,1955.97,1173.58,United Healthcare/Oxford,United Healthcare/Oxford,,1272.44,,,1272.44,1012.81,1567.26,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT  ,,,both,,,579.63,347.78,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC SPIROMETRY,94010,CPT,,,both,,,579.63,347.78,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC BRONCHOSPASM - PRE & POST BD,94060,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC HYPER SAL CHLG,94070,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC METHACHOLINE EVAL,94070,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC TOTAL VITAL CAPACITY,94150,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT  ,,,both,,,445.99,267.59,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC MAX VOL VENT,94200,CPT,,,both,,,445.99,267.59,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT  ,,,both,,,237.93,142.76,Aetna,Commerical,,171.77,,,171.77,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Aetna,Middlesex Employees,,154.59,,,154.59,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Anthem,Commerical,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Anthem,Indemnity,,,172.72,,172.72,122.96,190.27,percent of total billed charges,,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Anthem,State Preferred,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Anthem,Individual Exchange,,122.96,,,122.96,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Cigna,Cigna,,150.1,,,150.1,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Connecticare,Commerical,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Connecticare,Exchange,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,Multiplan,Multiplan,,,190.27,,190.27,122.96,190.27,percent of total billed charges,,
HC EXPIRED GAS QUANT SINGLE,94250,CPT,,,both,,,237.93,142.76,United Healthcare/Oxford,United Healthcare/Oxford,,154.48,,,154.48,122.96,190.27,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT  ,,,both,,,791.04,474.62,Aetna,Commerical,,572.31,,,572.31,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Aetna,Middlesex Employees,,515.08,,,515.08,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Anthem,Commerical,,512.09,,,512.09,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Anthem,Indemnity,,,575.45,,575.45,409.67,633.94,percent of total billed charges,,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Anthem,State Preferred,,512.09,,,512.09,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Anthem,Individual Exchange,,409.67,,,409.67,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Cigna,Cigna,,500.1,,,500.1,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Connecticare,Commerical,,534.91,,,534.91,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Connecticare,Exchange,,534.91,,,534.91,409.67,633.94,other,Could be inpatient or outpatient,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,Multiplan,Multiplan,,,633.94,,633.94,409.67,633.94,percent of total billed charges,,
HC SURFACTANT RX,94610,CPT,,,both,,,791.04,474.62,United Healthcare/Oxford,United Healthcare/Oxford,,514.68,,,514.68,409.67,633.94,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC BRONCHOSPASM EXERCISE TEST INC PRE/POST SPIRO AND PULSE OX,94617,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC PULM STRESS TEST (MEAS HEART RATE O2 AND O2 TITRATN WHEN PERFMD),94618,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT  ,,,both,,,756.02,453.61,Aetna,Commerical,,547.06,,,547.06,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Aetna,Middlesex Employees,,492.36,,,492.36,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Anthem,Commerical,,489.5,,,489.5,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Anthem,Indemnity,,,550.07,,550.07,391.6,605.98,percent of total billed charges,,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Anthem,State Preferred,,489.5,,,489.5,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Anthem,Individual Exchange,,391.6,,,391.6,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Cigna,Cigna,,478.06,,,478.06,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Connecticare,Commerical,,511.32,,,511.32,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Connecticare,Exchange,,511.32,,,511.32,391.6,605.98,other,Could be inpatient or outpatient,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,Multiplan,Multiplan,,,605.98,,605.98,391.6,605.98,percent of total billed charges,,
HC TREADMILL TEST,94620,CPT,,,both,,,756.02,453.61,United Healthcare/Oxford,United Healthcare/Oxford,,491.99,,,491.99,391.6,605.98,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT  ,,,both,,,1056.86,634.12,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC CARDIOPULM EXER TEST (MEAS OF MIN VENT C01 PROD 02 UPTAKE & ECG REC),94621,CPT,,,both,,,1056.86,634.12,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC AEROSOL INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC AEROSOL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC AEROSOL THERAPY,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BAG IN AERO INIT,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BAG IN AERO SUB,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC INEXSUFF INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC INEXSUFF SUBSEQ,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT  ,,,both,,,484.1,290.46,Aetna,Commerical,,350.06,,,350.06,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Aetna,Middlesex Employees,,315.06,,,315.06,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Anthem,Commerical,,313.22,,,313.22,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Anthem,Indemnity,,,351.98,,351.98,250.57,387.76,percent of total billed charges,,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Anthem,State Preferred,,313.22,,,313.22,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Anthem,Individual Exchange,,250.57,,,250.57,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Cigna,Cigna,,305.9,,,305.9,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Connecticare,Commerical,,327.19,,,327.19,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Connecticare,Exchange,,327.19,,,327.19,250.57,387.76,other,Could be inpatient or outpatient,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,Multiplan,Multiplan,,,387.76,,387.76,250.57,387.76,percent of total billed charges,,
HC INHALATION TRMT,94640,CPT,,,both,,,484.1,290.46,United Healthcare/Oxford,United Healthcare/Oxford,,314.82,,,314.82,250.57,387.76,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC INSTILL INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC INSTILL SUBSEQ,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC IPPB INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC IPPB SUBSEQ,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC MDI EXTEND,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC MDI SUBSEQUENT,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC MDI W SPACER INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC MDI WO SPACR INITIAL,94640,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT  ,,,both,,,456.29,273.77,Aetna,Commerical,,329.7,,,329.7,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Aetna,Middlesex Employees,,296.74,,,296.74,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Anthem,Commerical,,295.02,,,295.02,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Anthem,Indemnity,,,331.51,,331.51,236.01,365.21,percent of total billed charges,,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Anthem,State Preferred,,295.02,,,295.02,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Anthem,Individual Exchange,,236.01,,,236.01,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Cigna,Cigna,,288.11,,,288.11,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Connecticare,Commerical,,308.16,,,308.16,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Connecticare,Exchange,,308.16,,,308.16,236.01,365.21,other,Could be inpatient or outpatient,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,Multiplan,Multiplan,,,365.21,,365.21,236.01,365.21,percent of total billed charges,,
HC SPUTUM INDUCTION,94640,CPT,,,both,,,456.29,273.77,United Healthcare/Oxford,United Healthcare/Oxford,,296.52,,,296.52,236.01,365.21,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC AEROSOL PENTAMIDEN FOR P. CARINII,94642,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC CBT 1ST 1 HOUR,94644,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,52.1,,,52.1,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,46.89,,,46.89,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,37.29,57.72,percent of total billed charges,,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.29,,,37.29,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,45.53,,,45.53,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,37.29,57.72,percent of total billed charges,,
HC CBT EACH ADDL 1 HOUR,94645,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,46.85,,,46.85,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT  ,,,both,,,72.1,43.26,Aetna,Commerical,,52.1,,,52.1,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Aetna,Middlesex Employees,,46.89,,,46.89,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Commerical,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Indemnity,,,52.39,,52.39,37.29,57.72,percent of total billed charges,,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,State Preferred,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Anthem,Individual Exchange,,37.29,,,37.29,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Cigna,Cigna,,45.53,,,45.53,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Connecticare,Commerical,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Connecticare,Exchange,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,Multiplan,Multiplan,,,57.72,,57.72,37.29,57.72,percent of total billed charges,,
HC CBT EACH ADDL HOUR,94645,CPT,,,both,,,72.1,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,46.85,,,46.85,37.29,57.72,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BIPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BIPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BUBBLE BOTTLE INITIAL,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC BUBBLE BOTTLE SUBSEQ,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC CPAP INITIAL,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC CPAP SUBSEQ,94660,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT  ,,,both,,,275.75,165.45,Aetna,Commerical,,199.45,,,199.45,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT  ,,,both,,,70.92,42.55,Aetna,Commerical,,51.29,,,51.29,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Aetna,Middlesex Employees,,179.5,,,179.5,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Aetna,Middlesex Employees,,46.16,,,46.16,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Anthem,Commerical,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Anthem,Commerical,,45.89,,,45.89,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Anthem,Indemnity,,,200.55,,200.55,142.77,220.93,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Anthem,Indemnity,,,51.57,,51.57,45.89,56.81,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Anthem,State Preferred,,178.47,,,178.47,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Anthem,State Preferred,,45.89,,,45.89,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Anthem,Individual Exchange,,142.77,,,142.77,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Anthem,Individual Exchange,,36.71,,,36.71,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Cigna,Cigna,,174.29,,,174.29,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Cigna,Cigna,,44.81,,,44.81,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Connecticare,Commerical,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Connecticare,Commerical,,47.94,,,47.94,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Connecticare,Exchange,,186.42,,,186.42,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Connecticare,Exchange,,47.94,,,47.94,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,Multiplan,Multiplan,,,220.93,,220.93,142.77,220.93,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,Multiplan,Multiplan,,,56.81,,56.81,45.89,56.81,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - LAB,94664,CPT,,,both,,,275.75,165.45,United Healthcare/Oxford,United Healthcare/Oxford,,179.37,,,179.37,142.77,220.93,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB,94664,CPT,,,both,,,70.92,42.55,United Healthcare/Oxford,United Healthcare/Oxford,,46.12,,,46.12,45.89,56.81,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 15 MIN,94664,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT  ,,,both,,,620.06,372.04,Aetna,Commerical,,447.75,,,447.75,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Aetna,Middlesex Employees,,402.98,,,402.98,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Commerical,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Indemnity,,,450.21,,450.21,320.51,495.98,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,State Preferred,,400.64,,,400.64,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Anthem,Individual Exchange,,320.51,,,320.51,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Cigna,Cigna,,391.27,,,391.27,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Connecticare,Commerical,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Connecticare,Exchange,,418.5,,,418.5,320.51,495.98,other,Could be inpatient or outpatient,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,Multiplan,Multiplan,,,495.98,,495.98,320.51,495.98,percent of total billed charges,,
HC DEMO/EVAL PT USE OF MDI/IPPD/NEB - 30 MIN,94664,CPT,,,both,,,620.06,372.04,United Healthcare/Oxford,United Healthcare/Oxford,,402.67,,,402.67,320.51,495.98,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT  ,,,both,,,386.05,231.63,Aetna,Commerical,,279.24,,,279.24,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Aetna,Middlesex Employees,,251.31,,,251.31,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Anthem,Commerical,,249.85,,,249.85,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Anthem,Indemnity,,,280.77,,280.77,199.88,309.31,percent of total billed charges,,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Anthem,State Preferred,,249.85,,,249.85,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Anthem,Individual Exchange,,199.88,,,199.88,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Cigna,Cigna,,244,,,244,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Connecticare,Commerical,,260.99,,,260.99,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Connecticare,Exchange,,260.99,,,260.99,199.88,309.31,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,Multiplan,Multiplan,,,309.31,,309.31,199.88,309.31,percent of total billed charges,,
HC MANIPULATION OF CHEST WALL INITIAL-2,94667,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC MANIPULATION OF CHEST WALL INITIAL,94667,CPT,,,both,,,386.05,231.63,United Healthcare/Oxford,United Healthcare/Oxford,,251.12,,,251.12,199.88,309.31,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC CHEST PT; SUBSEQUENT,94668,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC MECHANICAL IPV CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT  ,,,both,,,445.7,267.42,Aetna,Commerical,,322.38,,,322.38,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Aetna,Middlesex Employees,,290.15,,,290.15,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Commerical,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Indemnity,,,324.15,,324.15,230.76,357.1,percent of total billed charges,,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,State Preferred,,288.45,,,288.45,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Anthem,Individual Exchange,,230.76,,,230.76,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Cigna,Cigna,,281.72,,,281.72,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Connecticare,Commerical,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Connecticare,Exchange,,301.31,,,301.31,230.76,357.1,other,Could be inpatient or outpatient,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,Multiplan,Multiplan,,,357.1,,357.1,230.76,357.1,percent of total billed charges,,
HC MECHANICALVEST CHEST WALL OSCILLIATION PER SESSION,94669,CPT,,,both,,,445.7,267.42,United Healthcare/Oxford,United Healthcare/Oxford,,289.92,,,289.92,230.76,357.1,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,69.35,107.31,percent of total billed charges,,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC INDIR CALORIMETRY,94690,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC PLETH LUNG VOLUME AND/OR AIRWAY RESISTANCE,94726,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT  ,,,both,,,707.95,424.77,Aetna,Commerical,,512.07,,,512.07,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Aetna,Middlesex Employees,,460.86,,,460.86,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Anthem,Commerical,,458.18,,,458.18,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Anthem,Indemnity,,,514.88,,514.88,366.55,567.21,percent of total billed charges,,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Anthem,State Preferred,,458.18,,,458.18,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Anthem,Individual Exchange,,366.55,,,366.55,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Cigna,Cigna,,447.47,,,447.47,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Connecticare,Commerical,,478.61,,,478.61,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Connecticare,Exchange,,478.61,,,478.61,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,Multiplan,Multiplan,,,567.21,,567.21,366.55,567.21,percent of total billed charges,,
HC PLETH RW GW,94726,CPT,,,both,,,707.95,424.77,United Healthcare/Oxford,United Healthcare/Oxford,,460.51,,,460.51,366.55,567.21,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT  ,,,both,,,1056.86,634.12,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC PLETH RW GW PR/PT,94726,CPT,,,both,,,1056.86,634.12,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT  ,,,both,,,2324.71,1394.83,Aetna,Commerical,,1681.09,,,1681.09,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Aetna,Middlesex Employees,,1512.99,,,1512.99,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Anthem,Commerical,,1504.21,,,1504.21,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Anthem,Indemnity,,,1690.33,,1690.33,1203.36,1862.15,percent of total billed charges,,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Anthem,State Preferred,,1504.21,,,1504.21,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Anthem,Individual Exchange,,1203.36,,,1203.36,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Cigna,Cigna,,1469.02,,,1469.02,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Connecticare,Commerical,,1571.25,,,1571.25,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Connecticare,Exchange,,1571.25,,,1571.25,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,Multiplan,Multiplan,,,1862.15,,1862.15,1203.36,1862.15,percent of total billed charges,,
HC PLETH TGV PRE/PST,94726,CPT,,,both,,,2324.71,1394.83,United Healthcare/Oxford,United Healthcare/Oxford,,1511.84,,,1511.84,1203.36,1862.15,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT  ,,,both,,,1130,678,Aetna,Commerical,,817.35,,,817.35,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT  ,,,both,,,579.63,347.78,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Aetna,Middlesex Employees,,735.61,,,735.61,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Anthem,Commerical,,731.34,,,731.34,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Anthem,Indemnity,,,821.83,,821.83,585.08,905.37,percent of total billed charges,,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Anthem,State Preferred,,731.34,,,731.34,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Anthem,Individual Exchange,,585.08,,,585.08,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Cigna,Cigna,,714.24,,,714.24,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Connecticare,Commerical,,763.94,,,763.94,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Connecticare,Exchange,,763.94,,,763.94,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,Multiplan,Multiplan,,,905.37,,905.37,585.08,905.37,percent of total billed charges,,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC PULM FUNCTION TEST BY GAS 2,94727,CPT,,,both,,,1130,678,United Healthcare/Oxford,United Healthcare/Oxford,,735.06,,,735.06,585.08,905.37,other,Could be inpatient or outpatient,
HC PULM FUNCTION TEST BY GAS,94727,CPT,,,both,,,579.63,347.78,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC PULM FUNCT TEST IMPULSE OSCILLOMETRY,94728,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT  ,,,both,,,199.82,119.89,Aetna,Commerical,,144.91,,,144.91,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Aetna,Middlesex Employees,,130.42,,,130.42,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Anthem,Commerical,,129.66,,,129.66,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Anthem,Indemnity,,,145.7,,145.7,103.73,160.51,percent of total billed charges,,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Anthem,State Preferred,,129.66,,,129.66,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Anthem,Individual Exchange,,103.73,,,103.73,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Cigna,Cigna,,126.63,,,126.63,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Connecticare,Commerical,,135.44,,,135.44,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Connecticare,Exchange,,135.44,,,135.44,103.73,160.51,other,Could be inpatient or outpatient,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,Multiplan,Multiplan,,,160.51,,160.51,103.73,160.51,percent of total billed charges,,
HC C0 DIFFUSE CAPACITY,94729,CPT,,,both,,,199.82,119.89,United Healthcare/Oxford,United Healthcare/Oxford,,130.32,,,130.32,103.73,160.51,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT  ,,,both,,,12.63,7.58,Aetna,Commerical,,9.12,,,9.12,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Aetna,Middlesex Employees,,8.21,,,8.21,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Anthem,Commerical,,8.17,,,8.17,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Anthem,Indemnity,,,9.17,,9.17,6.53,10.11,percent of total billed charges,,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Anthem,State Preferred,,8.17,,,8.17,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Anthem,Individual Exchange,,6.53,,,6.53,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Cigna,Cigna,,7.98,,,7.98,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Connecticare,Commerical,,8.53,,,8.53,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Connecticare,Exchange,,8.53,,,8.53,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,Multiplan,Multiplan,,,10.11,,10.11,6.53,10.11,percent of total billed charges,,
HC PULSE OX SGL,94760,CPT,,,both,,,12.63,7.58,United Healthcare/Oxford,United Healthcare/Oxford,,8.21,,,8.21,6.53,10.11,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT  ,,,both,,,20.41,12.25,Aetna,Commerical,,14.77,,,14.77,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Aetna,Middlesex Employees,,13.3,,,13.3,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Anthem,Commerical,,13.22,,,13.22,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Anthem,Indemnity,,,14.85,,14.85,10.58,16.35,percent of total billed charges,,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Anthem,State Preferred,,13.22,,,13.22,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Anthem,Individual Exchange,,10.58,,,10.58,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Cigna,Cigna,,12.91,,,12.91,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Connecticare,Commerical,,13.8,,,13.8,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Connecticare,Exchange,,13.8,,,13.8,10.58,16.35,other,Could be inpatient or outpatient,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,Multiplan,Multiplan,,,16.35,,16.35,10.58,16.35,percent of total billed charges,,
HC PULSE OX MULTIPLE,94761,CPT,,,both,,,20.41,12.25,United Healthcare/Oxford,United Healthcare/Oxford,,13.28,,,13.28,10.58,16.35,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT  ,,,both,,,333.72,200.23,Aetna,Commerical,,241.78,,,241.78,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Aetna,Middlesex Employees,,217.61,,,217.61,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Anthem,Commerical,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Anthem,Indemnity,,,243.11,,243.11,173.07,267.83,percent of total billed charges,,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Anthem,State Preferred,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Anthem,Individual Exchange,,173.07,,,173.07,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Cigna,Cigna,,211.29,,,211.29,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Connecticare,Commerical,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Connecticare,Exchange,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,Multiplan,Multiplan,,,267.83,,267.83,173.07,267.83,percent of total billed charges,,
HC CONTINUOUS PULSE OX  ( <12 ),94762,CPT,,,both,,,333.72,200.23,United Healthcare/Oxford,United Healthcare/Oxford,,217.44,,,217.44,173.07,267.83,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT  ,,,both,,,638.6,383.16,Aetna,Commerical,,461.59,,,461.59,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Aetna,Middlesex Employees,,415.43,,,415.43,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Anthem,Commerical,,413.02,,,413.02,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Anthem,Indemnity,,,464.12,,464.12,330.41,511.3,percent of total billed charges,,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Anthem,State Preferred,,413.02,,,413.02,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Anthem,Individual Exchange,,330.41,,,330.41,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Cigna,Cigna,,403.36,,,403.36,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Connecticare,Commerical,,431.43,,,431.43,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Connecticare,Exchange,,431.43,,,431.43,330.41,511.3,other,Could be inpatient or outpatient,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,Multiplan,Multiplan,,,511.3,,511.3,330.41,511.3,percent of total billed charges,,
HC CONTINUOUS PULSE OX ( 12 - 24),94762,CPT,,,both,,,638.6,383.16,United Healthcare/Oxford,United Healthcare/Oxford,,415.12,,,415.12,330.41,511.3,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT  ,,,both,,,466.59,279.95,Aetna,Commerical,,337.85,,,337.85,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Aetna,Middlesex Employees,,304.06,,,304.06,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Anthem,Commerical,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Anthem,Indemnity,,,339.7,,339.7,241.84,374.23,percent of total billed charges,,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Anthem,State Preferred,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Anthem,Individual Exchange,,241.84,,,241.84,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Cigna,Cigna,,295.22,,,295.22,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Connecticare,Commerical,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Connecticare,Exchange,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,Multiplan,Multiplan,,,374.23,,374.23,241.84,374.23,percent of total billed charges,,
HC CO EXPIRED GAS BY IR,94770,CPT,,,both,,,466.59,279.95,United Healthcare/Oxford,United Healthcare/Oxford,,303.83,,,303.83,241.84,374.23,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT  ,,,both,,,148.57,89.14,Aetna,Commerical,,107.46,,,107.46,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Aetna,Middlesex Employees,,96.71,,,96.71,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Anthem,Commerical,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Anthem,Indemnity,,,108.05,,108.05,76.92,119.03,percent of total billed charges,,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Anthem,State Preferred,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Anthem,Individual Exchange,,76.92,,,76.92,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Cigna,Cigna,,93.9,,,93.9,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Connecticare,Commerical,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Connecticare,Exchange,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,Multiplan,Multiplan,,,119.03,,119.03,76.92,119.03,percent of total billed charges,,
HC CAR SEAT TESTING FOR AIRWAY INTEGRITY 60+ MIN INFANT,94780,CPT,,,both,,,148.57,89.14,United Healthcare/Oxford,United Healthcare/Oxford,,96.64,,,96.64,76.92,119.03,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC UNLISTED PULM SERVICE OR PROCEDURE,94799,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT  ,,,both,,,4232.27,2539.36,Aetna,Commerical,,3060.99,,,3060.99,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Aetna,Middlesex Employees,,2754.89,,,2754.89,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Anthem,Commerical,,2738.9,,,2738.9,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Anthem,Indemnity,,,3077.79,,3077.79,2191.12,3390.63,percent of total billed charges,,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Anthem,State Preferred,,2738.9,,,2738.9,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Anthem,Individual Exchange,,2191.12,,,2191.12,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Cigna,Cigna,,2674.84,,,2674.84,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Connecticare,Commerical,,2860.97,,,2860.97,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Connecticare,Exchange,,2860.97,,,2860.97,2191.12,3390.63,other,Could be inpatient or outpatient,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,Multiplan,Multiplan,,,3390.63,,3390.63,2191.12,3390.63,percent of total billed charges,,
HC PERC TESTS W/ALLERGENIC EXTRACTS,95004,CPT,,,both,,,4232.27,2539.36,United Healthcare/Oxford,United Healthcare/Oxford,,2752.8,,,2752.8,2191.12,3390.63,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,69.35,107.31,percent of total billed charges,,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC FRACTIONAL EXHALED NITRIC OX (FENO) TESTING,95012,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT  ,,,both,,,3798.64,2279.18,Aetna,Commerical,,2748.38,,,2748.38,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Aetna,Middlesex Employees,,2473.53,,,2473.53,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Anthem,Commerical,,2459.18,,,2459.18,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Anthem,Indemnity,,,2763.47,,2763.47,1967.35,3044.36,percent of total billed charges,,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Anthem,State Preferred,,2459.18,,,2459.18,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Anthem,Individual Exchange,,1967.35,,,1967.35,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Cigna,Cigna,,2401.66,,,2401.66,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Connecticare,Commerical,,2568.78,,,2568.78,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Connecticare,Exchange,,2568.78,,,2568.78,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,Multiplan,Multiplan,,,3044.36,,3044.36,1967.35,3044.36,percent of total billed charges,,
HC CHALLENGE TEST INITIAL,95076,CPT,,,both,,,3798.64,2279.18,United Healthcare/Oxford,United Healthcare/Oxford,,2471.66,,,2471.66,1967.35,3044.36,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT  ,,,both,,,1900.35,1140.21,Aetna,Commerical,,1374.19,,,1374.19,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Aetna,Middlesex Employees,,1236.77,,,1236.77,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Anthem,Commerical,,1229.59,,,1229.59,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Anthem,Indemnity,,,1381.73,,1381.73,983.67,1522.18,percent of total billed charges,,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Anthem,State Preferred,,1229.59,,,1229.59,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Anthem,Individual Exchange,,983.67,,,983.67,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Cigna,Cigna,,1200.83,,,1200.83,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Connecticare,Commerical,,1284.4,,,1284.4,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Connecticare,Exchange,,1284.4,,,1284.4,983.67,1522.18,other,Could be inpatient or outpatient,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,Multiplan,Multiplan,,,1522.18,,1522.18,983.67,1522.18,percent of total billed charges,,
HC CHALLENGE TEST EA ADDL 60 MIN,95079,CPT,,,both,,,1900.35,1140.21,United Healthcare/Oxford,United Healthcare/Oxford,,1235.84,,,1235.84,983.67,1522.18,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT  ,,,both,,,225.97,135.58,Aetna,Commerical,,151.01,,,151.01,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Aetna,Middlesex Employees,,135.91,,,135.91,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Anthem,Commerical,,125.33,,,125.33,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Anthem,Indemnity,,,164.35,,164.35,100.26,181.05,percent of total billed charges,,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Anthem,State Preferred,,125.33,,,125.33,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Anthem,Individual Exchange,,100.26,,,100.26,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Cigna,Cigna,,133.03,,,133.03,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Connecticare,Commerical,,136.45,,,136.45,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Connecticare,Exchange,,136.45,,,136.45,100.26,181.05,other,Could be inpatient or outpatient,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,Multiplan,Multiplan,,,181.05,,181.05,100.26,181.05,percent of total billed charges,,
HC CONT GLUCOSE MONITORING PT EQUIP,95249,CPT,,,both,,,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,139.88,,,139.88,100.26,181.05,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT  ,,,both,,,142.14,85.28,Aetna,Commerical,,102.58,,,102.58,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Aetna,Middlesex Employees,,92.31,,,92.31,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Anthem,Commerical,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Anthem,Indemnity,,,103.14,,103.14,73.42,113.62,percent of total billed charges,,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Anthem,State Preferred,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Anthem,Individual Exchange,,73.42,,,73.42,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Cigna,Cigna,,89.64,,,89.64,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Connecticare,Commerical,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Connecticare,Exchange,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,Multiplan,Multiplan,,,113.62,,113.62,73.42,113.62,percent of total billed charges,,
HC PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,95251,CPT,,,both,,,142.14,85.28,United Healthcare/Oxford,United Healthcare/Oxford,,92.25,,,92.25,73.42,113.62,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC EEG CONT REC W/VID EEG TECH,95700,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR UNMONITORED,95705,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR INTMT MONITORING,95706,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC EEG W/O VID  2-12HR CONT MONITORING,95707,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT  ,,,both,,,2042.8,1225.68,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR UNMONITORED,95708,CPT,,,both,,,2042.8,1225.68,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT  ,,,both,,,2042.8,1225.68,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR INTMT MONITORING,95709,CPT,,,both,,,2042.8,1225.68,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT  ,,,both,,,2042.8,1225.68,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,Multiplan,Multiplan,,,1636.7,,1635.7,1057.68,1636.7,percent of total billed charges,,
HC EEG W/O VID EACH  12-16HR CONT MONITORING,95710,CPT,,,both,,,2042.8,1225.68,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC VEEG 2-12HR UNMONITORED,95711,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT  ,,,both,,,1063.99,638.39,Aetna,Commerical,,770.13,,,770.13,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Aetna,Middlesex Employees,,693.12,,,693.12,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Anthem,Commerical,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Anthem,Indemnity,,,774.36,,774.36,551.27,853.07,percent of total billed charges,,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Anthem,State Preferred,,689.09,,,689.09,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Anthem,Individual Exchange,,551.27,,,551.27,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Cigna,Cigna,,672.97,,,672.97,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Connecticare,Commerical,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Connecticare,Exchange,,719.81,,,719.81,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,Multiplan,Multiplan,,,853.07,,853.07,551.27,853.07,percent of total billed charges,,
HC VEEG 2-12HR INTMT MONITORING,95712,CPT,,,both,,,1063.99,638.39,United Healthcare/Oxford,United Healthcare/Oxford,,692.59,,,692.59,551.27,853.07,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT  ,,,both,,,2042.49,1225.49,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC VEEG 2-12HR CONT MONITORING,95713,CPT,,,both,,,2042.49,1225.49,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT  ,,,both,,,2042.49,1225.49,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC VEEG EACH 12-26HR UNMONITORED,95714,CPT,,,both,,,2042.49,1225.49,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT  ,,,both,,,2042.49,1225.49,Aetna,Commerical,,1477.58,,,1477.58,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Aetna,Middlesex Employees,,1329.82,,,1329.82,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Anthem,Commerical,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Anthem,Indemnity,,,1485.69,,1485.69,1057.68,1636.7,percent of total billed charges,,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Anthem,State Preferred,,1322.1,,,1322.1,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Anthem,Individual Exchange,,1057.68,,,1057.68,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Cigna,Cigna,,1291.18,,,1291.18,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Connecticare,Commerical,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Connecticare,Exchange,,1381.02,,,1381.02,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,Multiplan,Multiplan,,,1636.7,,1636.7,1057.68,1636.7,percent of total billed charges,,
HC VEEG EACH 12-26HR INTMT MONITORING,95715,CPT,,,both,,,2042.49,1225.49,United Healthcare/Oxford,United Healthcare/Oxford,,1328.81,,,1328.81,1057.68,1636.7,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT  ,,,both,,,3824.39,2294.63,Aetna,Commerical,,2766.28,,,2766.28,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Aetna,Middlesex Employees,,2489.65,,,2489.65,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Anthem,Commerical,,2475.2,,,2475.2,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Anthem,Indemnity,,,2781.47,,2781.47,1980.16,3064.2,percent of total billed charges,,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Anthem,State Preferred,,2475.2,,,2475.2,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Anthem,Individual Exchange,,1980.16,,,1980.16,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Cigna,Cigna,,2417.31,,,2417.31,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Connecticare,Commerical,,2585.52,,,2585.52,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Connecticare,Exchange,,2585.52,,,2585.52,1980.16,3064.2,other,Could be inpatient or outpatient,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,Multiplan,Multiplan,,,3064.2,,3064.2,1980.16,3064.2,percent of total billed charges,,
HC VEEG EACH 12-26HR CONT MONITORING,95716,CPT,,,both,,,3824.39,2294.63,United Healthcare/Oxford,United Healthcare/Oxford,,2487.77,,,2487.77,1980.16,3064.2,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM <6 YRS 4/> PARAMTRS,95782,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2576.04,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM <6 YRS CPAP/BILVL,95783,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC MSLT/MWT,95805,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY <6HRS,95807,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY 1-1,95807,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC SLEEP STUDY 2-1,95807,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC POLYSOM ANY AGE 1-3> PARAM,95808,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM 6/>YRS 4/> PARAM,95810,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC POLYSOM 6/>YRS CPAP 4/> PARM - TITRATION,95811,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC POLYSOM 6/>YRS CPAP 4/> PARM - VENT,95811,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT  ,,,both,,,887.86,532.72,Aetna,Commerical,,642.32,,,642.32,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Aetna,Middlesex Employees,,578.09,,,578.09,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Anthem,Commerical,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Anthem,Indemnity,,,645.85,,645.85,459.79,711.49,percent of total billed charges,,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Anthem,State Preferred,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Anthem,Individual Exchange,,459.79,,,459.79,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Cigna,Cigna,,561.29,,,561.29,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Connecticare,Commerical,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Connecticare,Exchange,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,Multiplan,Multiplan,,,711.49,,711.49,459.79,711.49,percent of total billed charges,,
HC EEG EXTEND 41-60M,95812,CPT,,,both,,,887.86,532.72,United Healthcare/Oxford,United Healthcare/Oxford,,577.64,,,577.64,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT  ,,,both,,,2325.74,1395.44,Aetna,Commerical,,1681.92,,,1681.92,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Aetna,Middlesex Employees,,1513.72,,,1513.72,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Anthem,Commerical,,1504.93,,,1504.93,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Anthem,Indemnity,,,1691.15,,1691.15,1203.94,1863.05,percent of total billed charges,,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Anthem,State Preferred,,1504.93,,,1504.93,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Anthem,Individual Exchange,,1203.94,,,1203.94,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Cigna,Cigna,,1469.74,,,1469.74,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Connecticare,Commerical,,1572.01,,,1572.01,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Connecticare,Exchange,,1572.01,,,1572.01,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,Multiplan,Multiplan,,,1863.05,,1862.05,1203.94,1863.05,percent of total billed charges,,
HC EEG EXT MNTR-4HR,95813,CPT,,,both,,,2325.74,1395.44,United Healthcare/Oxford,United Healthcare/Oxford,,1512.58,,,1512.58,1203.94,1863.05,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT  ,,,both,,,887.86,532.72,Aetna,Commerical,,642.32,,,642.32,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Aetna,Middlesex Employees,,578.09,,,578.09,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Anthem,Commerical,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Anthem,Indemnity,,,645.85,,645.85,459.79,711.49,percent of total billed charges,,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Anthem,State Preferred,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Anthem,Individual Exchange,,459.79,,,459.79,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Cigna,Cigna,,561.29,,,561.29,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Connecticare,Commerical,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Connecticare,Exchange,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,Multiplan,Multiplan,,,711.49,,711.49,459.79,711.49,percent of total billed charges,,
HC EEG EXTEND 61 - 119 MINUTES,95813,CPT,,,both,,,887.86,532.72,United Healthcare/Oxford,United Healthcare/Oxford,,577.64,,,577.64,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT  ,,,both,,,2905.63,1743.38,Aetna,Commerical,,2101.98,,,2101.98,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Aetna,Middlesex Employees,,1891.79,,,1891.79,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Anthem,Commerical,,1880.8,,,1880.8,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Anthem,Indemnity,,,2113.52,,2113.52,1504.64,2328.35,percent of total billed charges,,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Anthem,State Preferred,,1880.8,,,1880.8,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Anthem,Individual Exchange,,1504.64,,,1504.64,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Cigna,Cigna,,1836.82,,,1836.82,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Connecticare,Commerical,,1964.63,,,1964.63,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Connecticare,Exchange,,1964.63,,,1964.63,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,Multiplan,Multiplan,,,2328.35,,2328.35,1504.64,2328.35,percent of total billed charges,,
HC EEG TELEMTRY-5HR,95813,CPT,,,both,,,2905.63,1743.38,United Healthcare/Oxford,United Healthcare/Oxford,,1890.35,,,1890.35,1504.64,2328.35,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT  ,,,both,,,3488.61,2093.17,Aetna,Commerical,,2522.87,,,2522.87,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Aetna,Middlesex Employees,,2270.59,,,2270.59,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Anthem,Commerical,,2257.41,,,2257.41,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Anthem,Indemnity,,,2536.72,,2536.72,1805.93,2794.57,percent of total billed charges,,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Anthem,State Preferred,,2257.41,,,2257.41,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Anthem,Individual Exchange,,1805.93,,,1805.93,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Cigna,Cigna,,2204.6,,,2204.6,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Connecticare,Commerical,,2358.02,,,2358.02,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Connecticare,Exchange,,2358.02,,,2358.02,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,Multiplan,Multiplan,,,2794.57,,2794.57,1805.93,2794.57,percent of total billed charges,,
HC EEG TELEMTRY-6HR,95813,CPT,,,both,,,3488.61,2093.17,United Healthcare/Oxford,United Healthcare/Oxford,,2268.86,,,2268.86,1805.93,2794.57,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT  ,,,both,,,4068.5,2441.1,Aetna,Commerical,,2942.94,,,2942.94,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Aetna,Middlesex Employees,,2648.65,,,2648.65,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Anthem,Commerical,,2633.28,,,2633.28,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Anthem,Indemnity,,,2959.1,,2959.1,2106.62,3259.88,percent of total billed charges,,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Anthem,State Preferred,,2633.28,,,2633.28,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Anthem,Individual Exchange,,2106.62,,,2106.62,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Cigna,Cigna,,2571.68,,,2571.68,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Connecticare,Commerical,,2750.64,,,2750.64,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Connecticare,Exchange,,2750.64,,,2750.64,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,Multiplan,Multiplan,,,3259.88,,3259.88,2106.62,3259.88,percent of total billed charges,,
HC EEG TELEMTRY-7HR,95813,CPT,,,both,,,4068.5,2441.1,United Healthcare/Oxford,United Healthcare/Oxford,,2646.64,,,2646.64,2106.62,3259.88,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT  ,,,both,,,887.86,532.72,Aetna,Commerical,,642.32,,,642.32,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Aetna,Middlesex Employees,,578.09,,,578.09,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Anthem,Commerical,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Anthem,Indemnity,,,645.85,,645.85,459.79,711.49,percent of total billed charges,,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Anthem,State Preferred,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Anthem,Individual Exchange,,459.79,,,459.79,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Cigna,Cigna,,561.29,,,561.29,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Connecticare,Commerical,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Connecticare,Exchange,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,Multiplan,Multiplan,,,711.49,,711.49,459.79,711.49,percent of total billed charges,,
HC EEG AWAKE & DRWSY,95816,CPT,,,both,,,887.86,532.72,United Healthcare/Oxford,United Healthcare/Oxford,,577.64,,,577.64,459.79,711.49,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT  ,,,both,,,2331.92,1399.15,Aetna,Commerical,,1686.8,,,1686.8,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Aetna,Middlesex Employees,,1518.12,,,1518.12,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Anthem,Commerical,,1509.31,,,1509.31,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Anthem,Indemnity,,,1696.06,,1696.06,1207.45,1868.45,percent of total billed charges,,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Anthem,State Preferred,,1509.31,,,1509.31,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Anthem,Individual Exchange,,1207.45,,,1207.45,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Cigna,Cigna,,1474,,,1474,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Connecticare,Commerical,,1576.57,,,1576.57,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Connecticare,Exchange,,1576.57,,,1576.57,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,Multiplan,Multiplan,,,1868.45,,1868.45,1207.45,1868.45,percent of total billed charges,,
HC BEDSIDE EEG,95819,CPT,,,both,,,2331.92,1399.15,United Healthcare/Oxford,United Healthcare/Oxford,,1516.96,,,1516.96,1207.45,1868.45,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT  ,,,both,,,887.86,532.72,Aetna,Commerical,,642.32,,,642.32,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Aetna,Middlesex Employees,,578.09,,,578.09,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Anthem,Commerical,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Anthem,Indemnity,,,645.85,,645.85,459.79,711.49,percent of total billed charges,,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Anthem,State Preferred,,574.74,,,574.74,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Anthem,Individual Exchange,,459.79,,,459.79,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Cigna,Cigna,,561.29,,,561.29,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Connecticare,Commerical,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Connecticare,Exchange,,600.34,,,600.34,459.79,711.49,other,Could be inpatient or outpatient,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,Multiplan,Multiplan,,,711.49,,711.49,459.79,711.49,percent of total billed charges,,
HC EEG AWAKE & SLEEP,95819,CPT,,,both,,,887.86,532.72,United Healthcare/Oxford,United Healthcare/Oxford,,577.64,,,577.64,459.79,711.49,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT  ,,,both,,,1769.54,1061.72,Aetna,Commerical,,1279.75,,,1279.75,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Aetna,Middlesex Employees,,1151.78,,,1151.78,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Anthem,Commerical,,1145.09,,,1145.09,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Anthem,Indemnity,,,1286.78,,1286.78,916.08,1417.57,percent of total billed charges,,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Anthem,State Preferred,,1145.09,,,1145.09,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Anthem,Individual Exchange,,916.08,,,916.08,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Cigna,Cigna,,1118.31,,,1118.31,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Connecticare,Commerical,,1196.13,,,1196.13,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Connecticare,Exchange,,1196.13,,,1196.13,916.08,1417.57,other,Could be inpatient or outpatient,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,Multiplan,Multiplan,,,1417.57,,1417.57,916.08,1417.57,percent of total billed charges,,
HC IV MEDCAT'N(EEG),95819,CPT,,,both,,,1769.54,1061.72,United Healthcare/Oxford,United Healthcare/Oxford,,1150.9,,,1150.9,916.08,1417.57,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT  ,,,both,,,2331.92,1399.15,Aetna,Commerical,,1686.8,,,1686.8,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Aetna,Middlesex Employees,,1518.12,,,1518.12,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Anthem,Commerical,,1509.31,,,1509.31,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Anthem,Indemnity,,,1696.06,,1696.06,1207.45,1868.45,percent of total billed charges,,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Anthem,State Preferred,,1509.31,,,1509.31,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Anthem,Individual Exchange,,1207.45,,,1207.45,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Cigna,Cigna,,1474,,,1474,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Connecticare,Commerical,,1576.57,,,1576.57,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Connecticare,Exchange,,1576.57,,,1576.57,1207.45,1868.45,other,Could be inpatient or outpatient,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,Multiplan,Multiplan,,,1868.45,,1868.45,1207.45,1868.45,percent of total billed charges,,
HC BEDSIDE TRAC COMA,95822,CPT,,,both,,,2331.92,1399.15,United Healthcare/Oxford,United Healthcare/Oxford,,1516.96,,,1516.96,1207.45,1868.45,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT  ,,,both,,,2585.3,1551.18,Aetna,Commerical,,1869.96,,,1869.96,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Aetna,Middlesex Employees,,1682.97,,,1682.97,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Anthem,Commerical,,1673.2,,,1673.2,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Anthem,Indemnity,,,1880.24,,1880.24,1338.57,2071.36,percent of total billed charges,,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Anthem,State Preferred,,1673.2,,,1673.2,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Anthem,Individual Exchange,,1338.57,,,1338.57,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Cigna,Cigna,,1634.07,,,1634.07,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Connecticare,Commerical,,1747.78,,,1747.78,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Connecticare,Exchange,,1747.78,,,1747.78,1338.57,2071.36,other,Could be inpatient or outpatient,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,Multiplan,Multiplan,,,2071.36,,2071.36,1338.57,2071.36,percent of total billed charges,,
HC EEG CBRL SILENCE,95824,CPT,,,both,,,2585.3,1551.18,United Healthcare/Oxford,United Healthcare/Oxford,,1681.69,,,1681.69,1338.57,2071.36,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT  ,,,both,,,3547.32,2128.39,Aetna,Commerical,,2566.01,,,2566.01,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Aetna,Middlesex Employees,,2309.41,,,2309.41,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Anthem,Commerical,,2296.01,,,2296.01,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Anthem,Indemnity,,,2580.11,,2580.11,1836.81,2842.37,percent of total billed charges,,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Anthem,State Preferred,,2296.01,,,2296.01,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Anthem,Individual Exchange,,1836.81,,,1836.81,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Cigna,Cigna,,2242.31,,,2242.31,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Connecticare,Commerical,,2398.34,,,2398.34,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Connecticare,Exchange,,2398.34,,,2398.34,1836.81,2842.37,other,Could be inpatient or outpatient,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,Multiplan,Multiplan,,,2842.37,,2842.37,1836.81,2842.37,percent of total billed charges,,
HC ALL NIGHT TRACING,95827,CPT,,,both,,,3547.32,2128.39,United Healthcare/Oxford,United Healthcare/Oxford,,2307.66,,,2307.66,1836.81,2842.37,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT  ,,,both,,,4192.1,2515.26,Aetna,Commerical,,3031.67,,,3031.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Aetna,Middlesex Employees,,2728.5,,,2728.5,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Anthem,Commerical,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Anthem,Indemnity,,,3048.32,,3048.32,2170.14,3358.17,percent of total billed charges,,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Anthem,State Preferred,,2712.67,,,2712.67,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Anthem,Individual Exchange,,2170.14,,,2170.14,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Cigna,Cigna,,2649.22,,,2649.22,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Connecticare,Commerical,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Connecticare,Exchange,,2833.58,,,2833.58,2170.14,3358.17,other,Could be inpatient or outpatient,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,Multiplan,Multiplan,,,3358.17,,3358.17,2170.14,3358.17,percent of total billed charges,,
HC EEG ALL NIGHT RECORDING,95827,CPT,,,both,,,4192.1,2515.26,United Healthcare/Oxford,United Healthcare/Oxford,,2726.44,,,2726.44,2170.14,3358.17,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT  ,,,both,,,2173.3,1303.98,Aetna,Commerical,,1572.01,,,1572.01,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Aetna,Middlesex Employees,,1414.81,,,1414.81,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Anthem,Commerical,,1406.6,,,1406.6,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Anthem,Indemnity,,,1580.64,,1580.64,1125.27,1741.31,percent of total billed charges,,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Anthem,State Preferred,,1406.6,,,1406.6,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Anthem,Individual Exchange,,1125.27,,,1125.27,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Cigna,Cigna,,1373.69,,,1373.69,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Connecticare,Commerical,,1469.29,,,1469.29,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Connecticare,Exchange,,1469.29,,,1469.29,1125.27,1741.31,other,Could be inpatient or outpatient,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,Multiplan,Multiplan,,,1741.31,,1741.31,1125.27,1741.31,percent of total billed charges,,
HC INTRAOPERATIVE ELECTROCORTICOGRAM,95829,CPT,,,both,,,2173.3,1303.98,United Healthcare/Oxford,United Healthcare/Oxford,,1413.74,,,1413.74,1125.27,1741.31,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC MUSCLE TESST; EXTREM OR TRUNK,95831,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT  ,,,both,,,421.27,252.76,Aetna,Commerical,,304.47,,,304.47,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Aetna,Middlesex Employees,,274.02,,,274.02,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Anthem,Commerical,,272.43,,,272.43,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Anthem,Indemnity,,,306.14,,306.14,217.95,337.26,percent of total billed charges,,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Anthem,State Preferred,,272.43,,,272.43,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Anthem,Individual Exchange,,217.95,,,217.95,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Cigna,Cigna,,266.06,,,266.06,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Connecticare,Commerical,,284.57,,,284.57,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Connecticare,Exchange,,284.57,,,284.57,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,Multiplan,Multiplan,,,337.26,,337.26,217.95,337.26,percent of total billed charges,,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PO,95851,CPT,,,both,,,421.27,252.76,United Healthcare/Oxford,United Healthcare/Oxford,,273.82,,,273.82,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT  ,,,both,,,420.94,252.56,Aetna,Commerical,,304.47,,,304.47,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Aetna,Middlesex Employees,,274.02,,,274.02,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Anthem,Commerical,,272.43,,,272.43,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Anthem,Indemnity,,,306.14,,306.14,217.95,337.26,percent of total billed charges,,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Anthem,State Preferred,,272.43,,,272.43,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Anthem,Individual Exchange,,217.95,,,217.95,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Cigna,Cigna,,266.06,,,266.06,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Connecticare,Commerical,,284.57,,,284.57,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Connecticare,Exchange,,284.57,,,284.57,217.95,337.26,other,Could be inpatient or outpatient,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,Multiplan,Multiplan,,,337.26,,337.26,217.95,337.26,percent of total billed charges,,
HC ROM; EA EXTREMT /TRUNK (NOT HAND) - PRE OP,95851,CPT,,,both,,,420.94,252.56,United Healthcare/Oxford,United Healthcare/Oxford,,273.82,,,273.82,217.95,337.26,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT  ,,,both,,,1169.05,701.43,Aetna,Commerical,,845.84,,,845.84,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Aetna,Middlesex Employees,,761.26,,,761.26,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Anthem,Commerical,,756.84,,,756.84,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Anthem,Indemnity,,,850.49,,850.49,605.48,936.94,percent of total billed charges,,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Anthem,State Preferred,,756.84,,,756.84,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Anthem,Individual Exchange,,605.48,,,605.48,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Cigna,Cigna,,739.14,,,739.14,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Connecticare,Commerical,,790.57,,,790.57,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Connecticare,Exchange,,790.57,,,790.57,605.48,936.94,other,Could be inpatient or outpatient,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,Multiplan,Multiplan,,,936.94,,936.94,605.48,936.94,percent of total billed charges,,
HC CHOLINESTERASE INHIBITOR CHALLENGE TEST,95857,CPT,,,both,,,1169.05,701.43,United Healthcare/Oxford,United Healthcare/Oxford,,760.68,,,760.68,605.48,936.94,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT  ,,,both,,,350.2,210.12,Aetna,Commerical,,253.18,,,253.18,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Aetna,Middlesex Employees,,227.87,,,227.87,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Anthem,Commerical,,226.54,,,226.54,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Anthem,Indemnity,,,254.57,,254.57,181.23,280.45,percent of total billed charges,,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Anthem,State Preferred,,226.54,,,226.54,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Anthem,Individual Exchange,,181.23,,,181.23,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Cigna,Cigna,,221.24,,,221.24,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Connecticare,Commerical,,236.64,,,236.64,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Connecticare,Exchange,,236.64,,,236.64,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,Multiplan,Multiplan,,,280.45,,280.45,181.23,280.45,percent of total billed charges,,
HC EMG 1 EXTREMITY,95860,CPT,,,both,,,350.2,210.12,United Healthcare/Oxford,United Healthcare/Oxford,,227.69,,,227.69,181.23,280.45,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT  ,,,both,,,427.45,256.47,Aetna,Commerical,,309.35,,,309.35,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Aetna,Middlesex Employees,,278.41,,,278.41,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Anthem,Commerical,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Anthem,Indemnity,,,311.05,,311.05,221.44,342.67,percent of total billed charges,,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Anthem,State Preferred,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Anthem,Individual Exchange,,221.44,,,221.44,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Cigna,Cigna,,270.33,,,270.33,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Connecticare,Commerical,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Connecticare,Exchange,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,Multiplan,Multiplan,,,342.67,,342.67,221.44,342.67,percent of total billed charges,,
HC EMG 2 EXTREMETIES,95861,CPT,,,both,,,427.45,256.47,United Healthcare/Oxford,United Healthcare/Oxford,,278.21,,,278.21,221.44,342.67,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT  ,,,both,,,504.7,302.82,Aetna,Commerical,,365.53,,,365.53,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Aetna,Middlesex Employees,,328.98,,,328.98,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Anthem,Commerical,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Anthem,Indemnity,,,367.53,,367.53,261.65,404.89,percent of total billed charges,,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Anthem,State Preferred,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Anthem,Individual Exchange,,261.65,,,261.65,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Cigna,Cigna,,319.42,,,319.42,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Connecticare,Commerical,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Connecticare,Exchange,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,Multiplan,Multiplan,,,404.89,,404.89,261.65,404.89,percent of total billed charges,,
HC EMG 3 EXTREMETIES,95863,CPT,,,both,,,504.7,302.82,United Healthcare/Oxford,United Healthcare/Oxford,,328.72,,,328.72,261.65,404.89,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT  ,,,both,,,584.01,350.41,Aetna,Commerical,,421.7,,,421.7,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Aetna,Middlesex Employees,,379.53,,,379.53,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Anthem,Commerical,,377.33,,,377.33,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Anthem,Indemnity,,,424.02,,424.02,301.87,467.12,percent of total billed charges,,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Anthem,State Preferred,,377.33,,,377.33,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Anthem,Individual Exchange,,301.87,,,301.87,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Cigna,Cigna,,368.5,,,368.5,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Connecticare,Commerical,,394.15,,,394.15,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Connecticare,Exchange,,394.15,,,394.15,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,Multiplan,Multiplan,,,467.12,,467.12,301.87,467.12,percent of total billed charges,,
HC EMG 4 EXTREMETIES,95864,CPT,,,both,,,584.01,350.41,United Healthcare/Oxford,United Healthcare/Oxford,,379.25,,,379.25,301.87,467.12,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC EMG CRANIAL NERVE UNILATERAL,95867,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT  ,,,both,,,466.59,279.95,Aetna,Commerical,,337.85,,,337.85,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Aetna,Middlesex Employees,,304.06,,,304.06,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Anthem,Commerical,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Anthem,Indemnity,,,339.7,,339.7,241.84,374.23,percent of total billed charges,,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Anthem,State Preferred,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Anthem,Individual Exchange,,241.84,,,241.84,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Cigna,Cigna,,295.22,,,295.22,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Connecticare,Commerical,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Connecticare,Exchange,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,Multiplan,Multiplan,,,374.23,,374.23,241.84,374.23,percent of total billed charges,,
HC EMG CRANIAL NERVE BILATERAL,95868,CPT,,,both,,,466.59,279.95,United Healthcare/Oxford,United Healthcare/Oxford,,303.83,,,303.83,241.84,374.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT  ,,,both,,,271.92,163.15,Aetna,Commerical,,197.01,,,197.01,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Aetna,Middlesex Employees,,177.31,,,177.31,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Anthem,Commerical,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Anthem,Indemnity,,,198.09,,198.09,141.03,218.23,percent of total billed charges,,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Anthem,State Preferred,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Anthem,Individual Exchange,,141.03,,,141.03,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Cigna,Cigna,,172.16,,,172.16,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Connecticare,Commerical,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Connecticare,Exchange,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,Multiplan,Multiplan,,,218.23,,218.23,141.03,218.23,percent of total billed charges,,
HC EMG THORACIC PARASPINAL MUSCLE,95869,CPT,,,both,,,271.92,163.15,United Healthcare/Oxford,United Healthcare/Oxford,,177.17,,,177.17,141.03,218.23,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT  ,,,both,,,237.93,142.76,Aetna,Commerical,,171.77,,,171.77,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Aetna,Middlesex Employees,,154.59,,,154.59,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Anthem,Commerical,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Anthem,Indemnity,,,172.72,,172.72,122.96,190.27,percent of total billed charges,,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Anthem,State Preferred,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Anthem,Individual Exchange,,122.96,,,122.96,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Cigna,Cigna,,150.1,,,150.1,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Connecticare,Commerical,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Connecticare,Exchange,,160.55,,,160.55,122.96,190.27,other,Could be inpatient or outpatient,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,Multiplan,Multiplan,,,190.27,,190.27,122.96,190.27,percent of total billed charges,,
HC EMG LIMITED 1 EXTREMITY OR NON LIMB MUSCLES,95870,CPT,,,both,,,237.93,142.76,United Healthcare/Oxford,United Healthcare/Oxford,,154.48,,,154.48,122.96,190.27,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT  ,,,both,,,235.87,141.52,Aetna,Commerical,,170.96,,,170.96,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Aetna,Middlesex Employees,,153.86,,,153.86,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Anthem,Commerical,,152.97,,,152.97,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Anthem,Indemnity,,,171.9,,171.9,122.38,189.37,percent of total billed charges,,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Anthem,State Preferred,,152.97,,,152.97,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Anthem,Individual Exchange,,122.38,,,122.38,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Cigna,Cigna,,149.4,,,149.4,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Connecticare,Commerical,,159.79,,,159.79,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Connecticare,Exchange,,159.79,,,159.79,122.38,189.37,other,Could be inpatient or outpatient,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,Multiplan,Multiplan,,,189.37,,189.37,122.38,189.37,percent of total billed charges,,
HC ELEC STIMULATN FOR GUID W CHEMODENERVATION,95873,CPT,,,both,,,235.87,141.52,United Healthcare/Oxford,United Healthcare/Oxford,,153.75,,,153.75,122.38,189.37,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT  ,,,both,,,177.16,106.3,Aetna,Commerical,,127.81,,,127.81,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Aetna,Middlesex Employees,,115.03,,,115.03,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Anthem,Commerical,,114.37,,,114.37,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Anthem,Indemnity,,,128.51,,128.51,91.49,141.58,percent of total billed charges,,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Anthem,State Preferred,,114.37,,,114.37,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Anthem,Individual Exchange,,91.49,,,91.49,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Cigna,Cigna,,111.69,,,111.69,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Connecticare,Commerical,,119.47,,,119.47,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Connecticare,Exchange,,119.47,,,119.47,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,Multiplan,Multiplan,,,141.58,,141.58,91.49,141.58,percent of total billed charges,,
HC EMG EXTREMITY LIMITED W NCS,95885,CPT,,,both,,,177.16,106.3,United Healthcare/Oxford,United Healthcare/Oxford,,114.95,,,114.95,91.49,141.58,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT  ,,,both,,,198.79,119.27,Aetna,Commerical,,144.09,,,144.09,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Aetna,Middlesex Employees,,129.68,,,129.68,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Anthem,Commerical,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Anthem,Indemnity,,,144.89,,144.89,103.15,159.61,percent of total billed charges,,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Anthem,State Preferred,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Anthem,Individual Exchange,,103.15,,,103.15,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Cigna,Cigna,,125.91,,,125.91,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Connecticare,Commerical,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Connecticare,Exchange,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,Multiplan,Multiplan,,,159.61,,159.61,103.15,159.61,percent of total billed charges,,
HC EMG EMTREMITY COMPLETE W NCS,95886,CPT,,,both,,,198.79,119.27,United Healthcare/Oxford,United Healthcare/Oxford,,129.58,,,129.58,103.15,159.61,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT  ,,,both,,,187.46,112.48,Aetna,Commerical,,135.95,,,135.95,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Aetna,Middlesex Employees,,122.36,,,122.36,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Anthem,Commerical,,121.64,,,121.64,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Anthem,Indemnity,,,136.7,,136.7,97.31,150.59,percent of total billed charges,,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Anthem,State Preferred,,121.64,,,121.64,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Anthem,Individual Exchange,,97.31,,,97.31,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Cigna,Cigna,,118.8,,,118.8,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Connecticare,Commerical,,127.07,,,127.07,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Connecticare,Exchange,,127.07,,,127.07,97.31,150.59,other,Could be inpatient or outpatient,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,Multiplan,Multiplan,,,150.59,,150.59,97.31,150.59,percent of total billed charges,,
HC EMG NON-EXTREMITY W NCS,95887,CPT,,,both,,,187.46,112.48,United Healthcare/Oxford,United Healthcare/Oxford,,122.26,,,122.26,97.31,150.59,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC NERVE CONDUCTION 1-2 STUDIES,95907,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 3-4 STUDIES,95908,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 5-6 STUDIES,95909,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,843.76,547.2,846.76,percent of total billed charges,,
HC NERVE CONDUCTION 7-8 STUDIES,95910,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT  ,,,both,,,1885.93,1131.56,Aetna,Commerical,,1364.41,,,1364.41,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Aetna,Middlesex Employees,,1227.98,,,1227.98,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Anthem,Commerical,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Anthem,Indemnity,,,1371.91,,1371.91,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Anthem,State Preferred,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Anthem,Individual Exchange,,976.68,,,976.68,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Cigna,Cigna,,1192.3,,,1192.3,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Connecticare,Commerical,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Connecticare,Exchange,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,Multiplan,Multiplan,,,1511.36,,1511.36,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 9-10 STUDIES,95911,CPT,,,both,,,1885.93,1131.56,United Healthcare/Oxford,United Healthcare/Oxford,,1227.05,,,1227.05,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT  ,,,both,,,1885.93,1131.56,Aetna,Commerical,,1364.41,,,1364.41,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Aetna,Middlesex Employees,,1227.98,,,1227.98,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Anthem,Commerical,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Anthem,Indemnity,,,1371.91,,1371.91,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Anthem,State Preferred,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Anthem,Individual Exchange,,976.68,,,976.68,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Cigna,Cigna,,1192.3,,,1192.3,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Connecticare,Commerical,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Connecticare,Exchange,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,Multiplan,Multiplan,,,1511.36,,1511.36,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 11-12 STUDIES,95912,CPT,,,both,,,1885.93,1131.56,United Healthcare/Oxford,United Healthcare/Oxford,,1227.05,,,1227.05,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT  ,,,both,,,1885.93,1131.56,Aetna,Commerical,,1364.41,,,1364.41,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Aetna,Middlesex Employees,,1227.98,,,1227.98,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Anthem,Commerical,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Anthem,Indemnity,,,1371.91,,1371.91,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Anthem,State Preferred,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Anthem,Individual Exchange,,976.68,,,976.68,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Cigna,Cigna,,1192.3,,,1192.3,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Connecticare,Commerical,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Connecticare,Exchange,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,Multiplan,Multiplan,,,1511.36,,1511.36,976.68,1511.36,percent of total billed charges,,
HC NERVE CONDUCTION 13+ STUDIES,95913,CPT,,,both,,,1885.93,1131.56,United Healthcare/Oxford,United Healthcare/Oxford,,1227.05,,,1227.05,976.68,1511.36,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT  ,,,both,,,487.19,292.31,Aetna,Commerical,,352.5,,,352.5,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Aetna,Middlesex Employees,,317.25,,,317.25,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Anthem,Commerical,,315.41,,,315.41,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Anthem,Indemnity,,,354.44,,354.44,252.32,390.46,percent of total billed charges,,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Anthem,State Preferred,,315.41,,,315.41,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Anthem,Individual Exchange,,252.32,,,252.32,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Cigna,Cigna,,308.04,,,308.04,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Connecticare,Commerical,,329.47,,,329.47,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Connecticare,Exchange,,329.47,,,329.47,252.32,390.46,other,Could be inpatient or outpatient,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,Multiplan,Multiplan,,,390.46,,390.46,252.32,390.46,percent of total billed charges,,
HC VIDEO EVOKED POTENTIAL,95930,CPT,,,both,,,487.19,292.31,United Healthcare/Oxford,United Healthcare/Oxford,,317.01,,,317.01,252.32,390.46,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT  ,,,both,,,271.92,163.15,Aetna,Commerical,,197.01,,,197.01,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Aetna,Middlesex Employees,,177.31,,,177.31,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Anthem,Commerical,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Anthem,Indemnity,,,198.09,,198.09,141.03,218.23,percent of total billed charges,,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Anthem,State Preferred,,176.28,,,176.28,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Anthem,Individual Exchange,,141.03,,,141.03,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Cigna,Cigna,,172.16,,,172.16,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Connecticare,Commerical,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Connecticare,Exchange,,184.14,,,184.14,141.03,218.23,other,Could be inpatient or outpatient,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,Multiplan,Multiplan,,,218.23,,218.23,141.03,218.23,percent of total billed charges,,
HC OCULI BLINK REFLX,95933,CPT,,,both,,,271.92,163.15,United Healthcare/Oxford,United Healthcare/Oxford,,177.17,,,177.17,141.03,218.23,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT  ,,,both,,,259.56,155.74,Aetna,Commerical,,188.06,,,188.06,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Aetna,Middlesex Employees,,169.25,,,169.25,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Anthem,Commerical,,168.27,,,168.27,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Anthem,Indemnity,,,189.09,,189.09,134.61,208.31,percent of total billed charges,,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Anthem,State Preferred,,168.27,,,168.27,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Anthem,Individual Exchange,,134.61,,,134.61,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Cigna,Cigna,,164.33,,,164.33,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Connecticare,Commerical,,175.77,,,175.77,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Connecticare,Exchange,,175.77,,,175.77,134.61,208.31,other,Could be inpatient or outpatient,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,Multiplan,Multiplan,,,208.31,,208.31,134.61,208.31,percent of total billed charges,,
HC HREFLX GASTR/SOLS,95934,CPT,,,both,,,259.56,155.74,United Healthcare/Oxford,United Healthcare/Oxford,,169.13,,,169.13,134.61,208.31,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT  ,,,both,,,579.63,347.78,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC REPETITIVE EA NERVE STIM NEUROMUSCULAR JUNCTION TESTING ANY 1 METHOD,95937,CPT,,,both,,,579.63,347.78,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT  ,,,both,,,258.53,155.12,Aetna,Commerical,,187.24,,,187.24,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Aetna,Middlesex Employees,,168.51,,,168.51,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Anthem,Commerical,,167.54,,,167.54,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Anthem,Indemnity,,,188.27,,188.27,134.03,207.41,percent of total billed charges,,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Anthem,State Preferred,,167.54,,,167.54,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Anthem,Individual Exchange,,134.03,,,134.03,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Cigna,Cigna,,163.62,,,163.62,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Connecticare,Commerical,,175,,,175,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Connecticare,Exchange,,175,,,175,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,Multiplan,Multiplan,,,207.41,,207.41,134.03,207.41,percent of total billed charges,,
HC IONM IN OPERATING ROOM EA 15 MIN,95940,CPT,,,both,,,258.53,155.12,United Healthcare/Oxford,United Healthcare/Oxford,,168.38,,,168.38,134.03,207.41,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT  ,,,both,,,138.02,82.81,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC IONM IN OPERATNG ROOM EACH 15 MIN,95940,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT  ,,,both,,,4941.94,2965.16,Aetna,Commerical,,3573.87,,,3573.87,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Aetna,Middlesex Employees,,3216.48,,,3216.48,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Anthem,Commerical,,3197.81,,,3197.81,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Anthem,Indemnity,,,3593.49,,3593.49,2558.25,3958.75,percent of total billed charges,,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Anthem,State Preferred,,3197.81,,,3197.81,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Anthem,Individual Exchange,,2558.25,,,2558.25,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Cigna,Cigna,,3123.02,,,3123.02,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Connecticare,Commerical,,3340.33,,,3340.33,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Connecticare,Exchange,,3340.33,,,3340.33,2558.25,3958.75,other,Could be inpatient or outpatient,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,Multiplan,Multiplan,,,3958.75,,3958.75,2558.25,3958.75,percent of total billed charges,,
HC AMB 24HR STUDY,95951,CPT,,,both,,,4941.94,2965.16,United Healthcare/Oxford,United Healthcare/Oxford,,3214.04,,,3214.04,2558.25,3958.75,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT  ,,,both,,,3218.75,1931.25,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC EEG LONG TERM MNTR 12-24 HRS,95951,CPT,,,both,,,3218.75,1931.25,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT  ,,,both,,,1885.93,1131.56,Aetna,Commerical,,1364.41,,,1364.41,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Aetna,Middlesex Employees,,1227.98,,,1227.98,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Anthem,Commerical,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Anthem,Indemnity,,,1371.91,,1371.91,976.68,1511.36,percent of total billed charges,,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Anthem,State Preferred,,1220.84,,,1220.84,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Anthem,Individual Exchange,,976.68,,,976.68,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Cigna,Cigna,,1192.3,,,1192.3,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Connecticare,Commerical,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Connecticare,Exchange,,1275.26,,,1275.26,976.68,1511.36,other,Could be inpatient or outpatient,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,Multiplan,Multiplan,,,1511.36,,1511.36,976.68,1511.36,percent of total billed charges,,
HC AMB 24STD WO VIDEO,95953,CPT,,,both,,,1885.93,1131.56,United Healthcare/Oxford,United Healthcare/Oxford,,1227.05,,,1227.05,976.68,1511.36,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT  ,,,both,,,1584.72,950.83,Aetna,Commerical,,1146.24,,,1146.24,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Aetna,Middlesex Employees,,1031.62,,,1031.62,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Anthem,Commerical,,1025.63,,,1025.63,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Anthem,Indemnity,,,1152.54,,1152.54,820.51,1269.69,percent of total billed charges,,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Anthem,State Preferred,,1025.63,,,1025.63,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Anthem,Individual Exchange,,820.51,,,820.51,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Cigna,Cigna,,1001.64,,,1001.64,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Connecticare,Commerical,,1071.34,,,1071.34,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Connecticare,Exchange,,1071.34,,,1071.34,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,Multiplan,Multiplan,,,1269.69,,1269.69,820.51,1269.69,percent of total billed charges,,
HC EEG AMBULATORY 24HR UNATTENDED,95953,CPT,,,both,,,1584.72,950.83,United Healthcare/Oxford,United Healthcare/Oxford,,1030.83,,,1030.83,820.51,1269.69,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT  ,,,both,,,4476.15,2685.69,Aetna,Commerical,,3237.64,,,3237.64,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Aetna,Middlesex Employees,,2913.87,,,2913.87,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Anthem,Commerical,,2896.97,,,2896.97,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Anthem,Indemnity,,,3255.42,,3255.42,2317.57,3586.32,percent of total billed charges,,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Anthem,State Preferred,,2896.97,,,2896.97,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Anthem,Individual Exchange,,2317.57,,,2317.57,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Cigna,Cigna,,2829.21,,,2829.21,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Connecticare,Commerical,,3026.09,,,3026.09,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Connecticare,Exchange,,3026.09,,,3026.09,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,Multiplan,Multiplan,,,3586.32,,3586.32,2317.57,3586.32,percent of total billed charges,,
HC EMU LEVEL 3 & 4  > 12 HRS,95954,CPT,,,both,,,4476.15,2685.69,United Healthcare/Oxford,United Healthcare/Oxford,,2911.67,,,2911.67,2317.57,3586.32,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT  ,,,both,,,2238.63,1343.18,Aetna,Commerical,,1619.23,,,1619.23,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Aetna,Middlesex Employees,,1457.31,,,1457.31,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Anthem,Commerical,,1448.84,,,1448.84,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Anthem,Indemnity,,,1628.12,,1628.12,1159.08,1793.61,percent of total billed charges,,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Anthem,State Preferred,,1448.84,,,1448.84,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Anthem,Individual Exchange,,1159.08,,,1159.08,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Cigna,Cigna,,1414.96,,,1414.96,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Connecticare,Commerical,,1513.42,,,1513.42,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Connecticare,Exchange,,1513.42,,,1513.42,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,Multiplan,Multiplan,,,1793.61,,1793.61,1159.08,1793.61,percent of total billed charges,,
HC EMU LEVEL 3 & 4  2-12 HRS,95954,CPT,,,both,,,2238.63,1343.18,United Healthcare/Oxford,United Healthcare/Oxford,,1456.2,,,1456.2,1159.08,1793.61,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT  ,,,both,,,1450.24,870.14,Aetna,Commerical,,1048.55,,,1048.55,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Aetna,Middlesex Employees,,943.7,,,943.7,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Anthem,Commerical,,938.22,,,938.22,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Anthem,Indemnity,,,1054.31,,1054.31,750.57,1161.47,percent of total billed charges,,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Anthem,State Preferred,,938.22,,,938.22,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Anthem,Individual Exchange,,750.57,,,750.57,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Cigna,Cigna,,916.27,,,916.27,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Connecticare,Commerical,,980.03,,,980.03,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Connecticare,Exchange,,980.03,,,980.03,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,Multiplan,Multiplan,,,1161.47,,1161.47,750.57,1161.47,percent of total billed charges,,
HC EEG DURING NON-INTRACRANIAL SURGERY,95955,CPT,,,both,,,1450.24,870.14,United Healthcare/Oxford,United Healthcare/Oxford,,942.98,,,942.98,750.57,1161.47,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT  ,,,both,,,1585.17,951.1,Aetna,Commerical,,1146.24,,,1146.24,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Aetna,Middlesex Employees,,1031.62,,,1031.62,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Anthem,Commerical,,1025.63,,,1025.63,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Anthem,Indemnity,,,1152.54,,1152.54,820.51,1269.69,percent of total billed charges,,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Anthem,State Preferred,,1025.63,,,1025.63,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Anthem,Individual Exchange,,820.51,,,820.51,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Cigna,Cigna,,1001.64,,,1001.64,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Connecticare,Commerical,,1071.34,,,1071.34,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Connecticare,Exchange,,1071.34,,,1071.34,820.51,1269.69,other,Could be inpatient or outpatient,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,Multiplan,Multiplan,,,1269.69,,1269.69,820.51,1269.69,percent of total billed charges,,
HC EEG EMU 12-24 HRS,95956,CPT,,,both,,,1585.17,951.1,United Healthcare/Oxford,United Healthcare/Oxford,,1030.83,,,1030.83,820.51,1269.69,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT  ,,,both,,,679.8,407.88,Aetna,Commerical,,491.71,,,491.71,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT  ,,,both,,,808.12,484.87,Aetna,Commerical,,584.52,,,584.52,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Aetna,Middlesex Employees,,442.54,,,442.54,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Aetna,Middlesex Employees,,526.06,,,526.06,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Anthem,Commerical,,439.97,,,439.97,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Anthem,Commerical,,523.02,,,523.02,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Anthem,Indemnity,,,494.41,,494.41,351.97,544.66,percent of total billed charges,,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Anthem,Indemnity,,,587.73,,587.73,418.41,647.47,percent of total billed charges,,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Anthem,State Preferred,,439.97,,,439.97,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Anthem,State Preferred,,523.02,,,523.02,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Anthem,Individual Exchange,,351.97,,,351.97,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Anthem,Individual Exchange,,418.41,,,418.41,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Cigna,Cigna,,429.68,,,429.68,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Cigna,Cigna,,510.78,,,510.78,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Connecticare,Commerical,,459.58,,,459.58,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Connecticare,Commerical,,546.32,,,546.32,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Connecticare,Exchange,,459.58,,,459.58,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Connecticare,Exchange,,546.32,,,546.32,418.41,647.47,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,Multiplan,Multiplan,,,544.66,,544.66,351.97,544.66,percent of total billed charges,,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,Multiplan,Multiplan,,,647.47,,647.47,418.41,647.47,percent of total billed charges,,
HC EPI SPIKE ANALYSIS,95957,CPT,,,both,,,679.8,407.88,United Healthcare/Oxford,United Healthcare/Oxford,,442.21,,,442.21,351.97,544.66,other,Could be inpatient or outpatient,
HC EPI SPIKE ANALYSIS-OTHER DIAGNOSTIC SERVICES,95957,CPT,,,both,,,808.12,484.87,United Healthcare/Oxford,United Healthcare/Oxford,,525.67,,,525.67,418.41,647.47,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT  ,,,both,,,4274.5,2564.7,Aetna,Commerical,,3091.92,,,3091.92,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Aetna,Middlesex Employees,,2782.73,,,2782.73,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Anthem,Commerical,,2766.58,,,2766.58,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Anthem,Indemnity,,,3108.9,,3108.9,2213.26,3424.91,percent of total billed charges,,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Anthem,State Preferred,,2766.58,,,2766.58,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Anthem,Individual Exchange,,2213.26,,,2213.26,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Cigna,Cigna,,2701.87,,,2701.87,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Connecticare,Commerical,,2889.88,,,2889.88,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Connecticare,Exchange,,2889.88,,,2889.88,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,Multiplan,Multiplan,,,3424.91,,3424.91,2213.26,3424.91,percent of total billed charges,,
HC WADA  ACTIVATION TEST,95958,CPT,,,both,,,4274.5,2564.7,United Healthcare/Oxford,United Healthcare/Oxford,,2780.62,,,2780.62,2213.26,3424.91,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT  ,,,both,,,4939.88,2963.93,Aetna,Commerical,,3572.23,,,3572.23,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Aetna,Middlesex Employees,,3215.01,,,3215.01,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Anthem,Commerical,,3196.35,,,3196.35,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Anthem,Indemnity,,,3591.85,,3591.85,2557.08,3956.95,percent of total billed charges,,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Anthem,State Preferred,,3196.35,,,3196.35,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Anthem,Individual Exchange,,2557.08,,,2557.08,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Cigna,Cigna,,3121.59,,,3121.59,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Connecticare,Commerical,,3338.81,,,3338.81,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Connecticare,Exchange,,3338.81,,,3338.81,2557.08,3956.95,other,Could be inpatient or outpatient,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,Multiplan,Multiplan,,,3956.95,,3956.95,2557.08,3956.95,percent of total billed charges,,
HC WADA TEST,95958,CPT,,,both,,,4939.88,2963.93,United Healthcare/Oxford,United Healthcare/Oxford,,3212.57,,,3212.57,2557.08,3956.95,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT  ,,,both,,,3218.96,1931.37,Aetna,Commerical,,2328.3,,,2328.3,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Aetna,Middlesex Employees,,2095.47,,,2095.47,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Anthem,Commerical,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Anthem,Indemnity,,,2341.08,,2341.08,1666.65,2579.04,percent of total billed charges,,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Anthem,State Preferred,,2083.31,,,2083.31,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Anthem,Individual Exchange,,1666.65,,,1666.65,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Cigna,Cigna,,2034.58,,,2034.58,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Connecticare,Commerical,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Connecticare,Exchange,,2176.16,,,2176.16,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,Multiplan,Multiplan,,,2579.04,,2579.04,1666.65,2579.04,percent of total billed charges,,
HC INTRAOP EEG CORTICAL MAPPING 1 HR,95961,CPT,,,both,,,3218.96,1931.37,United Healthcare/Oxford,United Healthcare/Oxford,,2093.89,,,2093.89,1666.65,2579.04,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT  ,,,both,,,390.37,234.22,Aetna,Commerical,,282.48,,,282.48,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Aetna,Middlesex Employees,,254.24,,,254.24,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Anthem,Commerical,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Anthem,Indemnity,,,284.04,,284.04,202.22,312.91,percent of total billed charges,,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Anthem,State Preferred,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Anthem,Individual Exchange,,202.22,,,202.22,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Cigna,Cigna,,246.85,,,246.85,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Connecticare,Commerical,,264.03,,,264.03,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Connecticare,Exchange,,264.03,,,264.03,202.22,312.91,other,Could be inpatient or outpatient,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,Multiplan,Multiplan,,,312.91,,312.91,202.22,312.91,percent of total billed charges,,
HC INTRAOP EEG CORTICAL MAPPING EA ADD 1 HR,95962,CPT,,,both,,,390.37,234.22,United Healthcare/Oxford,United Healthcare/Oxford,,254.05,,,254.05,202.22,312.91,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT  ,,,both,,,173.04,103.82,Aetna,Commerical,,124.56,,,124.56,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Aetna,Middlesex Employees,,112.11,,,112.11,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Anthem,Commerical,,111.45,,,111.45,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Anthem,Indemnity,,,125.24,,125.24,89.15,137.97,percent of total billed charges,,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Anthem,State Preferred,,111.45,,,111.45,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Anthem,Individual Exchange,,89.15,,,89.15,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Cigna,Cigna,,108.85,,,108.85,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Connecticare,Commerical,,116.42,,,116.42,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Connecticare,Exchange,,116.42,,,116.42,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,Multiplan,Multiplan,,,137.97,,137.97,89.15,137.97,percent of total billed charges,,
HC ELEC ALYS IMPLT SIMPLE CN NPGT PRGRMG,95976,CPT,,,both,,,173.04,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,112.01,,,112.01,89.15,137.97,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT  ,,,both,,,544.87,326.92,Aetna,Commerical,,394.02,,,394.02,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Aetna,Middlesex Employees,,354.62,,,354.62,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Anthem,Commerical,,352.56,,,352.56,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Anthem,Indemnity,,,396.19,,396.19,282.05,436.46,percent of total billed charges,,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Anthem,State Preferred,,352.56,,,352.56,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Anthem,Individual Exchange,,282.05,,,282.05,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Cigna,Cigna,,344.31,,,344.31,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Connecticare,Commerical,,368.27,,,368.27,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Connecticare,Exchange,,368.27,,,368.27,282.05,436.46,other,Could be inpatient or outpatient,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,Multiplan,Multiplan,,,436.46,,436.46,282.05,436.46,percent of total billed charges,,
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG,95977,CPT,,,both,,,544.87,326.92,United Healthcare/Oxford,United Healthcare/Oxford,,354.35,,,354.35,282.05,436.46,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT  ,,,both,,,1337.97,802.78,Aetna,Commerical,,967.14,,,967.14,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Aetna,Middlesex Employees,,870.43,,,870.43,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Anthem,Commerical,,865.37,,,865.37,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Anthem,Indemnity,,,972.45,,972.45,692.3,1071.3,percent of total billed charges,,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Anthem,State Preferred,,865.37,,,865.37,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Anthem,Individual Exchange,,692.3,,,692.3,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Cigna,Cigna,,845.14,,,845.14,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Connecticare,Commerical,,903.94,,,903.94,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Connecticare,Exchange,,903.94,,,903.94,692.3,1071.3,other,Could be inpatient or outpatient,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,Multiplan,Multiplan,,,1071.3,,1071.3,692.3,1071.3,percent of total billed charges,,
HC REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,95990,CPT,,,both,,,1337.97,802.78,United Healthcare/Oxford,United Healthcare/Oxford,,869.76,,,869.76,692.3,1071.3,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - BF/KINETICS,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PO BF,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PO BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORT/KINETIC,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT  ,,,both,,,2442.13,1465.28,Aetna,Commerical,,1766.58,,,1766.58,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Aetna,Middlesex Employees,,1589.92,,,1589.92,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Commerical,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Indemnity,,,1776.28,,1776.28,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,State Preferred,,1580.69,,,1580.69,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Anthem,Individual Exchange,,1264.55,,,1264.55,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Cigna,Cigna,,1543.72,,,1543.72,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Commerical,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Connecticare,Exchange,,1651.14,,,1651.14,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,Multiplan,Multiplan,,,1956.83,,1956.83,1264.55,1956.83,percent of total billed charges,,
HC MOTION ANALYSIS VIDEO/3D - PRE OP BF/ORTHOSIS,96000,CPT,,,both,,,2442.13,1465.28,United Healthcare/Oxford,United Healthcare/Oxford,,1588.71,,,1588.71,1264.55,1956.83,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PO BF W/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PO BF/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF W/PRESSURE,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/KINETIC,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP BF/ORT/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PITCHING,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS - PRE OP PRESS BF PER SIDE,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT  ,,,both,,,2961.25,1776.75,Aetna,Commerical,,2141.87,,,2141.87,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Aetna,Middlesex Employees,,1927.69,,,1927.69,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Commerical,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Indemnity,,,2153.64,,2153.64,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,State Preferred,,1916.5,,,1916.5,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Anthem,Individual Exchange,,1533.2,,,1533.2,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Cigna,Cigna,,1871.68,,,1871.68,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Commerical,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Connecticare,Exchange,,2001.91,,,2001.91,1533.2,2372.55,other,Could be inpatient or outpatient,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,Multiplan,Multiplan,,,2372.55,,2372.55,1533.2,2372.55,percent of total billed charges,,
HC MOTION TEST W/FT PRESS MEAS PO BF/ORT/KINETIC/PRESS,96001,CPT,,,both,,,2961.25,1776.75,United Healthcare/Oxford,United Healthcare/Oxford,,1926.22,,,1926.22,1533.2,2372.55,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PO,96002,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT  ,,,both,,,578.86,347.32,Aetna,Commerical,,419.26,,,419.26,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Aetna,Middlesex Employees,,377.33,,,377.33,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Anthem,Commerical,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Anthem,Indemnity,,,421.56,,421.56,300.12,464.41,percent of total billed charges,,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Anthem,State Preferred,,375.15,,,375.15,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Anthem,Individual Exchange,,300.12,,,300.12,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Cigna,Cigna,,366.37,,,366.37,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Connecticare,Commerical,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Connecticare,Exchange,,391.86,,,391.86,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,Multiplan,Multiplan,,,464.41,,464.41,300.12,464.41,percent of total billed charges,,
HC DYNAMIC SURFACE EMG; 1-12 MUSCLES - PRE OP,96002,CPT,,,both,,,578.86,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,377.04,,,377.04,300.12,464.41,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT  ,,,both,,,1056.78,634.07,Aetna,Commerical,,764.43,,,764.43,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Aetna,Middlesex Employees,,687.99,,,687.99,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Anthem,Commerical,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Anthem,Indemnity,,,768.63,,768.63,547.2,846.76,percent of total billed charges,,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Anthem,State Preferred,,684,,,684,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Anthem,Individual Exchange,,547.2,,,547.2,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Cigna,Cigna,,668,,,668,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Connecticare,Commerical,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Connecticare,Exchange,,714.48,,,714.48,547.2,846.76,other,Could be inpatient or outpatient,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,Multiplan,Multiplan,,,846.76,,846.76,547.2,846.76,percent of total billed charges,,
HC DYNAMIC FINE WIRE EMG; 1 MUSCLE - PRE OP,96003,CPT,,,both,,,1056.78,634.07,United Healthcare/Oxford,United Healthcare/Oxford,,687.46,,,687.46,547.2,846.76,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT  ,,,both,,,525.61,315.37,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT  ,,,both,,,393.93,236.36,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC EXT DEV TESTING,96111,CPT,,,both,,,525.61,315.37,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC EXT DEV TESTING-EVALUATION or RE-EVALUATION,96111,CPT,,,both,,,393.93,236.36,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT  ,,,both,,,338.87,203.32,Aetna,Commerical,,245.04,,,245.04,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Aetna,Middlesex Employees,,220.54,,,220.54,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Anthem,Commerical,,219.25,,,219.25,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Anthem,Indemnity,,,246.39,,246.39,175.4,271.43,percent of total billed charges,,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Anthem,State Preferred,,219.25,,,219.25,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Anthem,Individual Exchange,,175.4,,,175.4,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Cigna,Cigna,,214.13,,,214.13,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Connecticare,Commerical,,229.03,,,229.03,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Connecticare,Exchange,,229.03,,,229.03,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,Multiplan,Multiplan,,,271.43,,271.43,175.4,271.43,percent of total billed charges,,
HC DEVELOPMENTAL TESTING FIRST HR,96112,CPT,,,both,,,338.87,203.32,United Healthcare/Oxford,United Healthcare/Oxford,,220.37,,,220.37,175.4,271.43,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT  ,,,both,,,61.8,37.08,Aetna,Commerical,,43.96,,,43.96,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,39.56,,,39.56,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,31.47,48.7,percent of total billed charges,,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,31.47,48.7,percent of total billed charges,,
HC DEVELOPMENTAL TESTING EA ADDL 30MIN,96113,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC STAND COG TEST PER HOUR,96125,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT  ,,,both,,,810.61,486.37,Aetna,Commerical,,586.14,,,586.14,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Aetna,Middlesex Employees,,527.53,,,527.53,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Anthem,Commerical,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Anthem,Indemnity,,,589.37,,589.37,419.57,649.27,percent of total billed charges,,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Anthem,State Preferred,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Anthem,Individual Exchange,,419.57,,,419.57,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Cigna,Cigna,,512.2,,,512.2,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Connecticare,Commerical,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Connecticare,Exchange,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,Multiplan,Multiplan,,,649.27,,649.27,419.57,649.27,percent of total billed charges,,
HC IV HYDRATION INIT 31MIN TO 1HR,96360,CPT,,,both,,,810.61,486.37,United Healthcare/Oxford,United Healthcare/Oxford,,527.13,,,527.13,419.57,649.27,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT  ,,,both,,,156.56,93.94,Aetna,Commerical,,113.97,,,113.97,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Aetna,Middlesex Employees,,102.58,,,102.58,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Anthem,Commerical,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Anthem,Indemnity,,,114.6,,114.6,81.58,126.25,percent of total billed charges,,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Anthem,State Preferred,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Anthem,Individual Exchange,,81.58,,,81.58,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Cigna,Cigna,,99.59,,,99.59,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Connecticare,Commerical,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Connecticare,Exchange,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,Multiplan,Multiplan,,,126.25,,126.25,81.58,126.25,percent of total billed charges,,
HC IV HYDRATION  EACH ADD'L HR,96361,CPT,,,both,,,156.56,93.94,United Healthcare/Oxford,United Healthcare/Oxford,,102.5,,,102.5,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT  ,,,both,,,810.61,486.37,Aetna,Commerical,,586.14,,,586.14,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Aetna,Middlesex Employees,,527.53,,,527.53,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Anthem,Commerical,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Anthem,Indemnity,,,589.37,,589.37,419.57,649.27,percent of total billed charges,,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Anthem,State Preferred,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Anthem,Individual Exchange,,419.57,,,419.57,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Cigna,Cigna,,512.2,,,512.2,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Connecticare,Commerical,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Connecticare,Exchange,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,Multiplan,Multiplan,,,649.27,,649.27,419.57,649.27,percent of total billed charges,,
HC THER/PROPH/DIAG IV INF INIT UP TO 1 HR,96365,CPT,,,both,,,810.61,486.37,United Healthcare/Oxford,United Healthcare/Oxford,,527.13,,,527.13,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT  ,,,both,,,156.56,93.94,Aetna,Commerical,,113.97,,,113.97,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Aetna,Middlesex Employees,,102.58,,,102.58,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Anthem,Commerical,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Anthem,Indemnity,,,114.6,,114.6,81.58,126.25,percent of total billed charges,,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Anthem,State Preferred,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Anthem,Individual Exchange,,81.58,,,81.58,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Cigna,Cigna,,99.59,,,99.59,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Connecticare,Commerical,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Connecticare,Exchange,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,Multiplan,Multiplan,,,126.25,,126.25,81.58,126.25,percent of total billed charges,,
HC THER/PROPH/DIAG IV INF EA ADDL HR,96366,CPT,,,both,,,156.56,93.94,United Healthcare/Oxford,United Healthcare/Oxford,,102.5,,,102.5,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT  ,,,both,,,247.2,148.32,Aetna,Commerical,,178.28,,,178.28,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Aetna,Middlesex Employees,,160.46,,,160.46,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Anthem,Commerical,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Anthem,Indemnity,,,179.27,,179.27,127.62,197.49,percent of total billed charges,,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Anthem,State Preferred,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Anthem,Individual Exchange,,127.62,,,127.62,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Cigna,Cigna,,155.79,,,155.79,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Connecticare,Commerical,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Connecticare,Exchange,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,Multiplan,Multiplan,,,197.49,,197.49,127.62,197.49,percent of total billed charges,,
HC TX/PROPH/DG ADDL NEW DRUG SEQ IV INF,96367,CPT,,,both,,,247.2,148.32,United Healthcare/Oxford,United Healthcare/Oxford,,160.34,,,160.34,127.62,197.49,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT  ,,,both,,,87.55,52.53,Aetna,Commerical,,64.31,,,64.31,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Aetna,Middlesex Employees,,57.88,,,57.88,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Anthem,Commerical,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Anthem,Indemnity,,,64.67,,64.67,46.04,71.24,percent of total billed charges,,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Anthem,State Preferred,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Anthem,Individual Exchange,,46.04,,,46.04,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Cigna,Cigna,,56.2,,,56.2,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Connecticare,Commerical,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Connecticare,Exchange,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,Multiplan,Multiplan,,,71.24,,71.24,46.04,71.24,percent of total billed charges,,
HC THER/DIAG CONCURRENT INF,96368,CPT,,,both,,,87.55,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,57.83,,,57.83,46.04,71.24,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT  ,,,both,,,810.37,486.22,Aetna,Commerical,,586.14,,,586.14,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Aetna,Middlesex Employees,,527.53,,,527.53,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Anthem,Commerical,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Anthem,Indemnity,,,589.37,,589.37,419.57,649.27,percent of total billed charges,,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Anthem,State Preferred,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Anthem,Individual Exchange,,419.57,,,419.57,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Cigna,Cigna,,512.2,,,512.2,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Connecticare,Commerical,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Connecticare,Exchange,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,Multiplan,Multiplan,,,649.27,,649.27,419.57,649.27,percent of total billed charges,,
HC SUBQ INFUSION INITIAL <= 1HR,96369,CPT,,,both,,,810.37,486.22,United Healthcare/Oxford,United Healthcare/Oxford,,527.13,,,527.13,419.57,649.27,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT  ,,,both,,,157.58,94.55,Aetna,Commerical,,113.97,,,113.97,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Aetna,Middlesex Employees,,102.58,,,102.58,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Anthem,Commerical,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Anthem,Indemnity,,,114.6,,114.6,81.58,126.25,percent of total billed charges,,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Anthem,State Preferred,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Anthem,Individual Exchange,,81.58,,,81.58,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Cigna,Cigna,,99.59,,,99.59,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Connecticare,Commerical,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Connecticare,Exchange,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,Multiplan,Multiplan,,,126.25,,126.25,81.58,126.25,percent of total billed charges,,
HC SUBQ INFUSION ADD 1 HR,96370,CPT,,,both,,,157.58,94.55,United Healthcare/Oxford,United Healthcare/Oxford,,102.5,,,102.5,81.58,126.25,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT  ,,,both,,,246.49,147.89,Aetna,Commerical,,178.28,,,178.28,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Aetna,Middlesex Employees,,160.46,,,160.46,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Anthem,Commerical,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Anthem,Indemnity,,,179.27,,179.27,127.62,197.49,percent of total billed charges,,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Anthem,State Preferred,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Anthem,Individual Exchange,,127.62,,,127.62,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Cigna,Cigna,,155.79,,,155.79,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Connecticare,Commerical,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Connecticare,Exchange,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,Multiplan,Multiplan,,,197.49,,197.49,127.62,197.49,percent of total billed charges,,
HC INJECTION IM,96372,CPT,,,both,,,246.49,147.89,United Healthcare/Oxford,United Healthcare/Oxford,,160.34,,,160.34,127.62,197.49,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT  ,,,both,,,225.57,135.34,Aetna,Commerical,,163.63,,,163.63,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Aetna,Middlesex Employees,,147.27,,,147.27,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Anthem,Commerical,,146.41,,,146.41,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Anthem,Indemnity,,,164.53,,164.53,117.13,181.25,percent of total billed charges,,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Anthem,State Preferred,,146.41,,,146.41,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Anthem,Individual Exchange,,117.13,,,117.13,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Cigna,Cigna,,142.99,,,142.99,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Connecticare,Commerical,,152.94,,,152.94,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Connecticare,Exchange,,152.94,,,152.94,117.13,181.25,other,Could be inpatient or outpatient,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,Multiplan,Multiplan,,,181.25,,181.25,117.13,181.25,percent of total billed charges,,
HC INJECTION INTER-ARTERL,96373,CPT,,,both,,,225.57,135.34,United Healthcare/Oxford,United Healthcare/Oxford,,147.16,,,147.16,117.13,181.25,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT  ,,,both,,,225.11,135.06,Aetna,Commerical,,162.82,,,162.82,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Aetna,Middlesex Employees,,146.54,,,146.54,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Anthem,Commerical,,145.69,,,145.69,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Anthem,Indemnity,,,163.71,,163.71,116.55,180.35,percent of total billed charges,,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Anthem,State Preferred,,145.69,,,145.69,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Anthem,Individual Exchange,,116.55,,,116.55,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Cigna,Cigna,,142.28,,,142.28,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Connecticare,Commerical,,152.18,,,152.18,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Connecticare,Exchange,,152.18,,,152.18,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,Multiplan,Multiplan,,,180.35,,180.35,116.55,180.35,percent of total billed charges,,
HC THER/PROPH/DIAG INJ IA,96373,CPT,,,both,,,225.11,135.06,United Healthcare/Oxford,United Healthcare/Oxford,,146.42,,,146.42,116.55,180.35,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT  ,,,both,,,810.61,486.37,Aetna,Commerical,,586.14,,,586.14,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Aetna,Middlesex Employees,,527.53,,,527.53,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Anthem,Commerical,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Anthem,Indemnity,,,589.37,,589.37,419.57,649.27,percent of total billed charges,,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Anthem,State Preferred,,524.47,,,524.47,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Anthem,Individual Exchange,,419.57,,,419.57,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Cigna,Cigna,,512.2,,,512.2,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Connecticare,Commerical,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Connecticare,Exchange,,547.85,,,547.85,419.57,649.27,other,Could be inpatient or outpatient,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,Multiplan,Multiplan,,,649.27,,649.27,419.57,649.27,percent of total billed charges,,
HC THER/PROPH/DIAG IV PUSH SNGL/INITIAL,96374,CPT,,,both,,,810.61,486.37,United Healthcare/Oxford,United Healthcare/Oxford,,527.13,,,527.13,419.57,649.27,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT  ,,,both,,,156.56,93.94,Aetna,Commerical,,113.97,,,113.97,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Aetna,Middlesex Employees,,102.58,,,102.58,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Anthem,Commerical,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Anthem,Indemnity,,,114.6,,114.6,81.58,126.25,percent of total billed charges,,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Anthem,State Preferred,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Anthem,Individual Exchange,,81.58,,,81.58,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Cigna,Cigna,,99.59,,,99.59,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Connecticare,Commerical,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Connecticare,Exchange,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,Multiplan,Multiplan,,,126.25,,126.25,81.58,126.25,percent of total billed charges,,
HC EA ADDL THER/PROPH/DIAG IV PUSH NEW DRUG,96375,CPT,,,both,,,156.56,93.94,United Healthcare/Oxford,United Healthcare/Oxford,,102.5,,,102.5,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT  ,,,both,,,157.58,94.55,Aetna,Commerical,,113.97,,,113.97,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Aetna,Middlesex Employees,,102.58,,,102.58,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Anthem,Commerical,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Anthem,Indemnity,,,114.6,,114.6,81.58,126.25,percent of total billed charges,,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Anthem,State Preferred,,101.98,,,101.98,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Anthem,Individual Exchange,,81.58,,,81.58,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Cigna,Cigna,,99.59,,,99.59,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Connecticare,Commerical,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Connecticare,Exchange,,106.52,,,106.52,81.58,126.25,other,Could be inpatient or outpatient,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,Multiplan,Multiplan,,,126.25,,126.25,81.58,126.25,percent of total billed charges,,
HC TX/PRO/DX INJ SAME DRUG ADDON,96376,CPT,,,both,,,157.58,94.55,United Healthcare/Oxford,United Healthcare/Oxford,,102.5,,,102.5,81.58,126.25,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,102.42,165.93,percent of total billed charges,,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,102.42,165.93,percent of total billed charges,,
HC CHEMO ANTI-NEOPL NONHORM SQ/IM,96401,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,102.42,165.93,percent of total billed charges,,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.92,102.42,165.93,percent of total billed charges,,
HC CHEMO ANTI-NEOPL HORMON SQ/IM,96402,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT  ,,,both,,,611.82,367.09,Aetna,Commerical,,336.46,,,336.46,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Aetna,Middlesex Employees,,302.82,,,302.82,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Anthem,Commerical,,399.49,,,399.49,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Anthem,Indemnity,,,445.3,,445.3,302.82,490.56,percent of total billed charges,,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Anthem,State Preferred,,399.49,,,399.49,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Anthem,Individual Exchange,,319.59,,,319.59,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Cigna,Cigna,,459.27,,,459.27,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Connecticare,Commerical,,427.57,,,427.57,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Connecticare,Exchange,,427.57,,,427.57,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,Multiplan,Multiplan,,,490.56,,490.56,302.82,490.56,percent of total billed charges,,
HC CHEMO HORMON ANTINEOPL SQ/IM,96402,CPT,,,both,,,611.82,367.09,United Healthcare/Oxford,United Healthcare/Oxford,,373,,,373,302.82,490.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT  ,,,both,,,680.83,408.5,Aetna,Commerical,,374.19,,,374.19,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Aetna,Middlesex Employees,,336.77,,,336.77,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Anthem,Commerical,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Anthem,Indemnity,,,495.23,,495.23,336.77,545.56,percent of total billed charges,,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Anthem,State Preferred,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Anthem,Individual Exchange,,355.43,,,355.43,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Cigna,Cigna,,510.78,,,510.78,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Connecticare,Commerical,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Connecticare,Exchange,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,Multiplan,Multiplan,,,545.56,,545.56,336.77,545.56,percent of total billed charges,,
HC CHEMO IV PUSH SNGL DRUG,96409,CPT,,,both,,,680.83,408.5,United Healthcare/Oxford,United Healthcare/Oxford,,414.82,,,414.82,336.77,545.56,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,102.42,165.93,percent of total billed charges,,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,102.42,165.93,percent of total billed charges,,
HC CHEMO IV PUSH EA ADDL DRUG,96411,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT  ,,,both,,,1059.87,635.92,Aetna,Commerical,,582.62,,,582.62,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Aetna,Middlesex Employees,,524.36,,,524.36,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Anthem,Commerical,,691.77,,,691.77,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Anthem,Indemnity,,,771.09,,771.09,524.36,849.46,percent of total billed charges,,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Anthem,State Preferred,,691.77,,,691.77,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Anthem,Individual Exchange,,553.41,,,553.41,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Cigna,Cigna,,795.29,,,795.29,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Connecticare,Commerical,,740.39,,,740.39,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Connecticare,Exchange,,740.39,,,740.39,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,Multiplan,Multiplan,,,849.46,,849.46,524.36,849.46,percent of total billed charges,,
HC CHEM IV INFUS UP TO 1HR,96413,CPT,,,both,,,1059.87,635.92,United Healthcare/Oxford,United Healthcare/Oxford,,645.89,,,645.89,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT  ,,,both,,,532.37,319.42,Aetna,Commerical,,292.54,,,292.54,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Aetna,Middlesex Employees,,263.29,,,263.29,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Anthem,Commerical,,347.36,,,347.36,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Anthem,Indemnity,,,387.18,,387.18,263.29,426.54,percent of total billed charges,,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Anthem,State Preferred,,347.36,,,347.36,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Anthem,Individual Exchange,,277.89,,,277.89,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Cigna,Cigna,,399.33,,,399.33,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Connecticare,Commerical,,371.76,,,371.76,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Connecticare,Exchange,,371.76,,,371.76,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,Multiplan,Multiplan,,,426.54,,426.54,263.29,426.54,percent of total billed charges,,
HC CHEM IV INFUS>1HR,96415,CPT,,,both,,,532.37,319.42,United Healthcare/Oxford,United Healthcare/Oxford,,324.32,,,324.32,263.29,426.54,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT  ,,,both,,,208.06,124.84,Aetna,Commerical,,113.8,,,113.8,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,102.42,,,102.42,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,102.42,165.93,percent of total billed charges,,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,108.1,,,108.1,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,155.34,,,155.34,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,102.42,165.93,percent of total billed charges,,
HC CHEMO IV INFUSION EA ADDL HR,96415,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT  ,,,both,,,207.1,124.26,Aetna,Commerical,,113.8,,,113.8,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT  ,,,both,,,528.99,317.39,Aetna,Commerical,,290.69,,,290.69,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Aetna,Middlesex Employees,,102.42,,,102.42,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Aetna,Middlesex Employees,,261.62,,,261.62,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Anthem,Commerical,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Anthem,Commerical,,345.15,,,345.15,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Anthem,Indemnity,,,150.62,,150.62,102.42,165.93,percent of total billed charges,,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Anthem,Indemnity,,,384.72,,384.72,261.62,423.83,percent of total billed charges,,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Anthem,State Preferred,,135.12,,,135.12,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Anthem,State Preferred,,345.15,,,345.15,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Anthem,Individual Exchange,,108.1,,,108.1,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Anthem,Individual Exchange,,276.12,,,276.12,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Cigna,Cigna,,155.34,,,155.34,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Cigna,Cigna,,396.8,,,396.8,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Connecticare,Commerical,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Connecticare,Commerical,,369.41,,,369.41,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Connecticare,Exchange,,144.62,,,144.62,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Connecticare,Exchange,,369.41,,,369.41,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,Multiplan,Multiplan,,,165.93,,165.93,102.42,165.93,percent of total billed charges,,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,Multiplan,Multiplan,,,423.83,,423.83,261.62,423.83,percent of total billed charges,,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR,96417,CPT,,,both,,,207.1,124.26,United Healthcare/Oxford,United Healthcare/Oxford,,126.16,,,126.16,102.42,165.93,other,Could be inpatient or outpatient,
HC CHEMO IV INFUS EACH ADDL SEQ UP TO 1 HR INPT,96417,CPT,,,both,,,528.99,317.39,United Healthcare/Oxford,United Healthcare/Oxford,,322.27,,,322.27,261.62,423.83,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT  ,,,both,,,595.34,357.2,Aetna,Commerical,,327.19,,,327.19,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Aetna,Middlesex Employees,,294.47,,,294.47,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Anthem,Commerical,,388.48,,,388.48,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Anthem,Indemnity,,,433.02,,433.02,294.47,477.04,percent of total billed charges,,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Anthem,State Preferred,,388.48,,,388.48,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Anthem,Individual Exchange,,310.78,,,310.78,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Cigna,Cigna,,446.61,,,446.61,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Connecticare,Commerical,,415.78,,,415.78,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Connecticare,Exchange,,415.78,,,415.78,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,Multiplan,Multiplan,,,477.04,,477.04,294.47,477.04,percent of total billed charges,,
HC CHEMO IA; INFUSION; > 8 HRS W PUMP,96425,CPT,,,both,,,595.34,357.2,United Healthcare/Oxford,United Healthcare/Oxford,,362.71,,,362.71,294.47,477.04,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT  ,,,both,,,331.66,199,Aetna,Commerical,,182.46,,,182.46,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Aetna,Middlesex Employees,,164.21,,,164.21,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Anthem,Commerical,,216.64,,,216.64,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Anthem,Indemnity,,,241.48,,241.48,164.21,266.02,percent of total billed charges,,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Anthem,State Preferred,,216.64,,,216.64,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Anthem,Individual Exchange,,173.31,,,173.31,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Cigna,Cigna,,249.06,,,249.06,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Connecticare,Commerical,,231.86,,,231.86,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Connecticare,Exchange,,231.86,,,231.86,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,Multiplan,Multiplan,,,266.02,,266.02,164.21,266.02,percent of total billed charges,,
HC CHEMO ADM PERI CAV,96446,CPT,,,both,,,331.66,199,United Healthcare/Oxford,United Healthcare/Oxford,,202.27,,,202.27,164.21,266.02,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT  ,,,both,,,362.56,217.54,Aetna,Commerical,,199.15,,,199.15,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Aetna,Middlesex Employees,,179.24,,,179.24,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Anthem,Commerical,,236.47,,,236.47,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Anthem,Indemnity,,,263.58,,263.58,179.24,290.37,percent of total billed charges,,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Anthem,State Preferred,,236.47,,,236.47,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Anthem,Individual Exchange,,189.18,,,189.18,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Cigna,Cigna,,271.85,,,271.85,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Connecticare,Commerical,,253.08,,,253.08,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Connecticare,Exchange,,253.08,,,253.08,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,Multiplan,Multiplan,,,290.37,,290.37,179.24,290.37,percent of total billed charges,,
HC CHEMO ADM PERICAV,96446,CPT,,,both,,,362.56,217.54,United Healthcare/Oxford,United Healthcare/Oxford,,220.78,,,220.78,179.24,290.37,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT  ,,,both,,,459.22,275.53,Aetna,Commerical,,252.34,,,252.34,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Aetna,Middlesex Employees,,227.11,,,227.11,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Anthem,Commerical,,299.62,,,299.62,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Anthem,Indemnity,,,333.98,,333.98,227.11,367.92,percent of total billed charges,,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Anthem,State Preferred,,299.62,,,299.62,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Anthem,Individual Exchange,,239.7,,,239.7,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Cigna,Cigna,,344.46,,,344.46,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Connecticare,Commerical,,320.67,,,320.67,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Connecticare,Exchange,,320.67,,,320.67,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,Multiplan,Multiplan,,,367.92,,367.92,227.11,367.92,percent of total billed charges,,
HC CHEMO INJ CNS & LP,96450,CPT,,,both,,,459.22,275.53,United Healthcare/Oxford,United Healthcare/Oxford,,279.75,,,279.75,227.11,367.92,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT  ,,,both,,,1059.87,635.92,Aetna,Commerical,,582.62,,,582.62,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Aetna,Middlesex Employees,,524.36,,,524.36,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Anthem,Commerical,,691.77,,,691.77,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Anthem,Indemnity,,,771.09,,771.09,524.36,849.46,percent of total billed charges,,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Anthem,State Preferred,,691.77,,,691.77,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Anthem,Individual Exchange,,553.41,,,553.41,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Cigna,Cigna,,795.29,,,795.29,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Connecticare,Commerical,,740.39,,,740.39,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Connecticare,Exchange,,740.39,,,740.39,524.36,849.46,other,Could be inpatient or outpatient,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,Multiplan,Multiplan,,,849.46,,849.46,524.36,849.46,percent of total billed charges,,
HC CHEMO INJ CNS &LP,96450,CPT,,,both,,,1059.87,635.92,United Healthcare/Oxford,United Healthcare/Oxford,,645.89,,,645.89,524.36,849.46,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT  ,,,both,,,680.83,408.5,Aetna,Commerical,,374.19,,,374.19,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Aetna,Middlesex Employees,,336.77,,,336.77,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Anthem,Commerical,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Anthem,Indemnity,,,495.23,,495.23,336.77,545.56,percent of total billed charges,,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Anthem,State Preferred,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Anthem,Individual Exchange,,355.43,,,355.43,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Cigna,Cigna,,510.78,,,510.78,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Connecticare,Commerical,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Connecticare,Exchange,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,Multiplan,Multiplan,,,545.56,,545.56,336.77,545.56,percent of total billed charges,,
HC REFILL AND MAINTENANCE OF PUMP,96521,CPT,,,both,,,680.83,408.5,United Healthcare/Oxford,United Healthcare/Oxford,,414.82,,,414.82,336.77,545.56,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT  ,,,both,,,225.57,135.34,Aetna,Commerical,,151.01,,,151.01,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Aetna,Middlesex Employees,,135.91,,,135.91,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Anthem,Commerical,,125.33,,,125.33,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Anthem,Indemnity,,,164.35,,164.35,100.26,181.05,percent of total billed charges,,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Anthem,State Preferred,,125.33,,,125.33,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Anthem,Individual Exchange,,100.26,,,100.26,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Cigna,Cigna,,133.03,,,133.03,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Connecticare,Commerical,,136.45,,,136.45,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Connecticare,Exchange,,136.45,,,136.45,100.26,181.05,other,Could be inpatient or outpatient,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,Multiplan,Multiplan,,,181.05,,181.05,100.26,181.05,percent of total billed charges,,
HC IRRIG DRUG DELIVERY DEVICE,96523,CPT,,,both,,,225.57,135.34,United Healthcare/Oxford,United Healthcare/Oxford,,139.88,,,139.88,100.26,181.05,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT  ,,,both,,,680.93,408.56,Aetna,Commerical,,374.19,,,374.19,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Aetna,Middlesex Employees,,336.77,,,336.77,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Anthem,Commerical,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Anthem,Indemnity,,,495.23,,495.23,336.77,545.56,percent of total billed charges,,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Anthem,State Preferred,,444.28,,,444.28,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Anthem,Individual Exchange,,355.43,,,355.43,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Cigna,Cigna,,510.78,,,510.78,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Connecticare,Commerical,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Connecticare,Exchange,,475.51,,,475.51,336.77,545.56,other,Could be inpatient or outpatient,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,Multiplan,Multiplan,,,545.56,,545.56,336.77,545.56,percent of total billed charges,,
HC SUB INJ SUBC RES,96542,CPT,,,both,,,680.93,408.56,United Healthcare/Oxford,United Healthcare/Oxford,,414.82,,,414.82,336.77,545.56,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT  ,,,both,,,220.42,132.25,Aetna,Commerical,,159.56,,,159.56,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Aetna,Middlesex Employees,,143.6,,,143.6,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Anthem,Commerical,,142.77,,,142.77,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Anthem,Indemnity,,,160.44,,160.44,114.21,176.75,percent of total billed charges,,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Anthem,State Preferred,,142.77,,,142.77,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Anthem,Individual Exchange,,114.21,,,114.21,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Cigna,Cigna,,139.43,,,139.43,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Connecticare,Commerical,,149.14,,,149.14,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Connecticare,Exchange,,149.14,,,149.14,114.21,176.75,other,Could be inpatient or outpatient,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,Multiplan,Multiplan,,,176.75,,176.75,114.21,176.75,percent of total billed charges,,
HC UNLIST SPEC DERMATOLOGICAL SVC OR PROC,96999,CPT,,,both,,,220.42,132.25,United Healthcare/Oxford,United Healthcare/Oxford,,143.5,,,143.5,114.21,176.75,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC PT ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT  ,,,both,,,787.95,472.77,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC PT COMP EVAL,97001,CPT,,,both,,,787.95,472.77,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT  ,,,both,,,1050.6,630.36,Aetna,Commerical,,759.54,,,759.54,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Aetna,Middlesex Employees,,683.59,,,683.59,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Anthem,Commerical,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Anthem,Indemnity,,,763.72,,763.72,543.7,841.35,percent of total billed charges,,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Anthem,State Preferred,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Anthem,Individual Exchange,,543.7,,,543.7,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Cigna,Cigna,,663.73,,,663.73,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Connecticare,Commerical,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Connecticare,Exchange,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,Multiplan,Multiplan,,,841.35,,841.35,543.7,841.35,percent of total billed charges,,
HC PT MULT NEED EVAL,97001,CPT,,,both,,,1050.6,630.36,United Healthcare/Oxford,United Healthcare/Oxford,,683.08,,,683.08,543.7,841.35,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC PT SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC SP ABBREVATD EVAL,97001,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC SP BASIC EVAL,97001,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC SP SIMPLE EVAL,97001,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT EVAL HIGH COMPLEX,97002,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT EVAL LOW COMPLEX,97002,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT EVAL MOD COMPLEX,97002,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT  ,,,both,,,657.3,394.38,Aetna,Commerical,,475.43,,,475.43,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Aetna,Middlesex Employees,,427.88,,,427.88,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Anthem,Commerical,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Anthem,Indemnity,,,478.04,,478.04,340.33,526.63,percent of total billed charges,,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Anthem,State Preferred,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Anthem,Individual Exchange,,340.33,,,340.33,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Cigna,Cigna,,415.45,,,415.45,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Connecticare,Commerical,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Connecticare,Exchange,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,Multiplan,Multiplan,,,526.63,,526.63,340.33,526.63,percent of total billed charges,,
HC PT INTERMED EVAL FACE UNIT 5,97002,CPT,,,both,,,657.3,394.38,United Healthcare/Oxford,United Healthcare/Oxford,,427.56,,,427.56,340.33,526.63,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT  ,,,both,,,919.54,551.73,Aetna,Commerical,,665.11,,,665.11,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Aetna,Middlesex Employees,,598.6,,,598.6,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Anthem,Commerical,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Anthem,Indemnity,,,668.77,,668.77,476.1,736.75,percent of total billed charges,,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Anthem,State Preferred,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Anthem,Individual Exchange,,476.1,,,476.1,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Cigna,Cigna,,581.2,,,581.2,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Connecticare,Commerical,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Connecticare,Exchange,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,Multiplan,Multiplan,,,736.75,,736.75,476.1,736.75,percent of total billed charges,,
HC PT MOD COMPLX EVAL FACE UNIT 7,97002,CPT,,,both,,,919.54,551.73,United Healthcare/Oxford,United Healthcare/Oxford,,598.15,,,598.15,476.1,736.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT RE-EVAL,97002,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT  ,,,both,,,525.61,315.37,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC PT RE-EVAL EST PLAN CARE,97002,CPT,,,both,,,525.61,315.37,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT  ,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC PT RE-EVAL-CCR,97002,CPT,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT  ,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC PT RE-EVAL-SCR,97002,CPT,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC SP RE-EVAL,97002,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC INITIAL EVAL - FEEDING TEAM,97003,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT  ,,,both,,,658.17,394.9,Aetna,Commerical,,475.43,,,475.43,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Aetna,Middlesex Employees,,427.88,,,427.88,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Anthem,Commerical,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Anthem,Indemnity,,,478.04,,478.04,340.33,526.63,percent of total billed charges,,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Anthem,State Preferred,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Anthem,Individual Exchange,,340.33,,,340.33,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Cigna,Cigna,,415.45,,,415.45,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Connecticare,Commerical,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Connecticare,Exchange,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,Multiplan,Multiplan,,,526.63,,526.63,340.33,526.63,percent of total billed charges,,
HC INTERMEDIATE EVAL,97003,CPT,,,both,,,658.17,394.9,United Healthcare/Oxford,United Healthcare/Oxford,,427.56,,,427.56,340.33,526.63,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT  ,,,both,,,919.79,551.87,Aetna,Commerical,,665.11,,,665.11,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Aetna,Middlesex Employees,,598.6,,,598.6,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Anthem,Commerical,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Anthem,Indemnity,,,668.77,,668.77,476.1,736.75,percent of total billed charges,,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Anthem,State Preferred,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Anthem,Individual Exchange,,476.1,,,476.1,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Cigna,Cigna,,581.2,,,581.2,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Connecticare,Commerical,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Connecticare,Exchange,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,Multiplan,Multiplan,,,736.75,,736.75,476.1,736.75,percent of total billed charges,,
HC MODERATE COMPLEXITY EVAL,97003,CPT,,,both,,,919.79,551.87,United Healthcare/Oxford,United Healthcare/Oxford,,598.15,,,598.15,476.1,736.75,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC OT ABBREV EVAL,97003,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT BASIC EVAL,97003,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT  ,,,both,,,787.95,472.77,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC OT COMP EVAL,97003,CPT,,,both,,,787.95,472.77,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT  ,,,both,,,787.86,472.71,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC OT FT COMPREHENSIVE FACE UNIT 6,97003,CPT,,,both,,,787.86,472.71,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT  ,,,both,,,657.3,394.38,Aetna,Commerical,,475.43,,,475.43,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Aetna,Middlesex Employees,,427.88,,,427.88,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Commerical,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Indemnity,,,478.04,,478.04,340.33,526.63,percent of total billed charges,,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,State Preferred,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Individual Exchange,,340.33,,,340.33,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Cigna,Cigna,,415.45,,,415.45,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Connecticare,Commerical,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Connecticare,Exchange,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Multiplan,Multiplan,,,526.63,,526.63,340.33,526.63,percent of total billed charges,,
HC OT FT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,United Healthcare/Oxford,United Healthcare/Oxford,,427.56,,,427.56,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT  ,,,both,,,657.3,394.38,Aetna,Commerical,,475.43,,,475.43,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Aetna,Middlesex Employees,,427.88,,,427.88,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Commerical,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Indemnity,,,478.04,,478.04,340.33,526.63,percent of total billed charges,,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,State Preferred,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Anthem,Individual Exchange,,340.33,,,340.33,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Cigna,Cigna,,415.45,,,415.45,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Connecticare,Commerical,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Connecticare,Exchange,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,Multiplan,Multiplan,,,526.63,,526.63,340.33,526.63,percent of total billed charges,,
HC OT INTERMED EVAL FACE UNIT 5,97003,CPT,,,both,,,657.3,394.38,United Healthcare/Oxford,United Healthcare/Oxford,,427.56,,,427.56,340.33,526.63,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT  ,,,both,,,919.54,551.73,Aetna,Commerical,,665.11,,,665.11,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Aetna,Middlesex Employees,,598.6,,,598.6,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Anthem,Commerical,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Anthem,Indemnity,,,668.77,,668.77,476.1,736.75,percent of total billed charges,,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Anthem,State Preferred,,595.13,,,595.13,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Anthem,Individual Exchange,,476.1,,,476.1,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Cigna,Cigna,,581.2,,,581.2,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Connecticare,Commerical,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Connecticare,Exchange,,621.65,,,621.65,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,Multiplan,Multiplan,,,736.75,,736.75,476.1,736.75,percent of total billed charges,,
HC OT MOD COMPLX FACE UNIT 7,97003,CPT,,,both,,,919.54,551.73,United Healthcare/Oxford,United Healthcare/Oxford,,598.15,,,598.15,476.1,736.75,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT  ,,,both,,,1050.1,630.06,Aetna,Commerical,,759.54,,,759.54,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Aetna,Middlesex Employees,,683.59,,,683.59,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Anthem,Commerical,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Anthem,Indemnity,,,763.72,,763.72,543.7,841.35,percent of total billed charges,,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Anthem,State Preferred,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Anthem,Individual Exchange,,543.7,,,543.7,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Cigna,Cigna,,663.73,,,663.73,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Connecticare,Commerical,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Connecticare,Exchange,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,Multiplan,Multiplan,,,841.35,,841.35,543.7,841.35,percent of total billed charges,,
HC OT MULT NEED EVAL,97003,CPT,,,both,,,1050.1,630.06,United Healthcare/Oxford,United Healthcare/Oxford,,683.08,,,683.08,543.7,841.35,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT  ,,,both,,,394.49,236.69,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Anthem,Indemnity,,,286.5,,286.5,203.96,315.62,percent of total billed charges,,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,Multiplan,Multiplan,,,315.62,,315.62,203.96,315.62,percent of total billed charges,,
HC OT SIMPLE EVAL,97003,CPT,,,both,,,394.49,236.69,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT  ,,,both,,,525.61,315.37,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT MULT NEED EVAL,97004,CPT,,,both,,,525.61,315.37,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT RE-EVAL - FEEDING TEAM,97004,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC OT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC PT HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC SP HOT/COLD PACK,97010,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT  ,,,both,,,1050.6,630.36,Aetna,Commerical,,759.54,,,759.54,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Aetna,Middlesex Employees,,683.59,,,683.59,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Anthem,Commerical,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Anthem,Indemnity,,,763.72,,763.72,543.7,841.35,percent of total billed charges,,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Anthem,State Preferred,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Anthem,Individual Exchange,,543.7,,,543.7,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Cigna,Cigna,,663.73,,,663.73,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Connecticare,Commerical,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Connecticare,Exchange,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,Multiplan,Multiplan,,,841.35,,841.35,543.7,841.35,percent of total billed charges,,
HC MECHANICAL TRACTION THERAPY 1+ AREAS,97012,CPT,,,both,,,1050.6,630.36,United Healthcare/Oxford,United Healthcare/Oxford,,683.08,,,683.08,543.7,841.35,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT  ,,,both,,,41.79,25.07,Aetna,Commerical,,30.23,,,30.23,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Aetna,Middlesex Employees,,27.2,,,27.2,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Anthem,Commerical,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Anthem,Indemnity,,,30.39,,30.39,21.63,33.48,percent of total billed charges,,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Anthem,State Preferred,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Anthem,Individual Exchange,,21.63,,,21.63,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Cigna,Cigna,,26.42,,,26.42,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Connecticare,Commerical,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Connecticare,Exchange,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,Multiplan,Multiplan,,,33.48,,33.48,21.63,33.48,percent of total billed charges,,
HC PARAFFIN BATH THERAPY 1+ AREAS-PT,97018,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PARAFFIN BATH THERAPY 1+ AREAS-OT,97018,CPT,,,both,,,41.79,25.07,United Healthcare/Oxford,United Healthcare/Oxford,,27.18,,,27.18,21.63,33.48,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC ELEC STIM/TEN 15M,97032,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC ELECTRICAL STIMULATION EA 15 MINS,97032,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC ELECTRIC CURRENT THERAPY EA 15 MINS,97033,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC APT-ULTRA SOUND,97035,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC OT ULTRASOUND 15M,97035,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC SP ULTRASOUND,97035,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT  ,,,both,,,66.95,40.17,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC ULTRASOUND THERAPY EA 15 MINS,97035,CPT,,,both,,,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC THERAPEUTIC EXERCISES EA 15 MINS,97110,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT  ,,,both,,,149.69,89.81,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC NEUROMUSCULAR REEDUCATION EA 15 MINS,97112,CPT,,,both,,,149.69,89.81,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT  ,,,both,,,166.86,100.12,Aetna,Commerical,,120.48,,,120.48,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Aetna,Middlesex Employees,,108.43,,,108.43,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Anthem,Commerical,,107.81,,,107.81,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Anthem,Indemnity,,,121.14,,121.14,86.25,133.46,percent of total billed charges,,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Anthem,State Preferred,,107.81,,,107.81,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Anthem,Individual Exchange,,86.25,,,86.25,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Cigna,Cigna,,105.29,,,105.29,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Connecticare,Commerical,,112.61,,,112.61,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Connecticare,Exchange,,112.61,,,112.61,86.25,133.46,other,Could be inpatient or outpatient,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,Multiplan,Multiplan,,,133.46,,133.46,86.25,133.46,percent of total billed charges,,
HC AQUATIC THERAPY/EXERCISES EA 15 MINS,97113,CPT,,,both,,,166.86,100.12,United Healthcare/Oxford,United Healthcare/Oxford,,108.36,,,108.36,86.25,133.46,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PT GAIT TRAIN THERAPEUTIC 15 MIN,97116,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC SP  GAIT TRAN 15M,97116,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC MASSAGE THERAPY EA 15 MINS,97124,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION,97127,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT  ,,,both,,,65.92,39.55,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Anthem,Indemnity,,,47.47,,47.47,33.8,52.3,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Cigna,Cigna,,41.26,,,41.26,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Connecticare,Commerical,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Connecticare,Exchange,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION 1ST 15 MIN,97129,CPT,,,both,,,65.92,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,42.47,,,42.47,33.8,52.3,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT  ,,,both,,,63.86,38.32,Aetna,Commerical,,45.59,,,45.59,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,41.04,,,41.04,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Anthem,Commerical,,40.79,,,40.79,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Anthem,Indemnity,,,45.84,,45.84,32.63,50.5,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Anthem,State Preferred,,40.79,,,40.79,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Anthem,Individual Exchange,,32.63,,,32.63,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Cigna,Cigna,,39.84,,,39.84,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Connecticare,Commerical,,42.61,,,42.61,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Connecticare,Exchange,,42.61,,,42.61,32.63,50.5,other,Could be inpatient or outpatient,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,Multiplan,Multiplan,,,50.5,,50.5,32.63,50.5,percent of total billed charges,,
HC THER INTERVENTION FOR COGNITIVE FUNCTION EA ADDL 15 MIN,97130,CPT,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,40.99,,,40.99,32.63,50.5,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC MANUAL THERAPY EA 15 MINS,97140,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC PT THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC SP THERAPY GROUP,97140,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT  ,,,both,,,77.25,46.35,Aetna,Commerical,,56.17,,,56.17,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Aetna,Middlesex Employees,,50.56,,,50.56,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Anthem,Commerical,,50.26,,,50.26,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Anthem,Indemnity,,,56.48,,56.48,40.21,62.22,percent of total billed charges,,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Anthem,State Preferred,,50.26,,,50.26,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Anthem,Individual Exchange,,40.21,,,40.21,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Cigna,Cigna,,49.09,,,49.09,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Connecticare,Commerical,,52.5,,,52.5,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Connecticare,Exchange,,52.5,,,52.5,40.21,62.22,other,Could be inpatient or outpatient,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,Multiplan,Multiplan,,,62.22,,62.22,40.21,62.22,percent of total billed charges,,
HC FEEDING GRP TRMT,97150,CPT,,,both,,,77.25,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,50.52,,,50.52,40.21,62.22,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT  ,,,both,,,262.65,157.59,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Anthem,Indemnity,,,191.54,,191.54,136.36,211.01,percent of total billed charges,,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,Multiplan,Multiplan,,,211.01,,211.01,136.36,211.01,percent of total billed charges,,
HC OT THERAPY GROUP,97150,CPT,,,both,,,262.65,157.59,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,350.95,,,350.95,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,315.85,,,315.85,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,381.93,,381.93,233.01,420.75,percent of total billed charges,,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,233.01,,,233.01,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,309.14,,,309.14,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,420.75,,420.75,233.01,420.75,percent of total billed charges,,
HC PT EVAL LOW COMPLEX,97161,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,325.08,,,325.08,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,350.95,,,350.95,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,315.85,,,315.85,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,381.93,,381.93,233.01,420.75,percent of total billed charges,,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,233.01,,,233.01,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,309.14,,,309.14,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,420.75,,420.75,233.01,420.75,percent of total billed charges,,
HC PT EVAL MOD COMPLEX,97162,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,325.08,,,325.08,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,350.95,,,350.95,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,315.85,,,315.85,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,381.93,,381.93,233.01,420.75,percent of total billed charges,,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,233.01,,,233.01,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,309.14,,,309.14,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,420.75,,420.75,233.01,420.75,percent of total billed charges,,
HC PT EVAL HIGH COMPLEX,97163,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,325.08,,,325.08,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT  ,,,both,,,525.15,315.09,Aetna,Commerical,,350.95,,,350.95,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Aetna,Middlesex Employees,,315.85,,,315.85,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Anthem,Commerical,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Anthem,Indemnity,,,381.93,,381.93,233.01,420.75,percent of total billed charges,,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Anthem,State Preferred,,291.26,,,291.26,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Anthem,Individual Exchange,,233.01,,,233.01,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Cigna,Cigna,,309.14,,,309.14,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Connecticare,Commerical,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Connecticare,Exchange,,317.11,,,317.11,233.01,420.75,other,Could be inpatient or outpatient,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,Multiplan,Multiplan,,,420.75,,420.75,233.01,420.75,percent of total billed charges,,
HC PT RE-EVAL EST PLAN CARE,97164,CPT,,,both,,,525.15,315.09,United Healthcare/Oxford,United Healthcare/Oxford,,325.08,,,325.08,233.01,420.75,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 3,97165,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 4,97165,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 5,97165,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL LOW COMPLEX  - 6,97165,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 4,97166,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 5,97166,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 6,97166,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL MOD COMPLEX  - 7,97166,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 5,97167,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 6,97167,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 7,97167,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT EVAL HIGH COMPLEX  - 8,97167,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT  ,,,both,,,525.61,315.37,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 4,97168,CPT,,,both,,,525.61,315.37,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT  ,,,both,,,657.3,394.38,Aetna,Commerical,,475.43,,,475.43,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Aetna,Middlesex Employees,,427.88,,,427.88,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Anthem,Commerical,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Anthem,Indemnity,,,478.04,,478.04,340.33,526.63,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Anthem,State Preferred,,425.41,,,425.41,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Anthem,Individual Exchange,,340.33,,,340.33,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Cigna,Cigna,,415.45,,,415.45,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Connecticare,Commerical,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Connecticare,Exchange,,444.36,,,444.36,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,Multiplan,Multiplan,,,526.63,,526.63,340.33,526.63,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 5,97168,CPT,,,both,,,657.3,394.38,United Healthcare/Oxford,United Healthcare/Oxford,,427.56,,,427.56,340.33,526.63,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT  ,,,both,,,787.95,472.77,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC OT RE-EVAL EST PLAN CARE - 6,97168,CPT,,,both,,,787.95,472.77,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT FNCTL ACT 15MN,97530,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT FNCTL ACT 15MN - FEEDING TEAM,97530,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PT FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC SP FUNCTL ACTIVTY EA 15MIN,97530,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC COGNTIVE TRNG 15M,97532,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC DVLOP COG SKL +15,97532,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT  ,,,both,,,217.22,130.33,Aetna,Commerical,,157.12,,,157.12,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Aetna,Middlesex Employees,,141.41,,,141.41,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Anthem,Commerical,,140.58,,,140.58,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Anthem,Indemnity,,,157.98,,157.98,112.46,174.04,percent of total billed charges,,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Anthem,State Preferred,,140.58,,,140.58,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Anthem,Individual Exchange,,112.46,,,112.46,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Cigna,Cigna,,137.3,,,137.3,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Connecticare,Commerical,,146.86,,,146.86,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Connecticare,Exchange,,146.86,,,146.86,112.46,174.04,other,Could be inpatient or outpatient,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,Multiplan,Multiplan,,,174.04,,174.04,112.46,174.04,percent of total billed charges,,
HC SENSORY INTEGRATION TECHNIQUES EA 15 MIN,97533,CPT,,,both,,,217.22,130.33,United Healthcare/Oxford,United Healthcare/Oxford,,141.3,,,141.3,112.46,174.04,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT  ,,,both,,,149.35,89.61,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC ADL TRAINING 15MN,97535,CPT,,,both,,,149.35,89.61,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC WHEELCHAIR MNGMENT TRAINING EA 15 MINS,97542,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT  ,,,both,,,324.45,194.67,Aetna,Commerical,,234.45,,,234.45,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Aetna,Middlesex Employees,,211.01,,,211.01,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Anthem,Commerical,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Anthem,Indemnity,,,235.75,,235.75,167.83,259.71,percent of total billed charges,,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Anthem,State Preferred,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Anthem,Individual Exchange,,167.83,,,167.83,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Cigna,Cigna,,204.88,,,204.88,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Connecticare,Commerical,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Connecticare,Exchange,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,Multiplan,Multiplan,,,259.71,,259.71,167.83,259.71,percent of total billed charges,,
HC WOUND CARE MGMT,97602,CPT,,,both,,,324.45,194.67,United Healthcare/Oxford,United Healthcare/Oxford,,210.85,,,210.85,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT  ,,,both,,,324.45,194.67,Aetna,Commerical,,234.45,,,234.45,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Aetna,Middlesex Employees,,211.01,,,211.01,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Anthem,Commerical,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Anthem,Indemnity,,,235.75,,235.75,167.83,259.71,percent of total billed charges,,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Anthem,State Preferred,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Anthem,Individual Exchange,,167.83,,,167.83,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Cigna,Cigna,,204.88,,,204.88,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Connecticare,Commerical,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Connecticare,Exchange,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,Multiplan,Multiplan,,,259.71,,259.71,167.83,259.71,percent of total billed charges,,
HC NEG PRES WNDTX<50,97605,CPT,,,both,,,324.45,194.67,United Healthcare/Oxford,United Healthcare/Oxford,,210.85,,,210.85,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT  ,,,both,,,324.45,194.67,Aetna,Commerical,,234.45,,,234.45,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Aetna,Middlesex Employees,,211.01,,,211.01,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Anthem,Commerical,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Anthem,Indemnity,,,235.75,,235.75,167.83,259.71,percent of total billed charges,,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Anthem,State Preferred,,209.78,,,209.78,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Anthem,Individual Exchange,,167.83,,,167.83,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Cigna,Cigna,,204.88,,,204.88,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Connecticare,Commerical,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Connecticare,Exchange,,219.14,,,219.14,167.83,259.71,other,Could be inpatient or outpatient,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,Multiplan,Multiplan,,,259.71,,259.71,167.83,259.71,percent of total billed charges,,
HC NEG PRES WNDTX>50,97606,CPT,,,both,,,324.45,194.67,United Healthcare/Oxford,United Healthcare/Oxford,,210.85,,,210.85,167.83,259.71,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT TEST & MEASURE EA 15MIN,97750,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT TEST/MEAS/EVAL - FEEDING TEAM,97750,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PT TEST & MEASURE EA 15 MIN,97750,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT  ,,,both,,,149.69,89.81,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Anthem,Indemnity,,,108.87,,108.87,77.5,119.94,percent of total billed charges,,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,Multiplan,Multiplan,,,119.94,,119.94,77.5,119.94,percent of total billed charges,,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-PT,97760,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC ORTHOTIC MGMT AND TRAINING EA 15 MINS-OT,97760,CPT,,,both,,,149.69,89.81,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT  ,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PROSTHETIC TRAINING UPPER AND/OR LOWER EXT INITIAL EA 15MIN,97761,CPT,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT O&P CK-OUT 15M,97762,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PT O&P CHECK-OUT EA 15MIN,97762,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC OT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT  ,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC PT ORTHO/PROSTETIC MGMT AND TRAINING SUBQ EA 15MIN,97763,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT  ,,,both,,,136.99,82.19,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Anthem,Indemnity,,,99.05,,99.05,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,Multiplan,Multiplan,,,109.11,,109.11,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M,97802,CPT,,,both,,,136.99,82.19,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT  ,,,both,,,136.99,82.19,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Anthem,Indemnity,,,99.05,,99.05,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,Multiplan,Multiplan,,,109.11,,109.11,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (FIT5),97802,CPT,,,both,,,136.99,82.19,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT  ,,,both,,,136.19,81.71,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Anthem,Indemnity,,,99.05,,99.05,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,Multiplan,Multiplan,,,109.11,,109.11,70.51,109.11,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (FT),97802,CPT,,,both,,,136.19,81.71,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (INTAKE ANA),97802,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,116.41,,,116.41,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,104.77,,,104.77,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,83.33,128.95,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,83.33,,,83.33,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,101.73,,,101.73,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,128.95,83.33,128.95,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (KETO DIET),97802,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,104.69,,,104.69,83.33,128.95,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (SM CLASS),97802,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT  ,,,both,,,81.03,48.62,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Anthem,Indemnity,,,58.93,,58.93,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,Multiplan,Multiplan,,,64.92,,64.92,41.96,64.92,percent of total billed charges,,
HC INIT NUTRITION THERAPY; EACH 15M (SM),97802,CPT,,,both,,,81.03,48.62,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT  ,,,both,,,41.79,25.07,Aetna,Commerical,,30.23,,,30.23,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Aetna,Middlesex Employees,,27.2,,,27.2,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Anthem,Commerical,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Anthem,Indemnity,,,30.39,,30.39,21.63,33.48,percent of total billed charges,,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Anthem,State Preferred,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Anthem,Individual Exchange,,21.63,,,21.63,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Cigna,Cigna,,26.42,,,26.42,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Connecticare,Commerical,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Connecticare,Exchange,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,Multiplan,Multiplan,,,33.48,,33.48,21.63,33.48,percent of total billed charges,,
HC NUTR CNSG PT TEAM,97803,CPT,,,both,,,41.79,25.07,United Healthcare/Oxford,United Healthcare/Oxford,,27.18,,,27.18,21.63,33.48,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT  ,,,both,,,115.36,69.22,Aetna,Commerical,,83.85,,,83.85,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Aetna,Middlesex Employees,,75.47,,,75.47,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Anthem,Commerical,,75.03,,,75.03,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Anthem,Indemnity,,,84.31,,84.31,60.02,92.88,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Anthem,State Preferred,,75.03,,,75.03,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Anthem,Individual Exchange,,60.02,,,60.02,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Cigna,Cigna,,73.28,,,73.28,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Connecticare,Commerical,,78.37,,,78.37,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Connecticare,Exchange,,78.37,,,78.37,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,Multiplan,Multiplan,,,92.88,,92.88,60.02,92.88,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M,97803,CPT,,,both,,,115.36,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,75.41,,,75.41,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,41.96,64.92,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,41.96,64.92,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M  (SM),97803,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT  ,,,both,,,115.36,69.22,Aetna,Commerical,,83.85,,,83.85,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Aetna,Middlesex Employees,,75.47,,,75.47,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Anthem,Commerical,,75.03,,,75.03,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Anthem,Indemnity,,,84.31,,84.31,60.02,92.88,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Anthem,State Preferred,,75.03,,,75.03,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Anthem,Individual Exchange,,60.02,,,60.02,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Cigna,Cigna,,73.28,,,73.28,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Connecticare,Commerical,,78.37,,,78.37,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Connecticare,Exchange,,78.37,,,78.37,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,Multiplan,Multiplan,,,92.88,,92.88,60.02,92.88,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (FIT5),97803,CPT,,,both,,,115.36,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,75.41,,,75.41,60.02,92.88,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT  ,,,both,,,160.68,96.41,Aetna,Commerical,,116.41,,,116.41,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Aetna,Middlesex Employees,,104.77,,,104.77,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Anthem,Commerical,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Anthem,Indemnity,,,117.06,,117.06,83.33,128.95,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Anthem,State Preferred,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Anthem,Individual Exchange,,83.33,,,83.33,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Cigna,Cigna,,101.73,,,101.73,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Connecticare,Commerical,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Connecticare,Exchange,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,Multiplan,Multiplan,,,128.95,,128.95,83.33,128.95,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (KETO DIET),97803,CPT,,,both,,,160.68,96.41,United Healthcare/Oxford,United Healthcare/Oxford,,104.69,,,104.69,83.33,128.95,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT  ,,,both,,,80.34,48.2,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Anthem,Indemnity,,,58.93,,58.93,41.96,64.92,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,Multiplan,Multiplan,,,64.92,,64.92,41.96,64.92,percent of total billed charges,,
HC RE-ASSESS NUTRITION THER; EA 15M (NUTR CNSLG),97803,CPT,,,both,,,80.34,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,46.41,,,46.41,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,41.77,,,41.77,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.22,,,33.22,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,40.55,,,40.55,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M,97804,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,41.74,,,41.74,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,46.41,,,46.41,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,41.77,,,41.77,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.22,,,33.22,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,40.55,,,40.55,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M (FIT5),97804,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,41.74,,,41.74,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT  ,,,both,,,64.89,38.93,Aetna,Commerical,,46.41,,,46.41,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Aetna,Middlesex Employees,,41.77,,,41.77,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Anthem,Commerical,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Anthem,Indemnity,,,46.66,,46.66,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Anthem,State Preferred,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Anthem,Individual Exchange,,33.22,,,33.22,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Cigna,Cigna,,40.55,,,40.55,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Connecticare,Commerical,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Connecticare,Exchange,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,Multiplan,Multiplan,,,51.4,,51.4,33.22,51.4,percent of total billed charges,,
HC GRP NUTRITION THERAPY; EA 30M (FT),97804,CPT,,,both,,,64.89,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,41.74,,,41.74,33.22,51.4,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT  ,,,both,,,56.65,33.99,Aetna,Commerical,,40.59,,,40.59,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,36.53,,,36.53,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.82,,40.82,29.05,44.97,percent of total billed charges,,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.05,,,29.05,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,35.47,,,35.47,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.97,,44.97,29.05,44.97,percent of total billed charges,,
HC SELF-MGMT EDUC & TRAIN 1 PT EA 30MIN,98960,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,36.5,,,36.5,29.05,44.97,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT  ,,,both,,,34.1,20.46,Aetna,Commerical,,18.74,,,18.74,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Aetna,Middlesex Employees,,16.86,,,16.86,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Anthem,Commerical,,22.25,,,22.25,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Anthem,Indemnity,,,24.81,,24.81,4.98,27.33,percent of total billed charges,,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Anthem,State Preferred,,4.98,,,4.98,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Anthem,Individual Exchange,,17.8,,,17.8,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Cigna,Cigna,,25.58,,,25.58,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Connecticare,Commerical,,23.81,,,23.81,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Connecticare,Exchange,,23.81,,,23.81,4.98,27.33,other,Could be inpatient or outpatient,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,Multiplan,Multiplan,,,27.33,,27.33,4.98,27.33,percent of total billed charges,,
HC SPECIMEN HANDLING PT-LAB,99001,CPT,,,both,,,34.1,20.46,United Healthcare/Oxford,United Healthcare/Oxford,,20.78,,,20.78,4.98,27.33,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT  ,,,both,,,530.45,318.27,Aetna,Commerical,,383.44,,,383.44,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Aetna,Middlesex Employees,,345.09,,,345.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Anthem,Commerical,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Anthem,Indemnity,,,385.54,,385.54,274.47,424.73,percent of total billed charges,,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Anthem,State Preferred,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Anthem,Individual Exchange,,274.47,,,274.47,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Cigna,Cigna,,335.07,,,335.07,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Connecticare,Commerical,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Connecticare,Exchange,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,Multiplan,Multiplan,,,424.73,,424.73,274.47,424.73,percent of total billed charges,,
HC SEDATION 30MN <5,99143,CPT,,,both,,,530.45,318.27,United Healthcare/Oxford,United Healthcare/Oxford,,344.83,,,344.83,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT  ,,,both,,,504.7,302.82,Aetna,Commerical,,365.53,,,365.53,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Aetna,Middlesex Employees,,328.98,,,328.98,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Anthem,Commerical,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Anthem,Indemnity,,,367.53,,367.53,261.65,404.89,percent of total billed charges,,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Anthem,State Preferred,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Anthem,Individual Exchange,,261.65,,,261.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Cigna,Cigna,,319.42,,,319.42,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Connecticare,Commerical,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Connecticare,Exchange,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,Multiplan,Multiplan,,,404.89,,404.89,261.65,404.89,percent of total billed charges,,
HC SEDATION 30MN >5,99144,CPT,,,both,,,504.7,302.82,United Healthcare/Oxford,United Healthcare/Oxford,,328.72,,,328.72,261.65,404.89,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT  ,,,both,,,253.38,152.03,Aetna,Commerical,,183.17,,,183.17,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Aetna,Middlesex Employees,,164.85,,,164.85,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Anthem,Commerical,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Anthem,Indemnity,,,184.17,,184.17,131.11,202.9,percent of total billed charges,,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Anthem,State Preferred,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Anthem,Individual Exchange,,131.11,,,131.11,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Cigna,Cigna,,160.07,,,160.07,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Connecticare,Commerical,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Connecticare,Exchange,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,Multiplan,Multiplan,,,202.9,,202.9,131.11,202.9,percent of total billed charges,,
HC SED EACH ADD 15MN,99145,CPT,,,both,,,253.38,152.03,United Healthcare/Oxford,United Healthcare/Oxford,,164.73,,,164.73,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT  ,,,both,,,525.3,315.18,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Anthem,Indemnity,,,382.27,,382.27,272.14,421.12,percent of total billed charges,,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC SED 2MD 30MN <5,99148,CPT,,,both,,,525.3,315.18,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT  ,,,both,,,530.11,318.07,Aetna,Commerical,,383.44,,,383.44,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Aetna,Middlesex Employees,,345.09,,,345.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Anthem,Commerical,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Anthem,Indemnity,,,385.54,,385.54,274.47,424.73,percent of total billed charges,,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Anthem,State Preferred,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Anthem,Individual Exchange,,274.47,,,274.47,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Cigna,Cigna,,335.07,,,335.07,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Connecticare,Commerical,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Connecticare,Exchange,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,Multiplan,Multiplan,,,424.73,,424.73,274.47,424.73,percent of total billed charges,,
HC SEDATN<5YR 1ST 30,99148,CPT,,,both,,,530.11,318.07,United Healthcare/Oxford,United Healthcare/Oxford,,344.83,,,344.83,274.47,424.73,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT  ,,,both,,,504.7,302.82,Aetna,Commerical,,365.53,,,365.53,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Aetna,Middlesex Employees,,328.98,,,328.98,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Anthem,Commerical,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Anthem,Indemnity,,,367.53,,367.53,261.65,404.89,percent of total billed charges,,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Anthem,State Preferred,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Anthem,Individual Exchange,,261.65,,,261.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Cigna,Cigna,,319.42,,,319.42,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Connecticare,Commerical,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Connecticare,Exchange,,341.65,,,341.65,261.65,404.89,other,Could be inpatient or outpatient,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,Multiplan,Multiplan,,,404.89,,404.89,261.65,404.89,percent of total billed charges,,
HC SED 2MD 30MN >5,99149,CPT,,,both,,,504.7,302.82,United Healthcare/Oxford,United Healthcare/Oxford,,328.72,,,328.72,261.65,404.89,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT  ,,,both,,,530.11,318.07,Aetna,Commerical,,383.44,,,383.44,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Aetna,Middlesex Employees,,345.09,,,345.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Anthem,Commerical,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Anthem,Indemnity,,,385.54,,385.54,274.47,424.73,percent of total billed charges,,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Anthem,State Preferred,,343.09,,,343.09,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Anthem,Individual Exchange,,274.47,,,274.47,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Cigna,Cigna,,335.07,,,335.07,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Connecticare,Commerical,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Connecticare,Exchange,,358.39,,,358.39,274.47,424.73,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,Multiplan,Multiplan,,,424.73,,424.73,274.47,424.73,percent of total billed charges,,
HC SEDATN>5YR 1ST 30,99149,CPT,,,both,,,530.11,318.07,United Healthcare/Oxford,United Healthcare/Oxford,,344.83,,,344.83,274.47,424.73,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT  ,,,both,,,253.38,152.03,Aetna,Commerical,,183.17,,,183.17,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Aetna,Middlesex Employees,,164.85,,,164.85,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Anthem,Commerical,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Anthem,Indemnity,,,184.17,,184.17,131.11,202.9,percent of total billed charges,,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Anthem,State Preferred,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Anthem,Individual Exchange,,131.11,,,131.11,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Cigna,Cigna,,160.07,,,160.07,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Connecticare,Commerical,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Connecticare,Exchange,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,Multiplan,Multiplan,,,202.9,,202.9,131.11,202.9,percent of total billed charges,,
HC SED 2MD EAADD 15M,99150,CPT,,,both,,,253.38,152.03,United Healthcare/Oxford,United Healthcare/Oxford,,164.73,,,164.73,131.11,202.9,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT  ,,,both,,,265.62,159.37,Aetna,Commerical,,192.13,,,192.13,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Aetna,Middlesex Employees,,172.92,,,172.92,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Anthem,Commerical,,171.91,,,171.91,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Anthem,Indemnity,,,193.18,,193.18,137.53,212.81,percent of total billed charges,,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Anthem,State Preferred,,171.91,,,171.91,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Anthem,Individual Exchange,,137.53,,,137.53,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Cigna,Cigna,,167.89,,,167.89,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Connecticare,Commerical,,179.58,,,179.58,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Connecticare,Exchange,,179.58,,,179.58,137.53,212.81,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,Multiplan,Multiplan,,,212.81,,212.81,137.53,212.81,percent of total billed charges,,
HC SEDATION ADD 15MN,99150,CPT,,,both,,,265.62,159.37,United Healthcare/Oxford,United Healthcare/Oxford,,172.78,,,172.78,137.53,212.81,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT  ,,,both,,,546.93,328.16,Aetna,Commerical,,395.65,,,395.65,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Aetna,Middlesex Employees,,356.08,,,356.08,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Anthem,Commerical,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Anthem,Indemnity,,,397.82,,397.82,283.22,438.26,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Anthem,State Preferred,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Anthem,Individual Exchange,,283.22,,,283.22,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Cigna,Cigna,,345.74,,,345.74,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Connecticare,Commerical,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Connecticare,Exchange,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,Multiplan,Multiplan,,,438.26,,438.26,283.22,438.26,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP <5 YRS 1ST 15MIN,99151,CPT,,,both,,,546.93,328.16,United Healthcare/Oxford,United Healthcare/Oxford,,355.81,,,355.81,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT  ,,,both,,,520.15,312.09,Aetna,Commerical,,376.11,,,376.11,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Aetna,Middlesex Employees,,338.5,,,338.5,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Anthem,Commerical,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Anthem,Indemnity,,,378.18,,378.18,269.22,416.62,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Anthem,State Preferred,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Anthem,Individual Exchange,,269.22,,,269.22,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Cigna,Cigna,,328.66,,,328.66,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Connecticare,Commerical,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Connecticare,Exchange,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,Multiplan,Multiplan,,,416.62,,416.62,269.22,416.62,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP 5/>YRS 1ST 15MIN,99152,CPT,,,both,,,520.15,312.09,United Healthcare/Oxford,United Healthcare/Oxford,,338.24,,,338.24,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT  ,,,both,,,260.59,156.35,Aetna,Commerical,,188.87,,,188.87,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Aetna,Middlesex Employees,,169.98,,,169.98,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Anthem,Commerical,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Anthem,Indemnity,,,189.91,,189.91,135.19,209.21,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Anthem,State Preferred,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Anthem,Individual Exchange,,135.19,,,135.19,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Cigna,Cigna,,165.05,,,165.05,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Connecticare,Commerical,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Connecticare,Exchange,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,Multiplan,Multiplan,,,209.21,,209.21,135.19,209.21,percent of total billed charges,,
HC MOD SED SAME PHYS/QHP EA ADDL 15MIN,99153,CPT,,,both,,,260.59,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,169.86,,,169.86,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT  ,,,both,,,540.75,324.45,Aetna,Commerical,,391.58,,,391.58,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Aetna,Middlesex Employees,,352.42,,,352.42,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Anthem,Commerical,,350.38,,,350.38,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Anthem,Indemnity,,,393.73,,393.73,280.3,433.75,percent of total billed charges,,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Anthem,State Preferred,,350.38,,,350.38,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Anthem,Individual Exchange,,280.3,,,280.3,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Cigna,Cigna,,342.18,,,342.18,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Connecticare,Commerical,,365.99,,,365.99,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Connecticare,Exchange,,365.99,,,365.99,280.3,433.75,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,Multiplan,Multiplan,,,433.75,,433.75,280.3,433.75,percent of total billed charges,,
HC MOD SED OTH PHYS/QHP <5 YRS 1ST 15MIN,99155,CPT,,,both,,,540.75,324.45,United Healthcare/Oxford,United Healthcare/Oxford,,352.16,,,352.16,280.3,433.75,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT  ,,,both,,,547,328.2,Aetna,Commerical,,395.65,,,395.65,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Aetna,Middlesex Employees,,356.08,,,356.08,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Anthem,Commerical,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Anthem,Indemnity,,,397.82,,397.82,283.22,438.26,percent of total billed charges,,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Anthem,State Preferred,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Anthem,Individual Exchange,,283.22,,,283.22,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Cigna,Cigna,,345.74,,,345.74,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Connecticare,Commerical,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Connecticare,Exchange,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,Multiplan,Multiplan,,,438.26,,438.26,283.22,438.26,percent of total billed charges,,
HC SEDATN<5YR 1ST 30,99155,CPT,,,both,,,547,328.2,United Healthcare/Oxford,United Healthcare/Oxford,,355.81,,,355.81,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT  ,,,both,,,520.15,312.09,Aetna,Commerical,,376.11,,,376.11,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Aetna,Middlesex Employees,,338.5,,,338.5,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Anthem,Commerical,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Anthem,Indemnity,,,378.18,,378.18,269.22,416.62,percent of total billed charges,,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Anthem,State Preferred,,336.53,,,336.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Anthem,Individual Exchange,,269.22,,,269.22,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Cigna,Cigna,,328.66,,,328.66,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Connecticare,Commerical,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Connecticare,Exchange,,351.53,,,351.53,269.22,416.62,other,Could be inpatient or outpatient,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,Multiplan,Multiplan,,,416.62,,416.62,269.22,416.62,percent of total billed charges,,
HC MOD SED OTH PHYS/QHP >= 5 YRS 1ST MIN,99156,CPT,,,both,,,520.15,312.09,United Healthcare/Oxford,United Healthcare/Oxford,,338.24,,,338.24,269.22,416.62,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT  ,,,both,,,547,328.2,Aetna,Commerical,,395.65,,,395.65,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Aetna,Middlesex Employees,,356.08,,,356.08,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Anthem,Commerical,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Anthem,Indemnity,,,397.82,,397.82,283.22,438.26,percent of total billed charges,,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Anthem,State Preferred,,354.02,,,354.02,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Anthem,Individual Exchange,,283.22,,,283.22,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Cigna,Cigna,,345.74,,,345.74,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Connecticare,Commerical,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Connecticare,Exchange,,369.79,,,369.79,283.22,438.26,other,Could be inpatient or outpatient,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,Multiplan,Multiplan,,,438.26,,438.26,283.22,438.26,percent of total billed charges,,
HC SEDATN>5YR 1ST 30,99156,CPT,,,both,,,547,328.2,United Healthcare/Oxford,United Healthcare/Oxford,,355.81,,,355.81,283.22,438.26,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT  ,,,both,,,260.59,156.35,Aetna,Commerical,,188.87,,,188.87,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Aetna,Middlesex Employees,,169.98,,,169.98,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Anthem,Commerical,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Anthem,Indemnity,,,189.91,,189.91,135.19,209.21,percent of total billed charges,,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Anthem,State Preferred,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Anthem,Individual Exchange,,135.19,,,135.19,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Cigna,Cigna,,165.05,,,165.05,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Connecticare,Commerical,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Connecticare,Exchange,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,Multiplan,Multiplan,,,209.21,,209.21,135.19,209.21,percent of total billed charges,,
HC MOD SED OTHER PHYS/QHP EA 15 MIN ADDIT'L,99157,CPT,,,both,,,260.59,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,169.86,,,169.86,135.19,209.21,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT  ,,,both,,,273.5,164.1,Aetna,Commerical,,197.82,,,197.82,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Aetna,Middlesex Employees,,178.04,,,178.04,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Anthem,Commerical,,177.01,,,177.01,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Anthem,Indemnity,,,198.91,,198.91,141.61,219.13,percent of total billed charges,,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Anthem,State Preferred,,177.01,,,177.01,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Anthem,Individual Exchange,,141.61,,,141.61,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Cigna,Cigna,,172.87,,,172.87,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Connecticare,Commerical,,184.9,,,184.9,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Connecticare,Exchange,,184.9,,,184.9,141.61,219.13,other,Could be inpatient or outpatient,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,Multiplan,Multiplan,,,219.13,,219.13,141.61,219.13,percent of total billed charges,,
HC SEDATION ADD 15MN,99157,CPT,,,both,,,273.5,164.1,United Healthcare/Oxford,United Healthcare/Oxford,,177.91,,,177.91,141.61,219.13,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT  ,,,both,,,134.93,80.96,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,outpatient,,,134.93,80.96,Anthem,Indemnity,,,97.41,,97.41,69.35,107.31,percent of total billed charges,,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC OCULAR SCREENING,99174,CPT,,,outpatient,,,134.93,80.96,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC OCULAR SCREENING,99174,CPT,,,both,,,134.93,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT  ,,,both,,,113.3,67.98,Aetna,Commerical,,82.23,,,82.23,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Aetna,Middlesex Employees,,74,,,74,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Anthem,Commerical,,73.57,,,73.57,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Anthem,Indemnity,,,82.67,,82.67,58.85,91.08,percent of total billed charges,,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Anthem,State Preferred,,73.57,,,73.57,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Anthem,Individual Exchange,,58.85,,,58.85,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Cigna,Cigna,,71.85,,,71.85,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Connecticare,Commerical,,76.85,,,76.85,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Connecticare,Exchange,,76.85,,,76.85,58.85,91.08,other,Could be inpatient or outpatient,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,Multiplan,Multiplan,,,91.08,,91.08,58.85,91.08,percent of total billed charges,,
HC INDUCED VOMITING,99175,CPT,,,both,,,113.3,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,73.94,,,73.94,58.85,91.08,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT  ,,,both,,,494.4,296.64,Aetna,Commerical,,357.38,,,357.38,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Aetna,Middlesex Employees,,321.64,,,321.64,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Anthem,Commerical,,319.78,,,319.78,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Anthem,Indemnity,,,359.35,,359.35,255.83,395.88,percent of total billed charges,,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Anthem,State Preferred,,319.78,,,319.78,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Anthem,Individual Exchange,,255.83,,,255.83,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Cigna,Cigna,,312.3,,,312.3,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Connecticare,Commerical,,334.03,,,334.03,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Connecticare,Exchange,,334.03,,,334.03,255.83,395.88,other,Could be inpatient or outpatient,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,Multiplan,Multiplan,,,395.88,,395.88,255.83,395.88,percent of total billed charges,,
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,99195,CPT,,,both,,,494.4,296.64,United Healthcare/Oxford,United Healthcare/Oxford,,321.4,,,321.4,255.83,395.88,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT  ,,,both,,,1702.59,1021.55,Aetna,Commerical,,1231.72,,,1231.72,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Aetna,Middlesex Employees,,1108.55,,,1108.55,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Anthem,Commerical,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Anthem,Indemnity,,,1238.48,,1238.48,881.69,1364.37,percent of total billed charges,,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Anthem,State Preferred,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Anthem,Individual Exchange,,881.69,,,881.69,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Cigna,Cigna,,1076.34,,,1076.34,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Connecticare,Commerical,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Connecticare,Exchange,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,Multiplan,Multiplan,,,1364.37,,1364.37,881.69,1364.37,percent of total billed charges,,
HC BC NEW ONSET CARE,99245,CPT,,,both,,,1702.59,1021.55,United Healthcare/Oxford,United Healthcare/Oxford,,1107.7,,,1107.7,881.69,1364.37,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT  ,,,outpatient,,,333.72,200.23,Aetna,Commerical,,,241.78,,241.78,173.07,267.83,percent of total billed charges,,
HC ER LEVEL 1,99281,CPT,,,outpatient,,,333.72,200.23,Aetna,Middlesex Employees,,,217.61,,217.61,173.07,267.83,percent of total billed charges,,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Anthem,Commerical,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,outpatient,,,333.72,200.23,Anthem,Indemnity,,,243.11,,243.11,173.07,267.83,percent of total billed charges,,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Anthem,State Preferred,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Anthem,Individual Exchange,,173.07,,,173.07,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Cigna,Cigna,,211.29,,,211.29,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Connecticare,Commerical,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,Connecticare,Exchange,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 1,99281,CPT,,,outpatient,,,333.72,200.23,Multiplan,Multiplan,,,267.83,,267.83,173.07,267.83,percent of total billed charges,,
HC ER LEVEL 1,99281,CPT,,,both,,,333.72,200.23,United Healthcare/Oxford,United Healthcare/Oxford,,217.44,,,217.44,173.07,267.83,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT  ,,,outpatient,,,640.66,384.4,Aetna,Commerical,,,463.22,,463.22,331.58,513.1,percent of total billed charges,,
HC ER LEVEL 2,99282,CPT,,,outpatient,,,640.66,384.4,Aetna,Middlesex Employees,,,416.89,,416.89,331.58,513.1,percent of total billed charges,,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Anthem,Commerical,,414.48,,,414.48,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,outpatient,,,640.66,384.4,Anthem,Indemnity,,,465.76,,465.76,331.58,513.1,percent of total billed charges,,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Anthem,State Preferred,,414.48,,,414.48,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Anthem,Individual Exchange,,331.58,,,331.58,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Cigna,Cigna,,404.78,,,404.78,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Connecticare,Commerical,,432.95,,,432.95,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,Connecticare,Exchange,,432.95,,,432.95,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 2,99282,CPT,,,outpatient,,,640.66,384.4,Multiplan,Multiplan,,,513.1,,513.1,331.58,513.1,percent of total billed charges,,
HC ER LEVEL 2,99282,CPT,,,both,,,640.66,384.4,United Healthcare/Oxford,United Healthcare/Oxford,,416.58,,,416.58,331.58,513.1,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT  ,,,outpatient,,,1353.42,812.05,Aetna,Commerical,,,979.35,,979.35,701.05,1084.82,percent of total billed charges,,
HC ER LEVEL 3,99283,CPT,,,outpatient,,,1353.42,812.05,Aetna,Middlesex Employees,,,881.42,,881.42,701.05,1084.82,percent of total billed charges,,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Anthem,Commerical,,876.3,,,876.3,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,outpatient,,,1353.42,812.05,Anthem,Indemnity,,,984.73,,984.73,701.05,1084.82,percent of total billed charges,,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Anthem,State Preferred,,876.3,,,876.3,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Anthem,Individual Exchange,,701.05,,,701.05,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Cigna,Cigna,,855.81,,,855.81,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Connecticare,Commerical,,915.36,,,915.36,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,Connecticare,Exchange,,915.36,,,915.36,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 3,99283,CPT,,,outpatient,,,1353.42,812.05,Multiplan,Multiplan,,,1084.82,,1084.82,701.05,1084.82,percent of total billed charges,,
HC ER LEVEL 3,99283,CPT,,,both,,,1353.42,812.05,United Healthcare/Oxford,United Healthcare/Oxford,,880.75,,,880.75,701.05,1084.82,other,Could be inpatient or outpatient,
HC ER LEVEL 4,99284,CPT  ,,,outpatient,,,1755.12,1053.07,Aetna,Commerical,,,1269.17,,1269.17,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Aetna,Middlesex Employees,,,1142.25,,1142.25,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Anthem,Commerical,,,1135.62,,1135.62,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Anthem,Indemnity,,,1276.14,,1276.14,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Anthem,State Preferred,,,1135.62,,1135.62,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Anthem,Individual Exchange,,,908.5,,908.5,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,both,,,1755.12,1053.07,Cigna,Cigna,,1109.06,,,1109.06,908.5,1405.85,other,Could be inpatient or outpatient,
HC ER LEVEL 4,99284,CPT,,,both,,,1755.12,1053.07,Connecticare,Commerical,,1186.23,,,1186.23,908.5,1405.85,other,Could be inpatient or outpatient,
HC ER LEVEL 4,99284,CPT,,,both,,,1755.12,1053.07,Connecticare,Exchange,,1186.23,,,1186.23,908.5,1405.85,other,Could be inpatient or outpatient,
HC ER LEVEL 4,99284,CPT,,,outpatient,,,1755.12,1053.07,Multiplan,Multiplan,,,1405.85,,1405.85,908.5,1405.85,percent of total billed charges,,
HC ER LEVEL 4,99284,CPT,,,both,,,1755.12,1053.07,United Healthcare/Oxford,United Healthcare/Oxford,,1141.38,,,1141.38,908.5,1405.85,other,Could be inpatient or outpatient,
HC ER LEVEL 5,99285,CPT  ,,,outpatient,,,2803.66,1682.2,Aetna,Commerical,,,2027.9,,2027.9,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Aetna,Middlesex Employees,,,1825.11,,1825.11,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Anthem,Commerical,,,1814.52,,1814.52,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Anthem,Indemnity,,,2039.04,,2039.04,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Anthem,State Preferred,,,1814.52,,1814.52,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Anthem,Individual Exchange,,,1451.62,,1451.62,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,both,,,2803.66,1682.2,Cigna,Cigna,,1772.08,,,1772.08,1451.62,2246.3,other,Could be inpatient or outpatient,
HC ER LEVEL 5,99285,CPT,,,both,,,2803.66,1682.2,Connecticare,Commerical,,1895.39,,,1895.39,1451.62,2246.3,other,Could be inpatient or outpatient,
HC ER LEVEL 5,99285,CPT,,,both,,,2803.66,1682.2,Connecticare,Exchange,,1895.39,,,1895.39,1451.62,2246.3,other,Could be inpatient or outpatient,
HC ER LEVEL 5,99285,CPT,,,outpatient,,,2803.66,1682.2,Multiplan,Multiplan,,,2246.3,,2246.3,1451.62,2246.3,percent of total billed charges,,
HC ER LEVEL 5,99285,CPT,,,both,,,2803.66,1682.2,United Healthcare/Oxford,United Healthcare/Oxford,,1823.73,,,1823.73,1451.62,2246.3,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT  ,,,outpatient,,,2930.35,1758.21,Aetna,Commerical,,,2119.9,,2119.9,1517.47,2348.19,percent of total billed charges,,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,outpatient,,,2930.35,1758.21,Aetna,Middlesex Employees,,,1907.91,,1907.91,1517.47,2348.19,percent of total billed charges,,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Anthem,Commerical,,1896.83,,,1896.83,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,outpatient,,,2930.35,1758.21,Anthem,Indemnity,,,2131.53,,2131.53,1517.47,2348.19,percent of total billed charges,,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Anthem,State Preferred,,1896.83,,,1896.83,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Anthem,Individual Exchange,,1517.47,,,1517.47,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Cigna,Cigna,,1852.47,,,1852.47,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Connecticare,Commerical,,1981.37,,,1981.37,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,Connecticare,Exchange,,1981.37,,,1981.37,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,outpatient,,,2930.35,1758.21,Multiplan,Multiplan,,,2348.19,,2348.19,1517.47,2348.19,percent of total billed charges,,
HC CRITICAL CARE 1ST HR ; 30-74 MIN,99291,CPT,,,both,,,2930.35,1758.21,United Healthcare/Oxford,United Healthcare/Oxford,,1906.46,,,1906.46,1517.47,2348.19,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT  ,,,outpatient,,,1465.41,879.25,Aetna,Commerical,,,1059.94,,1059.94,758.73,1174.1,percent of total billed charges,,
HC CRIT CARE +30 MIN,99292,CPT,,,outpatient,,,1465.41,879.25,Aetna,Middlesex Employees,,,953.95,,953.95,758.73,1174.1,percent of total billed charges,,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Anthem,Commerical,,948.41,,,948.41,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,outpatient,,,1465.41,879.25,Anthem,Indemnity,,,1065.77,,1065.77,758.73,1174.1,percent of total billed charges,,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Anthem,State Preferred,,948.41,,,948.41,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Anthem,Individual Exchange,,758.73,,,758.73,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Cigna,Cigna,,926.23,,,926.23,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Connecticare,Commerical,,990.68,,,990.68,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,Connecticare,Exchange,,990.68,,,990.68,758.73,1174.1,other,Could be inpatient or outpatient,
HC CRIT CARE +30 MIN,99292,CPT,,,outpatient,,,1465.41,879.25,Multiplan,Multiplan,,,1174.1,,1174.1,758.73,1174.1,percent of total billed charges,,
HC CRIT CARE +30 MIN,99292,CPT,,,both,,,1465.41,879.25,United Healthcare/Oxford,United Healthcare/Oxford,,953.23,,,953.23,758.73,1174.1,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT  ,,,both,,,2176.39,1305.83,Aetna,Commerical,,1573.64,,,1573.64,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Aetna,Middlesex Employees,,1416.27,,,1416.27,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Anthem,Commerical,,1408.06,,,1408.06,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,inpatient,,,2176.39,1305.83,Anthem,Indemnity,,,1582.28,,1582.28,1126.44,1743.11,percent of total billed charges,,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Anthem,State Preferred,,1408.06,,,1408.06,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Anthem,Individual Exchange,,1126.44,,,1126.44,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Cigna,Cigna,,1375.12,,,1375.12,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Connecticare,Commerical,,1470.81,,,1470.81,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,Connecticare,Exchange,,1470.81,,,1470.81,1126.44,1743.11,other,Could be inpatient or outpatient,
HC NEONATAL RESUS DR,99465,CPT,,,inpatient,,,2176.39,1305.83,Multiplan,Multiplan,,,1743.11,,1743.11,1126.44,1743.11,percent of total billed charges,,
HC NEONATAL RESUS DR,99465,CPT,,,both,,,2176.39,1305.83,United Healthcare/Oxford,United Healthcare/Oxford,,1415.2,,,1415.2,1126.44,1743.11,other,Could be inpatient or outpatient,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Aetna,Commerical,,7896.18,,,7896.18,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Aetna,Middlesex Employees,,7100.1,,,7100.1,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Anthem,Commerical,,4419,,,4419,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Anthem,Indemnity,,,3745.5,,3745.5,1750,7896.18,percent of total billed charges,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Anthem,State Preferred,,4419,,,4419,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Anthem,Individual Exchange,,3535.2,,,3535.2,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Cigna,Cigna,,1845,,,1845,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Connecticare,Commerical,,1750,,,1750,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Connecticare,Exchange,,1750,,,1750,1750,7896.18,per diem,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,Multiplan,Multiplan,,,4250,,4250,1750,7896.18,percent of total billed charges,,
HC R & B PSYCH,11400001,DRG,,,inpatient,,,5150,3090,United Healthcare/Oxford,United Healthcare/Oxford,,1750,,,1750,1750,7896.18,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Aetna,Commerical,,8054.1,,,8054.1,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Aetna,Middlesex Employees,,7242.12,,,7242.12,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Anthem,Commerical,,4419,,,4419,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Anthem,Indemnity,,,3745.5,,3745.5,2950,8054.1,percent of total billed charges,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Anthem,State Preferred,,4419,,,4419,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Anthem,Individual Exchange,,3535.2,,,3535.2,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Cigna,Cigna,,7765,,,7765,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Connecticare,Commerical,,3350,,,3350,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Connecticare,Exchange,,2950,,,2950,2950,8054.1,per diem,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,Multiplan,Multiplan,,,4250,,4250,2950,8054.1,percent of total billed charges,,
HC R & B MED/PSYCH,11900001,DRG,,,inpatient,,,5150,3090,United Healthcare/Oxford,United Healthcare/Oxford,,4255,,,4255,2950,8054.1,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Commerical,,7956.92,,,7956.92,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Middlesex Employees,,7154.73,,,7154.73,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Commerical,,8068,,,8068,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Indemnity,,,5730.74,,5730.74,5730.74,8985,percent of total billed charges,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,State Preferred,,8068,,,8068,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Individual Exchange,,6454.4,,,6454.4,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Cigna,Cigna,,7765,,,7765,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Commerical,,8985,,,8985,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Exchange,,8820,,,8820,5730.74,8985,per diem,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,Multiplan,Multiplan,,,6313.26,,6313.26,5730.74,8985,percent of total billed charges,,
HC R & B MED / SURG SEMI PR,12000001,DRG,,,inpatient,,,7879.5,4727.7,United Healthcare/Oxford,United Healthcare/Oxford,,8701,,,8701,5730.74,8985,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Commerical,,7520.17,,,7520.17,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Middlesex Employees,,7100.1,,,7100.1,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Commerical,,5099.73,,,5099.73,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Indemnity,,,5730.75,,5730.75,4079.78,7837,percent of total billed charges,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,State Preferred,,5099.73,,,5099.73,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Individual Exchange,,4079.78,,,4079.78,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Cigna,Cigna,,7837,,,7837,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Commerical,,5327.03,,,5327.03,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Exchange,,5327.03,,,5327.03,4079.78,7837,per diem,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,Multiplan,Multiplan,,,6313.26,,6313.26,4079.78,7837,percent of total billed charges,,
HC R & B MED / SURG REHAB,12800001,DRG,,,inpatient,,,7879.5,4727.7,United Healthcare/Oxford,United Healthcare/Oxford,,5125.62,,,5125.62,4079.78,7837,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Commerical,,5894.78,,,5894.78,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Middlesex Employees,,5300.5,,,5300.5,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Commerical,,6384,,,6384,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Indemnity,,,5311.65,,5311.65,5107.2,7214,percent of total billed charges,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Anthem,State Preferred,,6384,,,6384,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Individual Exchange,,5107.2,,,5107.2,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Cigna,Cigna,,5690,,,5690,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Commerical,,6528,,,6528,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Exchange,,6408,,,6408,5107.2,7214,per diem,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,Multiplan,Multiplan,,,5851.55,,5851.55,5107.2,7214,percent of total billed charges,,
HC R & B NICU LEVEL I,17100001,DRG,,,inpatient,,,7304.76,4382.86,United Healthcare/Oxford,United Healthcare/Oxford,,7214,,,7214,5107.2,7214,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Commerical,,7859.74,,,7859.74,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Middlesex Employees,,7067.33,,,7067.33,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Commerical,,7160,,,7160,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Indemnity,,,5311.65,,5311.65,5311.65,8692,percent of total billed charges,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,State Preferred,,7160,,,7160,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Individual Exchange,,5728,,,5728,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Cigna,Cigna,,7366,,,7366,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Commerical,,8692,,,8692,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Exchange,,8533,,,8533,5311.65,8692,per diem,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,Multiplan,Multiplan,,,5851.55,,5851.55,5311.65,8692,percent of total billed charges,,
HC R & B NICU LEVEL II,17200002,DRG,,,inpatient,,,7304.76,4382.86,United Healthcare/Oxford,United Healthcare/Oxford,,8296,,,8296,5311.65,8692,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Aetna,Commerical,,7859.74,,,7859.74,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Aetna,Middlesex Employees,,7067.33,,,7067.33,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Anthem,Commerical,,7924,,,7924,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Anthem,Indemnity,,,6197.33,,6197.33,5542.93,8761.5,percent of total billed charges,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Anthem,State Preferred,,7924,,,7924,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Anthem,Individual Exchange,,6339.2,,,6339.2,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Cigna,Cigna,,8399,,,8399,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Connecticare,Commerical,,8761.5,,,8761.5,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Connecticare,Exchange,,8529.27,,,8529.27,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,Multiplan,Multiplan,,,6827.26,,6827.26,5542.93,8761.5,percent of total billed charges,,
HC R & B NICU LEVEL 3,17300001,DRG,,,inpatient,,,8521.19,5112.71,United Healthcare/Oxford,United Healthcare/Oxford,,5542.93,,,5542.93,5542.93,8761.5,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Commerical,,5894.78,,,5894.78,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Middlesex Employees,,5300.5,,,5300.5,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Commerical,,6384,,,6384,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Indemnity,,,5311.65,,5311.65,4750.77,6384,percent of total billed charges,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,State Preferred,,6384,,,6384,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Individual Exchange,,5107.2,,,5107.2,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Cigna,Cigna,,5690,,,5690,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Commerical,,6360.83,,,6360.83,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Exchange,,6360.83,,,6360.83,4750.77,6384,per diem,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,Multiplan,Multiplan,,,5851.55,,5851.55,4750.77,6384,percent of total billed charges,,
HC R & B NICU LEVEL 1,17300002,DRG,,,inpatient,,,7304.76,4382.86,United Healthcare/Oxford,United Healthcare/Oxford,,4750.77,,,4750.77,4750.77,6384,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Commerical,,7859.74,,,7859.74,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Aetna,Middlesex Employees,,7067.33,,,7067.33,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Commerical,,7160,,,7160,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Indemnity,,,5311.65,,5311.65,4750.77,8469.41,percent of total billed charges,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Anthem,State Preferred,,7160,,,7160,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Anthem,Individual Exchange,,5728,,,5728,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Cigna,Cigna,,7366,,,7366,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Commerical,,8469.41,,,8469.41,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Connecticare,Exchange,,8469.41,,,8469.41,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,Multiplan,Multiplan,,,5851.55,,5851.55,4750.77,8469.41,percent of total billed charges,,
HC R & B NICU LEVEL 2,17300004,DRG,,,inpatient,,,7304.76,4382.86,United Healthcare/Oxford,United Healthcare/Oxford,,4750.77,,,4750.77,4750.77,8469.41,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Aetna,Commerical,,9038.69,,,9038.69,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Aetna,Middlesex Employees,,8127.44,,,8127.44,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Anthem,Commerical,,8497,,,8497,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Anthem,Indemnity,,,8144.69,,8144.69,6797.6,10080,percent of total billed charges,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Anthem,State Preferred,,8497,,,8497,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Anthem,Individual Exchange,,6797.6,,,6797.6,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Cigna,Cigna,,10080,,,10080,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Connecticare,Commerical,,9807,,,9807,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Connecticare,Exchange,,9627,,,9627,6797.6,10080,per diem,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,Multiplan,Multiplan,,,8972.57,,8972.57,6797.6,10080,percent of total billed charges,,
HC R & B NICU LEVEL 4,17400001,DRG,,,inpatient,,,11199.19,6719.51,United Healthcare/Oxford,United Healthcare/Oxford,,9560,,,9560,6797.6,10080,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Aetna,Commerical,,7896.18,,,7896.18,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Aetna,Middlesex Employees,,7100.1,,,7100.1,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Anthem,Commerical,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Anthem,Indemnity,,,4317.72,,4317.72,4317.72,7615.49,percent of total billed charges,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Anthem,State Preferred,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Anthem,Individual Exchange,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Cigna,Cigna,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Connecticare,Commerical,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Connecticare,Exchange,,,,,,4317.72,7615.49,per diem,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,Multiplan,Multiplan,,,4756.6,,4756.6,4317.72,7615.49,percent of total billed charges,,
HC R & B MED / SURG SUBACUTE,19000001,DRG,,,inpatient,,,5936.92,3562.15,United Healthcare/Oxford,United Healthcare/Oxford,,5175.75,,,5175.75,4317.72,7615.49,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Aetna,Commerical,,8742.54,,,8742.54,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Aetna,Middlesex Employees,,7861.13,,,7861.13,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Anthem,Commerical,,8986,,,8986,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Anthem,Indemnity,,,9295.59,,9295.59,7188.8,10285,percent of total billed charges,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Anthem,State Preferred,,8986,,,8986,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Anthem,Individual Exchange,,7188.8,,,7188.8,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Cigna,Cigna,,10285,,,10285,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Connecticare,Commerical,,9948,,,9948,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Connecticare,Exchange,,9766,,,9766,7188.8,10285,per diem,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,Multiplan,Multiplan,,,10240.44,,10240.44,7188.8,10285,percent of total billed charges,,
HC R & B ICU,20300001,DRG,,,inpatient,,,12781.27,7668.76,United Healthcare/Oxford,United Healthcare/Oxford,,9033,,,9033,7188.8,10285,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Commerical,,7896.18,,,7896.18,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Middlesex Employees,,7100.1,,,7100.1,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Commerical,,,,,,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Indemnity,,,5730.47,,5730.47,5730.47,8685.12,percent of total billed charges,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,State Preferred,,,,,,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Individual Exchange,,,,,,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Cigna,Cigna,,7266,,,7266,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Commerical,,8685.12,,,8685.12,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Exchange,,8685.12,,,8685.12,5730.47,8685.12,per diem,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,Multiplan,Multiplan,,,6312.95,,6312.95,5730.47,8685.12,percent of total billed charges,,
HC R & B ADULT STEP DOWN,20600001,DRG,,,inpatient,,,7879.5,4727.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5730.47,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Aetna,Commerical,,7896.18,,,7896.18,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Aetna,Middlesex Employees,,7100.1,,,7100.1,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Anthem,Commerical,,,,,,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Anthem,Indemnity,,,7513.58,,7513.58,7100.1,8685.12,percent of total billed charges,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Anthem,State Preferred,,,,,,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Anthem,Individual Exchange,,,,,,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Cigna,Cigna,,7196.8,,,7196.8,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Connecticare,Commerical,,8685.12,,,8685.12,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Connecticare,Exchange,,8685.12,,,8685.12,7100.1,8685.12,per diem,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,Multiplan,Multiplan,,,8277.3,,8277.3,7100.1,8685.12,percent of total billed charges,,
HC R & B TELEMETRY,20600005,DRG,,,inpatient,,,10330.9,6198.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7100.1,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Commerical,,5699.46,,,5699.46,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Aetna,Middlesex Employees,,5129.52,,,5129.52,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Commerical,,5099.73,,,5099.73,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Indemnity,,,5730.75,,5730.75,4079.78,8685.12,percent of total billed charges,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,State Preferred,,5099.73,,,5099.73,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Anthem,Individual Exchange,,4079.78,,,4079.78,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Cigna,Cigna,,4980.46,,,4980.46,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Commerical,,8685.12,,,8685.12,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Connecticare,Exchange,,8685.12,,,8685.12,4079.78,8685.12,per diem,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,Multiplan,Multiplan,,,6313.26,,6313.26,4079.78,8685.12,percent of total billed charges,,
HC R & B DISCHARGE DELAY DAY,22400001,DRG,,,inpatient,,,7879.5,4727.7,United Healthcare/Oxford,United Healthcare/Oxford,,5125.62,,,5125.62,4079.78,8685.12,per diem,,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS ,,,both,,,128.75,77.25,Aetna,Commerical,,95.25,,,95.25,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Aetna,Middlesex Employees,,85.73,,,85.73,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Anthem,Commerical,,85.22,,,85.22,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Anthem,Indemnity,,,92.99,,92.99,68.18,105.51,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Anthem,State Preferred,,85.22,,,85.22,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Anthem,Individual Exchange,,68.18,,,68.18,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Cigna,Cigna,,83.23,,,83.23,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Connecticare,Commerical,,89.03,,,89.03,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Connecticare,Exchange,,89.03,,,89.03,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,Multiplan,Multiplan,,,105.51,,105.51,68.18,105.51,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 0 - 150,25000006,HCPCS,,,both,,,128.75,77.25,United Healthcare/Oxford,United Healthcare/Oxford,,85.65,,,85.65,68.18,105.51,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS ,,,both,,,246.17,147.7,Aetna,Commerical,,183.17,,,183.17,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Aetna,Middlesex Employees,,164.85,,,164.85,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Anthem,Commerical,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Anthem,Indemnity,,,178.81,,178.81,131.11,202.9,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Anthem,State Preferred,,163.89,,,163.89,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Anthem,Individual Exchange,,131.11,,,131.11,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Cigna,Cigna,,160.07,,,160.07,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Connecticare,Commerical,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Connecticare,Exchange,,171.2,,,171.2,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,Multiplan,Multiplan,,,202.9,,202.9,131.11,202.9,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 150 - 300,25000007,HCPCS,,,both,,,246.17,147.7,United Healthcare/Oxford,United Healthcare/Oxford,,164.73,,,164.73,131.11,202.9,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS ,,,both,,,368.74,221.24,Aetna,Commerical,,275.17,,,275.17,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Aetna,Middlesex Employees,,247.65,,,247.65,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Anthem,Commerical,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Anthem,Indemnity,,,268.61,,268.61,196.96,304.79,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Anthem,State Preferred,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Anthem,Individual Exchange,,196.96,,,196.96,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,Multiplan,Multiplan,,,304.79,,304.78,196.96,304.79,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 300 - 450,25000008,HCPCS,,,both,,,368.74,221.24,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS ,,,both,,,492.34,295.4,Aetna,Commerical,,366.34,,,366.34,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Aetna,Middlesex Employees,,329.71,,,329.71,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Anthem,Commerical,,327.79,,,327.79,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Anthem,Indemnity,,,357.63,,357.63,262.24,405.8,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Anthem,State Preferred,,327.79,,,327.79,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Anthem,Individual Exchange,,262.24,,,262.24,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Cigna,Cigna,,320.12,,,320.12,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Connecticare,Commerical,,342.4,,,342.4,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Connecticare,Exchange,,342.4,,,342.4,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,Multiplan,Multiplan,,,405.8,,405.8,262.24,405.8,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 450 - 600,25000009,HCPCS,,,both,,,492.34,295.4,United Healthcare/Oxford,United Healthcare/Oxford,,329.46,,,329.46,262.24,405.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS ,,,both,,,613.88,368.33,Aetna,Commerical,,457.52,,,457.52,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Aetna,Middlesex Employees,,411.77,,,411.77,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Anthem,Commerical,,409.37,,,409.37,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Anthem,Indemnity,,,446.64,,446.64,327.49,506.8,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Anthem,State Preferred,,409.37,,,409.37,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Anthem,Individual Exchange,,327.49,,,327.49,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Cigna,Cigna,,399.81,,,399.81,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Connecticare,Commerical,,427.62,,,427.62,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Connecticare,Exchange,,427.62,,,427.62,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,Multiplan,Multiplan,,,506.8,,506.8,327.49,506.8,percent of total billed charges,,
HC HH CONTRACTED PHARMACY 600 - 750,25000010,HCPCS,,,both,,,613.88,368.33,United Healthcare/Oxford,United Healthcare/Oxford,,411.45,,,411.45,327.49,506.8,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS ,,,both,,,738.51,443.11,Aetna,Commerical,,550.32,,,550.32,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Aetna,Middlesex Employees,,495.29,,,495.29,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Anthem,Commerical,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Anthem,Indemnity,,,537.23,,537.23,393.94,609.59,percent of total billed charges,,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Anthem,State Preferred,,492.42,,,492.42,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Anthem,Individual Exchange,,393.94,,,393.94,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Cigna,Cigna,,480.91,,,480.91,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Connecticare,Commerical,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Connecticare,Exchange,,514.37,,,514.37,393.94,609.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,Multiplan,Multiplan,,,609.59,,609.59,393.94,609.59,percent of total billed charges,,
HC HH CONTRACTED PHARMACY  750 - 900,25000011,HCPCS,,,both,,,738.51,443.11,United Healthcare/Oxford,United Healthcare/Oxford,,494.92,,,494.92,393.94,609.59,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS ,,,both,,,2.16,1.3,Aetna,Commerical,,1.61,,,1.61,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Aetna,Middlesex Employees,,1.45,,,1.45,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Anthem,Commerical,,1.44,,,1.44,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Anthem,Indemnity,,,1.57,,1.57,1.15,1.79,percent of total billed charges,,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Anthem,State Preferred,,1.44,,,1.44,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Anthem,Individual Exchange,,1.15,,,1.15,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Cigna,Cigna,,1.4,,,1.4,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Connecticare,Commerical,,1.51,,,1.51,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Connecticare,Exchange,,1.51,,,1.51,1.15,1.79,other,Could be inpatient or outpatient,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,Multiplan,Multiplan,,,1.79,,1.79,1.15,1.79,percent of total billed charges,,
HC GADOBUTROL 1MMOL/ML SOLN,25000013,HCPCS,,,both,,,2.16,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.15,1.79,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Aetna,Commerical,,10.06,,,10.06,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Aetna,Middlesex Employees,,9.05,,,9.05,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Anthem,Commerical,,9,,,9,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Anthem,Indemnity,,,9.561390291,,9.561390291,7.2,11.14,percent of total billed charges,,11.14
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Anthem,State Preferred,,9,,,9,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Anthem,Individual Exchange,,7.2,,,7.2,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Cigna,Cigna,,8.79,,,8.79,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Connecticare,Commerical,,9.4,,,9.4,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Connecticare,Exchange,,9.4,,,9.4,7.2,11.14,other,Could be inpatient or outpatient,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,Multiplan,Multiplan,,,10.81893204,,10.81893204,7.2,10.81893204,percent of total billed charges,,
HC ELECTRODES,27000013,RC,,,both,,,12.72815534,7.87,United Healthcare/Oxford,United Healthcare/Oxford,,9.05,,,9.05,7.2,11.14,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Aetna,Commerical,,43.96,,,43.96,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Aetna,Middlesex Employees,,39.56,,,39.56,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Anthem,Indemnity,,,43.03719612,,43.03719612,31.47,48.7,percent of total billed charges,,48.7
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,Multiplan,Multiplan,,,48.69757282,,48.69757282,31.47,48.69757282,percent of total billed charges,,
HC GURD REDOT CRTCH,27000014,RC,,,both,,,57.29126214,35.41,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Aetna,Commerical,,15.58,,,15.58,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Aetna,Middlesex Employees,,14.03,,,14.03,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Anthem,Commerical,,13.94,,,13.94,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Anthem,Indemnity,,,14.80520388,,14.80520388,11.16,17.26,percent of total billed charges,,17.26
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Anthem,State Preferred,,13.94,,,13.94,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Anthem,Individual Exchange,,11.16,,,11.16,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Cigna,Cigna,,13.61,,,13.61,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Connecticare,Commerical,,14.56,,,14.56,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Connecticare,Exchange,,14.56,,,14.56,11.16,17.26,other,Could be inpatient or outpatient,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,Multiplan,Multiplan,,,16.75242718,,16.75242718,11.16,16.75242718,percent of total billed charges,,
HC ACCUMEASURE,27000015,RC,,,both,,,19.70873786,12.18,United Healthcare/Oxford,United Healthcare/Oxford,,14.01,,,14.01,11.16,17.26,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Aetna,Commerical,,25.91,,,25.91,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Aetna,Middlesex Employees,,23.32,,,23.32,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Anthem,Commerical,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Anthem,Indemnity,,,24.62185631,,24.62185631,18.55,28.7,percent of total billed charges,,28.7
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Anthem,State Preferred,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Anthem,Individual Exchange,,18.55,,,18.55,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Cigna,Cigna,,22.64,,,22.64,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Connecticare,Commerical,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Connecticare,Exchange,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,Multiplan,Multiplan,,,27.86019417,,27.86019417,18.55,27.86019417,percent of total billed charges,,
HC CUSTOM FLANGE,27000017,RC,,,both,,,32.77669903,20.26,United Healthcare/Oxford,United Healthcare/Oxford,,23.3,,,23.3,18.55,28.7,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Aetna,Commerical,,66.76,,,66.76,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Aetna,Middlesex Employees,,60.08,,,60.08,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Anthem,Commerical,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Anthem,Indemnity,,,63.1008,,63.1008,47.79,73.94,percent of total billed charges,,73.94
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Anthem,State Preferred,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Anthem,Individual Exchange,,47.79,,,47.79,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Cigna,Cigna,,58.33,,,58.33,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Connecticare,Commerical,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Connecticare,Exchange,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,Multiplan,Multiplan,,,71.4,,71.4,47.79,71.4,percent of total billed charges,,
HC COLLAR J,27000020,RC,,,both,,,84,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,60.04,,,60.04,47.79,73.94,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Aetna,Commerical,,38,,,38,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Aetna,Middlesex Employees,,34.21,,,34.21,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Anthem,Commerical,,34,,,34,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Anthem,Indemnity,,,36.11594563,,36.11594563,27.2,42.09,percent of total billed charges,,42.09
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Anthem,State Preferred,,34,,,34,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Anthem,Individual Exchange,,27.2,,,27.2,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Cigna,Cigna,,33.21,,,33.21,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Connecticare,Commerical,,35.51,,,35.51,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Connecticare,Exchange,,35.51,,,35.51,27.2,42.09,other,Could be inpatient or outpatient,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,Multiplan,Multiplan,,,40.86601942,,40.86601942,27.2,40.86601942,percent of total billed charges,,
HC CAVILONNOSTING,27000021,RC,,,both,,,48.0776699,29.71,United Healthcare/Oxford,United Healthcare/Oxford,,34.18,,,34.18,27.2,42.09,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Aetna,Commerical,,174.21,,,174.21,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Aetna,Middlesex Employees,,156.8,,,156.8,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Anthem,Commerical,,155.88,,,155.88,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Anthem,Indemnity,,,165.264,,165.264,124.71,192.98,percent of total billed charges,,192.98
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Anthem,State Preferred,,155.88,,,155.88,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Anthem,Individual Exchange,,124.71,,,124.71,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Cigna,Cigna,,152.24,,,152.24,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Connecticare,Commerical,,162.83,,,162.83,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Connecticare,Exchange,,162.83,,,162.83,124.71,192.98,other,Could be inpatient or outpatient,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,Multiplan,Multiplan,,,187,,187,124.71,187,percent of total billed charges,,
HC CANINOICP KIT 11043,27000024,RC,,,both,,,220,135.96,United Healthcare/Oxford,United Healthcare/Oxford,,156.67,,,156.67,124.71,192.98,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Aetna,Commerical,,16.32,,,16.32,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Aetna,Middlesex Employees,,14.69,,,14.69,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Anthem,Commerical,,14.6,,,14.6,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Anthem,Indemnity,,,15.51264466,,15.51264466,11.69,18.08,percent of total billed charges,,18.08
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Anthem,State Preferred,,14.6,,,14.6,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Anthem,Individual Exchange,,11.69,,,11.69,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Cigna,Cigna,,14.26,,,14.26,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Connecticare,Commerical,,15.25,,,15.25,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Connecticare,Exchange,,15.25,,,15.25,11.69,18.08,other,Could be inpatient or outpatient,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,Multiplan,Multiplan,,,17.55291262,,17.55291262,11.69,17.55291262,percent of total billed charges,,
HC CHLORAPREP 10.5ML,27000025,RC,,,both,,,20.65048544,12.76,United Healthcare/Oxford,United Healthcare/Oxford,,14.68,,,14.68,11.69,18.08,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Aetna,Commerical,,10.33,,,10.33,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Aetna,Middlesex Employees,,9.3,,,9.3,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Anthem,Commerical,,9.24,,,9.24,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Anthem,Indemnity,,,10.10838058,,10.10838058,7.39,11.44,percent of total billed charges,,11.44
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Anthem,State Preferred,,9.24,,,9.24,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Anthem,Individual Exchange,,7.39,,,7.39,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Cigna,Cigna,,9.03,,,9.03,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Connecticare,Commerical,,9.66,,,9.66,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Connecticare,Exchange,,9.66,,,9.66,7.39,11.44,other,Could be inpatient or outpatient,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,Multiplan,Multiplan,,,11.43786408,,11.43786408,7.39,11.43786408,percent of total billed charges,,
HC CPT Code PALM CUP/ EA,27000027,RC,,,both,,,13.45631068,8.32,United Healthcare/Oxford,United Healthcare/Oxford,,9.29,,,9.29,7.39,11.44,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Aetna,Commerical,,36.28,,,36.28,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Aetna,Middlesex Employees,,32.65,,,32.65,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Anthem,Commerical,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Anthem,Indemnity,,,34.48226796,,34.48226796,25.97,40.18,percent of total billed charges,,40.18
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Anthem,State Preferred,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Anthem,Individual Exchange,,25.97,,,25.97,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Cigna,Cigna,,31.7,,,31.7,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Connecticare,Commerical,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Connecticare,Exchange,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,Multiplan,Multiplan,,,39.01747573,,39.01747573,25.97,39.01747573,percent of total billed charges,,
HC C-SPLINT/ATTACH,27000028,RC,,,both,,,45.90291262,28.37,United Healthcare/Oxford,United Healthcare/Oxford,,32.62,,,32.62,25.97,40.18,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Aetna,Commerical,,50.48,,,50.48,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Aetna,Middlesex Employees,,45.43,,,45.43,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Anthem,Commerical,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Anthem,Indemnity,,,48.0768,,48.0768,36.13,55.91,percent of total billed charges,,55.91
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Anthem,State Preferred,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Anthem,Individual Exchange,,36.13,,,36.13,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Cigna,Cigna,,44.11,,,44.11,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Connecticare,Commerical,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Connecticare,Exchange,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,Multiplan,Multiplan,,,54.4,,54.4,36.13,54.4,percent of total billed charges,,
HC D-ADAPTED UTENSIL,27000029,RC,,,both,,,64,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,45.39,,,45.39,36.13,55.91,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Aetna,Commerical,,16.44,,,16.44,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Aetna,Middlesex Employees,,14.8,,,14.8,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Anthem,Commerical,,14.72,,,14.72,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Anthem,Indemnity,,,16.09610097,,16.09610097,11.78,18.22,percent of total billed charges,,18.22
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Anthem,State Preferred,,14.72,,,14.72,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Anthem,Individual Exchange,,11.78,,,11.78,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Cigna,Cigna,,14.37,,,14.37,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Connecticare,Commerical,,15.37,,,15.37,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Connecticare,Exchange,,15.37,,,15.37,11.78,18.22,other,Could be inpatient or outpatient,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,Multiplan,Multiplan,,,18.2131068,,18.2131068,11.78,18.2131068,percent of total billed charges,,
HC PERCUSSOR NEO 110,27000030,RC,,,both,,,21.42718447,13.24,United Healthcare/Oxford,United Healthcare/Oxford,,14.79,,,14.79,11.78,18.22,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Aetna,Commerical,,341.1,,,341.1,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Aetna,Middlesex Employees,,306.99,,,306.99,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Anthem,Commerical,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Anthem,Indemnity,,,324.5184,,324.5184,244.17,377.84,percent of total billed charges,,377.84
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Anthem,State Preferred,,305.21,,,305.21,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Anthem,Individual Exchange,,244.17,,,244.17,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Cigna,Cigna,,298.07,,,298.07,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Connecticare,Commerical,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Connecticare,Exchange,,318.82,,,318.82,244.17,377.84,other,Could be inpatient or outpatient,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,Multiplan,Multiplan,,,367.2,,367.2,244.17,367.2,percent of total billed charges,,
HC SURGICAL 4X8 HEMO,27000031,RC,,,both,,,432,266.98,United Healthcare/Oxford,United Healthcare/Oxford,,306.76,,,306.76,244.17,377.84,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Aetna,Commerical,,59.43,,,59.43,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Aetna,Middlesex Employees,,53.49,,,53.49,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Anthem,Commerical,,53.18,,,53.18,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Anthem,Indemnity,,,56.34,,56.34,42.54,65.83,percent of total billed charges,,65.83
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Anthem,State Preferred,,53.18,,,53.18,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Anthem,Individual Exchange,,42.54,,,42.54,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Cigna,Cigna,,51.93,,,51.93,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Connecticare,Commerical,,55.55,,,55.55,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Connecticare,Exchange,,55.55,,,55.55,42.54,65.83,other,Could be inpatient or outpatient,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,Multiplan,Multiplan,,,63.75,,63.75,42.54,63.75,percent of total billed charges,,
HC D-SPLINT,27000032,RC,,,both,,,75,46.35,United Healthcare/Oxford,United Healthcare/Oxford,,53.45,,,53.45,42.54,65.83,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Aetna,Commerical,,20.47,,,20.47,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Aetna,Middlesex Employees,,18.42,,,18.42,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Anthem,Commerical,,18.32,,,18.32,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Anthem,Indemnity,,,19.45826796,,19.45826796,14.66,22.68,percent of total billed charges,,22.68
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Anthem,State Preferred,,18.32,,,18.32,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Anthem,Individual Exchange,,14.66,,,14.66,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Cigna,Cigna,,17.89,,,17.89,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Connecticare,Commerical,,19.14,,,19.14,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Connecticare,Exchange,,19.14,,,19.14,14.66,22.68,other,Could be inpatient or outpatient,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,Multiplan,Multiplan,,,22.01747573,,22.01747573,14.66,22.01747573,percent of total billed charges,,
HC AQUACEL AG 4X4 #311811,27000033,RC,,,both,,,25.90291262,16.01,United Healthcare/Oxford,United Healthcare/Oxford,,18.42,,,18.42,14.66,22.68,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Aetna,Commerical,,28.5,,,28.5,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Aetna,Middlesex Employees,,25.65,,,25.65,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Anthem,Commerical,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Anthem,Indemnity,,,27.08695922,,27.08695922,20.4,31.57,percent of total billed charges,,31.57
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Anthem,State Preferred,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Anthem,Individual Exchange,,20.4,,,20.4,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Cigna,Cigna,,24.91,,,24.91,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Connecticare,Commerical,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Connecticare,Exchange,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,Multiplan,Multiplan,,,30.64951456,,30.64951456,20.4,30.64951456,percent of total billed charges,,
HC ECG,27000034,RC,,,both,,,36.05825243,22.29,United Healthcare/Oxford,United Healthcare/Oxford,,25.64,,,25.64,20.4,31.57,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Aetna,Commerical,,79.78,,,79.78,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Aetna,Middlesex Employees,,71.8,,,71.8,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Anthem,Commerical,,71.38,,,71.38,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Anthem,Indemnity,,,75.8712,,75.8712,57.11,88.37,percent of total billed charges,,88.37
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Anthem,State Preferred,,71.38,,,71.38,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Anthem,Individual Exchange,,57.11,,,57.11,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Cigna,Cigna,,69.72,,,69.72,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Connecticare,Commerical,,74.57,,,74.57,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Connecticare,Exchange,,74.57,,,74.57,57.11,88.37,other,Could be inpatient or outpatient,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,Multiplan,Multiplan,,,85.85,,85.85,57.11,85.85,percent of total billed charges,,
HC E-SPLINT,27000035,RC,,,both,,,101,62.42,United Healthcare/Oxford,United Healthcare/Oxford,,71.75,,,71.75,57.11,88.37,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Aetna,Commerical,,108.27,,,108.27,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Aetna,Middlesex Employees,,97.44,,,97.44,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Anthem,Commerical,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Anthem,Indemnity,,,102.9144,,102.9144,77.5,119.94,percent of total billed charges,,119.94
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Anthem,State Preferred,,96.88,,,96.88,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Anthem,Individual Exchange,,77.5,,,77.5,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Cigna,Cigna,,94.62,,,94.62,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Connecticare,Commerical,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Connecticare,Exchange,,101.2,,,101.2,77.5,119.94,other,Could be inpatient or outpatient,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,Multiplan,Multiplan,,,116.45,,116.45,77.5,116.45,percent of total billed charges,,
HC F-SPLINT,27000036,RC,,,both,,,137,84.67,United Healthcare/Oxford,United Healthcare/Oxford,,97.38,,,97.38,77.5,119.94,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Aetna,Commerical,,67.57,,,67.57,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Aetna,Middlesex Employees,,60.81,,,60.81,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Anthem,Commerical,,60.46,,,60.46,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Anthem,Indemnity,,,63.852,,63.852,48.38,74.84,percent of total billed charges,,74.84
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Anthem,State Preferred,,60.46,,,60.46,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Anthem,Individual Exchange,,48.38,,,48.38,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Cigna,Cigna,,59.04,,,59.04,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Connecticare,Commerical,,63.15,,,63.15,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Connecticare,Exchange,,63.15,,,63.15,48.38,74.84,other,Could be inpatient or outpatient,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,Multiplan,Multiplan,,,72.25,,72.25,48.38,72.25,percent of total billed charges,,
HC AQUACELL,27000037,RC,,,both,,,85,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,60.77,,,60.77,48.38,74.84,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Aetna,Commerical,,50.48,,,50.48,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Aetna,Middlesex Employees,,45.43,,,45.43,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Anthem,Commerical,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Anthem,Indemnity,,,48.0768,,48.0768,36.13,55.91,percent of total billed charges,,55.91
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Anthem,State Preferred,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Anthem,Individual Exchange,,36.13,,,36.13,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Cigna,Cigna,,44.11,,,44.11,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Connecticare,Commerical,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Connecticare,Exchange,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,Multiplan,Multiplan,,,54.4,,54.4,36.13,54.4,percent of total billed charges,,
HC GEL PILLOW,27000038,RC,,,both,,,64,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,45.39,,,45.39,36.13,55.91,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Aetna,Commerical,,138.4,,,138.4,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Aetna,Middlesex Employees,,124.56,,,124.56,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Anthem,Commerical,,123.84,,,123.84,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Anthem,Indemnity,,,131.46,,131.46,99.07,153.3,percent of total billed charges,,153.3
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Anthem,State Preferred,,123.84,,,123.84,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Anthem,Individual Exchange,,99.07,,,99.07,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Cigna,Cigna,,120.94,,,120.94,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Connecticare,Commerical,,129.35,,,129.35,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Connecticare,Exchange,,129.35,,,129.35,99.07,153.3,other,Could be inpatient or outpatient,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,Multiplan,Multiplan,,,148.75,,148.75,99.07,148.75,percent of total billed charges,,
HC G-SPLINT SUPPORT,27000039,RC,,,both,,,175,108.15,United Healthcare/Oxford,United Healthcare/Oxford,,124.47,,,124.47,99.07,153.3,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Aetna,Commerical,,140.84,,,140.84,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Aetna,Middlesex Employees,,126.75,,,126.75,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Anthem,Commerical,,126.02,,,126.02,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Anthem,Indemnity,,,133.7136,,133.7136,100.82,156.01,percent of total billed charges,,156.01
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Anthem,State Preferred,,126.02,,,126.02,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Anthem,Individual Exchange,,100.82,,,100.82,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Cigna,Cigna,,123.07,,,123.07,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Connecticare,Commerical,,131.63,,,131.63,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Connecticare,Exchange,,131.63,,,131.63,100.82,156.01,other,Could be inpatient or outpatient,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,Multiplan,Multiplan,,,151.3,,151.3,100.82,151.3,percent of total billed charges,,
HC HAND SPLINT  SML - LRG,27000040,RC,,,both,,,178,110,United Healthcare/Oxford,United Healthcare/Oxford,,126.66,,,126.66,100.82,156.01,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Aetna,Commerical,,164.45,,,164.45,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Aetna,Middlesex Employees,,148.01,,,148.01,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Anthem,Commerical,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Anthem,Indemnity,,,156.2496,,156.2496,117.72,182.16,percent of total billed charges,,182.16
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Anthem,State Preferred,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Anthem,Individual Exchange,,117.72,,,117.72,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Cigna,Cigna,,143.7,,,143.7,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Connecticare,Commerical,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Connecticare,Exchange,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,Multiplan,Multiplan,,,176.8,,176.8,117.72,176.8,percent of total billed charges,,
HC H-SPLINT SUPPORT,27000041,RC,,,both,,,208,128.54,United Healthcare/Oxford,United Healthcare/Oxford,,147.89,,,147.89,117.72,182.16,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Anthem,Indemnity,,,42.8184,,42.8184,32.05,49.6,percent of total billed charges,,49.6
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,Multiplan,Multiplan,,,48.45,,48.45,32.05,48.45,percent of total billed charges,,
HC INC SPIR,27000042,RC,,,both,,,57,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Aetna,Commerical,,200.27,,,200.27,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Aetna,Middlesex Employees,,180.24,,,180.24,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Anthem,Commerical,,179.19,,,179.19,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Anthem,Indemnity,,,190.0536,,190.0536,143.35,221.83,percent of total billed charges,,221.83
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Anthem,State Preferred,,179.19,,,179.19,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Anthem,Individual Exchange,,143.35,,,143.35,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Cigna,Cigna,,175,,,175,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Connecticare,Commerical,,187.18,,,187.18,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Connecticare,Exchange,,187.18,,,187.18,143.35,221.83,other,Could be inpatient or outpatient,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,Multiplan,Multiplan,,,215.05,,215.05,143.35,215.05,percent of total billed charges,,
HC I-SPLINT SUPPORT,27000044,RC,,,both,,,253,156.35,United Healthcare/Oxford,United Healthcare/Oxford,,180.11,,,180.11,143.35,221.83,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Aetna,Commerical,,283.31,,,283.31,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Aetna,Middlesex Employees,,254.98,,,254.98,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Anthem,Commerical,,253.49,,,253.49,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Anthem,Indemnity,,,268.9296,,268.9296,202.8,313.81,percent of total billed charges,,313.81
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Anthem,State Preferred,,253.49,,,253.49,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Anthem,Individual Exchange,,202.8,,,202.8,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Cigna,Cigna,,247.56,,,247.56,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Connecticare,Commerical,,264.8,,,264.8,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Connecticare,Exchange,,264.8,,,264.8,202.8,313.81,other,Could be inpatient or outpatient,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,Multiplan,Multiplan,,,304.3,,304.3,202.8,304.3,percent of total billed charges,,
HC J-SPLINT SUPPORT,27000045,RC,,,both,,,358,221.24,United Healthcare/Oxford,United Healthcare/Oxford,,254.78,,,254.78,202.8,313.81,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Aetna,Commerical,,338.66,,,338.66,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Aetna,Middlesex Employees,,304.79,,,304.79,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Anthem,Commerical,,303.03,,,303.03,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Anthem,Indemnity,,,321.5136,,321.5136,242.42,375.13,percent of total billed charges,,375.13
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Anthem,State Preferred,,303.03,,,303.03,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Anthem,Individual Exchange,,242.42,,,242.42,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Cigna,Cigna,,295.94,,,295.94,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Connecticare,Commerical,,316.53,,,316.53,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Connecticare,Exchange,,316.53,,,316.53,242.42,375.13,other,Could be inpatient or outpatient,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,Multiplan,Multiplan,,,363.8,,363.8,242.42,363.8,percent of total billed charges,,
HC K-SPLINT SUPPORT,27000047,RC,,,both,,,428,264.5,United Healthcare/Oxford,United Healthcare/Oxford,,304.56,,,304.56,242.42,375.13,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Aetna,Commerical,,6.96,,,6.96,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Aetna,Middlesex Employees,,6.26,,,6.26,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Anthem,Commerical,,6.23,,,6.23,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Anthem,Indemnity,,,6.614935922,,6.614935922,4.99,7.71,percent of total billed charges,,7.71
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Anthem,State Preferred,,6.23,,,6.23,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Anthem,Individual Exchange,,4.99,,,4.99,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Cigna,Cigna,,6.08,,,6.08,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Connecticare,Commerical,,6.5,,,6.5,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Connecticare,Exchange,,6.5,,,6.5,4.99,7.71,other,Could be inpatient or outpatient,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,Multiplan,Multiplan,,,7.484951456,,7.484951456,4.99,7.484951456,percent of total billed charges,,
HC MASK O2,27000048,RC,,,both,,,8.805825243,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,6.26,,,6.26,4.99,7.71,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Anthem,Indemnity,,,59.3448,,59.3448,44.87,69.44,percent of total billed charges,,69.44
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,Multiplan,Multiplan,,,67.15,,67.15,44.87,67.15,percent of total billed charges,,
HC PRONGS  CPAP 0 - 4,27000049,RC,,,both,,,79,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Aetna,Commerical,,10.1,,,10.1,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Aetna,Middlesex Employees,,9.09,,,9.09,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Anthem,Commerical,,9.04,,,9.04,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Anthem,Indemnity,,,9.597856311,,9.597856311,7.22,11.19,percent of total billed charges,,11.19
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Anthem,State Preferred,,9.04,,,9.04,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Anthem,Individual Exchange,,7.22,,,7.22,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Cigna,Cigna,,8.83,,,8.83,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Connecticare,Commerical,,9.44,,,9.44,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Connecticare,Exchange,,9.44,,,9.44,7.22,11.19,other,Could be inpatient or outpatient,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,Multiplan,Multiplan,,,10.86019417,,10.86019417,7.22,10.86019417,percent of total billed charges,,
HC NASAL ASPIRATOR,27000051,RC,,,both,,,12.77669903,7.9,United Healthcare/Oxford,United Healthcare/Oxford,,9.08,,,9.08,7.22,11.19,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Aetna,Commerical,,7.82,,,7.82,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Aetna,Middlesex Employees,,7.03,,,7.03,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Anthem,Commerical,,7,,,7,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Anthem,Indemnity,,,7.431774757,,7.431774757,5.6,8.65,percent of total billed charges,,8.65
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Anthem,State Preferred,,7,,,7,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Anthem,Individual Exchange,,5.6,,,5.6,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Cigna,Cigna,,6.83,,,6.83,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Connecticare,Commerical,,7.31,,,7.31,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Connecticare,Exchange,,7.31,,,7.31,5.6,8.65,other,Could be inpatient or outpatient,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,Multiplan,Multiplan,,,8.409223301,,8.409223301,5.6,8.409223301,percent of total billed charges,,
HC NEBULIZER AEROSOL,27000052,RC,,,both,,,9.893203883,6.11,United Healthcare/Oxford,United Healthcare/Oxford,,7.02,,,7.02,5.6,8.65,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Aetna,Commerical,,87.11,,,87.11,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Aetna,Middlesex Employees,,78.4,,,78.4,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Anthem,Commerical,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Anthem,Indemnity,,,82.632,,82.632,62.36,96.49,percent of total billed charges,,96.49
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Anthem,State Preferred,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Anthem,Individual Exchange,,62.36,,,62.36,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Cigna,Cigna,,76.12,,,76.12,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Connecticare,Commerical,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Connecticare,Exchange,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,Multiplan,Multiplan,,,93.5,,93.5,62.36,93.5,percent of total billed charges,,
HC SUTUER STAPLER #480200,27000053,RC,,,both,,,110,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,78.34,,,78.34,62.36,96.49,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Aetna,Commerical,,161.19,,,161.19,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Aetna,Middlesex Employees,,145.07,,,145.07,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Anthem,Commerical,,144.23,,,144.23,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Anthem,Indemnity,,,153.2448,,153.2448,115.38,178.55,percent of total billed charges,,178.55
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Anthem,State Preferred,,144.23,,,144.23,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Anthem,Individual Exchange,,115.38,,,115.38,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Cigna,Cigna,,140.86,,,140.86,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Connecticare,Commerical,,150.66,,,150.66,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Connecticare,Exchange,,150.66,,,150.66,115.38,178.55,other,Could be inpatient or outpatient,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,Multiplan,Multiplan,,,173.4,,173.4,115.38,173.4,percent of total billed charges,,
HC OTO-RHINO/EXTRACT,27000054,RC,,,both,,,204,126.07,United Healthcare/Oxford,United Healthcare/Oxford,,144.96,,,144.96,115.38,178.55,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Aetna,Commerical,,1.85,,,1.85,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Aetna,Middlesex Employees,,1.66,,,1.66,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Anthem,Commerical,,1.66,,,1.66,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Anthem,Indemnity,,,1.757662136,,1.757662136,1.32,2.05,percent of total billed charges,,2.05
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Anthem,State Preferred,,1.66,,,1.66,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Anthem,Individual Exchange,,1.32,,,1.32,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Cigna,Cigna,,1.61,,,1.61,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Connecticare,Commerical,,1.72,,,1.72,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Connecticare,Exchange,,1.72,,,1.72,1.32,2.05,other,Could be inpatient or outpatient,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,Multiplan,Multiplan,,,1.988834951,,1.988834951,1.32,1.988834951,percent of total billed charges,,
HC PERCUSSOR LARGE,27000055,RC,,,both,,,2.339805825,1.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.66,,,1.66,1.32,2.05,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Aetna,Commerical,,8.3,,,8.3,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Aetna,Middlesex Employees,,7.47,,,7.47,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Anthem,Commerical,,7.43,,,7.43,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Anthem,Indemnity,,,7.898539806,,7.898539806,5.94,9.2,percent of total billed charges,,9.2
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Anthem,State Preferred,,7.43,,,7.43,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Anthem,Individual Exchange,,5.94,,,5.94,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Cigna,Cigna,,7.26,,,7.26,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Connecticare,Commerical,,7.76,,,7.76,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Connecticare,Exchange,,7.76,,,7.76,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,Multiplan,Multiplan,,,8.937378641,,8.937378641,5.94,8.937378641,percent of total billed charges,,
HC RESTRAINT WRIST CH,27000056,RC,,,both,,,10.51456311,6.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.47,,,7.47,5.94,9.2,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Aetna,Commerical,,4.05,,,4.05,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Aetna,Middlesex Employees,,3.64,,,3.64,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Anthem,Commerical,,3.62,,,3.62,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Anthem,Indemnity,,,3.843518447,,3.843518447,2.9,4.48,percent of total billed charges,,4.48
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Anthem,State Preferred,,3.62,,,3.62,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Anthem,Individual Exchange,,2.9,,,2.9,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Cigna,Cigna,,3.54,,,3.54,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Connecticare,Commerical,,3.78,,,3.78,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Connecticare,Exchange,,3.78,,,3.78,2.9,4.48,other,Could be inpatient or outpatient,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,Multiplan,Multiplan,,,4.349029126,,4.349029126,2.9,4.349029126,percent of total billed charges,,
HC RESTRAINT INFANT,27000057,RC,,,both,,,5.116504854,3.16,United Healthcare/Oxford,United Healthcare/Oxford,,3.64,,,3.64,2.9,4.48,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Aetna,Commerical,,12.76,,,12.76,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Aetna,Middlesex Employees,,11.48,,,11.48,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Anthem,Commerical,,11.42,,,11.42,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Anthem,Indemnity,,,12.48596505,,12.48596505,9.13,14.13,percent of total billed charges,,14.13
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Anthem,State Preferred,,11.42,,,11.42,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Anthem,Individual Exchange,,9.13,,,9.13,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Cigna,Cigna,,11.15,,,11.15,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Connecticare,Commerical,,11.92,,,11.92,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Connecticare,Exchange,,11.92,,,11.92,9.13,14.13,other,Could be inpatient or outpatient,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,Multiplan,Multiplan,,,14.12815534,,14.12815534,9.13,14.12815534,percent of total billed charges,,
HC PHOTOTHERA MASK M P S,27000058,RC,,,both,,,16.62135922,10.27,United Healthcare/Oxford,United Healthcare/Oxford,,11.47,,,11.47,9.13,14.13,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Aetna,Commerical,,20.09,,,20.09,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Aetna,Middlesex Employees,,18.08,,,18.08,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Anthem,Commerical,,17.98,,,17.98,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Anthem,Indemnity,,,19.09360777,,19.09360777,14.39,22.25,percent of total billed charges,,22.25
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Anthem,State Preferred,,17.98,,,17.98,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Anthem,Individual Exchange,,14.39,,,14.39,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Cigna,Cigna,,17.56,,,17.56,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Connecticare,Commerical,,18.77,,,18.77,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Connecticare,Exchange,,18.77,,,18.77,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,Multiplan,Multiplan,,,21.60485437,,21.60485437,14.39,21.60485437,percent of total billed charges,,
HC SPIROMTR INCENT,27000059,RC,,,both,,,25.41747573,15.71,United Healthcare/Oxford,United Healthcare/Oxford,,18.07,,,18.07,14.39,22.25,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Aetna,Commerical,,31.09,,,31.09,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Aetna,Middlesex Employees,,27.98,,,27.98,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Anthem,Commerical,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Anthem,Indemnity,,,30.44183301,,30.44183301,22.25,34.44,percent of total billed charges,,34.44
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Anthem,State Preferred,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Anthem,Individual Exchange,,22.25,,,22.25,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Cigna,Cigna,,27.16,,,27.16,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Connecticare,Commerical,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Connecticare,Exchange,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,Multiplan,Multiplan,,,34.44563107,,34.44563107,22.25,34.44563107,percent of total billed charges,,
HC SPIROMETER INC PED VOLDY,27000060,RC,,,both,,,40.52427184,25.04,United Healthcare/Oxford,United Healthcare/Oxford,,27.96,,,27.96,22.25,34.44,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Aetna,Commerical,,8.04,,,8.04,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Aetna,Middlesex Employees,,7.24,,,7.24,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Anthem,Commerical,,7.19,,,7.19,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Anthem,Indemnity,,,7.650570874,,7.650570874,5.75,8.91,percent of total billed charges,,8.91
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Anthem,State Preferred,,7.19,,,7.19,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Anthem,Individual Exchange,,5.75,,,5.75,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Cigna,Cigna,,7.03,,,7.03,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Connecticare,Commerical,,7.51,,,7.51,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Connecticare,Exchange,,7.51,,,7.51,5.75,8.91,other,Could be inpatient or outpatient,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,Multiplan,Multiplan,,,8.656796117,,8.656796117,5.75,8.656796117,percent of total billed charges,,
HC BILLIMASK,27000061,RC,,,both,,,10.18446602,6.29,United Healthcare/Oxford,United Healthcare/Oxford,,7.23,,,7.23,5.75,8.91,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Aetna,Commerical,,30.23,,,30.23,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Aetna,Middlesex Employees,,27.2,,,27.2,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Anthem,Commerical,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Anthem,Indemnity,,,28.7279301,,28.7279301,21.63,33.48,percent of total billed charges,,33.48
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Anthem,State Preferred,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Anthem,Individual Exchange,,21.63,,,21.63,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Cigna,Cigna,,26.42,,,26.42,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Connecticare,Commerical,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Connecticare,Exchange,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,Multiplan,Multiplan,,,32.50631068,,32.50631068,21.63,32.50631068,percent of total billed charges,,
HC SUTURE STAPLER,27000062,RC,,,both,,,38.24271845,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,27.18,,,27.18,21.63,33.48,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Aetna,Commerical,,7.29,,,7.29,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Aetna,Middlesex Employees,,6.56,,,6.56,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Anthem,Commerical,,6.52,,,6.52,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Anthem,Indemnity,,,6.928543689,,6.928543689,5.22,8.08,percent of total billed charges,,8.08
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Anthem,State Preferred,,6.52,,,6.52,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Anthem,Individual Exchange,,5.22,,,5.22,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Cigna,Cigna,,6.36,,,6.36,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Connecticare,Commerical,,6.81,,,6.81,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Connecticare,Exchange,,6.81,,,6.81,5.22,8.08,other,Could be inpatient or outpatient,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,Multiplan,Multiplan,,,7.839805825,,7.839805825,5.22,7.839805825,percent of total billed charges,,
HC STERI STRIP 1/2X4IN,27000063,RC,,,both,,,9.223300971,5.7,United Healthcare/Oxford,United Healthcare/Oxford,,6.55,,,6.55,5.22,8.08,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Aetna,Commerical,,6.64,,,6.64,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Aetna,Middlesex Employees,,5.98,,,5.98,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Anthem,Commerical,,5.94,,,5.94,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Anthem,Indemnity,,,6.505537864,,6.505537864,4.75,7.36,percent of total billed charges,,7.36
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Anthem,State Preferred,,5.94,,,5.94,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Anthem,Individual Exchange,,4.75,,,4.75,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Cigna,Cigna,,5.8,,,5.8,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Connecticare,Commerical,,6.21,,,6.21,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Connecticare,Exchange,,6.21,,,6.21,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,Multiplan,Multiplan,,,7.361165049,,7.361165049,4.75,7.361165049,percent of total billed charges,,
HC OTOSCOPE TIP 2.5MM,27000064,RC,,,both,,,8.660194175,5.35,United Healthcare/Oxford,United Healthcare/Oxford,,5.97,,,5.97,4.75,7.36,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Aetna,Commerical,,6.97,,,6.97,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Aetna,Middlesex Employees,,6.27,,,6.27,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Anthem,Commerical,,6.24,,,6.24,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Anthem,Indemnity,,,6.826438835,,6.826438835,4.99,7.73,percent of total billed charges,,7.73
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Anthem,State Preferred,,6.24,,,6.24,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Anthem,Individual Exchange,,4.99,,,4.99,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Cigna,Cigna,,6.09,,,6.09,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Connecticare,Commerical,,6.52,,,6.52,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Connecticare,Exchange,,6.52,,,6.52,4.99,7.73,other,Could be inpatient or outpatient,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,Multiplan,Multiplan,,,7.724271845,,7.724271845,4.99,7.724271845,percent of total billed charges,,
HC OTOSCOPE TIP 4MM,27000065,RC,,,both,,,9.087378641,5.62,United Healthcare/Oxford,United Healthcare/Oxford,,6.27,,,6.27,4.99,7.73,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Aetna,Commerical,,12.08,,,12.08,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Aetna,Middlesex Employees,,10.87,,,10.87,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Anthem,Commerical,,10.02,,,10.02,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Anthem,Indemnity,,,12.79227961,,12.79227961,8.01,14.48,percent of total billed charges,,14.48
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Anthem,State Preferred,,10.02,,,10.02,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Anthem,Individual Exchange,,8.01,,,8.01,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Cigna,Cigna,,10.64,,,10.64,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Connecticare,Commerical,,10.91,,,10.91,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Connecticare,Exchange,,10.91,,,10.91,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,Multiplan,Multiplan,,,14.47475728,,14.47475728,8.01,14.47475728,percent of total billed charges,,
HC COLLAR EMT ADULT PEDI #555000,27000066,RC,,,both,,,17.02912621,10.52,United Healthcare/Oxford,United Healthcare/Oxford,,11.19,,,11.19,8.01,14.48,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Anthem,Indemnity,,,271.1832,,271.1832,203.96,315.62,percent of total billed charges,,315.62
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,Multiplan,Multiplan,,,306.85,,306.85,203.96,306.85,percent of total billed charges,,
HC COLLAR PEDI 1-2YRS,27000069,RC,,,both,,,361,223.1,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Anthem,Indemnity,,,271.1832,,271.1832,203.96,315.62,percent of total billed charges,,315.62
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,Multiplan,Multiplan,,,306.85,,306.85,203.96,306.85,percent of total billed charges,,
HC COLLAR PEDI 2-6YRS,27000070,RC,,,both,,,361,223.1,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Aetna,Commerical,,284.93,,,284.93,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Aetna,Middlesex Employees,,256.44,,,256.44,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Anthem,Commerical,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Anthem,Indemnity,,,271.1832,,271.1832,203.96,315.62,percent of total billed charges,,315.62
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Anthem,State Preferred,,254.95,,,254.95,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Anthem,Individual Exchange,,203.96,,,203.96,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Cigna,Cigna,,248.99,,,248.99,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Connecticare,Commerical,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Connecticare,Exchange,,266.31,,,266.31,203.96,315.62,other,Could be inpatient or outpatient,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,Multiplan,Multiplan,,,306.85,,306.85,203.96,306.85,percent of total billed charges,,
HC COLLAR PEDI 6-12YRS,27000071,RC,,,both,,,361,223.1,United Healthcare/Oxford,United Healthcare/Oxford,,256.24,,,256.24,203.96,315.62,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Aetna,Commerical,,9.92,,,9.92,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Aetna,Middlesex Employees,,8.92,,,8.92,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Anthem,Commerical,,8.87,,,8.87,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Anthem,Indemnity,,,9.430112621,,9.430112621,7.1,10.98,percent of total billed charges,,10.98
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Anthem,State Preferred,,8.87,,,8.87,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Anthem,Individual Exchange,,7.1,,,7.1,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Cigna,Cigna,,8.66,,,8.66,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Connecticare,Commerical,,9.27,,,9.27,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Connecticare,Exchange,,9.27,,,9.27,7.1,10.98,other,Could be inpatient or outpatient,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,Multiplan,Multiplan,,,10.67038835,,10.67038835,7.1,10.67038835,percent of total billed charges,,
HC TRACH HOLDER NEO,27000072,RC,,,both,,,12.55339806,7.76,United Healthcare/Oxford,United Healthcare/Oxford,,8.92,,,8.92,7.1,10.98,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Aetna,Commerical,,578.81,,,578.81,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Aetna,Middlesex Employees,,520.93,,,520.93,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Anthem,Commerical,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Anthem,Indemnity,,,549.8784,,549.8784,414.33,641.16,percent of total billed charges,,641.16
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Anthem,State Preferred,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Anthem,Individual Exchange,,414.33,,,414.33,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Cigna,Cigna,,505.8,,,505.8,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Connecticare,Commerical,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Connecticare,Exchange,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,Multiplan,Multiplan,,,622.2,,622.2,414.33,622.2,percent of total billed charges,,
HC ECMO CANNULA,27000073,RC,,,both,,,732,452.38,United Healthcare/Oxford,United Healthcare/Oxford,,520.54,,,520.54,414.33,641.16,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Aetna,Commerical,,4305.73,,,4305.73,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Aetna,Middlesex Employees,,3875.16,,,3875.16,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Anthem,Commerical,,3852.66,,,3852.66,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Anthem,Indemnity,,,4092.5376,,4092.5376,3082.13,4769.44,percent of total billed charges,,4769.44
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Anthem,State Preferred,,3852.66,,,3852.66,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Anthem,Individual Exchange,,3082.13,,,3082.13,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Cigna,Cigna,,3762.55,,,3762.55,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Connecticare,Commerical,,4024.37,,,4024.37,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Connecticare,Exchange,,4024.37,,,4024.37,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,Multiplan,Multiplan,,,4630.8,,4630.8,3082.13,4630.8,percent of total billed charges,,
HC ECMO CIRCUIT PACK,27000074,RC,,,both,,,5448,3366.86,United Healthcare/Oxford,United Healthcare/Oxford,,3872.22,,,3872.22,3082.13,4769.44,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Aetna,Commerical,,43.96,,,43.96,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Aetna,Middlesex Employees,,39.56,,,39.56,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Anthem,Indemnity,,,42.0672,,42.0672,31.47,48.7,percent of total billed charges,,48.7
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,Multiplan,Multiplan,,,47.6,,47.6,31.47,47.6,percent of total billed charges,,
HC ECMO DLP DOMES,27000075,RC,,,both,,,56,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Aetna,Commerical,,337.85,,,337.85,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Aetna,Middlesex Employees,,304.06,,,304.06,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Anthem,Commerical,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Anthem,Indemnity,,,320.7624,,320.7624,241.84,374.23,percent of total billed charges,,374.23
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Anthem,State Preferred,,302.3,,,302.3,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Anthem,Individual Exchange,,241.84,,,241.84,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Cigna,Cigna,,295.22,,,295.22,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Connecticare,Commerical,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Connecticare,Exchange,,315.77,,,315.77,241.84,374.23,other,Could be inpatient or outpatient,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,Multiplan,Multiplan,,,362.95,,362.95,241.84,362.95,percent of total billed charges,,
HC NITRIC OXIDE / HR,27000076,RC,,,both,,,427,263.89,United Healthcare/Oxford,United Healthcare/Oxford,,303.83,,,303.83,241.84,374.23,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Aetna,Commerical,,193.75,,,193.75,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Aetna,Middlesex Employees,,174.38,,,174.38,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Anthem,Commerical,,173.36,,,173.36,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Anthem,Indemnity,,,184.044,,184.044,138.69,214.62,percent of total billed charges,,214.62
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Anthem,State Preferred,,173.36,,,173.36,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Anthem,Individual Exchange,,138.69,,,138.69,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Cigna,Cigna,,169.31,,,169.31,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Connecticare,Commerical,,181.09,,,181.09,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Connecticare,Exchange,,181.09,,,181.09,138.69,214.62,other,Could be inpatient or outpatient,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,Multiplan,Multiplan,,,208.25,,208.25,138.69,208.25,percent of total billed charges,,
HC HH RBC BLOOD LBL,27000077,RC,,,both,,,245,151.41,United Healthcare/Oxford,United Healthcare/Oxford,,174.25,,,174.25,138.69,214.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Aetna,Commerical,,52.91,,,52.91,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Aetna,Middlesex Employees,,47.62,,,47.62,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Anthem,Commerical,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Anthem,Indemnity,,,50.3304,,50.3304,37.88,58.62,percent of total billed charges,,58.62
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Anthem,State Preferred,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Anthem,Individual Exchange,,37.88,,,37.88,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Cigna,Cigna,,46.24,,,46.24,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Connecticare,Commerical,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Connecticare,Exchange,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,Multiplan,Multiplan,,,56.95,,56.95,37.88,56.95,percent of total billed charges,,
HC HAND SPLINT - SM,27000082,RC,,,both,,,67,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,47.59,,,47.59,37.88,58.62,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Aetna,Commerical,,230.38,,,230.38,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Aetna,Middlesex Employees,,207.34,,,207.34,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Anthem,Commerical,,206.14,,,206.14,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Anthem,Indemnity,,,218.5992,,218.5992,164.92,255.2,percent of total billed charges,,255.2
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Anthem,State Preferred,,206.14,,,206.14,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Anthem,Individual Exchange,,164.92,,,164.92,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Cigna,Cigna,,201.32,,,201.32,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Connecticare,Commerical,,215.34,,,215.34,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Connecticare,Exchange,,215.34,,,215.34,164.92,255.2,other,Could be inpatient or outpatient,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,Multiplan,Multiplan,,,247.35,,247.35,164.92,247.35,percent of total billed charges,,
HC BURN DRESSING SM,27000083,RC,,,both,,,291,179.84,United Healthcare/Oxford,United Healthcare/Oxford,,207.19,,,207.19,164.92,255.2,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Anthem,Indemnity,,,55.5888,,55.5888,41.96,64.92,percent of total billed charges,,64.92
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,Multiplan,Multiplan,,,62.9,,62.9,41.96,62.9,percent of total billed charges,,
HC SLING STANDARD FLITE SMALL 575586,27000084,RC,,,both,,,74,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Anthem,Indemnity,,,55.5888,,55.5888,41.96,64.92,percent of total billed charges,,64.92
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,Multiplan,Multiplan,,,62.9,,62.9,41.96,62.9,percent of total billed charges,,
HC SLING STANDARD FLITE MEDIUM 575587,27000085,RC,,,both,,,74,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Anthem,Indemnity,,,55.5888,,55.5888,41.96,64.92,percent of total billed charges,,64.92
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,Multiplan,Multiplan,,,62.9,,62.9,41.96,62.9,percent of total billed charges,,
HC SLING STANDARD FLITE LARGE 575588,27000086,RC,,,both,,,74,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Aetna,Commerical,,29.36,,,29.36,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Aetna,Middlesex Employees,,26.43,,,26.43,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Anthem,Commerical,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Anthem,Indemnity,,,27.90379806,,27.90379806,21.02,32.53,percent of total billed charges,,32.53
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Anthem,State Preferred,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Anthem,Individual Exchange,,21.02,,,21.02,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Cigna,Cigna,,25.66,,,25.66,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Connecticare,Commerical,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Connecticare,Exchange,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,Multiplan,Multiplan,,,31.57378641,,31.57378641,21.02,31.57378641,percent of total billed charges,,
HC SLING DISP FLITE UNIVERSAL  575589,27000087,RC,,,both,,,37.14563107,22.96,United Healthcare/Oxford,United Healthcare/Oxford,,26.41,,,26.41,21.02,32.53,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Aetna,Commerical,,54.55,,,54.55,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Aetna,Middlesex Employees,,49.1,,,49.1,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Anthem,Commerical,,48.8,,,48.8,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Anthem,Indemnity,,,51.8328,,51.8328,39.04,60.42,percent of total billed charges,,60.42
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Anthem,State Preferred,,48.8,,,48.8,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Anthem,Individual Exchange,,39.04,,,39.04,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Cigna,Cigna,,47.66,,,47.66,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Connecticare,Commerical,,50.98,,,50.98,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Connecticare,Exchange,,50.98,,,50.98,39.04,60.42,other,Could be inpatient or outpatient,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,Multiplan,Multiplan,,,58.65,,58.65,39.04,58.65,percent of total billed charges,,
HC A-THERAPY SUPPLY,27000238,RC,,,both,,,69,42.64,United Healthcare/Oxford,United Healthcare/Oxford,,49.05,,,49.05,39.04,60.42,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Aetna,Commerical,,24.19,,,24.19,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Aetna,Middlesex Employees,,21.77,,,21.77,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Anthem,Commerical,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Anthem,Indemnity,,,22.98817864,,22.98817864,17.32,26.79,percent of total billed charges,,26.79
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Anthem,State Preferred,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Anthem,Individual Exchange,,17.32,,,17.32,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Cigna,Cigna,,21.13,,,21.13,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Connecticare,Commerical,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Connecticare,Exchange,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,Multiplan,Multiplan,,,26.01165049,,26.01165049,17.32,26.01165049,percent of total billed charges,,
HC HELIOX PER HOUR,27000239,RC,,,both,,,30.60194175,18.91,United Healthcare/Oxford,United Healthcare/Oxford,,21.75,,,21.75,17.32,26.79,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Aetna,Commerical,,11.99,,,11.99,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Aetna,Middlesex Employees,,10.79,,,10.79,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Anthem,Commerical,,10.72,,,10.72,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Anthem,Indemnity,,,11.38469126,,11.38469126,8.58,13.28,percent of total billed charges,,13.28
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Anthem,State Preferred,,10.72,,,10.72,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Anthem,Individual Exchange,,8.58,,,8.58,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Cigna,Cigna,,10.47,,,10.47,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Connecticare,Commerical,,11.2,,,11.2,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Connecticare,Exchange,,11.2,,,11.2,8.58,13.28,other,Could be inpatient or outpatient,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,Multiplan,Multiplan,,,12.88203883,,12.88203883,8.58,12.88203883,percent of total billed charges,,
HC ELECT KLR TRACE,27000240,RC,,,both,,,15.15533981,9.37,United Healthcare/Oxford,United Healthcare/Oxford,,10.77,,,10.77,8.58,13.28,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Aetna,Commerical,,7.43,,,7.43,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Aetna,Middlesex Employees,,6.69,,,6.69,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Anthem,Commerical,,6.66,,,6.66,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Anthem,Indemnity,,,7.059821359,,7.059821359,5.32,8.24,percent of total billed charges,,8.24
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Anthem,State Preferred,,6.66,,,6.66,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Anthem,Individual Exchange,,5.32,,,5.32,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Cigna,Cigna,,6.5,,,6.5,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Connecticare,Commerical,,6.95,,,6.95,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Connecticare,Exchange,,6.95,,,6.95,5.32,8.24,other,Could be inpatient or outpatient,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,Multiplan,Multiplan,,,7.988349515,,7.988349515,5.32,7.988349515,percent of total billed charges,,
HC STERI STRIP 1/4X4,27000241,RC,,,both,,,9.398058252,5.81,United Healthcare/Oxford,United Healthcare/Oxford,,6.68,,,6.68,5.32,8.24,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Aetna,Commerical,,12,,,12,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Aetna,Middlesex Employees,,10.8,,,10.8,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Anthem,Commerical,,10.73,,,10.73,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Anthem,Indemnity,,,11.40657087,,11.40657087,8.59,13.29,percent of total billed charges,,13.29
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Anthem,State Preferred,,10.73,,,10.73,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Anthem,Individual Exchange,,8.59,,,8.59,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Cigna,Cigna,,10.48,,,10.48,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Connecticare,Commerical,,11.22,,,11.22,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Connecticare,Exchange,,11.22,,,11.22,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,Multiplan,Multiplan,,,12.90679612,,12.90679612,8.59,12.90679612,percent of total billed charges,,
HC NITROGEN PER HOUR,27000242,RC,,,both,,,15.18446602,9.38,United Healthcare/Oxford,United Healthcare/Oxford,,10.79,,,10.79,8.59,13.29,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Aetna,Commerical,,102.58,,,102.58,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Aetna,Middlesex Employees,,92.31,,,92.31,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Anthem,Commerical,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Anthem,Indemnity,,,97.656,,97.656,73.42,113.62,percent of total billed charges,,113.62
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Anthem,State Preferred,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Anthem,Individual Exchange,,73.42,,,73.42,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Cigna,Cigna,,89.64,,,89.64,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Connecticare,Commerical,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Connecticare,Exchange,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,Multiplan,Multiplan,,,110.5,,110.5,73.42,110.5,percent of total billed charges,,
HC NITROUS OXIDE,27000242,RC,,,both,,,130,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,92.25,,,92.25,73.42,113.62,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Aetna,Commerical,,277.6,,,277.6,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Aetna,Middlesex Employees,,249.84,,,249.84,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Anthem,Commerical,,248.39,,,248.39,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Anthem,Indemnity,,,263.6712,,263.6712,198.71,307.5,percent of total billed charges,,307.5
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Anthem,State Preferred,,248.39,,,248.39,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Anthem,Individual Exchange,,198.71,,,198.71,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Cigna,Cigna,,242.58,,,242.58,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Connecticare,Commerical,,259.47,,,259.47,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Connecticare,Exchange,,259.47,,,259.47,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,Multiplan,Multiplan,,,298.35,,298.35,198.71,298.35,percent of total billed charges,,
HC OXYGEN INITIAL / DAY,27000242,RC,,,both,,,351,216.92,United Healthcare/Oxford,United Healthcare/Oxford,,249.65,,,249.65,198.71,307.5,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Aetna,Commerical,,207.6,,,207.6,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Aetna,Middlesex Employees,,186.84,,,186.84,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Anthem,Commerical,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Anthem,Indemnity,,,197.5656,,197.5656,148.61,229.95,percent of total billed charges,,229.95
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Anthem,State Preferred,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Anthem,Individual Exchange,,148.61,,,148.61,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Cigna,Cigna,,181.41,,,181.41,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Connecticare,Commerical,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Connecticare,Exchange,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,Multiplan,Multiplan,,,223.55,,223.55,148.61,223.55,percent of total billed charges,,
HC OXYGEN SUBS / DAY,27000242,RC,,,both,,,263,162.53,United Healthcare/Oxford,United Healthcare/Oxford,,186.69,,,186.69,148.61,229.95,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Aetna,Commerical,,981.79,,,981.79,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Aetna,Middlesex Employees,,883.61,,,883.61,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Anthem,Commerical,,878.49,,,878.49,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Anthem,Indemnity,,,932.9904,,932.9904,702.79,1087.53,percent of total billed charges,,1087.53
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Anthem,State Preferred,,878.49,,,878.49,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Anthem,Individual Exchange,,702.79,,,702.79,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Cigna,Cigna,,857.94,,,857.94,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Connecticare,Commerical,,917.64,,,917.64,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Connecticare,Exchange,,917.64,,,917.64,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,Multiplan,Multiplan,,,1055.7,,1055.7,702.79,1055.7,percent of total billed charges,,
HC RAD SUP 500 - 999,27000242,RC,,,both,,,1242,767.56,United Healthcare/Oxford,United Healthcare/Oxford,,882.95,,,882.95,702.79,1087.53,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Aetna,Commerical,,327.27,,,327.27,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Aetna,Middlesex Employees,,294.54,,,294.54,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Anthem,Commerical,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Anthem,Indemnity,,,310.9968,,310.9968,234.26,362.51,percent of total billed charges,,362.51
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Anthem,State Preferred,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Anthem,Individual Exchange,,234.26,,,234.26,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Cigna,Cigna,,285.98,,,285.98,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Connecticare,Commerical,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Connecticare,Exchange,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,Multiplan,Multiplan,,,351.9,,351.9,234.26,362.51,percent of total billed charges,,
HC RAD SUPPL 0 - 499,27000242,RC,,,both,,,414,255.85,United Healthcare/Oxford,United Healthcare/Oxford,,294.31,,,294.31,234.26,362.51,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Aetna,Commerical,,4.3,,,4.3,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Aetna,Middlesex Employees,,3.88,,,3.88,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Anthem,Commerical,,3.85,,,3.85,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Anthem,Indemnity,,,4.091487379,,4.091487379,3.08,4.77,percent of total billed charges,,4.77
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Anthem,State Preferred,,3.85,,,3.85,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Anthem,Individual Exchange,,3.08,,,3.08,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Cigna,Cigna,,3.76,,,3.76,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Connecticare,Commerical,,4.03,,,4.03,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Connecticare,Exchange,,4.03,,,4.03,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,Multiplan,Multiplan,,,4.62961165,,4.62961165,3.08,4.62961165,percent of total billed charges,,
HC SET PRIMARY,27000242,RC,,,both,,,5.446601942,3.37,United Healthcare/Oxford,United Healthcare/Oxford,,3.87,,,3.87,3.08,4.77,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Aetna,Commerical,,3.87,,,3.87,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Aetna,Middlesex Employees,,3.48,,,3.48,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Anthem,Commerical,,3.21,,,3.21,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Anthem,Indemnity,,,4.091487379,,4.091487379,2.57,4.63,percent of total billed charges,,4.63
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Anthem,State Preferred,,3.21,,,3.21,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Anthem,Individual Exchange,,2.57,,,2.57,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Cigna,Cigna,,3.4,,,3.4,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Connecticare,Commerical,,3.49,,,3.49,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Connecticare,Exchange,,3.49,,,3.49,2.57,4.63,other,Could be inpatient or outpatient,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,Multiplan,Multiplan,,,4.62961165,,4.62961165,2.57,4.62961165,percent of total billed charges,,
HC SET PRIMARY,27000243,RC,,,both,,,5.446601942,3.37,United Healthcare/Oxford,United Healthcare/Oxford,,3.57,,,3.57,2.57,4.63,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Aetna,Commerical,,186.47,,,186.47,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Aetna,Middlesex Employees,,167.82,,,167.82,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Anthem,Commerical,,154.75,,,154.75,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Anthem,Indemnity,,,197.5656,,197.5656,123.81,223.55,percent of total billed charges,,223.55
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Anthem,State Preferred,,154.75,,,154.75,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Anthem,Individual Exchange,,123.81,,,123.81,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Cigna,Cigna,,164.25,,,164.25,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Connecticare,Commerical,,168.48,,,168.48,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Connecticare,Exchange,,168.48,,,168.48,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,Multiplan,Multiplan,,,223.55,,223.55,123.81,223.55,percent of total billed charges,,
HC OXYGEN SUBS / DAY,27000244,RC,,,both,,,263,162.53,United Healthcare/Oxford,United Healthcare/Oxford,,172.72,,,172.72,123.81,223.55,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Aetna,Commerical,,248.85,,,248.85,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Aetna,Middlesex Employees,,223.96,,,223.96,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Anthem,Commerical,,206.52,,,206.52,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Anthem,Indemnity,,,263.6712,,263.6712,165.22,298.35,percent of total billed charges,,298.35
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Anthem,State Preferred,,206.52,,,206.52,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Anthem,Individual Exchange,,165.22,,,165.22,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Cigna,Cigna,,219.21,,,219.21,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Connecticare,Commerical,,224.86,,,224.86,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Connecticare,Exchange,,224.86,,,224.86,165.22,298.35,other,Could be inpatient or outpatient,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,Multiplan,Multiplan,,,298.35,,298.35,165.22,298.35,percent of total billed charges,,
HC OXYGEN INITIAL / DAY,27000245,RC,,,both,,,351,216.92,United Healthcare/Oxford,United Healthcare/Oxford,,230.51,,,230.51,165.22,298.35,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Aetna,Commerical,,92.17,,,92.17,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Aetna,Middlesex Employees,,82.96,,,82.96,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Anthem,Commerical,,76.5,,,76.5,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Anthem,Indemnity,,,97.656,,97.656,61.2,110.5,percent of total billed charges,,110.5
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Anthem,State Preferred,,76.5,,,76.5,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Anthem,Individual Exchange,,61.2,,,61.2,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Cigna,Cigna,,81.19,,,81.19,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Connecticare,Commerical,,83.28,,,83.28,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Connecticare,Exchange,,83.28,,,83.28,61.2,110.5,other,Could be inpatient or outpatient,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,Multiplan,Multiplan,,,110.5,,110.5,61.2,110.5,percent of total billed charges,,
HC NITROUS OXIDE,27000246,RC,,,both,,,130,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,85.38,,,85.38,61.2,110.5,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Aetna,Commerical,,293.52,,,293.52,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Aetna,Middlesex Employees,,264.16,,,264.16,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Anthem,Commerical,,243.6,,,243.6,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Anthem,Indemnity,,,310.9968,,310.9968,194.88,351.9,percent of total billed charges,,351.9
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Anthem,State Preferred,,243.6,,,243.6,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Anthem,Individual Exchange,,194.88,,,194.88,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Cigna,Cigna,,258.55,,,258.55,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Connecticare,Commerical,,265.22,,,265.22,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Connecticare,Exchange,,265.22,,,265.22,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,Multiplan,Multiplan,,,351.9,,351.9,194.88,351.9,percent of total billed charges,,
HC RAD SUPPL 0 - 499,27000247,RC,,,both,,,414,255.85,United Healthcare/Oxford,United Healthcare/Oxford,,271.89,,,271.89,194.88,351.9,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Aetna,Commerical,,880.55,,,880.55,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Aetna,Middlesex Employees,,792.5,,,792.5,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Anthem,Commerical,,730.79,,,730.79,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Anthem,Indemnity,,,932.9904,,932.9904,584.63,1055.7,percent of total billed charges,,1055.7
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Anthem,State Preferred,,730.79,,,730.79,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Anthem,Individual Exchange,,584.63,,,584.63,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Cigna,Cigna,,775.65,,,775.65,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Connecticare,Commerical,,795.66,,,795.66,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Connecticare,Exchange,,795.66,,,795.66,584.63,1055.7,other,Could be inpatient or outpatient,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,Multiplan,Multiplan,,,1055.7,,1055.7,584.63,1055.7,percent of total billed charges,,
HC RAD SUP 500 - 999,27000248,RC,,,both,,,1242,767.56,United Healthcare/Oxford,United Healthcare/Oxford,,815.66,,,815.66,584.63,1055.7,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Aetna,Commerical,,10.76,,,10.76,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Aetna,Middlesex Employees,,9.68,,,9.68,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Anthem,Commerical,,8.93,,,8.93,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Anthem,Indemnity,,,11.40657087,,11.40657087,7.14,12.9,percent of total billed charges,,12.9
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Anthem,State Preferred,,8.93,,,8.93,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Anthem,Individual Exchange,,7.14,,,7.14,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Cigna,Cigna,,9.48,,,9.48,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Connecticare,Commerical,,9.72,,,9.72,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Connecticare,Exchange,,9.72,,,9.72,7.14,12.9,other,Could be inpatient or outpatient,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,Multiplan,Multiplan,,,12.90679612,,12.90679612,7.14,12.90679612,percent of total billed charges,,
HC NITROGEN PER HOUR,27000249,RC,,,both,,,15.18446602,9.38,United Healthcare/Oxford,United Healthcare/Oxford,,9.97,,,9.97,7.14,12.9,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Aetna,Commerical,,28.5,,,28.5,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Aetna,Middlesex Employees,,25.65,,,25.65,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Anthem,Commerical,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Anthem,Indemnity,,,27.08695922,,27.08695922,20.4,31.57,percent of total billed charges,,31.57
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Anthem,State Preferred,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Anthem,Individual Exchange,,20.4,,,20.4,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Cigna,Cigna,,24.91,,,24.91,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Connecticare,Commerical,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Connecticare,Exchange,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,Multiplan,Multiplan,,,30.64951456,,30.64951456,20.4,30.64951456,percent of total billed charges,,
HC BLOOD CULTURE KIT,27000250,RC,,,both,,,36.05825243,22.29,United Healthcare/Oxford,United Healthcare/Oxford,,25.64,,,25.64,20.4,31.57,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Aetna,Commerical,,86.3,,,86.3,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Aetna,Middlesex Employees,,77.67,,,77.67,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Anthem,Commerical,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Anthem,Indemnity,,,81.8808,,81.8808,61.77,95.59,percent of total billed charges,,95.59
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Anthem,State Preferred,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Anthem,Individual Exchange,,61.77,,,61.77,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Cigna,Cigna,,75.41,,,75.41,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Connecticare,Commerical,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Connecticare,Exchange,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,Multiplan,Multiplan,,,92.65,,92.65,61.77,92.65,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES 0 - 150,27000251,RC,,,both,,,109,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,77.61,,,77.61,61.77,95.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Aetna,Commerical,,177.47,,,177.47,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Aetna,Middlesex Employees,,159.73,,,159.73,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Anthem,Commerical,,158.8,,,158.8,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Anthem,Indemnity,,,169.02,,169.02,127.04,196.59,percent of total billed charges,,196.59
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Anthem,State Preferred,,158.8,,,158.8,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Anthem,Individual Exchange,,127.04,,,127.04,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Cigna,Cigna,,155.08,,,155.08,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Connecticare,Commerical,,165.88,,,165.88,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Connecticare,Exchange,,165.88,,,165.88,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,Multiplan,Multiplan,,,191.25,,191.25,127.04,191.25,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES 150 - 300,27000252,RC,,,both,,,225,139.05,United Healthcare/Oxford,United Healthcare/Oxford,,159.61,,,159.61,127.04,196.59,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Aetna,Commerical,,267.03,,,267.03,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Aetna,Middlesex Employees,,240.32,,,240.32,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Anthem,Commerical,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Anthem,Indemnity,,,253.9056,,253.9056,191.14,295.78,percent of total billed charges,,295.78
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Anthem,State Preferred,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Anthem,Individual Exchange,,191.14,,,191.14,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Cigna,Cigna,,233.33,,,233.33,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Connecticare,Commerical,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Connecticare,Exchange,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,Multiplan,Multiplan,,,287.3,,287.3,191.14,287.3,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES 300 - 450,27000253,RC,,,both,,,338,208.88,United Healthcare/Oxford,United Healthcare/Oxford,,240.13,,,240.13,191.14,295.78,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Aetna,Commerical,,355.76,,,355.76,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Aetna,Middlesex Employees,,320.18,,,320.18,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Anthem,Commerical,,318.32,,,318.32,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Anthem,Indemnity,,,338.04,,338.04,254.66,394.07,percent of total billed charges,,394.07
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Anthem,State Preferred,,318.32,,,318.32,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Anthem,Individual Exchange,,254.66,,,254.66,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Cigna,Cigna,,310.88,,,310.88,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Connecticare,Commerical,,332.51,,,332.51,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Connecticare,Exchange,,332.51,,,332.51,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,Multiplan,Multiplan,,,382.5,,382.5,254.66,382.5,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES 450 - 600,27000254,RC,,,both,,,450,278.1,United Healthcare/Oxford,United Healthcare/Oxford,,319.94,,,319.94,254.66,394.07,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Aetna,Commerical,,444.49,,,444.49,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Aetna,Middlesex Employees,,400.04,,,400.04,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Anthem,Commerical,,397.72,,,397.72,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Anthem,Indemnity,,,422.1744,,422.1744,318.18,492.36,percent of total billed charges,,492.36
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Anthem,State Preferred,,397.72,,,397.72,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Anthem,Individual Exchange,,318.18,,,318.18,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Cigna,Cigna,,388.42,,,388.42,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Connecticare,Commerical,,415.45,,,415.45,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Connecticare,Exchange,,415.45,,,415.45,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,Multiplan,Multiplan,,,477.7,,477.7,318.18,477.7,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES 600 - 750,27000255,RC,,,both,,,562,347.32,United Healthcare/Oxford,United Healthcare/Oxford,,399.74,,,399.74,318.18,492.36,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Aetna,Commerical,,534.04,,,534.04,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Aetna,Middlesex Employees,,480.64,,,480.64,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Anthem,Commerical,,477.85,,,477.85,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Anthem,Indemnity,,,507.8112,,507.8112,382.28,591.56,percent of total billed charges,,591.56
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Anthem,State Preferred,,477.85,,,477.85,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Anthem,Individual Exchange,,382.28,,,382.28,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Cigna,Cigna,,466.67,,,466.67,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Connecticare,Commerical,,499.14,,,499.14,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Connecticare,Exchange,,499.14,,,499.14,382.28,591.56,other,Could be inpatient or outpatient,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,Multiplan,Multiplan,,,574.6,,574.6,382.28,574.6,percent of total billed charges,,
HC HH CONTRACTED M/S SUPPLIES  750 - 900,27000256,RC,,,both,,,676,417.77,United Healthcare/Oxford,United Healthcare/Oxford,,480.28,,,480.28,382.28,591.56,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Aetna,Commerical,,382.62,,,382.62,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Aetna,Middlesex Employees,,344.36,,,344.36,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Anthem,Commerical,,342.36,,,342.36,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Anthem,Indemnity,,,363.5808,,363.5808,273.88,423.83,percent of total billed charges,,423.83
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Anthem,State Preferred,,342.36,,,342.36,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Anthem,Individual Exchange,,273.88,,,273.88,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Cigna,Cigna,,334.35,,,334.35,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Connecticare,Commerical,,357.62,,,357.62,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Connecticare,Exchange,,357.62,,,357.62,273.88,423.83,other,Could be inpatient or outpatient,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,Multiplan,Multiplan,,,411.4,,411.4,273.88,411.4,percent of total billed charges,,
HC FECAL DRAIN SYSTEM,27000259,RC,,,both,,,484,299.11,United Healthcare/Oxford,United Healthcare/Oxford,,344.1,,,344.1,273.88,423.83,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Aetna,Commerical,,41.93,,,41.93,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Aetna,Middlesex Employees,,37.74,,,37.74,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Anthem,Commerical,,37.52,,,37.52,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Anthem,Indemnity,,,39.8136,,39.8136,30.02,46.44,percent of total billed charges,,46.44
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Anthem,State Preferred,,37.52,,,37.52,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Anthem,Individual Exchange,,30.02,,,30.02,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Cigna,Cigna,,36.64,,,36.64,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Connecticare,Commerical,,39.19,,,39.19,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Connecticare,Exchange,,39.19,,,39.19,30.02,46.44,other,Could be inpatient or outpatient,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,Multiplan,Multiplan,,,45.05,,45.05,30.02,45.05,percent of total billed charges,,
HC SEDARA SEDATN KIT,27000260,RC,,,both,,,53,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,30.02,46.44,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Aetna,Commerical,,831.18,,,831.18,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Aetna,Middlesex Employees,,748.07,,,748.07,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Anthem,Commerical,,743.73,,,743.73,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Anthem,Indemnity,,,790.2624,,790.2624,594.98,920.7,percent of total billed charges,,920.7
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Anthem,State Preferred,,743.73,,,743.73,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Anthem,Individual Exchange,,594.98,,,594.98,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Cigna,Cigna,,726.34,,,726.34,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Connecticare,Commerical,,776.87,,,776.87,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Connecticare,Exchange,,776.87,,,776.87,594.98,920.7,other,Could be inpatient or outpatient,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,Multiplan,Multiplan,,,894.2,,894.2,594.98,894.2,percent of total billed charges,,
HC UVC TRAY,27000262,RC,,,both,,,1052,650.14,United Healthcare/Oxford,United Healthcare/Oxford,,747.5,,,747.5,594.98,920.7,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Aetna,Commerical,,36.28,,,36.28,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Aetna,Middlesex Employees,,32.65,,,32.65,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Anthem,Commerical,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Anthem,Indemnity,,,34.48226796,,34.48226796,25.97,40.18,percent of total billed charges,,40.18
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Anthem,State Preferred,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Anthem,Individual Exchange,,25.97,,,25.97,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Cigna,Cigna,,31.7,,,31.7,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Connecticare,Commerical,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Connecticare,Exchange,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,Multiplan,Multiplan,,,39.01747573,,39.01747573,25.97,39.01747573,percent of total billed charges,,
HC VSI GUIDEWIRE,27000263,RC,,,both,,,45.90291262,28.37,United Healthcare/Oxford,United Healthcare/Oxford,,32.62,,,32.62,25.97,40.18,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Aetna,Commerical,,50.48,,,50.48,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Aetna,Middlesex Employees,,45.43,,,45.43,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Anthem,Commerical,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Anthem,Indemnity,,,48.0768,,48.0768,36.13,55.91,percent of total billed charges,,55.91
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Anthem,State Preferred,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Anthem,Individual Exchange,,36.13,,,36.13,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Cigna,Cigna,,44.11,,,44.11,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Connecticare,Commerical,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Connecticare,Exchange,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,Multiplan,Multiplan,,,54.4,,54.4,36.13,54.4,percent of total billed charges,,
HC PRIMASOL 2/0 CAL #008016,27000264,RC,,,both,,,64,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,45.39,,,45.39,36.13,55.91,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Aetna,Commerical,,2312.83,,,2312.83,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Aetna,Middlesex Employees,,2081.55,,,2081.55,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Anthem,Commerical,,2069.47,,,2069.47,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Anthem,Indemnity,,,2198.0112,,2198.0112,1655.58,2561.92,percent of total billed charges,,2561.92
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Anthem,State Preferred,,2069.47,,,2069.47,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Anthem,Individual Exchange,,1655.58,,,1655.58,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Cigna,Cigna,,2021.06,,,2021.06,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Connecticare,Commerical,,2161.7,,,2161.7,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Connecticare,Exchange,,2161.7,,,2161.7,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,Multiplan,Multiplan,,,2487.1,,2487.1,1655.58,2487.1,percent of total billed charges,,
HC HI EMBO - 6,27000265,RC,,,both,,,2926,1808.27,United Healthcare/Oxford,United Healthcare/Oxford,,2079.97,,,2079.97,1655.58,2561.92,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Aetna,Commerical,,1512.58,,,1512.58,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Aetna,Middlesex Employees,,1361.33,,,1361.33,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Anthem,Commerical,,1353.42,,,1353.42,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Anthem,Indemnity,,,1437.7968,,1437.7968,1082.73,1675.48,percent of total billed charges,,1675.48
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Anthem,State Preferred,,1353.42,,,1353.42,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Anthem,Individual Exchange,,1082.73,,,1082.73,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Cigna,Cigna,,1321.77,,,1321.77,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Connecticare,Commerical,,1413.74,,,1413.74,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Connecticare,Exchange,,1413.74,,,1413.74,1082.73,1675.48,other,Could be inpatient or outpatient,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,Multiplan,Multiplan,,,1626.9,,1626.9,1082.73,1626.9,percent of total billed charges,,
HC HI EMBO - 4,27000266,RC,,,both,,,1914,1182.85,United Healthcare/Oxford,United Healthcare/Oxford,,1360.29,,,1360.29,1082.73,1675.48,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Aetna,Commerical,,123.74,,,123.74,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Aetna,Middlesex Employees,,111.37,,,111.37,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Anthem,Commerical,,110.72,,,110.72,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Anthem,Indemnity,,,117.9384,,117.9384,88.58,137.07,percent of total billed charges,,137.07
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Anthem,State Preferred,,110.72,,,110.72,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Anthem,Individual Exchange,,88.58,,,88.58,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Cigna,Cigna,,108.13,,,108.13,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Connecticare,Commerical,,115.66,,,115.66,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Connecticare,Exchange,,115.66,,,115.66,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,Multiplan,Multiplan,,,133.45,,133.45,88.58,133.45,percent of total billed charges,,
HC MISC ACCESS - 2,27000267,RC,,,both,,,157,97.03,United Healthcare/Oxford,United Healthcare/Oxford,,111.28,,,111.28,88.58,137.07,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Aetna,Commerical,,56.98,,,56.98,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Aetna,Middlesex Employees,,51.29,,,51.29,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Anthem,Commerical,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Anthem,Indemnity,,,54.0864,,54.0864,40.8,63.12,percent of total billed charges,,63.12
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Anthem,State Preferred,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Anthem,Individual Exchange,,40.8,,,40.8,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Cigna,Cigna,,49.8,,,49.8,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Connecticare,Commerical,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Connecticare,Exchange,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,Multiplan,Multiplan,,,61.2,,61.2,40.8,61.2,percent of total billed charges,,
HC MISC ACCESS - 1,27000268,RC,,,both,,,72,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,51.25,,,51.25,40.8,63.12,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Aetna,Commerical,,78.16,,,78.16,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Aetna,Middlesex Employees,,70.34,,,70.34,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Anthem,Commerical,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Anthem,Indemnity,,,74.3688,,74.3688,55.94,86.57,percent of total billed charges,,86.57
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Anthem,State Preferred,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Anthem,Individual Exchange,,55.94,,,55.94,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Cigna,Cigna,,68.3,,,68.3,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Connecticare,Commerical,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Connecticare,Exchange,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,Multiplan,Multiplan,,,84.15,,84.15,55.94,84.15,percent of total billed charges,,
HC NEEDLE-1,27000269,RC,,,both,,,99,61.18,United Healthcare/Oxford,United Healthcare/Oxford,,70.29,,,70.29,55.94,86.57,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Aetna,Commerical,,275.17,,,275.17,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Aetna,Middlesex Employees,,247.65,,,247.65,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Anthem,Commerical,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Anthem,Indemnity,,,261.4176,,261.4176,196.96,304.79,percent of total billed charges,,304.79
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Anthem,State Preferred,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Anthem,Individual Exchange,,196.96,,,196.96,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,Multiplan,Multiplan,,,295.8,,295.8,196.96,295.8,percent of total billed charges,,
HC FDG/UP TO 45MCI,27000274,RC,,,both,,,348,215.06,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Anthem,Indemnity,,,42.8184,,42.8184,32.05,49.6,percent of total billed charges,,49.6
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,Multiplan,Multiplan,,,48.45,,48.45,32.05,48.45,percent of total billed charges,,
HC TRANSWARMER INFANT TRANSPORT,27000275,RC,,,both,,,57,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Aetna,Commerical,,18.44,,,18.44,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Aetna,Middlesex Employees,,16.6,,,16.6,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Anthem,Commerical,,16.51,,,16.51,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Anthem,Indemnity,,,17.53286214,,17.53286214,13.21,20.43,percent of total billed charges,,20.43
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Anthem,State Preferred,,16.51,,,16.51,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Anthem,Individual Exchange,,13.21,,,13.21,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Cigna,Cigna,,16.12,,,16.12,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Connecticare,Commerical,,17.25,,,17.25,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Connecticare,Exchange,,17.25,,,17.25,13.21,20.43,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,Multiplan,Multiplan,,,19.83883495,,19.83883495,13.21,19.83883495,percent of total billed charges,,
HC EFFLUENT SAMPLE BAG 100ML 5C4476,27000301,RC,,,both,,,23.33980583,14.42,United Healthcare/Oxford,United Healthcare/Oxford,,16.59,,,16.59,13.21,20.43,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Anthem,Indemnity,,,0.007293204,,0.007293204,0.01,0.01,percent of total billed charges,,0.01
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,Multiplan,Multiplan,,,0.008252427,,0.008252427,0.01,0.008252427,percent of total billed charges,,
HC S/A ANALYSIS KIT,27000303,RC,,,both,,,0.009708738,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Aetna,Commerical,,2618.25,,,2618.25,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Aetna,Middlesex Employees,,2356.42,,,2356.42,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Anthem,Commerical,,2172.95,,,2172.95,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Anthem,Indemnity,,,2774.1816,,2774.1816,1738.37,3139.05,percent of total billed charges,,3139.05
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Anthem,State Preferred,,2172.95,,,2172.95,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Anthem,Individual Exchange,,1738.37,,,1738.37,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Cigna,Cigna,,2306.36,,,2306.36,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Connecticare,Commerical,,2365.83,,,2365.83,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Connecticare,Exchange,,2365.83,,,2365.83,1738.37,3139.05,other,Could be inpatient or outpatient,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,Multiplan,Multiplan,,,3139.05,,3139.05,1738.37,3139.05,percent of total billed charges,,
HC IB BTE STIMULATOR,27000340,RC,,,both,,,3693,2282.27,United Healthcare/Oxford,United Healthcare/Oxford,,2425.3,,,2425.3,1738.37,3139.05,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Aetna,Commerical,,11.21,,,11.21,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Aetna,Middlesex Employees,,10.09,,,10.09,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Anthem,Commerical,,10.03,,,10.03,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Anthem,Indemnity,,,10.65537087,,10.65537087,8.02,12.42,percent of total billed charges,,12.42
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Anthem,State Preferred,,10.03,,,10.03,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Anthem,Individual Exchange,,8.02,,,8.02,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Cigna,Cigna,,9.8,,,9.8,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Connecticare,Commerical,,10.48,,,10.48,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Connecticare,Exchange,,10.48,,,10.48,8.02,12.42,other,Could be inpatient or outpatient,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,Multiplan,Multiplan,,,12.05679612,,12.05679612,8.02,12.05679612,percent of total billed charges,,
HC SPLINT CONFORM,27100033,RC,,,both,,,14.18446602,8.76,United Healthcare/Oxford,United Healthcare/Oxford,,10.08,,,10.08,8.02,12.42,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Aetna,Commerical,,15.77,,,15.77,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Aetna,Middlesex Employees,,14.2,,,14.2,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Anthem,Commerical,,14.11,,,14.11,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Anthem,Indemnity,,,14.98753398,,14.98753398,11.28,17.47,percent of total billed charges,,17.47
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Anthem,State Preferred,,14.11,,,14.11,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Anthem,Individual Exchange,,11.28,,,11.28,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Cigna,Cigna,,13.78,,,13.78,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Connecticare,Commerical,,14.74,,,14.74,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Connecticare,Exchange,,14.74,,,14.74,11.28,17.47,other,Could be inpatient or outpatient,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,Multiplan,Multiplan,,,16.95873786,,16.95873786,11.28,16.95873786,percent of total billed charges,,
HC BAG FEEDING PUMP,27100053,RC,,,both,,,19.95145631,12.33,United Healthcare/Oxford,United Healthcare/Oxford,,14.18,,,14.18,11.28,17.47,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Aetna,Commerical,,18.79,,,18.79,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Aetna,Middlesex Employees,,16.91,,,16.91,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Anthem,Commerical,,16.81,,,16.81,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Anthem,Indemnity,,,17.85376311,,17.85376311,13.44,20.82,percent of total billed charges,,20.82
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Anthem,State Preferred,,16.81,,,16.81,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Anthem,Individual Exchange,,13.44,,,13.44,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Cigna,Cigna,,16.42,,,16.42,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Connecticare,Commerical,,17.57,,,17.57,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Connecticare,Exchange,,17.57,,,17.57,13.44,20.82,other,Could be inpatient or outpatient,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,Multiplan,Multiplan,,,20.20194175,,20.20194175,13.44,20.20194175,percent of total billed charges,,
HC STOMAHESIVE POWDER,27100054,RC,,,both,,,23.76699029,14.69,United Healthcare/Oxford,United Healthcare/Oxford,,16.9,,,16.9,13.44,20.82,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Aetna,Commerical,,4.6,,,4.6,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Aetna,Middlesex Employees,,4.14,,,4.14,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Anthem,Commerical,,4.12,,,4.12,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Anthem,Indemnity,,,4.368629126,,4.368629126,3.29,5.09,percent of total billed charges,,5.09
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Anthem,State Preferred,,4.12,,,4.12,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Anthem,Individual Exchange,,3.29,,,3.29,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Cigna,Cigna,,4.01,,,4.01,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Connecticare,Commerical,,4.3,,,4.3,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Connecticare,Exchange,,4.3,,,4.3,3.29,5.09,other,Could be inpatient or outpatient,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,Multiplan,Multiplan,,,4.943203883,,4.943203883,3.29,4.943203883,percent of total billed charges,,
"HC ACE BANDAGE 3 - 6""",27100055,RC,,,both,,,5.815533981,3.6,United Healthcare/Oxford,United Healthcare/Oxford,,4.14,,,4.14,3.29,5.09,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Aetna,Commerical,,32.81,,,32.81,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Aetna,Middlesex Employees,,29.54,,,29.54,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Anthem,Commerical,,29.36,,,29.36,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Anthem,Indemnity,,,32.1192699,,32.1192699,23.49,36.35,percent of total billed charges,,36.35
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Anthem,State Preferred,,29.36,,,29.36,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Anthem,Individual Exchange,,23.49,,,23.49,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Cigna,Cigna,,28.67,,,28.67,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Connecticare,Commerical,,30.67,,,30.67,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Connecticare,Exchange,,30.67,,,30.67,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,Multiplan,Multiplan,,,36.34368932,,36.34368932,23.49,36.34368932,percent of total billed charges,,
HC BNDG 3X4YD FIBERG,27100056,RC,,,both,,,42.75728155,26.43,United Healthcare/Oxford,United Healthcare/Oxford,,29.51,,,29.51,23.49,36.35,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Aetna,Commerical,,1.74,,,1.74,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Aetna,Middlesex Employees,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Anthem,Commerical,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Anthem,Indemnity,,,1.699316505,,1.699316505,1.24,1.92,percent of total billed charges,,1.92
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Anthem,State Preferred,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Anthem,Individual Exchange,,1.24,,,1.24,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Cigna,Cigna,,1.52,,,1.52,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Connecticare,Commerical,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Connecticare,Exchange,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,Multiplan,Multiplan,,,1.922815534,,1.922815534,1.24,1.922815534,percent of total billed charges,,
HC BNDG 2IN CONFORM,27100057,RC,,,both,,,2.262135922,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Aetna,Commerical,,12.32,,,12.32,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Aetna,Middlesex Employees,,11.09,,,11.09,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Anthem,Commerical,,11.03,,,11.03,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Anthem,Indemnity,,,12.06295922,,12.06295922,8.83,13.65,percent of total billed charges,,13.65
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Anthem,State Preferred,,11.03,,,11.03,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Anthem,Individual Exchange,,8.83,,,8.83,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Cigna,Cigna,,10.77,,,10.77,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Connecticare,Commerical,,11.52,,,11.52,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Connecticare,Exchange,,11.52,,,11.52,8.83,13.65,other,Could be inpatient or outpatient,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,Multiplan,Multiplan,,,13.64951456,,13.64951456,8.83,13.64951456,percent of total billed charges,,
HC SPLINT PLASTER,27100058,RC,,,both,,,16.05825243,9.93,United Healthcare/Oxford,United Healthcare/Oxford,,11.08,,,11.08,8.83,13.65,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Anthem,Indemnity,,,18.29135534,,18.29135534,13.78,21.32,percent of total billed charges,,21.32
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,Multiplan,Multiplan,,,20.69708738,,20.69708738,13.78,20.69708738,percent of total billed charges,,
HC NIPPLE SHIELD,27100059,RC,,,both,,,24.34951456,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Aetna,Commerical,,9.85,,,9.85,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Aetna,Middlesex Employees,,8.86,,,8.86,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Anthem,Commerical,,8.82,,,8.82,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Anthem,Indemnity,,,9.357180583,,9.357180583,7.06,10.91,percent of total billed charges,,10.91
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Anthem,State Preferred,,8.82,,,8.82,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Anthem,Individual Exchange,,7.06,,,7.06,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Cigna,Cigna,,8.61,,,8.61,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Connecticare,Commerical,,9.21,,,9.21,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Connecticare,Exchange,,9.21,,,9.21,7.06,10.91,other,Could be inpatient or outpatient,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,Multiplan,Multiplan,,,10.58786408,,10.58786408,7.06,10.58786408,percent of total billed charges,,
HC CALCULI STRAINER,27100061,RC,,,both,,,12.45631068,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,8.86,,,8.86,7.06,10.91,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Aetna,Commerical,,8.61,,,8.61,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Aetna,Middlesex Employees,,7.74,,,7.74,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Anthem,Commerical,,7.7,,,7.7,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Anthem,Indemnity,,,8.182974757,,8.182974757,6.16,9.53,percent of total billed charges,,9.53
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Anthem,State Preferred,,7.7,,,7.7,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Anthem,Individual Exchange,,6.16,,,6.16,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Cigna,Cigna,,7.52,,,7.52,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Connecticare,Commerical,,8.04,,,8.04,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Connecticare,Exchange,,8.04,,,8.04,6.16,9.53,other,Could be inpatient or outpatient,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,Multiplan,Multiplan,,,9.259223301,,9.259223301,6.16,9.259223301,percent of total billed charges,,
HC URINARY DRAINAGE BAG  300098,27100062,RC,,,both,,,10.89320388,6.73,United Healthcare/Oxford,United Healthcare/Oxford,,7.74,,,7.74,6.16,9.53,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Aetna,Commerical,,10.05,,,10.05,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Aetna,Middlesex Employees,,9.04,,,9.04,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Anthem,Commerical,,8.98,,,8.98,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Anthem,Indemnity,,,9.831238835,,9.831238835,7.18,11.13,percent of total billed charges,,11.13
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Anthem,State Preferred,,8.98,,,8.98,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Anthem,Individual Exchange,,7.18,,,7.18,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Cigna,Cigna,,8.78,,,8.78,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Connecticare,Commerical,,9.39,,,9.39,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Connecticare,Exchange,,9.39,,,9.39,7.18,11.13,other,Could be inpatient or outpatient,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,Multiplan,Multiplan,,,11.12427184,,11.12427184,7.18,11.12427184,percent of total billed charges,,
HC STOCKING REG SM - XLRG,27100063,RC,,,both,,,13.08737864,8.09,United Healthcare/Oxford,United Healthcare/Oxford,,9.03,,,9.03,7.18,11.13,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Aetna,Commerical,,69.2,,,69.2,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Aetna,Middlesex Employees,,62.28,,,62.28,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Anthem,Commerical,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Anthem,Indemnity,,,66.1056,,66.1056,49.54,76.65,percent of total billed charges,,76.65
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Anthem,State Preferred,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Anthem,Individual Exchange,,49.54,,,49.54,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Cigna,Cigna,,60.47,,,60.47,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Connecticare,Commerical,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Connecticare,Exchange,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,Multiplan,Multiplan,,,74.8,,74.8,49.54,74.8,percent of total billed charges,,
HC POSEY ID BAND,27100064,RC,,,both,,,88,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,62.23,,,62.23,49.54,76.65,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Aetna,Commerical,,239.35,,,239.35,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Aetna,Middlesex Employees,,215.41,,,215.41,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Anthem,Commerical,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Anthem,Indemnity,,,227.6136,,227.6136,171.33,265.12,percent of total billed charges,,265.12
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Anthem,State Preferred,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Anthem,Individual Exchange,,171.33,,,171.33,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Cigna,Cigna,,209.15,,,209.15,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Connecticare,Commerical,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Connecticare,Exchange,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,Multiplan,Multiplan,,,257.55,,257.55,171.33,257.55,percent of total billed charges,,
HC SLEEVE COMPRESS,27100065,RC,,,both,,,303,187.25,United Healthcare/Oxford,United Healthcare/Oxford,,215.25,,,215.25,171.33,265.12,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Aetna,Commerical,,30.23,,,30.23,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Aetna,Middlesex Employees,,27.2,,,27.2,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Anthem,Commerical,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Anthem,Indemnity,,,28.7279301,,28.7279301,21.63,33.48,percent of total billed charges,,33.48
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Anthem,State Preferred,,27.04,,,27.04,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Anthem,Individual Exchange,,21.63,,,21.63,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Cigna,Cigna,,26.42,,,26.42,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Connecticare,Commerical,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Connecticare,Exchange,,28.25,,,28.25,21.63,33.48,other,Could be inpatient or outpatient,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,Multiplan,Multiplan,,,32.50631068,,32.50631068,21.63,32.50631068,percent of total billed charges,,
HC UNIVERSAL SLING,27100066,RC,,,both,,,38.24271845,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,27.18,,,27.18,21.63,33.48,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Anthem,Indemnity,,,59.3448,,59.3448,44.87,69.44,percent of total billed charges,,69.44
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,Multiplan,Multiplan,,,67.15,,67.15,44.87,67.15,percent of total billed charges,,
HC HYPOTHERMIA BLANKET,27100067,RC,,,both,,,79,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Aetna,Commerical,,102.58,,,102.58,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Aetna,Middlesex Employees,,92.31,,,92.31,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Anthem,Commerical,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Anthem,Indemnity,,,97.656,,97.656,73.42,113.62,percent of total billed charges,,113.62
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Anthem,State Preferred,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Anthem,Individual Exchange,,73.42,,,73.42,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Cigna,Cigna,,89.64,,,89.64,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Connecticare,Commerical,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Connecticare,Exchange,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,Multiplan,Multiplan,,,110.5,,110.5,73.42,110.5,percent of total billed charges,,
HC BREAST PUMP,27100068,RC,,,both,,,130,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,92.25,,,92.25,73.42,113.62,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Aetna,Commerical,,13.91,,,13.91,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Aetna,Middlesex Employees,,12.51,,,12.51,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Anthem,Commerical,,12.44,,,12.44,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Anthem,Indemnity,,,13.21528544,,13.21528544,9.96,15.4,percent of total billed charges,,15.4
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Anthem,State Preferred,,12.44,,,12.44,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Anthem,Individual Exchange,,9.96,,,9.96,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Cigna,Cigna,,12.15,,,12.15,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Connecticare,Commerical,,12.99,,,12.99,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Connecticare,Exchange,,12.99,,,12.99,9.96,15.4,other,Could be inpatient or outpatient,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,Multiplan,Multiplan,,,14.95339806,,14.95339806,9.96,14.95339806,percent of total billed charges,,
HC TRACH HOLDER,27100069,RC,,,both,,,17.59223301,10.87,United Healthcare/Oxford,United Healthcare/Oxford,,12.5,,,12.5,9.96,15.4,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Aetna,Commerical,,23.2,,,23.2,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Aetna,Middlesex Employees,,20.88,,,20.88,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Anthem,Commerical,,20.76,,,20.76,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Anthem,Indemnity,,,22.05464854,,22.05464854,16.61,25.7,percent of total billed charges,,25.7
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Anthem,State Preferred,,20.76,,,20.76,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Anthem,Individual Exchange,,16.61,,,16.61,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Cigna,Cigna,,20.27,,,20.27,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Connecticare,Commerical,,21.68,,,21.68,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Connecticare,Exchange,,21.68,,,21.68,16.61,25.7,other,Could be inpatient or outpatient,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,Multiplan,Multiplan,,,24.95533981,,24.95533981,16.61,24.95533981,percent of total billed charges,,
HC NASAL AIRWAY 16FR - 32FR,27100070,RC,,,both,,,29.3592233,18.14,United Healthcare/Oxford,United Healthcare/Oxford,,20.87,,,20.87,16.61,25.7,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC SLING SMALL,27100071,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Aetna,Commerical,,16.18,,,16.18,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Aetna,Middlesex Employees,,14.57,,,14.57,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Anthem,Commerical,,14.47,,,14.47,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Anthem,Indemnity,,,14.01753786,,14.01753786,11.57,17.92,percent of total billed charges,,17.92
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Anthem,State Preferred,,14.47,,,14.47,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Anthem,Individual Exchange,,11.57,,,11.57,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Cigna,Cigna,,14.13,,,14.13,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Connecticare,Commerical,,15.12,,,15.12,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Connecticare,Exchange,,15.12,,,15.12,11.57,17.92,other,Could be inpatient or outpatient,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,Multiplan,Multiplan,,,15.86116505,,15.86116505,11.57,15.86116505,percent of total billed charges,,
HC FEEDING BAG GASTRIC,27100073,RC,,,both,,,18.66019417,11.53,United Healthcare/Oxford,United Healthcare/Oxford,,14.54,,,14.54,11.57,17.92,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Aetna,Commerical,,8.82,,,8.82,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Aetna,Middlesex Employees,,7.94,,,7.94,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Anthem,Commerical,,7.89,,,7.89,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Anthem,Indemnity,,,8.627860194,,8.627860194,6.31,9.77,percent of total billed charges,,9.77
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Anthem,State Preferred,,7.89,,,7.89,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Anthem,Individual Exchange,,6.31,,,6.31,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Cigna,Cigna,,7.71,,,7.71,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Connecticare,Commerical,,8.24,,,8.24,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Connecticare,Exchange,,8.24,,,8.24,6.31,9.77,other,Could be inpatient or outpatient,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,Multiplan,Multiplan,,,9.762621359,,9.762621359,6.31,9.762621359,percent of total billed charges,,
HC SPLINT FINGER ALIM,27100074,RC,,,both,,,11.48543689,7.1,United Healthcare/Oxford,United Healthcare/Oxford,,7.93,,,7.93,6.31,9.77,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Aetna,Commerical,,26.78,,,26.78,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Aetna,Middlesex Employees,,24.1,,,24.1,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Anthem,Commerical,,23.96,,,23.96,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Anthem,Indemnity,,,25.45328155,,25.45328155,19.17,29.66,percent of total billed charges,,29.66
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Anthem,State Preferred,,23.96,,,23.96,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Anthem,Individual Exchange,,19.17,,,19.17,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Cigna,Cigna,,23.4,,,23.4,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Connecticare,Commerical,,25.03,,,25.03,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Connecticare,Exchange,,25.03,,,25.03,19.17,29.66,other,Could be inpatient or outpatient,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,Multiplan,Multiplan,,,28.80097087,,28.80097087,19.17,28.80097087,percent of total billed charges,,
HC RESTRAINTS MEDICAL ADILT,27100075,RC,,,both,,,33.88349515,20.94,United Healthcare/Oxford,United Healthcare/Oxford,,24.08,,,24.08,19.17,29.66,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Aetna,Commerical,,6.32,,,6.32,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Aetna,Middlesex Employees,,5.69,,,5.69,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Anthem,Commerical,,5.66,,,5.66,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Anthem,Indemnity,,,6.0096,,6.0096,4.53,7,percent of total billed charges,,7
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Anthem,State Preferred,,5.66,,,5.66,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Anthem,Individual Exchange,,4.53,,,4.53,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Cigna,Cigna,,5.52,,,5.52,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Connecticare,Commerical,,5.91,,,5.91,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Connecticare,Exchange,,5.91,,,5.91,4.53,7,other,Could be inpatient or outpatient,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,Multiplan,Multiplan,,,6.8,,6.8,4.53,6.8,percent of total billed charges,,
HC BARRIER WIPE,27100076,RC,,,both,,,8,4.94,United Healthcare/Oxford,United Healthcare/Oxford,,5.69,,,5.69,4.53,7,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Aetna,Commerical,,130.25,,,130.25,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Aetna,Middlesex Employees,,117.23,,,117.23,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Anthem,Commerical,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Anthem,Indemnity,,,123.948,,123.948,93.24,144.28,percent of total billed charges,,144.28
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Anthem,State Preferred,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Anthem,Individual Exchange,,93.24,,,93.24,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Cigna,Cigna,,113.83,,,113.83,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Connecticare,Commerical,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Connecticare,Exchange,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,Multiplan,Multiplan,,,140.25,,140.25,93.24,140.25,percent of total billed charges,,
HC ELBOW SPLINT XLG,27100077,RC,,,both,,,165,101.97,United Healthcare/Oxford,United Healthcare/Oxford,,117.14,,,117.14,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Aetna,Commerical,,130.25,,,130.25,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Aetna,Middlesex Employees,,117.23,,,117.23,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Anthem,Commerical,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Anthem,Indemnity,,,123.948,,123.948,93.24,144.28,percent of total billed charges,,144.28
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Anthem,State Preferred,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Anthem,Individual Exchange,,93.24,,,93.24,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Cigna,Cigna,,113.83,,,113.83,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Connecticare,Commerical,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Connecticare,Exchange,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,Multiplan,Multiplan,,,140.25,,140.25,93.24,140.25,percent of total billed charges,,
HC ELBOW SPLINT MED,27100078,RC,,,both,,,165,101.97,United Healthcare/Oxford,United Healthcare/Oxford,,117.14,,,117.14,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Aetna,Commerical,,130.25,,,130.25,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Aetna,Middlesex Employees,,117.23,,,117.23,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Anthem,Commerical,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Anthem,Indemnity,,,123.948,,123.948,93.24,144.28,percent of total billed charges,,144.28
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Anthem,State Preferred,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Anthem,Individual Exchange,,93.24,,,93.24,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Cigna,Cigna,,113.83,,,113.83,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Connecticare,Commerical,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Connecticare,Exchange,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,Multiplan,Multiplan,,,140.25,,140.25,93.24,140.25,percent of total billed charges,,
HC ELBOW SPLINT SM,27100079,RC,,,both,,,165,101.97,United Healthcare/Oxford,United Healthcare/Oxford,,117.14,,,117.14,93.24,144.28,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Aetna,Commerical,,1.83,,,1.83,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Aetna,Middlesex Employees,,1.64,,,1.64,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Anthem,Commerical,,1.64,,,1.64,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Anthem,Indemnity,,,1.786834951,,1.786834951,1.3,2.02,percent of total billed charges,,2.02
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Anthem,State Preferred,,1.64,,,1.64,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Anthem,Individual Exchange,,1.3,,,1.3,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Cigna,Cigna,,1.59,,,1.59,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Connecticare,Commerical,,1.7,,,1.7,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Connecticare,Exchange,,1.7,,,1.7,1.3,2.02,other,Could be inpatient or outpatient,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,Multiplan,Multiplan,,,2.02184466,,2.02184466,1.3,2.02184466,percent of total billed charges,,
HC GUAZE UNSTERILE WEBRIL,27100080,RC,,,both,,,2.378640777,1.47,United Healthcare/Oxford,United Healthcare/Oxford,,1.64,,,1.64,1.3,2.02,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Aetna,Commerical,,136.77,,,136.77,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Aetna,Middlesex Employees,,123.1,,,123.1,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Anthem,Commerical,,122.38,,,122.38,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Anthem,Indemnity,,,129.9576,,129.9576,97.9,151.5,percent of total billed charges,,151.5
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Anthem,State Preferred,,122.38,,,122.38,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Anthem,Individual Exchange,,97.9,,,97.9,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Cigna,Cigna,,119.52,,,119.52,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Connecticare,Commerical,,127.83,,,127.83,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Connecticare,Exchange,,127.83,,,127.83,97.9,151.5,other,Could be inpatient or outpatient,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,Multiplan,Multiplan,,,147.05,,147.05,97.9,147.05,percent of total billed charges,,
HC HAND SPLINT - LRG,27100081,RC,,,both,,,173,106.91,United Healthcare/Oxford,United Healthcare/Oxford,,122.99,,,122.99,97.9,151.5,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Aetna,Commerical,,132.7,,,132.7,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Aetna,Middlesex Employees,,119.44,,,119.44,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Anthem,Commerical,,118.74,,,118.74,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Anthem,Indemnity,,,126.2016,,126.2016,94.99,146.99,percent of total billed charges,,146.99
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Anthem,State Preferred,,118.74,,,118.74,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Anthem,Individual Exchange,,94.99,,,94.99,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Cigna,Cigna,,115.96,,,115.96,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Connecticare,Commerical,,124.03,,,124.03,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Connecticare,Exchange,,124.03,,,124.03,94.99,146.99,other,Could be inpatient or outpatient,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,Multiplan,Multiplan,,,142.8,,142.8,94.99,142.8,percent of total billed charges,,
HC MANUAL BREAST PUMP,27100083,RC,,,both,,,168,103.82,United Healthcare/Oxford,United Healthcare/Oxford,,119.34,,,119.34,94.99,146.99,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Aetna,Commerical,,33.79,,,33.79,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Aetna,Middlesex Employees,,30.41,,,30.41,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Anthem,Commerical,,30.23,,,30.23,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Anthem,Indemnity,,,33.07467961,,33.07467961,24.19,37.43,percent of total billed charges,,37.43
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Anthem,State Preferred,,30.23,,,30.23,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Anthem,Individual Exchange,,24.19,,,24.19,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Cigna,Cigna,,29.53,,,29.53,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Connecticare,Commerical,,31.58,,,31.58,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Connecticare,Exchange,,31.58,,,31.58,24.19,37.43,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,Multiplan,Multiplan,,,37.42475728,,37.42475728,24.19,37.42475728,percent of total billed charges,,
"HC FEEDING TUBE 6FR 36""",27100084,RC,,,both,,,44.02912621,27.21,United Healthcare/Oxford,United Healthcare/Oxford,,30.39,,,30.39,24.19,37.43,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Aetna,Commerical,,23.31,,,23.31,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Aetna,Middlesex Employees,,20.98,,,20.98,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Anthem,Commerical,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Anthem,Indemnity,,,22.1640466,,22.1640466,16.69,25.82,percent of total billed charges,,25.82
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Anthem,State Preferred,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Anthem,Individual Exchange,,16.69,,,16.69,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Cigna,Cigna,,20.37,,,20.37,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Connecticare,Commerical,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Connecticare,Exchange,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,Multiplan,Multiplan,,,25.07912621,,25.07912621,16.69,25.07912621,percent of total billed charges,,
HC WRAP THERMACARE,27100085,RC,,,both,,,29.50485437,18.23,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,16.69,25.82,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Aetna,Commerical,,309.35,,,309.35,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Aetna,Middlesex Employees,,278.41,,,278.41,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Anthem,Commerical,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Anthem,Indemnity,,,293.7192,,293.7192,221.44,342.67,percent of total billed charges,,342.67
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Anthem,State Preferred,,276.8,,,276.8,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Anthem,Individual Exchange,,221.44,,,221.44,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Cigna,Cigna,,270.33,,,270.33,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Connecticare,Commerical,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Connecticare,Exchange,,289.14,,,289.14,221.44,342.67,other,Could be inpatient or outpatient,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,Multiplan,Multiplan,,,332.35,,332.35,221.44,332.35,percent of total billed charges,,
HC PANTALOONS,27100087,RC,,,both,,,391,241.64,United Healthcare/Oxford,United Healthcare/Oxford,,278.21,,,278.21,221.44,342.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Aetna,Commerical,,77.34,,,77.34,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Aetna,Middlesex Employees,,69.61,,,69.61,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Anthem,Commerical,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Anthem,Indemnity,,,73.6176,,73.6176,55.36,85.67,percent of total billed charges,,85.67
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Anthem,State Preferred,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Anthem,Individual Exchange,,55.36,,,55.36,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Cigna,Cigna,,67.58,,,67.58,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Connecticare,Commerical,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Connecticare,Exchange,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,Multiplan,Multiplan,,,83.3,,83.3,55.36,83.3,percent of total billed charges,,
HC PEDI-WRAP,27100088,RC,,,both,,,98,60.56,United Healthcare/Oxford,United Healthcare/Oxford,,69.56,,,69.56,55.36,85.67,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Aetna,Commerical,,26.92,,,26.92,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Aetna,Middlesex Employees,,24.23,,,24.23,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Anthem,Commerical,,24.08,,,24.08,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Anthem,Indemnity,,,26.34305243,,26.34305243,19.27,29.81,percent of total billed charges,,29.81
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Anthem,State Preferred,,24.08,,,24.08,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Anthem,Individual Exchange,,19.27,,,19.27,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Cigna,Cigna,,23.51,,,23.51,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Connecticare,Commerical,,25.15,,,25.15,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Connecticare,Exchange,,25.15,,,25.15,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,Multiplan,Multiplan,,,29.80776699,,29.80776699,19.27,29.80776699,percent of total billed charges,,
HC RPLCMT PAD 3 4 5 ASPEN 007493,27100089,RC,,,both,,,35.06796117,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,24.21,,,24.21,19.27,29.81,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Aetna,Commerical,,43.96,,,43.96,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Aetna,Middlesex Employees,,39.56,,,39.56,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Anthem,Indemnity,,,42.0672,,42.0672,31.47,48.7,percent of total billed charges,,48.7
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,Multiplan,Multiplan,,,47.6,,47.6,31.47,47.6,percent of total billed charges,,
HC RPLCMT PAD ASPEN ADL 007644,27100090,RC,,,both,,,56,34.61,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Aetna,Commerical,,20.73,,,20.73,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Aetna,Middlesex Employees,,18.66,,,18.66,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Anthem,Commerical,,18.55,,,18.55,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Anthem,Indemnity,,,19.69894369,,19.69894369,14.84,22.96,percent of total billed charges,,22.96
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Anthem,State Preferred,,18.55,,,18.55,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Anthem,Individual Exchange,,14.84,,,14.84,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Cigna,Cigna,,18.12,,,18.12,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Connecticare,Commerical,,19.37,,,19.37,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Connecticare,Exchange,,19.37,,,19.37,14.84,22.96,other,Could be inpatient or outpatient,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,Multiplan,Multiplan,,,22.28980583,,22.28980583,14.84,22.28980583,percent of total billed charges,,
HC ASPIRATE BON MARROW NDL 15GX3/8 554773,27100096,RC,,,both,,,26.22330097,16.2,United Healthcare/Oxford,United Healthcare/Oxford,,18.64,,,18.64,14.84,22.96,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Aetna,Commerical,,14.75,,,14.75,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Aetna,Middlesex Employees,,13.28,,,13.28,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Anthem,Commerical,,13.2,,,13.2,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Anthem,Indemnity,,,14.01024466,,14.01024466,10.56,16.33,percent of total billed charges,,16.33
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Anthem,State Preferred,,13.2,,,13.2,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Anthem,Individual Exchange,,10.56,,,10.56,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Cigna,Cigna,,12.89,,,12.89,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Connecticare,Commerical,,13.78,,,13.78,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Connecticare,Exchange,,13.78,,,13.78,10.56,16.33,other,Could be inpatient or outpatient,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,Multiplan,Multiplan,,,15.85291262,,15.85291262,10.56,15.85291262,percent of total billed charges,,
HC BIOPATCH 2.5CM  000380,27100097,RC,,,both,,,18.65048544,11.53,United Healthcare/Oxford,United Healthcare/Oxford,,13.26,,,13.26,10.56,16.33,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Aetna,Commerical,,65.12,,,65.12,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Aetna,Middlesex Employees,,58.61,,,58.61,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Anthem,Commerical,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Anthem,Indemnity,,,61.5984,,61.5984,46.62,72.14,percent of total billed charges,,72.14
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Anthem,State Preferred,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Anthem,Individual Exchange,,46.62,,,46.62,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Cigna,Cigna,,56.91,,,56.91,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Connecticare,Commerical,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Connecticare,Exchange,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,Multiplan,Multiplan,,,69.7,,69.7,46.62,69.7,percent of total billed charges,,
"HC BONE MARROW SNARCOIL 2"" NDL  002732",27100098,RC,,,both,,,82,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,58.57,,,58.57,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Aetna,Commerical,,65.12,,,65.12,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Aetna,Middlesex Employees,,58.61,,,58.61,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Anthem,Commerical,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Anthem,Indemnity,,,61.5984,,61.5984,46.62,72.14,percent of total billed charges,,72.14
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Anthem,State Preferred,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Anthem,Individual Exchange,,46.62,,,46.62,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Cigna,Cigna,,56.91,,,56.91,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Connecticare,Commerical,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Connecticare,Exchange,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,Multiplan,Multiplan,,,69.7,,69.7,46.62,69.7,percent of total billed charges,,
"HC BONE MARROW SNARCOIL 3"" NDL  007156",27100099,RC,,,both,,,82,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,58.57,,,58.57,46.62,72.14,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Aetna,Commerical,,56.98,,,56.98,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Aetna,Middlesex Employees,,51.29,,,51.29,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Anthem,Commerical,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Anthem,Indemnity,,,54.0864,,54.0864,40.8,63.12,percent of total billed charges,,63.12
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Anthem,State Preferred,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Anthem,Individual Exchange,,40.8,,,40.8,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Cigna,Cigna,,49.8,,,49.8,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Connecticare,Commerical,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Connecticare,Exchange,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,Multiplan,Multiplan,,,61.2,,61.2,40.8,61.2,percent of total billed charges,,
HC BREATHING CIRCUIT W/MASK  006928,27100100,RC,,,both,,,72,44.5,United Healthcare/Oxford,United Healthcare/Oxford,,51.25,,,51.25,40.8,63.12,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Aetna,Commerical,,39.85,,,39.85,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Aetna,Middlesex Employees,,35.86,,,35.86,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Anthem,Commerical,,35.66,,,35.66,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Anthem,Indemnity,,,37.56,,37.56,28.52,44.14,percent of total billed charges,,44.14
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Anthem,State Preferred,,35.66,,,35.66,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Anthem,Individual Exchange,,28.52,,,28.52,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Cigna,Cigna,,34.82,,,34.82,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Connecticare,Commerical,,37.25,,,37.25,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Connecticare,Exchange,,37.25,,,37.25,28.52,44.14,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,Multiplan,Multiplan,,,42.5,,42.5,28.52,42.5,percent of total billed charges,,
HC CENTRAL LINE DRES KIT  574782,27100101,RC,,,both,,,50,30.9,United Healthcare/Oxford,United Healthcare/Oxford,,35.83,,,35.83,28.52,44.14,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Aetna,Commerical,,24.19,,,24.19,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Aetna,Middlesex Employees,,21.77,,,21.77,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Anthem,Commerical,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Anthem,Indemnity,,,23.68103301,,23.68103301,17.32,26.79,percent of total billed charges,,26.79
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Anthem,State Preferred,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Anthem,Individual Exchange,,17.32,,,17.32,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Cigna,Cigna,,21.13,,,21.13,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Connecticare,Commerical,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Connecticare,Exchange,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,Multiplan,Multiplan,,,26.79563107,,26.79563107,17.32,26.79563107,percent of total billed charges,,
HC C02 NASAL CANULLA ADULT 322448 PEDI 322789,27100102,RC,,,both,,,31.52427184,19.48,United Healthcare/Oxford,United Healthcare/Oxford,,21.75,,,21.75,17.32,26.79,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Aetna,Commerical,,15.95,,,15.95,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Aetna,Middlesex Employees,,14.35,,,14.35,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Anthem,Commerical,,14.27,,,14.27,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Anthem,Indemnity,,,15.16257087,,15.16257087,11.42,17.66,percent of total billed charges,,17.66
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Anthem,State Preferred,,14.27,,,14.27,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Anthem,Individual Exchange,,11.42,,,11.42,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Cigna,Cigna,,13.94,,,13.94,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Connecticare,Commerical,,14.9,,,14.9,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Connecticare,Exchange,,14.9,,,14.9,11.42,17.66,other,Could be inpatient or outpatient,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,Multiplan,Multiplan,,,17.15679612,,17.15679612,11.42,17.15679612,percent of total billed charges,,
HC NASAL ATOMIZER MAD  557681,27100103,RC,,,both,,,20.18446602,12.47,United Healthcare/Oxford,United Healthcare/Oxford,,14.34,,,14.34,11.42,17.66,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Aetna,Commerical,,156.31,,,156.31,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Aetna,Middlesex Employees,,140.68,,,140.68,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Anthem,Commerical,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Anthem,Indemnity,,,148.7376,,148.7376,111.88,173.14,percent of total billed charges,,173.14
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Anthem,State Preferred,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Anthem,Individual Exchange,,111.88,,,111.88,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Cigna,Cigna,,136.58,,,136.58,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Connecticare,Commerical,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Connecticare,Exchange,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,Multiplan,Multiplan,,,168.3,,168.3,111.88,168.3,percent of total billed charges,,
HC BONE MARROW PROC KIT,27100105,RC,,,both,,,198,122.36,United Healthcare/Oxford,United Healthcare/Oxford,,140.56,,,140.56,111.88,173.14,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Aetna,Commerical,,77.34,,,77.34,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Aetna,Middlesex Employees,,69.61,,,69.61,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Anthem,Commerical,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Anthem,Indemnity,,,73.6176,,73.6176,55.36,85.67,percent of total billed charges,,85.67
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Anthem,State Preferred,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Anthem,Individual Exchange,,55.36,,,55.36,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Cigna,Cigna,,67.58,,,67.58,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Connecticare,Commerical,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Connecticare,Exchange,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,Multiplan,Multiplan,,,83.3,,83.3,55.36,83.3,percent of total billed charges,,
HC LUMBAR PUNCT PROC KIT,27100106,RC,,,both,,,98,60.56,United Healthcare/Oxford,United Healthcare/Oxford,,69.56,,,69.56,55.36,85.67,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Aetna,Commerical,,24.1,,,24.1,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Aetna,Middlesex Employees,,21.69,,,21.69,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Anthem,Commerical,,21.56,,,21.56,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Anthem,Indemnity,,,23.58622136,,23.58622136,17.24,26.69,percent of total billed charges,,26.69
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Anthem,State Preferred,,21.56,,,21.56,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Anthem,Individual Exchange,,17.24,,,17.24,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Cigna,Cigna,,21.06,,,21.06,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Connecticare,Commerical,,22.52,,,22.52,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Connecticare,Exchange,,22.52,,,22.52,17.24,26.69,other,Could be inpatient or outpatient,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,Multiplan,Multiplan,,,26.68834951,,26.68834951,17.24,26.68834951,percent of total billed charges,,
HC RPLCLMT PAD 1 2 ASPEN #007496,27100108,RC,,,both,,,31.39805825,19.41,United Healthcare/Oxford,United Healthcare/Oxford,,21.67,,,21.67,17.24,26.69,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Aetna,Commerical,,68.38,,,68.38,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Aetna,Middlesex Employees,,61.54,,,61.54,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Anthem,Commerical,,61.19,,,61.19,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Anthem,Indemnity,,,65.3544,,65.3544,48.96,75.75,percent of total billed charges,,75.75
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Anthem,State Preferred,,61.19,,,61.19,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Anthem,Individual Exchange,,48.96,,,48.96,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Cigna,Cigna,,59.76,,,59.76,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Connecticare,Commerical,,63.92,,,63.92,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Connecticare,Exchange,,63.92,,,63.92,48.96,75.75,other,Could be inpatient or outpatient,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,Multiplan,Multiplan,,,73.95,,73.95,48.96,73.95,percent of total billed charges,,
HC HEIMLICH VALVE #300427,27100109,RC,,,both,,,87,53.77,United Healthcare/Oxford,United Healthcare/Oxford,,61.5,,,61.5,48.96,75.75,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Aetna,Commerical,,38.47,,,38.47,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Aetna,Middlesex Employees,,34.62,,,34.62,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Anthem,Commerical,,34.41,,,34.41,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Anthem,Indemnity,,,36.56083107,,36.56083107,27.53,42.61,percent of total billed charges,,42.61
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Anthem,State Preferred,,34.41,,,34.41,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Anthem,Individual Exchange,,27.53,,,27.53,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Cigna,Cigna,,33.61,,,33.61,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Connecticare,Commerical,,35.95,,,35.95,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Connecticare,Exchange,,35.95,,,35.95,27.53,42.61,other,Could be inpatient or outpatient,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,Multiplan,Multiplan,,,41.36941748,,41.36941748,27.53,42.61,percent of total billed charges,,
HC CO2 ADULT/PEDI (VENT) #321465,27100110,RC,,,both,,,48.66990291,30.08,United Healthcare/Oxford,United Healthcare/Oxford,,34.6,,,34.6,27.53,42.61,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Aetna,Commerical,,22.19,,,22.19,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Aetna,Middlesex Employees,,19.97,,,19.97,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Anthem,Commerical,,19.85,,,19.85,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Anthem,Indemnity,,,21.08465243,,21.08465243,15.88,24.57,percent of total billed charges,,24.57
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Anthem,State Preferred,,19.85,,,19.85,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Anthem,Individual Exchange,,15.88,,,15.88,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Cigna,Cigna,,19.39,,,19.39,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Connecticare,Commerical,,20.73,,,20.73,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Connecticare,Exchange,,20.73,,,20.73,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,Multiplan,Multiplan,,,23.85776699,,23.85776699,15.88,23.85776699,percent of total billed charges,,
HC C02 DETECTOR (RESP),27100111,RC,,,both,,,28.06796117,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,19.95,,,19.95,15.88,24.57,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Aetna,Commerical,,49.66,,,49.66,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Aetna,Middlesex Employees,,44.7,,,44.7,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Anthem,Commerical,,44.43,,,44.43,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Anthem,Indemnity,,,47.3256,,47.3256,35.54,55,percent of total billed charges,,55
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Anthem,State Preferred,,44.43,,,44.43,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Anthem,Individual Exchange,,35.54,,,35.54,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Cigna,Cigna,,43.4,,,43.4,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Connecticare,Commerical,,46.41,,,46.41,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Connecticare,Exchange,,46.41,,,46.41,35.54,55,other,Could be inpatient or outpatient,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,Multiplan,Multiplan,,,53.55,,53.55,35.54,53.55,percent of total billed charges,,
HC C02 INFANT/NEO VENT #321464,27100112,RC,,,both,,,63,38.93,United Healthcare/Oxford,United Healthcare/Oxford,,44.66,,,44.66,35.54,55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Aetna,Commerical,,11.33,,,11.33,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Aetna,Middlesex Employees,,10.19,,,10.19,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Anthem,Commerical,,10.13,,,10.13,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Anthem,Indemnity,,,10.76476893,,10.76476893,8.1,12.55,percent of total billed charges,,12.55
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Anthem,State Preferred,,10.13,,,10.13,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Anthem,Individual Exchange,,8.1,,,8.1,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Cigna,Cigna,,9.89,,,9.89,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Connecticare,Commerical,,10.58,,,10.58,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Connecticare,Exchange,,10.58,,,10.58,8.1,12.55,other,Could be inpatient or outpatient,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,Multiplan,Multiplan,,,12.18058252,,12.18058252,8.1,12.18058252,percent of total billed charges,,
HC SUCTION CANISTER LAERDAL #002594,27100113,RC,,,both,,,14.33009709,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,10.19,,,10.19,8.1,12.55,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Aetna,Commerical,,48.84,,,48.84,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Aetna,Middlesex Employees,,43.96,,,43.96,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Anthem,Commerical,,43.71,,,43.71,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Anthem,Indemnity,,,46.5744,,46.5744,34.96,54.1,percent of total billed charges,,54.1
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Anthem,State Preferred,,43.71,,,43.71,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Anthem,Individual Exchange,,34.96,,,34.96,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Cigna,Cigna,,42.68,,,42.68,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Connecticare,Commerical,,45.65,,,45.65,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Connecticare,Exchange,,45.65,,,45.65,34.96,54.1,other,Could be inpatient or outpatient,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,Multiplan,Multiplan,,,52.7,,52.7,34.96,52.7,percent of total billed charges,,
HC PRESSURE INFUSER 1000ML  #000170,27100114,RC,,,both,,,62,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,43.93,,,43.93,34.96,54.1,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Aetna,Commerical,,11.79,,,11.79,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Aetna,Middlesex Employees,,10.62,,,10.62,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Anthem,Commerical,,9.79,,,9.79,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Anthem,Indemnity,,,12.50055146,,12.50055146,7.83,14.14,percent of total billed charges,,14.14
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Anthem,State Preferred,,9.79,,,9.79,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Anthem,Individual Exchange,,7.83,,,7.83,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Cigna,Cigna,,10.39,,,10.39,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Connecticare,Commerical,,10.66,,,10.66,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Connecticare,Exchange,,10.66,,,10.66,7.83,14.14,other,Could be inpatient or outpatient,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,Multiplan,Multiplan,,,14.14466019,,14.14466019,7.83,14.14466019,percent of total billed charges,,
HC BLANKET ADULT LOWER  #554700,27100115,RC,,,both,,,16.6407767,10.28,United Healthcare/Oxford,United Healthcare/Oxford,,10.93,,,10.93,7.83,14.14,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Aetna,Commerical,,31.69,,,31.69,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Aetna,Middlesex Employees,,28.52,,,28.52,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Anthem,Commerical,,28.36,,,28.36,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Anthem,Indemnity,,,30.12093204,,30.12093204,22.69,35.11,percent of total billed charges,,35.11
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Anthem,State Preferred,,28.36,,,28.36,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Anthem,Individual Exchange,,22.69,,,22.69,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Cigna,Cigna,,27.7,,,27.7,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Connecticare,Commerical,,29.62,,,29.62,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Connecticare,Exchange,,29.62,,,29.62,22.69,35.11,other,Could be inpatient or outpatient,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,Multiplan,Multiplan,,,34.08252427,,34.08252427,22.69,34.08252427,percent of total billed charges,,
HB BLANKET PEDI UNDER #554804,27100116,RC,,,both,,,40.09708738,24.78,United Healthcare/Oxford,United Healthcare/Oxford,,28.5,,,28.5,22.69,35.11,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Aetna,Commerical,,38.29,,,38.29,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Aetna,Middlesex Employees,,34.46,,,34.46,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Anthem,Commerical,,31.77,,,31.77,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Anthem,Indemnity,,,40.5648,,40.5648,25.42,45.9,percent of total billed charges,,45.9
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Anthem,State Preferred,,31.77,,,31.77,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Anthem,Individual Exchange,,25.42,,,25.42,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Cigna,Cigna,,33.73,,,33.73,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Connecticare,Commerical,,34.6,,,34.6,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Connecticare,Exchange,,34.6,,,34.6,25.42,45.9,other,Could be inpatient or outpatient,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,Multiplan,Multiplan,,,45.9,,45.9,25.42,45.9,percent of total billed charges,,
HC EZ STABILIZER #580797,27100117,RC,,,both,,,54,33.37,United Healthcare/Oxford,United Healthcare/Oxford,,35.46,,,35.46,25.42,45.9,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Aetna,Commerical,,93.98,,,93.98,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Aetna,Middlesex Employees,,90.12,,,90.12,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Anthem,Commerical,,90.78,,,90.78,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Anthem,Indemnity,,,90.144,,90.144,72.62,105.61,percent of total billed charges,,105.61
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Anthem,State Preferred,,90.78,,,90.78,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Anthem,Individual Exchange,,72.62,,,72.62,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Cigna,Cigna,,105.61,,,105.61,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Connecticare,Commerical,,100.17,,,100.17,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Connecticare,Exchange,,100.17,,,100.17,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,Multiplan,Multiplan,,,102,,102,72.62,105.61,percent of total billed charges,,
HC POSITIONER NEO MED W/ COVER 12X20 #581293,27100118,RC,,,both,,,120,74.16,United Healthcare/Oxford,United Healthcare/Oxford,,82.44,,,82.44,72.62,105.61,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Aetna,Commerical,,42.29,,,42.29,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Aetna,Middlesex Employees,,40.55,,,40.55,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Anthem,Commerical,,40.85,,,40.85,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Anthem,Indemnity,,,40.5648,,40.5648,32.68,47.52,percent of total billed charges,,47.52
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Anthem,State Preferred,,40.85,,,40.85,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Anthem,Individual Exchange,,32.68,,,32.68,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Cigna,Cigna,,47.52,,,47.52,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Connecticare,Commerical,,45.08,,,45.08,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Connecticare,Exchange,,45.08,,,45.08,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,Multiplan,Multiplan,,,45.9,,45.9,32.68,47.52,percent of total billed charges,,
HC POSITIONER NEO SM W/ COVER 9X15 #581294,27100119,RC,,,both,,,54,33.37,United Healthcare/Oxford,United Healthcare/Oxford,,37.1,,,37.1,32.68,47.52,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Aetna,Commerical,,173.86,,,173.86,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Aetna,Middlesex Employees,,166.72,,,166.72,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Anthem,Commerical,,167.94,,,167.94,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Anthem,Indemnity,,,166.7664,,166.7664,134.35,195.37,percent of total billed charges,,195.37
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Anthem,State Preferred,,167.94,,,167.94,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Anthem,Individual Exchange,,134.35,,,134.35,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Cigna,Cigna,,195.37,,,195.37,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Connecticare,Commerical,,185.32,,,185.32,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Connecticare,Exchange,,185.32,,,185.32,134.35,195.37,other,Could be inpatient or outpatient,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,Multiplan,Multiplan,,,188.7,,188.7,134.35,195.37,percent of total billed charges,,
HC POSITIONER NEO LRG W/ COVER 16X24 #581292,27100120,RC,,,both,,,222,137.2,United Healthcare/Oxford,United Healthcare/Oxford,,152.52,,,152.52,134.35,195.37,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Aetna,Commerical,,101.81,,,101.81,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Aetna,Middlesex Employees,,97.63,,,97.63,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Anthem,Commerical,,98.34,,,98.34,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Anthem,Indemnity,,,97.656,,97.656,78.67,114.41,percent of total billed charges,,114.41
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Anthem,State Preferred,,98.34,,,98.34,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Anthem,Individual Exchange,,78.67,,,78.67,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Cigna,Cigna,,114.41,,,114.41,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Connecticare,Commerical,,108.52,,,108.52,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Connecticare,Exchange,,108.52,,,108.52,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,Multiplan,Multiplan,,,110.5,,110.5,78.67,114.41,percent of total billed charges,,
"HC POSITIONER TUBE 40"" NEO #581291",27100121,RC,,,both,,,130,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,89.31,,,89.31,78.67,114.41,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Aetna,Commerical,,90.07,,,90.07,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Aetna,Middlesex Employees,,86.36,,,86.36,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Anthem,Commerical,,87,,,87,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Anthem,Indemnity,,,86.388,,86.388,69.6,101.21,percent of total billed charges,,101.21
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Anthem,State Preferred,,87,,,87,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Anthem,Individual Exchange,,69.6,,,69.6,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Cigna,Cigna,,101.21,,,101.21,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Connecticare,Commerical,,96,,,96,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Connecticare,Exchange,,96,,,96,69.6,101.21,other,Could be inpatient or outpatient,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,Multiplan,Multiplan,,,97.75,,97.75,69.6,101.21,percent of total billed charges,,
"HC POSITIONER TUBE 30"" NEO #581373",27100122,RC,,,both,,,115,71.07,United Healthcare/Oxford,United Healthcare/Oxford,,79.01,,,79.01,69.6,101.21,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Aetna,Commerical,,23.5,,,23.5,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Aetna,Middlesex Employees,,22.53,,,22.53,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Anthem,Commerical,,22.69,,,22.69,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Anthem,Indemnity,,,22.536,,22.536,18.16,26.4,percent of total billed charges,,26.4
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Anthem,State Preferred,,22.69,,,22.69,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Anthem,Individual Exchange,,18.16,,,18.16,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Cigna,Cigna,,26.4,,,26.4,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Connecticare,Commerical,,25.04,,,25.04,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Connecticare,Exchange,,25.04,,,25.04,18.16,26.4,other,Could be inpatient or outpatient,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,Multiplan,Multiplan,,,25.5,,25.5,18.16,26.4,percent of total billed charges,,
HC POSITIONER HEAD W/COVER NEO #581372,27100123,RC,,,both,,,30,18.54,United Healthcare/Oxford,United Healthcare/Oxford,,20.61,,,20.61,18.16,26.4,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Aetna,Commerical,,16.02,,,16.02,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Aetna,Middlesex Employees,,15.37,,,15.37,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Anthem,Commerical,,15.48,,,15.48,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Anthem,Indemnity,,,15.36678058,,15.36678058,12.38,18.01,percent of total billed charges,,18.01
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Anthem,State Preferred,,15.48,,,15.48,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Anthem,Individual Exchange,,12.38,,,12.38,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Cigna,Cigna,,18.01,,,18.01,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Connecticare,Commerical,,17.08,,,17.08,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Connecticare,Exchange,,17.08,,,17.08,12.38,18.01,other,Could be inpatient or outpatient,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,Multiplan,Multiplan,,,17.38786408,,17.38786408,12.38,18.01,percent of total billed charges,,
HC FLEXIBLE ARM BOARD #650,27100124,RC,,,both,,,20.45631068,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,14.06,,,14.06,12.38,18.01,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Aetna,Commerical,,101.76,,,101.76,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Aetna,Middlesex Employees,,91.58,,,91.58,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Anthem,Commerical,,91.05,,,91.05,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Anthem,Indemnity,,,96.9048,,96.9048,72.84,112.72,percent of total billed charges,,112.72
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Anthem,State Preferred,,91.05,,,91.05,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Anthem,Individual Exchange,,72.84,,,72.84,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Cigna,Cigna,,88.92,,,88.92,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Connecticare,Commerical,,95.11,,,95.11,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Connecticare,Exchange,,95.11,,,95.11,72.84,112.72,other,Could be inpatient or outpatient,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,Multiplan,Multiplan,,,109.65,,109.65,72.84,109.65,percent of total billed charges,,
HC ABDUCT PILLOW SM - LRG,27200030,RC,,,both,,,129,79.72,United Healthcare/Oxford,United Healthcare/Oxford,,91.52,,,91.52,72.84,112.72,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Aetna,Commerical,,48.84,,,48.84,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Aetna,Middlesex Employees,,43.96,,,43.96,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Anthem,Commerical,,43.71,,,43.71,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Anthem,Indemnity,,,46.5744,,46.5744,34.96,54.1,percent of total billed charges,,54.1
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Anthem,State Preferred,,43.71,,,43.71,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Anthem,Individual Exchange,,34.96,,,34.96,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Cigna,Cigna,,42.68,,,42.68,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Connecticare,Commerical,,45.65,,,45.65,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Connecticare,Exchange,,45.65,,,45.65,34.96,54.1,other,Could be inpatient or outpatient,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,Multiplan,Multiplan,,,52.7,,52.7,34.96,52.7,percent of total billed charges,,
HC CAST BOOT,27200031,RC,,,both,,,62,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,43.93,,,43.93,34.96,54.1,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Anthem,Indemnity,,,93.9,,93.9,70.51,109.11,percent of total billed charges,,109.11
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,Multiplan,Multiplan,,,106.25,,106.25,70.51,106.25,percent of total billed charges,,
HC CLSET BDL COOK 4FR,27200032,RC,,,both,,,125,77.25,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Aetna,Commerical,,134.33,,,134.33,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Aetna,Middlesex Employees,,120.9,,,120.9,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Anthem,Commerical,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Anthem,Indemnity,,,127.704,,127.704,96.15,148.79,percent of total billed charges,,148.79
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Anthem,State Preferred,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Anthem,Individual Exchange,,96.15,,,96.15,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Cigna,Cigna,,117.38,,,117.38,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Connecticare,Commerical,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Connecticare,Exchange,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,Multiplan,Multiplan,,,144.5,,144.5,96.15,144.5,percent of total billed charges,,
HC CLSET COOKTRP 5FR,27200034,RC,,,both,,,170,105.06,United Healthcare/Oxford,United Healthcare/Oxford,,120.8,,,120.8,96.15,148.79,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Aetna,Commerical,,1513.4,,,1513.4,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Aetna,Middlesex Employees,,1362.06,,,1362.06,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Anthem,Commerical,,1354.15,,,1354.15,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Anthem,Indemnity,,,1438.548,,1438.548,1083.32,1676.38,percent of total billed charges,,1676.38
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Anthem,State Preferred,,1354.15,,,1354.15,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Anthem,Individual Exchange,,1083.32,,,1083.32,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Cigna,Cigna,,1322.47,,,1322.47,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Connecticare,Commerical,,1414.5,,,1414.5,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Connecticare,Exchange,,1414.5,,,1414.5,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,Multiplan,Multiplan,,,1627.75,,1627.75,1083.32,1676.38,percent of total billed charges,,
HC CRANL ACC/CARRINO,27200038,RC,,,both,,,1915,1183.47,United Healthcare/Oxford,United Healthcare/Oxford,,1361.02,,,1361.02,1083.32,1676.38,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Aetna,Commerical,,135.95,,,135.95,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Aetna,Middlesex Employees,,122.36,,,122.36,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Anthem,Commerical,,121.64,,,121.64,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Anthem,Indemnity,,,129.2064,,129.2064,97.31,150.59,percent of total billed charges,,150.59
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Anthem,State Preferred,,121.64,,,121.64,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Anthem,Individual Exchange,,97.31,,,97.31,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Cigna,Cigna,,118.8,,,118.8,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Connecticare,Commerical,,127.07,,,127.07,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Connecticare,Exchange,,127.07,,,127.07,97.31,150.59,other,Could be inpatient or outpatient,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,Multiplan,Multiplan,,,146.2,,146.2,97.31,146.2,percent of total billed charges,,
HC CNS DRAIN BAG,27200039,RC,,,both,,,172,106.3,United Healthcare/Oxford,United Healthcare/Oxford,,122.26,,,122.26,97.31,150.59,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Aetna,Commerical,,521.02,,,521.02,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Aetna,Middlesex Employees,,468.92,,,468.92,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Anthem,Commerical,,466.2,,,466.2,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Anthem,Indemnity,,,495.0408,,495.0408,372.95,577.13,percent of total billed charges,,577.13
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Anthem,State Preferred,,466.2,,,466.2,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Anthem,Individual Exchange,,372.95,,,372.95,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Cigna,Cigna,,455.29,,,455.29,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Connecticare,Commerical,,486.98,,,486.98,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Connecticare,Exchange,,486.98,,,486.98,372.95,577.13,other,Could be inpatient or outpatient,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,Multiplan,Multiplan,,,560.15,,560.15,372.95,560.15,percent of total billed charges,,
HC CATH HEMODIALYSIS 9FR,27200040,RC,,,both,,,659,407.26,United Healthcare/Oxford,United Healthcare/Oxford,,468.56,,,468.56,372.95,577.13,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Anthem,Indemnity,,,94.6512,,94.6512,71.09,110.02,percent of total billed charges,,110.02
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,Multiplan,Multiplan,,,107.1,,107.1,71.09,107.1,percent of total billed charges,,
HC CANNULA CPAP  1602,27200041,RC,,,both,,,126,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Anthem,Indemnity,,,18.29135534,,18.29135534,13.78,21.32,percent of total billed charges,,21.32
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,Multiplan,Multiplan,,,20.69708738,,20.69708738,13.78,20.69708738,percent of total billed charges,,
HC SPACER,27200042,RC,,,both,,,24.34951456,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Aetna,Commerical,,20.7,,,20.7,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Aetna,Middlesex Employees,,18.63,,,18.63,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Anthem,Commerical,,18.52,,,18.52,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Anthem,Indemnity,,,19.66977087,,19.66977087,14.81,22.92,percent of total billed charges,,22.92
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Anthem,State Preferred,,18.52,,,18.52,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Anthem,Individual Exchange,,14.81,,,14.81,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Cigna,Cigna,,18.09,,,18.09,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Connecticare,Commerical,,19.34,,,19.34,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Connecticare,Exchange,,19.34,,,19.34,14.81,22.92,other,Could be inpatient or outpatient,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,Multiplan,Multiplan,,,22.25679612,,22.25679612,14.81,22.25679612,percent of total billed charges,,
HC LEGBAG DRAINAGE,27200043,RC,,,both,,,26.18446602,16.18,United Healthcare/Oxford,United Healthcare/Oxford,,18.61,,,18.61,14.81,22.92,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Aetna,Commerical,,13.12,,,13.12,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Aetna,Middlesex Employees,,11.81,,,11.81,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Anthem,Commerical,,11.75,,,11.75,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Anthem,Indemnity,,,12.47137864,,12.47137864,9.4,14.54,percent of total billed charges,,14.54
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Anthem,State Preferred,,11.75,,,11.75,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Anthem,Individual Exchange,,9.4,,,9.4,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Cigna,Cigna,,11.47,,,11.47,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Connecticare,Commerical,,12.26,,,12.26,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Connecticare,Exchange,,12.26,,,12.26,9.4,14.54,other,Could be inpatient or outpatient,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,Multiplan,Multiplan,,,14.11165049,,14.11165049,9.4,14.11165049,percent of total billed charges,,
HC BUBBLE HUMIDIFIER,27200044,RC,,,both,,,16.60194175,10.26,United Healthcare/Oxford,United Healthcare/Oxford,,11.8,,,11.8,9.4,14.54,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Aetna,Commerical,,1.71,,,1.71,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Aetna,Middlesex Employees,,1.53,,,1.53,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Anthem,Commerical,,1.52,,,1.52,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Anthem,Indemnity,,,1.611798058,,1.611798058,1.22,1.89,percent of total billed charges,,1.89
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Anthem,State Preferred,,1.52,,,1.52,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Anthem,Individual Exchange,,1.22,,,1.22,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Cigna,Cigna,,1.49,,,1.49,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Connecticare,Commerical,,1.59,,,1.59,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Connecticare,Exchange,,1.59,,,1.59,1.22,1.89,other,Could be inpatient or outpatient,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,Multiplan,Multiplan,,,1.823786408,,1.823786408,1.22,1.823786408,percent of total billed charges,,
HC DRESSING OPSIT 6X8CL,27200045,RC,,,both,,,2.145631068,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,1.53,,,1.53,1.22,1.89,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Aetna,Commerical,,33.69,,,33.69,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Aetna,Middlesex Employees,,30.32,,,30.32,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Anthem,Commerical,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Anthem,Indemnity,,,32.01716505,,32.01716505,24.12,37.32,percent of total billed charges,,37.32
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Anthem,State Preferred,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Anthem,Individual Exchange,,24.12,,,24.12,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Cigna,Cigna,,29.44,,,29.44,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Connecticare,Commerical,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Connecticare,Exchange,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,Multiplan,Multiplan,,,36.22815534,,36.22815534,24.12,36.22815534,percent of total billed charges,,
HC DUODERMX THIN6X6,27200046,RC,,,both,,,42.62135922,26.34,United Healthcare/Oxford,United Healthcare/Oxford,,30.29,,,30.29,24.12,37.32,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Aetna,Commerical,,25.91,,,25.91,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Aetna,Middlesex Employees,,23.32,,,23.32,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Anthem,Commerical,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Anthem,Indemnity,,,24.62185631,,24.62185631,18.55,28.7,percent of total billed charges,,28.7
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Anthem,State Preferred,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Anthem,Individual Exchange,,18.55,,,18.55,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Cigna,Cigna,,22.64,,,22.64,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Connecticare,Commerical,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Connecticare,Exchange,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,Multiplan,Multiplan,,,27.86019417,,27.86019417,18.55,27.86019417,percent of total billed charges,,
HC DRESSING SET REG,27200047,RC,,,both,,,32.77669903,20.26,United Healthcare/Oxford,United Healthcare/Oxford,,23.3,,,23.3,18.55,28.7,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Aetna,Commerical,,5.91,,,5.91,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Aetna,Middlesex Employees,,5.32,,,5.32,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Anthem,Commerical,,5.29,,,5.29,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Anthem,Indemnity,,,5.61576699,,5.61576699,4.23,6.55,percent of total billed charges,,6.55
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Anthem,State Preferred,,5.29,,,5.29,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Anthem,Individual Exchange,,4.23,,,4.23,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Cigna,Cigna,,5.17,,,5.17,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Connecticare,Commerical,,5.52,,,5.52,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Connecticare,Exchange,,5.52,,,5.52,4.23,6.55,other,Could be inpatient or outpatient,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,Multiplan,Multiplan,,,6.354368932,,6.354368932,4.23,6.354368932,percent of total billed charges,,
HC DRESSING BIO 010092,27200048,RC,,,both,,,7.475728155,4.62,United Healthcare/Oxford,United Healthcare/Oxford,,5.31,,,5.31,4.23,6.55,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Aetna,Commerical,,14.69,,,14.69,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Aetna,Middlesex Employees,,13.22,,,13.22,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Anthem,Commerical,,13.14,,,13.14,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Anthem,Indemnity,,,14.37490485,,14.37490485,10.52,16.27,percent of total billed charges,,16.27
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Anthem,State Preferred,,13.14,,,13.14,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Anthem,Individual Exchange,,10.52,,,10.52,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Cigna,Cigna,,12.83,,,12.83,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Connecticare,Commerical,,13.73,,,13.73,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Connecticare,Exchange,,13.73,,,13.73,10.52,16.27,other,Could be inpatient or outpatient,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,Multiplan,Multiplan,,,16.26553398,,16.26553398,10.52,16.26553398,percent of total billed charges,,
HC DUODERM X-THIN,27200049,RC,,,both,,,19.13592233,11.83,United Healthcare/Oxford,United Healthcare/Oxford,,13.2,,,13.2,10.52,16.27,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Aetna,Commerical,,11.33,,,11.33,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Aetna,Middlesex Employees,,10.19,,,10.19,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Anthem,Commerical,,10.14,,,10.14,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Anthem,Indemnity,,,10.77206214,,10.77206214,8.11,12.55,percent of total billed charges,,12.55
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Anthem,State Preferred,,10.14,,,10.14,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Anthem,Individual Exchange,,8.11,,,8.11,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Cigna,Cigna,,9.9,,,9.9,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Connecticare,Commerical,,10.59,,,10.59,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Connecticare,Exchange,,10.59,,,10.59,8.11,12.55,other,Could be inpatient or outpatient,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,Multiplan,Multiplan,,,12.18883495,,12.18883495,8.11,12.18883495,percent of total billed charges,,
HC KERLIX,27200050,RC,,,both,,,14.33980583,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,10.19,,,10.19,8.11,12.55,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Aetna,Commerical,,8.24,,,8.24,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Aetna,Middlesex Employees,,7.42,,,7.42,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Anthem,Commerical,,7.37,,,7.37,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Anthem,Indemnity,,,7.825607767,,7.825607767,5.9,9.13,percent of total billed charges,,9.13
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Anthem,State Preferred,,7.37,,,7.37,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Anthem,Individual Exchange,,5.9,,,5.9,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Cigna,Cigna,,7.2,,,7.2,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Connecticare,Commerical,,7.7,,,7.7,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Connecticare,Exchange,,7.7,,,7.7,5.9,9.13,other,Could be inpatient or outpatient,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,Multiplan,Multiplan,,,8.854854369,,8.854854369,5.9,8.854854369,percent of total billed charges,,
HC DRESSING KRLIX STER,27200051,RC,,,both,,,10.41747573,6.44,United Healthcare/Oxford,United Healthcare/Oxford,,7.41,,,7.41,5.9,9.13,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Aetna,Commerical,,26.78,,,26.78,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Aetna,Middlesex Employees,,24.1,,,24.1,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Anthem,Commerical,,23.96,,,23.96,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Anthem,Indemnity,,,25.45328155,,25.45328155,19.17,29.66,percent of total billed charges,,29.66
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Anthem,State Preferred,,23.96,,,23.96,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Anthem,Individual Exchange,,19.17,,,19.17,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Cigna,Cigna,,23.4,,,23.4,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Connecticare,Commerical,,25.03,,,25.03,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Connecticare,Exchange,,25.03,,,25.03,19.17,29.66,other,Could be inpatient or outpatient,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,Multiplan,Multiplan,,,28.80097087,,28.80097087,19.17,28.80097087,percent of total billed charges,,
HC BUTTONFEED SET,27200052,RC,,,both,,,33.88349515,20.94,United Healthcare/Oxford,United Healthcare/Oxford,,24.08,,,24.08,19.17,29.66,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Aetna,Commerical,,6.2,,,6.2,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Aetna,Middlesex Employees,,5.58,,,5.58,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Anthem,Commerical,,5.55,,,5.55,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Anthem,Indemnity,,,6.067945631,,6.067945631,4.44,6.87,percent of total billed charges,,6.87
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Anthem,State Preferred,,5.55,,,5.55,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Anthem,Individual Exchange,,4.44,,,4.44,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Cigna,Cigna,,5.42,,,5.42,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Connecticare,Commerical,,5.8,,,5.8,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Connecticare,Exchange,,5.8,,,5.8,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,Multiplan,Multiplan,,,6.866019417,,6.866019417,4.44,6.866019417,percent of total billed charges,,
HC DRESSING 4X3 SPONGE,27200053,RC,,,both,,,8.077669903,4.99,United Healthcare/Oxford,United Healthcare/Oxford,,5.58,,,5.58,4.44,6.87,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Aetna,Commerical,,3.12,,,3.12,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Aetna,Middlesex Employees,,2.8,,,2.8,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Anthem,Commerical,,2.79,,,2.79,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Anthem,Indemnity,,,3.048559223,,3.048559223,2.24,3.45,percent of total billed charges,,3.45
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Anthem,State Preferred,,2.79,,,2.79,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Anthem,Individual Exchange,,2.24,,,2.24,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Cigna,Cigna,,2.72,,,2.72,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Connecticare,Commerical,,2.91,,,2.91,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Connecticare,Exchange,,2.91,,,2.91,2.24,3.45,other,Could be inpatient or outpatient,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,Multiplan,Multiplan,,,3.449514563,,3.449514563,2.24,3.449514563,percent of total billed charges,,
HC DRESSING 4X4SPONGE EX,27200054,RC,,,both,,,4.058252427,2.51,United Healthcare/Oxford,United Healthcare/Oxford,,2.8,,,2.8,2.24,3.45,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Aetna,Commerical,,3.39,,,3.39,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Aetna,Middlesex Employees,,3.06,,,3.06,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Anthem,Commerical,,3.03,,,3.03,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Anthem,Indemnity,,,3.216302913,,3.216302913,2.42,3.75,percent of total billed charges,,3.75
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Anthem,State Preferred,,3.03,,,3.03,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Anthem,Individual Exchange,,2.42,,,2.42,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Cigna,Cigna,,2.96,,,2.96,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Connecticare,Commerical,,3.17,,,3.17,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Connecticare,Exchange,,3.17,,,3.17,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,Multiplan,Multiplan,,,3.639320388,,3.639320388,2.42,3.639320388,percent of total billed charges,,
HC GAUZE VSLN1X8,27200055,RC,,,both,,,4.281553398,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.05,,,3.05,2.42,3.75,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Aetna,Commerical,,3.05,,,3.05,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Aetna,Middlesex Employees,,2.74,,,2.74,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Anthem,Commerical,,2.72,,,2.72,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Anthem,Indemnity,,,2.982920388,,2.982920388,2.17,3.37,percent of total billed charges,,3.37
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Anthem,State Preferred,,2.72,,,2.72,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Anthem,Individual Exchange,,2.17,,,2.17,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Cigna,Cigna,,2.66,,,2.66,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Connecticare,Commerical,,2.85,,,2.85,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Connecticare,Exchange,,2.85,,,2.85,2.17,3.37,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,Multiplan,Multiplan,,,3.375242718,,3.375242718,2.17,3.375242718,percent of total billed charges,,
HC GAUZE VASELINE 3X9,27200056,RC,,,both,,,3.970873786,2.45,United Healthcare/Oxford,United Healthcare/Oxford,,2.74,,,2.74,2.17,3.37,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Aetna,Commerical,,21.37,,,21.37,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Aetna,Middlesex Employees,,19.23,,,19.23,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Anthem,Commerical,,19.12,,,19.12,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Anthem,Indemnity,,,20.92420194,,20.92420194,15.3,23.67,percent of total billed charges,,23.67
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Anthem,State Preferred,,19.12,,,19.12,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Anthem,Individual Exchange,,15.3,,,15.3,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Cigna,Cigna,,18.68,,,18.68,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Connecticare,Commerical,,19.97,,,19.97,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Connecticare,Exchange,,19.97,,,19.97,15.3,23.67,other,Could be inpatient or outpatient,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,Multiplan,Multiplan,,,23.67621359,,23.67621359,15.3,23.67621359,percent of total billed charges,,
HC ELASTOPLAST 2INCH,27200057,RC,,,both,,,27.85436893,17.21,United Healthcare/Oxford,United Healthcare/Oxford,,19.22,,,19.22,15.3,23.67,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Aetna,Commerical,,6.73,,,6.73,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Aetna,Middlesex Employees,,6.06,,,6.06,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Anthem,Commerical,,6.02,,,6.02,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Anthem,Indemnity,,,6.40343301,,6.40343301,4.82,7.45,percent of total billed charges,,7.45
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Anthem,State Preferred,,6.02,,,6.02,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Anthem,Individual Exchange,,4.82,,,4.82,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Cigna,Cigna,,5.89,,,5.89,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Connecticare,Commerical,,6.3,,,6.3,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Connecticare,Exchange,,6.3,,,6.3,4.82,7.45,other,Could be inpatient or outpatient,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,Multiplan,Multiplan,,,7.245631068,,7.245631068,4.82,7.245631068,percent of total billed charges,,
"HC KLING 3""",27200058,RC,,,both,,,8.524271845,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,6.06,,,6.06,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Aetna,Commerical,,4.82,,,4.82,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Aetna,Middlesex Employees,,4.34,,,4.34,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Anthem,Commerical,,4.32,,,4.32,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Anthem,Indemnity,,,4.580132039,,4.580132039,3.46,5.34,percent of total billed charges,,5.34
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Anthem,State Preferred,,4.32,,,4.32,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Anthem,Individual Exchange,,3.46,,,3.46,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Cigna,Cigna,,4.21,,,4.21,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Connecticare,Commerical,,4.5,,,4.5,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Connecticare,Exchange,,4.5,,,4.5,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,Multiplan,Multiplan,,,5.182524272,,5.182524272,3.46,5.182524272,percent of total billed charges,,
HC STERI STRIP 1/8X3,27200059,RC,,,both,,,6.097087379,3.77,United Healthcare/Oxford,United Healthcare/Oxford,,4.34,,,4.34,3.46,5.34,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Aetna,Commerical,,6.73,,,6.73,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Aetna,Middlesex Employees,,6.06,,,6.06,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Anthem,Commerical,,6.02,,,6.02,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Anthem,Indemnity,,,6.40343301,,6.40343301,4.82,7.45,percent of total billed charges,,7.45
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Anthem,State Preferred,,6.02,,,6.02,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Anthem,Individual Exchange,,4.82,,,4.82,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Cigna,Cigna,,5.89,,,5.89,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Connecticare,Commerical,,6.3,,,6.3,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Connecticare,Exchange,,6.3,,,6.3,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,Multiplan,Multiplan,,,7.245631068,,7.245631068,4.82,7.245631068,percent of total billed charges,,
HC STERI-STRIPS 1/4,27200060,RC,,,both,,,8.524271845,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,6.06,,,6.06,4.82,7.45,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Aetna,Commerical,,4.96,,,4.96,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Aetna,Middlesex Employees,,4.47,,,4.47,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Anthem,Commerical,,4.44,,,4.44,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Anthem,Indemnity,,,4.718702913,,4.718702913,3.55,5.5,percent of total billed charges,,5.5
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Anthem,State Preferred,,4.44,,,4.44,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Anthem,Individual Exchange,,3.55,,,3.55,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Cigna,Cigna,,4.34,,,4.34,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Connecticare,Commerical,,4.64,,,4.64,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Connecticare,Exchange,,4.64,,,4.64,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,Multiplan,Multiplan,,,5.339320388,,5.339320388,3.55,5.339320388,percent of total billed charges,,
HC STERI STRIP 1/8 X 3,27200061,RC,,,both,,,6.281553398,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.55,5.5,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Aetna,Commerical,,15.18,,,15.18,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Aetna,Middlesex Employees,,13.66,,,13.66,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Anthem,Commerical,,13.59,,,13.59,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Anthem,Indemnity,,,14.43325049,,14.43325049,10.87,16.82,percent of total billed charges,,16.82
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Anthem,State Preferred,,13.59,,,13.59,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Anthem,Individual Exchange,,10.87,,,10.87,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Cigna,Cigna,,13.27,,,13.27,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Connecticare,Commerical,,14.19,,,14.19,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Connecticare,Exchange,,14.19,,,14.19,10.87,16.82,other,Could be inpatient or outpatient,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,Multiplan,Multiplan,,,16.3315534,,16.3315534,10.87,16.3315534,percent of total billed charges,,
HC STERI-STRIPS 1/2,27200063,RC,,,both,,,19.21359223,11.87,United Healthcare/Oxford,United Healthcare/Oxford,,13.66,,,13.66,10.87,16.82,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Aetna,Commerical,,1.74,,,1.74,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Aetna,Middlesex Employees,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Anthem,Commerical,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Anthem,Indemnity,,,1.648264078,,1.648264078,1.24,1.92,percent of total billed charges,,1.92
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Anthem,State Preferred,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Anthem,Individual Exchange,,1.24,,,1.24,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Cigna,Cigna,,1.52,,,1.52,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Connecticare,Commerical,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Connecticare,Exchange,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,Multiplan,Multiplan,,,1.865048544,,1.865048544,1.24,1.865048544,percent of total billed charges,,
HC CATH 12FR SUCTION 030554,27200064,RC,,,both,,,2.194174757,1.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Aetna,Commerical,,1.74,,,1.74,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Aetna,Middlesex Employees,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Anthem,Commerical,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Anthem,Indemnity,,,1.648264078,,1.648264078,1.24,1.92,percent of total billed charges,,1.92
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Anthem,State Preferred,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Anthem,Individual Exchange,,1.24,,,1.24,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Cigna,Cigna,,1.52,,,1.52,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Connecticare,Commerical,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Connecticare,Exchange,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,Multiplan,Multiplan,,,1.865048544,,1.865048544,1.24,1.865048544,percent of total billed charges,,
HC CATH SUCTION 14 FR  030555,27200065,RC,,,both,,,2.194174757,1.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Aetna,Commerical,,53.73,,,53.73,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Aetna,Middlesex Employees,,48.36,,,48.36,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Anthem,Commerical,,48.08,,,48.08,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Anthem,Indemnity,,,51.0816,,51.0816,38.46,59.52,percent of total billed charges,,59.52
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Anthem,State Preferred,,48.08,,,48.08,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Anthem,Individual Exchange,,38.46,,,38.46,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Cigna,Cigna,,46.96,,,46.96,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Connecticare,Commerical,,50.22,,,50.22,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Connecticare,Exchange,,50.22,,,50.22,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,Multiplan,Multiplan,,,57.8,,57.8,38.46,57.8,percent of total billed charges,,
HC CATH PEDI 8FR 3CC,27200066,RC,,,both,,,68,42.02,United Healthcare/Oxford,United Healthcare/Oxford,,48.32,,,48.32,38.46,59.52,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Aetna,Commerical,,7.22,,,7.22,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Aetna,Middlesex Employees,,6.5,,,6.5,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Anthem,Commerical,,6.46,,,6.46,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Anthem,Indemnity,,,6.85561165,,6.85561165,5.16,7.99,percent of total billed charges,,7.99
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Anthem,State Preferred,,6.46,,,6.46,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Anthem,Individual Exchange,,5.16,,,5.16,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Cigna,Cigna,,6.3,,,6.3,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Connecticare,Commerical,,6.74,,,6.74,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Connecticare,Exchange,,6.74,,,6.74,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,Multiplan,Multiplan,,,7.757281553,,7.757281553,5.16,7.757281553,percent of total billed charges,,
HC CATH MENTOR URI 10 - 14FR,27200067,RC,,,both,,,9.126213592,5.64,United Healthcare/Oxford,United Healthcare/Oxford,,6.49,,,6.49,5.16,7.99,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Aetna,Commerical,,78.16,,,78.16,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Aetna,Middlesex Employees,,70.34,,,70.34,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Anthem,Commerical,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Anthem,Indemnity,,,76.51300194,,76.51300194,55.94,86.57,percent of total billed charges,,86.57
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Anthem,State Preferred,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Anthem,Individual Exchange,,55.94,,,55.94,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Cigna,Cigna,,68.3,,,68.3,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Connecticare,Commerical,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Connecticare,Exchange,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,Multiplan,Multiplan,,,86.57621359,,86.57621359,55.94,86.57621359,percent of total billed charges,,
HC CATH UD 5-8FR URI,27200068,RC,,,both,,,101.8543689,62.94,United Healthcare/Oxford,United Healthcare/Oxford,,70.29,,,70.29,55.94,86.57,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Aetna,Commerical,,31.95,,,31.95,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Aetna,Middlesex Employees,,28.75,,,28.75,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Anthem,Commerical,,28.59,,,28.59,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Anthem,Indemnity,,,30.36890097,,30.36890097,22.87,35.39,percent of total billed charges,,35.39
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Anthem,State Preferred,,28.59,,,28.59,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Anthem,Individual Exchange,,22.87,,,22.87,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Cigna,Cigna,,27.92,,,27.92,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Connecticare,Commerical,,29.87,,,29.87,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Connecticare,Exchange,,29.87,,,29.87,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,Multiplan,Multiplan,,,34.3631068,,34.3631068,22.87,34.3631068,percent of total billed charges,,
HC CATH SURFACTANT,27200069,RC,,,both,,,40.42718447,24.99,United Healthcare/Oxford,United Healthcare/Oxford,,28.74,,,28.74,22.87,35.39,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Aetna,Commerical,,40.59,,,40.59,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Aetna,Middlesex Employees,,36.53,,,36.53,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Anthem,Commerical,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Anthem,Indemnity,,,38.3112,,38.3112,29.05,44.97,percent of total billed charges,,44.97
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Anthem,State Preferred,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Anthem,Individual Exchange,,29.05,,,29.05,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Cigna,Cigna,,35.47,,,35.47,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Connecticare,Commerical,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Connecticare,Exchange,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,Multiplan,Multiplan,,,43.35,,43.35,29.05,43.35,percent of total billed charges,,
HC CATH REPLOGLE 8FR,27200070,RC,,,both,,,51,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,36.5,,,36.5,29.05,44.97,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Aetna,Commerical,,17.49,,,17.49,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Aetna,Middlesex Employees,,15.74,,,15.74,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Anthem,Commerical,,15.65,,,15.65,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Anthem,Indemnity,,,16.61391845,,16.61391845,12.52,19.37,percent of total billed charges,,19.37
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Anthem,State Preferred,,15.65,,,15.65,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Anthem,Individual Exchange,,12.52,,,12.52,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Cigna,Cigna,,15.28,,,15.28,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Connecticare,Commerical,,16.35,,,16.35,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Connecticare,Exchange,,16.35,,,16.35,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,Multiplan,Multiplan,,,18.79902913,,18.79902913,12.52,18.79902913,percent of total billed charges,,
HC CATH FOLEY 16X5CC  033328,27200072,RC,,,both,,,22.11650485,13.67,United Healthcare/Oxford,United Healthcare/Oxford,,15.73,,,15.73,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Aetna,Commerical,,17.49,,,17.49,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Aetna,Middlesex Employees,,15.74,,,15.74,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Anthem,Commerical,,15.65,,,15.65,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Anthem,Indemnity,,,16.61391845,,16.61391845,12.52,19.37,percent of total billed charges,,19.37
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Anthem,State Preferred,,15.65,,,15.65,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Anthem,Individual Exchange,,12.52,,,12.52,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Cigna,Cigna,,15.28,,,15.28,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Connecticare,Commerical,,16.35,,,16.35,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Connecticare,Exchange,,16.35,,,16.35,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,Multiplan,Multiplan,,,18.79902913,,18.79902913,12.52,18.79902913,percent of total billed charges,,
HC CATH FOLEY 20X5CC,27200073,RC,,,both,,,22.11650485,13.67,United Healthcare/Oxford,United Healthcare/Oxford,,15.73,,,15.73,12.52,19.37,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Aetna,Commerical,,35.41,,,35.41,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Aetna,Middlesex Employees,,31.87,,,31.87,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Anthem,Commerical,,31.69,,,31.69,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Anthem,Indemnity,,,33.65813592,,33.65813592,25.36,39.23,percent of total billed charges,,39.23
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Anthem,State Preferred,,31.69,,,31.69,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Anthem,Individual Exchange,,25.36,,,25.36,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Cigna,Cigna,,30.95,,,30.95,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Connecticare,Commerical,,33.1,,,33.1,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Connecticare,Exchange,,33.1,,,33.1,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,Multiplan,Multiplan,,,38.08495146,,38.08495146,25.36,38.08495146,percent of total billed charges,,
HC CATH FOLEY 8X3CC,27200074,RC,,,both,,,44.80582524,27.69,United Healthcare/Oxford,United Healthcare/Oxford,,31.85,,,31.85,25.36,39.23,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Aetna,Commerical,,22.46,,,22.46,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Aetna,Middlesex Employees,,20.22,,,20.22,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Anthem,Commerical,,20.1,,,20.1,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Anthem,Indemnity,,,21.98900971,,21.98900971,16.08,24.88,percent of total billed charges,,24.88
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Anthem,State Preferred,,20.1,,,20.1,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Anthem,Individual Exchange,,16.08,,,16.08,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Cigna,Cigna,,19.62,,,19.62,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Connecticare,Commerical,,20.99,,,20.99,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Connecticare,Exchange,,20.99,,,20.99,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,Multiplan,Multiplan,,,24.88106796,,24.88106796,16.08,24.88106796,percent of total billed charges,,
HC CATH FOLEY 10X3CC  033331,27200075,RC,,,both,,,29.27184466,18.09,United Healthcare/Oxford,United Healthcare/Oxford,,20.2,,,20.2,16.08,24.88,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC CATH FOLEY 12X5CC 033332,27200076,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Aetna,Commerical,,17.15,,,17.15,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Aetna,Middlesex Employees,,15.44,,,15.44,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Anthem,Commerical,,15.35,,,15.35,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Anthem,Indemnity,,,16.30031068,,16.30031068,12.28,19,percent of total billed charges,,19
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Anthem,State Preferred,,15.35,,,15.35,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Anthem,Individual Exchange,,12.28,,,12.28,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Cigna,Cigna,,14.99,,,14.99,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Connecticare,Commerical,,16.03,,,16.03,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Connecticare,Exchange,,16.03,,,16.03,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,Multiplan,Multiplan,,,18.44417476,,18.44417476,12.28,18.44417476,percent of total billed charges,,
HC CATH FOLEY 14X5CC 033333,27200077,RC,,,both,,,21.69902913,13.41,United Healthcare/Oxford,United Healthcare/Oxford,,15.43,,,15.43,12.28,19,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC CATH FOLEY 18X5CC,27200078,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Aetna,Commerical,,354.13,,,354.13,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Aetna,Middlesex Employees,,318.72,,,318.72,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Anthem,Commerical,,316.87,,,316.87,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Anthem,Indemnity,,,336.5376,,336.5376,253.49,392.27,percent of total billed charges,,392.27
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Anthem,State Preferred,,316.87,,,316.87,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Anthem,Individual Exchange,,253.49,,,253.49,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Cigna,Cigna,,309.45,,,309.45,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Connecticare,Commerical,,330.99,,,330.99,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Connecticare,Exchange,,330.99,,,330.99,253.49,392.27,other,Could be inpatient or outpatient,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,Multiplan,Multiplan,,,380.8,,380.8,253.49,380.8,percent of total billed charges,,
HC FURHMAN DRAIN SET,27200079,RC,,,both,,,448,276.86,United Healthcare/Oxford,United Healthcare/Oxford,,318.48,,,318.48,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Aetna,Commerical,,1.65,,,1.65,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Aetna,Middlesex Employees,,1.49,,,1.49,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Anthem,Commerical,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Anthem,Indemnity,,,1.568038835,,1.568038835,1.18,1.83,percent of total billed charges,,1.83
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Anthem,State Preferred,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Anthem,Individual Exchange,,1.18,,,1.18,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Cigna,Cigna,,1.45,,,1.45,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Connecticare,Commerical,,1.55,,,1.55,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Connecticare,Exchange,,1.55,,,1.55,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,Multiplan,Multiplan,,,1.774271845,,1.774271845,1.18,1.774271845,percent of total billed charges,,
HC CATH 6 FR SUCTION,27200080,RC,,,both,,,2.087378641,1.29,United Healthcare/Oxford,United Healthcare/Oxford,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Aetna,Commerical,,1.65,,,1.65,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Aetna,Middlesex Employees,,1.49,,,1.49,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Anthem,Commerical,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Anthem,Indemnity,,,1.568038835,,1.568038835,1.18,1.83,percent of total billed charges,,1.83
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Anthem,State Preferred,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Anthem,Individual Exchange,,1.18,,,1.18,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Cigna,Cigna,,1.45,,,1.45,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Connecticare,Commerical,,1.55,,,1.55,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Connecticare,Exchange,,1.55,,,1.55,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,Multiplan,Multiplan,,,1.774271845,,1.774271845,1.18,1.774271845,percent of total billed charges,,
HC CATH 8FR SUCTION,27200081,RC,,,both,,,2.087378641,1.29,United Healthcare/Oxford,United Healthcare/Oxford,,1.48,,,1.48,1.18,1.83,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Aetna,Commerical,,1.74,,,1.74,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Aetna,Middlesex Employees,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Anthem,Commerical,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Anthem,Indemnity,,,1.648264078,,1.648264078,1.24,1.92,percent of total billed charges,,1.92
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Anthem,State Preferred,,1.55,,,1.55,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Anthem,Individual Exchange,,1.24,,,1.24,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Cigna,Cigna,,1.52,,,1.52,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Connecticare,Commerical,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Connecticare,Exchange,,1.62,,,1.62,1.24,1.92,other,Could be inpatient or outpatient,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,Multiplan,Multiplan,,,1.865048544,,1.865048544,1.24,1.865048544,percent of total billed charges,,
HC CATH 10FR SUCTION,27200082,RC,,,both,,,2.194174757,1.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.24,1.92,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Aetna,Commerical,,268.65,,,268.65,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Aetna,Middlesex Employees,,241.78,,,241.78,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Anthem,Commerical,,240.38,,,240.38,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Anthem,Indemnity,,,255.408,,255.408,192.3,297.59,percent of total billed charges,,297.59
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Anthem,State Preferred,,240.38,,,240.38,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Anthem,Individual Exchange,,192.3,,,192.3,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Cigna,Cigna,,234.76,,,234.76,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Connecticare,Commerical,,251.1,,,251.1,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Connecticare,Exchange,,251.1,,,251.1,192.3,297.59,other,Could be inpatient or outpatient,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,Multiplan,Multiplan,,,289,,289,192.3,289,percent of total billed charges,,
HC P CTH 5.5 FR,27200086,RC,,,both,,,340,210.12,United Healthcare/Oxford,United Healthcare/Oxford,,241.6,,,241.6,192.3,297.59,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Aetna,Commerical,,20.75,,,20.75,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Aetna,Middlesex Employees,,18.68,,,18.68,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Anthem,Commerical,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Anthem,Indemnity,,,19.7208233,,19.7208233,14.85,22.98,percent of total billed charges,,22.98
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Anthem,State Preferred,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Anthem,Individual Exchange,,14.85,,,14.85,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Cigna,Cigna,,18.14,,,18.14,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Connecticare,Commerical,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Connecticare,Exchange,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,Multiplan,Multiplan,,,22.31456311,,22.31456311,14.85,22.31456311,percent of total billed charges,,
HC CATH REPOGYLE SUCTION 10FR 039268,27200087,RC,,,both,,,26.25242718,16.22,United Healthcare/Oxford,United Healthcare/Oxford,,18.66,,,18.66,14.85,22.98,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Aetna,Commerical,,25.05,,,25.05,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Aetna,Middlesex Employees,,22.54,,,22.54,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Anthem,Commerical,,22.42,,,22.42,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Anthem,Indemnity,,,23.80501748,,23.80501748,17.94,27.74,percent of total billed charges,,27.74
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Anthem,State Preferred,,22.42,,,22.42,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Anthem,Individual Exchange,,17.94,,,17.94,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Cigna,Cigna,,21.89,,,21.89,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Connecticare,Commerical,,23.41,,,23.41,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Connecticare,Exchange,,23.41,,,23.41,17.94,27.74,other,Could be inpatient or outpatient,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,Multiplan,Multiplan,,,26.93592233,,26.93592233,17.94,26.93592233,percent of total billed charges,,
HC STYLET  14 FR,27200088,RC,,,both,,,31.68932039,19.58,United Healthcare/Oxford,United Healthcare/Oxford,,22.53,,,22.53,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Aetna,Commerical,,25.05,,,25.05,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Aetna,Middlesex Employees,,22.54,,,22.54,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Anthem,Commerical,,22.42,,,22.42,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Anthem,Indemnity,,,23.80501748,,23.80501748,17.94,27.74,percent of total billed charges,,27.74
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Anthem,State Preferred,,22.42,,,22.42,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Anthem,Individual Exchange,,17.94,,,17.94,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Cigna,Cigna,,21.89,,,21.89,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Connecticare,Commerical,,23.41,,,23.41,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Connecticare,Exchange,,23.41,,,23.41,17.94,27.74,other,Could be inpatient or outpatient,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,Multiplan,Multiplan,,,26.93592233,,26.93592233,17.94,26.93592233,percent of total billed charges,,
HC SATIN SLIP STYLET,27200089,RC,,,both,,,31.68932039,19.58,United Healthcare/Oxford,United Healthcare/Oxford,,22.53,,,22.53,17.94,27.74,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Aetna,Commerical,,32.12,,,32.12,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Aetna,Middlesex Employees,,28.92,,,28.92,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Anthem,Commerical,,28.74,,,28.74,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Anthem,Indemnity,,,30.52935146,,30.52935146,23,35.58,percent of total billed charges,,35.58
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Anthem,State Preferred,,28.74,,,28.74,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Anthem,Individual Exchange,,23,,,23,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Cigna,Cigna,,28.07,,,28.07,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Connecticare,Commerical,,30.02,,,30.02,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Connecticare,Exchange,,30.02,,,30.02,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,Multiplan,Multiplan,,,34.54466019,,34.54466019,23,34.54466019,percent of total billed charges,,
HC CATH BALLARD SUCT 6FR,27200090,RC,,,both,,,40.6407767,25.12,United Healthcare/Oxford,United Healthcare/Oxford,,28.89,,,28.89,23,35.58,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Aetna,Commerical,,33.96,,,33.96,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Aetna,Middlesex Employees,,30.56,,,30.56,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Anthem,Commerical,,30.39,,,30.39,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Anthem,Indemnity,,,33.2497165,,33.2497165,24.31,37.62,percent of total billed charges,,37.62
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Anthem,State Preferred,,30.39,,,30.39,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Anthem,Individual Exchange,,24.31,,,24.31,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Cigna,Cigna,,29.68,,,29.68,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Connecticare,Commerical,,31.75,,,31.75,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Connecticare,Exchange,,31.75,,,31.75,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,Multiplan,Multiplan,,,37.62281553,,37.62281553,24.31,37.62281553,percent of total billed charges,,
HC CATH BALLARD SUCT 8FR 10FR 039261; 039259,27200091,RC,,,both,,,44.26213592,27.35,United Healthcare/Oxford,United Healthcare/Oxford,,30.54,,,30.54,24.31,37.62,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Anthem,Indemnity,,,62.3496,,62.3496,47.21,73.04,percent of total billed charges,,73.04
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,Multiplan,Multiplan,,,70.55,,70.55,47.21,70.55,percent of total billed charges,,
HC CATH UVC KIT 5FR,27200094,RC,,,both,,,83,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Aetna,Commerical,,101.76,,,101.76,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Aetna,Middlesex Employees,,91.58,,,91.58,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Anthem,Commerical,,91.05,,,91.05,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Anthem,Indemnity,,,96.9048,,96.9048,72.84,112.72,percent of total billed charges,,112.72
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Anthem,State Preferred,,91.05,,,91.05,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Anthem,Individual Exchange,,72.84,,,72.84,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Cigna,Cigna,,88.92,,,88.92,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Connecticare,Commerical,,95.11,,,95.11,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Connecticare,Exchange,,95.11,,,95.11,72.84,112.72,other,Could be inpatient or outpatient,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,Multiplan,Multiplan,,,109.65,,109.65,72.84,109.65,percent of total billed charges,,
HC CATH TROCAR 10FR,27200095,RC,,,both,,,129,79.72,United Healthcare/Oxford,United Healthcare/Oxford,,91.52,,,91.52,72.84,112.72,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Aetna,Commerical,,7.3,,,7.3,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Aetna,Middlesex Employees,,6.57,,,6.57,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Anthem,Commerical,,6.53,,,6.53,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Anthem,Indemnity,,,6.935836893,,6.935836893,5.23,8.08,percent of total billed charges,,8.08
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Anthem,State Preferred,,6.53,,,6.53,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Anthem,Individual Exchange,,5.23,,,5.23,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Cigna,Cigna,,6.38,,,6.38,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Connecticare,Commerical,,6.82,,,6.82,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Connecticare,Exchange,,6.82,,,6.82,5.23,8.08,other,Could be inpatient or outpatient,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,Multiplan,Multiplan,,,7.848058252,,7.848058252,5.23,7.848058252,percent of total billed charges,,
HC SALEM SUMP 12 FR,27200096,RC,,,both,,,9.233009709,5.7,United Healthcare/Oxford,United Healthcare/Oxford,,6.56,,,6.56,5.23,8.08,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Aetna,Commerical,,144.09,,,144.09,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Aetna,Middlesex Employees,,129.68,,,129.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Anthem,Commerical,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Anthem,Indemnity,,,136.7184,,136.7184,103.15,159.61,percent of total billed charges,,159.61
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Anthem,State Preferred,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Anthem,Individual Exchange,,103.15,,,103.15,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Cigna,Cigna,,125.91,,,125.91,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Connecticare,Commerical,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Connecticare,Exchange,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,Multiplan,Multiplan,,,154.7,,154.7,103.15,154.7,percent of total billed charges,,
HC CATH 4FR CV WIRE J-TIP,27200097,RC,,,both,,,182,112.48,United Healthcare/Oxford,United Healthcare/Oxford,,129.58,,,129.58,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Aetna,Commerical,,38.31,,,38.31,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Aetna,Middlesex Employees,,34.48,,,34.48,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Anthem,Commerical,,34.28,,,34.28,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Anthem,Indemnity,,,36.40767379,,36.40767379,27.43,42.44,percent of total billed charges,,42.44
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Anthem,State Preferred,,34.28,,,34.28,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Anthem,Individual Exchange,,27.43,,,27.43,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Cigna,Cigna,,33.48,,,33.48,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Connecticare,Commerical,,35.8,,,35.8,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Connecticare,Exchange,,35.8,,,35.8,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,Multiplan,Multiplan,,,41.1961165,,41.1961165,27.43,41.1961165,percent of total billed charges,,
HC CATH UMBIL 2.8 PO;,27200102,RC,,,both,,,48.46601942,29.95,United Healthcare/Oxford,United Healthcare/Oxford,,34.45,,,34.45,27.43,42.44,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Anthem,Indemnity,,,62.3496,,62.3496,47.21,73.04,percent of total billed charges,,73.04
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,Multiplan,Multiplan,,,70.55,,70.55,47.21,70.55,percent of total billed charges,,
HC CATH UMBI 3.5 POLY,27200105,RC,,,both,,,83,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Aetna,Commerical,,211.67,,,211.67,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Aetna,Middlesex Employees,,190.51,,,190.51,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Anthem,Commerical,,189.39,,,189.39,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Anthem,Indemnity,,,201.3216,,201.3216,151.51,234.46,percent of total billed charges,,234.46
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Anthem,State Preferred,,189.39,,,189.39,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Anthem,Individual Exchange,,151.51,,,151.51,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Cigna,Cigna,,184.96,,,184.96,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Connecticare,Commerical,,197.83,,,197.83,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Connecticare,Exchange,,197.83,,,197.83,151.51,234.46,other,Could be inpatient or outpatient,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,Multiplan,Multiplan,,,227.8,,227.8,151.51,227.8,percent of total billed charges,,
HC PICC EPICUT TRAY VYGON,27200106,RC,,,both,,,268,165.62,United Healthcare/Oxford,United Healthcare/Oxford,,190.35,,,190.35,151.51,234.46,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Anthem,Indemnity,,,93.9,,93.9,70.51,109.11,percent of total billed charges,,109.11
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,Multiplan,Multiplan,,,106.25,,106.25,70.51,106.25,percent of total billed charges,,
HC CHEST TUBE 8FR,27200107,RC,,,both,,,125,77.25,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Aetna,Commerical,,144.09,,,144.09,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Aetna,Middlesex Employees,,129.68,,,129.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Anthem,Commerical,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Anthem,Indemnity,,,136.7184,,136.7184,103.15,159.61,percent of total billed charges,,159.61
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Anthem,State Preferred,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Anthem,Individual Exchange,,103.15,,,103.15,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Cigna,Cigna,,125.91,,,125.91,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Connecticare,Commerical,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Connecticare,Exchange,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,Multiplan,Multiplan,,,154.7,,154.7,103.15,154.7,percent of total billed charges,,
HC CATH URINARY 5S,27200108,RC,,,both,,,182,112.48,United Healthcare/Oxford,United Healthcare/Oxford,,129.58,,,129.58,103.15,159.61,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Aetna,Commerical,,75.71,,,75.71,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Aetna,Middlesex Employees,,68.14,,,68.14,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Anthem,Commerical,,67.74,,,67.74,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Anthem,Indemnity,,,72.1152,,72.1152,54.19,83.86,percent of total billed charges,,83.86
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Anthem,State Preferred,,67.74,,,67.74,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Anthem,Individual Exchange,,54.19,,,54.19,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Cigna,Cigna,,66.15,,,66.15,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Connecticare,Commerical,,70.76,,,70.76,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Connecticare,Exchange,,70.76,,,70.76,54.19,83.86,other,Could be inpatient or outpatient,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,Multiplan,Multiplan,,,81.6,,81.6,54.19,81.6,percent of total billed charges,,
HC CATH URINARY 3.5S,27200109,RC,,,both,,,96,59.33,United Healthcare/Oxford,United Healthcare/Oxford,,68.08,,,68.08,54.19,83.86,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Aetna,Commerical,,79.78,,,79.78,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Aetna,Middlesex Employees,,71.8,,,71.8,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Anthem,Commerical,,71.38,,,71.38,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Anthem,Indemnity,,,78.10292039,,78.10292039,57.11,88.37,percent of total billed charges,,88.37
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Anthem,State Preferred,,71.38,,,71.38,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Anthem,Individual Exchange,,57.11,,,57.11,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Cigna,Cigna,,69.72,,,69.72,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Connecticare,Commerical,,74.57,,,74.57,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Connecticare,Exchange,,74.57,,,74.57,57.11,88.37,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,Multiplan,Multiplan,,,88.37524272,,88.37524272,57.11,88.37524272,percent of total billed charges,,
HC HABERMAN FEEDER,27200110,RC,,,both,,,103.9708738,64.25,United Healthcare/Oxford,United Healthcare/Oxford,,71.75,,,71.75,57.11,88.37,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Aetna,Commerical,,23.77,,,23.77,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Aetna,Middlesex Employees,,21.4,,,21.4,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Anthem,Commerical,,21.27,,,21.27,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Anthem,Indemnity,,,22.59434563,,22.59434563,17.02,26.33,percent of total billed charges,,26.33
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Anthem,State Preferred,,21.27,,,21.27,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Anthem,Individual Exchange,,17.02,,,17.02,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Cigna,Cigna,,20.77,,,20.77,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Connecticare,Commerical,,22.22,,,22.22,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Connecticare,Exchange,,22.22,,,22.22,17.02,26.33,other,Could be inpatient or outpatient,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,Multiplan,Multiplan,,,25.56601942,,25.56601942,17.02,25.56601942,percent of total billed charges,,
HC CAUTERY PEN,27200111,RC,,,both,,,30.0776699,18.59,United Healthcare/Oxford,United Healthcare/Oxford,,21.38,,,21.38,17.02,26.33,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Aetna,Commerical,,8.29,,,8.29,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Aetna,Middlesex Employees,,7.46,,,7.46,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Anthem,Commerical,,7.42,,,7.42,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Anthem,Indemnity,,,7.891246602,,7.891246602,5.94,9.19,percent of total billed charges,,9.19
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Anthem,State Preferred,,7.42,,,7.42,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Anthem,Individual Exchange,,5.94,,,5.94,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Cigna,Cigna,,7.25,,,7.25,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Connecticare,Commerical,,7.75,,,7.75,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Connecticare,Exchange,,7.75,,,7.75,5.94,9.19,other,Could be inpatient or outpatient,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,Multiplan,Multiplan,,,8.929126214,,8.929126214,5.94,8.929126214,percent of total billed charges,,
HC FEEDING BAG DOBOFF,27200112,RC,,,both,,,10.50485437,6.49,United Healthcare/Oxford,United Healthcare/Oxford,,7.46,,,7.46,5.94,9.19,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Aetna,Commerical,,20.6,,,20.6,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Aetna,Middlesex Employees,,18.54,,,18.54,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Anthem,Commerical,,18.43,,,18.43,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Anthem,Indemnity,,,19.58225243,,19.58225243,14.75,22.82,percent of total billed charges,,22.82
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Anthem,State Preferred,,18.43,,,18.43,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Anthem,Individual Exchange,,14.75,,,14.75,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Cigna,Cigna,,18,,,18,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Connecticare,Commerical,,19.26,,,19.26,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Connecticare,Exchange,,19.26,,,19.26,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,Multiplan,Multiplan,,,22.15776699,,22.15776699,14.75,22.15776699,percent of total billed charges,,
HC CLAVE,27200113,RC,,,both,,,26.06796117,16.11,United Healthcare/Oxford,United Healthcare/Oxford,,18.53,,,18.53,14.75,22.82,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Aetna,Commerical,,12.12,,,12.12,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Aetna,Middlesex Employees,,10.91,,,10.91,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Anthem,Commerical,,10.85,,,10.85,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Anthem,Indemnity,,,11.52326214,,11.52326214,8.67,13.43,percent of total billed charges,,13.43
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Anthem,State Preferred,,10.85,,,10.85,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Anthem,Individual Exchange,,8.67,,,8.67,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Cigna,Cigna,,10.6,,,10.6,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Connecticare,Commerical,,11.33,,,11.33,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Connecticare,Exchange,,11.33,,,11.33,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,Multiplan,Multiplan,,,13.03883495,,13.03883495,8.67,13.03883495,percent of total billed charges,,
HC CLAVE EXTEN SET MICRO,27200114,RC,,,both,,,15.33980583,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,10.9,,,10.9,8.67,13.43,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Aetna,Commerical,,23.31,,,23.31,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Aetna,Middlesex Employees,,20.98,,,20.98,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Anthem,Commerical,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Anthem,Indemnity,,,22.1640466,,22.1640466,16.69,25.82,percent of total billed charges,,25.82
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Anthem,State Preferred,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Anthem,Individual Exchange,,16.69,,,16.69,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Cigna,Cigna,,20.37,,,20.37,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Connecticare,Commerical,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Connecticare,Exchange,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,Multiplan,Multiplan,,,25.07912621,,25.07912621,16.69,25.07912621,percent of total billed charges,,
HC CLAVE PIGGYBACK PIECE,27200115,RC,,,both,,,29.50485437,18.23,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,16.69,25.82,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Aetna,Commerical,,16.84,,,16.84,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Aetna,Middlesex Employees,,15.15,,,15.15,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Anthem,Commerical,,15.07,,,15.07,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Anthem,Indemnity,,,16.00858252,,16.00858252,12.06,18.66,percent of total billed charges,,18.66
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Anthem,State Preferred,,15.07,,,15.07,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Anthem,Individual Exchange,,12.06,,,12.06,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Cigna,Cigna,,14.72,,,14.72,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Connecticare,Commerical,,15.74,,,15.74,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Connecticare,Exchange,,15.74,,,15.74,12.06,18.66,other,Could be inpatient or outpatient,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,Multiplan,Multiplan,,,18.11407767,,18.11407767,12.06,18.11407767,percent of total billed charges,,
HC CLAVE BAGSPIKE,27200116,RC,,,both,,,21.31067961,13.17,United Healthcare/Oxford,United Healthcare/Oxford,,15.15,,,15.15,12.06,18.66,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Aetna,Commerical,,9.86,,,9.86,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Aetna,Middlesex Employees,,8.87,,,8.87,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Anthem,Commerical,,8.82,,,8.82,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Anthem,Indemnity,,,9.364473786,,9.364473786,7.06,10.92,percent of total billed charges,,10.92
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Anthem,State Preferred,,8.82,,,8.82,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Anthem,Individual Exchange,,7.06,,,7.06,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Cigna,Cigna,,8.61,,,8.61,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Connecticare,Commerical,,9.22,,,9.22,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Connecticare,Exchange,,9.22,,,9.22,7.06,10.92,other,Could be inpatient or outpatient,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,Multiplan,Multiplan,,,10.5961165,,10.5961165,7.06,10.5961165,percent of total billed charges,,
HC FILTER SET W/Y 11600-48,27200117,RC,,,both,,,12.46601942,7.71,United Healthcare/Oxford,United Healthcare/Oxford,,8.87,,,8.87,7.06,10.92,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Aetna,Commerical,,70.83,,,70.83,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Aetna,Middlesex Employees,,63.74,,,63.74,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Anthem,Commerical,,63.37,,,63.37,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Anthem,Indemnity,,,67.608,,67.608,50.69,78.46,percent of total billed charges,,78.46
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Anthem,State Preferred,,63.37,,,63.37,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Anthem,Individual Exchange,,50.69,,,50.69,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Cigna,Cigna,,61.89,,,61.89,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Connecticare,Commerical,,66.2,,,66.2,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Connecticare,Exchange,,66.2,,,66.2,50.69,78.46,other,Could be inpatient or outpatient,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,Multiplan,Multiplan,,,76.5,,76.5,50.69,76.5,percent of total billed charges,,
HC BLOOD DISP SET,27200118,RC,,,both,,,90,55.62,United Healthcare/Oxford,United Healthcare/Oxford,,63.7,,,63.7,50.69,78.46,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Aetna,Commerical,,28.5,,,28.5,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Aetna,Middlesex Employees,,25.65,,,25.65,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Anthem,Commerical,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Anthem,Indemnity,,,27.89650485,,27.89650485,20.4,31.57,percent of total billed charges,,31.57
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Anthem,State Preferred,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Anthem,Individual Exchange,,20.4,,,20.4,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Cigna,Cigna,,24.91,,,24.91,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Connecticare,Commerical,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Connecticare,Exchange,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,Multiplan,Multiplan,,,31.56553398,,31.56553398,20.4,31.56553398,percent of total billed charges,,
HC IV TUBING PCA SET,27200119,RC,,,both,,,37.13592233,22.95,United Healthcare/Oxford,United Healthcare/Oxford,,25.64,,,25.64,20.4,31.57,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Aetna,Commerical,,9.98,,,9.98,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Aetna,Middlesex Employees,,8.98,,,8.98,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Anthem,Commerical,,8.93,,,8.93,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Anthem,Indemnity,,,9.772893204,,9.772893204,7.14,11.06,percent of total billed charges,,11.06
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Anthem,State Preferred,,8.93,,,8.93,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Anthem,Individual Exchange,,7.14,,,7.14,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Cigna,Cigna,,8.73,,,8.73,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Connecticare,Commerical,,9.33,,,9.33,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Connecticare,Exchange,,9.33,,,9.33,7.14,11.06,other,Could be inpatient or outpatient,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,Multiplan,Multiplan,,,11.05825243,,11.05825243,7.14,11.05825243,percent of total billed charges,,
HC SET T PORT EXT,27200120,RC,,,both,,,13.00970874,8.04,United Healthcare/Oxford,United Healthcare/Oxford,,8.97,,,8.97,7.14,11.06,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Aetna,Commerical,,52.1,,,52.1,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Aetna,Middlesex Employees,,46.89,,,46.89,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Anthem,Commerical,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Anthem,Indemnity,,,49.5792,,49.5792,37.29,57.72,percent of total billed charges,,57.72
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Anthem,State Preferred,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Anthem,Individual Exchange,,37.29,,,37.29,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Cigna,Cigna,,45.53,,,45.53,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Connecticare,Commerical,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Connecticare,Exchange,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,Multiplan,Multiplan,,,56.1,,56.1,37.29,56.1,percent of total billed charges,,
HC IV TUBING BID W/ FILTER,27200121,RC,,,both,,,66,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,46.85,,,46.85,37.29,57.72,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Aetna,Commerical,,3.05,,,3.05,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Aetna,Middlesex Employees,,2.74,,,2.74,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Anthem,Commerical,,2.72,,,2.72,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Anthem,Indemnity,,,2.982920388,,2.982920388,2.17,3.37,percent of total billed charges,,3.37
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Anthem,State Preferred,,2.72,,,2.72,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Anthem,Individual Exchange,,2.17,,,2.17,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Cigna,Cigna,,2.66,,,2.66,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Connecticare,Commerical,,2.85,,,2.85,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Connecticare,Exchange,,2.85,,,2.85,2.17,3.37,other,Could be inpatient or outpatient,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,Multiplan,Multiplan,,,3.375242718,,3.375242718,2.17,3.375242718,percent of total billed charges,,
HC IV SET BIFUSE,27200122,RC,,,both,,,3.970873786,2.45,United Healthcare/Oxford,United Healthcare/Oxford,,2.74,,,2.74,2.17,3.37,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Anthem,Indemnity,,,55.5888,,55.5888,41.96,64.92,percent of total billed charges,,64.92
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,Multiplan,Multiplan,,,62.9,,62.9,41.96,62.9,percent of total billed charges,,
HC BLOOD TRANSFER SET,27200124,RC,,,both,,,74,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Aetna,Commerical,,66.76,,,66.76,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Aetna,Middlesex Employees,,60.08,,,60.08,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Anthem,Commerical,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Anthem,Indemnity,,,63.1008,,63.1008,47.79,73.94,percent of total billed charges,,73.94
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Anthem,State Preferred,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Anthem,Individual Exchange,,47.79,,,47.79,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Cigna,Cigna,,58.33,,,58.33,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Connecticare,Commerical,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Connecticare,Exchange,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,Multiplan,Multiplan,,,71.4,,71.4,47.79,71.4,percent of total billed charges,,
HC BLOOD CULT SAFETY TRANSFER,27200125,RC,,,both,,,84,51.91,United Healthcare/Oxford,United Healthcare/Oxford,,60.04,,,60.04,47.79,73.94,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Aetna,Commerical,,12.18,,,12.18,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Aetna,Middlesex Employees,,10.96,,,10.96,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Anthem,Commerical,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Anthem,Indemnity,,,11.57431456,,11.57431456,8.71,13.49,percent of total billed charges,,13.49
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Anthem,State Preferred,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Anthem,Individual Exchange,,8.71,,,8.71,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Cigna,Cigna,,10.64,,,10.64,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Connecticare,Commerical,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Connecticare,Exchange,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,Multiplan,Multiplan,,,13.09660194,,13.09660194,8.71,13.09660194,percent of total billed charges,,
HC ENDOTRACHEAL TUBE 2.0,27200126,RC,,,both,,,15.40776699,9.52,United Healthcare/Oxford,United Healthcare/Oxford,,10.95,,,10.95,8.71,13.49,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Aetna,Commerical,,31.95,,,31.95,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Aetna,Middlesex Employees,,28.75,,,28.75,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Anthem,Commerical,,28.59,,,28.59,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Anthem,Indemnity,,,30.36890097,,30.36890097,22.87,35.39,percent of total billed charges,,35.39
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Anthem,State Preferred,,28.59,,,28.59,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Anthem,Individual Exchange,,22.87,,,22.87,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Cigna,Cigna,,27.92,,,27.92,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Connecticare,Commerical,,29.87,,,29.87,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Connecticare,Exchange,,29.87,,,29.87,22.87,35.39,other,Could be inpatient or outpatient,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,Multiplan,Multiplan,,,34.3631068,,34.3631068,22.87,34.3631068,percent of total billed charges,,
HC I-STAT CARTRIDGE G3+,27200127,RC,,,both,,,40.42718447,24.99,United Healthcare/Oxford,United Healthcare/Oxford,,28.74,,,28.74,22.87,35.39,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Aetna,Commerical,,5.4,,,5.4,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Aetna,Middlesex Employees,,4.86,,,4.86,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Anthem,Commerical,,4.83,,,4.83,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Anthem,Indemnity,,,5.12712233,,5.12712233,3.87,5.98,percent of total billed charges,,5.98
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Anthem,State Preferred,,4.83,,,4.83,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Anthem,Individual Exchange,,3.87,,,3.87,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Cigna,Cigna,,4.72,,,4.72,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Connecticare,Commerical,,5.05,,,5.05,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Connecticare,Exchange,,5.05,,,5.05,3.87,5.98,other,Could be inpatient or outpatient,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,Multiplan,Multiplan,,,5.801456311,,5.801456311,3.87,5.801456311,percent of total billed charges,,
HC U-BAG COLLECTOR,27200128,RC,,,both,,,6.825242718,4.22,United Healthcare/Oxford,United Healthcare/Oxford,,4.85,,,4.85,3.87,5.98,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Aetna,Commerical,,31.09,,,31.09,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Aetna,Middlesex Employees,,27.98,,,27.98,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Anthem,Commerical,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Anthem,Indemnity,,,29.55206214,,29.55206214,22.25,34.44,percent of total billed charges,,34.44
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Anthem,State Preferred,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Anthem,Individual Exchange,,22.25,,,22.25,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Cigna,Cigna,,27.16,,,27.16,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Connecticare,Commerical,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Connecticare,Exchange,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,Multiplan,Multiplan,,,33.43883495,,33.43883495,22.25,33.43883495,percent of total billed charges,,
HC URETERAL BAG,27200129,RC,,,both,,,39.33980583,24.31,United Healthcare/Oxford,United Healthcare/Oxford,,27.96,,,27.96,22.25,34.44,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Anthem,Indemnity,,,43.83215534,,43.83215534,32.05,49.6,percent of total billed charges,,49.6
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,Multiplan,Multiplan,,,49.59708738,,49.59708738,32.05,49.59708738,percent of total billed charges,,
HC URIMETER DRAINAGE SEAM,27200130,RC,,,both,,,58.34951456,36.06,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Anthem,Indemnity,,,21.9817165,,21.9817165,16.07,24.87,percent of total billed charges,,24.87
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,Multiplan,Multiplan,,,24.87281553,,24.87281553,16.07,24.87281553,percent of total billed charges,,
HC OSTOMY PASTE STOMAHESIVE,27200131,RC,,,both,,,29.26213592,18.08,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Aetna,Commerical,,10.34,,,10.34,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Aetna,Middlesex Employees,,9.31,,,9.31,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Anthem,Commerical,,9.26,,,9.26,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Anthem,Indemnity,,,10.12296699,,10.12296699,7.41,11.46,percent of total billed charges,,11.46
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Anthem,State Preferred,,9.26,,,9.26,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Anthem,Individual Exchange,,7.41,,,7.41,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Cigna,Cigna,,9.04,,,9.04,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Connecticare,Commerical,,9.67,,,9.67,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Connecticare,Exchange,,9.67,,,9.67,7.41,11.46,other,Could be inpatient or outpatient,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,Multiplan,Multiplan,,,11.45436893,,11.45436893,7.41,11.45436893,percent of total billed charges,,
HC STOCKING ANTI-EMB,27200132,RC,,,both,,,13.47572816,8.33,United Healthcare/Oxford,United Healthcare/Oxford,,9.3,,,9.3,7.41,11.46,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Aetna,Commerical,,8.14,,,8.14,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Aetna,Middlesex Employees,,7.33,,,7.33,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Anthem,Commerical,,7.29,,,7.29,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Anthem,Indemnity,,,7.971471845,,7.971471845,5.83,9.02,percent of total billed charges,,9.02
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Anthem,State Preferred,,7.29,,,7.29,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Anthem,Individual Exchange,,5.83,,,5.83,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Cigna,Cigna,,7.11,,,7.11,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Connecticare,Commerical,,7.61,,,7.61,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Connecticare,Exchange,,7.61,,,7.61,5.83,9.02,other,Could be inpatient or outpatient,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,Multiplan,Multiplan,,,9.019902913,,9.019902913,5.83,9.019902913,percent of total billed charges,,
HC TRAP 40CC SPEC STERILE,27200134,RC,,,both,,,10.61165049,6.56,United Healthcare/Oxford,United Healthcare/Oxford,,7.32,,,7.32,5.83,9.02,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Aetna,Commerical,,5.61,,,5.61,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Aetna,Middlesex Employees,,5.05,,,5.05,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Anthem,Commerical,,5.03,,,5.03,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Anthem,Indemnity,,,5.499075728,,5.499075728,4.03,6.22,percent of total billed charges,,6.22
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Anthem,State Preferred,,5.03,,,5.03,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Anthem,Individual Exchange,,4.03,,,4.03,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Cigna,Cigna,,4.91,,,4.91,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Connecticare,Commerical,,5.25,,,5.25,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Connecticare,Exchange,,5.25,,,5.25,4.03,6.22,other,Could be inpatient or outpatient,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,Multiplan,Multiplan,,,6.222330097,,6.222330097,4.03,6.222330097,percent of total billed charges,,
HC ENEMA BAG PRELUBE TIP,27200135,RC,,,both,,,7.32038835,4.52,United Healthcare/Oxford,United Healthcare/Oxford,,5.05,,,5.05,4.03,6.22,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Aetna,Commerical,,21.59,,,21.59,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Aetna,Middlesex Employees,,19.43,,,19.43,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Anthem,Commerical,,19.31,,,19.31,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Anthem,Indemnity,,,21.13570485,,21.13570485,15.45,23.92,percent of total billed charges,,23.92
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Anthem,State Preferred,,19.31,,,19.31,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Anthem,Individual Exchange,,15.45,,,15.45,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Cigna,Cigna,,18.87,,,18.87,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Connecticare,Commerical,,20.18,,,20.18,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Connecticare,Exchange,,20.18,,,20.18,15.45,23.92,other,Could be inpatient or outpatient,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,Multiplan,Multiplan,,,23.91553398,,23.91553398,15.45,23.91553398,percent of total billed charges,,
HC TUBE 3.5 CUFFED ETT,27200137,RC,,,both,,,28.13592233,17.39,United Healthcare/Oxford,United Healthcare/Oxford,,19.42,,,19.42,15.45,23.92,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Aetna,Commerical,,133.51,,,133.51,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Aetna,Middlesex Employees,,120.17,,,120.17,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Anthem,Commerical,,119.46,,,119.46,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Anthem,Indemnity,,,126.9528,,126.9528,95.57,147.89,percent of total billed charges,,147.89
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Anthem,State Preferred,,119.46,,,119.46,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Anthem,Individual Exchange,,95.57,,,95.57,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Cigna,Cigna,,116.67,,,116.67,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Connecticare,Commerical,,124.79,,,124.79,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Connecticare,Exchange,,124.79,,,124.79,95.57,147.89,other,Could be inpatient or outpatient,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,Multiplan,Multiplan,,,143.65,,143.65,95.57,143.65,percent of total billed charges,,
HC MORGAN LENS  300995,27200138,RC,,,both,,,169,104.44,United Healthcare/Oxford,United Healthcare/Oxford,,120.07,,,120.07,95.57,147.89,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Aetna,Commerical,,6.45,,,6.45,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Aetna,Middlesex Employees,,5.81,,,5.81,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Anthem,Commerical,,5.76,,,5.76,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Anthem,Indemnity,,,6.308621359,,6.308621359,4.62,7.14,percent of total billed charges,,7.14
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Anthem,State Preferred,,5.76,,,5.76,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Anthem,Individual Exchange,,4.62,,,4.62,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Cigna,Cigna,,5.64,,,5.64,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Connecticare,Commerical,,6.03,,,6.03,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Connecticare,Exchange,,6.03,,,6.03,4.62,7.14,other,Could be inpatient or outpatient,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,Multiplan,Multiplan,,,7.138349515,,7.138349515,4.62,7.138349515,percent of total billed charges,,
HC SET T-PORT IV EXT,27200140,RC,,,both,,,8.398058252,5.19,United Healthcare/Oxford,United Healthcare/Oxford,,5.8,,,5.8,4.62,7.14,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC MEPILEX BORDER DRESSING 4X4,27200141,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Aetna,Commerical,,16.01,,,16.01,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Aetna,Middlesex Employees,,14.4,,,14.4,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Anthem,Commerical,,14.32,,,14.32,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Anthem,Indemnity,,,15.67309515,,15.67309515,11.46,17.73,percent of total billed charges,,17.73
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Anthem,State Preferred,,14.32,,,14.32,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Anthem,Individual Exchange,,11.46,,,11.46,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Cigna,Cigna,,13.99,,,13.99,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Connecticare,Commerical,,14.96,,,14.96,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Connecticare,Exchange,,14.96,,,14.96,11.46,17.73,other,Could be inpatient or outpatient,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,Multiplan,Multiplan,,,17.73446602,,17.73446602,11.46,17.73446602,percent of total billed charges,,
HC MANIFOLID MEDEX MX431,27200142,RC,,,both,,,20.86407767,12.89,United Healthcare/Oxford,United Healthcare/Oxford,,14.39,,,14.39,11.46,17.73,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Aetna,Commerical,,9.86,,,9.86,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Aetna,Middlesex Employees,,8.87,,,8.87,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Anthem,Commerical,,8.82,,,8.82,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Anthem,Indemnity,,,9.364473786,,9.364473786,7.06,10.92,percent of total billed charges,,10.92
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Anthem,State Preferred,,8.82,,,8.82,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Anthem,Individual Exchange,,7.06,,,7.06,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Cigna,Cigna,,8.61,,,8.61,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Connecticare,Commerical,,9.22,,,9.22,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Connecticare,Exchange,,9.22,,,9.22,7.06,10.92,other,Could be inpatient or outpatient,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,Multiplan,Multiplan,,,10.5961165,,10.5961165,7.06,10.5961165,percent of total billed charges,,
HC PICC NEEDLE,27200143,RC,,,both,,,12.46601942,7.71,United Healthcare/Oxford,United Healthcare/Oxford,,8.87,,,8.87,7.06,10.92,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Aetna,Commerical,,9.3,,,9.3,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Aetna,Middlesex Employees,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Anthem,Commerical,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Anthem,Indemnity,,,8.832069903,,8.832069903,6.66,10.3,percent of total billed charges,,10.3
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Anthem,State Preferred,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Anthem,Individual Exchange,,6.66,,,6.66,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Cigna,Cigna,,8.12,,,8.12,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Connecticare,Commerical,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Connecticare,Exchange,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,Multiplan,Multiplan,,,9.99368932,,9.99368932,6.66,9.99368932,percent of total billed charges,,
HC NEEDLE 22GX1.5 SPINAL 321015,27200144,RC,,,both,,,11.75728155,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Aetna,Commerical,,9.3,,,9.3,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Aetna,Middlesex Employees,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Anthem,Commerical,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Anthem,Indemnity,,,8.832069903,,8.832069903,6.66,10.3,percent of total billed charges,,10.3
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Anthem,State Preferred,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Anthem,Individual Exchange,,6.66,,,6.66,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Cigna,Cigna,,8.12,,,8.12,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Connecticare,Commerical,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Connecticare,Exchange,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,Multiplan,Multiplan,,,9.99368932,,9.99368932,6.66,9.99368932,percent of total billed charges,,
HC NEEDLE 22GX3 SPINAL 321016,27200145,RC,,,both,,,11.75728155,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Aetna,Commerical,,9.3,,,9.3,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Aetna,Middlesex Employees,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Anthem,Commerical,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Anthem,Indemnity,,,8.832069903,,8.832069903,6.66,10.3,percent of total billed charges,,10.3
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Anthem,State Preferred,,8.32,,,8.32,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Anthem,Individual Exchange,,6.66,,,6.66,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Cigna,Cigna,,8.12,,,8.12,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Connecticare,Commerical,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Connecticare,Exchange,,8.69,,,8.69,6.66,10.3,other,Could be inpatient or outpatient,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,Multiplan,Multiplan,,,9.99368932,,9.99368932,6.66,9.99368932,percent of total billed charges,,
HC NEEDLE 25GX3 SPINAL 321018,27200146,RC,,,both,,,11.75728155,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.36,,,8.36,6.66,10.3,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Aetna,Commerical,,15.94,,,15.94,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Aetna,Middlesex Employees,,14.34,,,14.34,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Anthem,Commerical,,14.26,,,14.26,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Anthem,Indemnity,,,15.15527767,,15.15527767,11.41,17.65,percent of total billed charges,,17.65
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Anthem,State Preferred,,14.26,,,14.26,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Anthem,Individual Exchange,,11.41,,,11.41,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Cigna,Cigna,,13.93,,,13.93,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Connecticare,Commerical,,14.89,,,14.89,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Connecticare,Exchange,,14.89,,,14.89,11.41,17.65,other,Could be inpatient or outpatient,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,Multiplan,Multiplan,,,17.14854369,,17.14854369,11.41,17.14854369,percent of total billed charges,,
HC EAR SYRINGE,27200147,RC,,,both,,,20.17475728,12.47,United Healthcare/Oxford,United Healthcare/Oxford,,14.34,,,14.34,11.41,17.65,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Aetna,Commerical,,87.11,,,87.11,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Aetna,Middlesex Employees,,78.4,,,78.4,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Anthem,Commerical,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Anthem,Indemnity,,,82.632,,82.632,62.36,96.49,percent of total billed charges,,96.49
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Anthem,State Preferred,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Anthem,Individual Exchange,,62.36,,,62.36,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Cigna,Cigna,,76.12,,,76.12,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Connecticare,Commerical,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Connecticare,Exchange,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,Multiplan,Multiplan,,,93.5,,93.5,62.36,93.5,percent of total billed charges,,
HC NEEDELE INTEROSSIUS,27200148,RC,,,both,,,110,67.98,United Healthcare/Oxford,United Healthcare/Oxford,,78.34,,,78.34,62.36,96.49,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Aetna,Commerical,,41.45,,,41.45,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Aetna,Middlesex Employees,,37.31,,,37.31,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Anthem,Commerical,,37.09,,,37.09,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Anthem,Indemnity,,,39.0624,,39.0624,29.67,45.92,percent of total billed charges,,45.92
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Anthem,State Preferred,,37.09,,,37.09,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Anthem,Individual Exchange,,29.67,,,29.67,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Cigna,Cigna,,36.22,,,36.22,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Connecticare,Commerical,,38.75,,,38.75,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Connecticare,Exchange,,38.75,,,38.75,29.67,45.92,other,Could be inpatient or outpatient,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,Multiplan,Multiplan,,,44.2,,44.2,29.67,44.2,percent of total billed charges,,
HC PROTECTOR HEEL/ELBOW,27200149,RC,,,both,,,52,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,37.28,,,37.28,29.67,45.92,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Aetna,Commerical,,5.41,,,5.41,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Aetna,Middlesex Employees,,4.87,,,4.87,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Anthem,Commerical,,4.84,,,4.84,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Anthem,Indemnity,,,5.149001942,,5.149001942,3.87,5.99,percent of total billed charges,,5.99
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Anthem,State Preferred,,4.84,,,4.84,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Anthem,Individual Exchange,,3.87,,,3.87,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Cigna,Cigna,,4.73,,,4.73,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Connecticare,Commerical,,5.06,,,5.06,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Connecticare,Exchange,,5.06,,,5.06,3.87,5.99,other,Could be inpatient or outpatient,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,Multiplan,Multiplan,,,5.826213592,,5.826213592,3.87,5.826213592,percent of total billed charges,,
HC SKIN STAPLE REMOVER,27200150,RC,,,both,,,6.854368932,4.23,United Healthcare/Oxford,United Healthcare/Oxford,,4.87,,,4.87,3.87,5.99,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Aetna,Commerical,,85.48,,,85.48,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Aetna,Middlesex Employees,,76.94,,,76.94,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Anthem,Commerical,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Anthem,Indemnity,,,81.1296,,81.1296,61.19,94.68,percent of total billed charges,,94.68
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Anthem,State Preferred,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Anthem,Individual Exchange,,61.19,,,61.19,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Cigna,Cigna,,74.69,,,74.69,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Connecticare,Commerical,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Connecticare,Exchange,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,Multiplan,Multiplan,,,91.8,,91.8,61.19,91.8,percent of total billed charges,,
HC LUMBAR PUCTURE TRAY,27200152,RC,,,both,,,108,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,76.87,,,76.87,61.19,94.68,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Aetna,Commerical,,9.23,,,9.23,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Aetna,Middlesex Employees,,8.3,,,8.3,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Anthem,Commerical,,8.25,,,8.25,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Anthem,Indemnity,,,8.766431068,,8.766431068,6.6,10.22,percent of total billed charges,,10.22
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Anthem,State Preferred,,8.25,,,8.25,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Anthem,Individual Exchange,,6.6,,,6.6,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Cigna,Cigna,,8.06,,,8.06,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Connecticare,Commerical,,8.62,,,8.62,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Connecticare,Exchange,,8.62,,,8.62,6.6,10.22,other,Could be inpatient or outpatient,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,Multiplan,Multiplan,,,9.919417476,,9.919417476,6.6,9.919417476,percent of total billed charges,,
HC CATH PROCEDURE TRAY,27200153,RC,,,both,,,11.66990291,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,8.29,,,8.29,6.6,10.22,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Anthem,Indemnity,,,62.3496,,62.3496,47.21,73.04,percent of total billed charges,,73.04
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,Multiplan,Multiplan,,,70.55,,70.55,47.21,70.55,percent of total billed charges,,
HC LUMBAR PUCTURE TRAY 22GX3.5 391144,27200154,RC,,,both,,,83,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Aetna,Commerical,,4.96,,,4.96,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Aetna,Middlesex Employees,,4.47,,,4.47,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Anthem,Commerical,,4.44,,,4.44,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Anthem,Indemnity,,,4.718702913,,4.718702913,3.55,5.5,percent of total billed charges,,5.5
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Anthem,State Preferred,,4.44,,,4.44,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Anthem,Individual Exchange,,3.55,,,3.55,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Cigna,Cigna,,4.34,,,4.34,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Connecticare,Commerical,,4.64,,,4.64,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Connecticare,Exchange,,4.64,,,4.64,3.55,5.5,other,Could be inpatient or outpatient,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,Multiplan,Multiplan,,,5.339320388,,5.339320388,3.55,5.339320388,percent of total billed charges,,
HC SUTURE TRAY REM PERMIUM,27200155,RC,,,both,,,6.281553398,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.55,5.5,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Aetna,Commerical,,55.36,,,55.36,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Aetna,Middlesex Employees,,49.83,,,49.83,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Anthem,Commerical,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Anthem,Indemnity,,,52.584,,52.584,39.63,61.32,percent of total billed charges,,61.32
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Anthem,State Preferred,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Anthem,Individual Exchange,,39.63,,,39.63,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Cigna,Cigna,,48.37,,,48.37,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Connecticare,Commerical,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Connecticare,Exchange,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,Multiplan,Multiplan,,,59.5,,59.5,39.63,59.5,percent of total billed charges,,
HC FOLEY CATH TRAY,27200156,RC,,,both,,,70,43.26,United Healthcare/Oxford,United Healthcare/Oxford,,49.78,,,49.78,39.63,61.32,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Aetna,Commerical,,18.56,,,18.56,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Aetna,Middlesex Employees,,16.71,,,16.71,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Anthem,Commerical,,16.61,,,16.61,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Anthem,Indemnity,,,17.63496699,,17.63496699,13.29,20.56,percent of total billed charges,,20.56
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Anthem,State Preferred,,16.61,,,16.61,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Anthem,Individual Exchange,,13.29,,,13.29,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Cigna,Cigna,,16.22,,,16.22,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Connecticare,Commerical,,17.35,,,17.35,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Connecticare,Exchange,,17.35,,,17.35,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,Multiplan,Multiplan,,,19.95436893,,19.95436893,13.29,19.95436893,percent of total billed charges,,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,27200157,RC,,,both,,,23.47572816,14.51,United Healthcare/Oxford,United Healthcare/Oxford,,16.7,,,16.7,13.29,20.56,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Aetna,Commerical,,20.3,,,20.3,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Aetna,Middlesex Employees,,18.27,,,18.27,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Anthem,Commerical,,18.16,,,18.16,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Anthem,Indemnity,,,19.29781748,,19.29781748,14.53,22.49,percent of total billed charges,,22.49
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Anthem,State Preferred,,18.16,,,18.16,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Anthem,Individual Exchange,,14.53,,,14.53,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Cigna,Cigna,,17.74,,,17.74,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Connecticare,Commerical,,18.98,,,18.98,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Connecticare,Exchange,,18.98,,,18.98,14.53,22.49,other,Could be inpatient or outpatient,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,Multiplan,Multiplan,,,21.83592233,,21.83592233,14.53,21.83592233,percent of total billed charges,,
HC NEEDLE SAFESTEP 22GX1 431085,27200158,RC,,,both,,,25.68932039,15.88,United Healthcare/Oxford,United Healthcare/Oxford,,18.26,,,18.26,14.53,22.49,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Aetna,Commerical,,3.85,,,3.85,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Aetna,Middlesex Employees,,3.46,,,3.46,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Anthem,Commerical,,3.45,,,3.45,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Anthem,Indemnity,,,3.770586408,,3.770586408,2.75,4.27,percent of total billed charges,,4.27
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Anthem,State Preferred,,3.45,,,3.45,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Anthem,Individual Exchange,,2.75,,,2.75,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Cigna,Cigna,,3.37,,,3.37,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Connecticare,Commerical,,3.6,,,3.6,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Connecticare,Exchange,,3.6,,,3.6,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,Multiplan,Multiplan,,,4.266504854,,4.266504854,2.75,4.266504854,percent of total billed charges,,
HC CANNULA NASAL HUDSON,27200159,RC,,,both,,,5.019417476,3.1,United Healthcare/Oxford,United Healthcare/Oxford,,3.46,,,3.46,2.75,4.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Aetna,Commerical,,14.69,,,14.69,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Aetna,Middlesex Employees,,13.22,,,13.22,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Anthem,Commerical,,13.14,,,13.14,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Anthem,Indemnity,,,14.37490485,,14.37490485,10.52,16.27,percent of total billed charges,,16.27
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Anthem,State Preferred,,13.14,,,13.14,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Anthem,Individual Exchange,,10.52,,,10.52,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Cigna,Cigna,,12.83,,,12.83,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Connecticare,Commerical,,13.73,,,13.73,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Connecticare,Exchange,,13.73,,,13.73,10.52,16.27,other,Could be inpatient or outpatient,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,Multiplan,Multiplan,,,16.26553398,,16.26553398,10.52,16.26553398,percent of total billed charges,,
HC CANNULA NASAL,27200160,RC,,,both,,,19.13592233,11.83,United Healthcare/Oxford,United Healthcare/Oxford,,13.2,,,13.2,10.52,16.27,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Aetna,Commerical,,11.26,,,11.26,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Aetna,Middlesex Employees,,10.13,,,10.13,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Anthem,Commerical,,10.07,,,10.07,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Anthem,Indemnity,,,10.6991301,,10.6991301,8.05,12.47,percent of total billed charges,,12.47
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Anthem,State Preferred,,10.07,,,10.07,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Anthem,Individual Exchange,,8.05,,,8.05,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Cigna,Cigna,,9.84,,,9.84,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Connecticare,Commerical,,10.53,,,10.53,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Connecticare,Exchange,,10.53,,,10.53,8.05,12.47,other,Could be inpatient or outpatient,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,Multiplan,Multiplan,,,12.10631068,,12.10631068,8.05,12.10631068,percent of total billed charges,,
HC ORAL AIRWAY 5CM - 10CM,27200161,RC,,,both,,,14.24271845,8.8,United Healthcare/Oxford,United Healthcare/Oxford,,10.12,,,10.12,8.05,12.47,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Aetna,Commerical,,21.69,,,21.69,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Aetna,Middlesex Employees,,19.52,,,19.52,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Anthem,Commerical,,19.41,,,19.41,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Anthem,Indemnity,,,20.61059417,,20.61059417,15.53,24.02,percent of total billed charges,,24.02
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Anthem,State Preferred,,19.41,,,19.41,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Anthem,Individual Exchange,,15.53,,,15.53,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Cigna,Cigna,,18.95,,,18.95,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Connecticare,Commerical,,20.27,,,20.27,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Connecticare,Exchange,,20.27,,,20.27,15.53,24.02,other,Could be inpatient or outpatient,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,Multiplan,Multiplan,,,23.32135922,,23.32135922,15.53,23.32135922,percent of total billed charges,,
HC FOLEY CATH,27200162,RC,,,both,,,27.4368932,16.96,United Healthcare/Oxford,United Healthcare/Oxford,,19.51,,,19.51,15.53,24.02,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Aetna,Commerical,,3.15,,,3.15,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Aetna,Middlesex Employees,,2.83,,,2.83,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Anthem,Commerical,,2.82,,,2.82,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Anthem,Indemnity,,,2.997506796,,2.997506796,2.26,3.49,percent of total billed charges,,3.49
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Anthem,State Preferred,,2.82,,,2.82,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Anthem,Individual Exchange,,2.26,,,2.26,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Cigna,Cigna,,2.76,,,2.76,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Connecticare,Commerical,,2.94,,,2.94,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Connecticare,Exchange,,2.94,,,2.94,2.26,3.49,other,Could be inpatient or outpatient,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,Multiplan,Multiplan,,,3.391747573,,3.391747573,2.26,3.391747573,percent of total billed charges,,
HC STOPCOCK MALE 4-WAY,27200163,RC,,,both,,,3.990291262,2.47,United Healthcare/Oxford,United Healthcare/Oxford,,2.83,,,2.83,2.26,3.49,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Aetna,Commerical,,1.79,,,1.79,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Aetna,Middlesex Employees,,1.6,,,1.6,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Anthem,Commerical,,1.59,,,1.59,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Anthem,Indemnity,,,1.743075728,,1.743075728,1.27,1.97,percent of total billed charges,,1.97
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Anthem,State Preferred,,1.59,,,1.59,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Anthem,Individual Exchange,,1.27,,,1.27,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Cigna,Cigna,,1.56,,,1.56,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Connecticare,Commerical,,1.66,,,1.66,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Connecticare,Exchange,,1.66,,,1.66,1.27,1.97,other,Could be inpatient or outpatient,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,Multiplan,Multiplan,,,1.972330097,,1.972330097,1.27,1.972330097,percent of total billed charges,,
HC TUBING CONN 5MMX6FT,27200164,RC,,,both,,,2.32038835,1.43,United Healthcare/Oxford,United Healthcare/Oxford,,1.61,,,1.61,1.27,1.97,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Aetna,Commerical,,33.86,,,33.86,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Aetna,Middlesex Employees,,30.47,,,30.47,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Anthem,Commerical,,30.29,,,30.29,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Anthem,Indemnity,,,33.14031845,,33.14031845,24.24,37.5,percent of total billed charges,,37.5
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Anthem,State Preferred,,30.29,,,30.29,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Anthem,Individual Exchange,,24.24,,,24.24,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Cigna,Cigna,,29.59,,,29.59,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Connecticare,Commerical,,31.64,,,31.64,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Connecticare,Exchange,,31.64,,,31.64,24.24,37.5,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,Multiplan,Multiplan,,,37.49902913,,37.49902913,24.24,37.49902913,percent of total billed charges,,
"HC FEEDING TUBE 10FR 36""  501018",27200165,RC,,,both,,,44.11650485,27.27,United Healthcare/Oxford,United Healthcare/Oxford,,30.45,,,30.45,24.24,37.5,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Anthem,Indemnity,,,92.3976,,92.3976,69.35,107.31,percent of total billed charges,,107.31
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,Multiplan,Multiplan,,,104.55,,104.55,69.35,104.55,percent of total billed charges,,
HC FEEDING TUBE 10FR,27200166,RC,,,both,,,123,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Aetna,Commerical,,86.3,,,86.3,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Aetna,Middlesex Employees,,77.67,,,77.67,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Anthem,Commerical,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Anthem,Indemnity,,,81.8808,,81.8808,61.77,95.59,percent of total billed charges,,95.59
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Anthem,State Preferred,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Anthem,Individual Exchange,,61.77,,,61.77,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Cigna,Cigna,,75.41,,,75.41,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Connecticare,Commerical,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Connecticare,Exchange,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,Multiplan,Multiplan,,,92.65,,92.65,61.77,92.65,percent of total billed charges,,
"HC FEEDING TUBE 8FR 36""",27200167,RC,,,both,,,109,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,77.61,,,77.61,61.77,95.59,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Aetna,Commerical,,8.73,,,8.73,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Aetna,Middlesex Employees,,7.86,,,7.86,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Anthem,Commerical,,7.8,,,7.8,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Anthem,Indemnity,,,8.292372816,,8.292372816,6.24,9.66,percent of total billed charges,,9.66
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Anthem,State Preferred,,7.8,,,7.8,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Anthem,Individual Exchange,,6.24,,,6.24,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Cigna,Cigna,,7.62,,,7.62,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Connecticare,Commerical,,8.15,,,8.15,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Connecticare,Exchange,,8.15,,,8.15,6.24,9.66,other,Could be inpatient or outpatient,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,Multiplan,Multiplan,,,9.383009709,,9.383009709,6.24,9.383009709,percent of total billed charges,,
HC PRESSURE TUBING 4FT,27200168,RC,,,both,,,11.03883495,6.82,United Healthcare/Oxford,United Healthcare/Oxford,,7.85,,,7.85,6.24,9.66,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Aetna,Commerical,,6.45,,,6.45,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Aetna,Middlesex Employees,,5.81,,,5.81,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Anthem,Commerical,,5.76,,,5.76,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Anthem,Indemnity,,,6.126291262,,6.126291262,4.62,7.14,percent of total billed charges,,7.14
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Anthem,State Preferred,,5.76,,,5.76,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Anthem,Individual Exchange,,4.62,,,4.62,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Cigna,Cigna,,5.64,,,5.64,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Connecticare,Commerical,,6.03,,,6.03,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Connecticare,Exchange,,6.03,,,6.03,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,Multiplan,Multiplan,,,6.932038835,,6.932038835,4.62,6.932038835,percent of total billed charges,,
"HC TUBING 60"" MICROBORE",27200169,RC,,,both,,,8.155339806,5.04,United Healthcare/Oxford,United Healthcare/Oxford,,5.8,,,5.8,4.62,7.14,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Aetna,Commerical,,5.41,,,5.41,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Aetna,Middlesex Employees,,4.87,,,4.87,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Anthem,Commerical,,4.83,,,4.83,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Anthem,Indemnity,,,5.287572816,,5.287572816,3.87,5.98,percent of total billed charges,,5.98
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Anthem,State Preferred,,4.83,,,4.83,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Anthem,Individual Exchange,,3.87,,,3.87,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Cigna,Cigna,,4.72,,,4.72,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Connecticare,Commerical,,5.06,,,5.06,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Connecticare,Exchange,,5.06,,,5.06,3.87,5.98,other,Could be inpatient or outpatient,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,Multiplan,Multiplan,,,5.983009709,,5.983009709,3.87,5.983009709,percent of total billed charges,,
"HC TUBING 60"" MICROBORE ABBOTT",27200170,RC,,,both,,,7.038834951,4.35,United Healthcare/Oxford,United Healthcare/Oxford,,4.86,,,4.86,3.87,5.98,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Aetna,Commerical,,14.88,,,14.88,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Aetna,Middlesex Employees,,13.39,,,13.39,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Anthem,Commerical,,13.32,,,13.32,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Anthem,Indemnity,,,14.14152233,,14.14152233,10.66,16.48,percent of total billed charges,,16.48
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Anthem,State Preferred,,13.32,,,13.32,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Anthem,Individual Exchange,,10.66,,,10.66,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Cigna,Cigna,,13,,,13,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Connecticare,Commerical,,13.91,,,13.91,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Connecticare,Exchange,,13.91,,,13.91,10.66,16.48,other,Could be inpatient or outpatient,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,Multiplan,Multiplan,,,16.00145631,,16.00145631,10.66,16.00145631,percent of total billed charges,,
HC CONNECTOR IV TUBING  501280,27200171,RC,,,both,,,18.82524272,11.64,United Healthcare/Oxford,United Healthcare/Oxford,,13.38,,,13.38,10.66,16.48,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Aetna,Commerical,,23.31,,,23.31,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Aetna,Middlesex Employees,,20.98,,,20.98,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Anthem,Commerical,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Anthem,Indemnity,,,22.82043495,,22.82043495,16.69,25.82,percent of total billed charges,,25.82
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Anthem,State Preferred,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Anthem,Individual Exchange,,16.69,,,16.69,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Cigna,Cigna,,20.37,,,20.37,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Connecticare,Commerical,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Connecticare,Exchange,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,Multiplan,Multiplan,,,25.82184466,,25.82184466,16.69,25.82184466,percent of total billed charges,,
HC TUBE INDWELLING 20' 5FR,27200172,RC,,,both,,,30.37864078,18.77,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Aetna,Commerical,,33.69,,,33.69,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Aetna,Middlesex Employees,,30.32,,,30.32,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Anthem,Commerical,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Anthem,Indemnity,,,32.97986796,,32.97986796,24.12,37.32,percent of total billed charges,,37.32
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Anthem,State Preferred,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Anthem,Individual Exchange,,24.12,,,24.12,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Cigna,Cigna,,29.44,,,29.44,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Connecticare,Commerical,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Connecticare,Exchange,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,Multiplan,Multiplan,,,37.31747573,,37.31747573,24.12,37.31747573,percent of total billed charges,,
HC TUBE INDWELLING 20' 8FR,27200173,RC,,,both,,,43.90291262,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,30.29,,,30.29,24.12,37.32,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Aetna,Commerical,,9.48,,,9.48,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Aetna,Middlesex Employees,,8.54,,,8.54,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Anthem,Commerical,,8.48,,,8.48,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Anthem,Indemnity,,,9.007106796,,9.007106796,6.78,10.5,percent of total billed charges,,10.5
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Anthem,State Preferred,,8.48,,,8.48,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Anthem,Individual Exchange,,6.78,,,6.78,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Cigna,Cigna,,8.28,,,8.28,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Connecticare,Commerical,,8.86,,,8.86,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Connecticare,Exchange,,8.86,,,8.86,6.78,10.5,other,Could be inpatient or outpatient,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,Multiplan,Multiplan,,,10.19174757,,10.19174757,6.78,10.19174757,percent of total billed charges,,
HC KAGAROO SET ADAPTOR,27200174,RC,,,both,,,11.99029126,7.41,United Healthcare/Oxford,United Healthcare/Oxford,,8.52,,,8.52,6.78,10.5,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Aetna,Commerical,,267.03,,,267.03,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Aetna,Middlesex Employees,,240.32,,,240.32,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Anthem,Commerical,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Anthem,Indemnity,,,261.4030136,,261.4030136,191.14,295.78,percent of total billed charges,,295.78
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Anthem,State Preferred,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Anthem,Individual Exchange,,191.14,,,191.14,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Cigna,Cigna,,233.33,,,233.33,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Connecticare,Commerical,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Connecticare,Exchange,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,Multiplan,Multiplan,,,295.7834951,,295.7834951,191.14,295.7834951,percent of total billed charges,,
HC TUBE GASTRO 12FR,27200175,RC,,,both,,,347.9805825,215.05,United Healthcare/Oxford,United Healthcare/Oxford,,240.13,,,240.13,191.14,295.78,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Anthem,Indemnity,,,253.4315417,,253.4315417,185.32,286.76,percent of total billed charges,,286.76
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,Multiplan,Multiplan,,,286.7635922,,286.7635922,185.32,286.7635922,percent of total billed charges,,
HC TUBE GASTRO 14FR,27200176,RC,,,both,,,337.368932,208.49,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Anthem,Indemnity,,,253.4315417,,253.4315417,185.32,286.76,percent of total billed charges,,286.76
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,Multiplan,Multiplan,,,286.7635922,,286.7635922,185.32,286.7635922,percent of total billed charges,,
HC TUBE GASTRO 16FR,27200177,RC,,,both,,,337.368932,208.49,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Aetna,Commerical,,249.92,,,249.92,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Aetna,Middlesex Employees,,224.93,,,224.93,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Anthem,Commerical,,223.63,,,223.63,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Anthem,Indemnity,,,244.6651107,,244.6651107,178.91,276.85,percent of total billed charges,,276.85
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Anthem,State Preferred,,223.63,,,223.63,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Anthem,Individual Exchange,,178.91,,,178.91,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Cigna,Cigna,,218.4,,,218.4,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Connecticare,Commerical,,233.6,,,233.6,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Connecticare,Exchange,,233.6,,,233.6,178.91,276.85,other,Could be inpatient or outpatient,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,Multiplan,Multiplan,,,276.8441748,,276.8441748,178.91,276.8441748,percent of total billed charges,,
HC TUBE GASTRO 20FR,27200178,RC,,,both,,,325.6990291,201.28,United Healthcare/Oxford,United Healthcare/Oxford,,224.77,,,224.77,178.91,276.85,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Aetna,Commerical,,24.95,,,24.95,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Aetna,Middlesex Employees,,22.45,,,22.45,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Anthem,Commerical,,22.32,,,22.32,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Anthem,Indemnity,,,24.43223301,,24.43223301,17.86,27.64,percent of total billed charges,,27.64
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Anthem,State Preferred,,22.32,,,22.32,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Anthem,Individual Exchange,,17.86,,,17.86,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Cigna,Cigna,,21.81,,,21.81,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Connecticare,Commerical,,23.33,,,23.33,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Connecticare,Exchange,,23.33,,,23.33,17.86,27.64,other,Could be inpatient or outpatient,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,Multiplan,Multiplan,,,27.64563107,,27.64563107,17.86,27.64563107,percent of total billed charges,,
"HC MIC-KEY EXT. 12"" Y-PORT 501334",27200180,RC,,,both,,,32.52427184,20.1,United Healthcare/Oxford,United Healthcare/Oxford,,22.44,,,22.44,17.86,27.64,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Aetna,Commerical,,11.26,,,11.26,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Aetna,Middlesex Employees,,10.13,,,10.13,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Anthem,Commerical,,10.07,,,10.07,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Anthem,Indemnity,,,11.02003107,,11.02003107,8.05,12.47,percent of total billed charges,,12.47
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Anthem,State Preferred,,10.07,,,10.07,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Anthem,Individual Exchange,,8.05,,,8.05,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Cigna,Cigna,,9.84,,,9.84,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Connecticare,Commerical,,10.53,,,10.53,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Connecticare,Exchange,,10.53,,,10.53,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,Multiplan,Multiplan,,,12.46941748,,12.46941748,8.05,12.46941748,percent of total billed charges,,
HC TUBE ENDOTRACHEAL 2.5MM,27200181,RC,,,both,,,14.66990291,9.07,United Healthcare/Oxford,United Healthcare/Oxford,,10.12,,,10.12,8.05,12.47,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Aetna,Commerical,,15.83,,,15.83,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Aetna,Middlesex Employees,,14.25,,,14.25,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Anthem,Commerical,,14.17,,,14.17,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Anthem,Indemnity,,,15.04587961,,15.04587961,11.33,17.54,percent of total billed charges,,17.54
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Anthem,State Preferred,,14.17,,,14.17,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Anthem,Individual Exchange,,11.33,,,11.33,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Cigna,Cigna,,13.83,,,13.83,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Connecticare,Commerical,,14.8,,,14.8,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Connecticare,Exchange,,14.8,,,14.8,11.33,17.54,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,Multiplan,Multiplan,,,17.02475728,,17.02475728,11.33,17.02475728,percent of total billed charges,,
HC TUBE ENDOTRACHEAL 3.0MM,27200182,RC,,,both,,,20.02912621,12.38,United Healthcare/Oxford,United Healthcare/Oxford,,14.24,,,14.24,11.33,17.54,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Aetna,Commerical,,11.82,,,11.82,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Aetna,Middlesex Employees,,10.65,,,10.65,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Anthem,Commerical,,10.58,,,10.58,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Anthem,Indemnity,,,11.23882718,,11.23882718,8.47,13.09,percent of total billed charges,,13.09
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Anthem,State Preferred,,10.58,,,10.58,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Anthem,Individual Exchange,,8.47,,,8.47,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Cigna,Cigna,,10.33,,,10.33,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Connecticare,Commerical,,11.04,,,11.04,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Connecticare,Exchange,,11.04,,,11.04,8.47,13.09,other,Could be inpatient or outpatient,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,Multiplan,Multiplan,,,12.71699029,,12.71699029,8.47,12.71699029,percent of total billed charges,,
HC ENDOTRACHEAL TUBE 3.5,27200183,RC,,,both,,,14.96116505,9.25,United Healthcare/Oxford,United Healthcare/Oxford,,10.63,,,10.63,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Aetna,Commerical,,4.52,,,4.52,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Aetna,Middlesex Employees,,4.07,,,4.07,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Anthem,Commerical,,4.05,,,4.05,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Anthem,Indemnity,,,4.426974757,,4.426974757,3.24,5.01,percent of total billed charges,,5.01
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Anthem,State Preferred,,4.05,,,4.05,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Anthem,Individual Exchange,,3.24,,,3.24,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Cigna,Cigna,,3.95,,,3.95,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Connecticare,Commerical,,4.22,,,4.22,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Connecticare,Exchange,,4.22,,,4.22,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,Multiplan,Multiplan,,,5.009223301,,5.009223301,3.24,5.009223301,percent of total billed charges,,
HC TUBE YANKAUER SUCTION,27200184,RC,,,both,,,5.893203883,3.64,United Healthcare/Oxford,United Healthcare/Oxford,,4.06,,,4.06,3.24,5.01,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Aetna,Commerical,,36.28,,,36.28,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Aetna,Middlesex Employees,,32.65,,,32.65,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Anthem,Commerical,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Anthem,Indemnity,,,34.48226796,,34.48226796,25.97,40.18,percent of total billed charges,,40.18
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Anthem,State Preferred,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Anthem,Individual Exchange,,25.97,,,25.97,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Cigna,Cigna,,31.7,,,31.7,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Connecticare,Commerical,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Connecticare,Exchange,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,Multiplan,Multiplan,,,39.01747573,,39.01747573,25.97,39.01747573,percent of total billed charges,,
HC TUBE ENDOTRACHEAL UNCUFF 4.5,27200185,RC,,,both,,,45.90291262,28.37,United Healthcare/Oxford,United Healthcare/Oxford,,32.62,,,32.62,25.97,40.18,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Aetna,Commerical,,12.18,,,12.18,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Aetna,Middlesex Employees,,10.96,,,10.96,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Anthem,Commerical,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Anthem,Indemnity,,,11.57431456,,11.57431456,8.71,13.49,percent of total billed charges,,13.49
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Anthem,State Preferred,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Anthem,Individual Exchange,,8.71,,,8.71,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Cigna,Cigna,,10.64,,,10.64,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Connecticare,Commerical,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Connecticare,Exchange,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,Multiplan,Multiplan,,,13.09660194,,13.09660194,8.71,13.09660194,percent of total billed charges,,
HC TUBE ENDOTRACHEAL UNCUFF 5.0,27200186,RC,,,both,,,15.40776699,9.52,United Healthcare/Oxford,United Healthcare/Oxford,,10.95,,,10.95,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Aetna,Commerical,,12.18,,,12.18,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Aetna,Middlesex Employees,,10.96,,,10.96,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Anthem,Commerical,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Anthem,Indemnity,,,11.57431456,,11.57431456,8.71,13.49,percent of total billed charges,,13.49
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Anthem,State Preferred,,10.9,,,10.9,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Anthem,Individual Exchange,,8.71,,,8.71,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Cigna,Cigna,,10.64,,,10.64,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Connecticare,Commerical,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Connecticare,Exchange,,11.38,,,11.38,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,Multiplan,Multiplan,,,13.09660194,,13.09660194,8.71,13.09660194,percent of total billed charges,,
HC TUBE ENDOTRACHEAL UNCUFF 5.5,27200187,RC,,,both,,,15.40776699,9.52,United Healthcare/Oxford,United Healthcare/Oxford,,10.95,,,10.95,8.71,13.49,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Aetna,Commerical,,21.08,,,21.08,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Aetna,Middlesex Employees,,18.97,,,18.97,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Anthem,Commerical,,18.87,,,18.87,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Anthem,Indemnity,,,20.63976699,,20.63976699,15.09,23.36,percent of total billed charges,,23.36
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Anthem,State Preferred,,18.87,,,18.87,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Anthem,Individual Exchange,,15.09,,,15.09,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Cigna,Cigna,,18.43,,,18.43,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Connecticare,Commerical,,19.7,,,19.7,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Connecticare,Exchange,,19.7,,,19.7,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,Multiplan,Multiplan,,,23.35436893,,23.35436893,15.09,23.35436893,percent of total billed charges,,
HC TUBE ENDOTRACHEAL UNCUFF 6.0,27200188,RC,,,both,,,27.47572816,16.98,United Healthcare/Oxford,United Healthcare/Oxford,,18.96,,,18.96,15.09,23.36,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Aetna,Commerical,,41.45,,,41.45,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Aetna,Middlesex Employees,,37.31,,,37.31,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Anthem,Commerical,,37.09,,,37.09,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Anthem,Indemnity,,,39.0624,,39.0624,29.67,45.92,percent of total billed charges,,45.92
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Anthem,State Preferred,,37.09,,,37.09,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Anthem,Individual Exchange,,29.67,,,29.67,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Cigna,Cigna,,36.22,,,36.22,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Connecticare,Commerical,,38.75,,,38.75,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Connecticare,Exchange,,38.75,,,38.75,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,Multiplan,Multiplan,,,44.2,,44.2,29.67,44.2,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 3.0,27200189,RC,,,both,,,52,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,37.28,,,37.28,29.67,45.92,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Aetna,Commerical,,11.5,,,11.5,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Aetna,Middlesex Employees,,10.35,,,10.35,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Anthem,Commerical,,10.29,,,10.29,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Anthem,Indemnity,,,11.2607068,,11.2607068,8.23,12.74,percent of total billed charges,,12.74
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Anthem,State Preferred,,10.29,,,10.29,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Anthem,Individual Exchange,,8.23,,,8.23,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Cigna,Cigna,,10.06,,,10.06,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Connecticare,Commerical,,10.75,,,10.75,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Connecticare,Exchange,,10.75,,,10.75,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,Multiplan,Multiplan,,,12.74174757,,12.74174757,8.23,12.74174757,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200190,RC,,,both,,,14.99029126,9.26,United Healthcare/Oxford,United Healthcare/Oxford,,10.34,,,10.34,8.23,12.74,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Aetna,Commerical,,11.82,,,11.82,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Aetna,Middlesex Employees,,10.65,,,10.65,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Anthem,Commerical,,10.58,,,10.58,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Anthem,Indemnity,,,11.56702136,,11.56702136,8.47,13.09,percent of total billed charges,,13.09
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Anthem,State Preferred,,10.58,,,10.58,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Anthem,Individual Exchange,,8.47,,,8.47,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Cigna,Cigna,,10.33,,,10.33,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Connecticare,Commerical,,11.04,,,11.04,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Connecticare,Exchange,,11.04,,,11.04,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,Multiplan,Multiplan,,,13.08834951,,13.08834951,8.47,13.08834951,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 6.0,27200191,RC,,,both,,,15.39805825,9.52,United Healthcare/Oxford,United Healthcare/Oxford,,10.63,,,10.63,8.47,13.09,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Aetna,Commerical,,11.17,,,11.17,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Aetna,Middlesex Employees,,10.05,,,10.05,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Anthem,Commerical,,10,,,10,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Anthem,Indemnity,,,10.93980583,,10.93980583,8,12.38,percent of total billed charges,,12.38
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Anthem,State Preferred,,10,,,10,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Anthem,Individual Exchange,,8,,,8,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Cigna,Cigna,,9.76,,,9.76,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Connecticare,Commerical,,10.43,,,10.43,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Connecticare,Exchange,,10.43,,,10.43,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,Multiplan,Multiplan,,,12.37864078,,12.37864078,8,12.37864078,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 6.5,27200192,RC,,,both,,,14.5631068,9,United Healthcare/Oxford,United Healthcare/Oxford,,10.04,,,10.04,8,12.38,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Aetna,Commerical,,10.72,,,10.72,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Aetna,Middlesex Employees,,9.64,,,9.64,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Anthem,Commerical,,9.59,,,9.59,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Anthem,Indemnity,,,10.49492039,,10.49492039,7.68,11.87,percent of total billed charges,,11.87
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Anthem,State Preferred,,9.59,,,9.59,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Anthem,Individual Exchange,,7.68,,,7.68,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Cigna,Cigna,,9.37,,,9.37,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Connecticare,Commerical,,10.02,,,10.02,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Connecticare,Exchange,,10.02,,,10.02,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,Multiplan,Multiplan,,,11.87524272,,11.87524272,7.68,11.87524272,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 7.0,27200193,RC,,,both,,,13.97087379,8.63,United Healthcare/Oxford,United Healthcare/Oxford,,9.64,,,9.64,7.68,11.87,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Aetna,Commerical,,10.79,,,10.79,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Aetna,Middlesex Employees,,9.71,,,9.71,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Anthem,Commerical,,9.66,,,9.66,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Anthem,Indemnity,,,10.56055922,,10.56055922,7.72,11.95,percent of total billed charges,,11.95
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Anthem,State Preferred,,9.66,,,9.66,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Anthem,Individual Exchange,,7.72,,,7.72,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Cigna,Cigna,,9.42,,,9.42,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Connecticare,Commerical,,10.08,,,10.08,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Connecticare,Exchange,,10.08,,,10.08,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,Multiplan,Multiplan,,,11.94951456,,11.94951456,7.72,11.94951456,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 7.5,27200194,RC,,,both,,,14.05825243,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,9.7,,,9.7,7.72,11.95,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Aetna,Commerical,,11.96,,,11.96,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Aetna,Middlesex Employees,,10.76,,,10.76,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Anthem,Commerical,,10.7,,,10.7,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Anthem,Indemnity,,,11.70559223,,11.70559223,8.56,13.24,percent of total billed charges,,13.24
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Anthem,State Preferred,,10.7,,,10.7,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Anthem,Individual Exchange,,8.56,,,8.56,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Cigna,Cigna,,10.45,,,10.45,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Connecticare,Commerical,,11.18,,,11.18,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Connecticare,Exchange,,11.18,,,11.18,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,Multiplan,Multiplan,,,13.24514563,,13.24514563,8.56,13.24514563,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 8.0,27200195,RC,,,both,,,15.58252427,9.63,United Healthcare/Oxford,United Healthcare/Oxford,,10.75,,,10.75,8.56,13.24,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Aetna,Commerical,,23.31,,,23.31,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Aetna,Middlesex Employees,,20.98,,,20.98,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Anthem,Commerical,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Anthem,Indemnity,,,22.82043495,,22.82043495,16.69,25.82,percent of total billed charges,,25.82
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Anthem,State Preferred,,20.87,,,20.87,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Anthem,Individual Exchange,,16.69,,,16.69,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Cigna,Cigna,,20.37,,,20.37,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Connecticare,Commerical,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Connecticare,Exchange,,21.79,,,21.79,16.69,25.82,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,Multiplan,Multiplan,,,25.82184466,,25.82184466,16.69,25.82184466,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 8.5,27200196,RC,,,both,,,30.37864078,18.77,United Healthcare/Oxford,United Healthcare/Oxford,,20.97,,,20.97,16.69,25.82,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Aetna,Commerical,,46.41,,,46.41,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Aetna,Middlesex Employees,,41.77,,,41.77,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Anthem,Commerical,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Anthem,Indemnity,,,45.42207379,,45.42207379,33.22,51.4,percent of total billed charges,,51.4
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Anthem,State Preferred,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Anthem,Individual Exchange,,33.22,,,33.22,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Cigna,Cigna,,40.55,,,40.55,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Connecticare,Commerical,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Connecticare,Exchange,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,Multiplan,Multiplan,,,51.3961165,,51.3961165,33.22,51.3961165,percent of total billed charges,,
HC HABERMAN FEEDER,27200197,RC,,,both,,,60.46601942,37.37,United Healthcare/Oxford,United Healthcare/Oxford,,41.74,,,41.74,33.22,51.4,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Aetna,Commerical,,73.27,,,73.27,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Aetna,Middlesex Employees,,65.94,,,65.94,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Anthem,Commerical,,65.56,,,65.56,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Anthem,Indemnity,,,69.8616,,69.8616,52.44,81.16,percent of total billed charges,,81.16
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Anthem,State Preferred,,65.56,,,65.56,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Anthem,Individual Exchange,,52.44,,,52.44,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Cigna,Cigna,,64.02,,,64.02,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Connecticare,Commerical,,68.48,,,68.48,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Connecticare,Exchange,,68.48,,,68.48,52.44,81.16,other,Could be inpatient or outpatient,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,Multiplan,Multiplan,,,79.05,,79.05,52.44,79.05,percent of total billed charges,,
HC CHEST DRAINAGE,27200198,RC,,,both,,,93,57.47,United Healthcare/Oxford,United Healthcare/Oxford,,65.89,,,65.89,52.44,81.16,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Aetna,Commerical,,134.33,,,134.33,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Aetna,Middlesex Employees,,120.9,,,120.9,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Anthem,Commerical,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Anthem,Indemnity,,,131.496466,,131.496466,96.15,148.79,percent of total billed charges,,148.79
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Anthem,State Preferred,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Anthem,Individual Exchange,,96.15,,,96.15,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Cigna,Cigna,,117.38,,,117.38,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Connecticare,Commerical,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Connecticare,Exchange,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,Multiplan,Multiplan,,,148.7912621,,148.7912621,96.15,148.7912621,percent of total billed charges,,
HC BLOOD BAG ATRIUM,27200199,RC,,,both,,,175.0485437,108.18,United Healthcare/Oxford,United Healthcare/Oxford,,120.8,,,120.8,96.15,148.79,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Aetna,Commerical,,6.87,,,6.87,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Aetna,Middlesex Employees,,6.18,,,6.18,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Anthem,Commerical,,6.15,,,6.15,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Anthem,Indemnity,,,6.724333981,,6.724333981,4.92,7.61,percent of total billed charges,,7.61
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Anthem,State Preferred,,6.15,,,6.15,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Anthem,Individual Exchange,,4.92,,,4.92,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Cigna,Cigna,,6,,,6,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Connecticare,Commerical,,6.42,,,6.42,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Connecticare,Exchange,,6.42,,,6.42,4.92,7.61,other,Could be inpatient or outpatient,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,Multiplan,Multiplan,,,7.608737864,,7.608737864,4.92,7.608737864,percent of total billed charges,,
HC TUBE 10FR SALEM SUMP,27200200,RC,,,both,,,8.951456311,5.53,United Healthcare/Oxford,United Healthcare/Oxford,,6.18,,,6.18,4.92,7.61,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Aetna,Commerical,,6.41,,,6.41,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Aetna,Middlesex Employees,,5.78,,,5.78,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Anthem,Commerical,,5.74,,,5.74,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Anthem,Indemnity,,,6.097118447,,6.097118447,4.6,7.11,percent of total billed charges,,7.11
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Anthem,State Preferred,,5.74,,,5.74,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Anthem,Individual Exchange,,4.6,,,4.6,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Cigna,Cigna,,5.61,,,5.61,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Connecticare,Commerical,,6,,,6,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Connecticare,Exchange,,6,,,6,4.6,7.11,other,Could be inpatient or outpatient,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,Multiplan,Multiplan,,,6.899029126,,6.899029126,4.6,6.899029126,percent of total billed charges,,
HC SALEM SUMP 14 FR,27200201,RC,,,both,,,8.116504854,5.02,United Healthcare/Oxford,United Healthcare/Oxford,,5.77,,,5.77,4.6,7.11,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Aetna,Commerical,,13.27,,,13.27,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Aetna,Middlesex Employees,,11.94,,,11.94,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Anthem,Commerical,,11.86,,,11.86,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Anthem,Indemnity,,,12.98190291,,12.98190291,9.49,14.69,percent of total billed charges,,14.69
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Anthem,State Preferred,,11.86,,,11.86,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Anthem,Individual Exchange,,9.49,,,9.49,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Cigna,Cigna,,11.59,,,11.59,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Connecticare,Commerical,,12.4,,,12.4,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Connecticare,Exchange,,12.4,,,12.4,9.49,14.69,other,Could be inpatient or outpatient,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,Multiplan,Multiplan,,,14.68932039,,14.68932039,9.49,14.68932039,percent of total billed charges,,
HC TUBE SALEM SUMP 18FR,27200202,RC,,,both,,,17.2815534,10.68,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,9.49,14.69,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Aetna,Commerical,,24.19,,,24.19,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Aetna,Middlesex Employees,,21.77,,,21.77,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Anthem,Commerical,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Anthem,Indemnity,,,22.98817864,,22.98817864,17.32,26.79,percent of total billed charges,,26.79
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Anthem,State Preferred,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Anthem,Individual Exchange,,17.32,,,17.32,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Cigna,Cigna,,21.13,,,21.13,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Connecticare,Commerical,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Connecticare,Exchange,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,Multiplan,Multiplan,,,26.01165049,,26.01165049,17.32,26.01165049,percent of total billed charges,,
HC AIR ELIMINATION FILTER,27200203,RC,,,both,,,30.60194175,18.91,United Healthcare/Oxford,United Healthcare/Oxford,,21.75,,,21.75,17.32,26.79,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Aetna,Commerical,,65.12,,,65.12,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Aetna,Middlesex Employees,,58.61,,,58.61,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Anthem,Commerical,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Anthem,Indemnity,,,63.75718835,,63.75718835,46.62,72.14,percent of total billed charges,,72.14
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Anthem,State Preferred,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Anthem,Individual Exchange,,46.62,,,46.62,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Cigna,Cigna,,56.91,,,56.91,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Connecticare,Commerical,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Connecticare,Exchange,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,Multiplan,Multiplan,,,72.14271845,,72.14271845,46.62,72.14271845,percent of total billed charges,,
HC BREAST PUMP KIT DUAL,27200204,RC,,,both,,,84.87378641,52.45,United Healthcare/Oxford,United Healthcare/Oxford,,58.57,,,58.57,46.62,72.14,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Aetna,Commerical,,19.19,,,19.19,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Aetna,Middlesex Employees,,17.28,,,17.28,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Anthem,Commerical,,17.18,,,17.18,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Anthem,Indemnity,,,18.79458641,,18.79458641,13.74,21.27,percent of total billed charges,,21.27
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Anthem,State Preferred,,17.18,,,17.18,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Anthem,Individual Exchange,,13.74,,,13.74,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Cigna,Cigna,,16.78,,,16.78,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Connecticare,Commerical,,17.94,,,17.94,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Connecticare,Exchange,,17.94,,,17.94,13.74,21.27,other,Could be inpatient or outpatient,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,Multiplan,Multiplan,,,21.26650485,,21.26650485,13.74,21.26650485,percent of total billed charges,,
HC PROBE SKIN,27200205,RC,,,both,,,25.01941748,15.46,United Healthcare/Oxford,United Healthcare/Oxford,,17.26,,,17.26,13.74,21.27,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Aetna,Commerical,,11.52,,,11.52,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Aetna,Middlesex Employees,,10.37,,,10.37,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Anthem,Commerical,,10.31,,,10.31,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Anthem,Indemnity,,,11.2752932,,11.2752932,8.25,12.76,percent of total billed charges,,12.76
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Anthem,State Preferred,,10.31,,,10.31,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Anthem,Individual Exchange,,8.25,,,8.25,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Cigna,Cigna,,10.07,,,10.07,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Connecticare,Commerical,,10.76,,,10.76,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Connecticare,Exchange,,10.76,,,10.76,8.25,12.76,other,Could be inpatient or outpatient,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,Multiplan,Multiplan,,,12.75825243,,12.75825243,8.25,12.75825243,percent of total billed charges,,
HC DRAINAGE PODS GRIKS,27200206,RC,,,both,,,15.00970874,9.28,United Healthcare/Oxford,United Healthcare/Oxford,,10.36,,,10.36,8.25,12.76,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Aetna,Commerical,,13.71,,,13.71,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Aetna,Middlesex Employees,,12.34,,,12.34,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Anthem,Commerical,,12.28,,,12.28,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Anthem,Indemnity,,,13.04024854,,13.04024854,9.82,15.2,percent of total billed charges,,15.2
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Anthem,State Preferred,,12.28,,,12.28,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Anthem,Individual Exchange,,9.82,,,9.82,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Cigna,Cigna,,11.99,,,11.99,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Connecticare,Commerical,,12.82,,,12.82,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Connecticare,Exchange,,12.82,,,12.82,9.82,15.2,other,Could be inpatient or outpatient,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,Multiplan,Multiplan,,,14.75533981,,14.75533981,9.82,14.75533981,percent of total billed charges,,
HC OSTOMY POUCHKIN,27200207,RC,,,both,,,17.3592233,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,12.34,,,12.34,9.82,15.2,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Aetna,Commerical,,33.69,,,33.69,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Aetna,Middlesex Employees,,30.32,,,30.32,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Anthem,Commerical,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Anthem,Indemnity,,,32.97986796,,32.97986796,24.12,37.32,percent of total billed charges,,37.32
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Anthem,State Preferred,,30.14,,,30.14,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Anthem,Individual Exchange,,24.12,,,24.12,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Cigna,Cigna,,29.44,,,29.44,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Connecticare,Commerical,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Connecticare,Exchange,,31.49,,,31.49,24.12,37.32,other,Could be inpatient or outpatient,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,Multiplan,Multiplan,,,37.31747573,,37.31747573,24.12,37.31747573,percent of total billed charges,,
HC VALVE ANTI-REFLUX,27200208,RC,,,both,,,43.90291262,27.13,United Healthcare/Oxford,United Healthcare/Oxford,,30.29,,,30.29,24.12,37.32,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Aetna,Commerical,,21.04,,,21.04,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Aetna,Middlesex Employees,,18.94,,,18.94,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Anthem,Commerical,,18.83,,,18.83,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Anthem,Indemnity,,,20.58871456,,20.58871456,15.06,23.3,percent of total billed charges,,23.3
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Anthem,State Preferred,,18.83,,,18.83,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Anthem,Individual Exchange,,15.06,,,15.06,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Cigna,Cigna,,18.39,,,18.39,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Connecticare,Commerical,,19.66,,,19.66,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Connecticare,Exchange,,19.66,,,19.66,15.06,23.3,other,Could be inpatient or outpatient,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,Multiplan,Multiplan,,,23.29660194,,23.29660194,15.06,23.29660194,percent of total billed charges,,
"HC GAUZE IODOFORM 1/2""",27200209,RC,,,both,,,27.40776699,16.94,United Healthcare/Oxford,United Healthcare/Oxford,,18.92,,,18.92,15.06,23.3,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Aetna,Commerical,,38.86,,,38.86,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Aetna,Middlesex Employees,,34.98,,,34.98,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Anthem,Commerical,,34.78,,,34.78,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Anthem,Indemnity,,,36.94007767,,36.94007767,27.82,43.05,percent of total billed charges,,43.05
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Anthem,State Preferred,,34.78,,,34.78,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Anthem,Individual Exchange,,27.82,,,27.82,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Cigna,Cigna,,33.97,,,33.97,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Connecticare,Commerical,,36.33,,,36.33,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Connecticare,Exchange,,36.33,,,36.33,27.82,43.05,other,Could be inpatient or outpatient,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,Multiplan,Multiplan,,,41.79854369,,41.79854369,27.82,41.79854369,percent of total billed charges,,
HC SNS STARTER,27200210,RC,,,both,,,49.17475728,30.39,United Healthcare/Oxford,United Healthcare/Oxford,,34.95,,,34.95,27.82,43.05,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Aetna,Commerical,,140.84,,,140.84,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Aetna,Middlesex Employees,,126.75,,,126.75,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Anthem,Commerical,,126.02,,,126.02,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Anthem,Indemnity,,,133.7136,,133.7136,100.82,156.01,percent of total billed charges,,156.01
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Anthem,State Preferred,,126.02,,,126.02,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Anthem,Individual Exchange,,100.82,,,100.82,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Cigna,Cigna,,123.07,,,123.07,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Connecticare,Commerical,,131.63,,,131.63,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Connecticare,Exchange,,131.63,,,131.63,100.82,156.01,other,Could be inpatient or outpatient,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,Multiplan,Multiplan,,,151.3,,151.3,100.82,151.3,percent of total billed charges,,
HC EXCHANGE TRANS TRAY,27200211,RC,,,both,,,178,110,United Healthcare/Oxford,United Healthcare/Oxford,,126.66,,,126.66,100.82,156.01,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Aetna,Commerical,,14.82,,,14.82,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Aetna,Middlesex Employees,,13.34,,,13.34,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Anthem,Commerical,,13.26,,,13.26,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Anthem,Indemnity,,,14.50618252,,14.50618252,10.61,16.41,percent of total billed charges,,16.41
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Anthem,State Preferred,,13.26,,,13.26,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Anthem,Individual Exchange,,10.61,,,10.61,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Cigna,Cigna,,12.95,,,12.95,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Connecticare,Commerical,,13.85,,,13.85,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Connecticare,Exchange,,13.85,,,13.85,10.61,16.41,other,Could be inpatient or outpatient,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,Multiplan,Multiplan,,,16.41407767,,16.41407767,10.61,16.41407767,percent of total billed charges,,
HC CATH 28G ABBOCATH,27200212,RC,,,both,,,19.31067961,11.93,United Healthcare/Oxford,United Healthcare/Oxford,,13.33,,,13.33,10.61,16.41,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Aetna,Commerical,,2.63,,,2.63,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Aetna,Middlesex Employees,,2.36,,,2.36,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Anthem,Commerical,,2.35,,,2.35,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Anthem,Indemnity,,,2.574500971,,2.574500971,1.88,2.92,percent of total billed charges,,2.92
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Anthem,State Preferred,,2.35,,,2.35,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Anthem,Individual Exchange,,1.88,,,1.88,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Cigna,Cigna,,2.3,,,2.3,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Connecticare,Commerical,,2.46,,,2.46,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Connecticare,Exchange,,2.46,,,2.46,1.88,2.92,other,Could be inpatient or outpatient,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,Multiplan,Multiplan,,,2.913106796,,2.913106796,1.88,2.913106796,percent of total billed charges,,
HC ENEMA MINERAL OIL,27200213,RC,,,both,,,3.427184466,2.12,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,1.88,2.92,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Anthem,Indemnity,,,43.83215534,,43.83215534,32.05,49.6,percent of total billed charges,,49.6
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,Multiplan,Multiplan,,,49.59708738,,49.59708738,32.05,49.59708738,percent of total billed charges,,
HC FOREIGN BODY REMOVER,27200215,RC,,,both,,,58.34951456,36.06,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Aetna,Commerical,,14.19,,,14.19,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Aetna,Middlesex Employees,,12.77,,,12.77,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Anthem,Commerical,,12.7,,,12.7,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Anthem,Indemnity,,,13.48513398,,13.48513398,10.16,15.72,percent of total billed charges,,15.72
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Anthem,State Preferred,,12.7,,,12.7,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Anthem,Individual Exchange,,10.16,,,10.16,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Cigna,Cigna,,12.4,,,12.4,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Connecticare,Commerical,,13.26,,,13.26,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Connecticare,Exchange,,13.26,,,13.26,10.16,15.72,other,Could be inpatient or outpatient,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,Multiplan,Multiplan,,,15.25873786,,15.25873786,10.16,15.25873786,percent of total billed charges,,
HC HP TEMP PROBE 9FR,27200216,RC,,,both,,,17.95145631,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,12.76,,,12.76,10.16,15.72,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Aetna,Commerical,,52.91,,,52.91,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Aetna,Middlesex Employees,,47.62,,,47.62,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Anthem,Commerical,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Anthem,Indemnity,,,51.80362718,,51.80362718,37.88,58.62,percent of total billed charges,,58.62
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Anthem,State Preferred,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Anthem,Individual Exchange,,37.88,,,37.88,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Cigna,Cigna,,46.24,,,46.24,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Connecticare,Commerical,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Connecticare,Exchange,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,Multiplan,Multiplan,,,58.61699029,,58.61699029,37.88,58.61699029,percent of total billed charges,,
HC CATH PEDI FOLEY 6FR,27200217,RC,,,both,,,68.96116505,42.62,United Healthcare/Oxford,United Healthcare/Oxford,,47.59,,,47.59,37.88,58.62,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Aetna,Commerical,,34.55,,,34.55,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Aetna,Middlesex Employees,,31.1,,,31.1,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Anthem,Commerical,,30.92,,,30.92,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Anthem,Indemnity,,,32.83400388,,32.83400388,24.74,38.27,percent of total billed charges,,38.27
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Anthem,State Preferred,,30.92,,,30.92,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Anthem,Individual Exchange,,24.74,,,24.74,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Cigna,Cigna,,30.19,,,30.19,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Connecticare,Commerical,,32.29,,,32.29,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Connecticare,Exchange,,32.29,,,32.29,24.74,38.27,other,Could be inpatient or outpatient,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,Multiplan,Multiplan,,,37.15242718,,37.15242718,24.74,37.15242718,percent of total billed charges,,
HC PEAKFLOW ASTHMA,27200218,RC,,,both,,,43.70873786,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,31.08,,,31.08,24.74,38.27,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Aetna,Commerical,,78.16,,,78.16,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Aetna,Middlesex Employees,,70.34,,,70.34,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Anthem,Commerical,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Anthem,Indemnity,,,74.3688,,74.3688,55.94,86.57,percent of total billed charges,,86.57
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Anthem,State Preferred,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Anthem,Individual Exchange,,55.94,,,55.94,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Cigna,Cigna,,68.3,,,68.3,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Connecticare,Commerical,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Connecticare,Exchange,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,Multiplan,Multiplan,,,84.15,,84.15,55.94,84.15,percent of total billed charges,,
HC CORDIS 5FR INTRODUCER,27200220,RC,,,both,,,99,61.18,United Healthcare/Oxford,United Healthcare/Oxford,,70.29,,,70.29,55.94,86.57,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Aetna,Commerical,,40.59,,,40.59,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Aetna,Middlesex Employees,,36.53,,,36.53,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Anthem,Commerical,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Anthem,Indemnity,,,38.3112,,38.3112,29.05,44.97,percent of total billed charges,,44.97
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Anthem,State Preferred,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Anthem,Individual Exchange,,29.05,,,29.05,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Cigna,Cigna,,35.47,,,35.47,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Connecticare,Commerical,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Connecticare,Exchange,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,Multiplan,Multiplan,,,43.35,,43.35,29.05,43.35,percent of total billed charges,,
HC VENT MASK CHILD  5052-600,27200221,RC,,,both,,,51,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,36.5,,,36.5,29.05,44.97,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Aetna,Commerical,,58.62,,,58.62,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Aetna,Middlesex Employees,,52.76,,,52.76,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Anthem,Commerical,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Anthem,Indemnity,,,55.5888,,55.5888,41.96,64.92,percent of total billed charges,,64.92
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Anthem,State Preferred,,52.44,,,52.44,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Anthem,Individual Exchange,,41.96,,,41.96,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Cigna,Cigna,,51.22,,,51.22,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Connecticare,Commerical,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Connecticare,Exchange,,54.78,,,54.78,41.96,64.92,other,Could be inpatient or outpatient,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,Multiplan,Multiplan,,,62.9,,62.9,41.96,62.9,percent of total billed charges,,
HC IV START KIT,27200222,RC,,,both,,,74,45.73,United Healthcare/Oxford,United Healthcare/Oxford,,52.72,,,52.72,41.96,64.92,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Aetna,Commerical,,80.59,,,80.59,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Aetna,Middlesex Employees,,72.53,,,72.53,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Anthem,Commerical,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Anthem,Indemnity,,,76.6224,,76.6224,57.69,89.28,percent of total billed charges,,89.28
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Anthem,State Preferred,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Anthem,Individual Exchange,,57.69,,,57.69,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Cigna,Cigna,,70.43,,,70.43,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Connecticare,Commerical,,75.33,,,75.33,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Connecticare,Exchange,,75.33,,,75.33,57.69,89.28,other,Could be inpatient or outpatient,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,Multiplan,Multiplan,,,86.7,,86.7,57.69,86.7,percent of total billed charges,,
HC SUTURE TRAY,27200223,RC,,,both,,,102,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,72.48,,,72.48,57.69,89.28,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Aetna,Commerical,,104.2,,,104.2,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Aetna,Middlesex Employees,,93.78,,,93.78,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Anthem,Commerical,,93.24,,,93.24,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Anthem,Indemnity,,,99.1584,,99.1584,74.59,115.43,percent of total billed charges,,115.43
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Anthem,State Preferred,,93.24,,,93.24,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Anthem,Individual Exchange,,74.59,,,74.59,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Cigna,Cigna,,91.06,,,91.06,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Connecticare,Commerical,,97.4,,,97.4,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Connecticare,Exchange,,97.4,,,97.4,74.59,115.43,other,Could be inpatient or outpatient,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,Multiplan,Multiplan,,,112.2,,112.2,74.59,112.2,percent of total billed charges,,
HC LATEX-FREE NPE 12-24FR,27200224,RC,,,both,,,132,81.58,United Healthcare/Oxford,United Healthcare/Oxford,,93.71,,,93.71,74.59,115.43,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Aetna,Commerical,,126.18,,,126.18,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Aetna,Middlesex Employees,,113.57,,,113.57,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Anthem,Commerical,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Anthem,Indemnity,,,123.5249942,,123.5249942,90.32,139.77,percent of total billed charges,,139.77
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Anthem,State Preferred,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Anthem,Individual Exchange,,90.32,,,90.32,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Cigna,Cigna,,110.26,,,110.26,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Connecticare,Commerical,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Connecticare,Exchange,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,Multiplan,Multiplan,,,139.7713592,,139.7713592,90.32,139.7713592,percent of total billed charges,,
HC DERMABOND ADHESIVE,27200225,RC,,,both,,,164.4368932,101.62,United Healthcare/Oxford,United Healthcare/Oxford,,113.48,,,113.48,90.32,139.77,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Aetna,Commerical,,85.48,,,85.48,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Aetna,Middlesex Employees,,76.94,,,76.94,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Anthem,Commerical,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Anthem,Indemnity,,,81.1296,,81.1296,61.19,94.68,percent of total billed charges,,94.68
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Anthem,State Preferred,,76.49,,,76.49,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Anthem,Individual Exchange,,61.19,,,61.19,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Cigna,Cigna,,74.69,,,74.69,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Connecticare,Commerical,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Connecticare,Exchange,,79.89,,,79.89,61.19,94.68,other,Could be inpatient or outpatient,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,Multiplan,Multiplan,,,91.8,,91.8,61.19,91.8,percent of total billed charges,,
HC HEART NEB,27200226,RC,,,both,,,108,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,76.87,,,76.87,61.19,94.68,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Anthem,Indemnity,,,47.01928544,,47.01928544,34.38,53.2,percent of total billed charges,,53.2
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,Multiplan,Multiplan,,,53.20339806,,53.20339806,34.38,53.20339806,percent of total billed charges,,
HC SET RADIAL ARTERY,27200227,RC,,,both,,,62.59223301,38.68,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Aetna,Commerical,,16.46,,,16.46,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Aetna,Middlesex Employees,,14.82,,,14.82,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Anthem,Commerical,,14.73,,,14.73,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Anthem,Indemnity,,,15.64392233,,15.64392233,11.78,18.23,percent of total billed charges,,18.23
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Anthem,State Preferred,,14.73,,,14.73,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Anthem,Individual Exchange,,11.78,,,11.78,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Cigna,Cigna,,14.38,,,14.38,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Connecticare,Commerical,,15.39,,,15.39,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Connecticare,Exchange,,15.39,,,15.39,11.78,18.23,other,Could be inpatient or outpatient,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,Multiplan,Multiplan,,,17.70145631,,17.70145631,11.78,17.70145631,percent of total billed charges,,
HC CV ADILT KIT,27200228,RC,,,both,,,20.82524272,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,14.8,,,14.8,11.78,18.23,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Aetna,Commerical,,16.39,,,16.39,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Aetna,Middlesex Employees,,14.76,,,14.76,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Anthem,Commerical,,14.67,,,14.67,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Anthem,Indemnity,,,16.05234175,,16.05234175,11.74,18.16,percent of total billed charges,,18.16
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Anthem,State Preferred,,14.67,,,14.67,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Anthem,Individual Exchange,,11.74,,,11.74,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Cigna,Cigna,,14.33,,,14.33,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Connecticare,Commerical,,15.33,,,15.33,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Connecticare,Exchange,,15.33,,,15.33,11.74,18.16,other,Could be inpatient or outpatient,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,Multiplan,Multiplan,,,18.16359223,,18.16359223,11.74,18.16359223,percent of total billed charges,,
HC TUBE ENDOTRACHEAL CUFFED 5.5,27200229,RC,,,both,,,21.36893204,13.21,United Healthcare/Oxford,United Healthcare/Oxford,,14.75,,,14.75,11.74,18.16,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Aetna,Commerical,,20.66,,,20.66,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Aetna,Middlesex Employees,,18.59,,,18.59,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Anthem,Commerical,,18.49,,,18.49,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Anthem,Indemnity,,,20.22405437,,20.22405437,14.79,22.88,percent of total billed charges,,22.88
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Anthem,State Preferred,,18.49,,,18.49,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Anthem,Individual Exchange,,14.79,,,14.79,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Cigna,Cigna,,18.04,,,18.04,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Connecticare,Commerical,,19.3,,,19.3,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Connecticare,Exchange,,19.3,,,19.3,14.79,22.88,other,Could be inpatient or outpatient,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,Multiplan,Multiplan,,,22.88398058,,22.88398058,14.79,22.88398058,percent of total billed charges,,
"HC GAUZE NU-PLAIN 1""",27200230,RC,,,both,,,26.9223301,16.64,United Healthcare/Oxford,United Healthcare/Oxford,,18.57,,,18.57,14.79,22.88,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Aetna,Commerical,,107.46,,,107.46,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Aetna,Middlesex Employees,,96.71,,,96.71,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Anthem,Commerical,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Anthem,Indemnity,,,102.1632,,102.1632,76.92,119.03,percent of total billed charges,,119.03
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Anthem,State Preferred,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Anthem,Individual Exchange,,76.92,,,76.92,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Cigna,Cigna,,93.9,,,93.9,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Connecticare,Commerical,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Connecticare,Exchange,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,Multiplan,Multiplan,,,115.6,,115.6,76.92,115.6,percent of total billed charges,,
HC CATH 4FR DBL LUMEN,27200231,RC,,,both,,,136,84.05,United Healthcare/Oxford,United Healthcare/Oxford,,96.64,,,96.64,76.92,119.03,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Aetna,Commerical,,3.16,,,3.16,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Aetna,Middlesex Employees,,2.84,,,2.84,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Anthem,Commerical,,2.83,,,2.83,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Anthem,Indemnity,,,3.092318447,,3.092318447,2.26,3.5,percent of total billed charges,,3.5
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Anthem,State Preferred,,2.83,,,2.83,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Anthem,Individual Exchange,,2.26,,,2.26,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Cigna,Cigna,,2.76,,,2.76,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Connecticare,Commerical,,2.95,,,2.95,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Connecticare,Exchange,,2.95,,,2.95,2.26,3.5,other,Could be inpatient or outpatient,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,Multiplan,Multiplan,,,3.499029126,,3.499029126,2.26,3.499029126,percent of total billed charges,,
HC GAUZE VASELINE 1X8,27200232,RC,,,both,,,4.116504854,2.55,United Healthcare/Oxford,United Healthcare/Oxford,,2.84,,,2.84,2.26,3.5,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Aetna,Commerical,,18.83,,,18.83,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Aetna,Middlesex Employees,,16.95,,,16.95,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Anthem,Commerical,,16.85,,,16.85,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Anthem,Indemnity,,,18.43721942,,18.43721942,13.48,20.86,percent of total billed charges,,20.86
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Anthem,State Preferred,,16.85,,,16.85,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Anthem,Individual Exchange,,13.48,,,13.48,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Cigna,Cigna,,16.45,,,16.45,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Connecticare,Commerical,,17.6,,,17.6,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Connecticare,Exchange,,17.6,,,17.6,13.48,20.86,other,Could be inpatient or outpatient,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,Multiplan,Multiplan,,,20.86213592,,20.86213592,13.48,20.86213592,percent of total billed charges,,
HC TRANDUCER ARTER KIT,27200233,RC,,,both,,,24.54368932,15.17,United Healthcare/Oxford,United Healthcare/Oxford,,16.93,,,16.93,13.48,20.86,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Aetna,Commerical,,65.12,,,65.12,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Aetna,Middlesex Employees,,58.61,,,58.61,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Anthem,Commerical,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Anthem,Indemnity,,,61.5984,,61.5984,46.62,72.14,percent of total billed charges,,72.14
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Anthem,State Preferred,,58.27,,,58.27,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Anthem,Individual Exchange,,46.62,,,46.62,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Cigna,Cigna,,56.91,,,56.91,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Connecticare,Commerical,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Connecticare,Exchange,,60.87,,,60.87,46.62,72.14,other,Could be inpatient or outpatient,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,Multiplan,Multiplan,,,69.7,,69.7,46.62,69.7,percent of total billed charges,,
HC OSTOMY 4X4 STOMADHESIVE,27200234,RC,,,both,,,82,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,58.57,,,58.57,46.62,72.14,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Aetna,Commerical,,13.03,,,13.03,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Aetna,Middlesex Employees,,11.73,,,11.73,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Anthem,Commerical,,11.66,,,11.66,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Anthem,Indemnity,,,12.38386019,,12.38386019,9.34,14.44,percent of total billed charges,,14.44
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Anthem,State Preferred,,11.66,,,11.66,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Anthem,Individual Exchange,,9.34,,,9.34,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Cigna,Cigna,,11.39,,,11.39,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Connecticare,Commerical,,12.18,,,12.18,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Connecticare,Exchange,,12.18,,,12.18,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,Multiplan,Multiplan,,,14.01262136,,14.01262136,9.34,14.01262136,percent of total billed charges,,
HC GAUZE XEROFORM 5X9,27200236,RC,,,both,,,16.48543689,10.19,United Healthcare/Oxford,United Healthcare/Oxford,,11.72,,,11.72,9.34,14.44,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Aetna,Commerical,,8.43,,,8.43,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Aetna,Middlesex Employees,,7.59,,,7.59,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Anthem,Commerical,,7.55,,,7.55,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Anthem,Indemnity,,,8.015231068,,8.015231068,6.03,9.34,percent of total billed charges,,9.34
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Anthem,State Preferred,,7.55,,,7.55,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Anthem,Individual Exchange,,6.03,,,6.03,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Cigna,Cigna,,7.37,,,7.37,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Connecticare,Commerical,,7.89,,,7.89,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Connecticare,Exchange,,7.89,,,7.89,6.03,9.34,other,Could be inpatient or outpatient,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,Multiplan,Multiplan,,,9.069417476,,9.069417476,6.03,9.069417476,percent of total billed charges,,
HC GAUZE XEROFORM 1X8,27200237,RC,,,both,,,10.66990291,6.59,United Healthcare/Oxford,United Healthcare/Oxford,,7.58,,,7.58,6.03,9.34,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Aetna,Commerical,,358.2,,,358.2,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Aetna,Middlesex Employees,,322.38,,,322.38,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Anthem,Commerical,,320.51,,,320.51,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Anthem,Indemnity,,,340.2936,,340.2936,256.41,396.78,percent of total billed charges,,396.78
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Anthem,State Preferred,,320.51,,,320.51,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Anthem,Individual Exchange,,256.41,,,256.41,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Cigna,Cigna,,313.01,,,313.01,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Connecticare,Commerical,,334.79,,,334.79,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Connecticare,Exchange,,334.79,,,334.79,256.41,396.78,other,Could be inpatient or outpatient,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,Multiplan,Multiplan,,,385.05,,385.05,256.41,385.05,percent of total billed charges,,
HC BRONCH EQUIP,27200239,RC,,,both,,,453,279.95,United Healthcare/Oxford,United Healthcare/Oxford,,322.13,,,322.13,256.41,396.78,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Aetna,Commerical,,2.44,,,2.44,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Aetna,Middlesex Employees,,2.19,,,2.19,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Anthem,Commerical,,2.17,,,2.17,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Anthem,Indemnity,,,2.311945631,,2.311945631,1.74,2.69,percent of total billed charges,,2.69
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Anthem,State Preferred,,2.17,,,2.17,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Anthem,Individual Exchange,,1.74,,,1.74,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Cigna,Cigna,,2.13,,,2.13,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Connecticare,Commerical,,2.27,,,2.27,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Connecticare,Exchange,,2.27,,,2.27,1.74,2.69,other,Could be inpatient or outpatient,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,Multiplan,Multiplan,,,2.616019417,,2.616019417,1.74,2.616019417,percent of total billed charges,,
HC PENROSE TBG 1/18,27200241,RC,,,both,,,3.077669903,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,2.19,,,2.19,1.74,2.69,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Anthem,Indemnity,,,62.3496,,62.3496,47.21,73.04,percent of total billed charges,,73.04
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,Multiplan,Multiplan,,,70.55,,70.55,47.21,70.55,percent of total billed charges,,
HC PICC EXTNSION SET,27200242,RC,,,both,,,83,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Aetna,Commerical,,36.28,,,36.28,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Aetna,Middlesex Employees,,32.65,,,32.65,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Anthem,Commerical,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Anthem,Indemnity,,,34.48226796,,34.48226796,25.97,40.18,percent of total billed charges,,40.18
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Anthem,State Preferred,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Anthem,Individual Exchange,,25.97,,,25.97,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Cigna,Cigna,,31.7,,,31.7,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Connecticare,Commerical,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Connecticare,Exchange,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,Multiplan,Multiplan,,,39.01747573,,39.01747573,25.97,39.01747573,percent of total billed charges,,
HC BREAST SHELLS,27200243,RC,,,both,,,45.90291262,28.37,United Healthcare/Oxford,United Healthcare/Oxford,,32.62,,,32.62,25.97,40.18,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Aetna,Commerical,,103.39,,,103.39,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Aetna,Middlesex Employees,,93.05,,,93.05,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Anthem,Commerical,,92.51,,,92.51,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Anthem,Indemnity,,,98.4072,,98.4072,74,114.52,percent of total billed charges,,114.52
HC SET APM,27200244,RC,,,both,,,131,80.96,Anthem,State Preferred,,92.51,,,92.51,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Anthem,Individual Exchange,,74,,,74,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Cigna,Cigna,,90.34,,,90.34,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Connecticare,Commerical,,96.64,,,96.64,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Connecticare,Exchange,,96.64,,,96.64,74,114.52,other,Could be inpatient or outpatient,
HC SET APM,27200244,RC,,,both,,,131,80.96,Multiplan,Multiplan,,,111.35,,111.35,74,111.35,percent of total billed charges,,
HC SET APM,27200244,RC,,,both,,,131,80.96,United Healthcare/Oxford,United Healthcare/Oxford,,92.98,,,92.98,74,114.52,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Aetna,Commerical,,46.41,,,46.41,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Aetna,Middlesex Employees,,41.77,,,41.77,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Anthem,Commerical,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Anthem,Indemnity,,,45.42207379,,45.42207379,33.22,51.4,percent of total billed charges,,51.4
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Anthem,State Preferred,,41.52,,,41.52,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Anthem,Individual Exchange,,33.22,,,33.22,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Cigna,Cigna,,40.55,,,40.55,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Connecticare,Commerical,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Connecticare,Exchange,,43.37,,,43.37,33.22,51.4,other,Could be inpatient or outpatient,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,Multiplan,Multiplan,,,51.3961165,,51.3961165,33.22,51.3961165,percent of total billed charges,,
HC DRNTUBE ATTDEVICE,27200246,RC,,,both,,,60.46601942,37.37,United Healthcare/Oxford,United Healthcare/Oxford,,41.74,,,41.74,33.22,51.4,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Aetna,Commerical,,3191.24,,,3191.24,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Aetna,Middlesex Employees,,2872.12,,,2872.12,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Anthem,Commerical,,2855.44,,,2855.44,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Anthem,Indemnity,,,3033.3456,,3033.3456,2284.35,3534.92,percent of total billed charges,,3534.92
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Anthem,State Preferred,,2855.44,,,2855.44,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Anthem,Individual Exchange,,2284.35,,,2284.35,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Cigna,Cigna,,2788.66,,,2788.66,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Connecticare,Commerical,,2982.71,,,2982.71,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Connecticare,Exchange,,2982.71,,,2982.71,2284.35,3534.92,other,Could be inpatient or outpatient,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,Multiplan,Multiplan,,,3432.3,,3432.3,2284.35,3432.3,percent of total billed charges,,
HC ABLATION NEEDLE,27200247,RC,,,both,,,4038,2495.48,United Healthcare/Oxford,United Healthcare/Oxford,,2869.94,,,2869.94,2284.35,3534.92,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Aetna,Commerical,,156.31,,,156.31,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Aetna,Middlesex Employees,,140.68,,,140.68,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Anthem,Commerical,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Anthem,Indemnity,,,148.7376,,148.7376,111.88,173.14,percent of total billed charges,,173.14
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Anthem,State Preferred,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Anthem,Individual Exchange,,111.88,,,111.88,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Cigna,Cigna,,136.58,,,136.58,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Connecticare,Commerical,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Connecticare,Exchange,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,Multiplan,Multiplan,,,168.3,,168.3,111.88,168.3,percent of total billed charges,,
HC CHEST TUBE CONNECTOR,27200248,RC,,,both,,,198,122.36,United Healthcare/Oxford,United Healthcare/Oxford,,140.56,,,140.56,111.88,173.14,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Anthem,Indemnity,,,45.072,,45.072,33.8,52.3,percent of total billed charges,,52.3
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Cigna,Cigna,,41.26,,,41.26,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Connecticare,Commerical,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Connecticare,Exchange,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,Multiplan,Multiplan,,,51,,51,33.8,51,percent of total billed charges,,
HC FOLEY CATH SET,27200249,RC,,,both,,,60,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,42.47,,,42.47,33.8,52.3,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Aetna,Commerical,,947.6,,,947.6,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Aetna,Middlesex Employees,,852.84,,,852.84,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Anthem,Commerical,,847.89,,,847.89,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Anthem,Indemnity,,,900.6888,,900.6888,678.32,1049.66,percent of total billed charges,,1049.66
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Anthem,State Preferred,,847.89,,,847.89,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Anthem,Individual Exchange,,678.32,,,678.32,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Cigna,Cigna,,828.06,,,828.06,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Connecticare,Commerical,,885.69,,,885.69,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Connecticare,Exchange,,885.69,,,885.69,678.32,1049.66,other,Could be inpatient or outpatient,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,Multiplan,Multiplan,,,1019.15,,1019.15,678.32,1049.66,percent of total billed charges,,
HC GASTRO ENT TUBE,27200250,RC,,,both,,,1199,740.98,United Healthcare/Oxford,United Healthcare/Oxford,,852.19,,,852.19,678.32,1049.66,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Aetna,Commerical,,1204.04,,,1204.04,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Aetna,Middlesex Employees,,1083.64,,,1083.64,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Anthem,Commerical,,1077.35,,,1077.35,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Anthem,Indemnity,,,1144.0776,,1144.0776,861.89,1333.71,percent of total billed charges,,1333.71
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Anthem,State Preferred,,1077.35,,,1077.35,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Anthem,Individual Exchange,,861.89,,,861.89,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Cigna,Cigna,,1052.15,,,1052.15,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Connecticare,Commerical,,1125.36,,,1125.36,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Connecticare,Exchange,,1125.36,,,1125.36,861.89,1333.71,other,Could be inpatient or outpatient,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,Multiplan,Multiplan,,,1294.55,,1294.55,861.89,1294.55,percent of total billed charges,,
HC LOW-PROFILE TUBE,27200251,RC,,,both,,,1523,941.21,United Healthcare/Oxford,United Healthcare/Oxford,,1082.82,,,1082.82,861.89,1333.71,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Aetna,Commerical,,190.5,,,190.5,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Aetna,Middlesex Employees,,171.44,,,171.44,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Anthem,Commerical,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Anthem,Indemnity,,,181.0392,,181.0392,136.36,211.01,percent of total billed charges,,211.01
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Anthem,State Preferred,,170.45,,,170.45,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Anthem,Individual Exchange,,136.36,,,136.36,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Cigna,Cigna,,166.46,,,166.46,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Connecticare,Commerical,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Connecticare,Exchange,,178.05,,,178.05,136.36,211.01,other,Could be inpatient or outpatient,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,Multiplan,Multiplan,,,204.85,,204.85,136.36,204.85,percent of total billed charges,,
HC TRAY LP,27200252,RC,,,both,,,241,148.94,United Healthcare/Oxford,United Healthcare/Oxford,,171.32,,,171.32,136.36,211.01,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Aetna,Commerical,,145.72,,,145.72,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Aetna,Middlesex Employees,,131.15,,,131.15,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Anthem,Commerical,,130.39,,,130.39,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Anthem,Indemnity,,,138.2208,,138.2208,104.31,161.42,percent of total billed charges,,161.42
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Anthem,State Preferred,,130.39,,,130.39,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Anthem,Individual Exchange,,104.31,,,104.31,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Cigna,Cigna,,127.34,,,127.34,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Connecticare,Commerical,,136.2,,,136.2,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Connecticare,Exchange,,136.2,,,136.2,104.31,161.42,other,Could be inpatient or outpatient,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,Multiplan,Multiplan,,,156.4,,156.4,104.31,156.4,percent of total billed charges,,
HC PERCUFIX CATHCUFF,27200254,RC,,,both,,,184,113.71,United Healthcare/Oxford,United Healthcare/Oxford,,131.05,,,131.05,104.31,161.42,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Aetna,Commerical,,437.98,,,437.98,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Aetna,Middlesex Employees,,394.19,,,394.19,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Anthem,Commerical,,391.89,,,391.89,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Anthem,Indemnity,,,416.1648,,416.1648,313.51,485.15,percent of total billed charges,,485.15
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Anthem,State Preferred,,391.89,,,391.89,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Anthem,Individual Exchange,,313.51,,,313.51,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Cigna,Cigna,,382.73,,,382.73,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Connecticare,Commerical,,409.36,,,409.36,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Connecticare,Exchange,,409.36,,,409.36,313.51,485.15,other,Could be inpatient or outpatient,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,Multiplan,Multiplan,,,470.9,,470.9,313.51,470.9,percent of total billed charges,,
HC PIGTAIL CATH,27200255,RC,,,both,,,554,342.37,United Healthcare/Oxford,United Healthcare/Oxford,,393.88,,,393.88,313.51,485.15,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Aetna,Commerical,,31.09,,,31.09,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Aetna,Middlesex Employees,,27.98,,,27.98,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Anthem,Commerical,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Anthem,Indemnity,,,29.55206214,,29.55206214,22.25,34.44,percent of total billed charges,,34.44
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Anthem,State Preferred,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Anthem,Individual Exchange,,22.25,,,22.25,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Cigna,Cigna,,27.16,,,27.16,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Connecticare,Commerical,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Connecticare,Exchange,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,Multiplan,Multiplan,,,33.43883495,,33.43883495,22.25,33.43883495,percent of total billed charges,,
HC VAGINAL DILATOR S,27200256,RC,,,both,,,39.33980583,24.31,United Healthcare/Oxford,United Healthcare/Oxford,,27.96,,,27.96,22.25,34.44,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Aetna,Commerical,,336.22,,,336.22,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Aetna,Middlesex Employees,,302.6,,,302.6,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Anthem,Commerical,,300.84,,,300.84,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Anthem,Indemnity,,,319.26,,319.26,240.68,372.43,percent of total billed charges,,372.43
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Anthem,State Preferred,,300.84,,,300.84,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Anthem,Individual Exchange,,240.68,,,240.68,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Cigna,Cigna,,293.8,,,293.8,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Connecticare,Commerical,,314.25,,,314.25,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Connecticare,Exchange,,314.25,,,314.25,240.68,372.43,other,Could be inpatient or outpatient,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,Multiplan,Multiplan,,,361.25,,361.25,240.68,361.25,percent of total billed charges,,
HC US BIOPSY SYS NEEDLE,27200273,RC,,,both,,,425,262.65,United Healthcare/Oxford,United Healthcare/Oxford,,302.37,,,302.37,240.68,372.43,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Aetna,Commerical,,271.1,,,271.1,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Aetna,Middlesex Employees,,243.99,,,243.99,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Anthem,Commerical,,242.56,,,242.56,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Anthem,Indemnity,,,257.6616,,257.6616,194.05,300.29,percent of total billed charges,,300.29
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Anthem,State Preferred,,242.56,,,242.56,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Anthem,Individual Exchange,,194.05,,,194.05,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Cigna,Cigna,,236.89,,,236.89,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Connecticare,Commerical,,253.38,,,253.38,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Connecticare,Exchange,,253.38,,,253.38,194.05,300.29,other,Could be inpatient or outpatient,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,Multiplan,Multiplan,,,291.55,,291.55,194.05,291.55,percent of total billed charges,,
HC US RENAL BX NEEDLE,27200274,RC,,,both,,,343,211.97,United Healthcare/Oxford,United Healthcare/Oxford,,243.8,,,243.8,194.05,300.29,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Aetna,Commerical,,84.66,,,84.66,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Aetna,Middlesex Employees,,76.2,,,76.2,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Anthem,Commerical,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Anthem,Indemnity,,,80.3784,,80.3784,60.6,93.78,percent of total billed charges,,93.78
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Anthem,State Preferred,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Anthem,Individual Exchange,,60.6,,,60.6,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Cigna,Cigna,,73.99,,,73.99,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Connecticare,Commerical,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Connecticare,Exchange,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,Multiplan,Multiplan,,,90.95,,90.95,60.6,90.95,percent of total billed charges,,
HC HH C CATH ADJ 1,27200275,RC,,,both,,,107,66.13,United Healthcare/Oxford,United Healthcare/Oxford,,76.14,,,76.14,60.6,93.78,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Aetna,Commerical,,272.72,,,272.72,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Aetna,Middlesex Employees,,245.45,,,245.45,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Anthem,Commerical,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Anthem,Indemnity,,,259.164,,259.164,195.22,302.09,percent of total billed charges,,302.09
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Anthem,State Preferred,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Anthem,Individual Exchange,,195.22,,,195.22,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Cigna,Cigna,,238.32,,,238.32,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Connecticare,Commerical,,254.9,,,254.9,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Connecticare,Exchange,,254.9,,,254.9,195.22,302.09,other,Could be inpatient or outpatient,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,Multiplan,Multiplan,,,293.25,,293.25,195.22,293.25,percent of total billed charges,,
HC HH C CATH ADJ 2,27200276,RC,,,both,,,345,213.21,United Healthcare/Oxford,United Healthcare/Oxford,,245.26,,,245.26,195.22,302.09,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Aetna,Commerical,,84.66,,,84.66,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Aetna,Middlesex Employees,,76.2,,,76.2,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Anthem,Commerical,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Anthem,Indemnity,,,80.3784,,80.3784,60.6,93.78,percent of total billed charges,,93.78
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Anthem,State Preferred,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Anthem,Individual Exchange,,60.6,,,60.6,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Cigna,Cigna,,73.99,,,73.99,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Connecticare,Commerical,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Connecticare,Exchange,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,Multiplan,Multiplan,,,90.95,,90.95,60.6,90.95,percent of total billed charges,,
HC HH CT NEEDLE 1,27200280,RC,,,both,,,107,66.13,United Healthcare/Oxford,United Healthcare/Oxford,,76.14,,,76.14,60.6,93.78,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Aetna,Commerical,,201.08,,,201.08,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Aetna,Middlesex Employees,,180.97,,,180.97,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Anthem,Commerical,,179.92,,,179.92,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Anthem,Indemnity,,,190.8048,,190.8048,143.94,222.73,percent of total billed charges,,222.73
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Anthem,State Preferred,,179.92,,,179.92,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Anthem,Individual Exchange,,143.94,,,143.94,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Cigna,Cigna,,175.72,,,175.72,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Connecticare,Commerical,,187.95,,,187.95,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Connecticare,Exchange,,187.95,,,187.95,143.94,222.73,other,Could be inpatient or outpatient,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,Multiplan,Multiplan,,,215.9,,215.9,143.94,215.9,percent of total billed charges,,
HC HH CT NEEDLE 4,27200296,RC,,,both,,,254,156.97,United Healthcare/Oxford,United Healthcare/Oxford,,180.84,,,180.84,143.94,222.73,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Aetna,Commerical,,124.56,,,124.56,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Aetna,Middlesex Employees,,112.11,,,112.11,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Anthem,Commerical,,111.45,,,111.45,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Anthem,Indemnity,,,118.6896,,118.6896,89.15,137.97,percent of total billed charges,,137.97
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Anthem,State Preferred,,111.45,,,111.45,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Anthem,Individual Exchange,,89.15,,,89.15,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Cigna,Cigna,,108.85,,,108.85,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Connecticare,Commerical,,116.42,,,116.42,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Connecticare,Exchange,,116.42,,,116.42,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,Multiplan,Multiplan,,,134.3,,134.3,89.15,134.3,percent of total billed charges,,
HC HH IR CATH 1,27200297,RC,,,both,,,158,97.64,United Healthcare/Oxford,United Healthcare/Oxford,,112.01,,,112.01,89.15,137.97,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Aetna,Commerical,,378.55,,,378.55,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Aetna,Middlesex Employees,,340.69,,,340.69,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Anthem,Commerical,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Anthem,Indemnity,,,359.8248,,359.8248,270.98,419.32,percent of total billed charges,,419.32
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Anthem,State Preferred,,338.72,,,338.72,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Anthem,Individual Exchange,,270.98,,,270.98,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Cigna,Cigna,,330.79,,,330.79,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Connecticare,Commerical,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Connecticare,Exchange,,353.81,,,353.81,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,Multiplan,Multiplan,,,407.15,,407.15,270.98,407.15,percent of total billed charges,,
HC HH IR CATH 2,27200298,RC,,,both,,,479,296.02,United Healthcare/Oxford,United Healthcare/Oxford,,340.44,,,340.44,270.98,419.32,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Aetna,Commerical,,5283.45,,,5283.45,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Aetna,Middlesex Employees,,4755.1,,,4755.1,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Anthem,Commerical,,4727.51,,,4727.51,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Anthem,Indemnity,,,5021.772,,5021.772,3782,5852.45,percent of total billed charges,,5852.45
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Anthem,State Preferred,,4727.51,,,4727.51,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Anthem,Individual Exchange,,3782,,,3782,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Cigna,Cigna,,4616.93,,,4616.93,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Connecticare,Commerical,,4938.22,,,4938.22,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Connecticare,Exchange,,4938.22,,,4938.22,3782,5852.45,other,Could be inpatient or outpatient,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,Multiplan,Multiplan,,,5682.25,,5682.25,3782,5682.25,percent of total billed charges,,
HC HH IR EMBO 7,27200299,RC,,,both,,,6685,4131.33,United Healthcare/Oxford,United Healthcare/Oxford,,4751.5,,,4751.5,3782,5852.45,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Aetna,Commerical,,327.27,,,327.27,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Aetna,Middlesex Employees,,294.54,,,294.54,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Anthem,Commerical,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Anthem,Indemnity,,,310.9968,,310.9968,234.26,362.51,percent of total billed charges,,362.51
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Anthem,State Preferred,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Anthem,Individual Exchange,,234.26,,,234.26,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Cigna,Cigna,,285.98,,,285.98,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Connecticare,Commerical,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Connecticare,Exchange,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,Multiplan,Multiplan,,,351.9,,351.9,234.26,351.9,percent of total billed charges,,
HC HH RAD SUP 0-499,27200300,RC,,,both,,,414,255.85,United Healthcare/Oxford,United Healthcare/Oxford,,294.31,,,294.31,234.26,362.51,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Aetna,Commerical,,981.79,,,981.79,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Aetna,Middlesex Employees,,883.61,,,883.61,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Anthem,Commerical,,878.49,,,878.49,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Anthem,Indemnity,,,932.9904,,932.9904,702.79,1087.53,percent of total billed charges,,1087.53
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Anthem,State Preferred,,878.49,,,878.49,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Anthem,Individual Exchange,,702.79,,,702.79,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Cigna,Cigna,,857.94,,,857.94,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Connecticare,Commerical,,917.64,,,917.64,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Connecticare,Exchange,,917.64,,,917.64,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,Multiplan,Multiplan,,,1055.7,,1055.7,702.79,1055.7,percent of total billed charges,,
HC HH RADSUP 500-999,27200301,RC,,,both,,,1242,767.56,United Healthcare/Oxford,United Healthcare/Oxford,,882.95,,,882.95,702.79,1087.53,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Aetna,Commerical,,243.42,,,243.42,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Aetna,Middlesex Employees,,219.08,,,219.08,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Anthem,Commerical,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Anthem,Indemnity,,,231.3696,,231.3696,174.24,269.63,percent of total billed charges,,269.63
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Anthem,State Preferred,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Anthem,Individual Exchange,,174.24,,,174.24,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Cigna,Cigna,,212.71,,,212.71,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Connecticare,Commerical,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Connecticare,Exchange,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,Multiplan,Multiplan,,,261.8,,261.8,174.24,261.8,percent of total billed charges,,
HC HH SHEATH - 1,27200302,RC,,,both,,,308,190.34,United Healthcare/Oxford,United Healthcare/Oxford,,218.91,,,218.91,174.24,269.63,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Aetna,Commerical,,711.52,,,711.52,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Aetna,Middlesex Employees,,640.36,,,640.36,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Anthem,Commerical,,636.65,,,636.65,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Anthem,Indemnity,,,676.08,,676.08,509.32,788.15,percent of total billed charges,,788.15
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Anthem,State Preferred,,636.65,,,636.65,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Anthem,Individual Exchange,,509.32,,,509.32,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Cigna,Cigna,,621.75,,,621.75,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Connecticare,Commerical,,665.02,,,665.02,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Connecticare,Exchange,,665.02,,,665.02,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,Multiplan,Multiplan,,,765,,765,509.32,765,percent of total billed charges,,
HC HH IR CATH 3,27200303,RC,,,both,,,900,556.2,United Healthcare/Oxford,United Healthcare/Oxford,,639.88,,,639.88,509.32,788.15,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Aetna,Commerical,,1539.45,,,1539.45,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Aetna,Middlesex Employees,,1385.51,,,1385.51,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Anthem,Commerical,,1377.46,,,1377.46,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Anthem,Indemnity,,,1463.3376,,1463.3376,1101.96,1705.24,percent of total billed charges,,1705.24
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Anthem,State Preferred,,1377.46,,,1377.46,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Anthem,Individual Exchange,,1101.96,,,1101.96,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Cigna,Cigna,,1345.24,,,1345.24,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Connecticare,Commerical,,1438.85,,,1438.85,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Connecticare,Exchange,,1438.85,,,1438.85,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,Multiplan,Multiplan,,,1655.8,,1655.8,1101.96,1655.8,percent of total billed charges,,
HC HH IR CATH 4,27200304,RC,,,both,,,1948,1203.86,United Healthcare/Oxford,United Healthcare/Oxford,,1384.45,,,1384.45,1101.96,1705.24,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Aetna,Commerical,,1745.41,,,1745.41,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Aetna,Middlesex Employees,,1570.87,,,1570.87,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Anthem,Commerical,,1561.75,,,1561.75,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Anthem,Indemnity,,,1658.6496,,1658.6496,1249.4,1933.38,percent of total billed charges,,1933.38
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Anthem,State Preferred,,1561.75,,,1561.75,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Anthem,Individual Exchange,,1249.4,,,1249.4,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Cigna,Cigna,,1525.22,,,1525.22,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Connecticare,Commerical,,1631.36,,,1631.36,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Connecticare,Exchange,,1631.36,,,1631.36,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,Multiplan,Multiplan,,,1876.8,,1876.8,1249.4,1876.8,percent of total billed charges,,
HC HH IR CATH 5,27200305,RC,,,both,,,2208,1364.54,United Healthcare/Oxford,United Healthcare/Oxford,,1569.68,,,1569.68,1249.4,1933.38,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Aetna,Commerical,,1262.66,,,1262.66,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Aetna,Middlesex Employees,,1136.39,,,1136.39,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Anthem,Commerical,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Anthem,Indemnity,,,1200.4176,,1200.4176,903.83,1398.64,percent of total billed charges,,1398.64
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Anthem,State Preferred,,1129.8,,,1129.8,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Anthem,Individual Exchange,,903.83,,,903.83,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Cigna,Cigna,,1103.37,,,1103.37,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Connecticare,Commerical,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Connecticare,Exchange,,1180.14,,,1180.14,903.83,1398.64,other,Could be inpatient or outpatient,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,Multiplan,Multiplan,,,1358.3,,1358.3,903.83,1358.3,percent of total billed charges,,
HC HH IR CATH 6,27200306,RC,,,both,,,1598,987.56,United Healthcare/Oxford,United Healthcare/Oxford,,1135.53,,,1135.53,903.83,1398.64,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Aetna,Commerical,,84.66,,,84.66,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Aetna,Middlesex Employees,,76.2,,,76.2,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Anthem,Commerical,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Anthem,Indemnity,,,80.3784,,80.3784,60.6,93.78,percent of total billed charges,,93.78
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Anthem,State Preferred,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Anthem,Individual Exchange,,60.6,,,60.6,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Cigna,Cigna,,73.99,,,73.99,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Connecticare,Commerical,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Connecticare,Exchange,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,Multiplan,Multiplan,,,90.95,,90.95,60.6,90.95,percent of total billed charges,,
HC CATH THORACIC 20--24FR,27200329,RC,,,both,,,107,66.13,United Healthcare/Oxford,United Healthcare/Oxford,,76.14,,,76.14,60.6,93.78,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Aetna,Commerical,,8.18,,,8.18,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Aetna,Middlesex Employees,,7.36,,,7.36,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Anthem,Commerical,,7.32,,,7.32,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Anthem,Indemnity,,,7.77455534,,7.77455534,5.86,9.06,percent of total billed charges,,9.06
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Anthem,State Preferred,,7.32,,,7.32,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Anthem,Individual Exchange,,5.86,,,5.86,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Cigna,Cigna,,7.14,,,7.14,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Connecticare,Commerical,,7.65,,,7.65,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Connecticare,Exchange,,7.65,,,7.65,5.86,9.06,other,Could be inpatient or outpatient,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,Multiplan,Multiplan,,,8.797087379,,8.797087379,5.86,8.797087379,percent of total billed charges,,
HC SWIVEL ADAPTOR,27200331,RC,,,both,,,10.34951456,6.4,United Healthcare/Oxford,United Healthcare/Oxford,,7.35,,,7.35,5.86,9.06,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Aetna,Commerical,,37.14,,,37.14,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Aetna,Middlesex Employees,,33.42,,,33.42,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Anthem,Commerical,,33.23,,,33.23,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Anthem,Indemnity,,,36.35662136,,36.35662136,26.59,41.14,percent of total billed charges,,41.14
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Anthem,State Preferred,,33.23,,,33.23,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Anthem,Individual Exchange,,26.59,,,26.59,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Cigna,Cigna,,32.46,,,32.46,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Connecticare,Commerical,,34.71,,,34.71,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Connecticare,Exchange,,34.71,,,34.71,26.59,41.14,other,Could be inpatient or outpatient,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,Multiplan,Multiplan,,,41.13834951,,41.13834951,26.59,41.13834951,percent of total billed charges,,
HC TUBE INDWELLING 20' 6.5FR,27200332,RC,,,both,,,48.39805825,29.91,United Healthcare/Oxford,United Healthcare/Oxford,,33.4,,,33.4,26.59,41.14,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Aetna,Commerical,,4.57,,,4.57,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Aetna,Middlesex Employees,,4.11,,,4.11,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Anthem,Commerical,,4.09,,,4.09,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Anthem,Indemnity,,,4.470733981,,4.470733981,3.27,5.06,percent of total billed charges,,5.06
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Anthem,State Preferred,,4.09,,,4.09,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Anthem,Individual Exchange,,3.27,,,3.27,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Cigna,Cigna,,3.99,,,3.99,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Connecticare,Commerical,,4.27,,,4.27,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Connecticare,Exchange,,4.27,,,4.27,3.27,5.06,other,Could be inpatient or outpatient,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,Multiplan,Multiplan,,,5.058737864,,5.058737864,3.27,5.058737864,percent of total billed charges,,
HC IV SET TRIFUSE,27200333,RC,,,both,,,5.951456311,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,4.11,,,4.11,3.27,5.06,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Aetna,Commerical,,136.77,,,136.77,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Aetna,Middlesex Employees,,123.1,,,123.1,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Anthem,Commerical,,122.38,,,122.38,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Anthem,Indemnity,,,129.9576,,129.9576,97.9,151.5,percent of total billed charges,,151.5
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Anthem,State Preferred,,122.38,,,122.38,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Anthem,Individual Exchange,,97.9,,,97.9,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Cigna,Cigna,,119.52,,,119.52,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Connecticare,Commerical,,127.83,,,127.83,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Connecticare,Exchange,,127.83,,,127.83,97.9,151.5,other,Could be inpatient or outpatient,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,Multiplan,Multiplan,,,147.05,,147.05,97.9,147.05,percent of total billed charges,,
HC MPA ANGIO CATH,27200334,RC,,,both,,,173,106.91,United Healthcare/Oxford,United Healthcare/Oxford,,122.99,,,122.99,97.9,151.5,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Aetna,Commerical,,313.42,,,313.42,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Aetna,Middlesex Employees,,282.08,,,282.08,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Anthem,Commerical,,280.44,,,280.44,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Anthem,Indemnity,,,298.2264,,298.2264,224.36,347.18,percent of total billed charges,,347.18
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Anthem,State Preferred,,280.44,,,280.44,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Anthem,Individual Exchange,,224.36,,,224.36,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Cigna,Cigna,,273.88,,,273.88,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Connecticare,Commerical,,292.94,,,292.94,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Connecticare,Exchange,,292.94,,,292.94,224.36,347.18,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,Multiplan,Multiplan,,,337.45,,337.45,224.36,337.45,percent of total billed charges,,
HC DIALYSIS CATH 7FR,27200364,RC,,,both,,,397,245.35,United Healthcare/Oxford,United Healthcare/Oxford,,281.87,,,281.87,224.36,347.18,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Aetna,Commerical,,1107.16,,,1107.16,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Aetna,Middlesex Employees,,996.45,,,996.45,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Anthem,Commerical,,990.66,,,990.66,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Anthem,Indemnity,,,1052.4312,,1052.4312,792.53,1226.4,percent of total billed charges,,1226.4
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Anthem,State Preferred,,990.66,,,990.66,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Anthem,Individual Exchange,,792.53,,,792.53,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Cigna,Cigna,,967.49,,,967.49,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Connecticare,Commerical,,1034.81,,,1034.81,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Connecticare,Exchange,,1034.81,,,1034.81,792.53,1226.4,other,Could be inpatient or outpatient,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,Multiplan,Multiplan,,,1190.85,,1190.85,792.53,1190.85,percent of total billed charges,,
HC HICK 13.5/36CM,27200365,RC,,,both,,,1401,865.82,United Healthcare/Oxford,United Healthcare/Oxford,,995.69,,,995.69,792.53,1226.4,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Aetna,Commerical,,874.33,,,874.33,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Aetna,Middlesex Employees,,786.9,,,786.9,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Anthem,Commerical,,782.34,,,782.34,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Anthem,Indemnity,,,830.8272,,830.8272,625.86,968.5,percent of total billed charges,,968.5
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Anthem,State Preferred,,782.34,,,782.34,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Anthem,Individual Exchange,,625.86,,,625.86,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Cigna,Cigna,,764.04,,,764.04,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Connecticare,Commerical,,817.21,,,817.21,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Connecticare,Exchange,,817.21,,,817.21,625.86,968.5,other,Could be inpatient or outpatient,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,Multiplan,Multiplan,,,940.1,,940.1,625.86,940.1,percent of total billed charges,,
HC TITAN DIALY ADAPT,27200366,RC,,,both,,,1106,683.51,United Healthcare/Oxford,United Healthcare/Oxford,,786.3,,,786.3,625.86,968.5,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Aetna,Commerical,,1509.33,,,1509.33,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Aetna,Middlesex Employees,,1358.39,,,1358.39,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Anthem,Commerical,,1350.51,,,1350.51,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Anthem,Indemnity,,,1434.792,,1434.792,1080.41,1671.87,percent of total billed charges,,1671.87
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Anthem,State Preferred,,1350.51,,,1350.51,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Anthem,Individual Exchange,,1080.41,,,1080.41,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Cigna,Cigna,,1318.92,,,1318.92,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Connecticare,Commerical,,1410.71,,,1410.71,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Connecticare,Exchange,,1410.71,,,1410.71,1080.41,1671.87,other,Could be inpatient or outpatient,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,Multiplan,Multiplan,,,1623.5,,1623.5,1080.41,1623.5,percent of total billed charges,,
HC SPLIT CATHETER,27200367,RC,,,both,,,1910,1180.38,United Healthcare/Oxford,United Healthcare/Oxford,,1357.36,,,1357.36,1080.41,1671.87,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Aetna,Commerical,,41.93,,,41.93,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Aetna,Middlesex Employees,,37.74,,,37.74,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Anthem,Commerical,,37.52,,,37.52,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Anthem,Indemnity,,,39.8136,,39.8136,30.02,46.44,percent of total billed charges,,46.44
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Anthem,State Preferred,,37.52,,,37.52,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Anthem,Individual Exchange,,30.02,,,30.02,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Cigna,Cigna,,36.64,,,36.64,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Connecticare,Commerical,,39.19,,,39.19,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Connecticare,Exchange,,39.19,,,39.19,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,Multiplan,Multiplan,,,45.05,,45.05,30.02,45.05,percent of total billed charges,,
HC BARD 8 FRENCH FOLEY CATH,27200368,RC,,,both,,,53,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,37.71,,,37.71,30.02,46.44,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Aetna,Commerical,,40.59,,,40.59,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Aetna,Middlesex Employees,,36.53,,,36.53,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Anthem,Commerical,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Anthem,Indemnity,,,38.3112,,38.3112,29.05,44.97,percent of total billed charges,,44.97
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Anthem,State Preferred,,36.32,,,36.32,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Anthem,Individual Exchange,,29.05,,,29.05,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Cigna,Cigna,,35.47,,,35.47,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Connecticare,Commerical,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Connecticare,Exchange,,37.94,,,37.94,29.05,44.97,other,Could be inpatient or outpatient,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,Multiplan,Multiplan,,,43.35,,43.35,29.05,43.35,percent of total billed charges,,
HC BARD 10 FRENCH FOLEY CATH,27200369,RC,,,both,,,51,31.52,United Healthcare/Oxford,United Healthcare/Oxford,,36.5,,,36.5,29.05,44.97,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Aetna,Commerical,,14.81,,,14.81,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Aetna,Middlesex Employees,,13.33,,,13.33,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Anthem,Commerical,,12.3,,,12.3,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Anthem,Indemnity,,,15.69497476,,15.69497476,9.83,17.76,percent of total billed charges,,17.76
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Anthem,State Preferred,,12.3,,,12.3,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Anthem,Individual Exchange,,9.83,,,9.83,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Cigna,Cigna,,13.04,,,13.04,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Connecticare,Commerical,,13.39,,,13.39,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Connecticare,Exchange,,13.39,,,13.39,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,Multiplan,Multiplan,,,17.7592233,,17.7592233,9.83,17.7592233,percent of total billed charges,,
HC CVL ADULT KIT BIO PATCH 000381,27200371,RC,,,both,,,20.89320388,12.91,United Healthcare/Oxford,United Healthcare/Oxford,,13.72,,,13.72,9.83,17.76,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Aetna,Commerical,,5.57,,,5.57,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Aetna,Middlesex Employees,,5.01,,,5.01,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Anthem,Commerical,,4.63,,,4.63,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Anthem,Indemnity,,,5.907495146,,5.907495146,3.71,6.68,percent of total billed charges,,6.68
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Anthem,State Preferred,,4.63,,,4.63,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Anthem,Individual Exchange,,3.71,,,3.71,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Cigna,Cigna,,4.91,,,4.91,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Connecticare,Commerical,,5.04,,,5.04,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Connecticare,Exchange,,5.04,,,5.04,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,Multiplan,Multiplan,,,6.684466019,,6.684466019,3.71,6.684466019,percent of total billed charges,,
HC CVL ADULT W/0 BIO PATCH 001099,27200372,RC,,,both,,,7.86407767,4.86,United Healthcare/Oxford,United Healthcare/Oxford,,5.16,,,5.16,3.71,6.68,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Aetna,Commerical,,4.65,,,4.65,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Aetna,Middlesex Employees,,4.18,,,4.18,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Anthem,Commerical,,4.16,,,4.16,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Anthem,Indemnity,,,4.419681553,,4.419681553,3.33,5.15,percent of total billed charges,,5.15
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Anthem,State Preferred,,4.16,,,4.16,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Anthem,Individual Exchange,,3.33,,,3.33,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Cigna,Cigna,,4.07,,,4.07,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Connecticare,Commerical,,4.35,,,4.35,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Connecticare,Exchange,,4.35,,,4.35,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,Multiplan,Multiplan,,,5.000970874,,5.000970874,3.33,5.000970874,percent of total billed charges,,
HC CVL NEO KIT 003629,27200373,RC,,,both,,,5.883495146,3.63,United Healthcare/Oxford,United Healthcare/Oxford,,4.18,,,4.18,3.33,5.15,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Aetna,Commerical,,16.02,,,16.02,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Aetna,Middlesex Employees,,14.41,,,14.41,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Anthem,Commerical,,14.32,,,14.32,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Anthem,Indemnity,,,15.2209165,,15.2209165,11.46,17.74,percent of total billed charges,,17.74
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Anthem,State Preferred,,14.32,,,14.32,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Anthem,Individual Exchange,,11.46,,,11.46,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Cigna,Cigna,,13.99,,,13.99,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Connecticare,Commerical,,14.97,,,14.97,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Connecticare,Exchange,,14.97,,,14.97,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,Multiplan,Multiplan,,,17.22281553,,17.22281553,11.46,17.22281553,percent of total billed charges,,
HC CVL PEDI KIT 010087,27200374,RC,,,both,,,20.26213592,12.52,United Healthcare/Oxford,United Healthcare/Oxford,,14.4,,,14.4,11.46,17.74,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Aetna,Commerical,,5.65,,,5.65,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Aetna,Middlesex Employees,,5.09,,,5.09,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Anthem,Commerical,,5.06,,,5.06,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Anthem,Indemnity,,,5.375091262,,5.375091262,4.05,6.26,percent of total billed charges,,6.26
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Anthem,State Preferred,,5.06,,,5.06,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Anthem,Individual Exchange,,4.05,,,4.05,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Cigna,Cigna,,4.94,,,4.94,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Connecticare,Commerical,,5.28,,,5.28,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Connecticare,Exchange,,5.28,,,5.28,4.05,6.26,other,Could be inpatient or outpatient,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,Multiplan,Multiplan,,,6.082038835,,6.082038835,4.05,6.082038835,percent of total billed charges,,
HC CVL NEO KIT 011211,27200375,RC,,,both,,,7.155339806,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,5.09,,,5.09,4.05,6.26,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Aetna,Commerical,,11.29,,,11.29,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Aetna,Middlesex Employees,,10.16,,,10.16,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Anthem,Commerical,,10.1,,,10.1,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Anthem,Indemnity,,,10.73559612,,10.73559612,8.08,12.5,percent of total billed charges,,12.5
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Anthem,State Preferred,,10.1,,,10.1,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Anthem,Individual Exchange,,8.08,,,8.08,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Cigna,Cigna,,9.87,,,9.87,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Connecticare,Commerical,,10.56,,,10.56,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Connecticare,Exchange,,10.56,,,10.56,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,Multiplan,Multiplan,,,12.14757282,,12.14757282,8.08,12.14757282,percent of total billed charges,,
HC CATH IV 22GX1 NEXIVA 007551,27200376,RC,,,both,,,14.29126214,8.83,United Healthcare/Oxford,United Healthcare/Oxford,,10.16,,,10.16,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Aetna,Commerical,,11.29,,,11.29,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Aetna,Middlesex Employees,,10.16,,,10.16,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Anthem,Commerical,,10.1,,,10.1,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Anthem,Indemnity,,,10.73559612,,10.73559612,8.08,12.5,percent of total billed charges,,12.5
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Anthem,State Preferred,,10.1,,,10.1,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Anthem,Individual Exchange,,8.08,,,8.08,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Cigna,Cigna,,9.87,,,9.87,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Connecticare,Commerical,,10.56,,,10.56,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Connecticare,Exchange,,10.56,,,10.56,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,Multiplan,Multiplan,,,12.14757282,,12.14757282,8.08,12.14757282,percent of total billed charges,,
HC CATH IV 24GX.75 NEXIVA 007552,27200377,RC,,,both,,,14.29126214,8.83,United Healthcare/Oxford,United Healthcare/Oxford,,10.16,,,10.16,8.08,12.5,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Aetna,Commerical,,10.96,,,10.96,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Aetna,Middlesex Employees,,9.87,,,9.87,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Anthem,Commerical,,9.81,,,9.81,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Anthem,Indemnity,,,10.42198835,,10.42198835,7.85,12.15,percent of total billed charges,,12.15
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Anthem,State Preferred,,9.81,,,9.81,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Anthem,Individual Exchange,,7.85,,,7.85,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Cigna,Cigna,,9.58,,,9.58,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Connecticare,Commerical,,10.25,,,10.25,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Connecticare,Exchange,,10.25,,,10.25,7.85,12.15,other,Could be inpatient or outpatient,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,Multiplan,Multiplan,,,11.79271845,,11.79271845,7.85,11.79271845,percent of total billed charges,,
HC CATH FECAL MGMT SYSTEM,27200378,RC,,,both,,,13.87378641,8.57,United Healthcare/Oxford,United Healthcare/Oxford,,9.86,,,9.86,7.85,12.15,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Aetna,Commerical,,17.59,,,17.59,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Aetna,Middlesex Employees,,15.83,,,15.83,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Anthem,Commerical,,15.74,,,15.74,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Anthem,Indemnity,,,16.7233165,,16.7233165,12.6,19.49,percent of total billed charges,,19.49
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Anthem,State Preferred,,15.74,,,15.74,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Anthem,Individual Exchange,,12.6,,,12.6,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Cigna,Cigna,,15.37,,,15.37,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Connecticare,Commerical,,16.44,,,16.44,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Connecticare,Exchange,,16.44,,,16.44,12.6,19.49,other,Could be inpatient or outpatient,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,Multiplan,Multiplan,,,18.92281553,,18.92281553,12.6,18.92281553,percent of total billed charges,,
HC STATLOCK SMALL 6-8FR  007645,27200379,RC,,,both,,,22.26213592,13.76,United Healthcare/Oxford,United Healthcare/Oxford,,15.82,,,15.82,12.6,19.49,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Aetna,Commerical,,661.04,,,661.04,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Aetna,Middlesex Employees,,594.93,,,594.93,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Anthem,Commerical,,591.48,,,591.48,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Anthem,Indemnity,,,628.0032,,628.0032,473.18,732.23,percent of total billed charges,,732.23
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Anthem,State Preferred,,591.48,,,591.48,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Anthem,Individual Exchange,,473.18,,,473.18,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Cigna,Cigna,,577.65,,,577.65,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Connecticare,Commerical,,617.85,,,617.85,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Connecticare,Exchange,,617.85,,,617.85,473.18,732.23,other,Could be inpatient or outpatient,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,Multiplan,Multiplan,,,710.6,,710.6,473.18,710.6,percent of total billed charges,,
HC SEPRAFILM,27200380,RC,,,both,,,836,516.65,United Healthcare/Oxford,United Healthcare/Oxford,,594.49,,,594.49,473.18,732.23,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Aetna,Commerical,,36.28,,,36.28,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Aetna,Middlesex Employees,,32.65,,,32.65,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Anthem,Commerical,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Anthem,Indemnity,,,35.51060971,,35.51060971,25.97,40.18,percent of total billed charges,,40.18
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Anthem,State Preferred,,32.46,,,32.46,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Anthem,Individual Exchange,,25.97,,,25.97,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Cigna,Cigna,,31.7,,,31.7,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Connecticare,Commerical,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Connecticare,Exchange,,33.9,,,33.9,25.97,40.18,other,Could be inpatient or outpatient,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,Multiplan,Multiplan,,,40.18106796,,40.18106796,25.97,40.18106796,percent of total billed charges,,
HC AMT G-TUBE EXT  008093,27200381,RC,,,both,,,47.27184466,29.21,United Healthcare/Oxford,United Healthcare/Oxford,,32.62,,,32.62,25.97,40.18,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Aetna,Commerical,,277.6,,,277.6,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Aetna,Middlesex Employees,,249.84,,,249.84,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Anthem,Commerical,,248.39,,,248.39,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Anthem,Indemnity,,,263.6712,,263.6712,198.71,307.5,percent of total billed charges,,307.5
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Anthem,State Preferred,,248.39,,,248.39,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Anthem,Individual Exchange,,198.71,,,198.71,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Cigna,Cigna,,242.58,,,242.58,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Connecticare,Commerical,,259.47,,,259.47,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Connecticare,Exchange,,259.47,,,259.47,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,Multiplan,Multiplan,,,298.35,,298.35,198.71,307.5,percent of total billed charges,,
HC HICKMAN CATH 9FR 039321,27200382,RC,,,both,,,351,216.92,United Healthcare/Oxford,United Healthcare/Oxford,,249.65,,,249.65,198.71,307.5,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Aetna,Commerical,,269.46,,,269.46,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Aetna,Middlesex Employees,,242.51,,,242.51,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Anthem,Commerical,,241.11,,,241.11,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Anthem,Indemnity,,,256.1592,,256.1592,192.89,298.49,percent of total billed charges,,298.49
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Anthem,State Preferred,,241.11,,,241.11,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Anthem,Individual Exchange,,192.89,,,192.89,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Cigna,Cigna,,235.47,,,235.47,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Connecticare,Commerical,,251.85,,,251.85,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Connecticare,Exchange,,251.85,,,251.85,192.89,298.49,other,Could be inpatient or outpatient,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,Multiplan,Multiplan,,,289.85,,289.85,192.89,289.85,percent of total billed charges,,
HC HICKMAN CATH 7FR 033408,27200383,RC,,,both,,,341,210.74,United Healthcare/Oxford,United Healthcare/Oxford,,242.34,,,242.34,192.89,298.49,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Aetna,Commerical,,1353.84,,,1353.84,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Aetna,Middlesex Employees,,1218.46,,,1218.46,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Anthem,Commerical,,1211.37,,,1211.37,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Anthem,Indemnity,,,1286.8056,,1286.8056,969.1,1499.64,percent of total billed charges,,1499.64
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Anthem,State Preferred,,1211.37,,,1211.37,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Anthem,Individual Exchange,,969.1,,,969.1,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Cigna,Cigna,,1183.04,,,1183.04,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Connecticare,Commerical,,1265.36,,,1265.36,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Connecticare,Exchange,,1265.36,,,1265.36,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,Multiplan,Multiplan,,,1456.05,,1456.05,969.1,1456.05,percent of total billed charges,,
HC MICROSENSOR KIT BASIC 574435,27200384,RC,,,both,,,1713,1058.63,United Healthcare/Oxford,United Healthcare/Oxford,,1217.53,,,1217.53,969.1,1499.64,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Aetna,Commerical,,1401.06,,,1401.06,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Aetna,Middlesex Employees,,1260.95,,,1260.95,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Anthem,Commerical,,1253.62,,,1253.62,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Anthem,Indemnity,,,1331.8776,,1331.8776,1002.89,1551.94,percent of total billed charges,,1551.94
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Anthem,State Preferred,,1253.62,,,1253.62,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Anthem,Individual Exchange,,1002.89,,,1002.89,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Cigna,Cigna,,1224.31,,,1224.31,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Connecticare,Commerical,,1309.5,,,1309.5,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Connecticare,Exchange,,1309.5,,,1309.5,1002.89,1551.94,other,Could be inpatient or outpatient,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,Multiplan,Multiplan,,,1507.05,,1507.05,1002.89,1507.05,percent of total billed charges,,
HC MICROSENSOR KIT SKULL BOLT 574436,27200385,RC,,,both,,,1773,1095.71,United Healthcare/Oxford,United Healthcare/Oxford,,1259.99,,,1259.99,1002.89,1551.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Aetna,Commerical,,3.56,,,3.56,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Aetna,Middlesex Employees,,3.21,,,3.21,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Anthem,Commerical,,3.19,,,3.19,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Anthem,Indemnity,,,3.384046602,,3.384046602,2.55,3.94,percent of total billed charges,,3.94
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Anthem,State Preferred,,3.19,,,3.19,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Anthem,Individual Exchange,,2.55,,,2.55,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Cigna,Cigna,,3.11,,,3.11,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Connecticare,Commerical,,3.32,,,3.32,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Connecticare,Exchange,,3.32,,,3.32,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,Multiplan,Multiplan,,,3.829126214,,3.829126214,2.55,3.829126214,percent of total billed charges,,
HC CATH IV 16G WING 031246,27200386,RC,,,both,,,4.504854369,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.55,3.94,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Aetna,Commerical,,2.89,,,2.89,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Aetna,Middlesex Employees,,2.61,,,2.61,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Anthem,Commerical,,2.59,,,2.59,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Anthem,Indemnity,,,2.749537864,,2.749537864,2.07,3.2,percent of total billed charges,,3.2
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Anthem,State Preferred,,2.59,,,2.59,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Anthem,Individual Exchange,,2.07,,,2.07,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Cigna,Cigna,,2.53,,,2.53,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Connecticare,Commerical,,2.7,,,2.7,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Connecticare,Exchange,,2.7,,,2.7,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,Multiplan,Multiplan,,,3.111165049,,3.111165049,2.07,3.111165049,percent of total billed charges,,
HC CATH IV 18G BD 031014,27200387,RC,,,both,,,3.660194175,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.07,3.2,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Aetna,Commerical,,1.89,,,1.89,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Aetna,Middlesex Employees,,1.7,,,1.7,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Anthem,Commerical,,1.69,,,1.69,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Anthem,Indemnity,,,1.845180583,,1.845180583,1.35,2.09,percent of total billed charges,,2.09
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Anthem,State Preferred,,1.69,,,1.69,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Anthem,Individual Exchange,,1.35,,,1.35,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Cigna,Cigna,,1.65,,,1.65,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Connecticare,Commerical,,1.76,,,1.76,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Connecticare,Exchange,,1.76,,,1.76,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,Multiplan,Multiplan,,,2.087864078,,2.087864078,1.35,2.087864078,percent of total billed charges,,
HC CATH JELCO 20G X 1-1/4 031008,27200388,RC,,,both,,,2.45631068,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.35,2.09,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Aetna,Commerical,,5.36,,,5.36,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Aetna,Middlesex Employees,,4.82,,,4.82,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Anthem,Commerical,,4.79,,,4.79,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Anthem,Indemnity,,,5.090656311,,5.090656311,3.83,5.93,percent of total billed charges,,5.93
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Anthem,State Preferred,,4.79,,,4.79,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Anthem,Individual Exchange,,3.83,,,3.83,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Cigna,Cigna,,4.68,,,4.68,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Connecticare,Commerical,,5.01,,,5.01,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Connecticare,Exchange,,5.01,,,5.01,3.83,5.93,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,Multiplan,Multiplan,,,5.760194175,,5.760194175,3.83,5.760194175,percent of total billed charges,,
HC CATH STABILIZATION DEV-FOLEY #574859,27200389,RC,,,both,,,6.776699029,4.19,United Healthcare/Oxford,United Healthcare/Oxford,,4.82,,,4.82,3.83,5.93,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Aetna,Commerical,,4002.89,,,4002.89,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Aetna,Middlesex Employees,,3602.6,,,3602.6,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Anthem,Commerical,,3581.69,,,3581.69,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Anthem,Indemnity,,,3804.828,,3804.828,2865.36,4433.98,percent of total billed charges,,4433.98
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Anthem,State Preferred,,3581.69,,,3581.69,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Anthem,Individual Exchange,,2865.36,,,2865.36,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Cigna,Cigna,,3497.92,,,3497.92,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Connecticare,Commerical,,3741.32,,,3741.32,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Connecticare,Exchange,,3741.32,,,3741.32,2865.36,4433.98,other,Could be inpatient or outpatient,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,Multiplan,Multiplan,,,4305.25,,4305.25,2865.36,4305.25,percent of total billed charges,,
HC BONE ABLATION KIT,27200391,RC,,,both,,,5065,3130.17,United Healthcare/Oxford,United Healthcare/Oxford,,3599.87,,,3599.87,2865.36,4433.98,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Aetna,Commerical,,164.45,,,164.45,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Aetna,Middlesex Employees,,148.01,,,148.01,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Anthem,Commerical,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Anthem,Indemnity,,,156.2496,,156.2496,117.72,182.16,percent of total billed charges,,182.16
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Anthem,State Preferred,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Anthem,Individual Exchange,,117.72,,,117.72,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Cigna,Cigna,,143.7,,,143.7,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Connecticare,Commerical,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Connecticare,Exchange,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,Multiplan,Multiplan,,,176.8,,176.8,117.72,176.8,percent of total billed charges,,
HC DIALY-NATE (LEUR),27200392,RC,,,both,,,208,128.54,United Healthcare/Oxford,United Healthcare/Oxford,,147.89,,,147.89,117.72,182.16,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Aetna,Commerical,,88.73,,,88.73,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Aetna,Middlesex Employees,,79.86,,,79.86,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Anthem,Commerical,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Anthem,Indemnity,,,84.1344,,84.1344,63.52,98.29,percent of total billed charges,,98.29
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Anthem,State Preferred,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Anthem,Individual Exchange,,63.52,,,63.52,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Cigna,Cigna,,77.54,,,77.54,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Connecticare,Commerical,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Connecticare,Exchange,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,Multiplan,Multiplan,,,95.2,,95.2,63.52,95.2,percent of total billed charges,,
HC HEMO DIALYSIS CATH 11.5FR,27200393,RC,,,both,,,112,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,79.8,,,79.8,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Aetna,Commerical,,88.73,,,88.73,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Aetna,Middlesex Employees,,79.86,,,79.86,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Anthem,Commerical,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Anthem,Indemnity,,,84.1344,,84.1344,63.52,98.29,percent of total billed charges,,98.29
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Anthem,State Preferred,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Anthem,Individual Exchange,,63.52,,,63.52,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Cigna,Cigna,,77.54,,,77.54,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Connecticare,Commerical,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Connecticare,Exchange,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,Multiplan,Multiplan,,,95.2,,95.2,63.52,95.2,percent of total billed charges,,
HC HEMO DIALYSIS CATH 9FR,27200394,RC,,,both,,,112,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,79.8,,,79.8,63.52,98.29,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Aetna,Commerical,,175.85,,,175.85,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Aetna,Middlesex Employees,,158.27,,,158.27,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Anthem,Commerical,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Anthem,Indemnity,,,166.7664,,166.7664,125.88,194.78,percent of total billed charges,,194.78
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Anthem,State Preferred,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Anthem,Individual Exchange,,125.88,,,125.88,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Cigna,Cigna,,153.66,,,153.66,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Connecticare,Commerical,,164.35,,,164.35,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Connecticare,Exchange,,164.35,,,164.35,125.88,194.78,other,Could be inpatient or outpatient,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,Multiplan,Multiplan,,,188.7,,188.7,125.88,188.7,percent of total billed charges,,
HC LOW RECIRC APD SET,27200395,RC,,,both,,,222,137.2,United Healthcare/Oxford,United Healthcare/Oxford,,158.14,,,158.14,125.88,194.78,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Aetna,Commerical,,352.5,,,352.5,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Aetna,Middlesex Employees,,317.25,,,317.25,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Anthem,Commerical,,315.41,,,315.41,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Anthem,Indemnity,,,335.0352,,335.0352,252.32,390.46,percent of total billed charges,,390.46
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Anthem,State Preferred,,315.41,,,315.41,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Anthem,Individual Exchange,,252.32,,,252.32,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Cigna,Cigna,,308.04,,,308.04,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Connecticare,Commerical,,329.47,,,329.47,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Connecticare,Exchange,,329.47,,,329.47,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,Multiplan,Multiplan,,,379.1,,379.1,252.32,379.1,percent of total billed charges,,
HC PRISMAFLEX M100 FILTER,27200396,RC,,,both,,,446,275.63,United Healthcare/Oxford,United Healthcare/Oxford,,317.01,,,317.01,252.32,390.46,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Aetna,Commerical,,471.36,,,471.36,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Aetna,Middlesex Employees,,424.22,,,424.22,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Anthem,Commerical,,421.76,,,421.76,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Anthem,Indemnity,,,447.7152,,447.7152,337.41,522.12,percent of total billed charges,,522.12
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Anthem,State Preferred,,421.76,,,421.76,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Anthem,Individual Exchange,,337.41,,,337.41,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Cigna,Cigna,,411.89,,,411.89,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Connecticare,Commerical,,440.56,,,440.56,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Connecticare,Exchange,,440.56,,,440.56,337.41,522.12,other,Could be inpatient or outpatient,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,Multiplan,Multiplan,,,506.6,,506.6,337.41,506.6,percent of total billed charges,,
HC PRISMAFLEX M60 FILTER,27200397,RC,,,both,,,596,368.33,United Healthcare/Oxford,United Healthcare/Oxford,,423.9,,,423.9,337.41,522.12,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Aetna,Commerical,,231.21,,,231.21,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Aetna,Middlesex Employees,,208.09,,,208.09,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Anthem,Commerical,,206.88,,,206.88,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Anthem,Indemnity,,,220.1016,,220.1016,165.5,256.11,percent of total billed charges,,256.11
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Anthem,State Preferred,,206.88,,,206.88,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Anthem,Individual Exchange,,165.5,,,165.5,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Cigna,Cigna,,202.03,,,202.03,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Connecticare,Commerical,,216.09,,,216.09,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Connecticare,Exchange,,216.09,,,216.09,165.5,256.11,other,Could be inpatient or outpatient,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,Multiplan,Multiplan,,,249.05,,249.05,165.5,249.05,percent of total billed charges,,
HC COMPREHENSV DIALY SUPPLIES,27200398,RC,,,both,,,293,181.07,United Healthcare/Oxford,United Healthcare/Oxford,,207.93,,,207.93,165.5,256.11,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Anthem,Indemnity,,,246.3936,,246.3936,185.32,286.76,percent of total billed charges,,286.76
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,Multiplan,Multiplan,,,278.8,,278.8,185.32,278.8,percent of total billed charges,,
HC TRACH TUBES,27200399,RC,,,both,,,328,202.7,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Aetna,Commerical,,130.25,,,130.25,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Aetna,Middlesex Employees,,117.23,,,117.23,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Anthem,Commerical,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Anthem,Indemnity,,,123.948,,123.948,93.24,144.28,percent of total billed charges,,144.28
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Anthem,State Preferred,,116.55,,,116.55,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Anthem,Individual Exchange,,93.24,,,93.24,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Cigna,Cigna,,113.83,,,113.83,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Connecticare,Commerical,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Connecticare,Exchange,,121.75,,,121.75,93.24,144.28,other,Could be inpatient or outpatient,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,Multiplan,Multiplan,,,140.25,,140.25,93.24,140.25,percent of total billed charges,,
HC MICKEY TRACH TUBES,27200400,RC,,,both,,,165,101.97,United Healthcare/Oxford,United Healthcare/Oxford,,117.14,,,117.14,93.24,144.28,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC DILATOR 10FR 033245,27200426,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Aetna,Commerical,,10.78,,,10.78,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Aetna,Middlesex Employees,,9.7,,,9.7,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Anthem,Commerical,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Anthem,Indemnity,,,10.24695146,,10.24695146,7.72,11.94,percent of total billed charges,,11.94
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Anthem,State Preferred,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Anthem,Individual Exchange,,7.72,,,7.72,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Cigna,Cigna,,9.42,,,9.42,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Connecticare,Commerical,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Connecticare,Exchange,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,Multiplan,Multiplan,,,11.59466019,,11.59466019,7.72,11.59466019,percent of total billed charges,,
HC DILATOR 12FR JCD 574933,27200427,RC,,,both,,,13.6407767,8.43,United Healthcare/Oxford,United Healthcare/Oxford,,9.69,,,9.69,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Aetna,Commerical,,112.34,,,112.34,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Aetna,Middlesex Employees,,101.1,,,101.1,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Anthem,Commerical,,100.52,,,100.52,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Anthem,Indemnity,,,106.6704,,106.6704,80.42,124.44,percent of total billed charges,,124.44
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Anthem,State Preferred,,100.52,,,100.52,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Anthem,Individual Exchange,,80.42,,,80.42,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Cigna,Cigna,,98.18,,,98.18,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Connecticare,Commerical,,105.01,,,105.01,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Connecticare,Exchange,,105.01,,,105.01,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,Multiplan,Multiplan,,,120.7,,120.7,80.42,120.7,percent of total billed charges,,
HC DILATOR 12FR. 039263,27200428,RC,,,both,,,142,87.76,United Healthcare/Oxford,United Healthcare/Oxford,,101.03,,,101.03,80.42,124.44,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC DILATOR 14FR 033244,27200429,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HC DILATOR 16FR 039439,27200430,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Aetna,Commerical,,11.1,,,11.1,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Aetna,Middlesex Employees,,10,,,10,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Anthem,Commerical,,9.94,,,9.94,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Anthem,Indemnity,,,10.55326602,,10.55326602,7.95,12.3,percent of total billed charges,,12.3
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Anthem,State Preferred,,9.94,,,9.94,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Anthem,Individual Exchange,,7.95,,,7.95,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Cigna,Cigna,,9.7,,,9.7,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Connecticare,Commerical,,10.38,,,10.38,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Connecticare,Exchange,,10.38,,,10.38,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,Multiplan,Multiplan,,,11.94126214,,11.94126214,7.95,11.94126214,percent of total billed charges,,
HC DILATOR 18FR 309297,27200431,RC,,,both,,,14.04854369,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,9.99,,,9.99,7.95,12.3,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Aetna,Commerical,,24.19,,,24.19,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Aetna,Middlesex Employees,,21.77,,,21.77,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Anthem,Commerical,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Anthem,Indemnity,,,22.98817864,,22.98817864,17.32,26.79,percent of total billed charges,,26.79
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Anthem,State Preferred,,21.64,,,21.64,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Anthem,Individual Exchange,,17.32,,,17.32,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Cigna,Cigna,,21.13,,,21.13,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Connecticare,Commerical,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Connecticare,Exchange,,22.6,,,22.6,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,Multiplan,Multiplan,,,26.01165049,,26.01165049,17.32,26.01165049,percent of total billed charges,,
HC DILATOR 20FR JCD 309298,27200432,RC,,,both,,,30.60194175,18.91,United Healthcare/Oxford,United Healthcare/Oxford,,21.75,,,21.75,17.32,26.79,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Aetna,Commerical,,19.29,,,19.29,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Aetna,Middlesex Employees,,17.36,,,17.36,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Anthem,Commerical,,17.25,,,17.25,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Anthem,Indemnity,,,18.32782136,,18.32782136,13.81,21.36,percent of total billed charges,,21.36
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Anthem,State Preferred,,17.25,,,17.25,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Anthem,Individual Exchange,,13.81,,,13.81,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Cigna,Cigna,,16.85,,,16.85,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Connecticare,Commerical,,18.02,,,18.02,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Connecticare,Exchange,,18.02,,,18.02,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,Multiplan,Multiplan,,,20.73834951,,20.73834951,13.81,20.73834951,percent of total billed charges,,
HC DILATOR 22FR JCD 574784,27200433,RC,,,both,,,24.39805825,15.08,United Healthcare/Oxford,United Healthcare/Oxford,,17.35,,,17.35,13.81,21.36,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Aetna,Commerical,,10.78,,,10.78,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Aetna,Middlesex Employees,,9.7,,,9.7,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Anthem,Commerical,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Anthem,Indemnity,,,10.24695146,,10.24695146,7.72,11.94,percent of total billed charges,,11.94
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Anthem,State Preferred,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Anthem,Individual Exchange,,7.72,,,7.72,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Cigna,Cigna,,9.42,,,9.42,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Connecticare,Commerical,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Connecticare,Exchange,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,Multiplan,Multiplan,,,11.59466019,,11.59466019,7.72,11.59466019,percent of total billed charges,,
HC DILATOR 6FR JCD 039408,27200434,RC,,,both,,,13.6407767,8.43,United Healthcare/Oxford,United Healthcare/Oxford,,9.69,,,9.69,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Aetna,Commerical,,10.78,,,10.78,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Aetna,Middlesex Employees,,9.7,,,9.7,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Anthem,Commerical,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Anthem,Indemnity,,,10.24695146,,10.24695146,7.72,11.94,percent of total billed charges,,11.94
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Anthem,State Preferred,,9.65,,,9.65,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Anthem,Individual Exchange,,7.72,,,7.72,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Cigna,Cigna,,9.42,,,9.42,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Connecticare,Commerical,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Connecticare,Exchange,,10.07,,,10.07,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,Multiplan,Multiplan,,,11.59466019,,11.59466019,7.72,11.59466019,percent of total billed charges,,
HC DILATOR 8FR-35 JCD 005201,27200435,RC,,,both,,,13.6407767,8.43,United Healthcare/Oxford,United Healthcare/Oxford,,9.69,,,9.69,7.72,11.94,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Aetna,Commerical,,146.54,,,146.54,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Aetna,Middlesex Employees,,131.88,,,131.88,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Anthem,Commerical,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Anthem,Indemnity,,,138.972,,138.972,104.89,162.32,percent of total billed charges,,162.32
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Anthem,State Preferred,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Anthem,Individual Exchange,,104.89,,,104.89,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Cigna,Cigna,,128.06,,,128.06,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Connecticare,Commerical,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Connecticare,Exchange,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,Multiplan,Multiplan,,,157.25,,157.25,104.89,157.25,percent of total billed charges,,
HC DILATOR ENDOVAS 300890,27200436,RC,,,both,,,185,114.33,United Healthcare/Oxford,United Healthcare/Oxford,,131.78,,,131.78,104.89,162.32,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Aetna,Commerical,,82.23,,,82.23,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Aetna,Middlesex Employees,,74,,,74,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Anthem,Commerical,,73.57,,,73.57,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Anthem,Indemnity,,,78.1248,,78.1248,58.85,91.08,percent of total billed charges,,91.08
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Anthem,State Preferred,,73.57,,,73.57,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Anthem,Individual Exchange,,58.85,,,58.85,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Cigna,Cigna,,71.85,,,71.85,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Connecticare,Commerical,,76.85,,,76.85,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Connecticare,Exchange,,76.85,,,76.85,58.85,91.08,other,Could be inpatient or outpatient,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,Multiplan,Multiplan,,,88.4,,88.4,58.85,88.4,percent of total billed charges,,
HC DILATOR VASCULAR 5FR 030759,27200437,RC,,,both,,,104,64.27,United Healthcare/Oxford,United Healthcare/Oxford,,73.94,,,73.94,58.85,91.08,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Aetna,Commerical,,8.69,,,8.69,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Aetna,Middlesex Employees,,7.82,,,7.82,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Anthem,Commerical,,7.77,,,7.77,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Anthem,Indemnity,,,8.255906796,,8.255906796,6.22,9.62,percent of total billed charges,,9.62
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Anthem,State Preferred,,7.77,,,7.77,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Anthem,Individual Exchange,,6.22,,,6.22,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Cigna,Cigna,,7.59,,,7.59,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Connecticare,Commerical,,8.12,,,8.12,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Connecticare,Exchange,,8.12,,,8.12,6.22,9.62,other,Could be inpatient or outpatient,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,Multiplan,Multiplan,,,9.341747573,,9.341747573,6.22,9.341747573,percent of total billed charges,,
HC EMPTY ENEMA BAG 575503,27200439,RC,,,both,,,10.99029126,6.79,United Healthcare/Oxford,United Healthcare/Oxford,,7.81,,,7.81,6.22,9.62,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Aetna,Commerical,,14.5,,,14.5,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Aetna,Middlesex Employees,,13.05,,,13.05,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Anthem,Commerical,,12.98,,,12.98,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Anthem,Indemnity,,,14.20716117,,14.20716117,10.38,16.07,percent of total billed charges,,16.07
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Anthem,State Preferred,,12.98,,,12.98,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Anthem,Individual Exchange,,10.38,,,10.38,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Cigna,Cigna,,12.68,,,12.68,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Connecticare,Commerical,,13.56,,,13.56,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Connecticare,Exchange,,13.56,,,13.56,10.38,16.07,other,Could be inpatient or outpatient,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,Multiplan,Multiplan,,,16.07572816,,16.07572816,10.38,16.07572816,percent of total billed charges,,
HC FEED SET 18FR RT ANGLE 310902,27200440,RC,,,both,,,18.91262136,11.69,United Healthcare/Oxford,United Healthcare/Oxford,,13.05,,,13.05,10.38,16.07,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Aetna,Commerical,,12.74,,,12.74,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Aetna,Middlesex Employees,,11.47,,,11.47,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Anthem,Commerical,,11.4,,,11.4,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Anthem,Indemnity,,,12.10671845,,12.10671845,9.12,14.11,percent of total billed charges,,14.11
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Anthem,State Preferred,,11.4,,,11.4,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Anthem,Individual Exchange,,9.12,,,9.12,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Cigna,Cigna,,11.14,,,11.14,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Connecticare,Commerical,,11.91,,,11.91,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Connecticare,Exchange,,11.91,,,11.91,9.12,14.11,other,Could be inpatient or outpatient,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,Multiplan,Multiplan,,,13.69902913,,13.69902913,9.12,13.69902913,percent of total billed charges,,
HC FEEDING TUBE ADPT RED 575649,27200441,RC,,,both,,,16.11650485,9.96,United Healthcare/Oxford,United Healthcare/Oxford,,11.45,,,11.45,9.12,14.11,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Aetna,Commerical,,78.16,,,78.16,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Aetna,Middlesex Employees,,70.34,,,70.34,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Anthem,Commerical,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Anthem,Indemnity,,,74.3688,,74.3688,55.94,86.57,percent of total billed charges,,86.57
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Anthem,State Preferred,,69.92,,,69.92,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Anthem,Individual Exchange,,55.94,,,55.94,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Cigna,Cigna,,68.3,,,68.3,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Connecticare,Commerical,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Connecticare,Exchange,,73.04,,,73.04,55.94,86.57,other,Could be inpatient or outpatient,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,Multiplan,Multiplan,,,84.15,,84.15,55.94,84.15,percent of total billed charges,,
HC FOLEY CATH ADAPTER 030374,27200442,RC,,,both,,,99,61.18,United Healthcare/Oxford,United Healthcare/Oxford,,70.29,,,70.29,55.94,86.57,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Aetna,Commerical,,13.54,,,13.54,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Aetna,Middlesex Employees,,12.19,,,12.19,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Anthem,Commerical,,12.11,,,12.11,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Anthem,Indemnity,,,12.86521165,,12.86521165,9.69,14.99,percent of total billed charges,,14.99
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Anthem,State Preferred,,12.11,,,12.11,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Anthem,Individual Exchange,,9.69,,,9.69,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Cigna,Cigna,,11.84,,,11.84,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Connecticare,Commerical,,12.65,,,12.65,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Connecticare,Exchange,,12.65,,,12.65,9.69,14.99,other,Could be inpatient or outpatient,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,Multiplan,Multiplan,,,14.55728155,,14.55728155,9.69,14.55728155,percent of total billed charges,,
HC INFANT QUICK CONN SPO2 005370,27200443,RC,,,both,,,17.12621359,10.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.17,,,12.17,9.69,14.99,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Aetna,Commerical,,131.88,,,131.88,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Aetna,Middlesex Employees,,118.69,,,118.69,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Anthem,Commerical,,118.01,,,118.01,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Anthem,Indemnity,,,125.4504,,125.4504,94.41,146.09,percent of total billed charges,,146.09
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Anthem,State Preferred,,118.01,,,118.01,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Anthem,Individual Exchange,,94.41,,,94.41,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Cigna,Cigna,,115.24,,,115.24,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Connecticare,Commerical,,123.26,,,123.26,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Connecticare,Exchange,,123.26,,,123.26,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,Multiplan,Multiplan,,,141.95,,141.95,94.41,141.95,percent of total billed charges,,
HC INTRODUCER 3.5FR 034711,27200444,RC,,,both,,,167,103.21,United Healthcare/Oxford,United Healthcare/Oxford,,118.6,,,118.6,94.41,146.09,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Aetna,Commerical,,115.6,,,115.6,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Aetna,Middlesex Employees,,104.04,,,104.04,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Anthem,Commerical,,103.44,,,103.44,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Anthem,Indemnity,,,109.6752,,109.6752,82.75,128.05,percent of total billed charges,,128.05
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Anthem,State Preferred,,103.44,,,103.44,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Anthem,Individual Exchange,,82.75,,,82.75,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Cigna,Cigna,,101.02,,,101.02,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Connecticare,Commerical,,108.05,,,108.05,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Connecticare,Exchange,,108.05,,,108.05,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,Multiplan,Multiplan,,,124.1,,124.1,82.75,124.1,percent of total billed charges,,
HC INTRODUCER 4.5FR 034855,27200445,RC,,,both,,,146,90.23,United Healthcare/Oxford,United Healthcare/Oxford,,103.96,,,103.96,82.75,128.05,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Aetna,Commerical,,155.49,,,155.49,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Aetna,Middlesex Employees,,139.94,,,139.94,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Anthem,Commerical,,139.14,,,139.14,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Anthem,Indemnity,,,147.9864,,147.9864,111.3,172.24,percent of total billed charges,,172.24
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Anthem,State Preferred,,139.14,,,139.14,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Anthem,Individual Exchange,,111.3,,,111.3,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Cigna,Cigna,,135.88,,,135.88,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Connecticare,Commerical,,145.33,,,145.33,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Connecticare,Exchange,,145.33,,,145.33,111.3,172.24,other,Could be inpatient or outpatient,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,Multiplan,Multiplan,,,167.45,,167.45,111.3,167.45,percent of total billed charges,,
HC INTRODUCER 5.5FR 000076,27200446,RC,,,both,,,197,121.75,United Healthcare/Oxford,United Healthcare/Oxford,,139.83,,,139.83,111.3,172.24,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Aetna,Commerical,,10.08,,,10.08,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Aetna,Middlesex Employees,,9.07,,,9.07,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Anthem,Commerical,,9.01,,,9.01,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Anthem,Indemnity,,,9.575976699,,9.575976699,7.21,11.16,percent of total billed charges,,11.16
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Anthem,State Preferred,,9.01,,,9.01,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Anthem,Individual Exchange,,7.21,,,7.21,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Cigna,Cigna,,8.81,,,8.81,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Connecticare,Commerical,,9.42,,,9.42,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Connecticare,Exchange,,9.42,,,9.42,7.21,11.16,other,Could be inpatient or outpatient,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,Multiplan,Multiplan,,,10.83543689,,10.83543689,7.21,10.83543689,percent of total billed charges,,
HC MINI MUFFS 555697,27200447,RC,,,both,,,12.74757282,7.88,United Healthcare/Oxford,United Healthcare/Oxford,,9.06,,,9.06,7.21,11.16,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Aetna,Commerical,,22.45,,,22.45,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Aetna,Middlesex Employees,,20.21,,,20.21,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Anthem,Commerical,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Anthem,Indemnity,,,21.33991456,,21.33991456,16.07,24.87,percent of total billed charges,,24.87
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Anthem,State Preferred,,20.09,,,20.09,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Anthem,Individual Exchange,,16.07,,,16.07,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Cigna,Cigna,,19.62,,,19.62,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Connecticare,Commerical,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Connecticare,Exchange,,20.98,,,20.98,16.07,24.87,other,Could be inpatient or outpatient,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,Multiplan,Multiplan,,,24.14660194,,24.14660194,16.07,24.14660194,percent of total billed charges,,
HR MRI DISPOSABLE KIT 001011,27200448,RC,,,both,,,28.40776699,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,20.19,,,20.19,16.07,24.87,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Aetna,Commerical,,28.5,,,28.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Aetna,Middlesex Employees,,25.65,,,25.65,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Anthem,Commerical,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Anthem,Indemnity,,,27.08695922,,27.08695922,20.4,31.57,percent of total billed charges,,31.57
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Anthem,State Preferred,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Anthem,Individual Exchange,,20.4,,,20.4,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Cigna,Cigna,,24.91,,,24.91,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Connecticare,Commerical,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Connecticare,Exchange,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,Multiplan,Multiplan,,,30.64951456,,30.64951456,20.4,30.64951456,percent of total billed charges,,
HC MRIDIUM PRIMARY ADMIN. SET 007818,27200449,RC,,,both,,,36.05825243,22.29,United Healthcare/Oxford,United Healthcare/Oxford,,25.64,,,25.64,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Aetna,Commerical,,28.5,,,28.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Aetna,Middlesex Employees,,25.65,,,25.65,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Anthem,Commerical,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Anthem,Indemnity,,,27.08695922,,27.08695922,20.4,31.57,percent of total billed charges,,31.57
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Anthem,State Preferred,,25.5,,,25.5,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Anthem,Individual Exchange,,20.4,,,20.4,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Cigna,Cigna,,24.91,,,24.91,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Connecticare,Commerical,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Connecticare,Exchange,,26.64,,,26.64,20.4,31.57,other,Could be inpatient or outpatient,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,Multiplan,Multiplan,,,30.64951456,,30.64951456,20.4,30.64951456,percent of total billed charges,,
HC MRIDIUM VENTED SYRINGE ADAPTER SET 007817,27200450,RC,,,both,,,36.05825243,22.29,United Healthcare/Oxford,United Healthcare/Oxford,,25.64,,,25.64,20.4,31.57,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Aetna,Commerical,,12.43,,,12.43,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Aetna,Middlesex Employees,,11.2,,,11.2,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Anthem,Commerical,,11.13,,,11.13,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Anthem,Indemnity,,,11.81499029,,11.81499029,8.9,13.77,percent of total billed charges,,13.77
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Anthem,State Preferred,,11.13,,,11.13,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Anthem,Individual Exchange,,8.9,,,8.9,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Cigna,Cigna,,10.87,,,10.87,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Connecticare,Commerical,,11.62,,,11.62,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Connecticare,Exchange,,11.62,,,11.62,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,Multiplan,Multiplan,,,13.36893204,,13.36893204,8.9,13.36893204,percent of total billed charges,,
HC NEONATAL QUADTRODE 006043,27200451,RC,,,both,,,15.72815534,9.72,United Healthcare/Oxford,United Healthcare/Oxford,,11.18,,,11.18,8.9,13.77,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Aetna,Commerical,,13.54,,,13.54,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Aetna,Middlesex Employees,,12.19,,,12.19,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Anthem,Commerical,,12.11,,,12.11,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Anthem,Indemnity,,,12.86521165,,12.86521165,9.69,14.99,percent of total billed charges,,14.99
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Anthem,State Preferred,,12.11,,,12.11,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Anthem,Individual Exchange,,9.69,,,9.69,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Cigna,Cigna,,11.84,,,11.84,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Connecticare,Commerical,,12.65,,,12.65,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Connecticare,Exchange,,12.65,,,12.65,9.69,14.99,other,Could be inpatient or outpatient,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,Multiplan,Multiplan,,,14.55728155,,14.55728155,9.69,14.55728155,percent of total billed charges,,
HC NEONATAL QUICK CONN SPO2 005371,27200452,RC,,,both,,,17.12621359,10.59,United Healthcare/Oxford,United Healthcare/Oxford,,12.17,,,12.17,9.69,14.99,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Aetna,Commerical,,16.38,,,16.38,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Aetna,Middlesex Employees,,14.75,,,14.75,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Anthem,Commerical,,14.66,,,14.66,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Anthem,Indemnity,,,16.03775534,,16.03775534,11.73,18.15,percent of total billed charges,,18.15
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Anthem,State Preferred,,14.66,,,14.66,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Anthem,Individual Exchange,,11.73,,,11.73,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Cigna,Cigna,,14.31,,,14.31,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Connecticare,Commerical,,15.31,,,15.31,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Connecticare,Exchange,,15.31,,,15.31,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,Multiplan,Multiplan,,,18.14708738,,18.14708738,11.73,18.14708738,percent of total billed charges,,
HC OXIMETER INFANT 552286,27200454,RC,,,both,,,21.34951456,13.19,United Healthcare/Oxford,United Healthcare/Oxford,,14.73,,,14.73,11.73,18.15,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Aetna,Commerical,,25.83,,,25.83,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Aetna,Middlesex Employees,,23.25,,,23.25,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Anthem,Commerical,,23.11,,,23.11,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Anthem,Indemnity,,,25.28553786,,25.28553786,18.49,28.61,percent of total billed charges,,28.61
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Anthem,State Preferred,,23.11,,,23.11,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Anthem,Individual Exchange,,18.49,,,18.49,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Cigna,Cigna,,22.57,,,22.57,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Connecticare,Commerical,,24.14,,,24.14,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Connecticare,Exchange,,24.14,,,24.14,18.49,28.61,other,Could be inpatient or outpatient,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,Multiplan,Multiplan,,,28.61116505,,28.61116505,18.49,28.61116505,percent of total billed charges,,
HC OXIMETER NEO 554647,27200455,RC,,,both,,,33.66019417,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,23.23,,,23.23,18.49,28.61,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Aetna,Commerical,,12.43,,,12.43,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Aetna,Middlesex Employees,,11.2,,,11.2,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Anthem,Commerical,,11.13,,,11.13,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Anthem,Indemnity,,,11.81499029,,11.81499029,8.9,13.77,percent of total billed charges,,13.77
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Anthem,State Preferred,,11.13,,,11.13,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Anthem,Individual Exchange,,8.9,,,8.9,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Cigna,Cigna,,10.87,,,10.87,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Connecticare,Commerical,,11.62,,,11.62,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Connecticare,Exchange,,11.62,,,11.62,8.9,13.77,other,Could be inpatient or outpatient,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,Multiplan,Multiplan,,,13.36893204,,13.36893204,8.9,13.36893204,percent of total billed charges,,
HC PED QUICK CONN SPO2 005369,27200457,RC,,,both,,,15.72815534,9.72,United Healthcare/Oxford,United Healthcare/Oxford,,11.18,,,11.18,8.9,13.77,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Aetna,Commerical,,10.88,,,10.88,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Aetna,Middlesex Employees,,9.79,,,9.79,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Anthem,Commerical,,9.74,,,9.74,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Anthem,Indemnity,,,10.34176311,,10.34176311,7.79,12.05,percent of total billed charges,,12.05
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Anthem,State Preferred,,9.74,,,9.74,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Anthem,Individual Exchange,,7.79,,,7.79,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Cigna,Cigna,,9.52,,,9.52,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Connecticare,Commerical,,10.18,,,10.18,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Connecticare,Exchange,,10.18,,,10.18,7.79,12.05,other,Could be inpatient or outpatient,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,Multiplan,Multiplan,,,11.70194175,,11.70194175,7.79,11.70194175,percent of total billed charges,,
HC QUADTRODE INVIVO (NON METAL) 307737,27200458,RC,,,both,,,13.76699029,8.51,United Healthcare/Oxford,United Healthcare/Oxford,,9.79,,,9.79,7.79,12.05,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Aetna,Commerical,,13.04,,,13.04,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Aetna,Middlesex Employees,,11.74,,,11.74,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Anthem,Commerical,,11.66,,,11.66,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Anthem,Indemnity,,,12.3984466,,12.3984466,9.34,14.45,percent of total billed charges,,14.45
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Anthem,State Preferred,,11.66,,,11.66,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Anthem,Individual Exchange,,9.34,,,9.34,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Cigna,Cigna,,11.4,,,11.4,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Connecticare,Commerical,,12.19,,,12.19,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Connecticare,Exchange,,12.19,,,12.19,9.34,14.45,other,Could be inpatient or outpatient,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,Multiplan,Multiplan,,,14.02912621,,14.02912621,9.34,14.02912621,percent of total billed charges,,
"HC TRAY LUMBAR PUNC 20GA X 3.5"" 391141",27200460,RC,,,both,,,16.50485437,10.2,United Healthcare/Oxford,United Healthcare/Oxford,,11.73,,,11.73,9.34,14.45,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Aetna,Commerical,,80.59,,,80.59,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Aetna,Middlesex Employees,,72.53,,,72.53,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Anthem,Commerical,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Anthem,Indemnity,,,76.6224,,76.6224,57.69,89.28,percent of total billed charges,,89.28
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Anthem,State Preferred,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Anthem,Individual Exchange,,57.69,,,57.69,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Cigna,Cigna,,70.43,,,70.43,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Connecticare,Commerical,,75.33,,,75.33,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Connecticare,Exchange,,75.33,,,75.33,57.69,89.28,other,Could be inpatient or outpatient,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,Multiplan,Multiplan,,,86.7,,86.7,57.69,86.7,percent of total billed charges,,
HC WINGED CATH ADPT 030375,27200462,RC,,,both,,,102,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,72.48,,,72.48,57.69,89.28,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Aetna,Commerical,,25.91,,,25.91,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Aetna,Middlesex Employees,,23.32,,,23.32,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Anthem,Commerical,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Anthem,Indemnity,,,24.62185631,,24.62185631,18.55,28.7,percent of total billed charges,,28.7
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Anthem,State Preferred,,23.18,,,23.18,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Anthem,Individual Exchange,,18.55,,,18.55,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Cigna,Cigna,,22.64,,,22.64,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Connecticare,Commerical,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Connecticare,Exchange,,24.22,,,24.22,18.55,28.7,other,Could be inpatient or outpatient,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,Multiplan,Multiplan,,,27.86019417,,27.86019417,18.55,27.86019417,percent of total billed charges,,
HC CO2 ENDOSCOPIC INSUFFLATOR TUBING SET #574534,27200463,RC,,,both,,,32.77669903,20.26,United Healthcare/Oxford,United Healthcare/Oxford,,23.3,,,23.3,18.55,28.7,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Aetna,Commerical,,69.2,,,69.2,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Aetna,Middlesex Employees,,62.28,,,62.28,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Anthem,Commerical,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Anthem,Indemnity,,,66.1056,,66.1056,49.54,76.65,percent of total billed charges,,76.65
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Anthem,State Preferred,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Anthem,Individual Exchange,,49.54,,,49.54,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Cigna,Cigna,,60.47,,,60.47,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Connecticare,Commerical,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Connecticare,Exchange,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,Multiplan,Multiplan,,,74.8,,74.8,49.54,76.65,percent of total billed charges,,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 15CM #039469             ,27200465,RC,,,both,,,88,54.38,United Healthcare/Oxford,United Healthcare/Oxford,,62.23,,,62.23,49.54,76.65,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Aetna,Commerical,,17.68,,,17.68,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Aetna,Middlesex Employees,,15.92,,,15.92,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Anthem,Commerical,,15.83,,,15.83,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Anthem,Indemnity,,,16.80354175,,16.80354175,12.66,19.58,percent of total billed charges,,19.58
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Anthem,State Preferred,,15.83,,,15.83,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Anthem,Individual Exchange,,12.66,,,12.66,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Cigna,Cigna,,15.45,,,15.45,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Connecticare,Commerical,,16.52,,,16.52,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Connecticare,Exchange,,16.52,,,16.52,12.66,19.58,other,Could be inpatient or outpatient,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,Multiplan,Multiplan,,,19.01359223,,19.01359223,12.66,19.01359223,percent of total billed charges,,
HC STERILE ARTHROGRAM 2 TRAY #575022,27200465,RC,,,both,,,22.36893204,13.82,United Healthcare/Oxford,United Healthcare/Oxford,,15.9,,,15.9,12.66,19.58,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Aetna,Commerical,,102.58,,,102.58,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Aetna,Middlesex Employees,,92.31,,,92.31,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Anthem,Commerical,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Anthem,Indemnity,,,97.656,,97.656,73.42,113.62,percent of total billed charges,,113.62
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Anthem,State Preferred,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Anthem,Individual Exchange,,73.42,,,73.42,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Cigna,Cigna,,89.64,,,89.64,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Connecticare,Commerical,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Connecticare,Exchange,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,Multiplan,Multiplan,,,110.5,,110.5,73.42,110.5,percent of total billed charges,,
HC COAXIAL ACHIEVE BX NEEDLE  18G X 11CM #575402             ,27200467,RC,,,both,,,130,80.34,United Healthcare/Oxford,United Healthcare/Oxford,,92.25,,,92.25,73.42,113.62,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Anthem,Indemnity,,,92.3976,,92.3976,69.35,107.31,percent of total billed charges,,107.31
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,Multiplan,Multiplan,,,104.55,,104.55,69.35,104.55,percent of total billed charges,,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 15CM #0320596            ,27200467,RC,,,both,,,123,76.01,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Anthem,Indemnity,,,94.6512,,94.6512,71.09,110.02,percent of total billed charges,,110.02
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,Multiplan,Multiplan,,,107.1,,107.1,71.09,107.1,percent of total billed charges,,
HC COAXIAL ACHIEVE BX NEEDLE  20G X 11CM #           ,27200468,RC,,,both,,,126,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Anthem,Indemnity,,,45.072,,45.072,33.8,52.3,percent of total billed charges,,52.3
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Cigna,Cigna,,41.26,,,41.26,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Connecticare,Commerical,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Connecticare,Exchange,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,Multiplan,Multiplan,,,51,,51,33.8,51,percent of total billed charges,,
HC AMPLATZ 530639,27200469,RC,,,both,,,60,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,42.47,,,42.47,33.8,52.3,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Anthem,Indemnity,,,60.096,,60.096,45.46,70.34,percent of total billed charges,,70.34
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,Multiplan,Multiplan,,,68,,68,45.46,68,percent of total billed charges,,
HC LAUREATE GUIDE WIRE 037508,27200470,RC,,,both,,,80,49.44,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Aetna,Commerical,,12.68,,,12.68,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Aetna,Middlesex Employees,,11.41,,,11.41,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Anthem,Commerical,,11.34,,,11.34,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Anthem,Indemnity,,,12.04837282,,12.04837282,9.08,14.04,percent of total billed charges,,14.04
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Anthem,State Preferred,,11.34,,,11.34,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Anthem,Individual Exchange,,9.08,,,9.08,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Cigna,Cigna,,11.08,,,11.08,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Connecticare,Commerical,,11.85,,,11.85,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Connecticare,Exchange,,11.85,,,11.85,9.08,14.04,other,Could be inpatient or outpatient,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,Multiplan,Multiplan,,,13.63300971,,13.63300971,9.08,13.63300971,percent of total billed charges,,
HC DIALATOR 10FR 574934,27200471,RC,,,both,,,16.03883495,9.91,United Healthcare/Oxford,United Healthcare/Oxford,,11.4,,,11.4,9.08,14.04,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Aetna,Commerical,,119.67,,,119.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Aetna,Middlesex Employees,,107.7,,,107.7,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Anthem,Commerical,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Anthem,Indemnity,,,113.4312,,113.4312,85.67,132.56,percent of total billed charges,,132.56
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Anthem,State Preferred,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Anthem,Individual Exchange,,85.67,,,85.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Cigna,Cigna,,104.57,,,104.57,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Connecticare,Commerical,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Connecticare,Exchange,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,Multiplan,Multiplan,,,128.35,,128.35,85.67,128.35,percent of total billed charges,,
HC CATH LOCKING 6FR  008101,27200472,RC,,,both,,,151,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,107.62,,,107.62,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Aetna,Commerical,,119.67,,,119.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Aetna,Middlesex Employees,,107.7,,,107.7,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Anthem,Commerical,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Anthem,Indemnity,,,113.4312,,113.4312,85.67,132.56,percent of total billed charges,,132.56
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Anthem,State Preferred,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Anthem,Individual Exchange,,85.67,,,85.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Cigna,Cigna,,104.57,,,104.57,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Connecticare,Commerical,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Connecticare,Exchange,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,Multiplan,Multiplan,,,128.35,,128.35,85.67,128.35,percent of total billed charges,,
HC CATH LOCKING 8FR 575192,27200473,RC,,,both,,,151,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,107.62,,,107.62,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Aetna,Commerical,,119.67,,,119.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Aetna,Middlesex Employees,,107.7,,,107.7,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Anthem,Commerical,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Anthem,Indemnity,,,113.4312,,113.4312,85.67,132.56,percent of total billed charges,,132.56
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Anthem,State Preferred,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Anthem,Individual Exchange,,85.67,,,85.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Cigna,Cigna,,104.57,,,104.57,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Connecticare,Commerical,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Connecticare,Exchange,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,Multiplan,Multiplan,,,128.35,,128.35,85.67,128.35,percent of total billed charges,,
HC CATH LOCKING 10FR 008102,27200474,RC,,,both,,,151,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,107.62,,,107.62,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Aetna,Commerical,,119.67,,,119.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Aetna,Middlesex Employees,,107.7,,,107.7,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Anthem,Commerical,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Anthem,Indemnity,,,113.4312,,113.4312,85.67,132.56,percent of total billed charges,,132.56
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Anthem,State Preferred,,107.08,,,107.08,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Anthem,Individual Exchange,,85.67,,,85.67,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Cigna,Cigna,,104.57,,,104.57,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Connecticare,Commerical,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Connecticare,Exchange,,111.85,,,111.85,85.67,132.56,other,Could be inpatient or outpatient,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,Multiplan,Multiplan,,,128.35,,128.35,85.67,128.35,percent of total billed charges,,
HC CATH LOCKING 12FR 575193,27200475,RC,,,both,,,151,93.32,United Healthcare/Oxford,United Healthcare/Oxford,,107.62,,,107.62,85.67,132.56,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Aetna,Commerical,,61.87,,,61.87,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Aetna,Middlesex Employees,,55.68,,,55.68,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Anthem,Commerical,,55.36,,,55.36,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Anthem,Indemnity,,,58.5936,,58.5936,44.29,68.54,percent of total billed charges,,68.54
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Anthem,State Preferred,,55.36,,,55.36,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Anthem,Individual Exchange,,44.29,,,44.29,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Cigna,Cigna,,54.07,,,54.07,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Connecticare,Commerical,,57.83,,,57.83,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Connecticare,Exchange,,57.83,,,57.83,44.29,68.54,other,Could be inpatient or outpatient,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,Multiplan,Multiplan,,,66.3,,66.3,44.29,66.3,percent of total billed charges,,
HC NEEDLE DISP HAWKINS-AKINS,27200476,RC,,,both,,,78,48.2,United Healthcare/Oxford,United Healthcare/Oxford,,55.64,,,55.64,44.29,68.54,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Aetna,Commerical,,38,,,38,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Aetna,Middlesex Employees,,34.21,,,34.21,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Anthem,Commerical,,34,,,34,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Anthem,Indemnity,,,36.11594563,,36.11594563,27.2,42.09,percent of total billed charges,,42.09
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Anthem,State Preferred,,34,,,34,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Anthem,Individual Exchange,,27.2,,,27.2,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Cigna,Cigna,,33.21,,,33.21,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Connecticare,Commerical,,35.51,,,35.51,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Connecticare,Exchange,,35.51,,,35.51,27.2,42.09,other,Could be inpatient or outpatient,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,Multiplan,Multiplan,,,40.86601942,,40.86601942,27.2,40.86601942,percent of total billed charges,,
HC YUEH 000038,27200478,RC,,,both,,,48.0776699,29.71,United Healthcare/Oxford,United Healthcare/Oxford,,34.18,,,34.18,27.2,42.09,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Aetna,Commerical,,88.73,,,88.73,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Aetna,Middlesex Employees,,79.86,,,79.86,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Anthem,Commerical,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Anthem,Indemnity,,,84.1344,,84.1344,63.52,98.29,percent of total billed charges,,98.29
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Anthem,State Preferred,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Anthem,Individual Exchange,,63.52,,,63.52,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Cigna,Cigna,,77.54,,,77.54,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Connecticare,Commerical,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Connecticare,Exchange,,82.94,,,82.94,63.52,98.29,other,Could be inpatient or outpatient,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,Multiplan,Multiplan,,,95.2,,95.2,63.52,95.2,percent of total billed charges,,
HC CO AXIAL ACHIEVE 18G X 10CM,27200479,RC,,,both,,,112,69.22,United Healthcare/Oxford,United Healthcare/Oxford,,79.8,,,79.8,63.52,98.29,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Aetna,Commerical,,749.78,,,749.78,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Aetna,Middlesex Employees,,674.8,,,674.8,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Anthem,Commerical,,670.89,,,670.89,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Anthem,Indemnity,,,712.8888,,712.8888,536.71,830.53,percent of total billed charges,,830.53
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Anthem,State Preferred,,670.89,,,670.89,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Anthem,Individual Exchange,,536.71,,,536.71,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Cigna,Cigna,,655.19,,,655.19,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Connecticare,Commerical,,700.79,,,700.79,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Connecticare,Exchange,,700.79,,,700.79,536.71,830.53,other,Could be inpatient or outpatient,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,Multiplan,Multiplan,,,806.65,,806.65,536.71,806.65,percent of total billed charges,,
HC BONE LESION BIOPSY TRAY,27200481,RC,,,both,,,949,586.48,United Healthcare/Oxford,United Healthcare/Oxford,,674.29,,,674.29,536.71,830.53,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Aetna,Commerical,,12.26,,,12.26,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Aetna,Middlesex Employees,,11.03,,,11.03,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Anthem,Commerical,,10.97,,,10.97,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Anthem,Indemnity,,,11.65453981,,11.65453981,8.78,13.58,percent of total billed charges,,13.58
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Anthem,State Preferred,,10.97,,,10.97,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Anthem,Individual Exchange,,8.78,,,8.78,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Cigna,Cigna,,10.71,,,10.71,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Connecticare,Commerical,,11.46,,,11.46,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Connecticare,Exchange,,11.46,,,11.46,8.78,13.58,other,Could be inpatient or outpatient,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,Multiplan,Multiplan,,,13.18737864,,13.18737864,8.78,13.18737864,percent of total billed charges,,
HC CHIBA BIOPSY NEEDLE 22G X 15CM 320640,27200482,RC,,,both,,,15.51456311,9.59,United Healthcare/Oxford,United Healthcare/Oxford,,11.02,,,11.02,8.78,13.58,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Aetna,Commerical,,16.31,,,16.31,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Aetna,Middlesex Employees,,14.68,,,14.68,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Anthem,Commerical,,14.59,,,14.59,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Anthem,Indemnity,,,15.49805825,,15.49805825,11.67,18.06,percent of total billed charges,,18.06
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Anthem,State Preferred,,14.59,,,14.59,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Anthem,Individual Exchange,,11.67,,,11.67,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Cigna,Cigna,,14.25,,,14.25,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Connecticare,Commerical,,15.24,,,15.24,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Connecticare,Exchange,,15.24,,,15.24,11.67,18.06,other,Could be inpatient or outpatient,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,Multiplan,Multiplan,,,17.53640777,,17.53640777,11.67,17.53640777,percent of total billed charges,,
HC MERIT DRAINAGE DEPOT BAG 300097,27200483,RC,,,both,,,20.63106796,12.75,United Healthcare/Oxford,United Healthcare/Oxford,,14.67,,,14.67,11.67,18.06,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Aetna,Commerical,,11.74,,,11.74,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Aetna,Middlesex Employees,,10.57,,,10.57,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Anthem,Commerical,,10.52,,,10.52,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Anthem,Indemnity,,,11.16589515,,11.16589515,8.41,13.01,percent of total billed charges,,13.01
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Anthem,State Preferred,,10.52,,,10.52,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Anthem,Individual Exchange,,8.41,,,8.41,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Cigna,Cigna,,10.26,,,10.26,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Connecticare,Commerical,,10.98,,,10.98,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Connecticare,Exchange,,10.98,,,10.98,8.41,13.01,other,Could be inpatient or outpatient,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,Multiplan,Multiplan,,,12.63446602,,12.63446602,8.41,12.63446602,percent of total billed charges,,
HC BIOPSY GRID 530234,27200484,RC,,,both,,,14.86407767,9.18,United Healthcare/Oxford,United Healthcare/Oxford,,10.57,,,10.57,8.41,13.01,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Aetna,Commerical,,27.64,,,27.64,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Aetna,Middlesex Employees,,24.88,,,24.88,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Anthem,Commerical,,24.73,,,24.73,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Anthem,Indemnity,,,26.27012039,,26.27012039,19.78,30.62,percent of total billed charges,,30.62
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Anthem,State Preferred,,24.73,,,24.73,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Anthem,Individual Exchange,,19.78,,,19.78,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Cigna,Cigna,,24.15,,,24.15,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Connecticare,Commerical,,25.83,,,25.83,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Connecticare,Exchange,,25.83,,,25.83,19.78,30.62,other,Could be inpatient or outpatient,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,Multiplan,Multiplan,,,29.72524272,,29.72524272,19.78,29.72524272,percent of total billed charges,,
HC SYRING 309735,27200487,RC,,,both,,,34.97087379,21.61,United Healthcare/Oxford,United Healthcare/Oxford,,24.85,,,24.85,19.78,30.62,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Aetna,Commerical,,66.76,,,66.76,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Aetna,Middlesex Employees,,60.08,,,60.08,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Anthem,Commerical,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Anthem,Indemnity,,,65.3471068,,65.3471068,47.79,73.94,percent of total billed charges,,73.94
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Anthem,State Preferred,,59.73,,,59.73,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Anthem,Individual Exchange,,47.79,,,47.79,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Cigna,Cigna,,58.33,,,58.33,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Connecticare,Commerical,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Connecticare,Exchange,,62.39,,,62.39,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,Multiplan,Multiplan,,,73.94174757,,73.94174757,47.79,73.94174757,percent of total billed charges,,
HC TUBE GASTRO FEEDING 18FR 307118,27200490,RC,,,both,,,86.99029126,53.76,United Healthcare/Oxford,United Healthcare/Oxford,,60.04,,,60.04,47.79,73.94,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Aetna,Commerical,,289.81,,,289.81,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Aetna,Middlesex Employees,,260.83,,,260.83,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Anthem,Commerical,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Anthem,Indemnity,,,283.7129243,,283.7129243,207.46,321.03,percent of total billed charges,,321.03
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Anthem,State Preferred,,259.32,,,259.32,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Anthem,Individual Exchange,,207.46,,,207.46,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Cigna,Cigna,,253.26,,,253.26,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Connecticare,Commerical,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Connecticare,Exchange,,270.87,,,270.87,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,Multiplan,Multiplan,,,321.0276699,,321.0276699,207.46,321.0276699,percent of total billed charges,,
HC TUBE GASTRO-ENTERIC FEEDING 16FR 555646,27200491,RC,,,both,,,377.6796117,233.41,United Healthcare/Oxford,United Healthcare/Oxford,,260.64,,,260.64,207.46,321.03,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Aetna,Commerical,,162.82,,,162.82,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Aetna,Middlesex Employees,,146.54,,,146.54,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Anthem,Commerical,,145.69,,,145.69,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Anthem,Indemnity,,,159.3929709,,159.3929709,116.55,180.35,percent of total billed charges,,180.35
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Anthem,State Preferred,,145.69,,,145.69,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Anthem,Individual Exchange,,116.55,,,116.55,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Cigna,Cigna,,142.28,,,142.28,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Connecticare,Commerical,,152.18,,,152.18,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Connecticare,Exchange,,152.18,,,152.18,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,Multiplan,Multiplan,,,180.3567961,,180.3567961,116.55,180.3567961,percent of total billed charges,,
HC TUBE MIC-GAST LP FEEDING 14FR 555662,27200492,RC,,,both,,,212.184466,131.13,United Healthcare/Oxford,United Healthcare/Oxford,,146.42,,,146.42,116.55,180.35,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Aetna,Commerical,,185.61,,,185.61,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Aetna,Middlesex Employees,,167.05,,,167.05,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Anthem,Commerical,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Anthem,Indemnity,,,181.7101748,,181.7101748,132.87,205.61,percent of total billed charges,,205.61
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Anthem,State Preferred,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Anthem,Individual Exchange,,132.87,,,132.87,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Cigna,Cigna,,162.2,,,162.2,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Connecticare,Commerical,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Connecticare,Exchange,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,Multiplan,Multiplan,,,205.6092233,,205.6092233,132.87,205.6092233,percent of total billed charges,,
HC TUBE MIC-GAST LP FEEDING 16FR 003838,27200493,RC,,,both,,,241.8932039,149.49,United Healthcare/Oxford,United Healthcare/Oxford,,166.92,,,166.92,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Aetna,Commerical,,185.61,,,185.61,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Aetna,Middlesex Employees,,167.05,,,167.05,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Anthem,Commerical,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Anthem,Indemnity,,,181.7101748,,181.7101748,132.87,205.61,percent of total billed charges,,205.61
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Anthem,State Preferred,,166.09,,,166.09,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Anthem,Individual Exchange,,132.87,,,132.87,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Cigna,Cigna,,162.2,,,162.2,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Connecticare,Commerical,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Connecticare,Exchange,,173.49,,,173.49,132.87,205.61,other,Could be inpatient or outpatient,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,Multiplan,Multiplan,,,205.6092233,,205.6092233,132.87,205.6092233,percent of total billed charges,,
HC TUBE MIC-GAST LP FEEDING 18FR 000819,27200494,RC,,,both,,,241.8932039,149.49,United Healthcare/Oxford,United Healthcare/Oxford,,166.92,,,166.92,132.87,205.61,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Aetna,Commerical,,86.3,,,86.3,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Aetna,Middlesex Employees,,77.67,,,77.67,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Anthem,Commerical,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Anthem,Indemnity,,,81.8808,,81.8808,61.77,95.59,percent of total billed charges,,95.59
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Anthem,State Preferred,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Anthem,Individual Exchange,,61.77,,,61.77,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Cigna,Cigna,,75.41,,,75.41,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Connecticare,Commerical,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Connecticare,Exchange,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,Multiplan,Multiplan,,,92.65,,92.65,61.77,92.65,percent of total billed charges,,
HC BIOPINCE FULL CORE BX NEEDLE 18GX 10CM #000313,27200495,RC,,,both,,,109,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,77.61,,,77.61,61.77,95.59,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Aetna,Commerical,,29.36,,,29.36,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Aetna,Middlesex Employees,,26.43,,,26.43,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Anthem,Commerical,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Anthem,Indemnity,,,27.90379806,,27.90379806,21.02,32.53,percent of total billed charges,,32.53
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Anthem,State Preferred,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Anthem,Individual Exchange,,21.02,,,21.02,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Cigna,Cigna,,25.66,,,25.66,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Connecticare,Commerical,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Connecticare,Exchange,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,Multiplan,Multiplan,,,31.57378641,,31.57378641,21.02,31.57378641,percent of total billed charges,,
HC COAXIAL INTRODUCER NEEDLE 17G X 6.8CM  #000314,27200496,RC,,,both,,,37.14563107,22.96,United Healthcare/Oxford,United Healthcare/Oxford,,26.41,,,26.41,21.02,32.53,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Aetna,Commerical,,86.3,,,86.3,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Aetna,Middlesex Employees,,77.67,,,77.67,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Anthem,Commerical,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Anthem,Indemnity,,,81.8808,,81.8808,61.77,95.59,percent of total billed charges,,95.59
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Anthem,State Preferred,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Anthem,Individual Exchange,,61.77,,,61.77,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Cigna,Cigna,,75.41,,,75.41,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Connecticare,Commerical,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Connecticare,Exchange,,80.66,,,80.66,61.77,95.59,other,Could be inpatient or outpatient,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,Multiplan,Multiplan,,,92.65,,92.65,61.77,92.65,percent of total billed charges,,
HC BIOPINCE BX NEEDLE 18GX 15CM #322515,27200497,RC,,,both,,,109,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,77.61,,,77.61,61.77,95.59,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Aetna,Commerical,,29.36,,,29.36,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Aetna,Middlesex Employees,,26.43,,,26.43,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Anthem,Commerical,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Anthem,Indemnity,,,27.90379806,,27.90379806,21.02,32.53,percent of total billed charges,,32.53
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Anthem,State Preferred,,26.28,,,26.28,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Anthem,Individual Exchange,,21.02,,,21.02,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Cigna,Cigna,,25.66,,,25.66,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Connecticare,Commerical,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Connecticare,Exchange,,27.44,,,27.44,21.02,32.53,other,Could be inpatient or outpatient,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,Multiplan,Multiplan,,,31.57378641,,31.57378641,21.02,31.57378641,percent of total billed charges,,
HC COAXIAL INTRODUCER NEEDLE 17G X 11.8CM  #322516,27200498,RC,,,both,,,37.14563107,22.96,United Healthcare/Oxford,United Healthcare/Oxford,,26.41,,,26.41,21.02,32.53,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Aetna,Commerical,,10.88,,,10.88,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Aetna,Middlesex Employees,,9.79,,,9.79,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Anthem,Commerical,,9.74,,,9.74,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Anthem,Indemnity,,,10.34176311,,10.34176311,7.79,12.05,percent of total billed charges,,12.05
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Anthem,State Preferred,,9.74,,,9.74,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Anthem,Individual Exchange,,7.79,,,7.79,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Cigna,Cigna,,9.52,,,9.52,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Connecticare,Commerical,,10.18,,,10.18,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Connecticare,Exchange,,10.18,,,10.18,7.79,12.05,other,Could be inpatient or outpatient,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,Multiplan,Multiplan,,,11.70194175,,11.70194175,7.79,11.70194175,percent of total billed charges,,
HC EVACUATED BOTTLES  #220002,27200499,RC,,,both,,,13.76699029,8.51,United Healthcare/Oxford,United Healthcare/Oxford,,9.79,,,9.79,7.79,12.05,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Aetna,Commerical,,20.73,,,20.73,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Aetna,Middlesex Employees,,18.66,,,18.66,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Anthem,Commerical,,18.55,,,18.55,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Anthem,Indemnity,,,19.69894369,,19.69894369,14.84,22.96,percent of total billed charges,,22.96
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Anthem,State Preferred,,18.55,,,18.55,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Anthem,Individual Exchange,,14.84,,,14.84,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Cigna,Cigna,,18.12,,,18.12,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Connecticare,Commerical,,19.37,,,19.37,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Connecticare,Exchange,,19.37,,,19.37,14.84,22.96,other,Could be inpatient or outpatient,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,Multiplan,Multiplan,,,22.28980583,,22.28980583,14.84,22.28980583,percent of total billed charges,,
HC SM ANGIOCATH 4F 40CM  #579032,27200500,RC,,,both,,,26.22330097,16.2,United Healthcare/Oxford,United Healthcare/Oxford,,18.64,,,18.64,14.84,22.96,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Aetna,Commerical,,20.13,,,20.13,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Aetna,Middlesex Employees,,18.12,,,18.12,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Anthem,Commerical,,18.01,,,18.01,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Anthem,Indemnity,,,19.12278058,,19.12278058,14.41,22.3,percent of total billed charges,,22.3
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Anthem,State Preferred,,18.01,,,18.01,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Anthem,Individual Exchange,,14.41,,,14.41,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Cigna,Cigna,,17.59,,,17.59,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Connecticare,Commerical,,18.8,,,18.8,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Connecticare,Exchange,,18.8,,,18.8,14.41,22.3,other,Could be inpatient or outpatient,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,Multiplan,Multiplan,,,21.63786408,,21.63786408,14.41,21.63786408,percent of total billed charges,,
HC OXIMETER NEO SOMA 005434,27200502,RC,,,both,,,25.45631068,15.73,United Healthcare/Oxford,United Healthcare/Oxford,,18.1,,,18.1,14.41,22.3,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Aetna,Commerical,,12.58,,,12.58,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Aetna,Middlesex Employees,,11.32,,,11.32,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Anthem,Commerical,,11.25,,,11.25,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Anthem,Indemnity,,,11.95356117,,11.95356117,9,13.93,percent of total billed charges,,13.93
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Anthem,State Preferred,,11.25,,,11.25,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Anthem,Individual Exchange,,9,,,9,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Cigna,Cigna,,10.99,,,10.99,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Connecticare,Commerical,,11.76,,,11.76,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Connecticare,Exchange,,11.76,,,11.76,9,13.93,other,Could be inpatient or outpatient,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,Multiplan,Multiplan,,,13.52572816,,13.52572816,9,13.52572816,percent of total billed charges,,
HC NEEDLE LP 22G X 120MM; SPR SPROTTE,27200503,RC,,,both,,,15.91262136,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,11.31,,,11.31,9,13.93,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Anthem,Indemnity,,,43.83215534,,43.83215534,32.05,49.6,percent of total billed charges,,49.6
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,Multiplan,Multiplan,,,49.59708738,,49.59708738,32.05,49.59708738,percent of total billed charges,,
HC COOK CATH  UDS 7 FR 30 CM  G15429,27200504,RC,,,both,,,58.34951456,36.06,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Anthem,Indemnity,,,42.8184,,42.8184,32.05,49.6,percent of total billed charges,,49.6
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,Multiplan,Multiplan,,,48.45,,48.45,32.05,48.45,percent of total billed charges,,
HC COOK UDS 5 FR G17318,27200505,RC,,,both,,,57,35.23,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Aetna,Commerical,,24.45,,,24.45,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Aetna,Middlesex Employees,,22.01,,,22.01,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Anthem,Commerical,,21.88,,,21.88,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Anthem,Indemnity,,,23.23614757,,23.23614757,17.5,27.08,percent of total billed charges,,27.08
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Anthem,State Preferred,,21.88,,,21.88,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Anthem,Individual Exchange,,17.5,,,17.5,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Cigna,Cigna,,21.36,,,21.36,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Connecticare,Commerical,,22.85,,,22.85,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Connecticare,Exchange,,22.85,,,22.85,17.5,27.08,other,Could be inpatient or outpatient,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,Multiplan,Multiplan,,,26.29223301,,26.29223301,17.5,26.29223301,percent of total billed charges,,
HC SKIN TEMP DRAGER 308695,27200508,RC,,,both,,,30.93203883,19.11,United Healthcare/Oxford,United Healthcare/Oxford,,21.99,,,21.99,17.5,27.08,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Aetna,Commerical,,21.83,,,21.83,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Aetna,Middlesex Employees,,19.65,,,19.65,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Anthem,Commerical,,19.54,,,19.54,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Anthem,Indemnity,,,20.74916505,,20.74916505,15.63,24.18,percent of total billed charges,,24.18
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Anthem,State Preferred,,19.54,,,19.54,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Anthem,Individual Exchange,,15.63,,,15.63,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Cigna,Cigna,,19.08,,,19.08,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Connecticare,Commerical,,20.4,,,20.4,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Connecticare,Exchange,,20.4,,,20.4,15.63,24.18,other,Could be inpatient or outpatient,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,Multiplan,Multiplan,,,23.47815534,,23.47815534,15.63,23.47815534,percent of total billed charges,,
HC SMARTSITE BLOOD SET 575777,27200509,RC,,,both,,,27.62135922,17.07,United Healthcare/Oxford,United Healthcare/Oxford,,19.63,,,19.63,15.63,24.18,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Aetna,Commerical,,22.41,,,22.41,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Aetna,Middlesex Employees,,20.17,,,20.17,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Anthem,Commerical,,20.06,,,20.06,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Anthem,Indemnity,,,21.30344854,,21.30344854,16.04,24.83,percent of total billed charges,,24.83
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Anthem,State Preferred,,20.06,,,20.06,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Anthem,Individual Exchange,,16.04,,,16.04,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Cigna,Cigna,,19.58,,,19.58,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Connecticare,Commerical,,20.95,,,20.95,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Connecticare,Exchange,,20.95,,,20.95,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,Multiplan,Multiplan,,,24.10533981,,24.10533981,16.04,24.10533981,percent of total billed charges,,
HC SUTURE GUT PLN 5-018IN PC1 YEL  481838,27200510,RC,,,both,,,28.3592233,17.53,United Healthcare/Oxford,United Healthcare/Oxford,,20.16,,,20.16,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Aetna,Commerical,,11.65,,,11.65,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Aetna,Middlesex Employees,,10.48,,,10.48,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Anthem,Commerical,,10.42,,,10.42,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Anthem,Indemnity,,,11.0710835,,11.0710835,8.34,12.9,percent of total billed charges,,12.9
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Anthem,State Preferred,,10.42,,,10.42,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Anthem,Individual Exchange,,8.34,,,8.34,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Cigna,Cigna,,10.18,,,10.18,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Connecticare,Commerical,,10.89,,,10.89,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Connecticare,Exchange,,10.89,,,10.89,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,Multiplan,Multiplan,,,12.52718447,,12.52718447,8.34,12.52718447,percent of total billed charges,,
HC SUTURE ETH 5-0 PS-2 18 GRN 484158,27200511,RC,,,both,,,14.73786408,9.11,United Healthcare/Oxford,United Healthcare/Oxford,,10.48,,,10.48,8.34,12.9,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Aetna,Commerical,,11.95,,,11.95,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Aetna,Middlesex Employees,,10.75,,,10.75,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Anthem,Commerical,,10.69,,,10.69,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Anthem,Indemnity,,,11.35551845,,11.35551845,8.55,13.23,percent of total billed charges,,13.23
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Anthem,State Preferred,,10.69,,,10.69,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Anthem,Individual Exchange,,8.55,,,8.55,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Cigna,Cigna,,10.44,,,10.44,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Connecticare,Commerical,,11.17,,,11.17,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Connecticare,Exchange,,11.17,,,11.17,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,Multiplan,Multiplan,,,12.84902913,,12.84902913,8.55,12.84902913,percent of total billed charges,,
HC SUTURE ETHLN 5-0 18IN P3 GRN 484159,27200512,RC,,,both,,,15.11650485,9.34,United Healthcare/Oxford,United Healthcare/Oxford,,10.74,,,10.74,8.55,13.23,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Aetna,Commerical,,11.87,,,11.87,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Aetna,Middlesex Employees,,10.68,,,10.68,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Anthem,Commerical,,10.62,,,10.62,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Anthem,Indemnity,,,11.28258641,,11.28258641,8.5,13.15,percent of total billed charges,,13.15
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Anthem,State Preferred,,10.62,,,10.62,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Anthem,Individual Exchange,,8.5,,,8.5,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Cigna,Cigna,,10.37,,,10.37,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Connecticare,Commerical,,11.1,,,11.1,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Connecticare,Exchange,,11.1,,,11.1,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,Multiplan,Multiplan,,,12.76650485,,12.76650485,8.5,12.76650485,percent of total billed charges,,
HC SUTURE ETHLN 3-0 18IN PS1 BLK 484167,27200513,RC,,,both,,,15.01941748,9.28,United Healthcare/Oxford,United Healthcare/Oxford,,10.67,,,10.67,8.5,13.15,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Aetna,Commerical,,16.2,,,16.2,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Aetna,Middlesex Employees,,14.58,,,14.58,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Anthem,Commerical,,14.5,,,14.5,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Anthem,Indemnity,,,15.4032466,,15.4032466,11.6,17.94,percent of total billed charges,,17.94
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Anthem,State Preferred,,14.5,,,14.5,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Anthem,Individual Exchange,,11.6,,,11.6,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Cigna,Cigna,,14.15,,,14.15,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Connecticare,Commerical,,15.14,,,15.14,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Connecticare,Exchange,,15.14,,,15.14,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,Multiplan,Multiplan,,,17.42912621,,17.42912621,11.6,17.42912621,percent of total billed charges,,
HC SUTURE MNCRL 5-0 P-3 18IN 484376,27200514,RC,,,both,,,20.50485437,12.67,United Healthcare/Oxford,United Healthcare/Oxford,,14.56,,,14.56,11.6,17.94,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Aetna,Commerical,,22.41,,,22.41,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Aetna,Middlesex Employees,,20.17,,,20.17,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Anthem,Commerical,,20.06,,,20.06,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Anthem,Indemnity,,,21.30344854,,21.30344854,16.04,24.83,percent of total billed charges,,24.83
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Anthem,State Preferred,,20.06,,,20.06,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Anthem,Individual Exchange,,16.04,,,16.04,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Cigna,Cigna,,19.58,,,19.58,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Connecticare,Commerical,,20.95,,,20.95,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Connecticare,Exchange,,20.95,,,20.95,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,Multiplan,Multiplan,,,24.10533981,,24.10533981,16.04,24.10533981,percent of total billed charges,,
HC SUTURE GUT PLN 6-0 18IN PC1 YEL 481736,27200515,RC,,,both,,,28.3592233,17.53,United Healthcare/Oxford,United Healthcare/Oxford,,20.16,,,20.16,16.04,24.83,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Aetna,Commerical,,12.32,,,12.32,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Aetna,Middlesex Employees,,11.09,,,11.09,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Anthem,Commerical,,11.03,,,11.03,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Anthem,Indemnity,,,11.71288544,,11.71288544,8.83,13.65,percent of total billed charges,,13.65
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Anthem,State Preferred,,11.03,,,11.03,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Anthem,Individual Exchange,,8.83,,,8.83,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Cigna,Cigna,,10.77,,,10.77,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Connecticare,Commerical,,11.52,,,11.52,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Connecticare,Exchange,,11.52,,,11.52,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,Multiplan,Multiplan,,,13.25339806,,13.25339806,8.83,13.25339806,percent of total billed charges,,
HC SUTURE ETHLN 6-0 18IN P1 GRN 484485,27200516,RC,,,both,,,15.59223301,9.63,United Healthcare/Oxford,United Healthcare/Oxford,,11.08,,,11.08,8.83,13.65,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Aetna,Commerical,,21.18,,,21.18,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Aetna,Middlesex Employees,,19.06,,,19.06,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Anthem,Commerical,,18.95,,,18.95,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Anthem,Indemnity,,,20.12924272,,20.12924272,15.16,23.46,percent of total billed charges,,23.46
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Anthem,State Preferred,,18.95,,,18.95,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Anthem,Individual Exchange,,15.16,,,15.16,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Cigna,Cigna,,18.51,,,18.51,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Connecticare,Commerical,,19.8,,,19.8,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Connecticare,Exchange,,19.8,,,19.8,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,Multiplan,Multiplan,,,22.77669903,,22.77669903,15.16,22.77669903,percent of total billed charges,,
HC SUTURE CHROMIC 6-0 18IN PS3 BRN 484337,27200517,RC,,,both,,,26.7961165,16.56,United Healthcare/Oxford,United Healthcare/Oxford,,19.06,,,19.06,15.16,23.46,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Aetna,Commerical,,17.31,,,17.31,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Aetna,Middlesex Employees,,15.58,,,15.58,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Anthem,Commerical,,15.48,,,15.48,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Anthem,Indemnity,,,16.45346796,,16.45346796,12.39,19.17,percent of total billed charges,,19.17
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Anthem,State Preferred,,15.48,,,15.48,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Anthem,Individual Exchange,,12.39,,,12.39,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Cigna,Cigna,,15.12,,,15.12,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Connecticare,Commerical,,16.17,,,16.17,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Connecticare,Exchange,,16.17,,,16.17,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,Multiplan,Multiplan,,,18.61747573,,18.61747573,12.39,18.61747573,percent of total billed charges,,
HC SUTURE 4-0 PERMA-HAND SILK 579073,27200518,RC,,,both,,,21.90291262,13.53,United Healthcare/Oxford,United Healthcare/Oxford,,15.56,,,15.56,12.39,19.17,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Aetna,Commerical,,14.89,,,14.89,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Aetna,Middlesex Employees,,13.4,,,13.4,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Anthem,Commerical,,13.32,,,13.32,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Anthem,Indemnity,,,14.15610874,,14.15610874,10.66,16.49,percent of total billed charges,,16.49
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Anthem,State Preferred,,13.32,,,13.32,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Anthem,Individual Exchange,,10.66,,,10.66,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Cigna,Cigna,,13.01,,,13.01,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Connecticare,Commerical,,13.91,,,13.91,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Connecticare,Exchange,,13.91,,,13.91,10.66,16.49,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,Multiplan,Multiplan,,,16.01796117,,16.01796117,10.66,16.01796117,percent of total billed charges,,
HC SUTURE MNCRL 5-0 PS-2 18IN 484362,27200519,RC,,,both,,,18.84466019,11.64,United Healthcare/Oxford,United Healthcare/Oxford,,13.39,,,13.39,10.66,16.49,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Aetna,Commerical,,38.97,,,38.97,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Aetna,Middlesex Employees,,35.07,,,35.07,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Anthem,Commerical,,34.86,,,34.86,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Anthem,Indemnity,,,38.13616311,,38.13616311,27.88,43.15,percent of total billed charges,,43.15
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Anthem,State Preferred,,34.86,,,34.86,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Anthem,Individual Exchange,,27.88,,,27.88,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Cigna,Cigna,,34.05,,,34.05,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Connecticare,Commerical,,36.41,,,36.41,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Connecticare,Exchange,,36.41,,,36.41,27.88,43.15,other,Could be inpatient or outpatient,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,Multiplan,Multiplan,,,43.15194175,,43.15194175,27.88,43.15194175,percent of total billed charges,,
HC CATH BALLARD SUCT 12FR 14FR #461719 461718,27200521,RC,,,both,,,50.76699029,31.38,United Healthcare/Oxford,United Healthcare/Oxford,,35.04,,,35.04,27.88,43.15,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Aetna,Commerical,,20.75,,,20.75,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Aetna,Middlesex Employees,,18.68,,,18.68,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Anthem,Commerical,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Anthem,Indemnity,,,19.7208233,,19.7208233,14.85,22.98,percent of total billed charges,,22.98
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Anthem,State Preferred,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Anthem,Individual Exchange,,14.85,,,14.85,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Cigna,Cigna,,18.14,,,18.14,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Connecticare,Commerical,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Connecticare,Exchange,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,Multiplan,Multiplan,,,22.31456311,,22.31456311,14.85,22.31456311,percent of total billed charges,,
HC SUTURE CHROMIC 5-0 18IN P3 BRN,27200522,RC,,,both,,,26.25242718,16.22,United Healthcare/Oxford,United Healthcare/Oxford,,18.66,,,18.66,14.85,22.98,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Aetna,Commerical,,16,,,16,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Aetna,Middlesex Employees,,14.39,,,14.39,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Anthem,Commerical,,14.31,,,14.31,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Anthem,Indemnity,,,15.2063301,,15.2063301,11.45,17.72,percent of total billed charges,,17.72
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Anthem,State Preferred,,14.31,,,14.31,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Anthem,Individual Exchange,,11.45,,,11.45,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Cigna,Cigna,,13.98,,,13.98,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Connecticare,Commerical,,14.96,,,14.96,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Connecticare,Exchange,,14.96,,,14.96,11.45,17.72,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,Multiplan,Multiplan,,,17.20631068,,17.20631068,11.45,17.20631068,percent of total billed charges,,
HC SUTURE MNCRL 4-0 PS-2 18IN,27200523,RC,,,both,,,20.24271845,12.51,United Healthcare/Oxford,United Healthcare/Oxford,,14.39,,,14.39,11.45,17.72,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Aetna,Commerical,,12.48,,,12.48,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Aetna,Middlesex Employees,,11.24,,,11.24,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Anthem,Commerical,,11.17,,,11.17,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Anthem,Indemnity,,,11.85874951,,11.85874951,8.93,13.82,percent of total billed charges,,13.82
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Anthem,State Preferred,,11.17,,,11.17,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Anthem,Individual Exchange,,8.93,,,8.93,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Cigna,Cigna,,10.91,,,10.91,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Connecticare,Commerical,,11.66,,,11.66,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Connecticare,Exchange,,11.66,,,11.66,8.93,13.82,other,Could be inpatient or outpatient,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,Multiplan,Multiplan,,,13.4184466,,13.4184466,8.93,13.4184466,percent of total billed charges,,
HC CAP DRESSING CHANGE KIT,27200525,RC,,,both,,,15.78640777,9.76,United Healthcare/Oxford,United Healthcare/Oxford,,11.23,,,11.23,8.93,13.82,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Aetna,Commerical,,36.86,,,36.86,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Aetna,Middlesex Employees,,33.18,,,33.18,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Anthem,Commerical,,30.59,,,30.59,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Anthem,Indemnity,,,39.0624,,39.0624,24.48,44.2,percent of total billed charges,,44.2
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Anthem,State Preferred,,30.59,,,30.59,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Anthem,Individual Exchange,,24.48,,,24.48,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Cigna,Cigna,,32.48,,,32.48,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Connecticare,Commerical,,33.32,,,33.32,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Connecticare,Exchange,,33.32,,,33.32,24.48,44.2,other,Could be inpatient or outpatient,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,Multiplan,Multiplan,,,44.2,,44.2,24.48,44.2,percent of total billed charges,,
HC PEDI/ADULT DRESSING CHARGE,27200526,RC,,,both,,,52,32.14,United Healthcare/Oxford,United Healthcare/Oxford,,34.15,,,34.15,24.48,44.2,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Aetna,Commerical,,11.04,,,11.04,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Aetna,Middlesex Employees,,9.94,,,9.94,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Anthem,Commerical,,9.88,,,9.88,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Anthem,Indemnity,,,10.50221359,,10.50221359,7.91,12.24,percent of total billed charges,,12.24
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Anthem,State Preferred,,9.88,,,9.88,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Anthem,Individual Exchange,,7.91,,,7.91,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Cigna,Cigna,,9.65,,,9.65,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Connecticare,Commerical,,10.32,,,10.32,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Connecticare,Exchange,,10.32,,,10.32,7.91,12.24,other,Could be inpatient or outpatient,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,Multiplan,Multiplan,,,11.88349515,,11.88349515,7.91,11.88349515,percent of total billed charges,,
HC NICU DRESSING KIT,27200527,RC,,,both,,,13.98058252,8.64,United Healthcare/Oxford,United Healthcare/Oxford,,9.94,,,9.94,7.91,12.24,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Aetna,Commerical,,50.48,,,50.48,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Aetna,Middlesex Employees,,45.43,,,45.43,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Anthem,Commerical,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Anthem,Indemnity,,,48.0768,,48.0768,36.13,55.91,percent of total billed charges,,55.91
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Anthem,State Preferred,,45.17,,,45.17,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Anthem,Individual Exchange,,36.13,,,36.13,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Cigna,Cigna,,44.11,,,44.11,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Connecticare,Commerical,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Connecticare,Exchange,,47.18,,,47.18,36.13,55.91,other,Could be inpatient or outpatient,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,Multiplan,Multiplan,,,54.4,,54.4,36.13,54.4,percent of total billed charges,,
HC BAG / TUBING CHANGE,27200528,RC,,,both,,,64,39.55,United Healthcare/Oxford,United Healthcare/Oxford,,45.39,,,45.39,36.13,55.91,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Aetna,Commerical,,100.13,,,100.13,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Aetna,Middlesex Employees,,90.12,,,90.12,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Anthem,Commerical,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Anthem,Indemnity,,,95.4024,,95.4024,71.68,110.92,percent of total billed charges,,110.92
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Anthem,State Preferred,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Anthem,Individual Exchange,,71.68,,,71.68,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Cigna,Cigna,,87.51,,,87.51,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Connecticare,Commerical,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Connecticare,Exchange,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,Multiplan,Multiplan,,,107.95,,107.95,71.68,107.95,percent of total billed charges,,
HC SYRINGE / TUBING CHANGE,27200529,RC,,,both,,,127,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,90.05,,,90.05,71.68,110.92,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Aetna,Commerical,,76.52,,,76.52,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Aetna,Middlesex Employees,,68.87,,,68.87,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Anthem,Commerical,,68.48,,,68.48,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Anthem,Indemnity,,,72.8664,,72.8664,54.78,84.76,percent of total billed charges,,84.76
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Anthem,State Preferred,,68.48,,,68.48,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Anthem,Individual Exchange,,54.78,,,54.78,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Cigna,Cigna,,66.87,,,66.87,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Connecticare,Commerical,,71.52,,,71.52,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Connecticare,Exchange,,71.52,,,71.52,54.78,84.76,other,Could be inpatient or outpatient,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,Multiplan,Multiplan,,,82.45,,82.45,54.78,82.45,percent of total billed charges,,
HC HAL / IL CHANGE KIT,27200530,RC,,,both,,,97,59.95,United Healthcare/Oxford,United Healthcare/Oxford,,68.82,,,68.82,54.78,84.76,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Aetna,Commerical,,23.65,,,23.65,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Aetna,Middlesex Employees,,21.28,,,21.28,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Anthem,Commerical,,21.17,,,21.17,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Anthem,Indemnity,,,22.47765437,,22.47765437,16.93,26.2,percent of total billed charges,,26.2
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Anthem,State Preferred,,21.17,,,21.17,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Anthem,Individual Exchange,,16.93,,,16.93,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Cigna,Cigna,,20.66,,,20.66,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Connecticare,Commerical,,22.11,,,22.11,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Connecticare,Exchange,,22.11,,,22.11,16.93,26.2,other,Could be inpatient or outpatient,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,Multiplan,Multiplan,,,25.43398058,,25.43398058,16.93,25.43398058,percent of total billed charges,,
HC MEDLINE CHANGE KIT,27200531,RC,,,both,,,29.9223301,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,21.27,,,21.27,16.93,26.2,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Aetna,Commerical,,60.24,,,60.24,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Aetna,Middlesex Employees,,54.22,,,54.22,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Anthem,Commerical,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Anthem,Indemnity,,,57.0912,,57.0912,43.12,66.73,percent of total billed charges,,66.73
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Anthem,State Preferred,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Anthem,Individual Exchange,,43.12,,,43.12,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Cigna,Cigna,,52.64,,,52.64,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Connecticare,Commerical,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Connecticare,Exchange,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,Multiplan,Multiplan,,,64.6,,64.6,43.12,64.6,percent of total billed charges,,
HC PRESSURE LINE CHANGE KIT PEDI,27200532,RC,,,both,,,76,46.97,United Healthcare/Oxford,United Healthcare/Oxford,,54.18,,,54.18,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Aetna,Commerical,,60.24,,,60.24,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Aetna,Middlesex Employees,,54.22,,,54.22,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Anthem,Commerical,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Anthem,Indemnity,,,57.0912,,57.0912,43.12,66.73,percent of total billed charges,,66.73
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Anthem,State Preferred,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Anthem,Individual Exchange,,43.12,,,43.12,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Cigna,Cigna,,52.64,,,52.64,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Connecticare,Commerical,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Connecticare,Exchange,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,Multiplan,Multiplan,,,64.6,,64.6,43.12,64.6,percent of total billed charges,,
HC PRESSURE LINE CHANGE KIT INFANT,27200533,RC,,,both,,,76,46.97,United Healthcare/Oxford,United Healthcare/Oxford,,54.18,,,54.18,43.12,66.73,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Aetna,Commerical,,129.75,,,129.75,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Aetna,Middlesex Employees,,116.78,,,116.78,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Anthem,Commerical,,107.68,,,107.68,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Anthem,Indemnity,,,137.4696,,137.4696,86.14,155.55,percent of total billed charges,,155.55
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Anthem,State Preferred,,107.68,,,107.68,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Anthem,Individual Exchange,,86.14,,,86.14,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Cigna,Cigna,,114.29,,,114.29,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Connecticare,Commerical,,117.24,,,117.24,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Connecticare,Exchange,,117.24,,,117.24,86.14,155.55,other,Could be inpatient or outpatient,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,Multiplan,Multiplan,,,155.55,,155.55,86.14,155.55,percent of total billed charges,,
HC CATHERIZATION KIT W/O CATH #580675,27200535,RC,,,both,,,183,113.09,United Healthcare/Oxford,United Healthcare/Oxford,,120.18,,,120.18,86.14,155.55,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Aetna,Commerical,,29.78,,,29.78,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Aetna,Middlesex Employees,,26.81,,,26.81,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Anthem,Commerical,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Anthem,Indemnity,,,31.5504,,31.5504,19.77,35.7,percent of total billed charges,,35.7
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Anthem,State Preferred,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Anthem,Individual Exchange,,19.77,,,19.77,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Cigna,Cigna,,26.23,,,26.23,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Connecticare,Commerical,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Connecticare,Exchange,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,Multiplan,Multiplan,,,35.7,,35.7,19.77,35.7,percent of total billed charges,,
HC CATH UMBILICAL POLY 5.0FR #580676,27200536,RC,,,both,,,42,25.96,United Healthcare/Oxford,United Healthcare/Oxford,,27.58,,,27.58,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Aetna,Commerical,,29.78,,,29.78,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Aetna,Middlesex Employees,,26.81,,,26.81,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Anthem,Commerical,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Anthem,Indemnity,,,31.5504,,31.5504,19.77,35.7,percent of total billed charges,,35.7
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Anthem,State Preferred,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Anthem,Individual Exchange,,19.77,,,19.77,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Cigna,Cigna,,26.23,,,26.23,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Connecticare,Commerical,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Connecticare,Exchange,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,Multiplan,Multiplan,,,35.7,,35.7,19.77,35.7,percent of total billed charges,,
HC CATH UMBI POLY SGL LUM 2.5FR #580677,27200537,RC,,,both,,,42,25.96,United Healthcare/Oxford,United Healthcare/Oxford,,27.58,,,27.58,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Aetna,Commerical,,29.78,,,29.78,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Aetna,Middlesex Employees,,26.81,,,26.81,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Anthem,Commerical,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Anthem,Indemnity,,,31.5504,,31.5504,19.77,35.7,percent of total billed charges,,35.7
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Anthem,State Preferred,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Anthem,Individual Exchange,,19.77,,,19.77,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Cigna,Cigna,,26.23,,,26.23,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Connecticare,Commerical,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Connecticare,Exchange,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,Multiplan,Multiplan,,,35.7,,35.7,19.77,35.7,percent of total billed charges,,
HC CATH UMBI POLY SGL LUM 3.5FR #580678,27200538,RC,,,both,,,42,25.96,United Healthcare/Oxford,United Healthcare/Oxford,,27.58,,,27.58,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Aetna,Commerical,,29.78,,,29.78,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Aetna,Middlesex Employees,,26.81,,,26.81,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Anthem,Commerical,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Anthem,Indemnity,,,31.5504,,31.5504,19.77,35.7,percent of total billed charges,,35.7
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Anthem,State Preferred,,24.72,,,24.72,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Anthem,Individual Exchange,,19.77,,,19.77,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Cigna,Cigna,,26.23,,,26.23,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Connecticare,Commerical,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Connecticare,Exchange,,26.91,,,26.91,19.77,35.7,other,Could be inpatient or outpatient,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,Multiplan,Multiplan,,,35.7,,35.7,19.77,35.7,percent of total billed charges,,
HC CATH UMBI POLY SGL LUM 5FR 40CM #580679,27200539,RC,,,both,,,42,25.96,United Healthcare/Oxford,United Healthcare/Oxford,,27.58,,,27.58,19.77,35.7,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Aetna,Commerical,,31.9,,,31.9,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Aetna,Middlesex Employees,,28.71,,,28.71,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Anthem,Commerical,,26.48,,,26.48,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Anthem,Indemnity,,,33.804,,33.804,21.18,38.25,percent of total billed charges,,38.25
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Anthem,State Preferred,,26.48,,,26.48,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Anthem,Individual Exchange,,21.18,,,21.18,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Cigna,Cigna,,28.1,,,28.1,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Connecticare,Commerical,,28.83,,,28.83,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Connecticare,Exchange,,28.83,,,28.83,21.18,38.25,other,Could be inpatient or outpatient,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,Multiplan,Multiplan,,,38.25,,38.25,21.18,38.25,percent of total billed charges,,
HC KIT DRESSING CHANGE PICC #580680,27200540,RC,,,both,,,45,27.81,United Healthcare/Oxford,United Healthcare/Oxford,,29.55,,,29.55,21.18,38.25,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Aetna,Commerical,,72.32,,,72.32,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Aetna,Middlesex Employees,,65.09,,,65.09,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Anthem,Commerical,,60.02,,,60.02,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Anthem,Indemnity,,,76.6224,,76.6224,48.01,86.7,percent of total billed charges,,86.7
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Anthem,State Preferred,,60.02,,,60.02,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Anthem,Individual Exchange,,48.01,,,48.01,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Cigna,Cigna,,63.7,,,63.7,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Connecticare,Commerical,,65.34,,,65.34,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Connecticare,Exchange,,65.34,,,65.34,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,Multiplan,Multiplan,,,86.7,,86.7,48.01,86.7,percent of total billed charges,,
HC SHEATH INTRODUCER 1.4FR PICC #580681,27200541,RC,,,both,,,102,63.04,United Healthcare/Oxford,United Healthcare/Oxford,,66.99,,,66.99,48.01,86.7,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Aetna,Commerical,,70.19,,,70.19,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Aetna,Middlesex Employees,,63.17,,,63.17,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Anthem,Commerical,,58.25,,,58.25,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Anthem,Indemnity,,,74.3688,,74.3688,46.6,84.15,percent of total billed charges,,84.15
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Anthem,State Preferred,,58.25,,,58.25,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Anthem,Individual Exchange,,46.6,,,46.6,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Cigna,Cigna,,61.83,,,61.83,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Connecticare,Commerical,,63.42,,,63.42,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Connecticare,Exchange,,63.42,,,63.42,46.6,84.15,other,Could be inpatient or outpatient,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,Multiplan,Multiplan,,,84.15,,84.15,46.6,84.15,percent of total billed charges,,
HC SHEATH INTRODUCER 1.9FR PICC #580682,27200542,RC,,,both,,,99,61.18,United Healthcare/Oxford,United Healthcare/Oxford,,65.01,,,65.01,46.6,84.15,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Aetna,Commerical,,207.73,,,207.73,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Aetna,Middlesex Employees,,186.95,,,186.95,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Anthem,Commerical,,172.4,,,172.4,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Anthem,Indemnity,,,220.1016,,220.1016,137.92,249.05,percent of total billed charges,,249.05
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Anthem,State Preferred,,172.4,,,172.4,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Anthem,Individual Exchange,,137.92,,,137.92,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Cigna,Cigna,,182.99,,,182.99,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Connecticare,Commerical,,187.71,,,187.71,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Connecticare,Exchange,,187.71,,,187.71,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,Multiplan,Multiplan,,,249.05,,249.05,137.92,249.05,percent of total billed charges,,
HC KIT COMPLETE POLY PICC 1.4FR #580685,27200543,RC,,,both,,,293,181.07,United Healthcare/Oxford,United Healthcare/Oxford,,192.42,,,192.42,137.92,249.05,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Aetna,Commerical,,202.06,,,202.06,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Aetna,Middlesex Employees,,181.85,,,181.85,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Anthem,Commerical,,167.69,,,167.69,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Anthem,Indemnity,,,214.092,,214.092,134.16,242.25,percent of total billed charges,,242.25
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Anthem,State Preferred,,167.69,,,167.69,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Anthem,Individual Exchange,,134.16,,,134.16,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Cigna,Cigna,,177.99,,,177.99,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Connecticare,Commerical,,182.58,,,182.58,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Connecticare,Exchange,,182.58,,,182.58,134.16,242.25,other,Could be inpatient or outpatient,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,Multiplan,Multiplan,,,242.25,,242.25,134.16,242.25,percent of total billed charges,,
HC KIT COMPLETE POLY PICC 1.9FR #580686,27200544,RC,,,both,,,285,176.13,United Healthcare/Oxford,United Healthcare/Oxford,,187.17,,,187.17,134.16,242.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Aetna,Commerical,,74.44,,,74.44,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Aetna,Middlesex Employees,,67,,,67,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Anthem,Commerical,,61.78,,,61.78,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Anthem,Indemnity,,,78.876,,78.876,49.42,89.25,percent of total billed charges,,89.25
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Anthem,State Preferred,,61.78,,,61.78,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Anthem,Individual Exchange,,49.42,,,49.42,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Cigna,Cigna,,65.57,,,65.57,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Connecticare,Commerical,,67.26,,,67.26,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Connecticare,Exchange,,67.26,,,67.26,49.42,89.25,other,Could be inpatient or outpatient,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,Multiplan,Multiplan,,,89.25,,89.25,49.42,89.25,percent of total billed charges,,
HC CATH UMBILICAL POLY 3.5FR #580687,27200545,RC,,,both,,,105,64.89,United Healthcare/Oxford,United Healthcare/Oxford,,68.96,,,68.96,49.42,89.25,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Aetna,Commerical,,12.55,,,12.55,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Aetna,Middlesex Employees,,12.03,,,12.03,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Anthem,Commerical,,12.12,,,12.12,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Anthem,Indemnity,,,12.03378641,,12.03378641,9.7,14.1,percent of total billed charges,,14.1
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Anthem,State Preferred,,12.12,,,12.12,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Anthem,Individual Exchange,,9.7,,,9.7,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Cigna,Cigna,,14.1,,,14.1,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Connecticare,Commerical,,13.37,,,13.37,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Connecticare,Exchange,,13.37,,,13.37,9.7,14.1,other,Could be inpatient or outpatient,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,Multiplan,Multiplan,,,13.61650485,,13.61650485,9.7,14.1,percent of total billed charges,,
HC  BAG SPIKE 180 - EQ FC-180,27200573,RC,,,both,,,16.01941748,9.9,United Healthcare/Oxford,United Healthcare/Oxford,,11.01,,,11.01,9.7,14.1,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Aetna,Commerical,,13.97,,,13.97,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Aetna,Middlesex Employees,,13.4,,,13.4,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Anthem,Commerical,,13.5,,,13.5,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Anthem,Indemnity,,,13.40490874,,13.40490874,10.8,15.7,percent of total billed charges,,15.7
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Anthem,State Preferred,,13.5,,,13.5,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Anthem,Individual Exchange,,10.8,,,10.8,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Cigna,Cigna,,15.7,,,15.7,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Connecticare,Commerical,,14.89,,,14.89,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Connecticare,Exchange,,14.89,,,14.89,10.8,15.7,other,Could be inpatient or outpatient,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,Multiplan,Multiplan,,,15.16796117,,15.16796117,10.8,15.7,percent of total billed charges,,
HC INTRALIPID FILTER SET - 474000,27200574,RC,,,both,,,17.84466019,11.03,United Healthcare/Oxford,United Healthcare/Oxford,,12.26,,,12.26,10.8,15.7,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Aetna,Commerical,,29.77,,,29.77,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Aetna,Middlesex Employees,,28.55,,,28.55,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Anthem,Commerical,,28.75,,,28.75,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Anthem,Indemnity,,,28.5528932,,28.5528932,23,33.45,percent of total billed charges,,33.45
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Anthem,State Preferred,,28.75,,,28.75,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Anthem,Individual Exchange,,23,,,23,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Cigna,Cigna,,33.45,,,33.45,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Connecticare,Commerical,,31.73,,,31.73,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Connecticare,Exchange,,31.73,,,31.73,23,33.45,other,Could be inpatient or outpatient,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,Multiplan,Multiplan,,,32.30825243,,32.30825243,23,33.45,percent of total billed charges,,
HC SILOUETTE 43MM  #579788,27200576,RC,,,both,,,38.00970874,23.49,United Healthcare/Oxford,United Healthcare/Oxford,,26.11,,,26.11,23,33.45,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Aetna,Commerical,,60.24,,,60.24,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Aetna,Middlesex Employees,,57.77,,,57.77,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Anthem,Commerical,,58.19,,,58.19,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Anthem,Indemnity,,,57.8424,,57.8424,46.55,67.69,percent of total billed charges,,67.69
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Anthem,State Preferred,,58.19,,,58.19,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Anthem,Individual Exchange,,46.55,,,46.55,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Cigna,Cigna,,67.69,,,67.69,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Connecticare,Commerical,,64.21,,,64.21,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Connecticare,Exchange,,64.21,,,64.21,46.55,67.69,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,Multiplan,Multiplan,,,65.45,,65.45,46.55,67.69,percent of total billed charges,,
HC SUBQ MINIMED SILOUETTE 9MM  #579787,27200577,RC,,,both,,,77,47.59,United Healthcare/Oxford,United Healthcare/Oxford,,52.84,,,52.84,46.55,67.69,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Aetna,Commerical,,25.96,,,25.96,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Aetna,Middlesex Employees,,23.37,,,23.37,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Anthem,Commerical,,23.23,,,23.23,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Anthem,Indemnity,,,24.68020194,,24.68020194,18.58,28.76,percent of total billed charges,,28.76
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Anthem,State Preferred,,23.23,,,23.23,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Anthem,Individual Exchange,,18.58,,,18.58,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Cigna,Cigna,,22.68,,,22.68,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Connecticare,Commerical,,24.26,,,24.26,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Connecticare,Exchange,,24.26,,,24.26,18.58,28.76,other,Could be inpatient or outpatient,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,Multiplan,Multiplan,,,27.92621359,,27.92621359,18.58,27.92621359,percent of total billed charges,,
HC LITER NORMAL SALINE BAG #223032,27200600,RC,,,both,,,32.85436893,20.3,United Healthcare/Oxford,United Healthcare/Oxford,,23.35,,,23.35,18.58,28.76,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Aetna,Commerical,,34.46,,,34.46,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Aetna,Middlesex Employees,,31.02,,,31.02,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Anthem,Commerical,,30.83,,,30.83,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Anthem,Indemnity,,,32.75377864,,32.75377864,24.66,38.17,percent of total billed charges,,38.17
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Anthem,State Preferred,,30.83,,,30.83,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Anthem,Individual Exchange,,24.66,,,24.66,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Cigna,Cigna,,30.12,,,30.12,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Connecticare,Commerical,,32.21,,,32.21,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Connecticare,Exchange,,32.21,,,32.21,24.66,38.17,other,Could be inpatient or outpatient,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,Multiplan,Multiplan,,,37.06165049,,37.06165049,24.66,37.06165049,percent of total billed charges,,
HC CENTRUSIL LIQUID BICARBONATE  #67753002,27200605,RC,,,both,,,43.60194175,26.94,United Healthcare/Oxford,United Healthcare/Oxford,,30.99,,,30.99,24.66,38.17,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Aetna,Commerical,,126.18,,,126.18,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Aetna,Middlesex Employees,,113.57,,,113.57,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Anthem,Commerical,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Anthem,Indemnity,,,120.192,,120.192,90.32,139.77,percent of total billed charges,,139.77
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Anthem,State Preferred,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Anthem,Individual Exchange,,90.32,,,90.32,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Cigna,Cigna,,110.26,,,110.26,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Connecticare,Commerical,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Connecticare,Exchange,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,Multiplan,Multiplan,,,136,,136,90.32,136,percent of total billed charges,,
HC BLOOD LINE CARTRIDGE - TABLO,27200606,RC,,,both,,,160,98.88,United Healthcare/Oxford,United Healthcare/Oxford,,113.48,,,113.48,90.32,139.77,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Aetna,Commerical,,20.91,,,20.91,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Aetna,Middlesex Employees,,18.82,,,18.82,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Anthem,Commerical,,18.7,,,18.7,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Anthem,Indemnity,,,19.86668738,,19.86668738,14.97,23.15,percent of total billed charges,,23.15
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Anthem,State Preferred,,18.7,,,18.7,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Anthem,Individual Exchange,,14.97,,,14.97,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Cigna,Cigna,,18.27,,,18.27,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Connecticare,Commerical,,19.54,,,19.54,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Connecticare,Exchange,,19.54,,,19.54,14.97,23.15,other,Could be inpatient or outpatient,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,Multiplan,Multiplan,,,22.47961165,,22.47961165,14.97,22.47961165,percent of total billed charges,,
HC CRIT-LINE III BLOOD CHAMBER II -FRENIUS  #191058,27200607,RC,,,both,,,26.44660194,16.35,United Healthcare/Oxford,United Healthcare/Oxford,,18.8,,,18.8,14.97,23.15,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Aetna,Commerical,,37.74,,,37.74,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Aetna,Middlesex Employees,,33.96,,,33.96,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Anthem,Commerical,,33.76,,,33.76,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Anthem,Indemnity,,,35.8606835,,35.8606835,27.01,41.79,percent of total billed charges,,41.79
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Anthem,State Preferred,,33.76,,,33.76,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Anthem,Individual Exchange,,27.01,,,27.01,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Cigna,Cigna,,32.97,,,32.97,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Connecticare,Commerical,,35.27,,,35.27,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Connecticare,Exchange,,35.27,,,35.27,27.01,41.79,other,Could be inpatient or outpatient,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,Multiplan,Multiplan,,,40.57718447,,40.57718447,27.01,40.57718447,percent of total billed charges,,
HC ACDS BAGS 750ML- TERUMO #40817,27200608,RC,,,both,,,47.73786408,29.5,United Healthcare/Oxford,United Healthcare/Oxford,,33.94,,,33.94,27.01,41.79,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Aetna,Commerical,,39,,,39,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Aetna,Middlesex Employees,,35.1,,,35.1,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Anthem,Commerical,,34.89,,,34.89,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Anthem,Indemnity,,,37.06406214,,37.06406214,27.91,43.2,percent of total billed charges,,43.2
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Anthem,State Preferred,,34.89,,,34.89,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Anthem,Individual Exchange,,27.91,,,27.91,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Cigna,Cigna,,34.08,,,34.08,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Connecticare,Commerical,,36.44,,,36.44,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Connecticare,Exchange,,36.44,,,36.44,27.91,43.2,other,Could be inpatient or outpatient,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,Multiplan,Multiplan,,,41.93883495,,41.93883495,27.91,41.93883495,percent of total billed charges,,
HC ASTO BLOOD WARMING TUBING  #40410,27200609,RC,,,both,,,49.33980583,30.49,United Healthcare/Oxford,United Healthcare/Oxford,,35.07,,,35.07,27.91,43.2,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Aetna,Commerical,,712.33,,,712.33,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Aetna,Middlesex Employees,,641.09,,,641.09,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Anthem,Commerical,,637.37,,,637.37,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Anthem,Indemnity,,,676.8312,,676.8312,509.9,789.05,percent of total billed charges,,789.05
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Anthem,State Preferred,,637.37,,,637.37,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Anthem,Individual Exchange,,509.9,,,509.9,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Cigna,Cigna,,622.47,,,622.47,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Connecticare,Commerical,,665.79,,,665.79,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Connecticare,Exchange,,665.79,,,665.79,509.9,789.05,other,Could be inpatient or outpatient,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,Multiplan,Multiplan,,,765.85,,765.85,509.9,765.85,percent of total billed charges,,
HC SPECTRA KIT/LINES,27200610,RC,,,both,,,901,556.82,United Healthcare/Oxford,United Healthcare/Oxford,,640.61,,,640.61,509.9,789.05,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Aetna,Commerical,,24.23,,,24.23,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Aetna,Middlesex Employees,,21.8,,,21.8,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Anthem,Commerical,,21.67,,,21.67,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Anthem,Indemnity,,,23.02464466,,23.02464466,17.34,26.83,percent of total billed charges,,26.83
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Anthem,State Preferred,,21.67,,,21.67,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Anthem,Individual Exchange,,17.34,,,17.34,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Cigna,Cigna,,21.17,,,21.17,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Connecticare,Commerical,,22.64,,,22.64,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Connecticare,Exchange,,22.64,,,22.64,17.34,26.83,other,Could be inpatient or outpatient,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,Multiplan,Multiplan,,,26.05291262,,26.05291262,17.34,26.05291262,percent of total billed charges,,
HC ULTRASET CAPD DISPOSABLE  DISC SET  #575227,27200611,RC,,,both,,,30.65048544,18.94,United Healthcare/Oxford,United Healthcare/Oxford,,21.78,,,21.78,17.34,26.83,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Aetna,Commerical,,164.45,,,164.45,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Aetna,Middlesex Employees,,148.01,,,148.01,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Anthem,Commerical,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Anthem,Indemnity,,,156.2496,,156.2496,117.72,182.16,percent of total billed charges,,182.16
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Anthem,State Preferred,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Anthem,Individual Exchange,,117.72,,,117.72,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Cigna,Cigna,,143.7,,,143.7,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Connecticare,Commerical,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Connecticare,Exchange,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,Multiplan,Multiplan,,,176.8,,176.8,117.72,176.8,percent of total billed charges,,
HC MINI CAP TRANSFER SET #082103,27200612,RC,,,both,,,208,128.54,United Healthcare/Oxford,United Healthcare/Oxford,,147.89,,,147.89,117.72,182.16,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Aetna,Commerical,,25.61,,,25.61,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Aetna,Middlesex Employees,,23.05,,,23.05,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Anthem,Commerical,,22.91,,,22.91,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Anthem,Indemnity,,,24.33742136,,24.33742136,18.33,28.37,percent of total billed charges,,28.37
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Anthem,State Preferred,,22.91,,,22.91,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Anthem,Individual Exchange,,18.33,,,18.33,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Cigna,Cigna,,22.38,,,22.38,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Connecticare,Commerical,,23.93,,,23.93,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Connecticare,Exchange,,23.93,,,23.93,18.33,28.37,other,Could be inpatient or outpatient,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,Multiplan,Multiplan,,,27.53834951,,27.53834951,18.33,27.53834951,percent of total billed charges,,
HC MINI CAP W/ IODINE #082166,27200613,RC,,,both,,,32.39805825,20.02,United Healthcare/Oxford,United Healthcare/Oxford,,23.03,,,23.03,18.33,28.37,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Aetna,Commerical,,27.62,,,27.62,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Aetna,Middlesex Employees,,24.86,,,24.86,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Anthem,Commerical,,24.72,,,24.72,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Anthem,Indemnity,,,26.25553398,,26.25553398,19.77,30.6,percent of total billed charges,,30.6
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Anthem,State Preferred,,24.72,,,24.72,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Anthem,Individual Exchange,,19.77,,,19.77,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Cigna,Cigna,,24.14,,,24.14,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Connecticare,Commerical,,25.81,,,25.81,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Connecticare,Exchange,,25.81,,,25.81,19.77,30.6,other,Could be inpatient or outpatient,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,Multiplan,Multiplan,,,29.70873786,,29.70873786,19.77,29.70873786,percent of total billed charges,,
HC EFFLUENT SAMPLE BAG   #080214,27200614,RC,,,both,,,34.95145631,21.6,United Healthcare/Oxford,United Healthcare/Oxford,,24.84,,,24.84,19.77,30.6,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Aetna,Commerical,,265.39,,,265.39,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Aetna,Middlesex Employees,,238.85,,,238.85,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Anthem,Commerical,,237.47,,,237.47,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Anthem,Indemnity,,,252.4032,,252.4032,189.97,293.97,percent of total billed charges,,293.97
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Anthem,State Preferred,,237.47,,,237.47,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Anthem,Individual Exchange,,189.97,,,189.97,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Cigna,Cigna,,231.91,,,231.91,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Connecticare,Commerical,,248.05,,,248.05,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Connecticare,Exchange,,248.05,,,248.05,189.97,293.97,other,Could be inpatient or outpatient,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,Multiplan,Multiplan,,,285.6,,285.6,189.97,285.6,percent of total billed charges,,
HC LOW RECIRCULATION APD SET #003500,27200615,RC,,,both,,,336,207.65,United Healthcare/Oxford,United Healthcare/Oxford,,238.67,,,238.67,189.97,293.97,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Aetna,Commerical,,97.69,,,97.69,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Aetna,Middlesex Employees,,87.93,,,87.93,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Anthem,Commerical,,87.42,,,87.42,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Anthem,Indemnity,,,93.1488,,93.1488,69.93,108.21,percent of total billed charges,,108.21
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Anthem,State Preferred,,87.42,,,87.42,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Anthem,Individual Exchange,,69.93,,,69.93,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Cigna,Cigna,,85.36,,,85.36,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Connecticare,Commerical,,91.31,,,91.31,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Connecticare,Exchange,,91.31,,,91.31,69.93,108.21,other,Could be inpatient or outpatient,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,Multiplan,Multiplan,,,105.4,,105.4,69.93,105.4,percent of total billed charges,,
HC AUTOMATED PD SET #003512,27200616,RC,,,both,,,124,76.63,United Healthcare/Oxford,United Healthcare/Oxford,,87.86,,,87.86,69.93,108.21,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Aetna,Commerical,,92.8,,,92.8,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Aetna,Middlesex Employees,,83.52,,,83.52,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Anthem,Commerical,,83.04,,,83.04,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Anthem,Indemnity,,,87.8904,,87.8904,66.43,102.8,percent of total billed charges,,102.8
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Anthem,State Preferred,,83.04,,,83.04,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Anthem,Individual Exchange,,66.43,,,66.43,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Cigna,Cigna,,81.1,,,81.1,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Connecticare,Commerical,,86.74,,,86.74,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Connecticare,Exchange,,86.74,,,86.74,66.43,102.8,other,Could be inpatient or outpatient,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,Multiplan,Multiplan,,,99.45,,99.45,66.43,99.45,percent of total billed charges,,
HC CYCLER DRAINAGE BAG 15L   BAXTER  5C4145P,27200617,RC,,,both,,,117,72.31,United Healthcare/Oxford,United Healthcare/Oxford,,83.46,,,83.46,66.43,102.8,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Aetna,Commerical,,16.6,,,16.6,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Aetna,Middlesex Employees,,14.94,,,14.94,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Anthem,Commerical,,14.85,,,14.85,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Anthem,Indemnity,,,15.7752,,15.7752,11.88,18.39,percent of total billed charges,,18.39
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Anthem,State Preferred,,14.85,,,14.85,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Anthem,Individual Exchange,,11.88,,,11.88,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Cigna,Cigna,,14.51,,,14.51,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Connecticare,Commerical,,15.51,,,15.51,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Connecticare,Exchange,,15.51,,,15.51,11.88,18.39,other,Could be inpatient or outpatient,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,Multiplan,Multiplan,,,17.85,,17.85,11.88,17.85,percent of total billed charges,,
HC DIALYSIS TUBING,27200619,RC,,,both,,,21,12.98,United Healthcare/Oxford,United Healthcare/Oxford,,14.92,,,14.92,11.88,18.39,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Aetna,Commerical,,25.96,,,25.96,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Aetna,Middlesex Employees,,23.37,,,23.37,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Anthem,Commerical,,23.23,,,23.23,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Anthem,Indemnity,,,24.68020194,,24.68020194,18.58,28.76,percent of total billed charges,,28.76
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Anthem,State Preferred,,23.23,,,23.23,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Anthem,Individual Exchange,,18.58,,,18.58,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Cigna,Cigna,,22.68,,,22.68,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Connecticare,Commerical,,24.26,,,24.26,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Connecticare,Exchange,,24.26,,,24.26,18.58,28.76,other,Could be inpatient or outpatient,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,Multiplan,Multiplan,,,27.92621359,,27.92621359,18.58,27.92621359,percent of total billed charges,,
HC MEDISYSTEMS HD BLOOD TUBING SET,27200619,RC,,,both,,,32.85436893,20.3,United Healthcare/Oxford,United Healthcare/Oxford,,23.35,,,23.35,18.58,28.76,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Aetna,Commerical,,19.72,,,19.72,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Aetna,Middlesex Employees,,17.75,,,17.75,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Anthem,Commerical,,16.36,,,16.36,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Anthem,Indemnity,,,20.88773592,,20.88773592,13.09,23.64,percent of total billed charges,,23.64
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Anthem,State Preferred,,16.36,,,16.36,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Anthem,Individual Exchange,,13.09,,,13.09,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Cigna,Cigna,,17.37,,,17.37,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Connecticare,Commerical,,17.81,,,17.81,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Connecticare,Exchange,,17.81,,,17.81,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,Multiplan,Multiplan,,,23.63495146,,23.63495146,13.09,23.63495146,percent of total billed charges,,
HC SKIN TEMP NEO ISOLETTE  579188,27200623,RC,,,both,,,27.80582524,17.19,United Healthcare/Oxford,United Healthcare/Oxford,,18.26,,,18.26,13.09,23.64,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Aetna,Commerical,,12.41,,,12.41,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Aetna,Middlesex Employees,,11.18,,,11.18,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Anthem,Commerical,,10.3,,,10.3,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Anthem,Indemnity,,,13.15693981,,13.15693981,8.24,14.88,percent of total billed charges,,14.88
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Anthem,State Preferred,,10.3,,,10.3,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Anthem,Individual Exchange,,8.24,,,8.24,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Cigna,Cigna,,10.93,,,10.93,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Connecticare,Commerical,,11.22,,,11.22,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Connecticare,Exchange,,11.22,,,11.22,8.24,14.88,other,Could be inpatient or outpatient,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,Multiplan,Multiplan,,,14.88737864,,14.88737864,8.24,14.88737864,percent of total billed charges,,
HC SKIN TEMP NEO PANDA 579187,27200624,RC,,,both,,,17.51456311,10.82,United Healthcare/Oxford,United Healthcare/Oxford,,11.49,,,11.49,8.24,14.88,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Aetna,Commerical,,689.12,,,689.12,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Aetna,Middlesex Employees,,620.22,,,620.22,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Anthem,Commerical,,571.92,,,571.92,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Anthem,Indemnity,,,730.1664,,730.1664,457.53,826.2,percent of total billed charges,,826.2
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Anthem,State Preferred,,571.92,,,571.92,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Anthem,Individual Exchange,,457.53,,,457.53,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Cigna,Cigna,,607.04,,,607.04,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Connecticare,Commerical,,622.69,,,622.69,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Connecticare,Exchange,,622.69,,,622.69,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,Multiplan,Multiplan,,,826.2,,826.2,457.53,826.2,percent of total billed charges,,
HC SILO BAG 3CM 310672,27200625,RC,,,both,,,972,600.7,United Healthcare/Oxford,United Healthcare/Oxford,,638.34,,,638.34,457.53,826.2,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Aetna,Commerical,,669.98,,,669.98,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Aetna,Middlesex Employees,,602.98,,,602.98,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Anthem,Commerical,,556.03,,,556.03,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Anthem,Indemnity,,,709.884,,709.884,444.82,803.25,percent of total billed charges,,803.25
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Anthem,State Preferred,,556.03,,,556.03,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Anthem,Individual Exchange,,444.82,,,444.82,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Cigna,Cigna,,590.17,,,590.17,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Connecticare,Commerical,,605.39,,,605.39,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Connecticare,Exchange,,605.39,,,605.39,444.82,803.25,other,Could be inpatient or outpatient,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,Multiplan,Multiplan,,,803.25,,803.25,444.82,803.25,percent of total billed charges,,
HC SILO BAG 3CM 310673,27200626,RC,,,both,,,945,584.01,United Healthcare/Oxford,United Healthcare/Oxford,,620.61,,,620.61,444.82,803.25,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Aetna,Commerical,,604.05,,,604.05,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Aetna,Middlesex Employees,,543.64,,,543.64,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Anthem,Commerical,,501.31,,,501.31,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Anthem,Indemnity,,,640.0224,,640.0224,401.05,724.2,percent of total billed charges,,724.2
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Anthem,State Preferred,,501.31,,,501.31,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Anthem,Individual Exchange,,401.05,,,401.05,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Cigna,Cigna,,532.1,,,532.1,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Connecticare,Commerical,,545.82,,,545.82,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Connecticare,Exchange,,545.82,,,545.82,401.05,724.2,other,Could be inpatient or outpatient,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,Multiplan,Multiplan,,,724.2,,724.2,401.05,724.2,percent of total billed charges,,
HC PRISMAFLEX DIALYSIS FILTER AND TUBING 580230,27200628,RC,,,both,,,852,526.54,United Healthcare/Oxford,United Healthcare/Oxford,,559.54,,,559.54,401.05,724.2,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Aetna,Commerical,,1248.51,,,1248.51,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Aetna,Middlesex Employees,,1123.66,,,1123.66,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Anthem,Commerical,,1036.17,,,1036.17,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Anthem,Indemnity,,,1322.8632,,1322.8632,828.93,1496.85,percent of total billed charges,,1496.85
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Anthem,State Preferred,,1036.17,,,1036.17,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Anthem,Individual Exchange,,828.93,,,828.93,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Cigna,Cigna,,1099.78,,,1099.78,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Connecticare,Commerical,,1128.14,,,1128.14,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Connecticare,Exchange,,1128.14,,,1128.14,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,Multiplan,Multiplan,,,1496.85,,1496.85,828.93,1496.85,percent of total billed charges,,
HC ON-Q 600ML PAIN PUMP 003957,27200646,RC,,,both,,,1761,1088.3,United Healthcare/Oxford,United Healthcare/Oxford,,1156.49,,,1156.49,828.93,1496.85,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Aetna,Commerical,,201.35,,,201.35,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Aetna,Middlesex Employees,,181.21,,,181.21,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Anthem,Commerical,,167.1,,,167.1,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Anthem,Indemnity,,,213.3408,,213.3408,133.68,241.4,percent of total billed charges,,241.4
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Anthem,State Preferred,,167.1,,,167.1,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Anthem,Individual Exchange,,133.68,,,133.68,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Cigna,Cigna,,177.36,,,177.36,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Connecticare,Commerical,,181.94,,,181.94,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Connecticare,Exchange,,181.94,,,181.94,133.68,241.4,other,Could be inpatient or outpatient,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,Multiplan,Multiplan,,,241.4,,241.4,133.68,241.4,percent of total billed charges,,
HC ON-Q 100ML PAIN INFUS PUMP 2.5IN KIT 309897,27200647,RC,,,both,,,284,175.51,United Healthcare/Oxford,United Healthcare/Oxford,,186.51,,,186.51,133.68,241.4,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Aetna,Commerical,,13.39,,,13.39,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Aetna,Middlesex Employees,,12.05,,,12.05,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Anthem,Commerical,,11.11,,,11.11,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Anthem,Indemnity,,,14.18528155,,14.18528155,8.88,16.05,percent of total billed charges,,16.05
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Anthem,State Preferred,,11.11,,,11.11,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Anthem,Individual Exchange,,8.88,,,8.88,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Cigna,Cigna,,11.79,,,11.79,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Connecticare,Commerical,,12.1,,,12.1,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Connecticare,Exchange,,12.1,,,12.1,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,Multiplan,Multiplan,,,16.05097087,,16.05097087,8.88,16.05097087,percent of total billed charges,,
HC SUTURE MNCRL 4-0 P-3 18IN 481883,27200648,RC,,,both,,,18.88349515,11.67,United Healthcare/Oxford,United Healthcare/Oxford,,12.4,,,12.4,8.88,16.05,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Aetna,Commerical,,9.16,,,9.16,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Aetna,Middlesex Employees,,8.24,,,8.24,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Anthem,Commerical,,7.61,,,7.61,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Anthem,Indemnity,,,9.707254369,,9.707254369,6.09,10.98,percent of total billed charges,,10.98
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Anthem,State Preferred,,7.61,,,7.61,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Anthem,Individual Exchange,,6.09,,,6.09,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Cigna,Cigna,,8.07,,,8.07,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Connecticare,Commerical,,8.28,,,8.28,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Connecticare,Exchange,,8.28,,,8.28,6.09,10.98,other,Could be inpatient or outpatient,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,Multiplan,Multiplan,,,10.98398058,,10.98398058,6.09,10.98398058,percent of total billed charges,,
HC SUTURE ETHLN 4-0 18IN P3 BLK 481041,27200649,RC,,,both,,,12.9223301,7.98,United Healthcare/Oxford,United Healthcare/Oxford,,8.49,,,8.49,6.09,10.98,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Aetna,Commerical,,48.36,,,48.36,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Aetna,Middlesex Employees,,43.53,,,43.53,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Anthem,Commerical,,40.14,,,40.14,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Anthem,Indemnity,,,51.0816,,51.0816,32.11,57.99,percent of total billed charges,,57.99
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Anthem,State Preferred,,40.14,,,40.14,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Anthem,Individual Exchange,,32.11,,,32.11,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Cigna,Cigna,,42.61,,,42.61,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Connecticare,Commerical,,43.7,,,43.7,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Connecticare,Exchange,,43.7,,,43.7,32.11,57.99,other,Could be inpatient or outpatient,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,Multiplan,Multiplan,,,57.8,,57.8,32.11,57.8,percent of total billed charges,,
HC SNUGGLE WRAP SMALL 003979,27200651,RC,,,both,,,68,42.02,United Healthcare/Oxford,United Healthcare/Oxford,,44.81,,,44.81,32.11,57.99,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Aetna,Commerical,,19.69,,,19.69,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Aetna,Middlesex Employees,,17.72,,,17.72,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Anthem,Commerical,,16.34,,,16.34,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Anthem,Indemnity,,,20.86585631,,20.86585631,13.07,23.61,percent of total billed charges,,23.61
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Anthem,State Preferred,,16.34,,,16.34,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Anthem,Individual Exchange,,13.07,,,13.07,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Cigna,Cigna,,17.35,,,17.35,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Connecticare,Commerical,,17.79,,,17.79,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Connecticare,Exchange,,17.79,,,17.79,13.07,23.61,other,Could be inpatient or outpatient,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,Multiplan,Multiplan,,,23.61019417,,23.61019417,13.07,23.61019417,percent of total billed charges,,
HC ACCESSORY SPIKE  575226,27200652,RC,,,both,,,27.77669903,17.17,United Healthcare/Oxford,United Healthcare/Oxford,,18.24,,,18.24,13.07,23.61,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Aetna,Commerical,,32.97,,,32.97,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Aetna,Middlesex Employees,,29.67,,,29.67,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Anthem,Commerical,,27.37,,,27.37,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Anthem,Indemnity,,,34.9344466,,34.9344466,21.89,39.53,percent of total billed charges,,39.53
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Anthem,State Preferred,,27.37,,,27.37,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Anthem,Individual Exchange,,21.89,,,21.89,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Cigna,Cigna,,29.04,,,29.04,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Connecticare,Commerical,,29.79,,,29.79,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Connecticare,Exchange,,29.79,,,29.79,21.89,39.53,other,Could be inpatient or outpatient,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,Multiplan,Multiplan,,,39.52912621,,39.52912621,21.89,39.52912621,percent of total billed charges,,
HC ALLIGATOR FORCEPS  578730,27200653,RC,,,both,,,46.50485437,28.74,United Healthcare/Oxford,United Healthcare/Oxford,,30.54,,,30.54,21.89,39.53,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Aetna,Commerical,,14.44,,,14.44,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Aetna,Middlesex Employees,,13,,,13,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Anthem,Commerical,,11.99,,,11.99,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Anthem,Indemnity,,,15.30114175,,15.30114175,9.58,17.31,percent of total billed charges,,17.31
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Anthem,State Preferred,,11.99,,,11.99,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Anthem,Individual Exchange,,9.58,,,9.58,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Cigna,Cigna,,12.72,,,12.72,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Connecticare,Commerical,,13.05,,,13.05,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Connecticare,Exchange,,13.05,,,13.05,9.58,17.31,other,Could be inpatient or outpatient,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,Multiplan,Multiplan,,,17.31359223,,17.31359223,9.58,17.31359223,percent of total billed charges,,
HC EAR WICK POPE  554813,27200654,RC,,,both,,,20.36893204,12.59,United Healthcare/Oxford,United Healthcare/Oxford,,13.38,,,13.38,9.58,17.31,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Aetna,Commerical,,89.56,,,89.56,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Aetna,Middlesex Employees,,80.61,,,80.61,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Anthem,Commerical,,74.33,,,74.33,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Anthem,Indemnity,,,94.6512,,94.6512,59.47,107.38,percent of total billed charges,,107.38
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Anthem,State Preferred,,74.33,,,74.33,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Anthem,Individual Exchange,,59.47,,,59.47,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Cigna,Cigna,,78.89,,,78.89,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Connecticare,Commerical,,80.93,,,80.93,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Connecticare,Exchange,,80.93,,,80.93,59.47,107.38,other,Could be inpatient or outpatient,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,Multiplan,Multiplan,,,107.1,,107.1,59.47,107.1,percent of total billed charges,,
HC SILOUETTE 23MM  #579790,27200655,RC,,,both,,,126,77.87,United Healthcare/Oxford,United Healthcare/Oxford,,82.97,,,82.97,59.47,107.38,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Aetna,Commerical,,47.07,,,47.07,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Aetna,Middlesex Employees,,42.36,,,42.36,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Anthem,Commerical,,39.06,,,39.06,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Anthem,Indemnity,,,49.5792,,49.5792,31.25,56.43,percent of total billed charges,,56.43
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Anthem,State Preferred,,39.06,,,39.06,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Anthem,Individual Exchange,,31.25,,,31.25,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Cigna,Cigna,,41.46,,,41.46,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Connecticare,Commerical,,42.53,,,42.53,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Connecticare,Exchange,,42.53,,,42.53,31.25,56.43,other,Could be inpatient or outpatient,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,Multiplan,Multiplan,,,56.1,,56.1,31.25,56.1,percent of total billed charges,,
HC SUBQ MINIMED SILOUETTE 13MM  #579789,27200656,RC,,,both,,,66,40.79,United Healthcare/Oxford,United Healthcare/Oxford,,43.6,,,43.6,31.25,56.43,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Aetna,Commerical,,16.42,,,16.42,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Aetna,Middlesex Employees,,15.75,,,15.75,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Anthem,Commerical,,15.86,,,15.86,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Anthem,Indemnity,,,15.75332039,,15.75332039,12.69,18.45,percent of total billed charges,,18.45
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Anthem,State Preferred,,15.86,,,15.86,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Anthem,Individual Exchange,,12.69,,,12.69,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Cigna,Cigna,,18.45,,,18.45,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Connecticare,Commerical,,17.5,,,17.5,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Connecticare,Exchange,,17.5,,,17.5,12.69,18.45,other,Could be inpatient or outpatient,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,Multiplan,Multiplan,,,17.82524272,,17.82524272,12.69,18.45,percent of total billed charges,,
HC TRANSDUCER HOLDER,27200675,RC,,,both,,,20.97087379,12.96,United Healthcare/Oxford,United Healthcare/Oxford,,14.41,,,14.41,12.69,18.45,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Aetna,Commerical,,12.24,,,12.24,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Aetna,Middlesex Employees,,11.74,,,11.74,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Anthem,Commerical,,11.82,,,11.82,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Anthem,Indemnity,,,11.74205825,,11.74205825,9.46,13.76,percent of total billed charges,,13.76
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Anthem,State Preferred,,11.82,,,11.82,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Anthem,Individual Exchange,,9.46,,,9.46,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Cigna,Cigna,,13.76,,,13.76,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Connecticare,Commerical,,13.05,,,13.05,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Connecticare,Exchange,,13.05,,,13.05,9.46,13.76,other,Could be inpatient or outpatient,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,Multiplan,Multiplan,,,13.28640777,,13.28640777,9.46,13.76,percent of total billed charges,,
HC SMALLBORE EXT SET W CHEMOLOCK PORT & SPIROS,27200676,RC,,,both,,,15.63106796,9.66,United Healthcare/Oxford,United Healthcare/Oxford,,10.74,,,10.74,9.46,13.76,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Aetna,Commerical,,31.15,,,31.15,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Aetna,Middlesex Employees,,29.87,,,29.87,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Anthem,Commerical,,30.09,,,30.09,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Anthem,Indemnity,,,29.88025631,,29.88025631,24.07,35.01,percent of total billed charges,,35.01
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Anthem,State Preferred,,30.09,,,30.09,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Anthem,Individual Exchange,,24.07,,,24.07,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Cigna,Cigna,,35.01,,,35.01,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Connecticare,Commerical,,33.21,,,33.21,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Connecticare,Exchange,,33.21,,,33.21,24.07,35.01,other,Could be inpatient or outpatient,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,Multiplan,Multiplan,,,33.81019417,,33.81019417,24.07,35.01,percent of total billed charges,,
HC CENTRAL LINE DRES KIT  #581297,27200678,RC,,,both,,,39.77669903,24.58,United Healthcare/Oxford,United Healthcare/Oxford,,27.33,,,27.33,24.07,35.01,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Aetna,Commerical,,508.81,,,508.81,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Aetna,Middlesex Employees,,457.93,,,457.93,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Anthem,Commerical,,455.27,,,455.27,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Anthem,Indemnity,,,483.7728,,483.7728,364.22,563.6,percent of total billed charges,,563.6
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Anthem,State Preferred,,455.27,,,455.27,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Anthem,Individual Exchange,,364.22,,,364.22,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Cigna,Cigna,,444.62,,,444.62,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Connecticare,Commerical,,475.56,,,475.56,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Connecticare,Exchange,,475.56,,,475.56,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,Multiplan,Multiplan,,,547.4,,547.4,364.22,547.4,percent of total billed charges,,
HC HH EMBO2 COILS,27800022,RC,,,both,,,644,397.99,United Healthcare/Oxford,United Healthcare/Oxford,,457.58,,,457.58,364.22,563.6,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Aetna,Commerical,,1664,,,1664,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Aetna,Middlesex Employees,,1497.6,,,1497.6,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Anthem,Commerical,,1488.91,,,1488.91,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Anthem,Indemnity,,,1581.276,,1581.276,1191.13,1843.21,percent of total billed charges,,1843.21
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Anthem,State Preferred,,1488.91,,,1488.91,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Anthem,Individual Exchange,,1191.13,,,1191.13,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Cigna,Cigna,,1454.09,,,1454.09,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Connecticare,Commerical,,1555.27,,,1555.27,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Connecticare,Exchange,,1555.27,,,1555.27,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,Multiplan,Multiplan,,,1789.25,,1789.25,1191.13,1843.21,percent of total billed charges,,
HC HH EMBO3 COILS,27800034,RC,,,both,,,2105,1300.89,United Healthcare/Oxford,United Healthcare/Oxford,,1496.47,,,1496.47,1191.13,1843.21,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Aetna,Commerical,,889.8,,,889.8,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Aetna,Middlesex Employees,,800.82,,,800.82,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Anthem,Commerical,,796.17,,,796.17,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Anthem,Indemnity,,,871.0638058,,871.0638058,636.94,985.63,percent of total billed charges,,985.63
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Anthem,State Preferred,,796.17,,,796.17,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Anthem,Individual Exchange,,636.94,,,636.94,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Cigna,Cigna,,777.56,,,777.56,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Connecticare,Commerical,,831.66,,,831.66,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Connecticare,Exchange,,831.66,,,831.66,636.94,985.63,other,Could be inpatient or outpatient,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,Multiplan,Multiplan,,,985.6286408,,985.6286408,636.94,985.6286408,percent of total billed charges,,
HC HH  SURGICAL IMPLANT 0 - 1 800,27800045,RC,,,both,,,1159.563107,716.61,United Healthcare/Oxford,United Healthcare/Oxford,,800.22,,,800.22,636.94,985.63,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Aetna,Commerical,,2668.59,,,2668.59,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Aetna,Middlesex Employees,,2401.73,,,2401.73,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Anthem,Commerical,,2387.8,,,2387.8,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Anthem,Indemnity,,,2612.396458,,2612.396458,1910.24,2955.99,percent of total billed charges,,2955.99
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Anthem,State Preferred,,2387.8,,,2387.8,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Anthem,Individual Exchange,,1910.24,,,1910.24,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Cigna,Cigna,,2331.94,,,2331.94,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Connecticare,Commerical,,2494.21,,,2494.21,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Connecticare,Exchange,,2494.21,,,2494.21,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,Multiplan,Multiplan,,,2955.986408,,2955.986408,1910.24,2955.986408,percent of total billed charges,,
HC HH SURGICAL IMPLANT 1 800 - 3 500,27800046,RC,,,both,,,3477.631068,2149.18,United Healthcare/Oxford,United Healthcare/Oxford,,2399.91,,,2399.91,1910.24,2955.99,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Aetna,Commerical,,4448.2,,,4448.2,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Aetna,Middlesex Employees,,4003.37,,,4003.37,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Anthem,Commerical,,3980.14,,,3980.14,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Anthem,Indemnity,,,4354.52407,,4354.52407,3184.12,4927.25,percent of total billed charges,,4927.25
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Anthem,State Preferred,,3980.14,,,3980.14,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Anthem,Individual Exchange,,3184.12,,,3184.12,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Cigna,Cigna,,3887.05,,,3887.05,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Connecticare,Commerical,,4157.54,,,4157.54,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Connecticare,Exchange,,4157.54,,,4157.54,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,Multiplan,Multiplan,,,4927.243689,,4927.243689,3184.12,4927.243689,percent of total billed charges,,
HC HH SURGICAL IMPLANT 3 500 - 7 000,27800047,RC,,,both,,,5796.757282,3582.4,United Healthcare/Oxford,United Healthcare/Oxford,,4000.34,,,4000.34,3184.12,4927.25,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Aetna,Commerical,,7116.78,,,7116.78,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Aetna,Middlesex Employees,,6405.11,,,6405.11,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Anthem,Commerical,,6367.93,,,6367.93,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Anthem,Indemnity,,,6966.920528,,6966.920528,5094.34,7883.23,percent of total billed charges,,7883.23
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Anthem,State Preferred,,6367.93,,,6367.93,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Anthem,Individual Exchange,,5094.34,,,5094.34,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Cigna,Cigna,,6218.99,,,6218.99,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Connecticare,Commerical,,6651.75,,,6651.75,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Connecticare,Exchange,,6651.75,,,6651.75,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,Multiplan,Multiplan,,,7883.230097,,7883.230097,5094.34,7883.230097,percent of total billed charges,,
HC HH SURGICAL IMPLANT 7 000 - 14 000,27800048,RC,,,both,,,9274.38835,5731.57,United Healthcare/Oxford,United Healthcare/Oxford,,6400.26,,,6400.26,5094.34,7883.23,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Aetna,Commerical,,9785.38,,,9785.38,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Aetna,Middlesex Employees,,8806.84,,,8806.84,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Anthem,Commerical,,8755.73,,,8755.73,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Anthem,Indemnity,,,9579.316986,,9579.316986,7004.58,10839.22,percent of total billed charges,,10839.22
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Anthem,State Preferred,,8755.73,,,8755.73,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Anthem,Individual Exchange,,7004.58,,,7004.58,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Cigna,Cigna,,8550.94,,,8550.94,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Connecticare,Commerical,,9145.96,,,9145.96,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Connecticare,Exchange,,9145.96,,,9145.96,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,Multiplan,Multiplan,,,10839.2165,,10839.2165,7004.58,10839.2165,percent of total billed charges,,
HC HH SURGICAL IMPLANT 14 000 - 17 500,27800049,RC,,,both,,,12752.01942,7880.75,United Healthcare/Oxford,United Healthcare/Oxford,,8800.17,,,8800.17,7004.58,10839.22,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Aetna,Commerical,,13343.77,,,13343.77,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Aetna,Middlesex Employees,,12009.39,,,12009.39,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Anthem,Commerical,,11939.7,,,11939.7,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Anthem,Indemnity,,,13062.77725,,13062.77725,9551.76,14780.83,percent of total billed charges,,14780.83
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Anthem,State Preferred,,11939.7,,,11939.7,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Anthem,Individual Exchange,,9551.76,,,9551.76,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Cigna,Cigna,,11660.44,,,11660.44,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Connecticare,Commerical,,12471.84,,,12471.84,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Connecticare,Exchange,,12471.84,,,12471.84,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,Multiplan,Multiplan,,,14780.83155,,14780.83155,9551.76,14780.83155,percent of total billed charges,,
HC HH SURGICAL IMPLANT 17 500 - 30 000,27800050,RC,,,both,,,17389.21359,10746.53,United Healthcare/Oxford,United Healthcare/Oxford,,12000.29,,,12000.29,9551.76,14780.83,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Aetna,Commerical,,58.76,,,58.76,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Aetna,Middlesex Employees,,52.88,,,52.88,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Anthem,Commerical,,69.77,,,69.77,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Anthem,Indemnity,,,77.77,,77.77,52.88,85.67,percent of total billed charges,,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Anthem,State Preferred,,69.77,,,69.77,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Anthem,Individual Exchange,,55.82,,,55.82,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Cigna,Cigna,,80.2,,,80.2,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Connecticare,Commerical,,74.66,,,74.66,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Connecticare,Exchange,,74.66,,,74.66,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,Multiplan,Multiplan,,,85.67,,85.67,52.88,85.67,percent of total billed charges,,
HC HH CONTRACTED LABS 0 - 150,30000062,CPT,,,both,,,107.12,64.27,United Healthcare/Oxford,United Healthcare/Oxford,,65.14,,,65.14,52.88,85.67,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Aetna,Commerical,,116.28,,,116.28,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Aetna,Middlesex Employees,,104.65,,,104.65,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Anthem,Commerical,,138.06,,,138.06,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Anthem,Indemnity,,,153.89,,153.89,104.65,169.53,percent of total billed charges,,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Anthem,State Preferred,,138.06,,,138.06,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Anthem,Individual Exchange,,110.44,,,110.44,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Cigna,Cigna,,158.72,,,158.72,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Connecticare,Commerical,,147.77,,,147.77,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Connecticare,Exchange,,147.77,,,147.77,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,Multiplan,Multiplan,,,169.53,,169.53,104.65,169.53,percent of total billed charges,,
HC HH CONTRACTED LABS 150 - 300,30000063,CPT,,,both,,,212.18,127.31,United Healthcare/Oxford,United Healthcare/Oxford,,128.9,,,128.9,104.65,169.53,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Aetna,Commerical,,175.04,,,175.04,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Aetna,Middlesex Employees,,157.54,,,157.54,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Anthem,Commerical,,207.83,,,207.83,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Anthem,Indemnity,,,231.65,,231.65,157.54,255.2,percent of total billed charges,,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Anthem,State Preferred,,207.83,,,207.83,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Anthem,Individual Exchange,,166.26,,,166.26,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Cigna,Cigna,,238.92,,,238.92,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Connecticare,Commerical,,222.43,,,222.43,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Connecticare,Exchange,,222.43,,,222.43,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,Multiplan,Multiplan,,,255.2,,255.2,157.54,255.2,percent of total billed charges,,
HC HH CONTRACTED LABS 300 - 450,30000064,CPT,,,both,,,318.27,190.96,United Healthcare/Oxford,United Healthcare/Oxford,,194.04,,,194.04,157.54,255.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Aetna,Commerical,,233.78,,,233.78,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Aetna,Middlesex Employees,,210.41,,,210.41,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Anthem,Commerical,,277.59,,,277.59,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Anthem,Indemnity,,,309.42,,309.42,210.41,340.87,percent of total billed charges,,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Anthem,State Preferred,,277.59,,,277.59,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Anthem,Individual Exchange,,222.07,,,222.07,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Cigna,Cigna,,319.12,,,319.12,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Connecticare,Commerical,,297.1,,,297.1,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Connecticare,Exchange,,297.1,,,297.1,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,Multiplan,Multiplan,,,340.87,,340.87,210.41,340.87,percent of total billed charges,,
HC HH CONTRACTED LABS 450 - 600,30000065,CPT,,,both,,,425.39,255.23,United Healthcare/Oxford,United Healthcare/Oxford,,259.18,,,259.18,210.41,340.87,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Aetna,Commerical,,292.54,,,292.54,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Aetna,Middlesex Employees,,263.29,,,263.29,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Anthem,Commerical,,347.36,,,347.36,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Anthem,Indemnity,,,387.18,,387.18,263.29,426.54,percent of total billed charges,,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Anthem,State Preferred,,347.36,,,347.36,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Anthem,Individual Exchange,,277.89,,,277.89,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Cigna,Cigna,,399.33,,,399.33,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Connecticare,Commerical,,371.76,,,371.76,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Connecticare,Exchange,,371.76,,,371.76,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,Multiplan,Multiplan,,,426.54,,426.54,263.29,426.54,percent of total billed charges,,
HC HH CONTRACTED LABS 600 - 750,30000066,CPT,,,both,,,532.51,319.51,United Healthcare/Oxford,United Healthcare/Oxford,,324.32,,,324.32,263.29,426.54,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Aetna,Commerical,,351.3,,,351.3,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Aetna,Middlesex Employees,,316.17,,,316.17,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Anthem,Commerical,,417.12,,,417.12,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Anthem,Indemnity,,,464.94,,464.94,316.17,512.2,percent of total billed charges,,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Anthem,State Preferred,,417.12,,,417.12,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Anthem,Individual Exchange,,333.69,,,333.69,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Cigna,Cigna,,479.53,,,479.53,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Connecticare,Commerical,,446.43,,,446.43,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Connecticare,Exchange,,446.43,,,446.43,316.17,512.2,other,Could be inpatient or outpatient,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,Multiplan,Multiplan,,,512.2,,512.2,316.17,512.2,percent of total billed charges,,
HC HH CONTRACTED LABS  750 - 900,30000067,CPT,,,both,,,639.63,383.78,United Healthcare/Oxford,United Healthcare/Oxford,,389.45,,,389.45,316.17,512.2,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Aetna,Commerical,,49.66,,,49.66,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Aetna,Middlesex Employees,,44.7,,,44.7,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Anthem,Commerical,,44.79,,,44.79,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Anthem,Indemnity,,,49.93,,49.93,35.83,55,percent of total billed charges,,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Anthem,State Preferred,,44.79,,,44.79,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Anthem,Individual Exchange,,35.83,,,35.83,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Cigna,Cigna,,51.5,,,51.5,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Connecticare,Commerical,,47.94,,,47.94,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Connecticare,Exchange,,47.94,,,47.94,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,Multiplan,Multiplan,,,55,,55,35.83,55,percent of total billed charges,,
HC MANUAL CHRG $1 - $500,30900071,CPT,,,both,,,69.01,41.41,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,35.83,55,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Aetna,Commerical,,40.24,,,40.24,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Aetna,Middlesex Employees,,36.23,,,36.23,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Anthem,Commerical,,36.31,,,36.31,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Anthem,Indemnity,,,40.47,,40.47,29.04,44.58,percent of total billed charges,,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Anthem,State Preferred,,36.31,,,36.31,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Anthem,Individual Exchange,,29.04,,,29.04,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Cigna,Cigna,,41.74,,,41.74,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Connecticare,Commerical,,38.86,,,38.86,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Connecticare,Exchange,,38.86,,,38.86,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,Multiplan,Multiplan,,,44.58,,44.58,29.04,44.58,percent of total billed charges,,
HC MANUAL CHRG $501 - $1000,30900072,CPT,,,both,,,56.65,33.99,United Healthcare/Oxford,United Healthcare/Oxford,,33.9,,,33.9,29.04,44.58,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Aetna,Commerical,,46.41,,,46.41,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Aetna,Middlesex Employees,,41.77,,,41.77,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Anthem,Commerical,,41.86,,,41.86,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Anthem,Indemnity,,,46.66,,46.66,33.48,51.4,percent of total billed charges,,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Anthem,State Preferred,,41.86,,,41.86,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Anthem,Individual Exchange,,33.48,,,33.48,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Cigna,Cigna,,48.12,,,48.12,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Connecticare,Commerical,,44.8,,,44.8,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Connecticare,Exchange,,44.8,,,44.8,33.48,51.4,other,Could be inpatient or outpatient,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,Multiplan,Multiplan,,,51.4,,51.4,33.48,51.4,percent of total billed charges,,
HC MANUAL CHRG  > $1 000,30900073,CPT,,,both,,,64.15,38.49,United Healthcare/Oxford,United Healthcare/Oxford,,39.08,,,39.08,33.48,51.4,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Aetna,Commerical,,3.73,,,3.73,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Aetna,Middlesex Employees,,3.35,,,3.35,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Anthem,Commerical,,3.36,,,3.36,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Anthem,Indemnity,,,3.75,,3.75,2.69,4.13,percent of total billed charges,,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Anthem,State Preferred,,3.36,,,3.36,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Anthem,Individual Exchange,,2.69,,,2.69,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Cigna,Cigna,,3.87,,,3.87,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Connecticare,Commerical,,3.6,,,3.6,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Connecticare,Exchange,,3.6,,,3.6,2.69,4.13,other,Could be inpatient or outpatient,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,Multiplan,Multiplan,,,4.13,,4.13,2.69,4.13,percent of total billed charges,,
HC PATH REFERRAL,30900074,CPT,,,both,,,5.16,3.1,United Healthcare/Oxford,United Healthcare/Oxford,,3.14,,,3.14,2.69,4.13,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Aetna,Commerical,,230.38,,,230.38,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Aetna,Middlesex Employees,,207.34,,,207.34,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Anthem,Commerical,,207.83,,,207.83,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Anthem,Indemnity,,,231.65,,231.65,166.26,255.2,percent of total billed charges,,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Anthem,State Preferred,,207.83,,,207.83,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Anthem,Individual Exchange,,166.26,,,166.26,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Cigna,Cigna,,238.92,,,238.92,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Connecticare,Commerical,,222.43,,,222.43,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Connecticare,Exchange,,222.43,,,222.43,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,Multiplan,Multiplan,,,255.2,,255.2,166.26,255.2,percent of total billed charges,,
HC HH CHEMO SVCS 0 - 700,33100010,CPT,,,both,,,318.27,190.96,United Healthcare/Oxford,United Healthcare/Oxford,,194.04,,,194.04,166.26,255.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Aetna,Commerical,,462.4,,,462.4,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Aetna,Middlesex Employees,,416.16,,,416.16,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Anthem,Commerical,,417.12,,,417.12,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Anthem,Indemnity,,,464.94,,464.94,333.69,512.2,percent of total billed charges,,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Anthem,State Preferred,,417.12,,,417.12,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Anthem,Individual Exchange,,333.69,,,333.69,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Cigna,Cigna,,479.53,,,479.53,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Connecticare,Commerical,,446.43,,,446.43,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Connecticare,Exchange,,446.43,,,446.43,333.69,512.2,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,Multiplan,Multiplan,,,512.2,,512.2,333.69,512.2,percent of total billed charges,,
HC HH CHEMO SVCS 700 - 1 000,33100011,CPT,,,both,,,639.29,383.57,United Healthcare/Oxford,United Healthcare/Oxford,,389.45,,,389.45,333.69,512.2,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Aetna,Commerical,,692.79,,,692.79,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Aetna,Middlesex Employees,,623.51,,,623.51,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Anthem,Commerical,,624.94,,,624.94,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Anthem,Indemnity,,,696.6,,696.6,499.96,767.41,percent of total billed charges,,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Anthem,State Preferred,,624.94,,,624.94,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Anthem,Individual Exchange,,499.96,,,499.96,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Cigna,Cigna,,718.46,,,718.46,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Connecticare,Commerical,,668.86,,,668.86,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Connecticare,Exchange,,668.86,,,668.86,499.96,767.41,other,Could be inpatient or outpatient,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,Multiplan,Multiplan,,,767.41,,767.41,499.96,767.41,percent of total billed charges,,
HC HH  CHEMO SVCS 1 000 - 1 300,33100012,CPT,,,both,,,957.81,574.68,United Healthcare/Oxford,United Healthcare/Oxford,,583.51,,,583.51,499.96,767.41,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Aetna,Commerical,,923.18,,,923.18,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Aetna,Middlesex Employees,,830.87,,,830.87,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Anthem,Commerical,,832.76,,,832.76,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Anthem,Indemnity,,,928.25,,928.25,666.21,1022.6,percent of total billed charges,,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Anthem,State Preferred,,832.76,,,832.76,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Anthem,Individual Exchange,,666.21,,,666.21,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Cigna,Cigna,,957.38,,,957.38,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Connecticare,Commerical,,891.29,,,891.29,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Connecticare,Exchange,,891.29,,,891.29,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,Multiplan,Multiplan,,,1022.6,,1022.6,666.21,1022.6,percent of total billed charges,,
HC HH CHEMO SVCS 1 300 - 1 600,33100013,CPT,,,both,,,1276.32,765.79,United Healthcare/Oxford,United Healthcare/Oxford,,777.55,,,777.55,666.21,1022.6,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Aetna,Commerical,,1154.38,,,1154.38,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Aetna,Middlesex Employees,,1038.94,,,1038.94,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Anthem,Commerical,,1032.91,,,1032.91,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Anthem,Indemnity,,,1160.72,,1160.72,826.32,1278.71,percent of total billed charges,,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Anthem,State Preferred,,1032.91,,,1032.91,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Anthem,Individual Exchange,,826.32,,,826.32,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Cigna,Cigna,,1197.15,,,1197.15,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Connecticare,Commerical,,1114.5,,,1114.5,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Connecticare,Exchange,,1114.5,,,1114.5,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,Multiplan,Multiplan,,,1278.71,,1278.71,826.32,1278.71,percent of total billed charges,,
HC HH CHEMO SVCS 1 600 - 1 900,33100014,CPT,,,both,,,1595.97,957.58,United Healthcare/Oxford,United Healthcare/Oxford,,972.27,,,972.27,826.32,1278.71,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Aetna,Commerical,,80.59,,,80.59,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Aetna,Middlesex Employees,,72.53,,,72.53,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Anthem,Commerical,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Anthem,Indemnity,,,81.04,,81.04,57.69,89.28,percent of total billed charges,,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Anthem,State Preferred,,72.12,,,72.12,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Anthem,Individual Exchange,,57.69,,,57.69,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Cigna,Cigna,,83.58,,,83.58,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Connecticare,Commerical,,77.81,,,77.81,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Connecticare,Exchange,,77.81,,,77.81,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,Multiplan,Multiplan,,,89.28,,89.28,57.69,89.28,percent of total billed charges,,
HC HH RADIATION THPY 0 - 200,33300005,CPT,,,both,,,111.24,66.74,United Healthcare/Oxford,United Healthcare/Oxford,,67.88,,,67.88,57.69,89.28,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Aetna,Commerical,,282.48,,,282.48,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Aetna,Middlesex Employees,,254.24,,,254.24,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Anthem,Commerical,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Anthem,Indemnity,,,284.04,,284.04,202.22,312.91,percent of total billed charges,,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Anthem,State Preferred,,252.77,,,252.77,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Anthem,Individual Exchange,,202.22,,,202.22,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Cigna,Cigna,,292.96,,,292.96,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Connecticare,Commerical,,272.73,,,272.73,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Connecticare,Exchange,,272.73,,,272.73,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,Multiplan,Multiplan,,,312.91,,312.91,202.22,312.91,percent of total billed charges,,
HC HH RADIATION THPY 200 - 800,33300006,CPT,,,both,,,390.37,234.22,United Healthcare/Oxford,United Healthcare/Oxford,,237.93,,,237.93,202.22,312.91,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Aetna,Commerical,,565.79,,,565.79,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Aetna,Middlesex Employees,,509.22,,,509.22,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Anthem,Commerical,,506.26,,,506.26,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Anthem,Indemnity,,,568.9,,568.9,405.01,626.73,percent of total billed charges,,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Anthem,State Preferred,,506.26,,,506.26,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Anthem,Individual Exchange,,405.01,,,405.01,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Cigna,Cigna,,586.76,,,586.76,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Connecticare,Commerical,,546.25,,,546.25,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Connecticare,Exchange,,546.25,,,546.25,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,Multiplan,Multiplan,,,626.73,,626.73,405.01,626.73,percent of total billed charges,,
HC HH RADIATION THPY 800 - 1 500,33300007,CPT,,,both,,,782.23,469.34,United Healthcare/Oxford,United Healthcare/Oxford,,476.54,,,476.54,405.01,626.73,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Aetna,Commerical,,1132.41,,,1132.41,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Aetna,Middlesex Employees,,1019.16,,,1019.16,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Anthem,Commerical,,1013.24,,,1013.24,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Anthem,Indemnity,,,1138.62,,1138.62,810.59,1254.35,percent of total billed charges,,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Anthem,State Preferred,,1013.24,,,1013.24,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Anthem,Individual Exchange,,810.59,,,810.59,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Cigna,Cigna,,1174.36,,,1174.36,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Connecticare,Commerical,,1093.28,,,1093.28,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Connecticare,Exchange,,1093.28,,,1093.28,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,Multiplan,Multiplan,,,1254.35,,1254.35,810.59,1254.35,percent of total billed charges,,
HC HH RADIATION THPY 1 500 - 3 000,33300008,CPT,,,both,,,1565.58,939.35,United Healthcare/Oxford,United Healthcare/Oxford,,953.76,,,953.76,810.59,1254.35,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Aetna,Commerical,,2020.57,,,2020.57,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Aetna,Middlesex Employees,,1818.51,,,1818.51,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Anthem,Commerical,,1807.96,,,1807.96,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Anthem,Indemnity,,,2031.67,,2031.67,1446.37,2238.18,percent of total billed charges,,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Anthem,State Preferred,,1807.96,,,1807.96,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Anthem,Individual Exchange,,1446.37,,,1446.37,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Cigna,Cigna,,2095.44,,,2095.44,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Connecticare,Commerical,,1950.77,,,1950.77,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Connecticare,Exchange,,1950.77,,,1950.77,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,Multiplan,Multiplan,,,2238.18,,2238.18,1446.37,2238.18,percent of total billed charges,,
HC HH RADIATION THPY 3 000 - 5 000,33300009,CPT,,,both,,,2793.5,1676.1,United Healthcare/Oxford,United Healthcare/Oxford,,1701.82,,,1701.82,1446.37,2238.18,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Aetna,Commerical,,2908.75,,,2908.75,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Aetna,Middlesex Employees,,2617.87,,,2617.87,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Anthem,Commerical,,2602.68,,,2602.68,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Anthem,Indemnity,,,2924.72,,2924.72,2082.15,3222.01,percent of total billed charges,,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Anthem,State Preferred,,2602.68,,,2602.68,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Anthem,Individual Exchange,,2082.15,,,2082.15,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Cigna,Cigna,,3016.52,,,3016.52,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Connecticare,Commerical,,2808.26,,,2808.26,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Connecticare,Exchange,,2808.26,,,2808.26,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,Multiplan,Multiplan,,,3222.01,,3222.01,2082.15,3222.01,percent of total billed charges,,
HC HH RADIATION THPY 5 000 - 8 000,33300010,CPT,,,both,,,4021.45,2412.87,United Healthcare/Oxford,United Healthcare/Oxford,,2449.88,,,2449.88,2082.15,3222.01,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Aetna,Commerical,,365.53,,,365.53,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Aetna,Middlesex Employees,,328.98,,,328.98,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Anthem,Commerical,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Anthem,Indemnity,,,367.53,,367.53,261.65,404.89,percent of total billed charges,,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Anthem,State Preferred,,327.06,,,327.06,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Anthem,Individual Exchange,,261.65,,,261.65,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Cigna,Cigna,,379.07,,,379.07,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Connecticare,Commerical,,352.9,,,352.9,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Connecticare,Exchange,,352.9,,,352.9,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,Multiplan,Multiplan,,,404.89,,404.89,261.65,404.89,percent of total billed charges,,
HC HH DIAGISOTRENAL,34000001,CPT,,,both,,,504.7,302.82,United Healthcare/Oxford,United Healthcare/Oxford,,307.87,,,307.87,261.65,404.89,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Aetna,Commerical,,248.3,,,248.3,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Aetna,Middlesex Employees,,223.47,,,223.47,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Anthem,Commerical,,222.17,,,222.17,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Anthem,Indemnity,,,249.66,,249.66,177.74,275.03,percent of total billed charges,,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Anthem,State Preferred,,222.17,,,222.17,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Anthem,Individual Exchange,,177.74,,,177.74,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Cigna,Cigna,,257.49,,,257.49,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Connecticare,Commerical,,239.72,,,239.72,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Connecticare,Exchange,,239.72,,,239.72,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,Multiplan,Multiplan,,,275.03,,275.03,177.74,275.03,percent of total billed charges,,
HC HH DIAGISOTGALLI,34300002,CPT,,,both,,,342.99,205.79,United Healthcare/Oxford,United Healthcare/Oxford,,209.13,,,209.13,177.74,275.03,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Cigna,Cigna,,590.98,,,590.98,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Connecticare,Commerical,,550.18,,,550.18,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Connecticare,Exchange,,550.18,,,550.18,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC HH DIAGISOTTHALL,34300003,CPT,,,both,,,787.95,472.77,United Healthcare/Oxford,United Healthcare/Oxford,,479.97,,,479.97,407.92,631.24,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Aetna,Commerical,,88.73,,,88.73,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Aetna,Middlesex Employees,,79.86,,,79.86,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Anthem,Commerical,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Anthem,Indemnity,,,89.22,,89.22,63.52,98.29,percent of total billed charges,,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Anthem,State Preferred,,79.39,,,79.39,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Anthem,Individual Exchange,,63.52,,,63.52,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Cigna,Cigna,,92.02,,,92.02,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Connecticare,Commerical,,85.67,,,85.67,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Connecticare,Exchange,,85.67,,,85.67,63.52,98.29,other,Could be inpatient or outpatient,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,Multiplan,Multiplan,,,98.29,,98.29,63.52,98.29,percent of total billed charges,,
HC HH DIAGISOTXENON,34300004,CPT,,,both,,,121.54,72.92,United Healthcare/Oxford,United Healthcare/Oxford,,74.74,,,74.74,63.52,98.29,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Aetna,Commerical,,,66.2,,66.2,47.4,77.35,percent of total billed charges,,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Aetna,Middlesex Employees,,,59.65,,59.65,47.4,77.35,percent of total billed charges,,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Anthem,Commerical,,59.24,,,59.24,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Anthem,Indemnity,,,68.36,,68.36,47.4,77.35,percent of total billed charges,,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Anthem,State Preferred,,59.24,,,59.24,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Anthem,Individual Exchange,,47.4,,,47.4,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Cigna,Cigna,,57.86,,,57.86,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Connecticare,Commerical,,61.88,,,61.88,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Connecticare,Exchange,,61.88,,,61.88,47.4,77.35,other,Could be inpatient or outpatient,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,Multiplan,Multiplan,,,77.35,,77.35,47.4,77.35,percent of total billed charges,,
HC OR TIME PER MIN,36000001,CPT,,,both,,,91,54.6,United Healthcare/Oxford,United Healthcare/Oxford,,59.54,,,59.54,47.4,77.35,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Aetna,Commerical,,,99.32,,99.32,71.09,110.02,percent of total billed charges,,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,,89.39,,89.39,71.09,110.02,percent of total billed charges,,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC OR ENDO TIME PER MIN,36000002,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Aetna,Commerical,,,6.81,,6.81,4.86,7.54,percent of total billed charges,,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Aetna,Middlesex Employees,,,6.13,,6.13,4.86,7.54,percent of total billed charges,,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Anthem,Commerical,,6.09,,,6.09,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Anthem,Indemnity,,,6.84,,6.84,4.86,7.54,percent of total billed charges,,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Anthem,State Preferred,,6.09,,,6.09,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Anthem,Individual Exchange,,4.86,,,4.86,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Cigna,Cigna,,5.95,,,5.95,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Connecticare,Commerical,,6.36,,,6.36,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Connecticare,Exchange,,6.36,,,6.36,4.86,7.54,other,Could be inpatient or outpatient,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,Multiplan,Multiplan,,,7.54,,7.54,4.86,7.54,percent of total billed charges,,
HC OR TIME PER MIN ADDL STAFF,36000003,CPT,,,both,,,9.41,5.65,United Healthcare/Oxford,United Healthcare/Oxford,,6.12,,,6.12,4.86,7.54,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Aetna,Commerical,,1305.8,,,1305.8,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Aetna,Middlesex Employees,,1175.22,,,1175.22,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Anthem,Commerical,,1168.4,,,1168.4,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Anthem,Indemnity,,,1312.97,,1312.97,934.72,1446.43,percent of total billed charges,,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Anthem,State Preferred,,1168.4,,,1168.4,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Anthem,Individual Exchange,,934.72,,,934.72,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Cigna,Cigna,,1141.08,,,1141.08,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Connecticare,Commerical,,1220.48,,,1220.48,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Connecticare,Exchange,,1220.48,,,1220.48,934.72,1446.43,other,Could be inpatient or outpatient,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,Multiplan,Multiplan,,,1446.43,,1446.43,934.72,1446.43,percent of total billed charges,,
HC LASER STANDBY,36000004,CPT,,,both,,,1805.59,1083.35,United Healthcare/Oxford,United Healthcare/Oxford,,1174.33,,,1174.33,934.72,1446.43,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Aetna,Commerical,,99.32,,,99.32,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Aetna,Middlesex Employees,,89.39,,,89.39,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Anthem,Commerical,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Anthem,Indemnity,,,99.86,,99.86,71.09,110.02,percent of total billed charges,,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Anthem,State Preferred,,88.87,,,88.87,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Anthem,Individual Exchange,,71.09,,,71.09,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Cigna,Cigna,,86.79,,,86.79,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Connecticare,Commerical,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Connecticare,Exchange,,92.83,,,92.83,71.09,110.02,other,Could be inpatient or outpatient,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,Multiplan,Multiplan,,,110.02,,110.02,71.09,110.02,percent of total billed charges,,
HC ENT MAN MIN,36000007,CPT,,,both,,,138.02,82.81,United Healthcare/Oxford,United Healthcare/Oxford,,89.32,,,89.32,71.09,110.02,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Aetna,Commerical,,,145.72,,145.72,104.31,161.42,percent of total billed charges,,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Aetna,Middlesex Employees,,,131.15,,131.15,104.31,161.42,percent of total billed charges,,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Anthem,Commerical,,130.39,,,130.39,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Anthem,Indemnity,,,146.52,,146.52,104.31,161.42,percent of total billed charges,,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Anthem,State Preferred,,130.39,,,130.39,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Anthem,Individual Exchange,,104.31,,,104.31,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Cigna,Cigna,,127.34,,,127.34,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Connecticare,Commerical,,136.2,,,136.2,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Connecticare,Exchange,,136.2,,,136.2,104.31,161.42,other,Could be inpatient or outpatient,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,Multiplan,Multiplan,,,161.42,,161.42,104.31,161.42,percent of total billed charges,,
HC OR ROBOTIC TIME PER MIN,36000008,CPT,,,both,,,201.88,121.13,United Healthcare/Oxford,United Healthcare/Oxford,,131.05,,,131.05,104.31,161.42,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Aetna,Commerical,,306.09,,,306.09,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Aetna,Middlesex Employees,,275.48,,,275.48,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Anthem,Commerical,,273.89,,,273.89,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Anthem,Indemnity,,,307.78,,307.78,219.11,339.07,percent of total billed charges,,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Anthem,State Preferred,,273.89,,,273.89,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Anthem,Individual Exchange,,219.11,,,219.11,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Cigna,Cigna,,267.49,,,267.49,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Connecticare,Commerical,,286.1,,,286.1,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Connecticare,Exchange,,286.1,,,286.1,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,Multiplan,Multiplan,,,339.07,,339.07,219.11,339.07,percent of total billed charges,,
HC HH  ANES SVCS 0 - 700,36000009,CPT,,,both,,,423.2,253.92,United Healthcare/Oxford,United Healthcare/Oxford,,275.28,,,275.28,219.11,339.07,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Aetna,Commerical,,582.89,,,582.89,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Aetna,Middlesex Employees,,524.6,,,524.6,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Anthem,Commerical,,521.56,,,521.56,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Anthem,Indemnity,,,586.09,,586.09,417.25,645.66,percent of total billed charges,,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Anthem,State Preferred,,521.56,,,521.56,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Anthem,Individual Exchange,,417.25,,,417.25,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Cigna,Cigna,,509.36,,,509.36,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Connecticare,Commerical,,544.8,,,544.8,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Connecticare,Exchange,,544.8,,,544.8,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,Multiplan,Multiplan,,,645.66,,645.66,417.25,645.66,percent of total billed charges,,
HC HH  ANES SVCS 700 - 1 000,36000010,CPT,,,both,,,805.86,483.52,United Healthcare/Oxford,United Healthcare/Oxford,,524.2,,,524.2,417.25,645.66,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Aetna,Commerical,,874.33,,,874.33,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Aetna,Middlesex Employees,,786.9,,,786.9,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Anthem,Commerical,,782.34,,,782.34,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Anthem,Indemnity,,,879.14,,879.14,625.86,968.5,percent of total billed charges,,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Anthem,State Preferred,,782.34,,,782.34,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Anthem,Individual Exchange,,625.86,,,625.86,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Cigna,Cigna,,764.04,,,764.04,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Connecticare,Commerical,,817.21,,,817.21,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Connecticare,Exchange,,817.21,,,817.21,625.86,968.5,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,Multiplan,Multiplan,,,968.5,,968.5,625.86,968.5,percent of total billed charges,,
HC HH  ANES SVCS 1 000 - 1 300,36000011,CPT,,,both,,,1208.8,725.28,United Healthcare/Oxford,United Healthcare/Oxford,,786.3,,,786.3,625.86,968.5,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Aetna,Commerical,,1165.78,,,1165.78,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Aetna,Middlesex Employees,,1049.21,,,1049.21,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Anthem,Commerical,,1043.11,,,1043.11,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Anthem,Indemnity,,,1172.18,,1172.18,834.49,1291.33,percent of total billed charges,,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Anthem,State Preferred,,1043.11,,,1043.11,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Anthem,Individual Exchange,,834.49,,,834.49,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Cigna,Cigna,,1018.71,,,1018.71,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Connecticare,Commerical,,1089.6,,,1089.6,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Connecticare,Exchange,,1089.6,,,1089.6,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,Multiplan,Multiplan,,,1291.33,,1291.33,834.49,1291.33,percent of total billed charges,,
HC HH ANES SVCS 1 300 - 1 600,36000012,CPT,,,both,,,1611.73,967.04,United Healthcare/Oxford,United Healthcare/Oxford,,1048.41,,,1048.41,834.49,1291.33,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Aetna,Commerical,,1456.41,,,1456.41,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Aetna,Middlesex Employees,,1310.77,,,1310.77,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Anthem,Commerical,,1303.16,,,1303.16,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Anthem,Indemnity,,,1464.41,,1464.41,1042.52,1613.26,percent of total billed charges,,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Anthem,State Preferred,,1303.16,,,1303.16,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Anthem,Individual Exchange,,1042.52,,,1042.52,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Cigna,Cigna,,1272.68,,,1272.68,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Connecticare,Commerical,,1361.25,,,1361.25,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Connecticare,Exchange,,1361.25,,,1361.25,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,Multiplan,Multiplan,,,1613.26,,1613.26,1042.52,1613.26,percent of total billed charges,,
HC HH ANES SVCS 1 600 - 1 900,36000013,CPT,,,both,,,2013.54,1208.12,United Healthcare/Oxford,United Healthcare/Oxford,,1309.78,,,1309.78,1042.52,1613.26,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Aetna,Commerical,,971.21,,,971.21,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Aetna,Middlesex Employees,,874.09,,,874.09,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Anthem,Commerical,,869.02,,,869.02,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Anthem,Indemnity,,,976.54,,976.54,695.21,1075.8,percent of total billed charges,,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Anthem,State Preferred,,869.02,,,869.02,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Anthem,Individual Exchange,,695.21,,,695.21,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Cigna,Cigna,,848.69,,,848.69,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Connecticare,Commerical,,907.75,,,907.75,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Connecticare,Exchange,,907.75,,,907.75,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,Multiplan,Multiplan,,,1075.8,,1075.8,695.21,1075.8,percent of total billed charges,,
HC HH OR SERVICES 0 - 2 000,36000014,CPT,,,both,,,1342.73,805.64,United Healthcare/Oxford,United Healthcare/Oxford,,873.43,,,873.43,695.21,1075.8,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Aetna,Commerical,,1943.24,,,1943.24,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Aetna,Middlesex Employees,,1748.92,,,1748.92,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Anthem,Commerical,,1738.76,,,1738.76,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Anthem,Indemnity,,,1953.91,,1953.91,1391.01,2152.51,percent of total billed charges,,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Anthem,State Preferred,,1738.76,,,1738.76,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Anthem,Individual Exchange,,1391.01,,,1391.01,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Cigna,Cigna,,1698.09,,,1698.09,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Connecticare,Commerical,,1816.26,,,1816.26,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Connecticare,Exchange,,1816.26,,,1816.26,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,Multiplan,Multiplan,,,2152.51,,2152.51,1391.01,2152.51,percent of total billed charges,,
HC HH OR SERVICES 2 000 - 4 500,36000015,CPT,,,both,,,2686.59,1611.95,United Healthcare/Oxford,United Healthcare/Oxford,,1747.59,,,1747.59,1391.01,2152.51,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Aetna,Commerical,,2913.63,,,2913.63,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Aetna,Middlesex Employees,,2622.26,,,2622.26,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Anthem,Commerical,,2607.05,,,2607.05,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Anthem,Indemnity,,,2929.63,,2929.63,2085.64,3227.42,percent of total billed charges,,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Anthem,State Preferred,,2607.05,,,2607.05,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Anthem,Individual Exchange,,2085.64,,,2085.64,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Cigna,Cigna,,2546.08,,,2546.08,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Connecticare,Commerical,,2723.25,,,2723.25,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Connecticare,Exchange,,2723.25,,,2723.25,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,Multiplan,Multiplan,,,3227.42,,3227.42,2085.64,3227.42,percent of total billed charges,,
HC HH OR SERVICES 4 500 - 7 000,36000016,CPT,,,both,,,4028.2,2416.92,United Healthcare/Oxford,United Healthcare/Oxford,,2620.28,,,2620.28,2085.64,3227.42,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Aetna,Commerical,,4370.04,,,4370.04,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Aetna,Middlesex Employees,,3933.03,,,3933.03,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Anthem,Commerical,,3910.21,,,3910.21,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Anthem,Indemnity,,,4394.04,,4394.04,3128.16,4840.67,percent of total billed charges,,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Anthem,State Preferred,,3910.21,,,3910.21,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Anthem,Individual Exchange,,3128.16,,,3128.16,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Cigna,Cigna,,3818.76,,,3818.76,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Connecticare,Commerical,,4084.48,,,4084.48,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Connecticare,Exchange,,4084.48,,,4084.48,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,Multiplan,Multiplan,,,4840.67,,4840.67,3128.16,4840.67,percent of total billed charges,,
HC HH OR SERVICES 7 000 - 10 000,36000017,CPT,,,both,,,6041.73,3625.04,United Healthcare/Oxford,United Healthcare/Oxford,,3930.06,,,3930.06,3128.16,4840.67,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Aetna,Commerical,,5342.07,,,5342.07,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Aetna,Middlesex Employees,,4807.86,,,4807.86,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Anthem,Commerical,,4779.96,,,4779.96,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Anthem,Indemnity,,,5371.41,,5371.41,3823.97,5917.39,percent of total billed charges,,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Anthem,State Preferred,,4779.96,,,4779.96,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Anthem,Individual Exchange,,3823.97,,,3823.97,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Cigna,Cigna,,4668.15,,,4668.15,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Connecticare,Commerical,,4993,,,4993,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Connecticare,Exchange,,4993,,,4993,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,Multiplan,Multiplan,,,5917.39,,5917.39,3823.97,5917.39,percent of total billed charges,,
HC HH OR SERVICES 10 000 - 13 000,36000018,CPT,,,both,,,7385.59,4431.36,United Healthcare/Oxford,United Healthcare/Oxford,,4804.22,,,4804.22,3823.97,5917.39,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Aetna,Commerical,,6410.15,,,6410.15,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Aetna,Middlesex Employees,,5769.14,,,5769.14,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Anthem,Commerical,,5735.66,,,5735.66,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Anthem,Indemnity,,,6445.36,,6445.36,4588.53,7100.5,percent of total billed charges,,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Anthem,State Preferred,,5735.66,,,5735.66,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Anthem,Individual Exchange,,4588.53,,,4588.53,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Cigna,Cigna,,5601.5,,,5601.5,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Connecticare,Commerical,,5991.29,,,5991.29,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Connecticare,Exchange,,5991.29,,,5991.29,4588.53,7100.5,other,Could be inpatient or outpatient,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,Multiplan,Multiplan,,,7100.5,,7100.5,4588.53,7100.5,percent of total billed charges,,
HC HH OR SERVICES 13 000 - 16 000,36000019,CPT,,,both,,,8862.26,5317.36,United Healthcare/Oxford,United Healthcare/Oxford,,5764.77,,,5764.77,4588.53,7100.5,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Aetna,Commerical,,,64.31,,64.31,46.04,71.24,percent of total billed charges,,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Aetna,Middlesex Employees,,,57.88,,57.88,46.04,71.24,percent of total billed charges,,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Anthem,Commerical,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Anthem,Indemnity,,,64.67,,64.67,46.04,71.24,percent of total billed charges,,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Anthem,State Preferred,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Anthem,Individual Exchange,,46.04,,,46.04,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Cigna,Cigna,,56.2,,,56.2,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Connecticare,Commerical,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Connecticare,Exchange,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,Multiplan,Multiplan,,,71.24,,71.24,46.04,71.24,percent of total billed charges,,
HC OR BARIATRIC TIME PER MIN,36000020,CPT,,,both,,,87.55,52.53,United Healthcare/Oxford,United Healthcare/Oxford,,57.83,,,57.83,46.04,71.24,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Aetna,Commerical,,,43.96,,43.96,31.47,48.7,percent of total billed charges,,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Aetna,Middlesex Employees,,,39.56,,39.56,31.47,48.7,percent of total billed charges,,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Anthem,Indemnity,,,44.2,,44.2,31.47,48.7,percent of total billed charges,,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,Multiplan,Multiplan,,,48.7,,48.7,31.47,48.7,percent of total billed charges,,
HC OR DENTAL TIME PER MIN,36000022,CPT,,,both,,,61.8,37.08,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Aetna,Commerical,,86.57,,,86.57,61.99,101.15,percent of total billed charges,,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Aetna,Middlesex Employees,,78,,,78,61.99,101.15,percent of total billed charges,,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Anthem,Commerical,,77.47,,,77.47,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Anthem,Indemnity,,,89.39,,89.39,61.99,101.15,percent of total billed charges,,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Anthem,State Preferred,,77.47,,,77.47,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Anthem,Individual Exchange,,61.99,,,61.99,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Cigna,Cigna,,75.66,,,75.66,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Connecticare,Commerical,,80.92,,,80.92,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Connecticare,Exchange,,80.92,,,80.92,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,Multiplan,Multiplan,,,101.15,,101.15,61.99,101.15,percent of total billed charges,,
HC OR TIME PER MIN TIER 2,36000023,CPT,,,both,,,119,71.4,United Healthcare/Oxford,United Healthcare/Oxford,,77.86,,,77.86,61.99,101.15,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Aetna,Commerical,,112.76,,,112.76,80.74,131.75,percent of total billed charges,,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Aetna,Middlesex Employees,,101.6,,,101.6,80.74,131.75,percent of total billed charges,,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Anthem,Commerical,,100.9,,,100.9,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Anthem,Indemnity,,,116.44,,116.44,80.74,131.75,percent of total billed charges,,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Anthem,State Preferred,,100.9,,,100.9,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Anthem,Individual Exchange,,80.74,,,80.74,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Cigna,Cigna,,98.55,,,98.55,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Connecticare,Commerical,,105.4,,,105.4,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Connecticare,Exchange,,105.4,,,105.4,80.74,131.75,other,Could be inpatient or outpatient,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,Multiplan,Multiplan,,,131.75,,131.75,80.74,131.75,percent of total billed charges,,
HC OR TIME PER MIN TIER 3,36000024,CPT,,,both,,,155,93,United Healthcare/Oxford,United Healthcare/Oxford,,101.42,,,101.42,80.74,131.75,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Aetna,Commerical,,48.02,,,48.02,36.36,56.1,percent of total billed charges,,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Aetna,Middlesex Employees,,43.26,,,43.26,36.36,56.1,percent of total billed charges,,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Anthem,Commerical,,42.97,,,42.97,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Anthem,Indemnity,,,49.58,,49.58,36.36,56.1,percent of total billed charges,,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Anthem,State Preferred,,42.97,,,42.97,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Anthem,Individual Exchange,,36.36,,,36.36,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Cigna,Cigna,,41.96,,,41.96,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Connecticare,Commerical,,44.88,,,44.88,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Connecticare,Exchange,,44.88,,,44.88,36.36,56.1,other,Could be inpatient or outpatient,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,Multiplan,Multiplan,,,56.1,,56.1,36.36,56.1,percent of total billed charges,,
HC OR PERFUSIONIST TIME PER MIN,36000026,CPT,,,both,,,66,39.6,United Healthcare/Oxford,United Healthcare/Oxford,,43.18,,,43.18,36.36,56.1,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Aetna,Commerical,,3011.32,,,3011.32,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Aetna,Middlesex Employees,,2710.19,,,2710.19,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Anthem,Commerical,,2694.46,,,2694.46,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Anthem,Indemnity,,,3027.86,,3027.86,2155.56,3335.63,percent of total billed charges,,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Anthem,State Preferred,,2694.46,,,2694.46,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Anthem,Individual Exchange,,2155.56,,,2155.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Cigna,Cigna,,2631.44,,,2631.44,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Connecticare,Commerical,,2814.56,,,2814.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Connecticare,Exchange,,2814.56,,,2814.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,Multiplan,Multiplan,,,3335.63,,3335.63,2155.56,3335.63,percent of total billed charges,,
HC EXT PACU ICU FLAT RATE,36100210,CPT,,,both,,,4163.26,2497.96,United Healthcare/Oxford,United Healthcare/Oxford,,2708.14,,,2708.14,2155.56,3335.63,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Aetna,Commerical,,,62.69,,62.69,44.87,69.44,percent of total billed charges,,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Aetna,Middlesex Employees,,,56.41,,56.41,44.87,69.44,percent of total billed charges,,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Anthem,Indemnity,,,63.03,,63.03,44.87,69.44,percent of total billed charges,,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC OR ANESTHESIA TIME PER MIN,37000008,RC,,,both,,,85.49,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Aetna,Commerical,,,12.56,,12.56,8.98,13.91,percent of total billed charges,,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Aetna,Middlesex Employees,,,11.3,,11.3,8.98,13.91,percent of total billed charges,,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Anthem,Commerical,,11.23,,,11.23,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Anthem,Indemnity,,,12.62,,12.62,8.98,13.91,percent of total billed charges,,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Anthem,State Preferred,,11.23,,,11.23,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Anthem,Individual Exchange,,8.98,,,8.98,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Cigna,Cigna,,10.97,,,10.97,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Connecticare,Commerical,,11.73,,,11.73,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Connecticare,Exchange,,11.73,,,11.73,8.98,13.91,other,Could be inpatient or outpatient,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,Multiplan,Multiplan,,,13.91,,13.91,8.98,13.91,percent of total billed charges,,
HC ANESTHESIA TIME PER MIN,37000009,RC,,,both,,,17.36,10.41,United Healthcare/Oxford,United Healthcare/Oxford,,11.29,,,11.29,8.98,13.91,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Aetna,Commerical,,497.41,,,497.41,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Aetna,Middlesex Employees,,447.67,,,447.67,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Anthem,Commerical,,445.07,,,445.07,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Anthem,Indemnity,,,500.14,,500.14,356.06,550.98,percent of total billed charges,,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Anthem,State Preferred,,445.07,,,445.07,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Anthem,Individual Exchange,,356.06,,,356.06,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Cigna,Cigna,,434.66,,,434.66,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Connecticare,Commerical,,464.91,,,464.91,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Connecticare,Exchange,,464.91,,,464.91,356.06,550.98,other,Could be inpatient or outpatient,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,Multiplan,Multiplan,,,550.98,,550.98,356.06,550.98,percent of total billed charges,,
HC CCMC ANESTHESIA,37000010,RC,,,both,,,687.01,412.21,United Healthcare/Oxford,United Healthcare/Oxford,,447.33,,,447.33,356.06,550.98,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Aetna,Commerical,,288.19,,,288.19,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Aetna,Middlesex Employees,,259.37,,,259.37,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Anthem,Commerical,,257.86,,,257.86,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Anthem,Indemnity,,,289.77,,289.77,206.29,319.23,percent of total billed charges,,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Anthem,State Preferred,,257.86,,,257.86,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Anthem,Individual Exchange,,206.29,,,206.29,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Cigna,Cigna,,251.84,,,251.84,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Connecticare,Commerical,,269.36,,,269.36,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Connecticare,Exchange,,269.36,,,269.36,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,Multiplan,Multiplan,,,319.23,,319.23,206.29,319.23,percent of total billed charges,,
HC HH  ANES SVCS 0 - 700,37000012,RC,,,both,,,398.43,239.06,United Healthcare/Oxford,United Healthcare/Oxford,,259.17,,,259.17,206.29,319.23,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Aetna,Commerical,,577.19,,,577.19,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Aetna,Middlesex Employees,,519.47,,,519.47,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Anthem,Commerical,,516.45,,,516.45,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Anthem,Indemnity,,,580.36,,580.36,413.16,639.35,percent of total billed charges,,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Anthem,State Preferred,,516.45,,,516.45,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Anthem,Individual Exchange,,413.16,,,413.16,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Cigna,Cigna,,504.38,,,504.38,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Connecticare,Commerical,,539.48,,,539.48,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Connecticare,Exchange,,539.48,,,539.48,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,Multiplan,Multiplan,,,639.35,,639.35,413.16,639.35,percent of total billed charges,,
HC HH  ANES SVCS 700 - 1 000,37000013,RC,,,both,,,797.99,478.8,United Healthcare/Oxford,United Healthcare/Oxford,,519.08,,,519.08,413.16,639.35,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Aetna,Commerical,,866.19,,,866.19,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Aetna,Middlesex Employees,,779.57,,,779.57,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Anthem,Commerical,,775.05,,,775.05,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Anthem,Indemnity,,,870.95,,870.95,620.04,959.48,percent of total billed charges,,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Anthem,State Preferred,,775.05,,,775.05,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Anthem,Individual Exchange,,620.04,,,620.04,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Cigna,Cigna,,756.92,,,756.92,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Connecticare,Commerical,,809.59,,,809.59,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Connecticare,Exchange,,809.59,,,809.59,620.04,959.48,other,Could be inpatient or outpatient,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,Multiplan,Multiplan,,,959.48,,959.48,620.04,959.48,percent of total billed charges,,
HC HH  ANES SVCS 1 000 - 1 300,37000014,RC,,,both,,,1197.54,718.52,United Healthcare/Oxford,United Healthcare/Oxford,,778.98,,,778.98,620.04,959.48,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Aetna,Commerical,,1099.02,,,1099.02,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Aetna,Middlesex Employees,,989.12,,,989.12,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Anthem,Commerical,,983.38,,,983.38,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Anthem,Indemnity,,,1105.06,,1105.06,786.7,1217.39,percent of total billed charges,,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Anthem,State Preferred,,983.38,,,983.38,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Anthem,Individual Exchange,,786.7,,,786.7,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Cigna,Cigna,,960.38,,,960.38,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Connecticare,Commerical,,1027.21,,,1027.21,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Connecticare,Exchange,,1027.21,,,1027.21,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,Multiplan,Multiplan,,,1217.39,,1217.39,786.7,1217.39,percent of total billed charges,,
HC HH ANES SVCS 1 300 - 1 600,37000015,RC,,,both,,,1519.45,911.67,United Healthcare/Oxford,United Healthcare/Oxford,,988.37,,,988.37,786.7,1217.39,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Aetna,Commerical,,1374.19,,,1374.19,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Aetna,Middlesex Employees,,1236.77,,,1236.77,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Anthem,Commerical,,1229.59,,,1229.59,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Anthem,Indemnity,,,1381.73,,1381.73,983.67,1522.18,percent of total billed charges,,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Anthem,State Preferred,,1229.59,,,1229.59,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Anthem,Individual Exchange,,983.67,,,983.67,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Cigna,Cigna,,1200.83,,,1200.83,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Connecticare,Commerical,,1284.4,,,1284.4,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Connecticare,Exchange,,1284.4,,,1284.4,983.67,1522.18,other,Could be inpatient or outpatient,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,Multiplan,Multiplan,,,1522.18,,1522.18,983.67,1522.18,percent of total billed charges,,
HC HH ANES SVCS 1 600 - 1 900,37000016,RC,,,both,,,1899.86,1139.91,United Healthcare/Oxford,United Healthcare/Oxford,,1235.84,,,1235.84,983.67,1522.18,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Aetna,Commerical,,687.91,,,687.91,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Aetna,Middlesex Employees,,619.12,,,619.12,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Anthem,Commerical,,615.52,,,615.52,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Anthem,Indemnity,,,691.68,,691.68,492.42,761.99,percent of total billed charges,,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Anthem,State Preferred,,615.52,,,615.52,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Anthem,Individual Exchange,,492.42,,,492.42,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Cigna,Cigna,,601.13,,,601.13,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Connecticare,Commerical,,642.96,,,642.96,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Connecticare,Exchange,,642.96,,,642.96,492.42,761.99,other,Could be inpatient or outpatient,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,Multiplan,Multiplan,,,761.99,,761.99,492.42,761.99,percent of total billed charges,,
HC DEEP SEDATION,37200001,RC,,,both,,,950.69,570.41,United Healthcare/Oxford,United Healthcare/Oxford,,618.65,,,618.65,492.42,761.99,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Aetna,Commerical,,759.54,,,759.54,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Aetna,Middlesex Employees,,683.59,,,683.59,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Anthem,Commerical,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Anthem,Indemnity,,,763.72,,763.72,543.7,841.35,percent of total billed charges,,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Anthem,State Preferred,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Anthem,Individual Exchange,,543.7,,,543.7,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Cigna,Cigna,,663.73,,,663.73,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Connecticare,Commerical,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Connecticare,Exchange,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,Multiplan,Multiplan,,,841.35,,841.35,543.7,841.35,percent of total billed charges,,
HC SEDATION 1ST 1/2 HOUR,37200002,RC,,,both,,,1050.6,630.36,United Healthcare/Oxford,United Healthcare/Oxford,,683.08,,,683.08,543.7,841.35,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Aetna,Commerical,,887.36,,,887.36,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Aetna,Middlesex Employees,,798.63,,,798.63,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Anthem,Commerical,,793.99,,,793.99,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Anthem,Indemnity,,,892.23,,892.23,635.19,982.92,percent of total billed charges,,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Anthem,State Preferred,,793.99,,,793.99,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Anthem,Individual Exchange,,635.19,,,635.19,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Cigna,Cigna,,775.41,,,775.41,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Connecticare,Commerical,,829.37,,,829.37,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Connecticare,Exchange,,829.37,,,829.37,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,Multiplan,Multiplan,,,982.92,,982.92,635.19,982.92,percent of total billed charges,,
HC SEDATION 1/2 - 1HR,37200003,RC,,,both,,,1227.76,736.66,United Healthcare/Oxford,United Healthcare/Oxford,,798.02,,,798.02,635.19,982.92,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Aetna,Commerical,,979.35,,,979.35,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Aetna,Middlesex Employees,,881.42,,,881.42,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Anthem,Commerical,,876.3,,,876.3,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Anthem,Indemnity,,,984.73,,984.73,701.05,1084.82,percent of total billed charges,,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Anthem,State Preferred,,876.3,,,876.3,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Anthem,Individual Exchange,,701.05,,,701.05,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Cigna,Cigna,,855.81,,,855.81,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Connecticare,Commerical,,915.36,,,915.36,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Connecticare,Exchange,,915.36,,,915.36,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,Multiplan,Multiplan,,,1084.82,,1084.82,701.05,1084.82,percent of total billed charges,,
HC SEDATION 1-2 HRS,37200004,RC,,,both,,,1353.42,812.05,United Healthcare/Oxford,United Healthcare/Oxford,,880.75,,,880.75,701.05,1084.82,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Aetna,Commerical,,1147.87,,,1147.87,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Aetna,Middlesex Employees,,1033.09,,,1033.09,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Anthem,Commerical,,1027.08,,,1027.08,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Anthem,Indemnity,,,1154.17,,1154.17,821.67,1271.49,percent of total billed charges,,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Anthem,State Preferred,,1027.08,,,1027.08,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Anthem,Individual Exchange,,821.67,,,821.67,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Cigna,Cigna,,1003.06,,,1003.06,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Connecticare,Commerical,,1072.87,,,1072.87,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Connecticare,Exchange,,1072.87,,,1072.87,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,Multiplan,Multiplan,,,1271.49,,1271.49,821.67,1271.49,percent of total billed charges,,
HC SEDATION 2-3 HRS,37200005,RC,,,both,,,1587.23,952.34,United Healthcare/Oxford,United Healthcare/Oxford,,1032.3,,,1032.3,821.67,1271.49,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Aetna,Commerical,,1393.73,,,1393.73,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Aetna,Middlesex Employees,,1254.36,,,1254.36,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Anthem,Commerical,,1247.07,,,1247.07,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Anthem,Indemnity,,,1401.38,,1401.38,997.66,1543.82,percent of total billed charges,,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Anthem,State Preferred,,1247.07,,,1247.07,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Anthem,Individual Exchange,,997.66,,,997.66,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Cigna,Cigna,,1217.9,,,1217.9,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Connecticare,Commerical,,1302.65,,,1302.65,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Connecticare,Exchange,,1302.65,,,1302.65,997.66,1543.82,other,Could be inpatient or outpatient,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,Multiplan,Multiplan,,,1543.82,,1543.82,997.66,1543.82,percent of total billed charges,,
HC SEDATION 3+ HRS,37200006,RC,,,both,,,1926.1,1155.66,United Healthcare/Oxford,United Healthcare/Oxford,,1253.4,,,1253.4,997.66,1543.82,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS ,,,both,,,86.66,52,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Anthem,Indemnity,,,63.03,,63.03,44.87,69.44,percent of total billed charges,,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC COMMERCIAL TRANS,39100016,HCPCS,,,both,,,86.66,52,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC COGNITIVE THERAPETIC INTERVENTION - MEDICARE,44000021,CPT,,,both,,,130.81,78.49,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Aetna,Commerical,,3358.94,,,3358.94,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Aetna,Middlesex Employees,,3023.05,,,3023.05,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Anthem,Commerical,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Anthem,Indemnity,,,3377.38,,3377.38,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Anthem,State Preferred,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Anthem,Individual Exchange,,2404.41,,,2404.41,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Cigna,Cigna,,2935.2,,,2935.2,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Connecticare,Commerical,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Connecticare,Exchange,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,Multiplan,Multiplan,,,3720.68,,3720.68,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATION WITH NOTIFICATION,45000435,HCPCS,,,both,,,4644.27,2786.56,United Healthcare/Oxford,United Healthcare/Oxford,,3020.75,,,3020.75,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Aetna,Commerical,,2686.5,,,2686.5,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Aetna,Middlesex Employees,,2417.85,,,2417.85,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Anthem,Commerical,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Anthem,Indemnity,,,2701.25,,2701.25,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Anthem,State Preferred,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Anthem,Individual Exchange,,1923.05,,,1923.05,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Cigna,Cigna,,2347.59,,,2347.59,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Connecticare,Commerical,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Connecticare,Exchange,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,Multiplan,Multiplan,,,2975.82,,2975.82,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION WITH NOTIFICATION,45000436,HCPCS,,,both,,,3714.18,2228.51,United Healthcare/Oxford,United Healthcare/Oxford,,2416.02,,,2416.02,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Aetna,Commerical,,2015.69,,,2015.69,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Aetna,Middlesex Employees,,1814.12,,,1814.12,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Anthem,Commerical,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Anthem,Indemnity,,,2026.76,,2026.76,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Anthem,State Preferred,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Anthem,Individual Exchange,,1442.87,,,1442.87,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Cigna,Cigna,,1761.41,,,1761.41,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Connecticare,Commerical,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Connecticare,Exchange,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,Multiplan,Multiplan,,,2232.77,,2232.77,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION WITH NOTIFICATION,45000437,HCPCS,,,both,,,2787.18,1672.31,United Healthcare/Oxford,United Healthcare/Oxford,,1812.75,,,1812.75,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Aetna,Commerical,,3358.94,,,3358.94,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Aetna,Middlesex Employees,,3023.05,,,3023.05,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Anthem,Commerical,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Anthem,Indemnity,,,3377.38,,3377.38,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Anthem,State Preferred,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Anthem,Individual Exchange,,2404.41,,,2404.41,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Cigna,Cigna,,2935.2,,,2935.2,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Connecticare,Commerical,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Connecticare,Exchange,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,Multiplan,Multiplan,,,3720.68,,3720.68,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATION WO NOTIFICATION,45000438,HCPCS,,,both,,,4644.27,2786.56,United Healthcare/Oxford,United Healthcare/Oxford,,3020.75,,,3020.75,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Aetna,Commerical,,2686.5,,,2686.5,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Aetna,Middlesex Employees,,2417.85,,,2417.85,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Anthem,Commerical,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Anthem,Indemnity,,,2701.25,,2701.25,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Anthem,State Preferred,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Anthem,Individual Exchange,,1923.05,,,1923.05,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Cigna,Cigna,,2347.59,,,2347.59,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Connecticare,Commerical,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Connecticare,Exchange,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,Multiplan,Multiplan,,,2975.82,,2975.82,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION WO NOTIFICATION,45000439,HCPCS,,,both,,,3714.18,2228.51,United Healthcare/Oxford,United Healthcare/Oxford,,2416.02,,,2416.02,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Aetna,Commerical,,2015.69,,,2015.69,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Aetna,Middlesex Employees,,1814.12,,,1814.12,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Anthem,Commerical,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Anthem,Indemnity,,,2026.76,,2026.76,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Anthem,State Preferred,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Anthem,Individual Exchange,,1442.87,,,1442.87,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Cigna,Cigna,,1761.41,,,1761.41,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Connecticare,Commerical,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Connecticare,Exchange,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,Multiplan,Multiplan,,,2232.77,,2232.77,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION WO NOTIFICATION,45000440,HCPCS,,,both,,,2787.18,1672.31,United Healthcare/Oxford,United Healthcare/Oxford,,1812.75,,,1812.75,1442.87,2232.77,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT ,,,both,,,8192.58,4915.55,Aetna,Commerical,,5925.77,,,5925.77,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Aetna,Middlesex Employees,,5333.2,,,5333.2,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Anthem,Commerical,,5302.24,,,5302.24,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Anthem,Indemnity,,,5958.31,,5958.31,4241.79,6563.95,percent of total billed charges,,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Anthem,State Preferred,,5302.24,,,5302.24,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Anthem,Individual Exchange,,4241.79,,,4241.79,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Cigna,Cigna,,5178.22,,,5178.22,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Connecticare,Commerical,,5538.56,,,5538.56,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Connecticare,Exchange,,5538.56,,,5538.56,4241.79,6563.95,other,Could be inpatient or outpatient,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,Multiplan,Multiplan,,,6563.95,,6563.95,4241.79,6563.95,percent of total billed charges,,
HC ED BH BORDER PER DIEM,45002000,CPT,,,both,,,8192.58,4915.55,United Healthcare/Oxford,United Healthcare/Oxford,,5329.16,,,5329.16,4241.79,6563.95,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT ,,,both,,,945.54,567.32,Aetna,Commerical,,683.84,,,683.84,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Aetna,Middlesex Employees,,615.46,,,615.46,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Anthem,Commerical,,611.88,,,611.88,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Anthem,Indemnity,,,687.59,,687.59,489.5,757.49,percent of total billed charges,,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Anthem,State Preferred,,611.88,,,611.88,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Anthem,Individual Exchange,,489.5,,,489.5,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Cigna,Cigna,,597.57,,,597.57,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Connecticare,Commerical,,639.15,,,639.15,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Connecticare,Exchange,,639.15,,,639.15,489.5,757.49,other,Could be inpatient or outpatient,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,Multiplan,Multiplan,,,757.49,,757.49,489.5,757.49,percent of total billed charges,,
HC S/A NURSING EXAM,45900001,CPT,,,both,,,945.54,567.32,United Healthcare/Oxford,United Healthcare/Oxford,,614.98,,,614.98,489.5,757.49,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT ,,,both,,,208.06,124.84,Aetna,Commerical,,,149.79,,149.79,107.23,165.93,percent of total billed charges,,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Aetna,Middlesex Employees,,,134.81,,134.81,107.23,165.93,percent of total billed charges,,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Anthem,Commerical,,134.03,,,134.03,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Anthem,Indemnity,,,150.62,,150.62,107.23,165.93,percent of total billed charges,,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Anthem,State Preferred,,134.03,,,134.03,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Anthem,Individual Exchange,,107.23,,,107.23,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Cigna,Cigna,,130.89,,,130.89,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Connecticare,Commerical,,140,,,140,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Connecticare,Exchange,,140,,,140,107.23,165.93,other,Could be inpatient or outpatient,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,Multiplan,Multiplan,,,165.93,,165.93,107.23,165.93,percent of total billed charges,,
HC CARDIOLOGY TIME PER MIN,48000028,CPT,,,both,,,208.06,124.84,United Healthcare/Oxford,United Healthcare/Oxford,,134.71,,,134.71,107.23,165.93,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT ,,,both,,,215.27,129.16,Aetna,Commerical,,,155.49,,155.49,111.3,172.24,percent of total billed charges,,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Aetna,Middlesex Employees,,,139.94,,139.94,111.3,172.24,percent of total billed charges,,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Anthem,Commerical,,139.14,,,139.14,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Anthem,Indemnity,,,156.34,,156.34,111.3,172.24,percent of total billed charges,,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Anthem,State Preferred,,139.14,,,139.14,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Anthem,Individual Exchange,,111.3,,,111.3,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Cigna,Cigna,,135.88,,,135.88,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Connecticare,Commerical,,145.33,,,145.33,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Connecticare,Exchange,,145.33,,,145.33,111.3,172.24,other,Could be inpatient or outpatient,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,Multiplan,Multiplan,,,172.24,,172.24,111.3,172.24,percent of total billed charges,,
HC OR EP TIME PER MIN,48000032,CPT,,,both,,,215.27,129.16,United Healthcare/Oxford,United Healthcare/Oxford,,139.83,,,139.83,111.3,172.24,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Aetna,Commerical,,118.04,,,118.04,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Aetna,Middlesex Employees,,106.24,,,106.24,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Anthem,Commerical,,105.62,,,105.62,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Anthem,Indemnity,,,118.69,,118.69,84.5,130.76,percent of total billed charges,,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Anthem,State Preferred,,105.62,,,105.62,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Anthem,Individual Exchange,,84.5,,,84.5,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Cigna,Cigna,,103.15,,,103.15,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Connecticare,Commerical,,110.33,,,110.33,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Connecticare,Exchange,,110.33,,,110.33,84.5,130.76,other,Could be inpatient or outpatient,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,Multiplan,Multiplan,,,130.76,,130.76,84.5,130.76,percent of total billed charges,,
HC GRAVITYDRAINA BAG,62100001,HCPCS,,,both,,,162.74,97.64,United Healthcare/Oxford,United Healthcare/Oxford,,106.16,,,106.16,84.5,130.76,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Aetna,Commerical,,5699.46,,,5699.46,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Aetna,Middlesex Employees,,5129.52,,,5129.52,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Anthem,Commerical,,5099.73,,,5099.73,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Anthem,Indemnity,,,5730.75,,5730.75,4079.78,6313.26,percent of total billed charges,,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Anthem,State Preferred,,5099.73,,,5099.73,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Anthem,Individual Exchange,,4079.78,,,4079.78,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Cigna,Cigna,,4980.46,,,4980.46,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Connecticare,Commerical,,5327.03,,,5327.03,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Connecticare,Exchange,,5327.03,,,5327.03,4079.78,6313.26,other,Could be inpatient or outpatient,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,Multiplan,Multiplan,,,6313.26,,6313.26,4079.78,6313.26,percent of total billed charges,,
HC EXT PACU FLAT RATE,71000001,RC,,,both,,,7879.5,4727.7,United Healthcare/Oxford,United Healthcare/Oxford,,5125.62,,,5125.62,4079.78,6313.26,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Aetna,Commerical,,3011.32,,,3011.32,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Aetna,Middlesex Employees,,2710.19,,,2710.19,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Anthem,Commerical,,2694.46,,,2694.46,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Anthem,Indemnity,,,3027.86,,3027.86,2155.56,3335.63,percent of total billed charges,,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Anthem,State Preferred,,2694.46,,,2694.46,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Anthem,Individual Exchange,,2155.56,,,2155.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Cigna,Cigna,,2631.44,,,2631.44,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Connecticare,Commerical,,2814.56,,,2814.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Connecticare,Exchange,,2814.56,,,2814.56,2155.56,3335.63,other,Could be inpatient or outpatient,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,Multiplan,Multiplan,,,3335.63,,3335.63,2155.56,3335.63,percent of total billed charges,,
HC H23 EXT PACU/HOUR,71000005,RC,,,both,,,4163.26,2497.96,United Healthcare/Oxford,United Healthcare/Oxford,,2708.14,,,2708.14,2155.56,3335.63,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Aetna,Commerical,,,22.48,,22.48,16.09,24.91,percent of total billed charges,,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Aetna,Middlesex Employees,,,20.24,,20.24,16.09,24.91,percent of total billed charges,,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Anthem,Commerical,,20.12,,,20.12,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Anthem,Indemnity,,,22.61,,22.61,16.09,24.91,percent of total billed charges,,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Anthem,State Preferred,,20.12,,,20.12,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Anthem,Individual Exchange,,16.09,,,16.09,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Cigna,Cigna,,19.65,,,19.65,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Connecticare,Commerical,,21.01,,,21.01,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Connecticare,Exchange,,21.01,,,21.01,16.09,24.91,other,Could be inpatient or outpatient,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,Multiplan,Multiplan,,,24.91,,24.91,16.09,24.91,percent of total billed charges,,
HC POSTOP TIME PER MIN,71000006,RC,,,both,,,31.09,18.65,United Healthcare/Oxford,United Healthcare/Oxford,,20.22,,,20.22,16.09,24.91,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Aetna,Commerical,,9244.82,,,9244.82,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Aetna,Middlesex Employees,,8320.34,,,8320.34,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Anthem,Commerical,,8272.05,,,8272.05,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Anthem,Indemnity,,,9295.59,,9295.59,6617.65,10240.44,percent of total billed charges,,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Anthem,State Preferred,,8272.05,,,8272.05,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Anthem,Individual Exchange,,6617.65,,,6617.65,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Cigna,Cigna,,8078.57,,,8078.57,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Connecticare,Commerical,,8640.73,,,8640.73,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Connecticare,Exchange,,8640.73,,,8640.73,6617.65,10240.44,other,Could be inpatient or outpatient,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,Multiplan,Multiplan,,,10240.44,,10240.44,6617.65,10240.44,percent of total billed charges,,
HC EXT PACU ICU FLAT RATE,71000008,RC,,,both,,,12781.28,7668.77,United Healthcare/Oxford,United Healthcare/Oxford,,8314.04,,,8314.04,6617.65,10240.44,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Aetna,Commerical,,1292.78,,,1292.78,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Aetna,Middlesex Employees,,1163.49,,,1163.49,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Anthem,Commerical,,1156.75,,,1156.75,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Anthem,Indemnity,,,1299.88,,1299.88,925.39,1432,percent of total billed charges,,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Anthem,State Preferred,,1156.75,,,1156.75,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Anthem,Individual Exchange,,925.39,,,925.39,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Cigna,Cigna,,1129.69,,,1129.69,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Connecticare,Commerical,,1208.3,,,1208.3,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Connecticare,Exchange,,1208.3,,,1208.3,925.39,1432,other,Could be inpatient or outpatient,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,Multiplan,Multiplan,,,1432,,1432,925.39,1432,percent of total billed charges,,
HC SLEEP STUDY,74000028,CPT,,,both,,,1788.08,1072.85,United Healthcare/Oxford,United Healthcare/Oxford,,1162.62,,,1162.62,925.39,1432,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Aetna,Commerical,,1529.68,,,1529.68,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Aetna,Middlesex Employees,,1376.71,,,1376.71,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Anthem,Commerical,,1368.72,,,1368.72,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Anthem,Indemnity,,,1538.08,,1538.08,1094.97,1694.42,percent of total billed charges,,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Anthem,State Preferred,,1368.72,,,1368.72,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Anthem,Individual Exchange,,1094.97,,,1094.97,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Cigna,Cigna,,1336.7,,,1336.7,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Connecticare,Commerical,,1429.73,,,1429.73,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Connecticare,Exchange,,1429.73,,,1429.73,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,Multiplan,Multiplan,,,1694.42,,1694.42,1094.97,1694.42,percent of total billed charges,,
HC HH GI SVCS 0 - 3 000,75000001,CPT,,,both,,,2114.83,1268.9,United Healthcare/Oxford,United Healthcare/Oxford,,1375.67,,,1375.67,1094.97,1694.42,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Aetna,Commerical,,3059.35,,,3059.35,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Aetna,Middlesex Employees,,2753.42,,,2753.42,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Anthem,Commerical,,2737.44,,,2737.44,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Anthem,Indemnity,,,3076.15,,3076.15,2189.96,3388.83,percent of total billed charges,,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Anthem,State Preferred,,2737.44,,,2737.44,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Anthem,Individual Exchange,,2189.96,,,2189.96,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Cigna,Cigna,,2673.41,,,2673.41,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Connecticare,Commerical,,2859.44,,,2859.44,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Connecticare,Exchange,,2859.44,,,2859.44,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,Multiplan,Multiplan,,,3388.83,,3388.83,2189.96,3388.83,percent of total billed charges,,
HC HH  GI SVCS 3 000 - 6 000,75000002,CPT,,,both,,,4229.66,2537.8,United Healthcare/Oxford,United Healthcare/Oxford,,2751.34,,,2751.34,2189.96,3388.83,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Aetna,Commerical,,4589.03,,,4589.03,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Aetna,Middlesex Employees,,4130.13,,,4130.13,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Anthem,Commerical,,4106.16,,,4106.16,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Anthem,Indemnity,,,4614.23,,4614.23,3284.92,5083.25,percent of total billed charges,,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Anthem,State Preferred,,4106.16,,,4106.16,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Anthem,Individual Exchange,,3284.92,,,3284.92,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Cigna,Cigna,,4010.12,,,4010.12,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Connecticare,Commerical,,4289.17,,,4289.17,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Connecticare,Exchange,,4289.17,,,4289.17,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,Multiplan,Multiplan,,,5083.25,,5083.25,3284.92,5083.25,percent of total billed charges,,
HC HH GI SVCS 6 000 - 10 000,75000003,CPT,,,both,,,6344.49,3806.69,United Healthcare/Oxford,United Healthcare/Oxford,,4127,,,4127,3284.92,5083.25,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Aetna,Commerical,,6119.53,,,6119.53,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Aetna,Middlesex Employees,,5507.57,,,5507.57,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Anthem,Commerical,,5475.61,,,5475.61,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Anthem,Indemnity,,,6153.13,,6153.13,4380.48,6778.57,percent of total billed charges,,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Anthem,State Preferred,,5475.61,,,5475.61,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Anthem,Individual Exchange,,4380.48,,,4380.48,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Cigna,Cigna,,5347.53,,,5347.53,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Connecticare,Commerical,,5719.65,,,5719.65,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Connecticare,Exchange,,5719.65,,,5719.65,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,Multiplan,Multiplan,,,6778.57,,6778.57,4380.48,6778.57,percent of total billed charges,,
HC HH GI SVCS 10 000 - 12 000,75000004,CPT,,,both,,,8460.45,5076.27,United Healthcare/Oxford,United Healthcare/Oxford,,5503.4,,,5503.4,4380.48,6778.57,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Aetna,Commerical,,7284.49,,,7284.49,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Aetna,Middlesex Employees,,6556.05,,,6556.05,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Anthem,Commerical,,6518,,,6518,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Anthem,Indemnity,,,7324.49,,7324.49,5214.39,8068.99,percent of total billed charges,,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Anthem,State Preferred,,6518,,,6518,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Anthem,Individual Exchange,,5214.39,,,5214.39,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Cigna,Cigna,,6365.54,,,6365.54,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Connecticare,Commerical,,6808.5,,,6808.5,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Connecticare,Exchange,,6808.5,,,6808.5,5214.39,8068.99,other,Could be inpatient or outpatient,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,Multiplan,Multiplan,,,8068.99,,8068.99,5214.39,8068.99,percent of total billed charges,,
HC HH  GI SVCS 12 000 - 14 000,75000005,CPT,,,both,,,10071.05,6042.63,United Healthcare/Oxford,United Healthcare/Oxford,,6551.08,,,6551.08,5214.39,8068.99,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Aetna,Commerical,,845.84,,,845.84,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Aetna,Middlesex Employees,,761.26,,,761.26,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Anthem,Commerical,,756.84,,,756.84,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Anthem,Indemnity,,,850.49,,850.49,605.48,936.94,percent of total billed charges,,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Anthem,State Preferred,,756.84,,,756.84,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Anthem,Individual Exchange,,605.48,,,605.48,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Cigna,Cigna,,739.14,,,739.14,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Connecticare,Commerical,,790.57,,,790.57,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Connecticare,Exchange,,790.57,,,790.57,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,Multiplan,Multiplan,,,936.94,,936.94,605.48,936.94,percent of total billed charges,,
HC NONDX SEDAT < 1/2 HR,76100033,CPT,,,both,,,1169.05,701.43,United Healthcare/Oxford,United Healthcare/Oxford,,760.68,,,760.68,605.48,936.94,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Aetna,Commerical,,1015.17,,,1015.17,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Aetna,Middlesex Employees,,913.65,,,913.65,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Anthem,Commerical,,908.35,,,908.35,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Anthem,Indemnity,,,1020.74,,1020.74,726.67,1124.5,percent of total billed charges,,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Anthem,State Preferred,,908.35,,,908.35,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Anthem,Individual Exchange,,726.67,,,726.67,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Cigna,Cigna,,887.11,,,887.11,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Connecticare,Commerical,,948.84,,,948.84,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Connecticare,Exchange,,948.84,,,948.84,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,Multiplan,Multiplan,,,1124.5,,1124.5,726.67,1124.5,percent of total billed charges,,
HC NONDX SEDAT 1/2-1HR,76100034,CPT,,,both,,,1403.89,842.33,United Healthcare/Oxford,United Healthcare/Oxford,,912.96,,,912.96,726.67,1124.5,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Aetna,Commerical,,1184.51,,,1184.51,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Aetna,Middlesex Employees,,1066.05,,,1066.05,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Anthem,Commerical,,1059.86,,,1059.86,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Anthem,Indemnity,,,1191.01,,1191.01,847.89,1312.07,percent of total billed charges,,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Anthem,State Preferred,,1059.86,,,1059.86,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Anthem,Individual Exchange,,847.89,,,847.89,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Cigna,Cigna,,1035.08,,,1035.08,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Connecticare,Commerical,,1107.1,,,1107.1,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Connecticare,Exchange,,1107.1,,,1107.1,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,Multiplan,Multiplan,,,1312.07,,1312.07,847.89,1312.07,percent of total billed charges,,
HC NONDX SEDAT 1-2HR,76100035,CPT,,,both,,,1637.7,982.62,United Healthcare/Oxford,United Healthcare/Oxford,,1065.25,,,1065.25,847.89,1312.07,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Aetna,Commerical,,1409.2,,,1409.2,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Aetna,Middlesex Employees,,1268.27,,,1268.27,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Anthem,Commerical,,1260.91,,,1260.91,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Anthem,Indemnity,,,1416.93,,1416.93,1008.73,1560.96,percent of total billed charges,,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Anthem,State Preferred,,1260.91,,,1260.91,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Anthem,Individual Exchange,,1008.73,,,1008.73,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Cigna,Cigna,,1231.42,,,1231.42,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Connecticare,Commerical,,1317.11,,,1317.11,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Connecticare,Exchange,,1317.11,,,1317.11,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,Multiplan,Multiplan,,,1560.96,,1560.96,1008.73,1560.96,percent of total billed charges,,
HC NONDX SEDAT 2-3HR,76100036,CPT,,,both,,,1947.73,1168.64,United Healthcare/Oxford,United Healthcare/Oxford,,1267.31,,,1267.31,1008.73,1560.96,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Aetna,Commerical,,1578.53,,,1578.53,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Aetna,Middlesex Employees,,1420.68,,,1420.68,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Anthem,Commerical,,1412.42,,,1412.42,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Anthem,Indemnity,,,1587.2,,1587.2,1129.94,1748.53,percent of total billed charges,,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Anthem,State Preferred,,1412.42,,,1412.42,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Anthem,Individual Exchange,,1129.94,,,1129.94,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Cigna,Cigna,,1379.39,,,1379.39,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Connecticare,Commerical,,1475.38,,,1475.38,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Connecticare,Exchange,,1475.38,,,1475.38,1129.94,1748.53,other,Could be inpatient or outpatient,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,Multiplan,Multiplan,,,1748.53,,1748.53,1129.94,1748.53,percent of total billed charges,,
HC NONDX SEDAT 3+ HR,76100037,CPT,,,both,,,2182.57,1309.54,United Healthcare/Oxford,United Healthcare/Oxford,,1419.6,,,1419.6,1129.94,1748.53,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT ,,,both,,,5297.29,3178.37,Aetna,Commerical,,3831.93,,,3831.93,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Aetna,Middlesex Employees,,3448.74,,,3448.74,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Anthem,Commerical,,3428.72,,,3428.72,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Anthem,Indemnity,,,3852.46,,3852.46,2742.98,4244.61,percent of total billed charges,,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Anthem,State Preferred,,3428.72,,,3428.72,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Anthem,Individual Exchange,,2742.98,,,2742.98,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Cigna,Cigna,,3348.53,,,3348.53,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Connecticare,Commerical,,3581.53,,,3581.53,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Connecticare,Exchange,,3581.53,,,3581.53,2742.98,4244.61,other,Could be inpatient or outpatient,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,Multiplan,Multiplan,,,4244.61,,4244.61,2742.98,4244.61,percent of total billed charges,,
HC RENAL ENDOSCOPY W/ REMOVAL OF FB OT CALCULUS,76100050,CPT,,,both,,,5297.29,3178.37,United Healthcare/Oxford,United Healthcare/Oxford,,3446.12,,,3446.12,2742.98,4244.61,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Aetna,Commerical,,1701.05,,,1701.05,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Aetna,Middlesex Employees,,1631.17,,,1631.17,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Anthem,Commerical,,1643.08,,,1643.08,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Anthem,Indemnity,,,1675.86,,1675.86,757.05,1846.2,percent of total billed charges,,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Anthem,State Preferred,,1643.08,,,1643.08,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Anthem,Individual Exchange,,1314.46,,,1314.46,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Cigna,Cigna,,847.6,,,847.6,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Connecticare,Commerical,,1813.1,,,1813.1,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Connecticare,Exchange,,1813.1,,,1813.1,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,Multiplan,Multiplan,,,1846.2,,1846.2,757.05,1846.2,percent of total billed charges,,
HC OUTPATIENT/HOME HEMODIALYSIS/COMPOSITE,82100004,RC,,,both,,,2304.11,1382.47,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,757.05,1846.2,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Aetna,Commerical,,1001.68,,,1001.68,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Aetna,Middlesex Employees,,960.53,,,960.53,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Anthem,Commerical,,967.54,,,967.54,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Anthem,Indemnity,,,986.84,,986.84,333.72,1087.15,percent of total billed charges,,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Anthem,State Preferred,,967.54,,,967.54,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Anthem,Individual Exchange,,774.03,,,774.03,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Cigna,Cigna,,717.6,,,717.6,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Connecticare,Commerical,,1067.66,,,1067.66,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Connecticare,Exchange,,1067.66,,,1067.66,333.72,1087.15,other,Could be inpatient or outpatient,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,Multiplan,Multiplan,,,1087.15,,1087.15,333.72,1087.15,percent of total billed charges,,
HC OUTPATIENT/HOME PERITONEAL DIALYSIS/COMPOSITE,83100004,RC,,,both,,,1356.51,813.91,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,1087.15,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Aetna,Commerical,,2391.8,,,2391.8,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Aetna,Middlesex Employees,,2152.62,,,2152.62,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Anthem,Commerical,,2140.13,,,2140.13,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Anthem,Indemnity,,,2404.93,,2404.93,1712.11,2649.38,percent of total billed charges,,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Anthem,State Preferred,,2140.13,,,2140.13,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Anthem,Individual Exchange,,1712.11,,,1712.11,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Cigna,Cigna,,2090.07,,,2090.07,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Connecticare,Commerical,,2235.51,,,2235.51,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Connecticare,Exchange,,2235.51,,,2235.51,1712.11,2649.38,other,Could be inpatient or outpatient,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,Multiplan,Multiplan,,,2649.38,,2649.38,1712.11,2649.38,percent of total billed charges,,
HC CONT RENAL RPLMT THERAPY,94000006,RC,,,both,,,3307.33,1984.4,United Healthcare/Oxford,United Healthcare/Oxford,,2150.99,,,2150.99,1712.11,2649.38,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Aetna,Commerical,,27.92,,,27.92,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Aetna,Middlesex Employees,,25.13,,,25.13,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Anthem,Commerical,,23.17,,,23.17,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Anthem,Indemnity,,,29.51,,29.51,18.54,33.48,percent of total billed charges,,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Anthem,State Preferred,,23.17,,,23.17,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Anthem,Individual Exchange,,18.54,,,18.54,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Cigna,Cigna,,24.6,,,24.6,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Connecticare,Commerical,,25.23,,,25.23,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Connecticare,Exchange,,25.23,,,25.23,18.54,33.48,other,Could be inpatient or outpatient,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,Multiplan,Multiplan,,,33.48,,33.48,18.54,33.48,percent of total billed charges,,
HC NUTR CNSG PT TEAM,94200015,RC,,,both,,,41.79,25.07,United Healthcare/Oxford,United Healthcare/Oxford,,25.87,,,25.87,18.54,33.48,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE 1ST ADMINISTRATION,0001A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS ,,,both,,,153.83,92.3,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 1st dose,0001A  ,HCPCS,,,both,,,153.83,92.3,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS ,,,both,,,153.83,92.3,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Pfizer-BioNTech COVID-19 2nd dose,0002A,HCPCS,,,both,,,153.83,92.3,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,77.27,,,77.27,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,83.68,,,83.68,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,108.42,,108.42,66.94,123.03,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,83.68,,,83.68,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,66.94,,,66.94,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,79.01,,,79.01,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,73.01,,,73.01,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,73.01,,,73.01,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,123.03,,123.03,66.94,123.03,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE 3RD ADMIN / BOOSTER,0003A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,123.03,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER BIONTECH COV-19 VACCINE  BOOSTER,0004A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS ,,,both,,,153.83,92.3,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Moderna COVID-19 1st dose,0011A,HCPCS,,,both,,,153.83,92.3,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS ,,,both,,,153.83,92.3,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Moderna COVID-19 2nd dose,0012A,HCPCS,,,both,,,153.83,92.3,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,77.27,,,77.27,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,83.68,,,83.68,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,108.42,,108.42,66.94,123.03,percent of total billed charges,,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,83.68,,,83.68,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,66.94,,,66.94,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,79.01,,,79.01,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,73.01,,,73.01,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,73.01,,,73.01,66.94,123.03,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,123.03,,123.03,66.94,123.03,percent of total billed charges,,
HC MODERNA COV-19 VACCINE 3RD ADMIN / BOOSTER,0013A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,123.03,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS ,,,both,,,153.83,92.3,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
ADM SARSCOV2  Janssen COVID-19,0031A,HCPCS,,,both,,,153.83,92.3,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC J&J COV-19 VACCINE ADMINISTRATION - BOOSTER,0034A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 1ST ADM-GRAY CAP,0051A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 2ND ADM-GRAY CAP,0052A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC 3RD ADM-GRAY CAP,0053A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 30MCG/0.3ML TRIS-SUC BOOSTR ADM-GRAY CAP,0054A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA COV-19 VACCINE ADMIN BOOSTER,0064A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 1ST ADMIN,0071A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,77.27,,,77.27,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,69.55,,,69.55,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.88,,111.88,66.94,126.95,percent of total billed charges,,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,83.68,,,83.68,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,66.94,,,66.94,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,79.01,,,79.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,73.01,,,73.01,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.95,,126.95,66.94,126.95,percent of total billed charges,,
HC PFIZER SARS COV2 10MCS TRIS-SUCR 2ND ADMIN,0072A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,85.93,,,85.93,66.94,126.95,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 10MCG TRIS-SUCR 3RD ADMIN,0073A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 1ST ADMIN (6M-4),0081A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 2ND ADMIN (6M-4),0082A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC PFIZER SARS COV2 3MCG/.2ML TRIS-SUCR 3RD ADMIN (6M-4),0083A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 1ST ADMIN,0091A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 2ND ADMIN,0092A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 50MCG/.5ML 3RD ADMIN,0093A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 1ST ADMIN,0111A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 2ND ADMIN,0112A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,105.64,,,105.64,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,95.08,,,95.08,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,87.67,,,87.67,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,70.14,,,70.14,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,93.05,,,93.05,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,95.45,,,95.45,70.14,126.65,other,Could be inpatient or outpatient,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,70.14,126.65,percent of total billed charges,,
HC MODERNA SARS COV2 25MCG/.25ML 3RD ADMIN,0113A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,97.85,,,97.85,70.14,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 30MCG/.3ML B ADMIN,0124A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 50MCG/.5ML B ADMIN,0134A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 25MCG/.25ML B ADMIN,0144A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 10MCG/.2ML B ADMIN,0154A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB MODERNA SARSCV2 BIVALENT 10MCG/.2ML ADMIN BOOSTER,0164A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS ,,,both,,,153.47,92.08,Aetna,Commerical,,100.93,,,100.93,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Aetna,Middlesex Employees,,80.63,,,80.63,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Anthem,Commerical,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Anthem,Indemnity,,,111.62,,111.62,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Anthem,State Preferred,,76.59,,,76.59,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Anthem,Individual Exchange,,61.27,,,61.27,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Cigna,Cigna,,80.97,,,80.97,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Connecticare,Commerical,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Connecticare,Exchange,,66.99,,,66.99,61.27,126.65,other,Could be inpatient or outpatient,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,Multiplan,Multiplan,,,126.65,,126.65,61.27,126.65,percent of total billed charges,,
HB PFIZER SARSCV2 BIVALENT 3MCG/0.2ML ADMIN 3RD DOSE,0173A,HCPCS,,,both,,,153.47,92.08,United Healthcare/Oxford,United Healthcare/Oxford,,90.64,,,90.64,61.27,126.65,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS ,,,both,,,1475.99,885.59,Aetna,Commerical,,986.18,,,986.18,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Aetna,Middlesex Employees,,887.57,,,887.57,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Anthem,Commerical,,818.46,,,818.46,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Anthem,Indemnity,,,1042,,1042,654.76,1182.35,percent of total billed charges,,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Anthem,State Preferred,,818.46,,,818.46,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Anthem,Individual Exchange,,654.76,,,654.76,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Cigna,Cigna,,868.71,,,868.71,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Connecticare,Commerical,,891.1,,,891.1,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Connecticare,Exchange,,891.1,,,891.1,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,Multiplan,Multiplan,,,1182.35,,1182.35,654.76,1182.35,percent of total billed charges,,
HC SARS COVID-19 RESPIRATORY PCR PANEL,0202U,HCPCS,,,both,,,1475.99,885.59,United Healthcare/Oxford,United Healthcare/Oxford,,913.51,,,913.51,654.76,1182.35,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS ,,,both,,,501.61,300.97,Aetna,Commerical,,345.27,,,345.27,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Aetna,Middlesex Employees,,310.74,,,310.74,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Anthem,Commerical,,286.55,,,286.55,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Anthem,Indemnity,,,364.81,,364.81,229.24,413.95,percent of total billed charges,,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Anthem,State Preferred,,286.55,,,286.55,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Anthem,Individual Exchange,,229.24,,,229.24,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Cigna,Cigna,,304.14,,,304.14,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Connecticare,Commerical,,311.98,,,311.98,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Connecticare,Exchange,,311.98,,,311.98,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,Multiplan,Multiplan,,,413.95,,413.95,229.24,413.95,percent of total billed charges,,
HC SARS COVID & INFLUENZA A/B RNA  HHC 3 TARGETS,0240U,HCPCS,,,both,,,501.61,300.97,United Healthcare/Oxford,United Healthcare/Oxford,,319.83,,,319.83,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS ,,,both,,,501.61,300.97,Aetna,Commerical,,345.27,,,345.27,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Aetna,Middlesex Employees,,310.74,,,310.74,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Anthem,Commerical,,286.55,,,286.55,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Anthem,Indemnity,,,364.81,,364.81,229.24,413.95,percent of total billed charges,,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Anthem,State Preferred,,286.55,,,286.55,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Anthem,Individual Exchange,,229.24,,,229.24,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Cigna,Cigna,,304.14,,,304.14,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Connecticare,Commerical,,311.98,,,311.98,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Connecticare,Exchange,,311.98,,,311.98,229.24,413.95,other,Could be inpatient or outpatient,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,Multiplan,Multiplan,,,413.95,,413.95,229.24,413.95,percent of total billed charges,,
HC SARS COVID & INFLUENZA A/B  RSV  HHC,0241U,HCPCS,,,both,,,501.61,300.97,United Healthcare/Oxford,United Healthcare/Oxford,,319.83,,,319.83,229.24,413.95,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS ,,,both,,,3277.46,1966.48,Aetna,Commerical,,2255.97,,,2255.97,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Aetna,Middlesex Employees,,2030.38,,,2030.38,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Anthem,Commerical,,1872.28,,,1872.28,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Anthem,Indemnity,,,2383.64,,2383.64,1497.83,2704.7,percent of total billed charges,,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Anthem,State Preferred,,1872.28,,,1872.28,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Anthem,Individual Exchange,,1497.83,,,1497.83,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Cigna,Cigna,,1987.22,,,1987.22,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Connecticare,Commerical,,2038.47,,,2038.47,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Connecticare,Exchange,,2038.47,,,2038.47,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,Multiplan,Multiplan,,,2704.7,,2704.7,1497.83,2704.7,percent of total billed charges,,
HC QUAN MR ALYS TISS COMPJ MRI (MP-MRI) W/O DX MRI 1ORGAN,0648T,HCPCS,,,both,,,3277.46,1966.48,United Healthcare/Oxford,United Healthcare/Oxford,,2089.71,,,2089.71,1497.83,2704.7,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS ,,,both,,,818.85,491.31,Aetna,Commerical,,563.64,,,563.64,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Aetna,Middlesex Employees,,507.28,,,507.28,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Anthem,Commerical,,467.78,,,467.78,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Anthem,Indemnity,,,595.53,,595.53,374.22,675.75,percent of total billed charges,,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Anthem,State Preferred,,467.78,,,467.78,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Anthem,Individual Exchange,,374.22,,,374.22,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Cigna,Cigna,,496.5,,,496.5,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Connecticare,Commerical,,509.3,,,509.3,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Connecticare,Exchange,,509.3,,,509.3,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,Multiplan,Multiplan,,,675.75,,675.75,374.22,675.75,percent of total billed charges,,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI 1 ORGAN,0649T,HCPCS,,,both,,,818.85,491.31,United Healthcare/Oxford,United Healthcare/Oxford,,522.1,,,522.1,374.22,675.75,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS ,,,both,,,328.57,197.14,Aetna,Commerical,,219.79,,,219.79,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Aetna,Middlesex Employees,,197.81,,,197.81,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Anthem,Commerical,,182.41,,,182.41,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Anthem,Indemnity,,,232.22,,232.22,145.92,263.5,percent of total billed charges,,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Anthem,State Preferred,,182.41,,,182.41,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Anthem,Individual Exchange,,145.92,,,145.92,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Cigna,Cigna,,193.61,,,193.61,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Connecticare,Commerical,,198.6,,,198.6,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Connecticare,Exchange,,198.6,,,198.6,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,Multiplan,Multiplan,,,263.5,,263.5,145.92,263.5,percent of total billed charges,,
HC QUAN US TISSUE CHARAC W/O DX US SAME ANATOMY,0689T,HCPCS,,,both,,,328.57,197.14,United Healthcare/Oxford,United Healthcare/Oxford,,203.59,,,203.59,145.92,263.5,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS ,,,both,,,81.37,48.82,Aetna,Commerical,,54.59,,,54.59,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Aetna,Middlesex Employees,,49.13,,,49.13,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Anthem,Commerical,,45.3,,,45.3,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Anthem,Indemnity,,,57.68,,57.68,36.25,65.45,percent of total billed charges,,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Anthem,State Preferred,,45.3,,,45.3,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Anthem,Individual Exchange,,36.25,,,36.25,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Cigna,Cigna,,48.09,,,48.09,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Connecticare,Commerical,,49.32,,,49.32,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Connecticare,Exchange,,49.32,,,49.32,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,Multiplan,Multiplan,,,65.45,,65.45,36.25,65.45,percent of total billed charges,,
HC QUAN US TISSUE CHARAC W DX US SAME ANATOMY,0690T,HCPCS,,,both,,,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,50.57,,,50.57,36.25,65.45,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS ,,,both,,,909.49,545.69,Aetna,Commerical,,626.03,,,626.03,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Aetna,Middlesex Employees,,563.43,,,563.43,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Anthem,Commerical,,519.56,,,519.56,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Anthem,Indemnity,,,661.46,,661.46,415.65,750.55,percent of total billed charges,,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Anthem,State Preferred,,519.56,,,519.56,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Anthem,Individual Exchange,,415.65,,,415.65,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Cigna,Cigna,,551.45,,,551.45,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Connecticare,Commerical,,565.67,,,565.67,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Connecticare,Exchange,,565.67,,,565.67,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,Multiplan,Multiplan,,,750.55,,750.55,415.65,750.55,percent of total billed charges,,
HC QUAN MR ALYS TISS COMPJ (MP-MRI) W/O DX MRI MULT ORGAN,0697T,HCPCS,,,both,,,909.49,545.69,United Healthcare/Oxford,United Healthcare/Oxford,,579.89,,,579.89,415.65,750.55,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS ,,,both,,,226.6,135.96,Aetna,Commerical,,155.98,,,155.98,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Aetna,Middlesex Employees,,140.37,,,140.37,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Anthem,Commerical,,129.45,,,129.45,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Anthem,Indemnity,,,164.8,,164.8,103.56,187,percent of total billed charges,,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Anthem,State Preferred,,129.45,,,129.45,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Anthem,Individual Exchange,,103.56,,,103.56,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Cigna,Cigna,,137.39,,,137.39,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Connecticare,Commerical,,140.93,,,140.93,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Connecticare,Exchange,,140.93,,,140.93,103.56,187,other,Could be inpatient or outpatient,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,Multiplan,Multiplan,,,187,,187,103.56,187,percent of total billed charges,,
HC QUAN MR ALYS TISS COMP  (MP-MRI) W DX MRI MULTI ORGAN,0698T,HCPCS,,,both,,,226.6,135.96,United Healthcare/Oxford,United Healthcare/Oxford,,144.48,,,144.48,103.56,187,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Aetna,Commerical,,329.7,,,329.7,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Aetna,Middlesex Employees,,296.74,,,296.74,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Anthem,Commerical,,295.02,,,295.02,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Anthem,Indemnity,,,321.86,,321.86,236.01,365.21,percent of total billed charges,,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Anthem,State Preferred,,295.02,,,295.02,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Anthem,Individual Exchange,,236.01,,,236.01,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Cigna,Cigna,,288.11,,,288.11,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Connecticare,Commerical,,308.16,,,308.16,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Connecticare,Exchange,,308.16,,,308.16,236.01,365.21,other,Could be inpatient or outpatient,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,Multiplan,Multiplan,,,365.21,,365.21,236.01,365.21,percent of total billed charges,,
HC EZ-IO I.O NDL SET,A4300,HCPCS,,,both,,,417,257.8,United Healthcare/Oxford,United Healthcare/Oxford,,296.52,,,296.52,236.01,365.21,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Aetna,Commerical,,41.8,,,41.8,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Aetna,Middlesex Employees,,37.62,,,37.62,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Anthem,Commerical,,34.68,,,34.68,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Anthem,Indemnity,,,44.16,,44.16,27.75,50.11,percent of total billed charges,,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Anthem,State Preferred,,34.68,,,34.68,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Anthem,Individual Exchange,,27.75,,,27.75,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Cigna,Cigna,,36.82,,,36.82,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Connecticare,Commerical,,37.76,,,37.76,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Connecticare,Exchange,,37.76,,,37.76,27.75,50.11,other,Could be inpatient or outpatient,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,Multiplan,Multiplan,,,50.11,,50.11,27.75,50.11,percent of total billed charges,,
HC TRAY SILICONE URINE METER STATLOCK 18FR #A902418,A4315,HCPCS,,,both,,,58.95,35.37,United Healthcare/Oxford,United Healthcare/Oxford,,38.72,,,38.72,27.75,50.11,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Aetna,Commerical,,26.36,,,26.36,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Aetna,Middlesex Employees,,25.28,,,25.28,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Anthem,Commerical,,25.46,,,25.46,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Anthem,Indemnity,,,25.21,,25.21,20.37,29.62,percent of total billed charges,,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Anthem,State Preferred,,25.46,,,25.46,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Anthem,Individual Exchange,,20.37,,,20.37,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Cigna,Cigna,,29.62,,,29.62,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Connecticare,Commerical,,28.1,,,28.1,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Connecticare,Exchange,,28.1,,,28.1,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,Multiplan,Multiplan,,,28.61,,28.61,20.37,29.62,percent of total billed charges,,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4455,HCPCS,,,both,,,33.66,20.2,United Healthcare/Oxford,United Healthcare/Oxford,,23.12,,,23.12,20.37,29.62,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Aetna,Commerical,,23.86,,,23.86,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Aetna,Middlesex Employees,,21.48,,,21.48,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Anthem,Commerical,,19.81,,,19.81,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Anthem,Indemnity,,,25.21,,25.21,15.85,28.61,percent of total billed charges,,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Anthem,State Preferred,,19.81,,,19.81,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Anthem,Individual Exchange,,15.85,,,15.85,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Cigna,Cigna,,21.02,,,21.02,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Connecticare,Commerical,,21.56,,,21.56,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Connecticare,Exchange,,21.56,,,21.56,15.85,28.61,other,Could be inpatient or outpatient,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,Multiplan,Multiplan,,,28.61,,28.61,15.85,28.61,percent of total billed charges,,
HC ADHESIVE REMOOVER SPRAY 50ML (ESENTA),A4456,HCPCS,,,both,,,33.66,20.2,United Healthcare/Oxford,United Healthcare/Oxford,,22.1,,,22.1,15.85,28.61,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Aetna,Commerical,,56.98,,,56.98,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Aetna,Middlesex Employees,,51.29,,,51.29,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Anthem,Commerical,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Anthem,Indemnity,,,55.63,,55.63,40.8,63.12,percent of total billed charges,,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Anthem,State Preferred,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Anthem,Individual Exchange,,40.8,,,40.8,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Cigna,Cigna,,49.8,,,49.8,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Connecticare,Commerical,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Connecticare,Exchange,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,Multiplan,Multiplan,,,63.12,,63.12,40.8,63.12,percent of total billed charges,,
HC ARM IMMOBILIZER,A4565,HCPCS,,,both,,,72,44.56,United Healthcare/Oxford,United Healthcare/Oxford,,51.25,,,51.25,40.8,63.12,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Aetna,Commerical,,21.03,,,21.03,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Aetna,Middlesex Employees,,18.93,,,18.93,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Anthem,Commerical,,18.82,,,18.82,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Anthem,Indemnity,,,20.53,,20.53,15.05,23.29,percent of total billed charges,,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Anthem,State Preferred,,18.82,,,18.82,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Anthem,Individual Exchange,,15.05,,,15.05,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Cigna,Cigna,,18.38,,,18.38,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Connecticare,Commerical,,19.65,,,19.65,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Connecticare,Exchange,,19.65,,,19.65,15.05,23.29,other,Could be inpatient or outpatient,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,Multiplan,Multiplan,,,23.29,,23.29,15.05,23.29,percent of total billed charges,,
HC OXIMETER PEDI 552285,A4606,HCPCS,,,both,,,27.4,16.44,United Healthcare/Oxford,United Healthcare/Oxford,,18.91,,,18.91,15.05,23.29,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Anthem,Indemnity,,,64.37,,64.37,47.21,73.04,percent of total billed charges,,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,Multiplan,Multiplan,,,73.04,,73.04,47.21,73.04,percent of total billed charges,,
HC AEROCHAMBER MASK,A4627,HCPCS,,,both,,,83,51.56,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Aetna,Commerical,,31.09,,,31.09,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Aetna,Middlesex Employees,,27.98,,,27.98,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Anthem,Commerical,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Anthem,Indemnity,,,30.35,,30.35,22.25,34.44,percent of total billed charges,,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Anthem,State Preferred,,27.82,,,27.82,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Anthem,Individual Exchange,,22.25,,,22.25,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Cigna,Cigna,,27.16,,,27.16,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Connecticare,Commerical,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Connecticare,Exchange,,29.05,,,29.05,22.25,34.44,other,Could be inpatient or outpatient,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,Multiplan,Multiplan,,,34.44,,34.44,22.25,34.44,percent of total billed charges,,
HC AEROCHAMBER MP,A4627,HCPCS,,,both,,,39.34,24.31,United Healthcare/Oxford,United Healthcare/Oxford,,27.96,,,27.96,22.25,34.44,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Aetna,Commerical,,87.11,,,87.11,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Aetna,Middlesex Employees,,78.4,,,78.4,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Anthem,Commerical,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Anthem,Indemnity,,,85.04,,85.04,62.36,96.49,percent of total billed charges,,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Anthem,State Preferred,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Anthem,Individual Exchange,,62.36,,,62.36,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Cigna,Cigna,,90.33,,,90.33,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Connecticare,Commerical,,84.1,,,84.1,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Connecticare,Exchange,,84.1,,,84.1,62.36,96.49,other,Could be inpatient or outpatient,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,Multiplan,Multiplan,,,96.49,,96.49,62.36,96.49,percent of total billed charges,,
HC HH DIAGISOTTC,A4641,HCPCS,,,both,,,116,68.11,United Healthcare/Oxford,United Healthcare/Oxford,,73.37,,,73.37,62.36,96.49,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Aetna,Commerical,,16.65,,,16.65,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Aetna,Middlesex Employees,,14.98,,,14.98,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Anthem,Commerical,,13.82,,,13.82,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Anthem,Indemnity,,,17.59,,17.59,11.05,19.96,percent of total billed charges,,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Anthem,State Preferred,,13.82,,,13.82,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Anthem,Individual Exchange,,11.05,,,11.05,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Cigna,Cigna,,14.66,,,14.66,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Connecticare,Commerical,,15.04,,,15.04,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Connecticare,Exchange,,15.04,,,15.04,11.05,19.96,other,Could be inpatient or outpatient,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,Multiplan,Multiplan,,,19.96,,19.96,11.05,19.96,percent of total billed charges,,
HC NEEDLE POWERLOCK 19G - 22G #431081 - 431084,A4649,HCPCS,,,both,,,23.48,14.09,United Healthcare/Oxford,United Healthcare/Oxford,,15.42,,,15.42,11.05,19.96,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Aetna,Commerical,,13.18,,,13.18,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Aetna,Middlesex Employees,,11.87,,,11.87,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Anthem,Commerical,,10.94,,,10.94,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Anthem,Indemnity,,,13.93,,13.93,8.76,15.81,percent of total billed charges,,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Anthem,State Preferred,,10.94,,,10.94,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Anthem,Individual Exchange,,8.76,,,8.76,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Cigna,Cigna,,11.62,,,11.62,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Connecticare,Commerical,,11.92,,,11.92,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Connecticare,Exchange,,11.92,,,11.92,8.76,15.81,other,Could be inpatient or outpatient,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,Multiplan,Multiplan,,,15.81,,15.81,8.76,15.81,percent of total billed charges,,
"HC POWERLOC SAF INF SET W/O Y-INJ SITE 20GX0.75"" #580998",A4649,HCPCS,,,both,,,18.6,11.16,United Healthcare/Oxford,United Healthcare/Oxford,,12.22,,,12.22,8.76,15.81,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Anthem,Indemnity,,,188.35,,188.35,138.11,213.72,percent of total billed charges,,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC DIALYZER - REVECLEAR 300/400 GAMBRO,A4690,HCPCS,,,both,,,244,150.86,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Aetna,Commerical,,362.27,,,362.27,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Aetna,Middlesex Employees,,326.05,,,326.05,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Anthem,Commerical,,324.15,,,324.15,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Anthem,Indemnity,,,353.65,,353.65,259.32,401.29,percent of total billed charges,,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Anthem,State Preferred,,324.15,,,324.15,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Anthem,Individual Exchange,,259.32,,,259.32,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Cigna,Cigna,,316.57,,,316.57,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Connecticare,Commerical,,338.6,,,338.6,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Connecticare,Exchange,,338.6,,,338.6,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,Multiplan,Multiplan,,,401.29,,401.29,259.32,401.29,percent of total billed charges,,
HC DIALYZER F160 FRESENIUS,A4690,HCPCS,,,both,,,458,283.26,United Healthcare/Oxford,United Healthcare/Oxford,,325.8,,,325.8,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Aetna,Commerical,,362.27,,,362.27,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Aetna,Middlesex Employees,,326.05,,,326.05,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Anthem,Commerical,,324.15,,,324.15,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Anthem,Indemnity,,,353.65,,353.65,259.32,401.29,percent of total billed charges,,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Anthem,State Preferred,,324.15,,,324.15,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Anthem,Individual Exchange,,259.32,,,259.32,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Cigna,Cigna,,316.57,,,316.57,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Connecticare,Commerical,,338.6,,,338.6,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Connecticare,Exchange,,338.6,,,338.6,259.32,401.29,other,Could be inpatient or outpatient,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,Multiplan,Multiplan,,,401.29,,401.29,259.32,401.29,percent of total billed charges,,
HC DIALYZER F3/F4 FRESENIUS 520161 520165,A4690,HCPCS,,,both,,,472.1,283.26,United Healthcare/Oxford,United Healthcare/Oxford,,325.8,,,325.8,259.32,401.29,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Aetna,Commerical,,34.46,,,34.46,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Aetna,Middlesex Employees,,31.02,,,31.02,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Anthem,Commerical,,30.83,,,30.83,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Anthem,Indemnity,,,33.64,,33.64,24.66,38.17,percent of total billed charges,,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Anthem,State Preferred,,30.83,,,30.83,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Anthem,Individual Exchange,,24.66,,,24.66,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Cigna,Cigna,,30.12,,,30.12,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Connecticare,Commerical,,32.21,,,32.21,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Connecticare,Exchange,,32.21,,,32.21,24.66,38.17,other,Could be inpatient or outpatient,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,Multiplan,Multiplan,,,38.17,,38.17,24.66,38.17,percent of total billed charges,,
HC ACID 2K 2.5CA   #0822510,A4709,HCPCS,,,both,,,44.91,26.95,United Healthcare/Oxford,United Healthcare/Oxford,,30.99,,,30.99,24.66,38.17,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Aetna,Commerical,,61.05,,,61.05,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Aetna,Middlesex Employees,,54.95,,,54.95,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Anthem,Commerical,,54.63,,,54.63,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Anthem,Indemnity,,,59.61,,59.61,43.7,67.63,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Anthem,State Preferred,,54.63,,,54.63,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Anthem,Individual Exchange,,43.7,,,43.7,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Cigna,Cigna,,53.35,,,53.35,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Connecticare,Commerical,,57.06,,,57.06,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Connecticare,Exchange,,57.06,,,57.06,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,Multiplan,Multiplan,,,67.63,,67.63,43.7,67.63,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 1500 ML,A4721,HCPCS,,,both,,,79.57,47.74,United Healthcare/Oxford,United Healthcare/Oxford,,54.91,,,54.91,43.7,67.63,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Indemnity,,,61.19,,61.19,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Indemnity,,,61.19,,61.19,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 1500 ML,A4721,HCPCS,,,both,,,81.69,49.01,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Aetna,Commerical,,56.98,,,56.98,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Aetna,Middlesex Employees,,51.29,,,51.29,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Commerical,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Indemnity,,,55.63,,55.63,40.8,63.12,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,State Preferred,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Individual Exchange,,40.8,,,40.8,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Cigna,Cigna,,49.8,,,49.8,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Connecticare,Commerical,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Connecticare,Exchange,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Multiplan,Multiplan,,,63.12,,63.12,40.8,63.12,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,United Healthcare/Oxford,United Healthcare/Oxford,,51.25,,,51.25,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Indemnity,,,61.19,,61.19,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Indemnity,,,61.99,,61.99,45.46,70.34,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Aetna,Commerical,,64.31,,,64.31,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Aetna,Middlesex Employees,,57.88,,,57.88,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Commerical,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Indemnity,,,62.78,,62.78,46.04,71.24,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,State Preferred,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Individual Exchange,,46.04,,,46.04,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Cigna,Cigna,,56.2,,,56.2,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Connecticare,Commerical,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Connecticare,Exchange,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Multiplan,Multiplan,,,71.24,,71.24,46.04,71.24,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,United Healthcare/Oxford,United Healthcare/Oxford,,57.83,,,57.83,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Indemnity,,,61.99,,61.99,45.46,70.34,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Indemnity,,,64.37,,64.37,47.21,73.04,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Multiplan,Multiplan,,,73.04,,73.04,47.21,73.04,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Aetna,Commerical,,56.98,,,56.98,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Aetna,Middlesex Employees,,51.29,,,51.29,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Commerical,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Indemnity,,,55.63,,55.63,40.8,63.12,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,State Preferred,,50.99,,,50.99,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Anthem,Individual Exchange,,40.8,,,40.8,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Cigna,Cigna,,49.8,,,49.8,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Connecticare,Commerical,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Connecticare,Exchange,,53.27,,,53.27,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,Multiplan,Multiplan,,,63.12,,63.12,40.8,63.12,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2000 ML,A4722,HCPCS,,,both,,,74.26,44.56,United Healthcare/Oxford,United Healthcare/Oxford,,51.25,,,51.25,40.8,63.12,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Aetna,Commerical,,62.69,,,62.69,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Aetna,Middlesex Employees,,56.41,,,56.41,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Commerical,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Indemnity,,,61.19,,61.19,44.87,69.44,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,State Preferred,,56.09,,,56.09,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Anthem,Individual Exchange,,44.87,,,44.87,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Cigna,Cigna,,54.78,,,54.78,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Connecticare,Commerical,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Connecticare,Exchange,,58.59,,,58.59,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,Multiplan,Multiplan,,,69.44,,69.44,44.87,69.44,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 1.5% DEX 2500 ML,A4722,HCPCS,,,both,,,81.69,49.01,United Healthcare/Oxford,United Healthcare/Oxford,,56.37,,,56.37,44.87,69.44,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Indemnity,,,61.99,,61.99,45.46,70.34,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Aetna,Commerical,,64.31,,,64.31,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Aetna,Middlesex Employees,,57.88,,,57.88,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Commerical,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Indemnity,,,62.78,,62.78,46.04,71.24,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,State Preferred,,57.55,,,57.55,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Anthem,Individual Exchange,,46.04,,,46.04,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Cigna,Cigna,,56.2,,,56.2,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Connecticare,Commerical,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Connecticare,Exchange,,60.11,,,60.11,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,Multiplan,Multiplan,,,71.24,,71.24,46.04,71.24,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 2.5% DEX 2500 ML,A4722,HCPCS,,,both,,,83.81,50.29,United Healthcare/Oxford,United Healthcare/Oxford,,57.83,,,57.83,46.04,71.24,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Commerical,,63.5,,,63.5,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Aetna,Middlesex Employees,,57.14,,,57.14,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Commerical,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Indemnity,,,61.99,,61.99,45.46,70.34,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,State Preferred,,56.82,,,56.82,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Anthem,Individual Exchange,,45.46,,,45.46,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Cigna,Cigna,,55.48,,,55.48,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Commerical,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Connecticare,Exchange,,59.35,,,59.35,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,Multiplan,Multiplan,,,70.34,,70.34,45.46,70.34,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2000 ML,A4722,HCPCS,,,both,,,82.75,49.65,United Healthcare/Oxford,United Healthcare/Oxford,,57.1,,,57.1,45.46,70.34,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Aetna,Commerical,,65.94,,,65.94,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Aetna,Middlesex Employees,,59.35,,,59.35,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Commerical,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Indemnity,,,64.37,,64.37,47.21,73.04,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,State Preferred,,59.01,,,59.01,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Anthem,Individual Exchange,,47.21,,,47.21,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Cigna,Cigna,,57.63,,,57.63,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Connecticare,Commerical,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Connecticare,Exchange,,61.64,,,61.64,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,Multiplan,Multiplan,,,73.04,,73.04,47.21,73.04,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 2500 ML,A4722,HCPCS,,,both,,,85.93,51.56,United Healthcare/Oxford,United Healthcare/Oxford,,59.31,,,59.31,47.21,73.04,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Aetna,Commerical,,69.2,,,69.2,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Aetna,Middlesex Employees,,62.28,,,62.28,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Commerical,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Indemnity,,,67.55,,67.55,49.54,76.65,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,State Preferred,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Individual Exchange,,49.54,,,49.54,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Cigna,Cigna,,60.47,,,60.47,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Connecticare,Commerical,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Connecticare,Exchange,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Multiplan,Multiplan,,,76.65,,76.65,49.54,76.65,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,United Healthcare/Oxford,United Healthcare/Oxford,,62.23,,,62.23,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Aetna,Commerical,,71.64,,,71.64,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Aetna,Middlesex Employees,,64.47,,,64.47,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Commerical,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Indemnity,,,69.94,,69.94,51.27,79.36,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,State Preferred,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Individual Exchange,,51.27,,,51.27,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Cigna,Cigna,,62.6,,,62.6,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Connecticare,Commerical,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Connecticare,Exchange,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Multiplan,Multiplan,,,79.36,,79.36,51.27,79.36,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,United Healthcare/Oxford,United Healthcare/Oxford,,64.43,,,64.43,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Aetna,Commerical,,74.08,,,74.08,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Aetna,Middlesex Employees,,66.68,,,66.68,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Commerical,,66.29,,,66.29,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Indemnity,,,72.32,,72.32,53.03,82.06,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,State Preferred,,66.29,,,66.29,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Individual Exchange,,53.03,,,53.03,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Cigna,Cigna,,64.74,,,64.74,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Connecticare,Commerical,,69.24,,,69.24,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Connecticare,Exchange,,69.24,,,69.24,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Multiplan,Multiplan,,,82.06,,82.06,53.03,82.06,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,United Healthcare/Oxford,United Healthcare/Oxford,,66.62,,,66.62,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Aetna,Commerical,,74.08,,,74.08,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Aetna,Middlesex Employees,,66.68,,,66.68,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Commerical,,66.29,,,66.29,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Indemnity,,,72.32,,72.32,53.03,82.06,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,State Preferred,,66.29,,,66.29,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Anthem,Individual Exchange,,53.03,,,53.03,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Cigna,Cigna,,64.74,,,64.74,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Connecticare,Commerical,,69.24,,,69.24,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Connecticare,Exchange,,69.24,,,69.24,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,Multiplan,Multiplan,,,82.06,,82.06,53.03,82.06,percent of total billed charges,,
HC DIALYSATE PC-2 PERI DIAL SOL 4.25% DEX 3000 ML,A4723,HCPCS,,,both,,,96.54,57.92,United Healthcare/Oxford,United Healthcare/Oxford,,66.62,,,66.62,53.03,82.06,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Aetna,Commerical,,69.2,,,69.2,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Aetna,Middlesex Employees,,62.28,,,62.28,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Commerical,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Indemnity,,,67.55,,67.55,49.54,76.65,percent of total billed charges,,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,State Preferred,,61.91,,,61.91,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Anthem,Individual Exchange,,49.54,,,49.54,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Cigna,Cigna,,60.47,,,60.47,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Connecticare,Commerical,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Connecticare,Exchange,,64.67,,,64.67,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,Multiplan,Multiplan,,,76.65,,76.65,49.54,76.65,percent of total billed charges,,
HC DIALYSATE PD-2 PERI DIAL SOL 1.5% DEX 3000 ML,A4723,HCPCS,,,both,,,90.18,54.11,United Healthcare/Oxford,United Healthcare/Oxford,,62.23,,,62.23,49.54,76.65,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Aetna,Commerical,,71.64,,,71.64,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Aetna,Middlesex Employees,,64.47,,,64.47,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Commerical,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Indemnity,,,69.94,,69.94,51.27,79.36,percent of total billed charges,,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,State Preferred,,64.1,,,64.1,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Anthem,Individual Exchange,,51.27,,,51.27,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Cigna,Cigna,,62.6,,,62.6,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Connecticare,Commerical,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Connecticare,Exchange,,66.96,,,66.96,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,Multiplan,Multiplan,,,79.36,,79.36,51.27,79.36,percent of total billed charges,,
HC DIALYSATE PD-2 PERI DIAL SOL 2.5% DEX 3000 ML,A4723,HCPCS,,,both,,,93.36,56.02,United Healthcare/Oxford,United Healthcare/Oxford,,64.43,,,64.43,51.27,79.36,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Aetna,Commerical,,82.95,,,82.95,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Aetna,Middlesex Employees,,74.65,,,74.65,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Anthem,Commerical,,68.84,,,68.84,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Anthem,Indemnity,,,87.64,,87.64,55.07,99.45,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Anthem,State Preferred,,68.84,,,68.84,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Anthem,Individual Exchange,,55.07,,,55.07,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Cigna,Cigna,,73.07,,,73.07,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Connecticare,Commerical,,74.95,,,74.95,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Connecticare,Exchange,,74.95,,,74.95,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,Multiplan,Multiplan,,,99.45,,99.45,55.07,99.45,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 1.5% DEX 5L 5000 CC #007910,A4725,HCPCS,,,both,,,117,70.2,United Healthcare/Oxford,United Healthcare/Oxford,,76.84,,,76.84,55.07,99.45,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Aetna,Commerical,,83.66,,,83.66,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Aetna,Middlesex Employees,,75.29,,,75.29,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Anthem,Commerical,,69.43,,,69.43,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Anthem,Indemnity,,,88.39,,88.39,55.54,100.3,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Anthem,State Preferred,,69.43,,,69.43,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Anthem,Individual Exchange,,55.54,,,55.54,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Cigna,Cigna,,73.69,,,73.69,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Connecticare,Commerical,,75.59,,,75.59,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Connecticare,Exchange,,75.59,,,75.59,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,Multiplan,Multiplan,,,100.3,,100.3,55.54,100.3,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 2.5% DEX 5L 1000 CC #007911,A4725,HCPCS,,,both,,,118,70.8,United Healthcare/Oxford,United Healthcare/Oxford,,77.5,,,77.5,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Aetna,Commerical,,80.82,,,80.82,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Aetna,Middlesex Employees,,72.75,,,72.75,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Anthem,Commerical,,67.08,,,67.08,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Anthem,Indemnity,,,85.4,,85.4,53.66,96.9,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Anthem,State Preferred,,67.08,,,67.08,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Anthem,Individual Exchange,,53.66,,,53.66,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Cigna,Cigna,,71.2,,,71.2,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Connecticare,Commerical,,73.03,,,73.03,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Connecticare,Exchange,,73.03,,,73.03,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,Multiplan,Multiplan,,,96.9,,96.9,53.66,96.9,percent of total billed charges,,
HC DIALYSATE DIAL PERI SOL 4.25% DEX 5L 1000 CC #007912,A4725,HCPCS,,,both,,,114,68.4,United Healthcare/Oxford,United Healthcare/Oxford,,74.87,,,74.87,53.66,96.9,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Aetna,Commerical,,81.53,,,81.53,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Aetna,Middlesex Employees,,73.38,,,73.38,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Anthem,Commerical,,67.67,,,67.67,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Anthem,Indemnity,,,86.15,,86.15,54.13,97.75,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Anthem,State Preferred,,67.67,,,67.67,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Anthem,Individual Exchange,,54.13,,,54.13,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Cigna,Cigna,,71.82,,,71.82,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Connecticare,Commerical,,73.67,,,73.67,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Connecticare,Exchange,,73.67,,,73.67,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,Multiplan,Multiplan,,,97.75,,97.75,54.13,97.75,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 1.5% DEX 5L 5000 CC #574976,A4725,HCPCS,,,both,,,115,69,United Healthcare/Oxford,United Healthcare/Oxford,,75.52,,,75.52,54.13,97.75,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Aetna,Commerical,,83.66,,,83.66,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Aetna,Middlesex Employees,,75.29,,,75.29,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Anthem,Commerical,,69.43,,,69.43,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Anthem,Indemnity,,,88.39,,88.39,55.54,100.3,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Anthem,State Preferred,,69.43,,,69.43,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Anthem,Individual Exchange,,55.54,,,55.54,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Cigna,Cigna,,73.69,,,73.69,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Connecticare,Commerical,,75.59,,,75.59,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Connecticare,Exchange,,75.59,,,75.59,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,Multiplan,Multiplan,,,100.3,,100.3,55.54,100.3,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 2.5% DEX 5L 5000 CC  #008084,A4725,HCPCS,,,both,,,118,70.8,United Healthcare/Oxford,United Healthcare/Oxford,,77.5,,,77.5,55.54,100.3,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Aetna,Commerical,,86.5,,,86.5,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Aetna,Middlesex Employees,,77.85,,,77.85,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Anthem,Commerical,,71.79,,,71.79,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Anthem,Indemnity,,,91.39,,91.39,57.43,103.7,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Anthem,State Preferred,,71.79,,,71.79,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Anthem,Individual Exchange,,57.43,,,57.43,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Cigna,Cigna,,76.19,,,76.19,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Connecticare,Commerical,,78.16,,,78.16,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Connecticare,Exchange,,78.16,,,78.16,57.43,103.7,other,Could be inpatient or outpatient,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,Multiplan,Multiplan,,,103.7,,103.7,57.43,103.7,percent of total billed charges,,
HC DIALYSATE LOW CALCIUM PERI DIAL SOL 4.25% DEX 5L 5000 CC #008077,A4725,HCPCS,,,both,,,122,73.2,United Healthcare/Oxford,United Healthcare/Oxford,,80.12,,,80.12,57.43,103.7,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Aetna,Commerical,,15.91,,,15.91,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Aetna,Middlesex Employees,,15.25,,,15.25,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Anthem,Commerical,,15.36,,,15.36,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Anthem,Indemnity,,,15.21,,15.21,12.29,17.87,percent of total billed charges,,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Anthem,State Preferred,,15.36,,,15.36,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Anthem,Individual Exchange,,12.29,,,12.29,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Cigna,Cigna,,17.87,,,17.87,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Connecticare,Commerical,,16.95,,,16.95,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Connecticare,Exchange,,16.95,,,16.95,12.29,17.87,other,Could be inpatient or outpatient,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,Multiplan,Multiplan,,,17.26,,17.26,12.29,17.87,percent of total billed charges,,
HC HYDRAFERA BLUE FOAM 4X4  WOUND DRSNG #582932,A6209,HCPCS,,,both,,,20.31,12.19,United Healthcare/Oxford,United Healthcare/Oxford,,13.95,,,13.95,12.29,17.87,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Aetna,Commerical,,28.19,,,28.19,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Aetna,Middlesex Employees,,25.36,,,25.36,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Anthem,Commerical,,23.39,,,23.39,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Anthem,Indemnity,,,29.78,,29.78,18.71,33.79,percent of total billed charges,,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Anthem,State Preferred,,23.39,,,23.39,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Anthem,Individual Exchange,,18.71,,,18.71,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Cigna,Cigna,,24.82,,,24.82,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Connecticare,Commerical,,25.46,,,25.46,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Connecticare,Exchange,,25.46,,,25.46,18.71,33.79,other,Could be inpatient or outpatient,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,Multiplan,Multiplan,,,33.79,,33.79,18.71,33.79,percent of total billed charges,,
HC WOUND CLEANING SOLUTION #580747,A6260,HCPCS,,,both,,,39.75,23.85,United Healthcare/Oxford,United Healthcare/Oxford,,26.1,,,26.1,18.71,33.79,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Aetna,Commerical,,272.72,,,272.72,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Aetna,Middlesex Employees,,245.45,,,245.45,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Anthem,Commerical,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Anthem,Indemnity,,,266.23,,266.23,195.22,302.09,percent of total billed charges,,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Anthem,State Preferred,,244.02,,,244.02,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Anthem,Individual Exchange,,195.22,,,195.22,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Cigna,Cigna,,282.83,,,282.83,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Connecticare,Commerical,,263.3,,,263.3,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Connecticare,Exchange,,263.3,,,263.3,195.22,302.09,other,Could be inpatient or outpatient,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,Multiplan,Multiplan,,,302.09,,302.09,195.22,302.09,percent of total billed charges,,
HC DIAG ISO MIBI,A9500,HCPCS,,,both,,,355.4,213.24,United Healthcare/Oxford,United Healthcare/Oxford,,229.7,,,229.7,195.22,302.09,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Aetna,Commerical,,299.59,,,299.59,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Aetna,Middlesex Employees,,269.62,,,269.62,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Anthem,Commerical,,268.07,,,268.07,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Anthem,Indemnity,,,292.46,,292.46,214.45,331.85,percent of total billed charges,,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Anthem,State Preferred,,268.07,,,268.07,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Anthem,Individual Exchange,,214.45,,,214.45,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Cigna,Cigna,,310.69,,,310.69,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Connecticare,Commerical,,289.24,,,289.24,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Connecticare,Exchange,,289.24,,,289.24,214.45,331.85,other,Could be inpatient or outpatient,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,Multiplan,Multiplan,,,331.85,,331.85,214.45,331.85,percent of total billed charges,,
HC HH TC99 MEDRONATE <=30 MCI,A9503,HCPCS,,,both,,,402,234.25,United Healthcare/Oxford,United Healthcare/Oxford,,252.33,,,252.33,214.45,331.85,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Aetna,Commerical,,171.77,,,171.77,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Aetna,Middlesex Employees,,154.59,,,154.59,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Anthem,Commerical,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Anthem,Indemnity,,,167.69,,167.69,122.96,190.27,percent of total billed charges,,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Anthem,State Preferred,,153.7,,,153.7,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Anthem,Individual Exchange,,122.96,,,122.96,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Cigna,Cigna,,178.14,,,178.14,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Connecticare,Commerical,,165.84,,,165.84,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Connecticare,Exchange,,165.84,,,165.84,122.96,190.27,other,Could be inpatient or outpatient,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,Multiplan,Multiplan,,,190.27,,190.27,122.96,190.27,percent of total billed charges,,
HC DIAG ISOTOPE THAL,A9505,HCPCS,,,both,,,231,134.31,United Healthcare/Oxford,United Healthcare/Oxford,,144.67,,,144.67,122.96,190.27,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Aetna,Commerical,,5153.2,,,5153.2,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Aetna,Middlesex Employees,,4637.88,,,4637.88,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Anthem,Commerical,,4610.96,,,4610.96,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Anthem,Indemnity,,,5030.58,,5030.58,3688.76,5708.18,percent of total billed charges,,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Anthem,State Preferred,,4610.96,,,4610.96,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Anthem,Individual Exchange,,3688.76,,,3688.76,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Cigna,Cigna,,5344.13,,,5344.13,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Connecticare,Commerical,,4975.18,,,4975.18,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Connecticare,Exchange,,4975.18,,,4975.18,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,Multiplan,Multiplan,,,5708.18,,5708.18,3688.76,5708.18,percent of total billed charges,,
HC HH I123MIBG 1SMC1,A9508,HCPCS,,,both,,,6917,4029.3,United Healthcare/Oxford,United Healthcare/Oxford,,4340.26,,,4340.26,3688.76,5708.18,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Aetna,Commerical,,6.27,,,6.27,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Aetna,Middlesex Employees,,5.64,,,5.64,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Anthem,Commerical,,5.61,,,5.61,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Anthem,Indemnity,,,6.12,,6.12,4.49,6.94,percent of total billed charges,,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Anthem,State Preferred,,5.61,,,5.61,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Anthem,Individual Exchange,,4.49,,,4.49,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Cigna,Cigna,,6.5,,,6.5,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Connecticare,Commerical,,6.05,,,6.05,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Connecticare,Exchange,,6.05,,,6.05,4.49,6.94,other,Could be inpatient or outpatient,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,Multiplan,Multiplan,,,6.94,,6.94,4.49,6.94,percent of total billed charges,,
HC HHTC99 PERTECHNETATE 1MCI,A9512,HCPCS,,,both,,,8.42,4.9,United Healthcare/Oxford,United Healthcare/Oxford,,5.28,,,5.28,4.49,6.94,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Aetna,Commerical,,525.9,,,525.9,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Aetna,Middlesex Employees,,473.31,,,473.31,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Anthem,Commerical,,470.56,,,470.56,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Anthem,Indemnity,,,513.39,,513.39,376.45,582.54,percent of total billed charges,,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Anthem,State Preferred,,470.56,,,470.56,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Anthem,Individual Exchange,,376.45,,,376.45,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Cigna,Cigna,,545.39,,,545.39,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Connecticare,Commerical,,507.73,,,507.73,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Connecticare,Exchange,,507.73,,,507.73,376.45,582.54,other,Could be inpatient or outpatient,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,Multiplan,Multiplan,,,582.54,,582.54,376.45,582.54,percent of total billed charges,,
HC HH IODINE -123 CAPS,A9516,HCPCS,,,both,,,706,411.2,United Healthcare/Oxford,United Healthcare/Oxford,,442.94,,,442.94,376.45,582.54,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Aetna,Commerical,,60.24,,,60.24,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Aetna,Middlesex Employees,,54.22,,,54.22,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Anthem,Commerical,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Anthem,Indemnity,,,58.81,,58.81,43.12,66.73,percent of total billed charges,,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Anthem,State Preferred,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Anthem,Individual Exchange,,43.12,,,43.12,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Cigna,Cigna,,62.47,,,62.47,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Connecticare,Commerical,,58.16,,,58.16,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Connecticare,Exchange,,58.16,,,58.16,43.12,66.73,other,Could be inpatient or outpatient,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,Multiplan,Multiplan,,,66.73,,66.73,43.12,66.73,percent of total billed charges,,
HC HH I131 PER 1 MCI,A9517,HCPCS,,,both,,,80,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,50.74,,,50.74,43.12,66.73,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Aetna,Commerical,,115.6,,,115.6,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Aetna,Middlesex Employees,,104.04,,,104.04,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Anthem,Commerical,,103.44,,,103.44,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Anthem,Indemnity,,,112.85,,112.85,82.75,128.05,percent of total billed charges,,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Anthem,State Preferred,,103.44,,,103.44,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Anthem,Individual Exchange,,82.75,,,82.75,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Cigna,Cigna,,119.88,,,119.88,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Connecticare,Commerical,,111.61,,,111.61,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Connecticare,Exchange,,111.61,,,111.61,82.75,128.05,other,Could be inpatient or outpatient,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,Multiplan,Multiplan,,,128.05,,128.05,82.75,128.05,percent of total billed charges,,
HC HH TC99M MEBROFENIN,A9537,HCPCS,,,both,,,155,90.39,United Healthcare/Oxford,United Healthcare/Oxford,,97.37,,,97.37,82.75,128.05,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Aetna,Commerical,,61.87,,,61.87,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Aetna,Middlesex Employees,,55.68,,,55.68,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Anthem,Commerical,,55.36,,,55.36,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Anthem,Indemnity,,,60.4,,60.4,44.29,68.54,percent of total billed charges,,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Anthem,State Preferred,,55.36,,,55.36,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Anthem,Individual Exchange,,44.29,,,44.29,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Cigna,Cigna,,64.17,,,64.17,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Connecticare,Commerical,,59.74,,,59.74,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Connecticare,Exchange,,59.74,,,59.74,44.29,68.54,other,Could be inpatient or outpatient,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,Multiplan,Multiplan,,,68.54,,68.54,44.29,68.54,percent of total billed charges,,
HC HHTC99 PENTETATE DTPA <= 250 MCI,A9539,HCPCS,,,both,,,82,48.38,United Healthcare/Oxford,United Healthcare/Oxford,,52.11,,,52.11,44.29,68.54,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Aetna,Commerical,,175.85,,,175.85,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Aetna,Middlesex Employees,,158.27,,,158.27,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Anthem,Commerical,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Anthem,Indemnity,,,171.66,,171.66,125.88,194.78,percent of total billed charges,,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Anthem,State Preferred,,157.34,,,157.34,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Anthem,Individual Exchange,,125.88,,,125.88,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Cigna,Cigna,,182.36,,,182.36,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Connecticare,Commerical,,169.77,,,169.77,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Connecticare,Exchange,,169.77,,,169.77,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,Multiplan,Multiplan,,,194.78,,194.78,125.88,194.78,percent of total billed charges,,
HC HH TC MAA <= 10 MCI,A9540,HCPCS,,,both,,,236,137.49,United Healthcare/Oxford,United Healthcare/Oxford,,148.1,,,148.1,125.88,194.78,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Aetna,Commerical,,51.29,,,51.29,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Aetna,Middlesex Employees,,46.16,,,46.16,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Anthem,Commerical,,45.89,,,45.89,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Anthem,Indemnity,,,50.07,,50.07,36.71,56.81,percent of total billed charges,,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Anthem,State Preferred,,45.89,,,45.89,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Anthem,Individual Exchange,,36.71,,,36.71,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Cigna,Cigna,,53.19,,,53.19,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Connecticare,Commerical,,49.52,,,49.52,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Connecticare,Exchange,,49.52,,,49.52,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,Multiplan,Multiplan,,,56.81,,56.81,36.71,56.81,percent of total billed charges,,
HC HH TC MAA <= 10MCI,A9540,HCPCS,,,both,,,69,40.1,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,36.71,56.81,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Aetna,Commerical,,86.3,,,86.3,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Aetna,Middlesex Employees,,77.67,,,77.67,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Anthem,Commerical,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Anthem,Indemnity,,,84.24,,84.24,61.77,95.59,percent of total billed charges,,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Anthem,State Preferred,,77.21,,,77.21,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Anthem,Individual Exchange,,61.77,,,61.77,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Cigna,Cigna,,89.49,,,89.49,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Connecticare,Commerical,,83.31,,,83.31,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Connecticare,Exchange,,83.31,,,83.31,61.77,95.59,other,Could be inpatient or outpatient,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,Multiplan,Multiplan,,,95.59,,95.59,61.77,95.59,percent of total billed charges,,
HC HH TC99 SULFUR COLLOID <= 20 MCI,A9541,HCPCS,,,both,,,115,67.48,United Healthcare/Oxford,United Healthcare/Oxford,,72.68,,,72.68,61.77,95.59,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Aetna,Commerical,,1019.24,,,1019.24,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Aetna,Middlesex Employees,,917.32,,,917.32,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Anthem,Commerical,,911.99,,,911.99,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Anthem,Indemnity,,,994.99,,994.99,729.59,1129.01,percent of total billed charges,,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Anthem,State Preferred,,911.99,,,911.99,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Anthem,Individual Exchange,,729.59,,,729.59,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Cigna,Cigna,,1057,,,1057,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Connecticare,Commerical,,984.04,,,984.04,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Connecticare,Exchange,,984.04,,,984.04,729.59,1129.01,other,Could be inpatient or outpatient,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,Multiplan,Multiplan,,,1129.01,,1129.01,729.59,1129.01,percent of total billed charges,,
HC HHINDIUM1110.5MCI,A9547,HCPCS,,,both,,,1369,796.95,United Healthcare/Oxford,United Healthcare/Oxford,,858.45,,,858.45,729.59,1129.01,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Aetna,Commerical,,270.27,,,270.27,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Aetna,Middlesex Employees,,243.24,,,243.24,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Anthem,Commerical,,241.84,,,241.84,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Anthem,Indemnity,,,263.85,,263.85,193.47,299.39,percent of total billed charges,,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Anthem,State Preferred,,241.84,,,241.84,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Anthem,Individual Exchange,,193.47,,,193.47,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Cigna,Cigna,,280.29,,,280.29,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Connecticare,Commerical,,260.95,,,260.95,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Connecticare,Exchange,,260.95,,,260.95,193.47,299.39,other,Could be inpatient or outpatient,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,Multiplan,Multiplan,,,299.39,,299.39,193.47,299.39,percent of total billed charges,,
HC TC99M SUCCIMER =< 10 MCI,A9551,HCPCS,,,both,,,363,211.33,United Healthcare/Oxford,United Healthcare/Oxford,,227.64,,,227.64,193.47,299.39,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Aetna,Commerical,,231.21,,,231.21,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Aetna,Middlesex Employees,,208.09,,,208.09,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Anthem,Commerical,,206.88,,,206.88,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Anthem,Indemnity,,,225.7,,225.7,165.5,256.11,percent of total billed charges,,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Anthem,State Preferred,,206.88,,,206.88,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Anthem,Individual Exchange,,165.5,,,165.5,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Cigna,Cigna,,239.77,,,239.77,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Connecticare,Commerical,,223.21,,,223.21,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Connecticare,Exchange,,223.21,,,223.21,165.5,256.11,other,Could be inpatient or outpatient,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,Multiplan,Multiplan,,,256.11,,256.11,165.5,256.11,percent of total billed charges,,
HC FLOURODEOXYGLU F-18 FDG DX PER STUDY DOSE <= 45 MCI,A9552,HCPCS,,,both,,,301.3,180.78,United Healthcare/Oxford,United Healthcare/Oxford,,194.73,,,194.73,165.5,256.11,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Aetna,Commerical,,49.66,,,49.66,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Aetna,Middlesex Employees,,44.7,,,44.7,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Anthem,Commerical,,44.43,,,44.43,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Anthem,Indemnity,,,48.47,,49.47,35.54,55,percent of total billed charges,,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Anthem,State Preferred,,44.43,,,44.43,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Anthem,Individual Exchange,,35.54,,,35.54,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Cigna,Cigna,,51.5,,,51.5,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Connecticare,Commerical,,47.94,,,47.94,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Connecticare,Exchange,,47.94,,,47.94,35.54,55,other,Could be inpatient or outpatient,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,Multiplan,Multiplan,,,55,,55,35.54,55,percent of total billed charges,,
HC TC RBC UPT 25MCI,A9560,HCPCS,,,both,,,63,38.83,United Healthcare/Oxford,United Healthcare/Oxford,,41.83,,,41.83,35.54,55,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Aetna,Commerical,,602.42,,,602.42,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Aetna,Middlesex Employees,,542.18,,,542.18,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Anthem,Commerical,,539.04,,,539.04,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Anthem,Indemnity,,,588.1,,588.1,431.23,667.31,percent of total billed charges,,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Anthem,State Preferred,,539.04,,,539.04,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Anthem,Individual Exchange,,431.23,,,431.23,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Cigna,Cigna,,624.75,,,624.75,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Connecticare,Commerical,,581.62,,,581.62,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Connecticare,Exchange,,581.62,,,581.62,431.23,667.31,other,Could be inpatient or outpatient,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,Multiplan,Multiplan,,,667.31,,667.31,431.23,667.31,percent of total billed charges,,
HC HH TC99 MERTIATIDE,A9562,HCPCS,,,both,,,809,471.04,United Healthcare/Oxford,United Healthcare/Oxford,,507.39,,,507.39,431.23,667.31,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Aetna,Commerical,,2297.36,,,2297.36,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Aetna,Middlesex Employees,,2067.63,,,2067.63,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Anthem,Commerical,,2055.62,,,2055.62,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Anthem,Indemnity,,,2242.7,,2242.7,1644.5,2544.78,percent of total billed charges,,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Anthem,State Preferred,,2055.62,,,2055.62,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Anthem,Individual Exchange,,1644.5,,,1644.5,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Cigna,Cigna,,2382.48,,,2382.48,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Connecticare,Commerical,,2218,,,2218,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Connecticare,Exchange,,2218,,,2218,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,Multiplan,Multiplan,,,2544.78,,2544.78,1644.5,2544.78,percent of total billed charges,,
HC HH INDIUMLABELWBC,A9570,HCPCS,,,both,,,3084,1796.32,United Healthcare/Oxford,United Healthcare/Oxford,,1934.95,,,1934.95,1644.5,2544.78,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Aetna,Commerical,,4944.8,,,4944.8,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Aetna,Middlesex Employees,,4450.32,,,4450.32,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Anthem,Commerical,,4424.48,,,4424.48,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Anthem,Indemnity,,,4827.13,,4827.13,3539.59,5477.32,percent of total billed charges,,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Anthem,State Preferred,,4424.48,,,4424.48,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Anthem,Individual Exchange,,3539.59,,,3539.59,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Cigna,Cigna,,5128.01,,,5128.01,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Connecticare,Commerical,,4773.97,,,4773.97,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Connecticare,Exchange,,4773.97,,,4773.97,3539.59,5477.32,other,Could be inpatient or outpatient,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,Multiplan,Multiplan,,,5477.32,,5477.32,3539.59,5477.32,percent of total billed charges,,
HC HH IODINE I-123 IOBENGUANE DX PER STUDY DOSE < 15 MILLICURIES,A9582,HCPCS,,,both,,,6443.91,3866.35,United Healthcare/Oxford,United Healthcare/Oxford,,4164.72,,,4164.72,3539.59,5477.32,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Commerical,,31.72,,,31.72,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Middlesex Employees,,30.42,,,30.42,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Commerical,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Indemnity,,,30.34,,30.34,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,State Preferred,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Individual Exchange,,24.51,,,24.51,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Cigna,Cigna,,35.64,,,35.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Commerical,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Exchange,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,Multiplan,Multiplan,,,34.43,,34.43,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 10FR  #581285,B4034,HCPCS,,,both,,,40.5,24.3,United Healthcare/Oxford,United Healthcare/Oxford,,27.82,,,27.82,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Commerical,,31.72,,,31.72,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Middlesex Employees,,30.42,,,30.42,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Commerical,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Indemnity,,,30.34,,30.34,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,State Preferred,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Individual Exchange,,24.51,,,24.51,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Cigna,Cigna,,35.64,,,35.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Commerical,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Exchange,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,Multiplan,Multiplan,,,34.43,,34.43,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 14FR  #581287,B4034,HCPCS,,,both,,,40.5,24.3,United Healthcare/Oxford,United Healthcare/Oxford,,27.82,,,27.82,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Commerical,,31.72,,,31.72,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Middlesex Employees,,30.42,,,30.42,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Commerical,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Indemnity,,,30.34,,30.34,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,State Preferred,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Individual Exchange,,24.51,,,24.51,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Cigna,Cigna,,35.64,,,35.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Commerical,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Exchange,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,Multiplan,Multiplan,,,34.43,,34.43,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 6FR  #581288,B4034,HCPCS,,,both,,,40.5,24.3,United Healthcare/Oxford,United Healthcare/Oxford,,27.82,,,27.82,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Commerical,,31.72,,,31.72,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Aetna,Middlesex Employees,,30.42,,,30.42,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Commerical,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Indemnity,,,30.34,,30.34,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,State Preferred,,30.64,,,30.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Anthem,Individual Exchange,,24.51,,,24.51,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Cigna,Cigna,,35.64,,,35.64,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Commerical,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Connecticare,Exchange,,33.81,,,33.81,24.51,35.64,other,Could be inpatient or outpatient,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,Multiplan,Multiplan,,,34.43,,34.43,24.51,35.64,percent of total billed charges,,
HC ANCHORIS TUBE SET 8FR  #581283,B4034,HCPCS,,,both,,,40.5,24.3,United Healthcare/Oxford,United Healthcare/Oxford,,27.82,,,27.82,24.51,35.64,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Aetna,Commerical,,1002.96,,,1002.96,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Aetna,Middlesex Employees,,902.67,,,902.67,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Anthem,Commerical,,897.43,,,897.43,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Anthem,Indemnity,,,979.1,,979.1,717.94,1110.98,percent of total billed charges,,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Anthem,State Preferred,,897.43,,,897.43,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Anthem,Individual Exchange,,717.94,,,717.94,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Cigna,Cigna,,876.44,,,876.44,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Connecticare,Commerical,,937.43,,,937.43,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Connecticare,Exchange,,937.43,,,937.43,717.94,1110.98,other,Could be inpatient or outpatient,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,Multiplan,Multiplan,,,1110.98,,1110.98,717.94,1110.98,percent of total billed charges,,
HC 0270-14-1.5-22  ;  MIC KEY G-J TUBE 14FR1.5-22CM,B4087,HCPCS,,,both,,,1269,784.22,United Healthcare/Oxford,United Healthcare/Oxford,,901.98,,,901.98,717.94,1110.98,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Aetna,Commerical,,239.35,,,239.35,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Aetna,Middlesex Employees,,215.41,,,215.41,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Anthem,Commerical,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Anthem,Indemnity,,,233.64,,233.64,171.33,265.12,percent of total billed charges,,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Anthem,State Preferred,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Anthem,Individual Exchange,,171.33,,,171.33,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Cigna,Cigna,,209.15,,,209.15,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Connecticare,Commerical,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Connecticare,Exchange,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,Multiplan,Multiplan,,,265.12,,265.12,171.33,265.12,percent of total billed charges,,
HC COOK FEEDING TUBE NASAL NJFT-10FR  002016,B4087,HCPCS,,,both,,,303,187.14,United Healthcare/Oxford,United Healthcare/Oxford,,215.25,,,215.25,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Aetna,Commerical,,239.35,,,239.35,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Aetna,Middlesex Employees,,215.41,,,215.41,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Anthem,Commerical,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Anthem,Indemnity,,,233.64,,233.64,171.33,265.12,percent of total billed charges,,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Anthem,State Preferred,,214.16,,,214.16,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Anthem,Individual Exchange,,171.33,,,171.33,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Cigna,Cigna,,209.15,,,209.15,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Connecticare,Commerical,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Connecticare,Exchange,,223.71,,,223.71,171.33,265.12,other,Could be inpatient or outpatient,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,Multiplan,Multiplan,,,265.12,,265.12,171.33,265.12,percent of total billed charges,,
HC COOK FEEDING TUBE NASAL NJFT-8FR  002012,B4087,HCPCS,,,both,,,303,187.14,United Healthcare/Oxford,United Healthcare/Oxford,,215.25,,,215.25,171.33,265.12,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Aetna,Commerical,,33.87,,,33.87,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Aetna,Middlesex Employees,,30.48,,,30.48,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Anthem,Commerical,,30.3,,,30.3,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Anthem,Indemnity,,,33.07,,33.07,24.24,37.52,percent of total billed charges,,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Anthem,State Preferred,,30.3,,,30.3,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Anthem,Individual Exchange,,24.24,,,24.24,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Cigna,Cigna,,29.6,,,29.6,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Connecticare,Commerical,,31.66,,,31.66,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Connecticare,Exchange,,31.66,,,31.66,24.24,37.52,other,Could be inpatient or outpatient,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,Multiplan,Multiplan,,,37.52,,37.52,24.24,37.52,percent of total billed charges,,
HC FEEDING TUBE 12FR 109CM CORFLO,B4087,HCPCS,,,both,,,44.14,26.48,United Healthcare/Oxford,United Healthcare/Oxford,,30.47,,,30.47,24.24,37.52,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Aetna,Commerical,,420.89,,,420.89,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Aetna,Middlesex Employees,,378.8,,,378.8,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Anthem,Commerical,,376.6,,,376.6,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Anthem,Indemnity,,,410.87,,410.87,301.28,466.22,percent of total billed charges,,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Anthem,State Preferred,,376.6,,,376.6,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Anthem,Individual Exchange,,301.28,,,301.28,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Cigna,Cigna,,367.79,,,367.79,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Connecticare,Commerical,,393.38,,,393.38,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Connecticare,Exchange,,393.38,,,393.38,301.28,466.22,other,Could be inpatient or outpatient,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,Multiplan,Multiplan,,,466.22,,466.22,301.28,466.22,percent of total billed charges,,
HC G BUTTONLOWPROFLE,B4087,HCPCS,,,both,,,533,329.09,United Healthcare/Oxford,United Healthcare/Oxford,,378.51,,,378.51,301.28,466.22,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Aetna,Commerical,,218.17,,,218.17,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Aetna,Middlesex Employees,,196.36,,,196.36,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Anthem,Commerical,,195.22,,,195.22,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Anthem,Indemnity,,,212.98,,212.98,156.18,241.67,percent of total billed charges,,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Anthem,State Preferred,,195.22,,,195.22,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Anthem,Individual Exchange,,156.18,,,156.18,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Cigna,Cigna,,190.65,,,190.65,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Connecticare,Commerical,,203.92,,,203.92,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Connecticare,Exchange,,203.92,,,203.92,156.18,241.67,other,Could be inpatient or outpatient,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,Multiplan,Multiplan,,,241.67,,241.67,156.18,241.67,percent of total billed charges,,
HC G/E FEEDING TUBE,B4087,HCPCS,,,both,,,276,170.59,United Healthcare/Oxford,United Healthcare/Oxford,,196.22,,,196.22,156.18,241.67,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Aetna,Commerical,,59.43,,,59.43,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Aetna,Middlesex Employees,,53.49,,,53.49,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Anthem,Commerical,,53.18,,,53.18,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Anthem,Indemnity,,,58.02,,58.02,42.54,65.83,percent of total billed charges,,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Anthem,State Preferred,,53.18,,,53.18,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Anthem,Individual Exchange,,42.54,,,42.54,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Cigna,Cigna,,51.93,,,51.93,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Connecticare,Commerical,,55.55,,,55.55,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Connecticare,Exchange,,55.55,,,55.55,42.54,65.83,other,Could be inpatient or outpatient,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,Multiplan,Multiplan,,,65.83,,65.83,42.54,65.83,percent of total billed charges,,
HC GI FEEDING  MIC-TUBE 14FR 309676,B4087,HCPCS,,,both,,,75,46.47,United Healthcare/Oxford,United Healthcare/Oxford,,53.45,,,53.45,42.54,65.83,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Aetna,Commerical,,372.04,,,372.04,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Aetna,Middlesex Employees,,334.84,,,334.84,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Anthem,Commerical,,332.9,,,332.9,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Anthem,Indemnity,,,363.19,,363.19,266.32,412.11,percent of total billed charges,,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Anthem,State Preferred,,332.9,,,332.9,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Anthem,Individual Exchange,,266.32,,,266.32,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Cigna,Cigna,,325.1,,,325.1,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Connecticare,Commerical,,347.72,,,347.72,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Connecticare,Exchange,,347.72,,,347.72,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,Multiplan,Multiplan,,,412.11,,412.11,266.32,412.11,percent of total billed charges,,
HC G-J TUBE 16FR-15CM,B4087,HCPCS,,,both,,,484.83,290.9,United Healthcare/Oxford,United Healthcare/Oxford,,334.59,,,334.59,266.32,412.11,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Aetna,Commerical,,367.97,,,367.97,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Aetna,Middlesex Employees,,331.17,,,331.17,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Anthem,Commerical,,329.25,,,329.25,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Anthem,Indemnity,,,359.22,,359.22,263.41,407.6,percent of total billed charges,,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Anthem,State Preferred,,329.25,,,329.25,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Anthem,Individual Exchange,,263.41,,,263.41,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Cigna,Cigna,,321.55,,,321.55,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Connecticare,Commerical,,343.93,,,343.93,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Connecticare,Exchange,,343.93,,,343.93,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,Multiplan,Multiplan,,,407.6,,407.6,263.41,407.6,percent of total billed charges,,
HC G-J TUBE 16FR-22CM 501323,B4087,HCPCS,,,both,,,479.53,287.72,United Healthcare/Oxford,United Healthcare/Oxford,,330.92,,,330.92,263.41,407.6,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Aetna,Commerical,,409.49,,,409.49,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Aetna,Middlesex Employees,,368.55,,,368.55,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Anthem,Commerical,,366.4,,,366.4,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Anthem,Indemnity,,,399.74,,399.74,293.12,453.59,percent of total billed charges,,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Anthem,State Preferred,,366.4,,,366.4,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Anthem,Individual Exchange,,293.12,,,293.12,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Cigna,Cigna,,357.83,,,357.83,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Connecticare,Commerical,,382.73,,,382.73,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Connecticare,Exchange,,382.73,,,382.73,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,Multiplan,Multiplan,,,453.59,,453.59,293.12,453.59,percent of total billed charges,,
HC G-J TUBE 16FR-30CM 307076,B4087,HCPCS,,,both,,,533.63,320.18,United Healthcare/Oxford,United Healthcare/Oxford,,368.26,,,368.26,293.12,453.59,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Aetna,Commerical,,391.58,,,391.58,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Aetna,Middlesex Employees,,352.42,,,352.42,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Anthem,Commerical,,350.38,,,350.38,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Anthem,Indemnity,,,382.26,,382.26,280.3,433.75,percent of total billed charges,,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Anthem,State Preferred,,350.38,,,350.38,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Anthem,Individual Exchange,,280.3,,,280.3,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Cigna,Cigna,,342.18,,,342.18,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Connecticare,Commerical,,365.99,,,365.99,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Connecticare,Exchange,,365.99,,,365.99,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,Multiplan,Multiplan,,,433.75,,433.75,280.3,433.75,percent of total billed charges,,
HC G-J TUBE 16FR-45CM 309500,B4087,HCPCS,,,both,,,510.29,306.17,United Healthcare/Oxford,United Healthcare/Oxford,,352.16,,,352.16,280.3,433.75,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Aetna,Commerical,,384.25,,,384.25,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Aetna,Middlesex Employees,,345.82,,,345.82,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Anthem,Commerical,,343.82,,,343.82,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Anthem,Indemnity,,,375.1,,375.1,275.05,425.63,percent of total billed charges,,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Anthem,State Preferred,,343.82,,,343.82,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Anthem,Individual Exchange,,275.05,,,275.05,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Cigna,Cigna,,335.77,,,335.77,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Connecticare,Commerical,,359.14,,,359.14,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Connecticare,Exchange,,359.14,,,359.14,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,Multiplan,Multiplan,,,425.63,,425.63,275.05,425.63,percent of total billed charges,,
HC G-J TUBE 18FR-30CM 501329,B4087,HCPCS,,,both,,,500.74,300.44,United Healthcare/Oxford,United Healthcare/Oxford,,345.57,,,345.57,275.05,425.63,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Aetna,Commerical,,377.74,,,377.74,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Aetna,Middlesex Employees,,339.96,,,339.96,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Anthem,Commerical,,337.99,,,337.99,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Anthem,Indemnity,,,368.75,,368.75,270.39,418.42,percent of total billed charges,,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Anthem,State Preferred,,337.99,,,337.99,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Anthem,Individual Exchange,,270.39,,,270.39,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Cigna,Cigna,,330.09,,,330.09,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Connecticare,Commerical,,353.05,,,353.05,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Connecticare,Exchange,,353.05,,,353.05,270.39,418.42,other,Could be inpatient or outpatient,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,Multiplan,Multiplan,,,418.42,,418.42,270.39,418.42,percent of total billed charges,,
HC G-J TUBE 18FR--45CM 306919,B4087,HCPCS,,,both,,,492.26,295.36,United Healthcare/Oxford,United Healthcare/Oxford,,339.7,,,339.7,270.39,418.42,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Aetna,Commerical,,442.05,,,442.05,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Aetna,Middlesex Employees,,397.85,,,397.85,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Anthem,Commerical,,395.54,,,395.54,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Anthem,Indemnity,,,431.53,,431.53,316.43,489.66,percent of total billed charges,,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Anthem,State Preferred,,395.54,,,395.54,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Anthem,Individual Exchange,,316.43,,,316.43,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Cigna,Cigna,,386.29,,,386.29,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Connecticare,Commerical,,413.17,,,413.17,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Connecticare,Exchange,,413.17,,,413.17,316.43,489.66,other,Could be inpatient or outpatient,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,Multiplan,Multiplan,,,489.66,,489.66,316.43,489.66,percent of total billed charges,,
HC GJ TUBE LOWPROFLE,B4087,HCPCS,,,both,,,576.07,345.64,United Healthcare/Oxford,United Healthcare/Oxford,,397.55,,,397.55,316.43,489.66,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Aetna,Commerical,,311.8,,,311.8,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Aetna,Middlesex Employees,,280.62,,,280.62,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Anthem,Commerical,,278.98,,,278.98,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Anthem,Indemnity,,,304.37,,304.37,223.19,345.37,percent of total billed charges,,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Anthem,State Preferred,,278.98,,,278.98,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Anthem,Individual Exchange,,223.19,,,223.19,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Cigna,Cigna,,272.46,,,272.46,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Connecticare,Commerical,,291.42,,,291.42,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Connecticare,Exchange,,291.42,,,291.42,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,Multiplan,Multiplan,,,345.37,,345.37,223.19,345.37,percent of total billed charges,,
HC MIC G-TUBE 18FR 500020,B4087,HCPCS,,,both,,,406.32,243.79,United Healthcare/Oxford,United Healthcare/Oxford,,280.41,,,280.41,223.19,345.37,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Aetna,Commerical,,212.48,,,212.48,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Aetna,Middlesex Employees,,191.24,,,191.24,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Anthem,Commerical,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Anthem,Indemnity,,,207.42,,207.42,152.09,235.36,percent of total billed charges,,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Anthem,State Preferred,,190.12,,,190.12,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Anthem,Individual Exchange,,152.09,,,152.09,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Cigna,Cigna,,185.67,,,185.67,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Connecticare,Commerical,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Connecticare,Exchange,,198.6,,,198.6,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,Multiplan,Multiplan,,,235.36,,235.36,152.09,235.36,percent of total billed charges,,
HC MIC J TUBE 12FR 506024,B4087,HCPCS,,,both,,,276.89,166.13,United Healthcare/Oxford,United Healthcare/Oxford,,191.09,,,191.09,152.09,235.36,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Aetna,Commerical,,220.62,,,220.62,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Aetna,Middlesex Employees,,198.55,,,198.55,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Anthem,Commerical,,197.41,,,197.41,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Anthem,Indemnity,,,215.37,,215.37,157.92,244.38,percent of total billed charges,,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Anthem,State Preferred,,197.41,,,197.41,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Anthem,Individual Exchange,,157.92,,,157.92,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Cigna,Cigna,,192.78,,,192.78,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Connecticare,Commerical,,206.2,,,206.2,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Connecticare,Exchange,,206.2,,,206.2,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,Multiplan,Multiplan,,,244.38,,244.38,157.92,244.38,percent of total billed charges,,
HC MIC JEJUNAL FEED TUBE 14FR-5ML 034616,B4087,HCPCS,,,both,,,287.5,172.5,United Healthcare/Oxford,United Healthcare/Oxford,,198.41,,,198.41,157.92,244.38,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Aetna,Commerical,,781.53,,,781.53,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Aetna,Middlesex Employees,,703.37,,,703.37,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Anthem,Commerical,,699.3,,,699.3,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Anthem,Indemnity,,,762.93,,762.93,559.44,865.69,percent of total billed charges,,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Anthem,State Preferred,,699.3,,,699.3,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Anthem,Individual Exchange,,559.44,,,559.44,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Cigna,Cigna,,682.94,,,682.94,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Connecticare,Commerical,,730.46,,,730.46,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Connecticare,Exchange,,730.46,,,730.46,559.44,865.69,other,Could be inpatient or outpatient,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,Multiplan,Multiplan,,,865.69,,865.69,559.44,865.69,percent of total billed charges,,
HC MIC JEJUNAL FEED TUBE 22FR-45CM,B4087,HCPCS,,,both,,,989,611.08,United Healthcare/Oxford,United Healthcare/Oxford,,702.84,,,702.84,559.44,865.69,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Aetna,Commerical,,164.45,,,164.45,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Aetna,Middlesex Employees,,148.01,,,148.01,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Anthem,Commerical,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Anthem,Indemnity,,,160.53,,160.53,117.72,182.16,percent of total billed charges,,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Anthem,State Preferred,,147.15,,,147.15,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Anthem,Individual Exchange,,117.72,,,117.72,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Cigna,Cigna,,143.7,,,143.7,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Connecticare,Commerical,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Connecticare,Exchange,,153.7,,,153.7,117.72,182.16,other,Could be inpatient or outpatient,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,Multiplan,Multiplan,,,182.16,,182.16,117.72,182.16,percent of total billed charges,,
HC NJ FEEDING TUBE 10FR,B4087,HCPCS,,,both,,,208,128.58,United Healthcare/Oxford,United Healthcare/Oxford,,147.89,,,147.89,117.72,182.16,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Aetna,Commerical,,14.5,,,14.5,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Aetna,Middlesex Employees,,13.05,,,13.05,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Anthem,Commerical,,12.98,,,12.98,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Anthem,Indemnity,,,14.17,,14.17,10.38,16.07,percent of total billed charges,,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Anthem,State Preferred,,12.98,,,12.98,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Anthem,Individual Exchange,,10.38,,,10.38,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Cigna,Cigna,,12.68,,,12.68,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Connecticare,Commerical,,13.56,,,13.56,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Connecticare,Exchange,,13.56,,,13.56,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,Multiplan,Multiplan,,,16.07,,16.07,10.38,16.07,percent of total billed charges,,
HC TUBE DECOMP.18FR 1.2CM 311786,B4087,HCPCS,,,both,,,18.91,11.35,United Healthcare/Oxford,United Healthcare/Oxford,,13.05,,,13.05,10.38,16.07,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Aetna,Commerical,,33.79,,,33.79,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Aetna,Middlesex Employees,,30.41,,,30.41,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Anthem,Commerical,,30.23,,,30.23,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Anthem,Indemnity,,,32.98,,32.98,24.19,37.43,percent of total billed charges,,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Anthem,State Preferred,,30.23,,,30.23,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Anthem,Individual Exchange,,24.19,,,24.19,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Cigna,Cigna,,29.53,,,29.53,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Connecticare,Commerical,,31.58,,,31.58,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Connecticare,Exchange,,31.58,,,31.58,24.19,37.43,other,Could be inpatient or outpatient,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,Multiplan,Multiplan,,,37.43,,37.43,24.19,37.43,percent of total billed charges,,
HC TUBE ENT FEED 8FR 501305,B4087,HCPCS,,,both,,,44.03,26.42,United Healthcare/Oxford,United Healthcare/Oxford,,30.39,,,30.39,24.19,37.43,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Aetna,Commerical,,306.09,,,306.09,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Aetna,Middlesex Employees,,275.48,,,275.48,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Anthem,Commerical,,273.89,,,273.89,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Anthem,Indemnity,,,298.82,,298.82,219.11,339.07,percent of total billed charges,,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Anthem,State Preferred,,273.89,,,273.89,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Anthem,Individual Exchange,,219.11,,,219.11,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Cigna,Cigna,,267.49,,,267.49,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Connecticare,Commerical,,286.1,,,286.1,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Connecticare,Exchange,,286.1,,,286.1,219.11,339.07,other,Could be inpatient or outpatient,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,Multiplan,Multiplan,,,339.07,,339.07,219.11,339.07,percent of total billed charges,,
HC 0230-14-1.7 ;  J TUBE 14F 1.7CM AMT,B4088,HCPCS,,,both,,,387,239.34,United Healthcare/Oxford,United Healthcare/Oxford,,275.28,,,275.28,219.11,339.07,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Aetna,Commerical,,394.02,,,394.02,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Aetna,Middlesex Employees,,354.62,,,354.62,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Anthem,Commerical,,352.56,,,352.56,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Anthem,Indemnity,,,384.65,,384.65,282.05,436.46,percent of total billed charges,,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Anthem,State Preferred,,352.56,,,352.56,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Anthem,Individual Exchange,,282.05,,,282.05,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Cigna,Cigna,,344.31,,,344.31,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Connecticare,Commerical,,368.27,,,368.27,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Connecticare,Exchange,,368.27,,,368.27,282.05,436.46,other,Could be inpatient or outpatient,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,Multiplan,Multiplan,,,436.46,,436.46,282.05,436.46,percent of total billed charges,,
HC 0250-18-22 ; GJ TRANSGASTRIC FEED TUBE 18F 22CM,B4088,HCPCS,,,both,,,513.48,308.09,United Healthcare/Oxford,United Healthcare/Oxford,,354.35,,,354.35,282.05,436.46,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.0-15  ;  G-J LP TUBE 16FR1.0-15CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Commerical,,597.54,,,597.54,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Middlesex Employees,,537.79,,,537.79,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Commerical,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Indemnity,,,583.32,,583.32,427.73,661.9,percent of total billed charges,,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,State Preferred,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Individual Exchange,,427.73,,,427.73,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Cigna,Cigna,,522.16,,,522.16,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Commerical,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Exchange,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Multiplan,Multiplan,,,661.9,,661.9,427.73,661.9,percent of total billed charges,,
HC 0270-16-1.2-22  ;  G-J LP TUBE 16FR1.2-22CM,B4088,HCPCS,,,both,,,778.7,467.22,United Healthcare/Oxford,United Healthcare/Oxford,,537.38,,,537.38,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Aetna,Commerical,,558.46,,,558.46,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Aetna,Middlesex Employees,,502.62,,,502.62,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Anthem,Commerical,,499.7,,,499.7,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Anthem,Indemnity,,,545.18,,545.18,399.76,618.61,percent of total billed charges,,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Anthem,State Preferred,,499.7,,,499.7,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Anthem,Individual Exchange,,399.76,,,399.76,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Cigna,Cigna,,488.02,,,488.02,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Connecticare,Commerical,,521.97,,,521.97,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Connecticare,Exchange,,521.97,,,521.97,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,Multiplan,Multiplan,,,618.61,,618.61,399.76,618.61,percent of total billed charges,,
HC 0270-16-1.2-30  ;  G-J LP TUBE 16FR1.2-30CM,B4088,HCPCS,,,both,,,727.78,436.67,United Healthcare/Oxford,United Healthcare/Oxford,,502.24,,,502.24,399.76,618.61,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.5-15  ;  G-J LP TUBE 16FR1.5-15CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Commerical,,580.45,,,580.45,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Middlesex Employees,,522.4,,,522.4,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Commerical,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Indemnity,,,566.63,,566.63,415.5,642.96,percent of total billed charges,,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,State Preferred,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Individual Exchange,,415.5,,,415.5,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Cigna,Cigna,,507.22,,,507.22,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Commerical,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Exchange,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,Multiplan,Multiplan,,,642.96,,642.96,415.5,642.96,percent of total billed charges,,
HC 0270-16-1.5-22  ;  G-J LP TUBE 16FR1.5-22CM,B4088,HCPCS,,,both,,,756.42,453.85,United Healthcare/Oxford,United Healthcare/Oxford,,522,,,522,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Commerical,,552.77,,,552.77,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Middlesex Employees,,497.49,,,497.49,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Commerical,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Indemnity,,,539.61,,539.61,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,State Preferred,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Individual Exchange,,395.68,,,395.68,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Cigna,Cigna,,483.04,,,483.04,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Commerical,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Exchange,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Multiplan,Multiplan,,,612.3,,612.3,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.5-30  ;  G-J LP TUBE 16FR1.5-30CM,B4088,HCPCS,,,both,,,720.35,432.21,United Healthcare/Oxford,United Healthcare/Oxford,,497.12,,,497.12,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-1.7-15  ;  G-J LP TUBE 16FR1.7-15CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Commerical,,597.54,,,597.54,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Middlesex Employees,,537.79,,,537.79,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Commerical,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Indemnity,,,583.32,,583.32,427.73,661.9,percent of total billed charges,,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,State Preferred,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Individual Exchange,,427.73,,,427.73,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Cigna,Cigna,,522.16,,,522.16,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Commerical,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Exchange,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,Multiplan,Multiplan,,,661.9,,661.9,427.73,661.9,percent of total billed charges,,
HC 0270-16-1.7-22  ;  G-J LP TUBE 16FR1.7-22CM,B4088,HCPCS,,,both,,,778.7,467.22,United Healthcare/Oxford,United Healthcare/Oxford,,537.38,,,537.38,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Commerical,,552.77,,,552.77,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Middlesex Employees,,497.49,,,497.49,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Commerical,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Indemnity,,,539.61,,539.61,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,State Preferred,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Individual Exchange,,395.68,,,395.68,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Cigna,Cigna,,483.04,,,483.04,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Commerical,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Exchange,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,Multiplan,Multiplan,,,612.3,,612.3,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.7-30  ;  G-J LP TUBE 16FR1.7-30CM,B4088,HCPCS,,,both,,,720.35,432.21,United Healthcare/Oxford,United Healthcare/Oxford,,497.12,,,497.12,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Commerical,,552.77,,,552.77,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Aetna,Middlesex Employees,,497.49,,,497.49,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Commerical,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Indemnity,,,539.61,,539.6,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,State Preferred,,494.61,,,494.61,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Anthem,Individual Exchange,,395.68,,,395.68,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Cigna,Cigna,,483.04,,,483.04,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Commerical,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Connecticare,Exchange,,516.65,,,516.65,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,Multiplan,Multiplan,,,612.3,,612.3,395.68,612.3,percent of total billed charges,,
HC 0270-16-1.7-45  ;  G-J LP TUBE 16FR1.7-45CM,B4088,HCPCS,,,both,,,720.35,432.21,United Healthcare/Oxford,United Healthcare/Oxford,,497.12,,,497.12,395.68,612.3,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-2.0-22  ;  G-J LP TUBE 16FR2.0-22CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Commerical,,580.45,,,580.45,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Middlesex Employees,,522.4,,,522.4,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Commerical,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Indemnity,,,566.63,,566.63,415.5,642.96,percent of total billed charges,,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,State Preferred,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Individual Exchange,,415.5,,,415.5,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Cigna,Cigna,,507.22,,,507.22,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Commerical,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Exchange,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Multiplan,Multiplan,,,642.96,,642.96,415.5,642.96,percent of total billed charges,,
HC 0270-16-2.0-30  ;  G-J LP TUBE 16FR2.0-30CM,B4088,HCPCS,,,both,,,756.42,453.85,United Healthcare/Oxford,United Healthcare/Oxford,,522,,,522,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Aetna,Commerical,,643.13,,,643.13,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Aetna,Middlesex Employees,,578.82,,,578.82,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Anthem,Commerical,,575.46,,,575.46,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Anthem,Indemnity,,,627.83,,627.83,460.37,712.39,percent of total billed charges,,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Anthem,State Preferred,,575.46,,,575.46,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Anthem,Individual Exchange,,460.37,,,460.37,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Cigna,Cigna,,562,,,562,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Connecticare,Commerical,,601.11,,,601.11,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Connecticare,Exchange,,601.11,,,601.11,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,Multiplan,Multiplan,,,712.39,,712.39,460.37,712.39,percent of total billed charges,,
HC 0270-16-2.0-45  ;  G-J LP TUBE 16FR 2.0-45CM,B4088,HCPCS,,,both,,,838.11,502.87,United Healthcare/Oxford,United Healthcare/Oxford,,578.38,,,578.38,460.37,712.39,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-2.3-30  ;  G-J LP TUBE 16FR2.3-30CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Aetna,Commerical,,542.18,,,542.18,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Aetna,Middlesex Employees,,487.96,,,487.96,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Anthem,Commerical,,485.14,,,485.14,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Anthem,Indemnity,,,529.28,,529.28,388.1,600.58,percent of total billed charges,,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Anthem,State Preferred,,485.14,,,485.14,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Anthem,Individual Exchange,,388.1,,,388.1,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Cigna,Cigna,,473.78,,,473.78,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Connecticare,Commerical,,506.76,,,506.76,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Connecticare,Exchange,,506.76,,,506.76,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,Multiplan,Multiplan,,,600.58,,600.58,388.1,600.58,percent of total billed charges,,
HC 0270-16-2.5-30  ;  G-J LP TUBE 16FR2.5-30CM,B4088,HCPCS,,,both,,,706.56,423.94,United Healthcare/Oxford,United Healthcare/Oxford,,487.59,,,487.59,388.1,600.58,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Aetna,Commerical,,638.25,,,638.25,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Aetna,Middlesex Employees,,574.43,,,574.43,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Anthem,Commerical,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Anthem,Indemnity,,,623.06,,623.06,456.87,706.99,percent of total billed charges,,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Anthem,State Preferred,,571.09,,,571.09,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Anthem,Individual Exchange,,456.87,,,456.87,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Cigna,Cigna,,557.73,,,557.73,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Connecticare,Commerical,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Connecticare,Exchange,,596.54,,,596.54,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,Multiplan,Multiplan,,,706.99,,706.99,456.87,706.99,percent of total billed charges,,
HC 0270-16-2.7-30  ;  G-J LP TUBE 16FR2.7-30CM,B4088,HCPCS,,,both,,,831.75,499.05,United Healthcare/Oxford,United Healthcare/Oxford,,573.99,,,573.99,456.87,706.99,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Aetna,Commerical,,578.81,,,578.81,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Aetna,Middlesex Employees,,520.93,,,520.93,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Anthem,Commerical,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Anthem,Indemnity,,,565.05,,565.06,414.33,641.16,percent of total billed charges,,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Anthem,State Preferred,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Anthem,Individual Exchange,,414.33,,,414.33,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Cigna,Cigna,,505.8,,,505.8,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Connecticare,Commerical,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Connecticare,Exchange,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,Multiplan,Multiplan,,,641.16,,641.16,414.33,641.16,percent of total billed charges,,
HC 0270-16-2.7-45  ;  G-J LP TUBE 16FR2.7-45CM,B4088,HCPCS,,,both,,,754.3,452.58,United Healthcare/Oxford,United Healthcare/Oxford,,520.54,,,520.54,414.33,641.16,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Aetna,Commerical,,577.19,,,577.19,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Aetna,Middlesex Employees,,519.47,,,519.47,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Anthem,Commerical,,516.45,,,516.45,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Anthem,Indemnity,,,563.46,,563.46,413.16,639.35,percent of total billed charges,,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Anthem,State Preferred,,516.45,,,516.45,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Anthem,Individual Exchange,,413.16,,,413.16,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Cigna,Cigna,,504.38,,,504.38,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Connecticare,Commerical,,539.48,,,539.48,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Connecticare,Exchange,,539.48,,,539.48,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,Multiplan,Multiplan,,,639.35,,639.35,413.16,639.35,percent of total billed charges,,
HC 0270-16-3.0-45  ;  G-J LP TUBE 16FR3.0-45CM,B4088,HCPCS,,,both,,,752.18,451.31,United Healthcare/Oxford,United Healthcare/Oxford,,519.08,,,519.08,413.16,639.35,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-16-3.5-45  ;  G-J LP TUBE 16FR3.5-45CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Aetna,Commerical,,586.96,,,586.96,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Aetna,Middlesex Employees,,528.27,,,528.27,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Anthem,Commerical,,525.2,,,525.2,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Anthem,Indemnity,,,572.99,,572.99,420.16,650.17,percent of total billed charges,,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Anthem,State Preferred,,525.2,,,525.2,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Anthem,Individual Exchange,,420.16,,,420.16,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Cigna,Cigna,,512.92,,,512.92,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Connecticare,Commerical,,548.6,,,548.6,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Connecticare,Exchange,,548.6,,,548.6,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,Multiplan,Multiplan,,,650.17,,650.17,420.16,650.17,percent of total billed charges,,
HC 0270-18-1.7-22  ;  G-J LP TUBE 18FR1.7-22CM,B4088,HCPCS,,,both,,,764.91,458.95,United Healthcare/Oxford,United Healthcare/Oxford,,527.86,,,527.86,420.16,650.17,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Aetna,Commerical,,568.24,,,568.24,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Aetna,Middlesex Employees,,511.42,,,511.42,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Anthem,Commerical,,508.44,,,508.44,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Anthem,Indemnity,,,554.72,,554.72,406.76,629.43,percent of total billed charges,,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Anthem,State Preferred,,508.44,,,508.44,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Anthem,Individual Exchange,,406.76,,,406.76,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Cigna,Cigna,,496.55,,,496.55,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Connecticare,Commerical,,531.11,,,531.11,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Connecticare,Exchange,,531.11,,,531.11,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,Multiplan,Multiplan,,,629.43,,629.43,406.76,629.43,percent of total billed charges,,
HC 0270-18-1.7-30  ;  G-J LP TUBE 18FR1.7-30CM,B4088,HCPCS,,,both,,,740.51,444.31,United Healthcare/Oxford,United Healthcare/Oxford,,511.02,,,511.02,406.76,629.43,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Aetna,Commerical,,639.06,,,639.06,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Aetna,Middlesex Employees,,575.16,,,575.16,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Anthem,Commerical,,571.82,,,571.82,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Anthem,Indemnity,,,623.86,,623.86,457.45,707.89,percent of total billed charges,,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Anthem,State Preferred,,571.82,,,571.82,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Anthem,Individual Exchange,,457.45,,,457.45,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Cigna,Cigna,,558.44,,,558.44,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Connecticare,Commerical,,597.31,,,597.31,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Connecticare,Exchange,,597.31,,,597.31,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,Multiplan,Multiplan,,,707.89,,707.89,457.45,707.89,percent of total billed charges,,
HC 0270-18-2.3-30  ;  G-J LP TUBE 18FR2.3-30CM,B4088,HCPCS,,,both,,,832.81,499.69,United Healthcare/Oxford,United Healthcare/Oxford,,574.72,,,574.72,457.45,707.89,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Aetna,Commerical,,621.15,,,621.15,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Aetna,Middlesex Employees,,559.03,,,559.03,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Anthem,Commerical,,555.8,,,555.8,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Anthem,Indemnity,,,606.37,,606.37,444.64,688.05,percent of total billed charges,,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Anthem,State Preferred,,555.8,,,555.8,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Anthem,Individual Exchange,,444.64,,,444.64,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Cigna,Cigna,,542.8,,,542.8,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Connecticare,Commerical,,580.57,,,580.57,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Connecticare,Exchange,,580.57,,,580.57,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,Multiplan,Multiplan,,,688.05,,688.05,444.64,688.05,percent of total billed charges,,
HC 0270-18-2.5-30  ;  G-J LP TUBE 18FR2.5-30CM,B4088,HCPCS,,,both,,,809.47,485.68,United Healthcare/Oxford,United Healthcare/Oxford,,558.61,,,558.61,444.64,688.05,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Commerical,,580.45,,,580.45,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Aetna,Middlesex Employees,,522.4,,,522.4,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Commerical,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Indemnity,,,566.63,,566.63,415.5,642.96,percent of total billed charges,,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,State Preferred,,519.37,,,519.37,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Anthem,Individual Exchange,,415.5,,,415.5,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Cigna,Cigna,,507.22,,,507.22,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Commerical,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Connecticare,Exchange,,542.52,,,542.52,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,Multiplan,Multiplan,,,642.96,,642.96,415.5,642.96,percent of total billed charges,,
HC 0270-18-2.7-30  ;  G-J LP TUBE 18FR2.7-30CM,B4088,HCPCS,,,both,,,756.42,453.85,United Healthcare/Oxford,United Healthcare/Oxford,,522,,,522,415.5,642.96,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Commerical,,569.05,,,569.05,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Aetna,Middlesex Employees,,512.15,,,512.15,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Commerical,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Indemnity,,,555.51,,555.51,407.33,630.33,percent of total billed charges,,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,State Preferred,,509.17,,,509.17,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Anthem,Individual Exchange,,407.33,,,407.33,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Cigna,Cigna,,497.27,,,497.27,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Commerical,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Connecticare,Exchange,,531.86,,,531.86,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,Multiplan,Multiplan,,,630.33,,630.33,407.33,630.33,percent of total billed charges,,
HC 0270-18-3.0-45  ;  G-J LP TUBE 18FR3.0-45CM,B4088,HCPCS,,,both,,,741.57,444.94,United Healthcare/Oxford,United Healthcare/Oxford,,511.76,,,511.76,407.33,630.33,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Commerical,,597.54,,,597.54,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Aetna,Middlesex Employees,,537.79,,,537.79,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Commerical,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Indemnity,,,583.32,,583.32,427.73,661.9,percent of total billed charges,,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,State Preferred,,534.67,,,534.67,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Anthem,Individual Exchange,,427.73,,,427.73,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Cigna,Cigna,,522.16,,,522.16,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Commerical,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Connecticare,Exchange,,558.5,,,558.5,427.73,661.9,other,Could be inpatient or outpatient,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,Multiplan,Multiplan,,,661.9,,661.9,427.73,661.9,percent of total billed charges,,
HC 0270-18-3.5-45  ;  G-J LP TUBE 18FR3.5-45CM,B4088,HCPCS,,,both,,,778.7,467.22,United Healthcare/Oxford,United Healthcare/Oxford,,537.38,,,537.38,427.73,661.9,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1410-15  ;  G-J LP TUBE 14FR1.0-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1410-22  ;  G-J LP TUBE 14FR1.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1412-15  ;  G-J LP TUBE 14FR1.2-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1412-22  ;  G-J LP TUBE 14FR1.2-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1415-15  ;  G-J LP TUBE 14FR1.5-15CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1415-22  ;  G-J LP TUBE 14FR1.5-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1415-30  ;  G-J LP TUBE 14FR1.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1417-15  ;  G-J LP TUBE 14FR1.7-15CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1417-22  ;  G-J LP TUBE 14FR1.7-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1417-30  ;  G-J LP TUBE 14FR1.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1420-22  ;  G-J LP TUBE 14FR2.0-22CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1427-30  ;  G-J LP TUBE 14FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1615-22  ;  G-J LP TUBE 16FR1.5-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1620-22  ;  G-J LP TUBE 16FR2.0-22CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1623-30  ;  G-J LP TUBE 16FR2.3-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1625-30  ;  G-J LP TUBE 16FR2.5-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1627-30  ;  G-J LP TUBE 16FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Commerical,,734.31,,,734.31,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Aetna,Middlesex Employees,,660.88,,,660.88,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Commerical,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Indemnity,,,716.84,,716.84,525.64,813.39,percent of total billed charges,,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,State Preferred,,657.04,,,657.04,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Anthem,Individual Exchange,,525.64,,,525.64,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Cigna,Cigna,,641.68,,,641.68,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Commerical,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Connecticare,Exchange,,686.33,,,686.33,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,Multiplan,Multiplan,,,813.39,,813.39,525.64,813.39,percent of total billed charges,,
HC GJ-1627-45  ;  G-J LP TUBE 16FR2.7-45CM AMT,B4088,HCPCS,,,both,,,956.93,574.16,United Healthcare/Oxford,United Healthcare/Oxford,,660.37,,,660.37,525.64,813.39,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Commerical,,756.29,,,756.29,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Aetna,Middlesex Employees,,680.66,,,680.66,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Commerical,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Indemnity,,,738.3,,738.3,541.37,837.74,percent of total billed charges,,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,State Preferred,,676.71,,,676.71,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Anthem,Individual Exchange,,541.37,,,541.37,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Cigna,Cigna,,660.89,,,660.89,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Commerical,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Connecticare,Exchange,,706.87,,,706.87,541.37,837.74,other,Could be inpatient or outpatient,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,Multiplan,Multiplan,,,837.74,,837.74,541.37,837.74,percent of total billed charges,,
HC GJ-1827-30 ;  GJ LP TUBE 18FR2.7-30CM AMT,B4088,HCPCS,,,both,,,985.58,591.35,United Healthcare/Oxford,United Healthcare/Oxford,,680.15,,,680.15,541.37,837.74,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Commerical,,359.02,,,359.02,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Middlesex Employees,,323.12,,,323.12,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Commerical,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Indemnity,,,350.47,,350.47,256.99,397.68,percent of total billed charges,,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,State Preferred,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Individual Exchange,,256.99,,,256.99,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Cigna,Cigna,,313.73,,,313.73,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Commerical,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Exchange,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Multiplan,Multiplan,,,397.68,,397.68,256.99,397.68,percent of total billed charges,,
HC M1-5-1450 ;  14-5.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,United Healthcare/Oxford,United Healthcare/Oxford,,322.86,,,322.86,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Commerical,,359.02,,,359.02,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Middlesex Employees,,323.12,,,323.12,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Commerical,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Indemnity,,,350.47,,350.47,256.99,397.68,percent of total billed charges,,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,State Preferred,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Individual Exchange,,256.99,,,256.99,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Cigna,Cigna,,313.73,,,313.73,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Commerical,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Exchange,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Multiplan,Multiplan,,,397.68,,397.68,256.99,397.68,percent of total billed charges,,
HC M1-5-1455 ;  14-5.5 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,United Healthcare/Oxford,United Healthcare/Oxford,,322.86,,,322.86,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Commerical,,359.02,,,359.02,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Aetna,Middlesex Employees,,323.12,,,323.12,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Commerical,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Indemnity,,,350.47,,350.47,256.99,397.68,percent of total billed charges,,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,State Preferred,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Anthem,Individual Exchange,,256.99,,,256.99,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Cigna,Cigna,,313.73,,,313.73,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Commerical,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Connecticare,Exchange,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,Multiplan,Multiplan,,,397.68,,397.68,256.99,397.68,percent of total billed charges,,
HC M1-5-1460 ;  14-6.0 TUBE MINI 1 BUTTON,B4088,HCPCS,,,both,,,454,280.72,United Healthcare/Oxford,United Healthcare/Oxford,,322.86,,,322.86,256.99,397.68,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Aetna,Commerical,,608.94,,,608.94,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Aetna,Middlesex Employees,,548.05,,,548.05,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Anthem,Commerical,,544.87,,,544.87,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Anthem,Indemnity,,,594.45,,594.45,435.89,674.52,percent of total billed charges,,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Anthem,State Preferred,,544.87,,,544.87,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Anthem,Individual Exchange,,435.89,,,435.89,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Cigna,Cigna,,532.13,,,532.13,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Connecticare,Commerical,,569.15,,,569.15,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Connecticare,Exchange,,569.15,,,569.15,435.89,674.52,other,Could be inpatient or outpatient,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,Multiplan,Multiplan,,,674.52,,674.52,435.89,674.52,percent of total billed charges,,
HC MIC LP GJ TUBE 16FR 1.2-15  309295,B4088,HCPCS,,,both,,,793.55,476.13,United Healthcare/Oxford,United Healthcare/Oxford,,547.63,,,547.63,435.89,674.52,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Aetna,Commerical,,2511.48,,,2511.48,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Aetna,Middlesex Employees,,2260.32,,,2260.32,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Anthem,Commerical,,2247.2,,,2247.2,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Anthem,Indemnity,,,2525.26,,2525.26,1797.76,2781.95,percent of total billed charges,,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Anthem,State Preferred,,2247.2,,,2247.2,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Anthem,Individual Exchange,,1797.76,,,1797.76,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Cigna,Cigna,,2194.65,,,2194.65,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Connecticare,Commerical,,2347.37,,,2347.37,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Connecticare,Exchange,,2347.37,,,2347.37,1797.76,2781.95,other,Could be inpatient or outpatient,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,Multiplan,Multiplan,,,2781.95,,2781.95,1797.76,2781.95,percent of total billed charges,,
HC HYPERBARIC THERPY,C1300,HCPCS,,,both,,,3371,1963.73,United Healthcare/Oxford,United Healthcare/Oxford,,2258.61,,,2258.61,1797.76,2781.95,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Aetna,Commerical,,10.68,,,10.68,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Aetna,Middlesex Employees,,9.61,,,9.61,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Anthem,Commerical,,9.55,,,9.55,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Anthem,Indemnity,,,10.42,,10.42,7.64,11.82,percent of total billed charges,,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Anthem,State Preferred,,9.55,,,9.55,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Anthem,Individual Exchange,,7.64,,,7.64,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Cigna,Cigna,,9.33,,,9.33,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Connecticare,Commerical,,9.98,,,9.98,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Connecticare,Exchange,,9.98,,,9.98,7.64,11.82,other,Could be inpatient or outpatient,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,Multiplan,Multiplan,,,11.82,,11.82,7.64,11.82,percent of total billed charges,,
HC IRRIG BTL ADAPTR,C1713,HCPCS,,,both,,,13.5,8.35,United Healthcare/Oxford,United Healthcare/Oxford,,9.6,,,9.6,7.64,11.82,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Aetna,Commerical,,477.06,,,477.06,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Aetna,Middlesex Employees,,429.36,,,429.36,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Anthem,Commerical,,426.87,,,426.87,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Anthem,Indemnity,,,465.71,,465.71,341.49,528.44,percent of total billed charges,,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Anthem,State Preferred,,426.87,,,426.87,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Anthem,Individual Exchange,,341.49,,,341.49,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Cigna,Cigna,,416.87,,,416.87,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Connecticare,Commerical,,445.89,,,445.89,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Connecticare,Exchange,,445.89,,,445.89,341.49,528.44,other,Could be inpatient or outpatient,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,Multiplan,Multiplan,,,528.44,,528.44,341.49,528.44,percent of total billed charges,,
HC STEINMAN PIN HOLD,C1713,HCPCS,,,both,,,604,373.01,United Healthcare/Oxford,United Healthcare/Oxford,,429.03,,,429.03,341.49,528.44,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Aetna,Commerical,,43.96,,,43.96,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Aetna,Middlesex Employees,,39.56,,,39.56,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Commerical,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Indemnity,,,46.44,,46.44,29.19,52.7,percent of total billed charges,,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,State Preferred,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Individual Exchange,,29.19,,,29.19,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Cigna,Cigna,,38.72,,,38.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Connecticare,Commerical,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Connecticare,Exchange,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,Multiplan,Multiplan,,,52.7,,52.7,29.19,52.7,percent of total billed charges,,
HC CATH CEMTESIS 10CM 5FR ONESTEP  OSC-5F-10LT,C1715,HCPCS,,,both,,,62,37.2,United Healthcare/Oxford,United Healthcare/Oxford,,40.72,,,40.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Aetna,Commerical,,98.55,,,98.55,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Aetna,Middlesex Employees,,88.69,,,88.69,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Anthem,Commerical,,81.79,,,81.79,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Anthem,Indemnity,,,104.12,,104.12,65.43,118.15,percent of total billed charges,,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Anthem,State Preferred,,81.79,,,81.79,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Anthem,Individual Exchange,,65.43,,,65.43,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Cigna,Cigna,,86.81,,,86.81,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Connecticare,Commerical,,89.05,,,89.05,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Connecticare,Exchange,,89.05,,,89.05,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,Multiplan,Multiplan,,,118.15,,118.15,65.43,118.15,percent of total billed charges,,
HC CATH CEMTESIS 12CM 5FR ONESTEP  OSC-5F-12LT,C1715,HCPCS,,,both,,,139,83.4,United Healthcare/Oxford,United Healthcare/Oxford,,91.29,,,91.29,65.43,118.15,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Aetna,Commerical,,43.96,,,43.96,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Aetna,Middlesex Employees,,39.56,,,39.56,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Commerical,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Indemnity,,,46.44,,46.44,29.19,52.7,percent of total billed charges,,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,State Preferred,,36.48,,,36.48,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Anthem,Individual Exchange,,29.19,,,29.19,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Cigna,Cigna,,38.72,,,38.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Connecticare,Commerical,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Connecticare,Exchange,,39.72,,,39.72,29.19,52.7,other,Could be inpatient or outpatient,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,Multiplan,Multiplan,,,52.7,,52.7,29.19,52.7,percent of total billed charges,,
HC CATH CEMTESIS 7CM 5FR ONESTEP  OSC-5F-7LT,C1715,HCPCS,,,both,,,62,37.2,United Healthcare/Oxford,United Healthcare/Oxford,,40.72,,,40.72,29.19,52.7,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Aetna,Commerical,,298.78,,,298.78,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Aetna,Middlesex Employees,,268.89,,,268.89,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Anthem,Commerical,,267.33,,,267.33,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Anthem,Indemnity,,,291.66,,291.66,213.86,330.95,percent of total billed charges,,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Anthem,State Preferred,,267.33,,,267.33,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Anthem,Individual Exchange,,213.86,,,213.86,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Cigna,Cigna,,261.08,,,261.08,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Connecticare,Commerical,,279.24,,,279.24,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Connecticare,Exchange,,279.24,,,279.24,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,Multiplan,Multiplan,,,330.95,,330.95,213.86,330.95,percent of total billed charges,,
HC HH HI PTA-1CATH,C1725,HCPCS,,,both,,,378,233.61,United Healthcare/Oxford,United Healthcare/Oxford,,268.69,,,268.69,213.86,330.95,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Aetna,Commerical,,364.71,,,364.71,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Aetna,Middlesex Employees,,328.24,,,328.24,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Anthem,Commerical,,326.34,,,326.34,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Anthem,Indemnity,,,356.03,,356.03,261.07,403.99,percent of total billed charges,,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Anthem,State Preferred,,326.34,,,326.34,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Anthem,Individual Exchange,,261.07,,,261.07,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Cigna,Cigna,,318.71,,,318.71,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Connecticare,Commerical,,340.88,,,340.88,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Connecticare,Exchange,,340.88,,,340.88,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,Multiplan,Multiplan,,,403.99,,403.99,261.07,403.99,percent of total billed charges,,
HC HH HI PTA-2CATH,C1725,HCPCS,,,both,,,461,285.17,United Healthcare/Oxford,United Healthcare/Oxford,,327.99,,,327.99,261.07,403.99,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Aetna,Commerical,,508.81,,,508.81,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Aetna,Middlesex Employees,,457.93,,,457.93,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Anthem,Commerical,,455.27,,,455.27,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Anthem,Indemnity,,,496.7,,496.7,364.22,563.6,percent of total billed charges,,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Anthem,State Preferred,,455.27,,,455.27,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Anthem,Individual Exchange,,364.22,,,364.22,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Cigna,Cigna,,444.62,,,444.62,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Connecticare,Commerical,,475.56,,,475.56,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Connecticare,Exchange,,475.56,,,475.56,364.22,563.6,other,Could be inpatient or outpatient,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,Multiplan,Multiplan,,,563.6,,563.6,364.22,563.6,percent of total billed charges,,
HC HH HI PTA-3CATH,C1725,HCPCS,,,both,,,644,397.84,United Healthcare/Oxford,United Healthcare/Oxford,,457.58,,,457.58,364.22,563.6,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Aetna,Commerical,,55.36,,,55.36,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Aetna,Middlesex Employees,,49.83,,,49.83,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Anthem,Commerical,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Anthem,Indemnity,,,54.04,,54.04,39.63,61.32,percent of total billed charges,,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Anthem,State Preferred,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Anthem,Individual Exchange,,39.63,,,39.63,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Cigna,Cigna,,48.37,,,48.37,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Connecticare,Commerical,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Connecticare,Exchange,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,Multiplan,Multiplan,,,61.32,,61.32,39.63,61.32,percent of total billed charges,,
HC MIC-KEY OVER-THE-WIRE STOMA 007774,C1725,HCPCS,,,both,,,70,43.28,United Healthcare/Oxford,United Healthcare/Oxford,,49.78,,,49.78,39.63,61.32,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Aetna,Commerical,,420.07,,,420.07,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Aetna,Middlesex Employees,,378.06,,,378.06,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Anthem,Commerical,,375.87,,,375.87,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Anthem,Indemnity,,,410.07,,410.07,300.7,465.31,percent of total billed charges,,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Anthem,State Preferred,,375.87,,,375.87,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Anthem,Individual Exchange,,300.7,,,300.7,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Cigna,Cigna,,367.08,,,367.08,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Connecticare,Commerical,,392.62,,,392.62,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Connecticare,Exchange,,392.62,,,392.62,300.7,465.31,other,Could be inpatient or outpatient,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,Multiplan,Multiplan,,,465.31,,465.31,300.7,465.31,percent of total billed charges,,
HC COOK ATBDILATE CATH,C1726,HCPCS,,,both,,,531,328.45,United Healthcare/Oxford,United Healthcare/Oxford,,377.77,,,377.77,300.7,465.31,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Aetna,Commerical,,250.74,,,250.74,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Aetna,Middlesex Employees,,225.66,,,225.66,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Anthem,Commerical,,224.36,,,224.36,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Anthem,Indemnity,,,244.78,,244.78,179.49,277.75,percent of total billed charges,,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Anthem,State Preferred,,224.36,,,224.36,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Anthem,Individual Exchange,,179.49,,,179.49,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Cigna,Cigna,,219.11,,,219.11,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Connecticare,Commerical,,234.36,,,234.36,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Connecticare,Exchange,,234.36,,,234.36,179.49,277.75,other,Could be inpatient or outpatient,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,Multiplan,Multiplan,,,277.75,,277.75,179.49,277.75,percent of total billed charges,,
HC DILATATION CATHETER 322302,C1726,HCPCS,,,both,,,317,196.06,United Healthcare/Oxford,United Healthcare/Oxford,,225.5,,,225.5,179.49,277.75,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Aetna,Commerical,,1016.8,,,1016.8,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Aetna,Middlesex Employees,,915.11,,,915.11,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Anthem,Commerical,,909.81,,,909.81,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Anthem,Indemnity,,,992.6,,992.6,727.84,1126.3,percent of total billed charges,,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Anthem,State Preferred,,909.81,,,909.81,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Anthem,Individual Exchange,,727.84,,,727.84,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Cigna,Cigna,,888.53,,,888.53,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Connecticare,Commerical,,950.36,,,950.36,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Connecticare,Exchange,,950.36,,,950.36,727.84,1126.3,other,Could be inpatient or outpatient,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,Multiplan,Multiplan,,,1126.3,,1126.3,727.84,1126.3,percent of total billed charges,,
HC ANGIOPLASTY CATH,C1727,HCPCS,,,both,,,1286,795.04,United Healthcare/Oxford,United Healthcare/Oxford,,914.42,,,914.42,727.84,1126.3,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Aetna,Commerical,,258.06,,,258.06,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Aetna,Middlesex Employees,,232.26,,,232.26,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Anthem,Commerical,,230.91,,,230.91,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Anthem,Indemnity,,,251.93,,251.93,184.73,285.86,percent of total billed charges,,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Anthem,State Preferred,,230.91,,,230.91,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Anthem,Individual Exchange,,184.73,,,184.73,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Cigna,Cigna,,225.51,,,225.51,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Connecticare,Commerical,,241.2,,,241.2,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Connecticare,Exchange,,241.2,,,241.2,184.73,285.86,other,Could be inpatient or outpatient,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,Multiplan,Multiplan,,,285.86,,285.86,184.73,285.86,percent of total billed charges,,
HC BALLOON ANGIOCATH 309311,C1727,HCPCS,,,both,,,327,201.79,United Healthcare/Oxford,United Healthcare/Oxford,,232.08,,,232.08,184.73,285.86,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Aetna,Commerical,,102.58,,,102.58,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Aetna,Middlesex Employees,,92.31,,,92.31,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Anthem,Commerical,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Anthem,Indemnity,,,100.13,,100.13,73.42,113.62,percent of total billed charges,,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Anthem,State Preferred,,91.78,,,91.78,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Anthem,Individual Exchange,,73.42,,,73.42,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Cigna,Cigna,,89.64,,,89.64,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Connecticare,Commerical,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Connecticare,Exchange,,95.87,,,95.87,73.42,113.62,other,Could be inpatient or outpatient,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,Multiplan,Multiplan,,,113.62,,113.62,73.42,113.62,percent of total billed charges,,
HC ATRIUM PEDI,C1729,HCPCS,,,both,,,133.67,80.2,United Healthcare/Oxford,United Healthcare/Oxford,,92.25,,,92.25,73.42,113.62,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Aetna,Commerical,,128.63,,,128.63,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Aetna,Middlesex Employees,,115.77,,,115.77,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Anthem,Commerical,,115.09,,,115.09,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Anthem,Indemnity,,,125.56,,125.56,92.07,142.48,percent of total billed charges,,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Anthem,State Preferred,,115.09,,,115.09,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Anthem,Individual Exchange,,92.07,,,92.07,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Cigna,Cigna,,112.4,,,112.4,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Connecticare,Commerical,,120.22,,,120.22,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Connecticare,Exchange,,120.22,,,120.22,92.07,142.48,other,Could be inpatient or outpatient,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,Multiplan,Multiplan,,,142.48,,142.48,92.07,142.48,percent of total billed charges,,
HC CATH DRAINTUBE+TRAY,C1729,HCPCS,,,both,,,163,100.57,United Healthcare/Oxford,United Healthcare/Oxford,,115.68,,,115.68,92.07,142.48,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Aetna,Commerical,,389.13,,,389.13,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Aetna,Middlesex Employees,,350.22,,,350.22,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Anthem,Commerical,,348.18,,,348.18,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Anthem,Indemnity,,,379.88,,379.88,278.55,431.04,percent of total billed charges,,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Anthem,State Preferred,,348.18,,,348.18,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Anthem,Individual Exchange,,278.55,,,278.55,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Cigna,Cigna,,340.05,,,340.05,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Connecticare,Commerical,,363.71,,,363.71,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Connecticare,Exchange,,363.71,,,363.71,278.55,431.04,other,Could be inpatient or outpatient,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,Multiplan,Multiplan,,,431.04,,431.04,278.55,431.04,percent of total billed charges,,
HC CHAIT C TUBE SET,C1729,HCPCS,,,both,,,492,304.27,United Healthcare/Oxford,United Healthcare/Oxford,,349.95,,,349.95,278.55,431.04,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Aetna,Commerical,,333.77,,,333.77,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Aetna,Middlesex Employees,,300.4,,,300.4,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Anthem,Commerical,,298.66,,,298.66,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Anthem,Indemnity,,,325.84,,325.84,238.93,369.72,percent of total billed charges,,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Anthem,State Preferred,,298.66,,,298.66,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Anthem,Individual Exchange,,238.93,,,238.93,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Cigna,Cigna,,291.67,,,291.67,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Connecticare,Commerical,,311.96,,,311.96,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Connecticare,Exchange,,311.96,,,311.96,238.93,369.72,other,Could be inpatient or outpatient,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,Multiplan,Multiplan,,,369.72,,369.72,238.93,369.72,percent of total billed charges,,
HC CNSMON ICP DRAIN KIT,C1729,HCPCS,,,both,,,422,260.98,United Healthcare/Oxford,United Healthcare/Oxford,,300.17,,,300.17,238.93,369.72,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Aetna,Commerical,,116.41,,,116.41,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Aetna,Middlesex Employees,,104.77,,,104.77,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Anthem,Commerical,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Anthem,Indemnity,,,113.65,,113.65,83.33,128.95,percent of total billed charges,,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Anthem,State Preferred,,104.16,,,104.16,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Anthem,Individual Exchange,,83.33,,,83.33,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Cigna,Cigna,,101.73,,,101.73,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Connecticare,Commerical,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Connecticare,Exchange,,108.8,,,108.8,83.33,128.95,other,Could be inpatient or outpatient,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,Multiplan,Multiplan,,,128.95,,128.95,83.33,128.95,percent of total billed charges,,
HC DRAINAGE CATH 6FRX16CM 575115,C1729,HCPCS,,,both,,,147,91.03,United Healthcare/Oxford,United Healthcare/Oxford,,104.69,,,104.69,83.33,128.95,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Aetna,Commerical,,372.04,,,372.04,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Aetna,Middlesex Employees,,334.84,,,334.84,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Anthem,Commerical,,332.9,,,332.9,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Anthem,Indemnity,,,363.19,,363.19,266.32,412.11,percent of total billed charges,,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Anthem,State Preferred,,332.9,,,332.9,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Anthem,Individual Exchange,,266.32,,,266.32,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Cigna,Cigna,,325.1,,,325.1,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Connecticare,Commerical,,347.72,,,347.72,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Connecticare,Exchange,,347.72,,,347.72,266.32,412.11,other,Could be inpatient or outpatient,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,Multiplan,Multiplan,,,412.11,,412.11,266.32,412.11,percent of total billed charges,,
HC FUHRMAN CATH COOK,C1729,HCPCS,,,both,,,484.83,290.9,United Healthcare/Oxford,United Healthcare/Oxford,,334.59,,,334.59,266.32,412.11,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Aetna,Commerical,,279.24,,,279.24,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Aetna,Middlesex Employees,,251.31,,,251.31,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Anthem,Commerical,,249.85,,,249.85,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Anthem,Indemnity,,,272.59,,272.59,199.88,309.31,percent of total billed charges,,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Anthem,State Preferred,,249.85,,,249.85,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Anthem,Individual Exchange,,199.88,,,199.88,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Cigna,Cigna,,244,,,244,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Connecticare,Commerical,,260.99,,,260.99,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Connecticare,Exchange,,260.99,,,260.99,199.88,309.31,other,Could be inpatient or outpatient,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,Multiplan,Multiplan,,,309.31,,309.31,199.88,309.31,percent of total billed charges,,
HC FURHMAN CATHETER,C1729,HCPCS,,,both,,,353,218.33,United Healthcare/Oxford,United Healthcare/Oxford,,251.12,,,251.12,199.88,309.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Aetna,Commerical,,188.06,,,188.06,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Aetna,Middlesex Employees,,169.25,,,169.25,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Anthem,Commerical,,168.27,,,168.27,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Anthem,Indemnity,,,183.58,,183.58,134.61,208.31,percent of total billed charges,,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Anthem,State Preferred,,168.27,,,168.27,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Anthem,Individual Exchange,,134.61,,,134.61,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Cigna,Cigna,,164.33,,,164.33,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Connecticare,Commerical,,175.77,,,175.77,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Connecticare,Exchange,,175.77,,,175.77,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,Multiplan,Multiplan,,,208.31,,208.31,134.61,208.31,percent of total billed charges,,
HC HH HI DRN1 CATH,C1729,HCPCS,,,both,,,238,147.04,United Healthcare/Oxford,United Healthcare/Oxford,,169.13,,,169.13,134.61,208.31,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Aetna,Commerical,,5297.3,,,5297.3,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Aetna,Middlesex Employees,,4767.57,,,4767.57,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Anthem,Commerical,,4739.9,,,4739.9,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Anthem,Indemnity,,,5171.25,,5171.25,3791.92,5867.79,percent of total billed charges,,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Anthem,State Preferred,,4739.9,,,4739.9,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Anthem,Individual Exchange,,3791.92,,,3791.92,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Cigna,Cigna,,4629.03,,,4629.03,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Connecticare,Commerical,,4951.15,,,4951.15,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Connecticare,Exchange,,4951.15,,,4951.15,3791.92,5867.79,other,Could be inpatient or outpatient,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,Multiplan,Multiplan,,,5867.79,,5867.79,3791.92,5867.79,percent of total billed charges,,
HC HH HCATH9ABLATION,C1732,HCPCS,,,both,,,6702,4141.97,United Healthcare/Oxford,United Healthcare/Oxford,,4763.96,,,4763.96,3791.92,5867.79,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Aetna,Commerical,,344.36,,,344.36,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Aetna,Middlesex Employees,,309.92,,,309.92,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Anthem,Commerical,,308.13,,,308.13,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Anthem,Indemnity,,,336.17,,336.17,246.51,381.45,percent of total billed charges,,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Anthem,State Preferred,,308.13,,,308.13,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Anthem,Individual Exchange,,246.51,,,246.51,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Cigna,Cigna,,300.92,,,300.92,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Connecticare,Commerical,,321.86,,,321.86,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Connecticare,Exchange,,321.86,,,321.86,246.51,381.45,other,Could be inpatient or outpatient,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,Multiplan,Multiplan,,,381.45,,381.45,246.51,381.45,percent of total billed charges,,
HC CURL CATH DIALYS,C1750,HCPCS,,,both,,,436,269.26,United Healthcare/Oxford,United Healthcare/Oxford,,309.69,,,309.69,246.51,381.45,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Aetna,Commerical,,348.43,,,348.43,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Aetna,Middlesex Employees,,313.58,,,313.58,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Anthem,Commerical,,311.77,,,311.77,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Anthem,Indemnity,,,340.14,,340.14,249.41,385.96,percent of total billed charges,,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Anthem,State Preferred,,311.77,,,311.77,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Anthem,Individual Exchange,,249.41,,,249.41,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Cigna,Cigna,,304.48,,,304.48,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Connecticare,Commerical,,325.66,,,325.66,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Connecticare,Exchange,,325.66,,,325.66,249.41,385.96,other,Could be inpatient or outpatient,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,Multiplan,Multiplan,,,385.96,,385.96,249.41,385.96,percent of total billed charges,,
HC DIALYSIS CATH 9FR,C1750,HCPCS,,,both,,,441,272.44,United Healthcare/Oxford,United Healthcare/Oxford,,313.35,,,313.35,249.41,385.96,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Aetna,Commerical,,340.29,,,340.29,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Aetna,Middlesex Employees,,306.26,,,306.26,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Anthem,Commerical,,304.49,,,304.49,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Anthem,Indemnity,,,332.2,,332.2,243.59,376.94,percent of total billed charges,,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Anthem,State Preferred,,304.49,,,304.49,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Anthem,Individual Exchange,,243.59,,,243.59,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Cigna,Cigna,,297.37,,,297.37,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Connecticare,Commerical,,318.05,,,318.05,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Connecticare,Exchange,,318.05,,,318.05,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,Multiplan,Multiplan,,,376.94,,376.94,243.59,376.94,percent of total billed charges,,
HC HH HI CVC-1 CATH,C1750,HCPCS,,,both,,,431,266.08,United Healthcare/Oxford,United Healthcare/Oxford,,306.03,,,306.03,243.59,376.94,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Aetna,Commerical,,207.6,,,207.6,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Aetna,Middlesex Employees,,186.84,,,186.84,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Anthem,Commerical,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Anthem,Indemnity,,,202.65,,202.65,148.61,229.95,percent of total billed charges,,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Anthem,State Preferred,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Anthem,Individual Exchange,,148.61,,,148.61,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Cigna,Cigna,,181.41,,,181.41,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Connecticare,Commerical,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Connecticare,Exchange,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,Multiplan,Multiplan,,,229.95,,229.95,148.61,229.95,percent of total billed charges,,
HC HH HI CVC-2CATH,C1750,HCPCS,,,both,,,263,162.32,United Healthcare/Oxford,United Healthcare/Oxford,,186.69,,,186.69,148.61,229.95,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Aetna,Commerical,,610.57,,,610.57,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Aetna,Middlesex Employees,,549.52,,,549.52,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Anthem,Commerical,,546.32,,,546.32,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Anthem,Indemnity,,,596.04,,596.04,437.06,676.33,percent of total billed charges,,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Anthem,State Preferred,,546.32,,,546.32,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Anthem,Individual Exchange,,437.06,,,437.06,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Cigna,Cigna,,533.54,,,533.54,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Connecticare,Commerical,,570.67,,,570.67,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Connecticare,Exchange,,570.67,,,570.67,437.06,676.33,other,Could be inpatient or outpatient,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,Multiplan,Multiplan,,,676.33,,676.33,437.06,676.33,percent of total billed charges,,
HC HH HI CVC-3CATH,C1750,HCPCS,,,both,,,773,477.41,United Healthcare/Oxford,United Healthcare/Oxford,,549.09,,,549.09,437.06,676.33,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Aetna,Commerical,,393.21,,,393.21,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Aetna,Middlesex Employees,,353.89,,,353.89,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Anthem,Commerical,,351.83,,,351.83,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Anthem,Indemnity,,,383.85,,383.85,281.46,435.55,percent of total billed charges,,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Anthem,State Preferred,,351.83,,,351.83,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Anthem,Individual Exchange,,281.46,,,281.46,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Cigna,Cigna,,343.61,,,343.61,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Connecticare,Commerical,,367.51,,,367.51,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Connecticare,Exchange,,367.51,,,367.51,281.46,435.55,other,Could be inpatient or outpatient,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,Multiplan,Multiplan,,,435.55,,435.55,281.46,435.55,percent of total billed charges,,
HC SWAN NECK CATH,C1750,HCPCS,,,both,,,497,307.45,United Healthcare/Oxford,United Healthcare/Oxford,,353.62,,,353.62,281.46,435.55,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Aetna,Commerical,,790.48,,,790.48,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Aetna,Middlesex Employees,,711.43,,,711.43,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Anthem,Commerical,,707.31,,,707.31,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Anthem,Indemnity,,,771.67,,771.67,565.84,875.61,percent of total billed charges,,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Anthem,State Preferred,,707.31,,,707.31,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Anthem,Individual Exchange,,565.84,,,565.84,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Cigna,Cigna,,690.76,,,690.76,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Connecticare,Commerical,,738.83,,,738.83,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Connecticare,Exchange,,738.83,,,738.83,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,Multiplan,Multiplan,,,875.61,,875.61,565.84,875.61,percent of total billed charges,,
HC BROVIAC 4.2 SGL,C1751,HCPCS,,,both,,,1000,618.08,United Healthcare/Oxford,United Healthcare/Oxford,,710.9,,,710.9,565.84,875.61,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Aetna,Commerical,,720.47,,,720.47,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Aetna,Middlesex Employees,,648.42,,,648.42,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Anthem,Commerical,,644.66,,,644.66,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Anthem,Indemnity,,,703.33,,703.33,515.73,798.07,percent of total billed charges,,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Anthem,State Preferred,,644.66,,,644.66,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Anthem,Individual Exchange,,515.73,,,515.73,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Cigna,Cigna,,629.58,,,629.58,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Connecticare,Commerical,,673.39,,,673.39,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Connecticare,Exchange,,673.39,,,673.39,515.73,798.07,other,Could be inpatient or outpatient,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,Multiplan,Multiplan,,,798.07,,798.07,515.73,798.07,percent of total billed charges,,
HC BROVIAC 6.6SGL,C1751,HCPCS,,,both,,,912,563.34,United Healthcare/Oxford,United Healthcare/Oxford,,647.93,,,647.93,515.73,798.07,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Aetna,Commerical,,594.28,,,594.28,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Aetna,Middlesex Employees,,534.85,,,534.85,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Anthem,Commerical,,531.75,,,531.75,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Anthem,Indemnity,,,580.15,,580.15,425.41,658.29,percent of total billed charges,,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Anthem,State Preferred,,531.75,,,531.75,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Anthem,Individual Exchange,,425.41,,,425.41,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Cigna,Cigna,,519.31,,,519.31,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Connecticare,Commerical,,555.46,,,555.46,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Connecticare,Exchange,,555.46,,,555.46,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,Multiplan,Multiplan,,,658.29,,658.29,425.41,658.29,percent of total billed charges,,
HC CATH  BROVIAC 2.7 - 4.2FR,C1751,HCPCS,,,both,,,752,464.68,United Healthcare/Oxford,United Healthcare/Oxford,,534.46,,,534.46,425.41,658.29,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Aetna,Commerical,,106.65,,,106.65,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Aetna,Middlesex Employees,,95.98,,,95.98,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Anthem,Commerical,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Anthem,Indemnity,,,104.11,,104.11,76.34,118.13,percent of total billed charges,,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Anthem,State Preferred,,95.43,,,95.43,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Anthem,Individual Exchange,,76.34,,,76.34,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Cigna,Cigna,,93.19,,,93.19,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Connecticare,Commerical,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Connecticare,Exchange,,99.68,,,99.68,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,Multiplan,Multiplan,,,118.13,,118.13,76.34,118.13,percent of total billed charges,,
HC CATH 3.5FR SILUMB,C1751,HCPCS,,,both,,,135,83.39,United Healthcare/Oxford,United Healthcare/Oxford,,95.91,,,95.91,76.34,118.13,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Aetna,Commerical,,122.11,,,122.11,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Aetna,Middlesex Employees,,109.9,,,109.9,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Anthem,Commerical,,109.26,,,109.26,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Anthem,Indemnity,,,119.21,,119.21,87.42,135.27,percent of total billed charges,,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Anthem,State Preferred,,109.26,,,109.26,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Anthem,Individual Exchange,,87.42,,,87.42,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Cigna,Cigna,,106.7,,,106.7,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Connecticare,Commerical,,114.13,,,114.13,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Connecticare,Exchange,,114.13,,,114.13,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,Multiplan,Multiplan,,,135.27,,135.27,87.42,135.27,percent of total billed charges,,
HC CATH 3FR 8CM,C1751,HCPCS,,,both,,,155,95.48,United Healthcare/Oxford,United Healthcare/Oxford,,109.82,,,109.82,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Aetna,Commerical,,121.3,,,121.3,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Aetna,Middlesex Employees,,109.17,,,109.17,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Anthem,Commerical,,108.54,,,108.54,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Anthem,Indemnity,,,118.41,,118.41,86.84,134.36,percent of total billed charges,,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Anthem,State Preferred,,108.54,,,108.54,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Anthem,Individual Exchange,,86.84,,,86.84,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Cigna,Cigna,,106,,,106,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Connecticare,Commerical,,113.38,,,113.38,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Connecticare,Exchange,,113.38,,,113.38,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,Multiplan,Multiplan,,,134.36,,134.36,86.84,134.36,percent of total billed charges,,
HC CATH 50 POLY UMB,C1751,HCPCS,,,both,,,153,94.84,United Healthcare/Oxford,United Healthcare/Oxford,,109.09,,,109.09,86.84,134.36,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Aetna,Commerical,,195.38,,,195.38,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Aetna,Middlesex Employees,,175.84,,,175.84,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Anthem,Commerical,,174.82,,,174.82,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Anthem,Indemnity,,,190.74,,190.74,139.86,216.43,percent of total billed charges,,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Anthem,State Preferred,,174.82,,,174.82,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Anthem,Individual Exchange,,139.86,,,139.86,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Cigna,Cigna,,170.74,,,170.74,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Connecticare,Commerical,,182.62,,,182.62,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Connecticare,Exchange,,182.62,,,182.62,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,Multiplan,Multiplan,,,216.43,,216.43,139.86,216.43,percent of total billed charges,,
HC CATH 5FR DLUM SIL,C1751,HCPCS,,,both,,,247,152.77,United Healthcare/Oxford,United Healthcare/Oxford,,175.71,,,175.71,139.86,216.43,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Aetna,Commerical,,359.02,,,359.02,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Aetna,Middlesex Employees,,323.12,,,323.12,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Anthem,Commerical,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Anthem,Indemnity,,,350.47,,350.47,256.99,397.68,percent of total billed charges,,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Anthem,State Preferred,,321.23,,,321.23,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Anthem,Individual Exchange,,256.99,,,256.99,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Cigna,Cigna,,313.73,,,313.73,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Connecticare,Commerical,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Connecticare,Exchange,,335.56,,,335.56,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,Multiplan,Multiplan,,,397.68,,397.68,256.99,397.68,percent of total billed charges,,
HC CATH CECOSTOMY 0-6CM 032235,C1751,HCPCS,,,both,,,467.86,280.72,United Healthcare/Oxford,United Healthcare/Oxford,,322.86,,,322.86,256.99,397.68,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Aetna,Commerical,,350.88,,,350.88,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Aetna,Middlesex Employees,,315.79,,,315.79,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Anthem,Commerical,,313.96,,,313.96,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Anthem,Indemnity,,,342.53,,342.53,251.16,388.66,percent of total billed charges,,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Anthem,State Preferred,,313.96,,,313.96,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Anthem,Individual Exchange,,251.16,,,251.16,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Cigna,Cigna,,306.61,,,306.61,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Connecticare,Commerical,,327.95,,,327.95,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Connecticare,Exchange,,327.95,,,327.95,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,Multiplan,Multiplan,,,388.66,,388.66,251.16,388.66,percent of total billed charges,,
HC CATH CECOSTOMY 3-9CM 001176,C1751,HCPCS,,,both,,,457.25,274.35,United Healthcare/Oxford,United Healthcare/Oxford,,315.55,,,315.55,251.16,388.66,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Aetna,Commerical,,354.13,,,354.13,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Aetna,Middlesex Employees,,318.72,,,318.72,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Anthem,Commerical,,316.87,,,316.87,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Anthem,Indemnity,,,345.7,,345.7,253.49,392.27,percent of total billed charges,,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Anthem,State Preferred,,316.87,,,316.87,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Anthem,Individual Exchange,,253.49,,,253.49,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Cigna,Cigna,,309.45,,,309.45,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Connecticare,Commerical,,330.99,,,330.99,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Connecticare,Exchange,,330.99,,,330.99,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,Multiplan,Multiplan,,,392.27,,392.27,253.49,392.27,percent of total billed charges,,
HC CATH CECOSTOMY 6-14CM 001177,C1751,HCPCS,,,both,,,461.49,276.89,United Healthcare/Oxford,United Healthcare/Oxford,,318.48,,,318.48,253.49,392.27,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Aetna,Commerical,,60.24,,,60.24,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Aetna,Middlesex Employees,,54.22,,,54.22,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Anthem,Commerical,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Anthem,Indemnity,,,58.81,,58.81,43.12,66.73,percent of total billed charges,,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Anthem,State Preferred,,53.9,,,53.9,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Anthem,Individual Exchange,,43.12,,,43.12,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Cigna,Cigna,,52.64,,,52.64,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Connecticare,Commerical,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Connecticare,Exchange,,56.31,,,56.31,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,Multiplan,Multiplan,,,66.73,,66.73,43.12,66.73,percent of total billed charges,,
HC CATH CECOSTOMY CHAIT PERCUT 003837,C1751,HCPCS,,,both,,,78.51,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,54.18,,,54.18,43.12,66.73,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Aetna,Commerical,,188.87,,,188.87,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Aetna,Middlesex Employees,,169.98,,,169.98,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Anthem,Commerical,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Anthem,Indemnity,,,184.38,,184.38,135.19,209.21,percent of total billed charges,,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Anthem,State Preferred,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Anthem,Individual Exchange,,135.19,,,135.19,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Cigna,Cigna,,165.05,,,165.05,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Connecticare,Commerical,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Connecticare,Exchange,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,Multiplan,Multiplan,,,209.21,,209.21,135.19,209.21,percent of total billed charges,,
HC CATH CENT LINE 4FR 30CM,C1751,HCPCS,,,both,,,246.13,147.68,United Healthcare/Oxford,United Healthcare/Oxford,,169.86,,,169.86,135.19,209.21,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Aetna,Commerical,,180.73,,,180.73,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Aetna,Middlesex Employees,,162.65,,,162.65,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Anthem,Commerical,,161.71,,,161.71,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Anthem,Indemnity,,,176.43,,176.43,129.36,200.19,percent of total billed charges,,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Anthem,State Preferred,,161.71,,,161.71,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Anthem,Individual Exchange,,129.36,,,129.36,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Cigna,Cigna,,157.92,,,157.92,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Connecticare,Commerical,,168.92,,,168.92,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Connecticare,Exchange,,168.92,,,168.92,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,Multiplan,Multiplan,,,200.19,,200.19,129.36,200.19,percent of total billed charges,,
HC CATH CV KIT FR 8 CM 3 LUMEN,C1751,HCPCS,,,both,,,229,141.31,United Healthcare/Oxford,United Healthcare/Oxford,,162.53,,,162.53,129.36,200.19,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Aetna,Commerical,,211.67,,,211.67,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Aetna,Middlesex Employees,,190.51,,,190.51,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Anthem,Commerical,,189.39,,,189.39,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Anthem,Indemnity,,,206.62,,206.62,151.51,234.46,percent of total billed charges,,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Anthem,State Preferred,,189.39,,,189.39,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Anthem,Individual Exchange,,151.51,,,151.51,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Cigna,Cigna,,184.96,,,184.96,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Connecticare,Commerical,,197.83,,,197.83,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Connecticare,Exchange,,197.83,,,197.83,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,Multiplan,Multiplan,,,234.46,,235.46,151.51,234.46,percent of total billed charges,,
HC CATH CVC PICC DL POWER 5FR 303103,C1751,HCPCS,,,both,,,275.83,165.5,United Healthcare/Oxford,United Healthcare/Oxford,,190.35,,,190.35,151.51,234.46,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Aetna,Commerical,,87.11,,,87.11,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Aetna,Middlesex Employees,,78.4,,,78.4,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Anthem,Commerical,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Anthem,Indemnity,,,85.04,,85.04,62.36,96.49,percent of total billed charges,,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Anthem,State Preferred,,77.95,,,77.95,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Anthem,Individual Exchange,,62.36,,,62.36,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Cigna,Cigna,,76.12,,,76.12,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Connecticare,Commerical,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Connecticare,Exchange,,81.41,,,81.41,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,Multiplan,Multiplan,,,96.49,,96.49,62.36,96.49,percent of total billed charges,,
HC CATH DBL LUMEN 4FR,C1751,HCPCS,,,both,,,113.52,68.11,United Healthcare/Oxford,United Healthcare/Oxford,,78.34,,,78.34,62.36,96.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Aetna,Commerical,,178.28,,,178.28,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Aetna,Middlesex Employees,,160.46,,,160.46,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Anthem,Commerical,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Anthem,Indemnity,,,174.05,,174.05,127.62,197.49,percent of total billed charges,,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Anthem,State Preferred,,159.52,,,159.52,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Anthem,Individual Exchange,,127.62,,,127.62,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Cigna,Cigna,,155.79,,,155.79,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Connecticare,Commerical,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Connecticare,Exchange,,166.63,,,166.63,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,Multiplan,Multiplan,,,197.49,,197.49,127.62,197.49,percent of total billed charges,,
HC CATH DBL LUMEN 7FR,C1751,HCPCS,,,both,,,232.34,139.4,United Healthcare/Oxford,United Healthcare/Oxford,,160.34,,,160.34,127.62,197.49,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Aetna,Commerical,,34.55,,,34.55,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Aetna,Middlesex Employees,,31.1,,,31.1,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Anthem,Commerical,,30.92,,,30.92,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Anthem,Indemnity,,,33.72,,33.72,24.74,38.27,percent of total billed charges,,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Anthem,State Preferred,,30.92,,,30.92,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Anthem,Individual Exchange,,24.74,,,24.74,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Cigna,Cigna,,30.19,,,30.19,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Connecticare,Commerical,,32.29,,,32.29,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Connecticare,Exchange,,32.29,,,32.29,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,Multiplan,Multiplan,,,38.27,,38.27,24.74,38.27,percent of total billed charges,,
HC CATH MPA 5FR 65CM 034266,C1751,HCPCS,,,both,,,43.71,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,31.08,,,31.08,24.74,38.27,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Aetna,Commerical,,220.62,,,220.62,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Aetna,Middlesex Employees,,198.55,,,198.55,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Anthem,Commerical,,197.41,,,197.41,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Anthem,Indemnity,,,215.37,,215.37,157.92,244.38,percent of total billed charges,,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Anthem,State Preferred,,197.41,,,197.41,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Anthem,Individual Exchange,,157.92,,,157.92,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Cigna,Cigna,,192.78,,,192.78,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Connecticare,Commerical,,206.2,,,206.2,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Connecticare,Exchange,,206.2,,,206.2,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,Multiplan,Multiplan,,,244.38,,244.38,157.92,244.38,percent of total billed charges,,
HC CATH PICC POWER LUMEN SOLO 4FR 000128,C1751,HCPCS,,,both,,,287.5,172.5,United Healthcare/Oxford,United Healthcare/Oxford,,198.41,,,198.41,157.92,244.38,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Aetna,Commerical,,324.01,,,324.01,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Aetna,Middlesex Employees,,291.61,,,291.61,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Anthem,Commerical,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Anthem,Indemnity,,,316.3,,316.3,231.93,358.9,percent of total billed charges,,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Anthem,State Preferred,,289.91,,,289.91,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Anthem,Individual Exchange,,231.93,,,231.93,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Cigna,Cigna,,283.13,,,283.13,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Connecticare,Commerical,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Connecticare,Exchange,,302.84,,,302.84,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,Multiplan,Multiplan,,,358.9,,358.9,231.93,358.9,percent of total billed charges,,
HC CATH POWERPICC 4FR DUAL LUM 003776,C1751,HCPCS,,,both,,,422.24,253.34,United Healthcare/Oxford,United Healthcare/Oxford,,291.39,,,291.39,231.93,358.9,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Aetna,Commerical,,122.11,,,122.11,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Aetna,Middlesex Employees,,109.9,,,109.9,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Anthem,Commerical,,109.26,,,109.26,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Anthem,Indemnity,,,119.21,,119.21,87.42,135.27,percent of total billed charges,,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Anthem,State Preferred,,109.26,,,109.26,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Anthem,Individual Exchange,,87.42,,,87.42,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Cigna,Cigna,,106.7,,,106.7,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Connecticare,Commerical,,114.13,,,114.13,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Connecticare,Exchange,,114.13,,,114.13,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,Multiplan,Multiplan,,,135.27,,135.27,87.42,135.27,percent of total billed charges,,
HC CATH SINGLE LUMEN 3FR,C1751,HCPCS,,,both,,,155,95.48,United Healthcare/Oxford,United Healthcare/Oxford,,109.82,,,109.82,87.42,135.27,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Aetna,Commerical,,17.08,,,17.08,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Aetna,Middlesex Employees,,15.38,,,15.38,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Anthem,Commerical,,15.29,,,15.29,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Anthem,Indemnity,,,16.67,,16.67,12.23,18.92,percent of total billed charges,,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Anthem,State Preferred,,15.29,,,15.29,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Anthem,Individual Exchange,,12.23,,,12.23,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Cigna,Cigna,,14.92,,,14.92,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Connecticare,Commerical,,15.97,,,15.97,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Connecticare,Exchange,,15.97,,,15.97,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,Multiplan,Multiplan,,,18.92,,18.92,12.23,18.92,percent of total billed charges,,
HC CATH STABILIZATION DEV 10-12FR 007646,C1751,HCPCS,,,both,,,21.61,13.36,United Healthcare/Oxford,United Healthcare/Oxford,,15.36,,,15.36,12.23,18.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Aetna,Commerical,,100.13,,,100.13,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Aetna,Middlesex Employees,,90.12,,,90.12,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Anthem,Commerical,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Anthem,Indemnity,,,97.75,,97.75,71.68,110.92,percent of total billed charges,,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Anthem,State Preferred,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Anthem,Individual Exchange,,71.68,,,71.68,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Cigna,Cigna,,87.51,,,87.51,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Connecticare,Commerical,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Connecticare,Exchange,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,Multiplan,Multiplan,,,110.92,,110.92,71.68,110.92,percent of total billed charges,,
HC CATH TRIPLE LUMEN 7FR,C1751,HCPCS,,,both,,,127,78.29,United Healthcare/Oxford,United Healthcare/Oxford,,90.05,,,90.05,71.68,110.92,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Aetna,Commerical,,52.91,,,52.91,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Aetna,Middlesex Employees,,47.62,,,47.62,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Anthem,Commerical,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Anthem,Indemnity,,,51.66,,51.66,37.88,58.62,percent of total billed charges,,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Anthem,State Preferred,,47.35,,,47.35,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Anthem,Individual Exchange,,37.88,,,37.88,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Cigna,Cigna,,46.24,,,46.24,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Connecticare,Commerical,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Connecticare,Exchange,,49.46,,,49.46,37.88,58.62,other,Could be inpatient or outpatient,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,Multiplan,Multiplan,,,58.62,,58.62,37.88,58.62,percent of total billed charges,,
HC CHEST DRAIN ATS RECOVERY 552300,C1751,HCPCS,,,both,,,67,41.38,United Healthcare/Oxford,United Healthcare/Oxford,,47.59,,,47.59,37.88,58.62,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Aetna,Commerical,,541.37,,,541.37,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Aetna,Middlesex Employees,,487.23,,,487.23,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Anthem,Commerical,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Anthem,Indemnity,,,528.49,,528.49,387.52,599.68,percent of total billed charges,,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Anthem,State Preferred,,484.4,,,484.4,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Anthem,Individual Exchange,,387.52,,,387.52,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Cigna,Cigna,,473.08,,,473.08,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Connecticare,Commerical,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Connecticare,Exchange,,506,,,506,387.52,599.68,other,Could be inpatient or outpatient,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,Multiplan,Multiplan,,,599.68,,599.68,387.52,599.68,percent of total billed charges,,
HC COOKCVCATH5X65DBL,C1751,HCPCS,,,both,,,685,423.3,United Healthcare/Oxford,United Healthcare/Oxford,,486.86,,,486.86,387.52,599.68,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Aetna,Commerical,,241.78,,,241.78,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Aetna,Middlesex Employees,,217.61,,,217.61,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Anthem,Commerical,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Anthem,Indemnity,,,236.03,,236.03,173.07,267.83,percent of total billed charges,,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Anthem,State Preferred,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Anthem,Individual Exchange,,173.07,,,173.07,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Cigna,Cigna,,211.29,,,211.29,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Connecticare,Commerical,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Connecticare,Exchange,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,Multiplan,Multiplan,,,267.83,,267.83,173.07,267.83,percent of total billed charges,,
HC CV CATH SET 3FR 50CM PICC 309561,C1751,HCPCS,,,both,,,306,189.05,United Healthcare/Oxford,United Healthcare/Oxford,,217.44,,,217.44,173.07,267.83,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Aetna,Commerical,,267.03,,,267.03,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Aetna,Middlesex Employees,,240.32,,,240.32,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Anthem,Commerical,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Anthem,Indemnity,,,260.67,,260.67,191.14,295.78,percent of total billed charges,,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Anthem,State Preferred,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Anthem,Individual Exchange,,191.14,,,191.14,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Cigna,Cigna,,233.33,,,233.33,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Connecticare,Commerical,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Connecticare,Exchange,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,Multiplan,Multiplan,,,295.78,,295.78,191.14,295.78,percent of total billed charges,,
HC CV CATH SET 5FR 60CM SET 034910,C1751,HCPCS,,,both,,,338,208.79,United Healthcare/Oxford,United Healthcare/Oxford,,240.13,,,240.13,191.14,295.78,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Aetna,Commerical,,146.54,,,146.54,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Aetna,Middlesex Employees,,131.88,,,131.88,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Anthem,Commerical,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Anthem,Indemnity,,,143.05,,143.05,104.89,162.32,percent of total billed charges,,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Anthem,State Preferred,,131.11,,,131.11,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Anthem,Individual Exchange,,104.89,,,104.89,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Cigna,Cigna,,128.06,,,128.06,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Connecticare,Commerical,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Connecticare,Exchange,,136.96,,,136.96,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,Multiplan,Multiplan,,,162.32,,162.32,104.89,162.32,percent of total billed charges,,
HC HH HI EMBO-1,C1751,HCPCS,,,both,,,185,114.58,United Healthcare/Oxford,United Healthcare/Oxford,,131.78,,,131.78,104.89,162.32,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Aetna,Commerical,,299.59,,,299.59,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Aetna,Middlesex Employees,,269.62,,,269.62,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Anthem,Commerical,,268.07,,,268.07,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Anthem,Indemnity,,,292.46,,292.46,214.45,331.85,percent of total billed charges,,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Anthem,State Preferred,,268.07,,,268.07,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Anthem,Individual Exchange,,214.45,,,214.45,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Cigna,Cigna,,261.79,,,261.79,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Connecticare,Commerical,,280.01,,,280.01,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Connecticare,Exchange,,280.01,,,280.01,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,Multiplan,Multiplan,,,331.85,,331.85,214.45,331.85,percent of total billed charges,,
HC HH HI EMBO-2,C1751,HCPCS,,,both,,,379,234.25,United Healthcare/Oxford,United Healthcare/Oxford,,269.43,,,269.43,214.45,331.85,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Aetna,Commerical,,4803.14,,,4803.14,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Aetna,Middlesex Employees,,4322.82,,,4322.82,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Anthem,Commerical,,4297.73,,,4297.73,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Anthem,Indemnity,,,4688.85,,4688.85,3438.19,5320.41,percent of total billed charges,,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Anthem,State Preferred,,4297.73,,,4297.73,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Anthem,Individual Exchange,,3438.19,,,3438.19,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Cigna,Cigna,,4197.21,,,4197.21,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Connecticare,Commerical,,4489.28,,,4489.28,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Connecticare,Exchange,,4489.28,,,4489.28,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,Multiplan,Multiplan,,,5320.41,,5320.41,3438.19,5320.41,percent of total billed charges,,
HC HH HI EMBO-7,C1751,HCPCS,,,both,,,6077,3755.59,United Healthcare/Oxford,United Healthcare/Oxford,,4319.55,,,4319.55,3438.19,5320.41,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Aetna,Commerical,,196.2,,,196.2,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Aetna,Middlesex Employees,,176.58,,,176.58,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Anthem,Commerical,,175.56,,,175.56,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Anthem,Indemnity,,,191.53,,191.53,140.45,217.33,percent of total billed charges,,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Anthem,State Preferred,,175.56,,,175.56,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Anthem,Individual Exchange,,140.45,,,140.45,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Cigna,Cigna,,171.44,,,171.44,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Connecticare,Commerical,,183.37,,,183.37,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Connecticare,Exchange,,183.37,,,183.37,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,Multiplan,Multiplan,,,217.33,,217.33,140.45,217.33,percent of total billed charges,,
HC HH HIINFUSE-1CATH,C1751,HCPCS,,,both,,,248,153.41,United Healthcare/Oxford,United Healthcare/Oxford,,176.44,,,176.44,140.45,217.33,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Aetna,Commerical,,226.31,,,226.31,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Aetna,Middlesex Employees,,203.68,,,203.68,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Anthem,Commerical,,202.51,,,202.51,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Anthem,Indemnity,,,220.93,,220.93,162.01,250.69,percent of total billed charges,,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Anthem,State Preferred,,202.51,,,202.51,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Anthem,Individual Exchange,,162.01,,,162.01,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Cigna,Cigna,,197.77,,,197.77,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Connecticare,Commerical,,211.53,,,211.53,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Connecticare,Exchange,,211.53,,,211.53,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,Multiplan,Multiplan,,,250.69,,250.69,162.01,250.69,percent of total billed charges,,
HC HH HIINFUSE-2CATH,C1751,HCPCS,,,both,,,286,176.96,United Healthcare/Oxford,United Healthcare/Oxford,,203.53,,,203.53,162.01,250.69,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Aetna,Commerical,,564.98,,,564.98,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Aetna,Middlesex Employees,,508.48,,,508.48,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Anthem,Commerical,,505.54,,,505.54,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Anthem,Indemnity,,,551.53,,551.53,404.43,625.82,percent of total billed charges,,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Anthem,State Preferred,,505.54,,,505.54,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Anthem,Individual Exchange,,404.43,,,404.43,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Cigna,Cigna,,493.71,,,493.71,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Connecticare,Commerical,,528.06,,,528.06,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Connecticare,Exchange,,528.06,,,528.06,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,Multiplan,Multiplan,,,625.82,,625.82,404.43,625.82,percent of total billed charges,,
HC HH HIINFUSE-3CATH,C1751,HCPCS,,,both,,,715,441.76,United Healthcare/Oxford,United Healthcare/Oxford,,508.1,,,508.1,404.43,625.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Aetna,Commerical,,1026.57,,,1026.57,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Aetna,Middlesex Employees,,923.91,,,923.91,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Anthem,Commerical,,918.55,,,918.55,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Anthem,Indemnity,,,1002.14,,1002.14,734.84,1137.12,percent of total billed charges,,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Anthem,State Preferred,,918.55,,,918.55,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Anthem,Individual Exchange,,734.84,,,734.84,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Cigna,Cigna,,897.06,,,897.06,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Connecticare,Commerical,,959.49,,,959.49,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Connecticare,Exchange,,959.49,,,959.49,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,Multiplan,Multiplan,,,1137.12,,1137.12,734.84,1137.12,percent of total billed charges,,
HC HH HIINFUSE-4CATH,C1751,HCPCS,,,both,,,1299,802.67,United Healthcare/Oxford,United Healthcare/Oxford,,923.21,,,923.21,734.84,1137.12,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Aetna,Commerical,,1380.69,,,1380.69,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Aetna,Middlesex Employees,,1242.62,,,1242.62,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Anthem,Commerical,,1235.42,,,1235.42,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Anthem,Indemnity,,,1347.85,,1347.85,988.33,1529.4,percent of total billed charges,,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Anthem,State Preferred,,1235.42,,,1235.42,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Anthem,Individual Exchange,,988.33,,,988.33,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Cigna,Cigna,,1206.52,,,1206.52,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Connecticare,Commerical,,1290.48,,,1290.48,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Connecticare,Exchange,,1290.48,,,1290.48,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,Multiplan,Multiplan,,,1529.4,,1529.4,988.33,1529.4,percent of total billed charges,,
HC HH HIINFUSE-5CATH,C1751,HCPCS,,,both,,,1747,1079.57,United Healthcare/Oxford,United Healthcare/Oxford,,1241.69,,,1241.69,988.33,1529.4,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Aetna,Commerical,,2819.2,,,2819.2,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Aetna,Middlesex Employees,,2537.29,,,2537.29,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Anthem,Commerical,,2522.55,,,2522.55,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Anthem,Indemnity,,,2752.12,,2752.12,2018.04,3122.82,percent of total billed charges,,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Anthem,State Preferred,,2522.55,,,2522.55,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Anthem,Individual Exchange,,2018.04,,,2018.04,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Cigna,Cigna,,2463.55,,,2463.55,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Connecticare,Commerical,,2634.98,,,2634.98,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Connecticare,Exchange,,2634.98,,,2634.98,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,Multiplan,Multiplan,,,3122.82,,3122.82,2018.04,3122.82,percent of total billed charges,,
HC HH HIINFUSE-6CATH,C1751,HCPCS,,,both,,,3567,2204.34,United Healthcare/Oxford,United Healthcare/Oxford,,2535.36,,,2535.36,2018.04,3122.82,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Aetna,Commerical,,245.85,,,245.85,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Aetna,Middlesex Employees,,221.27,,,221.27,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Anthem,Commerical,,219.99,,,219.99,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Anthem,Indemnity,,,240,,240,175.99,272.33,percent of total billed charges,,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Anthem,State Preferred,,219.99,,,219.99,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Anthem,Individual Exchange,,175.99,,,175.99,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Cigna,Cigna,,214.84,,,214.84,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Connecticare,Commerical,,229.79,,,229.79,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Connecticare,Exchange,,229.79,,,229.79,175.99,272.33,other,Could be inpatient or outpatient,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,Multiplan,Multiplan,,,272.33,,272.33,175.99,272.33,percent of total billed charges,,
HC HH PICC LINE,C1751,HCPCS,,,both,,,311,192.23,United Healthcare/Oxford,United Healthcare/Oxford,,221.1,,,221.1,175.99,272.33,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Aetna,Commerical,,1151.94,,,1151.94,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Aetna,Middlesex Employees,,1036.75,,,1036.75,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Anthem,Commerical,,1030.73,,,1030.73,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Anthem,Indemnity,,,1124.53,,1124.53,824.58,1275.99,percent of total billed charges,,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Anthem,State Preferred,,1030.73,,,1030.73,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Anthem,Individual Exchange,,824.58,,,824.58,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Cigna,Cigna,,1006.62,,,1006.62,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Connecticare,Commerical,,1076.67,,,1076.67,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Connecticare,Exchange,,1076.67,,,1076.67,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,Multiplan,Multiplan,,,1275.99,,1275.99,824.58,1275.99,percent of total billed charges,,
HC HICK 13.5/28CM,C1751,HCPCS,,,both,,,1457,900.7,United Healthcare/Oxford,United Healthcare/Oxford,,1035.96,,,1035.96,824.58,1275.99,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Aetna,Commerical,,871.9,,,871.9,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Aetna,Middlesex Employees,,784.71,,,784.71,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Anthem,Commerical,,780.15,,,780.15,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Anthem,Indemnity,,,851.14,,851.14,624.13,965.79,percent of total billed charges,,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Anthem,State Preferred,,780.15,,,780.15,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Anthem,Individual Exchange,,624.13,,,624.13,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Cigna,Cigna,,761.9,,,761.9,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Connecticare,Commerical,,814.92,,,814.92,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Connecticare,Exchange,,814.92,,,814.92,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,Multiplan,Multiplan,,,965.79,,965.79,624.13,965.79,percent of total billed charges,,
HC HICK 7DBL,C1751,HCPCS,,,both,,,1103,681.73,United Healthcare/Oxford,United Healthcare/Oxford,,784.11,,,784.11,624.13,965.79,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Aetna,Commerical,,901.2,,,901.2,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Aetna,Middlesex Employees,,811.08,,,811.08,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Anthem,Commerical,,806.37,,,806.37,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Anthem,Indemnity,,,879.76,,879.76,645.09,998.26,percent of total billed charges,,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Anthem,State Preferred,,806.37,,,806.37,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Anthem,Individual Exchange,,645.09,,,645.09,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Cigna,Cigna,,787.51,,,787.51,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Connecticare,Commerical,,842.31,,,842.31,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Connecticare,Exchange,,842.31,,,842.31,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,Multiplan,Multiplan,,,998.26,,998.26,645.09,998.26,percent of total billed charges,,
HC HICK 9.6DBL,C1751,HCPCS,,,both,,,1140,704.65,United Healthcare/Oxford,United Healthcare/Oxford,,810.47,,,810.47,645.09,998.26,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Aetna,Commerical,,630.1,,,630.1,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Aetna,Middlesex Employees,,567.09,,,567.09,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Commerical,,563.81,,,563.81,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Indemnity,,,615.12,,615.12,451.04,697.97,percent of total billed charges,,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,State Preferred,,563.81,,,563.81,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Individual Exchange,,451.04,,,451.04,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Cigna,Cigna,,550.62,,,550.62,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Connecticare,Commerical,,588.94,,,588.94,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Connecticare,Exchange,,588.94,,,588.94,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,Multiplan,Multiplan,,,697.97,,697.97,451.04,697.97,percent of total billed charges,,
HC HICK REPAIR 42FR,C1751,HCPCS,,,both,,,797,492.68,United Healthcare/Oxford,United Healthcare/Oxford,,566.66,,,566.66,451.04,697.97,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Aetna,Commerical,,701.75,,,701.75,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Aetna,Middlesex Employees,,631.57,,,631.57,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Anthem,Commerical,,627.9,,,627.9,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Anthem,Indemnity,,,685.05,,685.05,502.33,777.33,percent of total billed charges,,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Anthem,State Preferred,,627.9,,,627.9,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Anthem,Individual Exchange,,502.33,,,502.33,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Cigna,Cigna,,613.22,,,613.22,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Connecticare,Commerical,,655.89,,,655.89,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Connecticare,Exchange,,655.89,,,655.89,502.33,777.33,other,Could be inpatient or outpatient,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,Multiplan,Multiplan,,,777.33,,777.33,502.33,777.33,percent of total billed charges,,
HC HICK REPAIR 7FR,C1751,HCPCS,,,both,,,888,548.7,United Healthcare/Oxford,United Healthcare/Oxford,,631.09,,,631.09,502.33,777.33,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Aetna,Commerical,,630.1,,,630.1,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Aetna,Middlesex Employees,,567.09,,,567.09,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Commerical,,563.81,,,563.81,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Indemnity,,,615.12,,615.12,451.04,697.97,percent of total billed charges,,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,State Preferred,,563.81,,,563.81,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Anthem,Individual Exchange,,451.04,,,451.04,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Cigna,Cigna,,550.62,,,550.62,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Connecticare,Commerical,,588.94,,,588.94,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Connecticare,Exchange,,588.94,,,588.94,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,Multiplan,Multiplan,,,697.97,,697.97,451.04,697.97,percent of total billed charges,,
HC HICKMAN REPAIR KIT 2.7FR,C1751,HCPCS,,,both,,,797,492.68,United Healthcare/Oxford,United Healthcare/Oxford,,566.66,,,566.66,451.04,697.97,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Aetna,Commerical,,453.45,,,453.45,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Aetna,Middlesex Employees,,408.11,,,408.11,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Anthem,Commerical,,405.73,,,405.73,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Anthem,Indemnity,,,442.66,,442.66,324.59,502.28,percent of total billed charges,,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Anthem,State Preferred,,405.73,,,405.73,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Anthem,Individual Exchange,,324.59,,,324.59,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Cigna,Cigna,,396.25,,,396.25,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Connecticare,Commerical,,423.82,,,423.82,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Connecticare,Exchange,,423.82,,,423.82,324.59,502.28,other,Could be inpatient or outpatient,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,Multiplan,Multiplan,,,502.28,,502.28,324.59,502.28,percent of total billed charges,,
HC HICKMAN REPAIR KIT 4.2FR,C1751,HCPCS,,,both,,,574,354.55,United Healthcare/Oxford,United Healthcare/Oxford,,407.8,,,407.8,324.59,502.28,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Aetna,Commerical,,100.13,,,100.13,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Aetna,Middlesex Employees,,90.12,,,90.12,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Anthem,Commerical,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Anthem,Indemnity,,,97.75,,97.75,71.68,110.92,percent of total billed charges,,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Anthem,State Preferred,,89.6,,,89.6,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Anthem,Individual Exchange,,71.68,,,71.68,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Cigna,Cigna,,87.51,,,87.51,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Connecticare,Commerical,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Connecticare,Exchange,,93.59,,,93.59,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,Multiplan,Multiplan,,,110.92,,110.92,71.68,110.92,percent of total billed charges,,
HC PICC 3 4 5FR SINGLE,C1751,HCPCS,,,both,,,130.49,78.29,United Healthcare/Oxford,United Healthcare/Oxford,,90.05,,,90.05,71.68,110.92,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Aetna,Commerical,,91.99,,,91.99,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Aetna,Middlesex Employees,,82.79,,,82.79,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Anthem,Commerical,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Anthem,Indemnity,,,89.8,,89.8,65.85,101.9,percent of total billed charges,,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Anthem,State Preferred,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Anthem,Individual Exchange,,65.85,,,65.85,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Cigna,Cigna,,80.39,,,80.39,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Connecticare,Commerical,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Connecticare,Exchange,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,Multiplan,Multiplan,,,101.9,,101.9,65.85,101.9,percent of total billed charges,,
HC PICC 4 5 FR DUAL,C1751,HCPCS,,,both,,,119.88,71.93,United Healthcare/Oxford,United Healthcare/Oxford,,82.73,,,82.73,65.85,101.9,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Aetna,Commerical,,175.03,,,175.03,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Aetna,Middlesex Employees,,157.53,,,157.53,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Anthem,Commerical,,156.62,,,156.62,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Anthem,Indemnity,,,170.86,,170.86,125.3,193.88,percent of total billed charges,,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Anthem,State Preferred,,156.62,,,156.62,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Anthem,Individual Exchange,,125.3,,,125.3,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Cigna,Cigna,,152.95,,,152.95,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Connecticare,Commerical,,163.59,,,163.59,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Connecticare,Exchange,,163.59,,,163.59,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,Multiplan,Multiplan,,,193.88,,193.88,125.3,193.88,percent of total billed charges,,
HC PICC INSERTION KIT VYGON,C1751,HCPCS,,,both,,,221,136.85,United Healthcare/Oxford,United Healthcare/Oxford,,157.4,,,157.4,125.3,193.88,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Aetna,Commerical,,424.96,,,424.96,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Aetna,Middlesex Employees,,382.46,,,382.46,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Anthem,Commerical,,380.24,,,380.24,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Anthem,Indemnity,,,414.84,,414.84,304.19,470.72,percent of total billed charges,,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Anthem,State Preferred,,380.24,,,380.24,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Anthem,Individual Exchange,,304.19,,,304.19,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Cigna,Cigna,,371.34,,,371.34,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Connecticare,Commerical,,397.18,,,397.18,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Connecticare,Exchange,,397.18,,,397.18,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,Multiplan,Multiplan,,,470.72,,470.72,304.19,470.72,percent of total billed charges,,
HC PICC LINE CATH,C1751,HCPCS,,,both,,,538,332.27,United Healthcare/Oxford,United Healthcare/Oxford,,382.17,,,382.17,304.19,470.72,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Aetna,Commerical,,255.63,,,255.63,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Aetna,Middlesex Employees,,230.07,,,230.07,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Anthem,Commerical,,228.72,,,228.72,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Anthem,Indemnity,,,249.54,,249.54,182.98,283.15,percent of total billed charges,,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Anthem,State Preferred,,228.72,,,228.72,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Anthem,Individual Exchange,,182.98,,,182.98,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Cigna,Cigna,,223.38,,,223.38,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Connecticare,Commerical,,238.92,,,238.92,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Connecticare,Exchange,,238.92,,,238.92,182.98,283.15,other,Could be inpatient or outpatient,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,Multiplan,Multiplan,,,283.15,,283.15,182.98,283.15,percent of total billed charges,,
HC PICC LINE KIT,C1751,HCPCS,,,both,,,323,199.87,United Healthcare/Oxford,United Healthcare/Oxford,,229.89,,,229.89,182.98,283.15,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Aetna,Commerical,,188.87,,,188.87,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Aetna,Middlesex Employees,,169.98,,,169.98,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Anthem,Commerical,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Anthem,Indemnity,,,184.38,,184.38,135.19,209.21,percent of total billed charges,,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Anthem,State Preferred,,168.99,,,168.99,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Anthem,Individual Exchange,,135.19,,,135.19,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Cigna,Cigna,,165.05,,,165.05,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Connecticare,Commerical,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Connecticare,Exchange,,176.53,,,176.53,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,Multiplan,Multiplan,,,209.21,,209.21,135.19,209.21,percent of total billed charges,,
HC POWER PICC 4/5 SINGLE,C1751,HCPCS,,,both,,,239,147.68,United Healthcare/Oxford,United Healthcare/Oxford,,169.86,,,169.86,135.19,209.21,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Aetna,Commerical,,228.76,,,228.76,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Aetna,Middlesex Employees,,205.88,,,205.88,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Anthem,Commerical,,204.69,,,204.69,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Anthem,Indemnity,,,223.31,,223.31,163.76,253.39,percent of total billed charges,,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Anthem,State Preferred,,204.69,,,204.69,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Anthem,Individual Exchange,,163.76,,,163.76,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Cigna,Cigna,,199.9,,,199.9,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Connecticare,Commerical,,213.81,,,213.81,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Connecticare,Exchange,,213.81,,,213.81,163.76,253.39,other,Could be inpatient or outpatient,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,Multiplan,Multiplan,,,253.39,,253.39,163.76,253.39,percent of total billed charges,,
HC POWER PICC DUAL,C1751,HCPCS,,,both,,,289,178.87,United Healthcare/Oxford,United Healthcare/Oxford,,205.73,,,205.73,163.76,253.39,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Aetna,Commerical,,938.65,,,938.65,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Aetna,Middlesex Employees,,844.78,,,844.78,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Anthem,Commerical,,839.88,,,839.88,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Anthem,Indemnity,,,916.31,,916.31,671.9,1039.74,percent of total billed charges,,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Anthem,State Preferred,,839.88,,,839.88,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Anthem,Individual Exchange,,671.9,,,671.9,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Cigna,Cigna,,820.24,,,820.24,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Connecticare,Commerical,,877.32,,,877.32,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Connecticare,Exchange,,877.32,,,877.32,671.9,1039.74,other,Could be inpatient or outpatient,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,Multiplan,Multiplan,,,1039.74,,1039.74,671.9,1039.74,percent of total billed charges,,
HC CATH ADJ,C1752,HCPCS,,,both,,,1188,733.93,United Healthcare/Oxford,United Healthcare/Oxford,,844.15,,,844.15,671.9,1039.74,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Aetna,Commerical,,530.78,,,530.78,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Aetna,Middlesex Employees,,477.71,,,477.71,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Anthem,Commerical,,474.94,,,474.94,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Anthem,Indemnity,,,518.16,,519.16,379.95,587.95,percent of total billed charges,,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Anthem,State Preferred,,474.94,,,474.94,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Anthem,Individual Exchange,,379.95,,,379.95,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Cigna,Cigna,,463.83,,,463.83,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Connecticare,Commerical,,496.1,,,496.1,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Connecticare,Exchange,,496.1,,,496.1,379.95,587.95,other,Could be inpatient or outpatient,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,Multiplan,Multiplan,,,587.95,,587.95,379.95,587.95,percent of total billed charges,,
HC AC BALLOON ANGIO CATH,C1757,HCPCS,,,both,,,672,415.03,United Healthcare/Oxford,United Healthcare/Oxford,,477.34,,,477.34,379.95,587.95,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Aetna,Commerical,,372.85,,,372.85,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Aetna,Middlesex Employees,,335.57,,,335.57,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Anthem,Commerical,,333.62,,,333.62,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Anthem,Indemnity,,,363.98,,363.98,266.9,413.01,percent of total billed charges,,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Anthem,State Preferred,,333.62,,,333.62,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Anthem,Individual Exchange,,266.9,,,266.9,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Cigna,Cigna,,325.82,,,325.82,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Connecticare,Commerical,,348.49,,,348.49,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Connecticare,Exchange,,348.49,,,348.49,266.9,413.01,other,Could be inpatient or outpatient,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,Multiplan,Multiplan,,,413.01,,413.01,266.9,413.01,percent of total billed charges,,
HC HH EMBOLIZATION 2,C1757,HCPCS,,,both,,,472,291.53,United Healthcare/Oxford,United Healthcare/Oxford,,335.32,,,335.32,266.9,413.01,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Aetna,Commerical,,1090.07,,,1090.07,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Aetna,Middlesex Employees,,981.06,,,981.06,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Anthem,Commerical,,975.36,,,975.36,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Anthem,Indemnity,,,1064.13,,1064.13,780.29,1207.47,percent of total billed charges,,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Anthem,State Preferred,,975.36,,,975.36,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Anthem,Individual Exchange,,780.29,,,780.29,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Cigna,Cigna,,952.56,,,952.56,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Connecticare,Commerical,,1018.84,,,1018.84,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Connecticare,Exchange,,1018.84,,,1018.84,780.29,1207.47,other,Could be inpatient or outpatient,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,Multiplan,Multiplan,,,1207.47,,1207.47,780.29,1207.47,percent of total billed charges,,
HC 2 X 2 DURAGENS,C1762,HCPCS,,,both,,,1379,852.33,United Healthcare/Oxford,United Healthcare/Oxford,,980.32,,,980.32,780.29,1207.47,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Aetna,Commerical,,397.28,,,397.28,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Aetna,Middlesex Employees,,357.55,,,357.55,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Anthem,Commerical,,355.47,,,355.47,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Anthem,Indemnity,,,387.82,,387.82,284.38,440.06,percent of total billed charges,,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Anthem,State Preferred,,355.47,,,355.47,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Anthem,Individual Exchange,,284.38,,,284.38,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Cigna,Cigna,,347.16,,,347.16,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Connecticare,Commerical,,371.32,,,371.32,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Connecticare,Exchange,,371.32,,,371.32,284.38,440.06,other,Could be inpatient or outpatient,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,Multiplan,Multiplan,,,440.06,,440.06,284.38,440.06,percent of total billed charges,,
HC 3 X 3 DURAGEN,C1762,HCPCS,,,both,,,503,310.63,United Healthcare/Oxford,United Healthcare/Oxford,,357.28,,,357.28,284.38,440.06,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Aetna,Commerical,,2122.33,,,2122.33,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Aetna,Middlesex Employees,,1910.1,,,1910.1,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Anthem,Commerical,,1899.02,,,1899.02,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Anthem,Indemnity,,,2071.84,,2071.84,1519.21,2350.9,percent of total billed charges,,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Anthem,State Preferred,,1899.02,,,1899.02,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Anthem,Individual Exchange,,1519.21,,,1519.21,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Cigna,Cigna,,1854.6,,,1854.6,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Connecticare,Commerical,,1983.65,,,1983.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Connecticare,Exchange,,1983.65,,,1983.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,Multiplan,Multiplan,,,2350.9,,2350.9,1519.21,2350.9,percent of total billed charges,,
HC SIRGISIS 7X10,C1763,HCPCS,,,both,,,2685,1659.46,United Healthcare/Oxford,United Healthcare/Oxford,,1908.65,,,1908.65,1519.21,2350.9,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Aetna,Commerical,,1011.1,,,1011.1,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Aetna,Middlesex Employees,,909.99,,,909.99,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Anthem,Commerical,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Anthem,Indemnity,,,987.04,,987.04,723.78,1119.99,percent of total billed charges,,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Anthem,State Preferred,,904.71,,,904.71,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Anthem,Individual Exchange,,723.78,,,723.78,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Cigna,Cigna,,883.55,,,883.55,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Connecticare,Commerical,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Connecticare,Exchange,,945.03,,,945.03,723.78,1119.99,other,Could be inpatient or outpatient,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,Multiplan,Multiplan,,,1119.99,,1119.99,723.78,1119.99,percent of total billed charges,,
HC ADHESION BARRIER,C1765,HCPCS,,,both,,,1279,790.58,United Healthcare/Oxford,United Healthcare/Oxford,,909.3,,,909.3,723.78,1119.99,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Aetna,Commerical,,881.66,,,881.66,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Aetna,Middlesex Employees,,793.5,,,793.5,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Anthem,Commerical,,788.89,,,788.89,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Anthem,Indemnity,,,860.68,,860.68,631.11,976.61,percent of total billed charges,,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Anthem,State Preferred,,788.89,,,788.89,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Anthem,Individual Exchange,,631.11,,,631.11,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Cigna,Cigna,,770.44,,,770.44,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Connecticare,Commerical,,824.05,,,824.05,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Connecticare,Exchange,,824.05,,,824.05,631.11,976.61,other,Could be inpatient or outpatient,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,Multiplan,Multiplan,,,976.61,,976.61,631.11,976.61,percent of total billed charges,,
HC SILAS SHEET .007,C1765,HCPCS,,,both,,,1115,689.37,United Healthcare/Oxford,United Healthcare/Oxford,,792.89,,,792.89,631.11,976.61,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Aetna,Commerical,,1348.13,,,1348.13,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Aetna,Middlesex Employees,,1213.32,,,1213.32,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Anthem,Commerical,,1206.28,,,1206.28,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Anthem,Indemnity,,,1316.06,,1316.06,965.02,1493.32,percent of total billed charges,,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Anthem,State Preferred,,1206.28,,,1206.28,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Anthem,Individual Exchange,,965.02,,,965.02,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Cigna,Cigna,,1178.07,,,1178.07,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Connecticare,Commerical,,1260.04,,,1260.04,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Connecticare,Exchange,,1260.04,,,1260.04,965.02,1493.32,other,Could be inpatient or outpatient,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,Multiplan,Multiplan,,,1493.32,,1493.32,965.02,1493.32,percent of total billed charges,,
HC SILO BAG,C1765,HCPCS,,,both,,,1706,1054.11,United Healthcare/Oxford,United Healthcare/Oxford,,1212.4,,,1212.4,965.02,1493.32,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Aetna,Commerical,,52.1,,,52.1,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Aetna,Middlesex Employees,,46.89,,,46.89,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Anthem,Commerical,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Anthem,Indemnity,,,50.86,,50.86,37.29,57.72,percent of total billed charges,,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Anthem,State Preferred,,46.62,,,46.62,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Anthem,Individual Exchange,,37.29,,,37.29,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Cigna,Cigna,,45.53,,,45.53,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Connecticare,Commerical,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Connecticare,Exchange,,48.69,,,48.69,37.29,57.72,other,Could be inpatient or outpatient,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,Multiplan,Multiplan,,,57.72,,57.72,37.29,57.72,percent of total billed charges,,
HC ANGLED GUIDEWIRE 575630,C1769,HCPCS,,,both,,,66,40.74,United Healthcare/Oxford,United Healthcare/Oxford,,46.85,,,46.85,37.29,57.72,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Aetna,Commerical,,84.66,,,84.66,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Aetna,Middlesex Employees,,76.2,,,76.2,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Anthem,Commerical,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Anthem,Indemnity,,,82.65,,82.65,60.6,93.78,percent of total billed charges,,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Anthem,State Preferred,,75.75,,,75.75,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Anthem,Individual Exchange,,60.6,,,60.6,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Cigna,Cigna,,73.99,,,73.99,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Connecticare,Commerical,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Connecticare,Exchange,,79.13,,,79.13,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,Multiplan,Multiplan,,,93.78,,93.78,60.6,93.78,percent of total billed charges,,
HC GLIDECATH XP 5 FR 575647,C1769,HCPCS,,,both,,,107,66.2,United Healthcare/Oxford,United Healthcare/Oxford,,76.14,,,76.14,60.6,93.78,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Aetna,Commerical,,107.46,,,107.46,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Aetna,Middlesex Employees,,96.71,,,96.71,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Anthem,Commerical,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Anthem,Indemnity,,,104.9,,104.9,76.92,119.03,percent of total billed charges,,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Anthem,State Preferred,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Anthem,Individual Exchange,,76.92,,,76.92,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Cigna,Cigna,,93.9,,,93.9,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Connecticare,Commerical,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Connecticare,Exchange,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,Multiplan,Multiplan,,,119.03,,119.03,76.92,119.03,percent of total billed charges,,
HC GLIDEWIRE,C1769,HCPCS,,,both,,,136,84.02,United Healthcare/Oxford,United Healthcare/Oxford,,96.64,,,96.64,76.92,119.03,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Aetna,Commerical,,250.74,,,250.74,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Aetna,Middlesex Employees,,225.66,,,225.66,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Anthem,Commerical,,224.36,,,224.36,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Anthem,Indemnity,,,244.78,,244.78,179.49,277.75,percent of total billed charges,,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Anthem,State Preferred,,224.36,,,224.36,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Anthem,Individual Exchange,,179.49,,,179.49,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Cigna,Cigna,,219.11,,,219.11,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Connecticare,Commerical,,234.36,,,234.36,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Connecticare,Exchange,,234.36,,,234.36,179.49,277.75,other,Could be inpatient or outpatient,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,Multiplan,Multiplan,,,277.75,,277.75,179.49,277.75,percent of total billed charges,,
HC GLIDEWIRE ANGLED TIP 037211,C1769,HCPCS,,,both,,,317,196.06,United Healthcare/Oxford,United Healthcare/Oxford,,225.5,,,225.5,179.49,277.75,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Aetna,Commerical,,20.22,,,20.22,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Aetna,Middlesex Employees,,18.2,,,18.2,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Anthem,Commerical,,18.09,,,18.09,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Anthem,Indemnity,,,19.74,,19.74,14.47,22.4,percent of total billed charges,,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Anthem,State Preferred,,18.09,,,18.09,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Anthem,Individual Exchange,,14.47,,,14.47,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Cigna,Cigna,,17.67,,,17.67,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Connecticare,Commerical,,18.9,,,18.9,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Connecticare,Exchange,,18.9,,,18.9,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,Multiplan,Multiplan,,,22.4,,22.4,14.47,22.4,percent of total billed charges,,
HC GUIDE WIRE,C1769,HCPCS,,,both,,,25.59,15.81,United Healthcare/Oxford,United Healthcare/Oxford,,18.19,,,18.19,14.47,22.4,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Aetna,Commerical,,73.27,,,73.27,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Aetna,Middlesex Employees,,65.94,,,65.94,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Anthem,Commerical,,65.56,,,65.56,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Anthem,Indemnity,,,71.52,,71.52,52.44,81.16,percent of total billed charges,,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Anthem,State Preferred,,65.56,,,65.56,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Anthem,Individual Exchange,,52.44,,,52.44,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Cigna,Cigna,,64.02,,,64.02,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Connecticare,Commerical,,68.48,,,68.48,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Connecticare,Exchange,,68.48,,,68.48,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,Multiplan,Multiplan,,,81.16,,81.16,52.44,81.16,percent of total billed charges,,
HC GUIDEWIRE MANDRIL 309592,C1769,HCPCS,,,both,,,93,57.29,United Healthcare/Oxford,United Healthcare/Oxford,,65.89,,,65.89,52.44,81.16,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Aetna,Commerical,,77.34,,,77.34,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Aetna,Middlesex Employees,,69.61,,,69.61,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Anthem,Commerical,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Anthem,Indemnity,,,75.5,,75.5,55.36,85.67,percent of total billed charges,,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Anthem,State Preferred,,69.2,,,69.2,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Anthem,Individual Exchange,,55.36,,,55.36,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Cigna,Cigna,,67.58,,,67.58,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Connecticare,Commerical,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Connecticare,Exchange,,72.29,,,72.29,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,Multiplan,Multiplan,,,85.67,,85.67,55.36,85.67,percent of total billed charges,,
HC GUIDEWIRE SMALL VESSEL 037602,C1769,HCPCS,,,both,,,98,60.47,United Healthcare/Oxford,United Healthcare/Oxford,,69.56,,,69.56,55.36,85.67,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Anthem,Indemnity,,,46.09,,46.09,33.8,52.3,percent of total billed charges,,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Cigna,Cigna,,41.26,,,41.26,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Connecticare,Commerical,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Connecticare,Exchange,,44.13,,,44.13,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC GUIDEWIRE SUPER STIFF 530639,C1769,HCPCS,,,both,,,60,36.92,United Healthcare/Oxford,United Healthcare/Oxford,,42.47,,,42.47,33.8,52.3,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Aetna,Commerical,,107.46,,,107.46,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Aetna,Middlesex Employees,,96.71,,,96.71,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Anthem,Commerical,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Anthem,Indemnity,,,104.9,,104.9,76.92,119.03,percent of total billed charges,,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Anthem,State Preferred,,96.15,,,96.15,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Anthem,Individual Exchange,,76.92,,,76.92,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Cigna,Cigna,,93.9,,,93.9,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Connecticare,Commerical,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Connecticare,Exchange,,100.43,,,100.43,76.92,119.03,other,Could be inpatient or outpatient,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,Multiplan,Multiplan,,,119.03,,119.03,76.92,119.03,percent of total billed charges,,
HC GUIDEWIRE WHOLEY 037155,C1769,HCPCS,,,both,,,136,84.02,United Healthcare/Oxford,United Healthcare/Oxford,,96.64,,,96.64,76.92,119.03,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Aetna,Commerical,,39.73,,,39.73,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Aetna,Middlesex Employees,,35.76,,,35.76,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Anthem,Commerical,,35.55,,,35.55,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Anthem,Indemnity,,,38.78,,38.78,28.44,44,percent of total billed charges,,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Anthem,State Preferred,,35.55,,,35.55,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Anthem,Individual Exchange,,28.44,,,28.44,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Cigna,Cigna,,34.72,,,34.72,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Connecticare,Commerical,,37.13,,,37.13,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Connecticare,Exchange,,37.13,,,37.13,28.44,44,other,Could be inpatient or outpatient,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,Multiplan,Multiplan,,,44,,44,28.44,44,percent of total billed charges,,
HC GWIRE COOK ST 50CM,C1769,HCPCS,,,both,,,50,31.06,United Healthcare/Oxford,United Healthcare/Oxford,,35.73,,,35.73,28.44,44,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Aetna,Commerical,,105.83,,,105.83,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Aetna,Middlesex Employees,,95.25,,,95.25,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Anthem,Commerical,,94.69,,,94.69,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Anthem,Indemnity,,,103.32,,103.32,75.75,117.23,percent of total billed charges,,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Anthem,State Preferred,,94.69,,,94.69,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Anthem,Individual Exchange,,75.75,,,75.75,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Cigna,Cigna,,92.48,,,92.48,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Connecticare,Commerical,,98.92,,,98.92,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Connecticare,Exchange,,98.92,,,98.92,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,Multiplan,Multiplan,,,117.23,,117.23,75.75,117.23,percent of total billed charges,,
HC HH HI WIRE 1GUIDE,C1769,HCPCS,,,both,,,134,82.75,United Healthcare/Oxford,United Healthcare/Oxford,,95.17,,,95.17,75.75,117.23,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Aetna,Commerical,,241.78,,,241.78,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Aetna,Middlesex Employees,,217.61,,,217.61,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Anthem,Commerical,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Anthem,Indemnity,,,236.03,,236.03,173.07,267.83,percent of total billed charges,,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Anthem,State Preferred,,216.35,,,216.35,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Anthem,Individual Exchange,,173.07,,,173.07,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Cigna,Cigna,,211.29,,,211.29,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Connecticare,Commerical,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Connecticare,Exchange,,225.99,,,225.99,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,Multiplan,Multiplan,,,267.83,,267.83,173.07,267.83,percent of total billed charges,,
HC HH HI WIRE 3GUIDE,C1769,HCPCS,,,both,,,306,189.05,United Healthcare/Oxford,United Healthcare/Oxford,,217.44,,,217.44,173.07,267.83,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Aetna,Commerical,,578.81,,,578.81,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Aetna,Middlesex Employees,,520.93,,,520.93,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Anthem,Commerical,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Anthem,Indemnity,,,565.05,,565.05,414.33,641.16,percent of total billed charges,,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Anthem,State Preferred,,517.91,,,517.91,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Anthem,Individual Exchange,,414.33,,,414.33,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Cigna,Cigna,,505.8,,,505.8,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Connecticare,Commerical,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Connecticare,Exchange,,541,,,541,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,Multiplan,Multiplan,,,641.16,,641.16,414.33,641.16,percent of total billed charges,,
HC HH HI WIRE 4GUIDE,C1769,HCPCS,,,both,,,732,452.58,United Healthcare/Oxford,United Healthcare/Oxford,,520.54,,,520.54,414.33,641.16,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Aetna,Commerical,,2382.03,,,2382.03,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Aetna,Middlesex Employees,,2143.83,,,2143.83,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Anthem,Commerical,,2131.39,,,2131.39,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Anthem,Indemnity,,,2325.35,,2325.35,1705.11,2638.56,percent of total billed charges,,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Anthem,State Preferred,,2131.39,,,2131.39,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Anthem,Individual Exchange,,1705.11,,,1705.11,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Cigna,Cigna,,2081.54,,,2081.54,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Connecticare,Commerical,,2226.38,,,2226.38,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Connecticare,Exchange,,2226.38,,,2226.38,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,Multiplan,Multiplan,,,2638.56,,2638.56,1705.11,2638.56,percent of total billed charges,,
HC HH HI WIRE 5GUIDE,C1769,HCPCS,,,both,,,3014,1862.51,United Healthcare/Oxford,United Healthcare/Oxford,,2142.2,,,2142.2,1705.11,2638.56,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Anthem,Indemnity,,,188.35,,188.35,138.11,213.72,percent of total billed charges,,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC HH HI WIRE-2GUIDE,C1769,HCPCS,,,both,,,244,150.86,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Aetna,Commerical,,121.3,,,121.3,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Aetna,Middlesex Employees,,109.17,,,109.17,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Anthem,Commerical,,108.54,,,108.54,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Anthem,Indemnity,,,118.41,,118.41,86.84,134.36,percent of total billed charges,,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Anthem,State Preferred,,108.54,,,108.54,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Anthem,Individual Exchange,,86.84,,,86.84,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Cigna,Cigna,,106,,,106,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Connecticare,Commerical,,113.38,,,113.38,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Connecticare,Exchange,,113.38,,,113.38,86.84,134.36,other,Could be inpatient or outpatient,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,Multiplan,Multiplan,,,134.36,,134.36,86.84,134.36,percent of total billed charges,,
HC HH IR WIRE,C1769,HCPCS,,,both,,,153,94.84,United Healthcare/Oxford,United Healthcare/Oxford,,109.09,,,109.09,86.84,134.36,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Aetna,Commerical,,1650.98,,,1650.98,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Aetna,Middlesex Employees,,1485.88,,,1485.88,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Anthem,Commerical,,1477.26,,,1477.26,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Anthem,Indemnity,,,1611.7,,1611.7,1181.8,1828.78,percent of total billed charges,,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Anthem,State Preferred,,1477.26,,,1477.26,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Anthem,Individual Exchange,,1181.8,,,1181.8,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Cigna,Cigna,,1442.71,,,1442.71,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Connecticare,Commerical,,1543.09,,,1543.09,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Connecticare,Exchange,,1543.09,,,1543.09,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,Multiplan,Multiplan,,,1828.78,,1828.78,1181.8,1828.78,percent of total billed charges,,
HC HH WIRE ADJ 1,C1769,HCPCS,,,both,,,2089,1290.91,United Healthcare/Oxford,United Healthcare/Oxford,,1484.76,,,1484.76,1181.8,1828.78,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Aetna,Commerical,,257.25,,,257.25,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Aetna,Middlesex Employees,,231.53,,,231.53,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Anthem,Commerical,,230.18,,,230.18,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Anthem,Indemnity,,,251.13,,251.13,184.15,284.95,percent of total billed charges,,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Anthem,State Preferred,,230.18,,,230.18,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Anthem,Individual Exchange,,184.15,,,184.15,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Cigna,Cigna,,224.8,,,224.8,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Connecticare,Commerical,,240.44,,,240.44,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Connecticare,Exchange,,240.44,,,240.44,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,Multiplan,Multiplan,,,284.95,,284.95,184.15,284.95,percent of total billed charges,,
HC HH WIRE ADJUNCT 2,C1769,HCPCS,,,both,,,325,201.14,United Healthcare/Oxford,United Healthcare/Oxford,,231.35,,,231.35,184.15,284.95,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Aetna,Commerical,,631.74,,,631.74,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Aetna,Middlesex Employees,,568.56,,,568.56,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Anthem,Commerical,,565.27,,,565.27,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Anthem,Indemnity,,,616.7,,616.7,452.21,699.77,percent of total billed charges,,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Anthem,State Preferred,,565.27,,,565.27,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Anthem,Individual Exchange,,452.21,,,452.21,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Cigna,Cigna,,552.04,,,552.04,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Connecticare,Commerical,,590.45,,,590.45,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Connecticare,Exchange,,590.45,,,590.45,452.21,699.77,other,Could be inpatient or outpatient,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,Multiplan,Multiplan,,,699.77,,699.77,452.21,699.77,percent of total billed charges,,
HC HH WIRE ADJUNCT 4,C1769,HCPCS,,,both,,,799,493.96,United Healthcare/Oxford,United Healthcare/Oxford,,568.13,,,568.13,452.21,699.77,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Aetna,Commerical,,142.47,,,142.47,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Aetna,Middlesex Employees,,128.21,,,128.21,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Anthem,Commerical,,127.47,,,127.47,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Anthem,Indemnity,,,139.08,,139.08,101.98,157.81,percent of total billed charges,,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Anthem,State Preferred,,127.47,,,127.47,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Anthem,Individual Exchange,,101.98,,,101.98,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Cigna,Cigna,,124.5,,,124.5,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Connecticare,Commerical,,133.16,,,133.16,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Connecticare,Exchange,,133.16,,,133.16,101.98,157.81,other,Could be inpatient or outpatient,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,Multiplan,Multiplan,,,157.81,,157.81,101.98,157.81,percent of total billed charges,,
HC HI WIRE-2,C1769,HCPCS,,,both,,,180,111.4,United Healthcare/Oxford,United Healthcare/Oxford,,128.12,,,128.12,101.98,157.81,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Aetna,Commerical,,221.43,,,221.43,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Aetna,Middlesex Employees,,199.29,,,199.29,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Anthem,Commerical,,198.13,,,198.13,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Anthem,Indemnity,,,216.16,,216.16,158.5,245.28,percent of total billed charges,,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Anthem,State Preferred,,198.13,,,198.13,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Anthem,Individual Exchange,,158.5,,,158.5,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Cigna,Cigna,,193.5,,,193.5,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Connecticare,Commerical,,206.97,,,206.97,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Connecticare,Exchange,,206.97,,,206.97,158.5,245.28,other,Could be inpatient or outpatient,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,Multiplan,Multiplan,,,245.28,,245.28,158.5,245.28,percent of total billed charges,,
HC PLATINUM PLUS GUIDEWIRE 180CM STRAIGHT TIP,C1769,HCPCS,,,both,,,280,173.14,United Healthcare/Oxford,United Healthcare/Oxford,,199.14,,,199.14,158.5,245.28,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC STRAIGHT GUIDEWIRE 575642,C1769,HCPCS,,,both,,,328,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Aetna,Commerical,,133.51,,,133.51,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Aetna,Middlesex Employees,,120.17,,,120.17,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Anthem,Commerical,,119.46,,,119.46,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Anthem,Indemnity,,,130.34,,130.34,95.57,147.89,percent of total billed charges,,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Anthem,State Preferred,,119.46,,,119.46,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Anthem,Individual Exchange,,95.57,,,95.57,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Cigna,Cigna,,116.67,,,116.67,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Connecticare,Commerical,,124.79,,,124.79,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Connecticare,Exchange,,124.79,,,124.79,95.57,147.89,other,Could be inpatient or outpatient,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,Multiplan,Multiplan,,,147.89,,147.89,95.57,147.89,percent of total billed charges,,
HC WHOLEY WIRE,C1769,HCPCS,,,both,,,169,104.39,United Healthcare/Oxford,United Healthcare/Oxford,,120.07,,,120.07,95.57,147.89,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Aetna,Commerical,,156.31,,,156.31,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Aetna,Middlesex Employees,,140.68,,,140.68,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Anthem,Commerical,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Anthem,Indemnity,,,152.58,,152.58,111.88,173.14,percent of total billed charges,,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Anthem,State Preferred,,139.86,,,139.86,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Anthem,Individual Exchange,,111.88,,,111.88,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Cigna,Cigna,,136.58,,,136.58,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Connecticare,Commerical,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Connecticare,Exchange,,146.09,,,146.09,111.88,173.14,other,Could be inpatient or outpatient,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,Multiplan,Multiplan,,,173.14,,173.14,111.88,173.14,percent of total billed charges,,
HC WIRE ADJ,C1769,HCPCS,,,both,,,198,122.21,United Healthcare/Oxford,United Healthcare/Oxford,,140.56,,,140.56,111.88,173.14,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Aetna,Commerical,,1487.34,,,1487.34,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Aetna,Middlesex Employees,,1338.6,,,1338.6,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Anthem,Commerical,,1330.84,,,1330.84,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Anthem,Indemnity,,,1451.95,,1451.95,1064.67,1647.52,percent of total billed charges,,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Anthem,State Preferred,,1330.84,,,1330.84,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Anthem,Individual Exchange,,1064.67,,,1064.67,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Cigna,Cigna,,1299.72,,,1299.72,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Connecticare,Commerical,,1390.16,,,1390.16,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Connecticare,Exchange,,1390.16,,,1390.16,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,Multiplan,Multiplan,,,1647.52,,1647.52,1064.67,1647.52,percent of total billed charges,,
HC HH HI SNARE-3,C1773,HCPCS,,,both,,,1882,1162.96,United Healthcare/Oxford,United Healthcare/Oxford,,1337.6,,,1337.6,1064.67,1647.52,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Aetna,Commerical,,801.07,,,801.07,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Aetna,Middlesex Employees,,720.96,,,720.96,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Anthem,Commerical,,716.78,,,716.78,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Anthem,Indemnity,,,782.01,,782.01,573.42,887.34,percent of total billed charges,,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Anthem,State Preferred,,716.78,,,716.78,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Anthem,Individual Exchange,,573.42,,,573.42,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Cigna,Cigna,,700.01,,,700.01,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Connecticare,Commerical,,748.72,,,748.72,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Connecticare,Exchange,,748.72,,,748.72,573.42,887.34,other,Could be inpatient or outpatient,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,Multiplan,Multiplan,,,887.34,,887.34,573.42,887.34,percent of total billed charges,,
HC HEMASHIELD GRAFT,C1781,HCPCS,,,both,,,1014,626.36,United Healthcare/Oxford,United Healthcare/Oxford,,720.41,,,720.41,573.42,887.34,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Aetna,Commerical,,1261.03,,,1261.03,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Aetna,Middlesex Employees,,1134.92,,,1134.92,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Anthem,Commerical,,1128.34,,,1128.34,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Anthem,Indemnity,,,1231.02,,1231.02,902.66,1396.83,percent of total billed charges,,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Anthem,State Preferred,,1128.34,,,1128.34,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Anthem,Individual Exchange,,902.66,,,902.66,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Cigna,Cigna,,1101.94,,,1101.94,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Connecticare,Commerical,,1178.63,,,1178.63,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Connecticare,Exchange,,1178.63,,,1178.63,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,Multiplan,Multiplan,,,1396.83,,1396.83,902.66,1396.83,percent of total billed charges,,
HC HH HI PORT CATH,C1788,HCPCS,,,both,,,1595,986,United Healthcare/Oxford,United Healthcare/Oxford,,1134.06,,,1134.06,902.66,1396.83,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Aetna,Commerical,,1353.02,,,1353.02,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Aetna,Middlesex Employees,,1217.72,,,1217.72,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Anthem,Commerical,,1210.65,,,1210.65,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Anthem,Indemnity,,,1320.83,,1320.83,968.52,1498.74,percent of total billed charges,,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Anthem,State Preferred,,1210.65,,,1210.65,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Anthem,Individual Exchange,,968.52,,,968.52,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Cigna,Cigna,,1182.33,,,1182.33,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Connecticare,Commerical,,1264.61,,,1264.61,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Connecticare,Exchange,,1264.61,,,1264.61,968.52,1498.74,other,Could be inpatient or outpatient,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,Multiplan,Multiplan,,,1498.74,,1498.74,968.52,1498.74,percent of total billed charges,,
HC HH PORTA CATH,C1788,HCPCS,,,both,,,1712,1057.93,United Healthcare/Oxford,United Healthcare/Oxford,,1216.79,,,1216.79,968.52,1498.74,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Aetna,Commerical,,3574.68,,,3574.68,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Aetna,Middlesex Employees,,3217.22,,,3217.22,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Anthem,Commerical,,3198.53,,,3198.53,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Anthem,Indemnity,,,3489.61,,3489.61,2558.83,3959.65,percent of total billed charges,,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Anthem,State Preferred,,3198.53,,,3198.53,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Anthem,Individual Exchange,,2558.83,,,2558.83,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Cigna,Cigna,,3123.72,,,3123.72,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Connecticare,Commerical,,3341.09,,,3341.09,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Connecticare,Exchange,,3341.09,,,3341.09,2558.83,3959.65,other,Could be inpatient or outpatient,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,Multiplan,Multiplan,,,3959.65,,3959.65,2558.83,3959.65,percent of total billed charges,,
HC PORT CATH TITAN,C1788,HCPCS,,,both,,,4523,2795.05,United Healthcare/Oxford,United Healthcare/Oxford,,3214.77,,,3214.77,2558.83,3959.65,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Aetna,Commerical,,630.92,,,630.92,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Aetna,Middlesex Employees,,567.83,,,567.83,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Anthem,Commerical,,564.53,,,564.53,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Anthem,Indemnity,,,615.91,,615.91,451.62,698.87,percent of total billed charges,,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Anthem,State Preferred,,564.53,,,564.53,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Anthem,Individual Exchange,,451.62,,,451.62,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Cigna,Cigna,,551.32,,,551.32,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Connecticare,Commerical,,589.69,,,589.69,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Connecticare,Exchange,,589.69,,,589.69,451.62,698.87,other,Could be inpatient or outpatient,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,Multiplan,Multiplan,,,698.87,,698.87,451.62,698.87,percent of total billed charges,,
HC BIOPSY NDL BONE,C1830,HCPCS,,,both,,,822.2,493.32,United Healthcare/Oxford,United Healthcare/Oxford,,567.4,,,567.4,451.62,698.87,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Aetna,Commerical,,5149.13,,,5149.13,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Aetna,Middlesex Employees,,4634.22,,,4634.22,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Anthem,Commerical,,4607.32,,,4607.32,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Anthem,Indemnity,,,5026.6,,5026.6,3685.86,5703.66,percent of total billed charges,,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Anthem,State Preferred,,4607.32,,,4607.32,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Anthem,Individual Exchange,,3685.86,,,3685.86,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Cigna,Cigna,,4499.56,,,4499.56,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Connecticare,Commerical,,4812.66,,,4812.66,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Connecticare,Exchange,,4812.66,,,4812.66,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,Multiplan,Multiplan,,,5703.66,,5703.66,3685.86,5703.66,percent of total billed charges,,
HC HH HI STENTGRAFT2,C1874,HCPCS,,,both,,,6515,4026.11,United Healthcare/Oxford,United Healthcare/Oxford,,4630.7,,,4630.7,3685.86,5703.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Aetna,Commerical,,6897.8,,,6897.8,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Aetna,Middlesex Employees,,6208.01,,,6208.01,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Anthem,Commerical,,6171.98,,,6171.98,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Anthem,Indemnity,,,6733.67,,6733.67,4937.59,7640.66,percent of total billed charges,,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Anthem,State Preferred,,6171.98,,,6171.98,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Anthem,Individual Exchange,,4937.59,,,4937.59,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Cigna,Cigna,,6027.63,,,6027.63,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Connecticare,Commerical,,6447.06,,,6447.06,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Connecticare,Exchange,,6447.06,,,6447.06,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,Multiplan,Multiplan,,,7640.66,,7640.66,4937.59,7640.66,percent of total billed charges,,
HC HH IR STENT 3,C1876,HCPCS,,,both,,,8727,5393.41,United Healthcare/Oxford,United Healthcare/Oxford,,6203.31,,,6203.31,4937.59,7640.66,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Aetna,Commerical,,2037.67,,,2037.67,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Aetna,Middlesex Employees,,1833.9,,,1833.9,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Anthem,Commerical,,1823.26,,,1823.26,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Anthem,Indemnity,,,1989.18,,1989.18,1458.6,2257.12,percent of total billed charges,,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Anthem,State Preferred,,1823.26,,,1823.26,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Anthem,Individual Exchange,,1458.6,,,1458.6,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Cigna,Cigna,,1780.62,,,1780.62,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Connecticare,Commerical,,1904.52,,,1904.52,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Connecticare,Exchange,,1904.52,,,1904.52,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,Multiplan,Multiplan,,,2257.12,,2257.12,1458.6,2257.12,percent of total billed charges,,
HC HH STENT ADJ B IR,C1876,HCPCS,,,both,,,2578,1593.26,United Healthcare/Oxford,United Healthcare/Oxford,,1832.51,,,1832.51,1458.6,2257.12,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Aetna,Commerical,,2614.05,,,2614.05,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Aetna,Middlesex Employees,,2352.65,,,2352.65,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Anthem,Commerical,,2338.99,,,2338.99,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Anthem,Indemnity,,,2551.85,,2551.85,1871.19,2895.57,percent of total billed charges,,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Anthem,State Preferred,,2338.99,,,2338.99,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Anthem,Individual Exchange,,1871.19,,,1871.19,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Cigna,Cigna,,2284.28,,,2284.28,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Connecticare,Commerical,,2443.24,,,2443.24,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Connecticare,Exchange,,2443.24,,,2443.24,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,Multiplan,Multiplan,,,2895.57,,2895.57,1871.19,2895.57,percent of total billed charges,,
HC HH HI FILTER-2,C1880,HCPCS,,,both,,,3307,2043.93,United Healthcare/Oxford,United Healthcare/Oxford,,2350.86,,,2350.86,1871.19,2895.57,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Aetna,Commerical,,152.24,,,152.24,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Aetna,Middlesex Employees,,137.01,,,137.01,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Anthem,Commerical,,136.22,,,136.22,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Anthem,Indemnity,,,148.61,,148.61,108.98,168.63,percent of total billed charges,,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Anthem,State Preferred,,136.22,,,136.22,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Anthem,Individual Exchange,,108.98,,,108.98,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Cigna,Cigna,,133.03,,,133.03,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Connecticare,Commerical,,142.29,,,142.29,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Connecticare,Exchange,,142.29,,,142.29,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,Multiplan,Multiplan,,,168.63,,168.63,108.98,168.63,percent of total billed charges,,
HC HH HI GUIDE-1CATH,C1887,HCPCS,,,both,,,193,119.03,United Healthcare/Oxford,United Healthcare/Oxford,,136.91,,,136.91,108.98,168.63,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Aetna,Commerical,,370.41,,,370.41,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Aetna,Middlesex Employees,,333.38,,,333.38,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Anthem,Commerical,,331.44,,,331.44,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Anthem,Indemnity,,,361.6,,361.6,265.15,410.3,percent of total billed charges,,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Anthem,State Preferred,,331.44,,,331.44,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Anthem,Individual Exchange,,265.15,,,265.15,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Cigna,Cigna,,323.68,,,323.68,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Connecticare,Commerical,,346.21,,,346.21,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Connecticare,Exchange,,346.21,,,346.21,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,Multiplan,Multiplan,,,410.3,,410.3,265.15,410.3,percent of total billed charges,,
HC HH HI GUIDE-2CATH,C1887,HCPCS,,,both,,,469,289.63,United Healthcare/Oxford,United Healthcare/Oxford,,333.12,,,333.12,265.15,410.3,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Aetna,Commerical,,1390.47,,,1390.47,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Aetna,Middlesex Employees,,1251.42,,,1251.42,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Anthem,Commerical,,1244.16,,,1244.16,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Anthem,Indemnity,,,1357.38,,1357.38,995.33,1540.22,percent of total billed charges,,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Anthem,State Preferred,,1244.16,,,1244.16,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Anthem,Individual Exchange,,995.33,,,995.33,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Cigna,Cigna,,1215.06,,,1215.06,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Connecticare,Commerical,,1299.61,,,1299.61,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Connecticare,Exchange,,1299.61,,,1299.61,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,Multiplan,Multiplan,,,1540.22,,1540.22,995.33,1540.22,percent of total billed charges,,
HC HH HI GUIDE-3CATH,C1887,HCPCS,,,both,,,1759,1087.21,United Healthcare/Oxford,United Healthcare/Oxford,,1250.47,,,1250.47,995.33,1540.22,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Aetna,Commerical,,2522.05,,,2522.05,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Aetna,Middlesex Employees,,2269.84,,,2269.84,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Anthem,Commerical,,2256.67,,,2256.67,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Anthem,Indemnity,,,2462.04,,2462.04,1805.34,2793.67,percent of total billed charges,,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Anthem,State Preferred,,2256.67,,,2256.67,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Anthem,Individual Exchange,,1805.34,,,1805.34,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Cigna,Cigna,,2203.9,,,2203.9,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Connecticare,Commerical,,2357.25,,,2357.25,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Connecticare,Exchange,,2357.25,,,2357.25,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,Multiplan,Multiplan,,,2793.67,,2793.67,1805.34,2793.67,percent of total billed charges,,
HC HH HI GUIDE-4CATH,C1887,HCPCS,,,both,,,3191,1972,United Healthcare/Oxford,United Healthcare/Oxford,,2268.13,,,2268.13,1805.34,2793.67,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Aetna,Commerical,,166.89,,,166.89,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Aetna,Middlesex Employees,,150.2,,,150.2,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Anthem,Commerical,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Anthem,Indemnity,,,162.91,,162.91,119.46,184.86,percent of total billed charges,,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Anthem,State Preferred,,149.33,,,149.33,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Anthem,Individual Exchange,,119.46,,,119.46,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Cigna,Cigna,,145.84,,,145.84,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Connecticare,Commerical,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Connecticare,Exchange,,155.98,,,155.98,119.46,184.86,other,Could be inpatient or outpatient,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,Multiplan,Multiplan,,,184.86,,184.86,119.46,184.86,percent of total billed charges,,
HC HH HI WIRE 2GUIDE,C1887,HCPCS,,,both,,,211,130.49,United Healthcare/Oxford,United Healthcare/Oxford,,150.08,,,150.08,119.46,184.86,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Aetna,Commerical,,134.33,,,134.33,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Aetna,Middlesex Employees,,120.9,,,120.9,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Anthem,Commerical,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Anthem,Indemnity,,,131.13,,131.13,96.15,148.79,percent of total billed charges,,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Anthem,State Preferred,,120.19,,,120.19,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Anthem,Individual Exchange,,96.15,,,96.15,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Cigna,Cigna,,117.38,,,117.38,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Connecticare,Commerical,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Connecticare,Exchange,,125.54,,,125.54,96.15,148.79,other,Could be inpatient or outpatient,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,Multiplan,Multiplan,,,148.79,,148.79,96.15,148.79,percent of total billed charges,,
HC HI GUIDE CATH 1,C1887,HCPCS,,,both,,,170,105.03,United Healthcare/Oxford,United Healthcare/Oxford,,120.8,,,120.8,96.15,148.79,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Aetna,Commerical,,87.92,,,87.92,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Aetna,Middlesex Employees,,79.13,,,79.13,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Anthem,Commerical,,78.67,,,78.67,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Anthem,Indemnity,,,85.83,,85.83,62.94,97.39,percent of total billed charges,,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Anthem,State Preferred,,78.67,,,78.67,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Anthem,Individual Exchange,,62.94,,,62.94,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Cigna,Cigna,,76.84,,,76.84,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Connecticare,Commerical,,82.18,,,82.18,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Connecticare,Exchange,,82.18,,,82.18,62.94,97.39,other,Could be inpatient or outpatient,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,Multiplan,Multiplan,,,97.39,,97.39,62.94,97.39,percent of total billed charges,,
HC PEELAWAY INTRODCER,C1892,HCPCS,,,both,,,111,68.75,United Healthcare/Oxford,United Healthcare/Oxford,,79.07,,,79.07,62.94,97.39,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Aetna,Commerical,,207.6,,,207.6,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Aetna,Middlesex Employees,,186.84,,,186.84,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Anthem,Commerical,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Anthem,Indemnity,,,202.65,,202.65,148.61,229.95,percent of total billed charges,,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Anthem,State Preferred,,185.75,,,185.75,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Anthem,Individual Exchange,,148.61,,,148.61,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Cigna,Cigna,,181.41,,,181.41,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Connecticare,Commerical,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Connecticare,Exchange,,194.02,,,194.02,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,Multiplan,Multiplan,,,229.95,,229.95,148.61,229.95,percent of total billed charges,,
HC INTROKIT 5FR,C1894,HCPCS,,,both,,,263,162.32,United Healthcare/Oxford,United Healthcare/Oxford,,186.69,,,186.69,148.61,229.95,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Aetna,Commerical,,327.27,,,327.27,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Aetna,Middlesex Employees,,294.54,,,294.54,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Anthem,Commerical,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Anthem,Indemnity,,,319.48,,319.48,234.26,362.51,percent of total billed charges,,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Anthem,State Preferred,,292.83,,,292.83,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Anthem,Individual Exchange,,234.26,,,234.26,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Cigna,Cigna,,285.98,,,285.98,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Connecticare,Commerical,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Connecticare,Exchange,,305.88,,,305.88,234.26,362.51,other,Could be inpatient or outpatient,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,Multiplan,Multiplan,,,362.51,,362.51,234.26,362.51,percent of total billed charges,,
HC INTROKIT 7FR,C1894,HCPCS,,,both,,,414,255.89,United Healthcare/Oxford,United Healthcare/Oxford,,294.31,,,294.31,234.26,362.51,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Aetna,Commerical,,5337.18,,,5337.18,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Aetna,Middlesex Employees,,4803.47,,,4803.47,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Anthem,Commerical,,4775.58,,,4775.58,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Anthem,Indemnity,,,5210.19,,5210.19,3820.46,5911.97,percent of total billed charges,,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Anthem,State Preferred,,4775.58,,,4775.58,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Anthem,Individual Exchange,,3820.46,,,3820.46,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Cigna,Cigna,,4663.89,,,4663.89,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Connecticare,Commerical,,4988.43,,,4988.43,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Connecticare,Exchange,,4988.43,,,4988.43,3820.46,5911.97,other,Could be inpatient or outpatient,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,Multiplan,Multiplan,,,5911.97,,5911.97,3820.46,5911.97,percent of total billed charges,,
HC PACEMAKER SYSTEM,C2619,HCPCS,,,both,,,6753,4173.16,United Healthcare/Oxford,United Healthcare/Oxford,,4799.82,,,4799.82,3820.46,5911.97,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Aetna,Commerical,,2015.69,,,2015.69,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Aetna,Middlesex Employees,,1814.12,,,1814.12,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Anthem,Commerical,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Anthem,Indemnity,,,1967.73,,1967.73,1442.87,2232.77,percent of total billed charges,,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Anthem,State Preferred,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Anthem,Individual Exchange,,1442.87,,,1442.87,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Cigna,Cigna,,1761.41,,,1761.41,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Connecticare,Commerical,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Connecticare,Exchange,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,Multiplan,Multiplan,,,2232.77,,2232.77,1442.87,2232.77,percent of total billed charges,,
HC HI OCC-3 CATH,C2628,HCPCS,,,both,,,2550,1576.07,United Healthcare/Oxford,United Healthcare/Oxford,,1812.75,,,1812.75,1442.87,2232.77,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Aetna,Commerical,,535.68,,,535.68,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Aetna,Middlesex Employees,,482.1,,,482.1,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Commerical,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Indemnity,,,522.92,,522.92,383.45,593.36,percent of total billed charges,,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,State Preferred,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Individual Exchange,,383.45,,,383.45,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Cigna,Cigna,,468.09,,,468.09,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Connecticare,Commerical,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Connecticare,Exchange,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Multiplan,Multiplan,,,593.36,,593.36,383.45,593.36,percent of total billed charges,,
HC BC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,United Healthcare/Oxford,United Healthcare/Oxford,,481.74,,,481.74,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Aetna,Commerical,,535.68,,,535.68,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Aetna,Middlesex Employees,,482.1,,,482.1,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Commerical,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Indemnity,,,522.92,,522.92,383.45,593.36,percent of total billed charges,,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,State Preferred,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Anthem,Individual Exchange,,383.45,,,383.45,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Cigna,Cigna,,468.09,,,468.09,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Connecticare,Commerical,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Connecticare,Exchange,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,Multiplan,Multiplan,,,593.36,,593.36,383.45,593.36,percent of total billed charges,,
HC CTC INSULIN PUMP,E0784,HCPCS,,,both,,,719,418.84,United Healthcare/Oxford,United Healthcare/Oxford,,481.74,,,481.74,383.45,593.36,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC ADMIN FLU VACCINE,G0008,HCPCS,,,both,,,21,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC ADMIN PNEUMONIA V,G0009,HCPCS,,,both,,,25.83,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Aetna,Commerical,,19.24,,,19.24,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Aetna,Middlesex Employees,,17.32,,,17.32,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Anthem,Commerical,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Anthem,Indemnity,,,19.35,,19.35,13.78,21.32,percent of total billed charges,,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Anthem,State Preferred,,17.22,,,17.22,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Anthem,Individual Exchange,,13.78,,,13.78,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Cigna,Cigna,,16.82,,,16.82,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Connecticare,Commerical,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Connecticare,Exchange,,17.99,,,17.99,13.78,21.32,other,Could be inpatient or outpatient,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,Multiplan,Multiplan,,,21.32,,21.32,13.78,21.32,percent of total billed charges,,
HC ADMIN HEP B VACCI,G0010,HCPCS,,,both,,,21,15.05,United Healthcare/Oxford,United Healthcare/Oxford,,17.3,,,17.3,13.78,21.32,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Aetna,Commerical,,243.42,,,243.42,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Aetna,Middlesex Employees,,219.08,,,219.08,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Anthem,Commerical,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Anthem,Indemnity,,,244.75,,244.75,174.24,269.63,percent of total billed charges,,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Anthem,State Preferred,,217.81,,,217.81,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Anthem,Individual Exchange,,174.24,,,174.24,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Cigna,Cigna,,212.71,,,212.71,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Connecticare,Commerical,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Connecticare,Exchange,,227.51,,,227.51,174.24,269.63,other,Could be inpatient or outpatient,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,Multiplan,Multiplan,,,269.63,,269.63,174.24,269.63,percent of total billed charges,,
HC HBOT FULL BODY CHAMBER 30M,G0277,HCPCS,,,both,,,326.73,190.33,United Healthcare/Oxford,United Healthcare/Oxford,,218.91,,,218.91,174.24,269.63,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Aetna,Commerical,,,275.17,,275.17,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Aetna,Middlesex Employees,,,247.65,,247.65,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Anthem,Commerical,,,246.21,,246.21,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Anthem,Indemnity,,,276.67,,276.67,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Anthem,State Preferred,,,246.21,,246.21,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Anthem,Individual Exchange,,,196.96,,196.96,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,Multiplan,Multiplan,,,304.79,,304.79,196.96,304.79,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 1,G0378,HCPCS,,,both,,,369,215.15,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Aetna,Commerical,,,416,,416,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Aetna,Middlesex Employees,,,374.4,,374.4,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Anthem,Commerical,,,372.23,,372.23,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Anthem,Indemnity,,,418.29,,418.29,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Anthem,State Preferred,,,372.23,,373.23,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Anthem,Individual Exchange,,,297.78,,297.78,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Cigna,Cigna,,363.52,,,363.52,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Connecticare,Commerical,,388.81,,,388.81,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Connecticare,Exchange,,388.81,,,388.81,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,Multiplan,Multiplan,,,460.8,,460.8,297.78,460.8,percent of total billed charges,,
HC OBSV PER HOUR - LEVEL 2,G0378,HCPCS,,,both,,,558,325.27,United Healthcare/Oxford,United Healthcare/Oxford,,374.12,,,374.12,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Aetna,Commerical,,,275.17,,275.17,196.96,304.79,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Aetna,Middlesex Employees,,,247.65,,247.65,196.96,304.79,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Anthem,Commerical,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Anthem,Indemnity,,,276.67,,276.67,196.96,304.79,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Anthem,State Preferred,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Anthem,Individual Exchange,,196.96,,,196.96,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,Multiplan,Multiplan,,,304.79,,304.79,196.96,304.79,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 1,G0379,HCPCS,,,both,,,369,215.15,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Aetna,Commerical,,,416,,416,297.78,460.8,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Aetna,Middlesex Employees,,,374.4,,374.4,297.78,460.8,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Anthem,Commerical,,372.23,,,372.23,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Anthem,Indemnity,,,418.29,,418.29,297.78,460.8,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Anthem,State Preferred,,372.23,,,372.23,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Anthem,Individual Exchange,,297.78,,,297.78,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Cigna,Cigna,,363.52,,,363.52,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Connecticare,Commerical,,388.81,,,388.81,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Connecticare,Exchange,,388.81,,,388.81,297.78,460.8,other,Could be inpatient or outpatient,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,Multiplan,Multiplan,,,460.8,,460.8,297.78,460.8,percent of total billed charges,,
HC OBSV DIRECT ADMIT PER HOUR - LEVEL 2,G0379,HCPCS,,,both,,,558,325.27,United Healthcare/Oxford,United Healthcare/Oxford,,374.12,,,374.12,297.78,460.8,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Aetna,Commerical,,2015.69,,,2015.69,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Aetna,Middlesex Employees,,1814.12,,,1814.12,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Anthem,Commerical,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Anthem,Indemnity,,,2026.76,,2026.76,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Anthem,State Preferred,,1803.59,,,1803.59,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Anthem,Individual Exchange,,1442.87,,,1442.87,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Cigna,Cigna,,1761.41,,,1761.41,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Connecticare,Commerical,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Connecticare,Exchange,,1883.97,,,1883.97,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,Multiplan,Multiplan,,,2232.77,,2232.77,1442.87,2232.77,percent of total billed charges,,
HC TRAUMA EVALUATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,2706,1576.07,United Healthcare/Oxford,United Healthcare/Oxford,,1812.75,,,1812.75,1442.87,2232.77,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Aetna,Commerical,,3358.94,,,3358.94,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Aetna,Middlesex Employees,,3023.05,,,3023.05,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Anthem,Commerical,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Anthem,Indemnity,,,3377.38,,3377.38,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Anthem,State Preferred,,3005.51,,,3005.51,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Anthem,Individual Exchange,,2404.41,,,2404.41,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Cigna,Cigna,,2935.2,,,2935.2,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Connecticare,Commerical,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Connecticare,Exchange,,3139.45,,,3139.45,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,Multiplan,Multiplan,,,3720.68,,3720.68,2404.41,3720.68,percent of total billed charges,,
HC TRAUMA FULL ACTIVATED W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,4509,2626.36,United Healthcare/Oxford,United Healthcare/Oxford,,3020.75,,,3020.75,2404.41,3720.68,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Aetna,Commerical,,2686.5,,,2686.5,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Aetna,Middlesex Employees,,2417.85,,,2417.85,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Anthem,Commerical,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Anthem,Indemnity,,,2701.25,,2701.25,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Anthem,State Preferred,,2403.82,,,2403.82,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Anthem,Individual Exchange,,1923.05,,,1923.05,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Cigna,Cigna,,2347.59,,,2347.59,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Connecticare,Commerical,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Connecticare,Exchange,,2510.95,,,2510.95,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,Multiplan,Multiplan,,,2975.82,,2975.82,1923.05,2975.82,percent of total billed charges,,
HC TRAUMA PARTIAL ACTIVATION W/ NOTIFICATION & CRIT CARE,G0390,HCPCS,,,both,,,3606,2100.58,United Healthcare/Oxford,United Healthcare/Oxford,,2416.02,,,2416.02,1923.05,2975.82,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Aetna,Commerical,,2046.63,,,2046.63,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Aetna,Middlesex Employees,,1841.96,,,1841.96,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Anthem,Commerical,,1831.28,,,1831.28,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Anthem,Indemnity,,,2057.86,,2057.86,1465.02,2267.04,percent of total billed charges,,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Anthem,State Preferred,,1831.28,,,1831.28,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Anthem,Individual Exchange,,1465.02,,,1465.02,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Cigna,Cigna,,1788.44,,,1788.44,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Connecticare,Commerical,,1912.89,,,1912.89,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Connecticare,Exchange,,1912.89,,,1912.89,1465.02,2267.04,other,Could be inpatient or outpatient,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,Multiplan,Multiplan,,,2267.04,,2267.04,1465.02,2267.04,percent of total billed charges,,
HC TRAUMA RESPONS W/HOSP CRITICAL CARE,G0390,HCPCS,,,both,,,2747,1600.26,United Healthcare/Oxford,United Healthcare/Oxford,,1840.57,,,1840.57,1465.02,2267.04,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Aetna,Commerical,,1183.38,,,1183.38,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Aetna,Middlesex Employees,,1134.76,,,1134.76,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Anthem,Commerical,,1143.04,,,1143.04,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Anthem,Indemnity,,,1165.85,,1165.85,757.05,1284.35,percent of total billed charges,,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Anthem,State Preferred,,1143.04,,,1143.04,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Anthem,Individual Exchange,,914.43,,,914.43,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Cigna,Cigna,,847.6,,,847.6,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Connecticare,Commerical,,1261.33,,,1261.33,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Connecticare,Exchange,,1261.33,,,1261.33,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,Multiplan,Multiplan,,,1284.35,,1284.35,757.05,1284.35,percent of total billed charges,,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0491,HCPCS,,,both,,,1556.33,906.6,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Aetna,Commerical,,661.78,,,661.78,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Aetna,Middlesex Employees,,634.59,,,634.59,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Anthem,Commerical,,639.23,,,639.23,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Anthem,Indemnity,,,651.98,,651.98,333.72,718.25,percent of total billed charges,,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Anthem,State Preferred,,639.23,,,639.23,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Anthem,Individual Exchange,,511.38,,,511.38,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Cigna,Cigna,,717.6,,,717.6,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Connecticare,Commerical,,705.37,,,705.37,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Connecticare,Exchange,,705.37,,,705.37,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,Multiplan,Multiplan,,,718.25,,718.25,333.72,718.25,percent of total billed charges,,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0491,HCPCS,,,both,,,870.35,507,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Aetna,Commerical,,1183.38,,,1183.38,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Aetna,Middlesex Employees,,1134.76,,,1134.76,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Anthem,Commerical,,1143.04,,,1143.04,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Anthem,Indemnity,,,1165.85,,1165.85,757.05,1284.35,percent of total billed charges,,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Anthem,State Preferred,,1143.04,,,1143.04,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Anthem,Individual Exchange,,914.43,,,914.43,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Cigna,Cigna,,847.6,,,847.6,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Connecticare,Commerical,,1261.33,,,1261.33,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Connecticare,Exchange,,1261.33,,,1261.33,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,Multiplan,Multiplan,,,1284.35,,1284.35,757.05,1284.35,percent of total billed charges,,
HC DIALYSIS ACUTE KIDNEY INJURY NO ESRD - MCR FAC,G0492,HCPCS,,,both,,,1556.33,906.6,United Healthcare/Oxford,United Healthcare/Oxford,,757.05,,,757.05,757.05,1284.35,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Aetna,Commerical,,661.78,,,661.78,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Aetna,Middlesex Employees,,634.59,,,634.59,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Anthem,Commerical,,639.23,,,639.23,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Anthem,Indemnity,,,651.98,,651.98,333.72,718.25,percent of total billed charges,,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Anthem,State Preferred,,639.23,,,639.23,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Anthem,Individual Exchange,,511.38,,,511.38,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Cigna,Cigna,,717.6,,,717.6,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Connecticare,Commerical,,705.37,,,705.37,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Connecticare,Exchange,,705.37,,,705.37,333.72,718.25,other,Could be inpatient or outpatient,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,Multiplan,Multiplan,,,718.25,,718.25,333.72,718.25,percent of total billed charges,,
HC DIALYSIS EVAL ACUTE KIDNEY INJURY NO ESRD,G0492,HCPCS,,,both,,,870.35,507,United Healthcare/Oxford,United Healthcare/Oxford,,333.72,,,333.72,333.72,718.25,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY STATUS,G8978,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY GOAL STATUS,G8979,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOBILITY D/C STATUS,G8980,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION CURRENT STATUS,G8981,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION GOAL STATUS,G8982,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC BODY POSITION D/C  STATUS,G8983,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY CURRENT STATUS,G8984,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY GOAL STATUS,G8985,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC CARRY D/C STATUS,G8986,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARE CURRENT STATUS,G8987,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARE GOAL STATUS,G8988,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SELF CARED/C STATUS,G8989,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT CURRENT STATUS,G8990,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT GOAL STATUS,G8991,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC OTHER PT/OT D/C STATUS,G8992,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT CURRENT STATUS,G8993,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT GOAL STATUS,G8994,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SUB PT/OT D/C STATUS,G8995,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW CURRENT STATUS,G8996,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW GOAL STATUS,G8997,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SWALLOW D/C STATUS,G8998,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH CURRENT STATUS,G8999,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH D/C STATUS,G9158,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP CURRENT STATUS,G9159,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP GOAL STATUS,G9160,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG COMP D/C STATUS,G9161,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS CURRENT STATUS,G9162,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS GOAL STATUS,G9163,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC LANG EXPRESS D/C STATUS,G9164,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION CURRENT STATUS,G9165,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION GOAL STATUS,G9166,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC ATTENTION D/C STATUS,G9167,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY CURRENT STATUS,G9168,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY GOAL STATUS,G9169,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MEMORY D/C STATUS,G9170,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE CURRENT STATUS,G9171,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE GOAL STATUS,G9172,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC VOICE D/C STATUS,G9173,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG CURRENT STATUS,G9174,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG GOAL STATUS,G9175,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC SPEECH LANG D/C STATUS,G9176,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Aetna,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Aetna,Middlesex Employees,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Anthem,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Anthem,State Preferred,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Anthem,Individual Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Cigna,Cigna,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Connecticare,Commerical,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Connecticare,Exchange,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
HC MOTOR SPEECH GOAL STATUS,G9186,HCPCS,,,both,,,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.01,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Aetna,Commerical,,21.59,,,21.59,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Aetna,Middlesex Employees,,19.43,,,19.43,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Anthem,Commerical,,19.31,,,19.31,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Anthem,Indemnity,,,21.08,,21.08,15.45,23.92,percent of total billed charges,,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Anthem,State Preferred,,19.31,,,19.31,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Anthem,Individual Exchange,,15.45,,,15.45,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Cigna,Cigna,,18.87,,,18.87,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Connecticare,Commerical,,20.18,,,20.18,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Connecticare,Exchange,,20.18,,,20.18,15.45,23.92,other,Could be inpatient or outpatient,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,Multiplan,Multiplan,,,23.92,,23.92,15.45,23.92,percent of total billed charges,,
HC COLLAR CERVICLE,L0120,HCPCS,,,both,,,27.32,16.88,United Healthcare/Oxford,United Healthcare/Oxford,,19.42,,,19.42,15.45,23.92,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Aetna,Commerical,,39.92,,,39.92,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Aetna,Middlesex Employees,,35.93,,,35.93,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Anthem,Commerical,,35.72,,,35.72,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Anthem,Indemnity,,,38.97,,38.97,28.58,44.22,percent of total billed charges,,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Anthem,State Preferred,,35.72,,,35.72,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Anthem,Individual Exchange,,28.58,,,28.58,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Cigna,Cigna,,34.88,,,34.88,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Connecticare,Commerical,,37.31,,,37.31,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Connecticare,Exchange,,37.31,,,37.31,28.58,44.22,other,Could be inpatient or outpatient,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,Multiplan,Multiplan,,,44.22,,44.22,28.58,44.22,percent of total billed charges,,
"HC KNEE IMMOBILZER 12"" - 24""",L1830,HCPCS,,,both,,,51,31.21,United Healthcare/Oxford,United Healthcare/Oxford,,35.9,,,35.9,28.58,44.22,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Aetna,Commerical,,44.77,,,44.77,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Aetna,Middlesex Employees,,40.3,,,40.3,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Anthem,Commerical,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Anthem,Indemnity,,,43.71,,43.71,32.05,49.6,percent of total billed charges,,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Anthem,State Preferred,,40.06,,,40.06,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Anthem,Individual Exchange,,32.05,,,32.05,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Cigna,Cigna,,39.12,,,39.12,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Connecticare,Commerical,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Connecticare,Exchange,,41.85,,,41.85,32.05,49.6,other,Could be inpatient or outpatient,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,Multiplan,Multiplan,,,49.6,,49.6,32.05,49.6,percent of total billed charges,,
HC STRAP CLAVICAL SM - LRG,L3650,HCPCS,,,both,,,58.35,35.01,United Healthcare/Oxford,United Healthcare/Oxford,,40.26,,,40.26,32.05,49.6,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Aetna,Commerical,,13.36,,,13.36,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Aetna,Middlesex Employees,,12.02,,,12.02,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Anthem,Commerical,,11.95,,,11.95,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Anthem,Indemnity,,,13.04,,13.04,9.56,14.8,percent of total billed charges,,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Anthem,State Preferred,,11.95,,,11.95,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Anthem,Individual Exchange,,9.56,,,9.56,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Cigna,Cigna,,11.67,,,11.67,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Connecticare,Commerical,,12.49,,,12.49,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Connecticare,Exchange,,12.49,,,12.49,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,Multiplan,Multiplan,,,14.8,,14.8,9.56,14.8,percent of total billed charges,,
HC IMMOB SHOLDER SM-LRG,L3670,HCPCS,,,both,,,16.9,10.45,United Healthcare/Oxford,United Healthcare/Oxford,,12.01,,,12.01,9.56,14.8,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Aetna,Commerical,,13.41,,,13.41,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Aetna,Middlesex Employees,,12.07,,,12.07,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Anthem,Commerical,,12,,,12,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Anthem,Indemnity,,,13.09,,13.09,9.59,14.85,percent of total billed charges,,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Anthem,State Preferred,,12,,,12,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Anthem,Individual Exchange,,9.59,,,9.59,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Cigna,Cigna,,11.72,,,11.72,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Connecticare,Commerical,,12.53,,,12.53,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Connecticare,Exchange,,12.53,,,12.53,9.59,14.85,other,Could be inpatient or outpatient,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,Multiplan,Multiplan,,,14.85,,14.85,9.59,14.85,percent of total billed charges,,
HC IMMOB SHOLDER XSM,L3670,HCPCS,,,both,,,16.96,10.48,United Healthcare/Oxford,United Healthcare/Oxford,,12.06,,,12.06,9.59,14.85,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Aetna,Commerical,,20.75,,,20.75,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Aetna,Middlesex Employees,,18.68,,,18.68,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Anthem,Commerical,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Anthem,Indemnity,,,20.26,,20.26,14.85,22.98,percent of total billed charges,,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Anthem,State Preferred,,18.57,,,18.57,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Anthem,Individual Exchange,,14.85,,,14.85,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Cigna,Cigna,,18.14,,,18.14,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Connecticare,Commerical,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Connecticare,Exchange,,19.39,,,19.39,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,Multiplan,Multiplan,,,22.98,,22.98,14.85,22.98,percent of total billed charges,,
HC SPLINT PRE-CUT 4X30 003893,L3908,HCPCS,,,both,,,26.25,16.22,United Healthcare/Oxford,United Healthcare/Oxford,,18.66,,,18.66,14.85,22.98,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Aetna,Commerical,,26.51,,,26.51,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Aetna,Middlesex Employees,,23.86,,,23.86,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Anthem,Commerical,,23.72,,,23.72,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Anthem,Indemnity,,,25.88,,25.88,18.98,29.37,percent of total billed charges,,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Anthem,State Preferred,,23.72,,,23.72,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Anthem,Individual Exchange,,18.98,,,18.98,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Cigna,Cigna,,23.17,,,23.17,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Connecticare,Commerical,,24.78,,,24.78,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Connecticare,Exchange,,24.78,,,24.78,18.98,29.37,other,Could be inpatient or outpatient,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,18.98,29.37,percent of total billed charges,,
HC SPLINT PRE-CUT 5X30 007332,L3908,HCPCS,,,both,,,33.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,23.84,,,23.84,18.98,29.37,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Aetna,Commerical,,19.26,,,19.26,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Aetna,Middlesex Employees,,17.34,,,17.34,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Anthem,Commerical,,17.24,,,17.24,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Anthem,Indemnity,,,18.81,,18.81,13.8,21.34,percent of total billed charges,,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Anthem,State Preferred,,17.24,,,17.24,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Anthem,Individual Exchange,,13.8,,,13.8,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Cigna,Cigna,,16.84,,,16.84,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Connecticare,Commerical,,18.01,,,18.01,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Connecticare,Exchange,,18.01,,,18.01,13.8,21.34,other,Could be inpatient or outpatient,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,Multiplan,Multiplan,,,21.34,,21.34,13.8,21.34,percent of total billed charges,,
HC WRIST/FORARM  SPLINT,L3908,HCPCS,,,both,,,24.38,15.07,United Healthcare/Oxford,United Healthcare/Oxford,,17.32,,,17.32,13.8,21.34,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Aetna,Commerical,,43.96,,,43.96,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Aetna,Middlesex Employees,,39.56,,,39.56,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Anthem,Commerical,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Anthem,Indemnity,,,42.92,,42.92,31.47,48.7,percent of total billed charges,,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Anthem,State Preferred,,39.34,,,39.34,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Anthem,Individual Exchange,,31.47,,,31.47,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Cigna,Cigna,,38.42,,,38.42,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Connecticare,Commerical,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Connecticare,Exchange,,41.09,,,41.09,31.47,48.7,other,Could be inpatient or outpatient,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,Multiplan,Multiplan,,,48.7,,48.7,31.47,48.7,percent of total billed charges,,
HC ANKLE STIRRUP PEDI SM ADLT 305921; 305922,L4350,HCPCS,,,both,,,57.29,34.37,United Healthcare/Oxford,United Healthcare/Oxford,,39.53,,,39.53,31.47,48.7,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Aetna,Commerical,,15.47,,,15.47,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Aetna,Middlesex Employees,,13.93,,,13.93,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Anthem,Commerical,,13.84,,,13.84,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Anthem,Indemnity,,,15.1,,15.1,11.07,17.14,percent of total billed charges,,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Anthem,State Preferred,,13.84,,,13.84,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Anthem,Individual Exchange,,11.07,,,11.07,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Cigna,Cigna,,13.52,,,13.52,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Connecticare,Commerical,,14.46,,,14.46,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Connecticare,Exchange,,14.46,,,14.46,11.07,17.14,other,Could be inpatient or outpatient,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,Multiplan,Multiplan,,,17.14,,17.14,11.07,17.14,percent of total billed charges,,
HC SHOE CAST XSM - LRG,L4350,HCPCS,,,both,,,19.57,12.1,United Healthcare/Oxford,United Healthcare/Oxford,,13.92,,,13.92,11.07,17.14,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Aetna,Commerical,,410.3,,,410.3,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Aetna,Middlesex Employees,,369.28,,,369.28,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Anthem,Commerical,,367.12,,,367.12,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Anthem,Indemnity,,,400.54,,400.54,293.7,454.49,percent of total billed charges,,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Anthem,State Preferred,,367.12,,,367.12,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Anthem,Individual Exchange,,293.7,,,293.7,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Cigna,Cigna,,358.54,,,358.54,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Connecticare,Commerical,,383.49,,,383.49,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Connecticare,Exchange,,383.49,,,383.49,293.7,454.49,other,Could be inpatient or outpatient,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,Multiplan,Multiplan,,,454.49,,454.49,293.7,454.49,percent of total billed charges,,
HC LITHIMUM ION BATTERY CHARGER,L7368,HCPCS,,,both,,,519,320.81,United Healthcare/Oxford,United Healthcare/Oxford,,368.99,,,368.99,293.7,454.49,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Aetna,Commerical,,677.32,,,677.32,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Aetna,Middlesex Employees,,609.59,,,609.59,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Anthem,Commerical,,606.05,,,606.05,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Anthem,Indemnity,,,661.21,,661.21,484.85,750.27,percent of total billed charges,,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Anthem,State Preferred,,606.05,,,606.05,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Anthem,Individual Exchange,,484.85,,,484.85,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Cigna,Cigna,,591.87,,,591.87,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Connecticare,Commerical,,633.07,,,633.07,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Connecticare,Exchange,,633.07,,,633.07,484.85,750.27,other,Could be inpatient or outpatient,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,Multiplan,Multiplan,,,750.27,,750.27,484.85,750.27,percent of total billed charges,,
HC BAHA REPAIR,L7510,HCPCS,,,both,,,857,529.6,United Healthcare/Oxford,United Healthcare/Oxford,,609.13,,,609.13,484.85,750.27,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Aetna,Commerical,,35.22,,,35.22,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Aetna,Middlesex Employees,,31.7,,,31.7,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Anthem,Commerical,,31.52,,,31.52,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Anthem,Indemnity,,,34.38,,34.38,25.21,39.01,percent of total billed charges,,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Anthem,State Preferred,,31.52,,,31.52,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Anthem,Individual Exchange,,25.21,,,25.21,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Cigna,Cigna,,30.77,,,30.77,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Connecticare,Commerical,,32.91,,,32.91,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Connecticare,Exchange,,32.91,,,32.91,25.21,39.01,other,Could be inpatient or outpatient,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,Multiplan,Multiplan,,,39.01,,39.01,25.21,39.01,percent of total billed charges,,
HC CI REPAIR MIN PRT,L7510,HCPCS,,,both,,,44.56,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,31.67,,,31.67,25.21,39.01,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Aetna,Commerical,,911.78,,,911.78,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Aetna,Middlesex Employees,,820.61,,,820.61,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Anthem,Commerical,,815.84,,,815.84,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Anthem,Indemnity,,,890.09,,890.09,652.67,1009.98,percent of total billed charges,,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Anthem,State Preferred,,815.84,,,815.84,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Anthem,Individual Exchange,,652.67,,,652.67,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Cigna,Cigna,,796.76,,,796.76,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Connecticare,Commerical,,852.2,,,852.2,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Connecticare,Exchange,,852.2,,,852.2,652.67,1009.98,other,Could be inpatient or outpatient,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,Multiplan,Multiplan,,,1009.98,,1009.98,652.67,1009.98,percent of total billed charges,,
HC COCHLEAR REPAIR,L7510,HCPCS,,,both,,,1154,712.93,United Healthcare/Oxford,United Healthcare/Oxford,,819.98,,,819.98,652.67,1009.98,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Anthem,Indemnity,,,188.35,,188.35,138.11,213.72,percent of total billed charges,,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC HF6/7 COIL MAGNET,L7510,HCPCS,,,both,,,244,150.86,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Anthem,Indemnity,,,94.57,,94.57,69.35,107.31,percent of total billed charges,,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC CI REPAIR LABOR HA,L7520,HCPCS,,,both,,,131,75.75,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Aetna,Commerical,,96.88,,,96.88,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Aetna,Middlesex Employees,,87.2,,,87.2,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Anthem,Commerical,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Anthem,Indemnity,,,94.57,,94.57,69.35,107.31,percent of total billed charges,,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Anthem,State Preferred,,86.68,,,86.68,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Anthem,Individual Exchange,,69.35,,,69.35,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Cigna,Cigna,,84.66,,,84.66,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Connecticare,Commerical,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Connecticare,Exchange,,90.55,,,90.55,69.35,107.31,other,Could be inpatient or outpatient,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,Multiplan,Multiplan,,,107.31,,107.31,69.35,107.31,percent of total billed charges,,
HC CI REPAIR PROSTHETIC LABOR PER 15MIN,L7520,HCPCS,,,both,,,131,75.75,United Healthcare/Oxford,United Healthcare/Oxford,,87.13,,,87.13,69.35,107.31,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Aetna,Commerical,,90.37,,,90.37,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Aetna,Middlesex Employees,,81.33,,,81.33,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Anthem,Commerical,,80.85,,,80.85,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Anthem,Indemnity,,,88.21,,88.21,64.69,100.1,percent of total billed charges,,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Anthem,State Preferred,,80.85,,,80.85,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Anthem,Individual Exchange,,64.69,,,64.69,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Cigna,Cigna,,78.97,,,78.97,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Connecticare,Commerical,,84.46,,,84.46,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Connecticare,Exchange,,84.46,,,84.46,64.69,100.1,other,Could be inpatient or outpatient,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,Multiplan,Multiplan,,,100.1,,100.1,64.69,100.1,percent of total billed charges,,
HC MISC PROSTHETIC SERVICES PROCEDURE,L8499,HCPCS,,,both,,,114,70.66,United Healthcare/Oxford,United Healthcare/Oxford,,81.27,,,81.27,64.69,100.1,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Aetna,Commerical,,318.31,,,318.31,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Aetna,Middlesex Employees,,286.48,,,286.48,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Anthem,Commerical,,284.81,,,284.81,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Anthem,Indemnity,,,310.73,,310.73,227.84,352.59,percent of total billed charges,,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Anthem,State Preferred,,284.81,,,284.81,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Anthem,Individual Exchange,,227.84,,,227.84,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Cigna,Cigna,,278.16,,,278.16,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Connecticare,Commerical,,297.51,,,297.51,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Connecticare,Exchange,,297.51,,,297.51,227.84,352.59,other,Could be inpatient or outpatient,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,Multiplan,Multiplan,,,352.59,,352.59,227.84,352.59,percent of total billed charges,,
HC PASSY-MUIR VLV,L8501,HCPCS,,,both,,,403,248.89,United Healthcare/Oxford,United Healthcare/Oxford,,286.26,,,286.26,227.84,352.59,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Aetna,Commerical,,661.04,,,661.04,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Aetna,Middlesex Employees,,594.93,,,594.93,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Anthem,Commerical,,591.48,,,591.48,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Anthem,Indemnity,,,645.31,,645.31,473.18,732.23,percent of total billed charges,,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Anthem,State Preferred,,591.48,,,591.48,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Anthem,Individual Exchange,,473.18,,,473.18,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Cigna,Cigna,,577.65,,,577.65,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Connecticare,Commerical,,617.85,,,617.85,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Connecticare,Exchange,,617.85,,,617.85,473.18,732.23,other,Could be inpatient or outpatient,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,Multiplan,Multiplan,,,732.23,,732.23,473.18,732.23,percent of total billed charges,,
HC COCHLEAR MIC,L8616,HCPCS,,,both,,,836,516.87,United Healthcare/Oxford,United Healthcare/Oxford,,594.49,,,594.49,473.18,732.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Aetna,Commerical,,520.21,,,520.21,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Aetna,Middlesex Employees,,468.19,,,468.19,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Anthem,Commerical,,465.47,,,465.47,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Anthem,Indemnity,,,507.83,,507.83,372.37,576.23,percent of total billed charges,,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Anthem,State Preferred,,465.47,,,465.47,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Anthem,Individual Exchange,,372.37,,,372.37,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Cigna,Cigna,,454.58,,,454.58,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Connecticare,Commerical,,486.21,,,486.21,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Connecticare,Exchange,,486.21,,,486.21,372.37,576.23,other,Could be inpatient or outpatient,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,Multiplan,Multiplan,,,576.23,,576.23,372.37,576.23,percent of total billed charges,,
HC HS DETACH COIL,L8617,HCPCS,,,both,,,658,406.75,United Healthcare/Oxford,United Healthcare/Oxford,,467.83,,,467.83,372.37,576.23,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Aetna,Commerical,,315.06,,,315.06,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Aetna,Middlesex Employees,,283.55,,,283.55,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Anthem,Commerical,,281.9,,,281.9,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Anthem,Indemnity,,,307.56,,307.56,225.53,348.98,percent of total billed charges,,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Anthem,State Preferred,,281.9,,,281.9,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Anthem,Individual Exchange,,225.53,,,225.53,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Cigna,Cigna,,275.31,,,275.31,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Connecticare,Commerical,,294.47,,,294.47,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Connecticare,Exchange,,294.47,,,294.47,225.53,348.98,other,Could be inpatient or outpatient,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,Multiplan,Multiplan,,,348.98,,348.98,225.53,348.98,percent of total billed charges,,
HC COCHLEAR CABLE,L8618,HCPCS,,,both,,,399,246.34,United Healthcare/Oxford,United Healthcare/Oxford,,283.33,,,283.33,225.53,348.98,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Aetna,Commerical,,15090.81,,,15090.81,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Aetna,Middlesex Employees,,13581.73,,,13581.73,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Anthem,Commerical,,13502.9,,,13502.9,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Anthem,Indemnity,,,14731.73,,14731.73,10802.32,16716.02,percent of total billed charges,,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Anthem,State Preferred,,13502.9,,,13502.9,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Anthem,Individual Exchange,,10802.32,,,10802.32,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Cigna,Cigna,,13187.09,,,13187.09,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Connecticare,Commerical,,14104.72,,,14104.72,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Connecticare,Exchange,,14104.72,,,14104.72,10802.32,16716.02,other,Could be inpatient or outpatient,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,Multiplan,Multiplan,,,16716.02,,16716.02,10802.32,16716.02,percent of total billed charges,,
HC REPLACE CI EXT PR,L8619,HCPCS,,,both,,,19093,11799.54,United Healthcare/Oxford,United Healthcare/Oxford,,13571.44,,,13571.44,10802.32,16716.02,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Aetna,Commerical,,15543.45,,,15543.45,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Aetna,Middlesex Employees,,13989.11,,,13989.11,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Anthem,Commerical,,13907.91,,,13907.91,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Anthem,Indemnity,,,15173.59,,15173.59,11126.32,17217.4,percent of total billed charges,,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Anthem,State Preferred,,13907.91,,,13907.91,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Anthem,Individual Exchange,,11126.32,,,11126.32,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Cigna,Cigna,,13582.62,,,13582.62,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Connecticare,Commerical,,14527.78,,,14527.78,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Connecticare,Exchange,,14527.78,,,14527.78,11126.32,17217.4,other,Could be inpatient or outpatient,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,Multiplan,Multiplan,,,17217.4,,17217.4,11126.32,17217.4,percent of total billed charges,,
HC UPGD CI EXT PROC,L8619,HCPCS,,,both,,,19666,12153.46,United Healthcare/Oxford,United Healthcare/Oxford,,13978.5,,,13978.5,11126.32,17217.4,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Aetna,Commerical,,380.18,,,380.18,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Aetna,Middlesex Employees,,342.16,,,342.16,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Anthem,Commerical,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Anthem,Indemnity,,,371.13,,371.13,272.14,421.12,percent of total billed charges,,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Anthem,State Preferred,,340.17,,,340.17,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Anthem,Individual Exchange,,272.14,,,272.14,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Cigna,Cigna,,332.22,,,332.22,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Connecticare,Commerical,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Connecticare,Exchange,,355.34,,,355.34,272.14,421.12,other,Could be inpatient or outpatient,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,Multiplan,Multiplan,,,421.12,,421.12,272.14,421.12,percent of total billed charges,,
HC CI LITHIUM BAT EL,L8624,HCPCS,,,both,,,481,297.26,United Healthcare/Oxford,United Healthcare/Oxford,,341.91,,,341.91,272.14,421.12,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Aetna,Commerical,,10645.06,,,10645.06,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Aetna,Middlesex Employees,,9580.55,,,9580.55,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Anthem,Commerical,,9524.95,,,9524.95,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Anthem,Indemnity,,,10391.76,,10391.76,7619.96,11791.48,percent of total billed charges,,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Anthem,State Preferred,,9524.95,,,9524.95,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Anthem,Individual Exchange,,7619.96,,,7619.96,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Cigna,Cigna,,9302.17,,,9302.17,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Connecticare,Commerical,,9949.47,,,9949.47,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Connecticare,Exchange,,9949.47,,,9949.47,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,Multiplan,Multiplan,,,11791.48,,11791.48,7619.96,11791.48,percent of total billed charges,,
HC FRDM SPEECH PROC,L8627,HCPCS,,,both,,,13468,8323.4,United Healthcare/Oxford,United Healthcare/Oxford,,9573.29,,,9573.29,7619.96,11791.48,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Aetna,Commerical,,3006.44,,,3006.44,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Aetna,Middlesex Employees,,2705.8,,,2705.8,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Anthem,Commerical,,2690.09,,,2690.09,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Anthem,Indemnity,,,2934.9,,2934.9,2152.08,3330.22,percent of total billed charges,,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Anthem,State Preferred,,2690.09,,,2690.09,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Anthem,Individual Exchange,,2152.08,,,2152.08,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Cigna,Cigna,,2627.18,,,2627.18,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Connecticare,Commerical,,2809.99,,,2809.99,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Connecticare,Exchange,,2809.99,,,2809.99,2152.08,3330.22,other,Could be inpatient or outpatient,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,Multiplan,Multiplan,,,3330.22,,3330.22,2152.08,3330.22,percent of total billed charges,,
HC FRDM CNTRLR-5 RMT,L8628,HCPCS,,,both,,,3804,2350.74,United Healthcare/Oxford,United Healthcare/Oxford,,2703.75,,,2703.75,2152.08,3330.22,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Aetna,Commerical,,7268.21,,,7268.21,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Aetna,Middlesex Employees,,6541.39,,,6541.39,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Anthem,Commerical,,6503.42,,,6503.42,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Anthem,Indemnity,,,7095.27,,7095.27,5202.74,8050.96,percent of total billed charges,,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Anthem,State Preferred,,6503.42,,,6503.42,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Anthem,Individual Exchange,,5202.74,,,5202.74,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Cigna,Cigna,,6351.31,,,6351.31,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Connecticare,Commerical,,6793.27,,,6793.27,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Connecticare,Exchange,,6793.27,,,6793.27,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,Multiplan,Multiplan,,,8050.96,,8050.96,5202.74,8050.96,percent of total billed charges,,
HC BAHABONE PROCESSOR,L8691,HCPCS,,,both,,,9196,5683.03,United Healthcare/Oxford,United Healthcare/Oxford,,6536.43,,,6536.43,5202.74,8050.96,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Aetna,Commerical,,5889.95,,,5889.95,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Aetna,Middlesex Employees,,5300.96,,,5300.96,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Anthem,Commerical,,5270.19,,,5270.19,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Anthem,Indemnity,,,5749.8,,5749.8,4216.16,6524.27,percent of total billed charges,,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Anthem,State Preferred,,5270.19,,,5270.19,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Anthem,Individual Exchange,,4216.16,,,4216.16,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Cigna,Cigna,,5146.93,,,5146.93,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Connecticare,Commerical,,5505.08,,,5505.08,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Connecticare,Exchange,,5505.08,,,5505.08,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,Multiplan,Multiplan,,,6524.27,,6524.27,4216.16,6524.27,percent of total billed charges,,
HC BAHASOFT PROCESR,L8692,HCPCS,,,both,,,7452,4605.37,United Healthcare/Oxford,United Healthcare/Oxford,,5296.94,,,5296.94,4216.16,6524.27,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC BAHA MAGNET,L9900,HCPCS,,,both,,,328,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Aetna,Commerical,,126.18,,,126.18,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Aetna,Middlesex Employees,,113.57,,,113.57,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Anthem,Commerical,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Anthem,Indemnity,,,123.18,,123.18,90.32,139.77,percent of total billed charges,,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Anthem,State Preferred,,112.91,,,112.91,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Anthem,Individual Exchange,,90.32,,,90.32,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Cigna,Cigna,,110.26,,,110.26,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Connecticare,Commerical,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Connecticare,Exchange,,117.94,,,117.94,90.32,139.77,other,Could be inpatient or outpatient,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,Multiplan,Multiplan,,,139.77,,139.77,90.32,139.77,percent of total billed charges,,
HC BAHA SOFTBAND FEE,L9900,HCPCS,,,both,,,160,98.66,United Healthcare/Oxford,United Healthcare/Oxford,,113.48,,,113.48,90.32,139.77,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Aetna,Commerical,,1066.3,,,1066.3,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Aetna,Middlesex Employees,,959.67,,,959.67,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Anthem,Commerical,,884.95,,,884.95,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Anthem,Indemnity,,,1160.45,,1160.45,707.96,1278.4,percent of total billed charges,,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Anthem,State Preferred,,884.95,,,884.95,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Anthem,Individual Exchange,,707.96,,,707.96,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Cigna,Cigna,,939.28,,,939.28,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Connecticare,Commerical,,963.5,,,963.5,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Connecticare,Exchange,,963.5,,,963.5,707.96,1278.4,other,Could be inpatient or outpatient,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,Multiplan,Multiplan,,,1278.4,,1278.4,707.96,1278.4,percent of total billed charges,,
HC BAMLANIVIMAB AND ETESEVIMAB MONOCLONAL AB INFUSION,M0245,HCPCS,,,both,,,1595.47,957.28,United Healthcare/Oxford,United Healthcare/Oxford,,987.72,,,987.72,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Aetna,Commerical,,1066.3,,,1066.3,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Aetna,Middlesex Employees,,959.67,,,959.67,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Anthem,Commerical,,884.95,,,884.95,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Anthem,Indemnity,,,1160.45,,1160.45,707.96,1278.4,percent of total billed charges,,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Anthem,State Preferred,,884.95,,,884.95,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Anthem,Individual Exchange,,707.96,,,707.96,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Cigna,Cigna,,939.28,,,939.28,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Connecticare,Commerical,,963.5,,,963.5,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Connecticare,Exchange,,963.5,,,963.5,707.96,1278.4,other,Could be inpatient or outpatient,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,Multiplan,Multiplan,,,1278.4,,1278.4,707.96,1278.4,percent of total billed charges,,
HC SOTROVIMAB MONOCLONAL INFUSION,M0247,HCPCS,,,both,,,1595.47,957.28,United Healthcare/Oxford,United Healthcare/Oxford,,987.72,,,987.72,707.96,1278.4,other,Could be inpatient or outpatient,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Aetna,Commerical,,73292.31,,,73292.31,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Aetna,Middlesex Employees,,65903.29,,,65903.29,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Anthem,Commerical,,88399.98,,,88399.98,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Anthem,Indemnity,,,145978.04,,145978,65903.29,198097.9,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Anthem,State Preferred,,88399.98,,,88399.98,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Anthem,Individual Exchange,,70719.99,,,70719.99,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Cigna,Cigna,,71316.7,,,71316.7,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Connecticare,Commerical,,105605.5,,,105605.5,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Connecticare,Exchange,,105605.5,,,105605.5,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,Multiplan,Multiplan,,,160816.06,,160816.1,65903.29,198097.9,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,MS025,DRG,,,inpatient,,,200717.37,120430.42,United Healthcare/Oxford,United Healthcare/Oxford,,198097.9,,,198097.9,65903.29,198097.9,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Aetna,Commerical,,43392.51,,,43392.51,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Aetna,Middlesex Employees,,39017.8,,,39017.8,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Anthem,Commerical,,30055.89,,,30055.89,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Anthem,Indemnity,,,64992.46,,64992.46,24044.72,71598.66,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Anthem,State Preferred,,30055.89,,,30055.89,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Anthem,Individual Exchange,,24044.72,,,24044.72,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Cigna,Cigna,,36833.9,,,36833.9,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Connecticare,Commerical,,54543.5,,,54543.5,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Connecticare,Exchange,,54543.5,,,54543.5,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,Multiplan,Multiplan,,,71598.66,,71598.66,24044.72,71598.66,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,MS026,DRG,,,inpatient,,,89363.55,53618.13,United Healthcare/Oxford,United Healthcare/Oxford,,70918.3,,,70918.3,24044.72,71598.66,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Aetna,Commerical,,19388.14,,,19388.14,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Aetna,Middlesex Employees,,17433.49,,,17433.49,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Anthem,Commerical,,19921.18,,,19921.18,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Anthem,Indemnity,,,40861.38,,40861.38,15936.95,45014.76,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Anthem,State Preferred,,19921.18,,,19921.18,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Anthem,Individual Exchange,,15936.95,,,15936.95,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Cigna,Cigna,,24834.6,,,24834.6,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Connecticare,Commerical,,24370.5,,,24370.5,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Connecticare,Exchange,,24370.5,,,24370.5,15936.95,45014.76,per diem,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,Multiplan,Multiplan,,,45014.76,,45014.76,15936.95,45014.76,percent of total billed charges,,
CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,MS027,DRG,,,inpatient,,,56183.72,33710.23,United Healthcare/Oxford,United Healthcare/Oxford,,24931.2,,,24931.2,15936.95,45014.76,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Aetna,Commerical,,18863.38,,,18863.38,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Aetna,Middlesex Employees,,16961.59,,,16961.59,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Anthem,Commerical,,12992.52,,,12992.52,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Anthem,Indemnity,,,14842.73,,14842.72,10394.02,20798.75,percent of total billed charges,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Anthem,State Preferred,,12992.52,,,12992.52,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Anthem,Individual Exchange,,10394.02,,,10394.02,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Cigna,Cigna,,11117.49,,,11117.49,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Connecticare,Commerical,,20798.75,,,20798.75,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Connecticare,Exchange,,20798.75,,,20798.75,10394.02,20798.75,per diem,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,Multiplan,Multiplan,,,16351.42,,16351.42,10394.02,20798.75,percent of total billed charges,,
TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC,MS087,DRG,,,inpatient,,,20408.5,12245.1,United Healthcare/Oxford,United Healthcare/Oxford,,15110.23,,,15110.23,10394.02,20798.75,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Aetna,Commerical,,22007.27,,,22007.27,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Aetna,Middlesex Employees,,19788.52,,,19788.52,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Anthem,Commerical,,16863.65,,,16863.65,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Anthem,Indemnity,,,17758.71,,17758.71,9570.83,23736.59,percent of total billed charges,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Anthem,State Preferred,,16863.65,,,16863.65,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Anthem,Individual Exchange,,13490.91,,,13490.91,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Cigna,Cigna,,16392.52,,,16392.52,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Connecticare,Commerical,,23736.59,,,23736.59,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Connecticare,Exchange,,23736.59,,,23736.59,9570.83,23736.59,per diem,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,Multiplan,Multiplan,,,19563.8,,19563.8,9570.83,23736.59,percent of total billed charges,,
OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,MS093,DRG,,,inpatient,,,24417.93,14650.76,United Healthcare/Oxford,United Healthcare/Oxford,,9570.83,,,9570.83,9570.83,23736.59,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Aetna,Commerical,,52660.26,,,52660.26,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Aetna,Middlesex Employees,,47351.11,,,47351.11,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Anthem,Commerical,,43585.1,,,43585.1,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Anthem,Indemnity,,,49499.17,,49499.17,12433.84,69168.76,percent of total billed charges,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Anthem,State Preferred,,43585.1,,,43585.1,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Anthem,Individual Exchange,,34868.08,,,34868.08,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Cigna,Cigna,,12433.84,,,12433.84,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Connecticare,Commerical,,69168.76,,,69168.76,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Connecticare,Exchange,,69168.76,,,69168.76,12433.84,69168.76,per diem,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,Multiplan,Multiplan,,,54530.54,,54530.54,12433.84,69168.76,percent of total billed charges,,
SEIZURES W MCC,MS100,DRG,,,inpatient,,,68060.54,40836.32,United Healthcare/Oxford,United Healthcare/Oxford,,29949.76,,,29949.76,12433.84,69168.76,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Aetna,Commerical,,27509.09,,,27509.09,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Aetna,Middlesex Employees,,24735.66,,,24735.66,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Anthem,Commerical,,14053.98,,,14053.98,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Anthem,Indemnity,,,15779.68,,15779.68,9710.44,17383.61,percent of total billed charges,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Anthem,State Preferred,,14053.98,,,14053.98,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Anthem,Individual Exchange,,11243.18,,,11243.18,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Cigna,Cigna,,9710.44,,,9710.44,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Connecticare,Commerical,,9721.56,,,9721.56,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Connecticare,Exchange,,9721.56,,,9721.56,9710.44,17383.61,per diem,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,Multiplan,Multiplan,,,17383.61,,17383.61,9710.44,17383.61,percent of total billed charges,,
SEIZURES W/O MCC,MS101,DRG,,,inpatient,,,21696.8,13018.08,United Healthcare/Oxford,United Healthcare/Oxford,,13967.23,,,13967.23,9710.44,17383.61,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Aetna,Commerical,,24365.19,,,24365.19,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Aetna,Middlesex Employees,,21908.72,,,21908.72,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Anthem,Commerical,,28879.5,,,28879.5,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Anthem,Indemnity,,,26261.06,,26261.06,7912.19,28930.38,percent of total billed charges,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Anthem,State Preferred,,28879.5,,,28879.5,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Anthem,Individual Exchange,,23103.6,,,23103.6,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Cigna,Cigna,,25650.4,,,25650.4,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Connecticare,Commerical,,7912.19,,,7912.19,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Connecticare,Exchange,,7912.19,,,7912.19,7912.19,28930.38,per diem,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,Multiplan,Multiplan,,,28930.38,,28930.38,7912.19,28930.38,percent of total billed charges,,
HEADACHES W/O MCC,MS103,DRG,,,inpatient,,,36108.51,21665.11,United Healthcare/Oxford,United Healthcare/Oxford,,17920.72,,,17920.72,7912.19,28930.38,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Aetna,Commerical,,23616.02,,,23616.02,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Aetna,Middlesex Employees,,21254.41,,,21254.41,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Anthem,Commerical,,21630.18,,,21630.18,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Anthem,Indemnity,,,45685.06,,45685.06,7723.65,112921.71,percent of total billed charges,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Anthem,State Preferred,,21630.18,,,21630.18,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Anthem,Individual Exchange,,17304.14,,,17304.14,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Cigna,Cigna,,112921.71,,,112921.71,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Connecticare,Commerical,,7723.65,,,7723.65,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Connecticare,Exchange,,7723.65,,,7723.65,7723.65,112921.71,per diem,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,Multiplan,Multiplan,,,50328.75,,50328.75,7723.65,112921.71,percent of total billed charges,,
OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC,MS134,DRG,,,inpatient,,,62816.2,37689.72,United Healthcare/Oxford,United Healthcare/Oxford,,19070.82,,,19070.82,7723.65,112921.71,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Aetna,Commerical,,22793.25,,,22793.25,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Aetna,Middlesex Employees,,9716.06,,,9716.06,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Anthem,Commerical,,14591.88,,,14591.88,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Anthem,Indemnity,,,15921.51,,15921.51,9716.06,17539.86,percent of total billed charges,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Anthem,State Preferred,,14591.88,,,14591.88,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Anthem,Individual Exchange,,11673.5,,,11673.5,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Cigna,Cigna,,17309.26,,,17309.26,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Connecticare,Commerical,,15197.99,,,15197.99,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Connecticare,Exchange,,15197.99,,,15197.99,9716.06,17539.86,per diem,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,Multiplan,Multiplan,,,17539.86,,17539.86,9716.06,17539.86,percent of total billed charges,,
OTITIS MEDIA & URI W/O MCC,MS153,DRG,,,inpatient,,,21891.81,13135.08,United Healthcare/Oxford,United Healthcare/Oxford,,15060.21,,,15060.21,9716.06,17539.86,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Aetna,Commerical,,53446.23,,,53446.23,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Aetna,Middlesex Employees,,48057.84,,,48057.84,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Anthem,Commerical,,80857.11,,,80857.11,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Anthem,Indemnity,,,120306.92,,120306.9,41801.34,132535.59,percent of total billed charges,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Anthem,State Preferred,,80857.11,,,80857.11,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Anthem,Individual Exchange,,64685.69,,,64685.69,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Cigna,Cigna,,41801.34,,,41801.34,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Connecticare,Commerical,,57404.54,,,57404.54,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Connecticare,Exchange,,57404.54,,,57404.54,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,Multiplan,Multiplan,,,132535.59,,132535.6,41801.34,132535.59,percent of total billed charges,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,MS177,DRG,,,inpatient,,,165420.01,99252.01,United Healthcare/Oxford,United Healthcare/Oxford,,68182.89,,,68182.89,41801.34,132535.59,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Aetna,Commerical,,33796.88,,,33796.88,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Aetna,Middlesex Employees,,30389.52,,,30389.52,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Anthem,Commerical,,44983.89,,,44983.89,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Anthem,Indemnity,,,61810.48,,61810.48,15070.21,68093.25,percent of total billed charges,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Anthem,State Preferred,,44983.89,,,44983.89,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Anthem,Individual Exchange,,35987.12,,,35987.12,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Cigna,Cigna,,25051.18,,,25051.18,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Connecticare,Commerical,,15070.21,,,15070.21,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Connecticare,Exchange,,15070.21,,,15070.21,15070.21,68093.25,per diem,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,Multiplan,Multiplan,,,68093.25,,68093.25,15070.21,68093.25,percent of total billed charges,,
RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,MS178,DRG,,,inpatient,,,84988.38,50993.03,United Healthcare/Oxford,United Healthcare/Oxford,,37398.08,,,37398.08,15070.21,68093.25,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Aetna,Commerical,,38512.73,,,38512.73,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Aetna,Middlesex Employees,,34629.92,,,34629.92,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Anthem,Commerical,,38966.89,,,38966.89,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Anthem,Indemnity,,,56580.88,,56580.88,18112.67,62332.07,percent of total billed charges,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Anthem,State Preferred,,38966.89,,,38966.89,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Anthem,Individual Exchange,,31173.52,,,31173.52,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Cigna,Cigna,,48018.07,,,48018.07,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Connecticare,Commerical,,18112.67,,,18112.67,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Connecticare,Exchange,,18112.67,,,18112.67,18112.67,62332.07,per diem,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,Multiplan,Multiplan,,,62332.07,,62332.07,18112.67,62332.07,percent of total billed charges,,
PULMONARY EDEMA & RESPIRATORY FAILURE,MS189,DRG,,,inpatient,,,77797.76,46678.66,United Healthcare/Oxford,United Healthcare/Oxford,,38113.43,,,38113.43,18112.67,62332.07,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Aetna,Commerical,,40870.65,,,40870.65,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Aetna,Middlesex Employees,,36750.12,,,36750.12,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Anthem,Commerical,,39761.76,,,39761.76,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Anthem,Indemnity,,,45842.46,,45842.46,26498.07,50502.15,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Anthem,State Preferred,,39761.76,,,39761.76,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Anthem,Individual Exchange,,31809.41,,,31809.41,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Cigna,Cigna,,31080.23,,,31080.23,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Connecticare,Commerical,,26498.07,,,26498.07,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Connecticare,Exchange,,26498.07,,,26498.07,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,Multiplan,Multiplan,,,50502.15,,50502.15,26498.07,50502.15,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W MCC,MS193,DRG,,,inpatient,,,63032.62,37819.57,United Healthcare/Oxford,United Healthcare/Oxford,,30338.56,,,30338.56,26498.07,50502.15,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Aetna,Commerical,,28295.06,,,28295.06,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Aetna,Middlesex Employees,,25442.39,,,25442.39,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Anthem,Commerical,,23057.1,,,23057.1,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Anthem,Indemnity,,,26461.08,,26461.08,13442.49,31552.61,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Anthem,State Preferred,,23057.1,,,23057.1,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Anthem,Individual Exchange,,18445.68,,,18445.68,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Cigna,Cigna,,21687.61,,,21687.61,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Connecticare,Commerical,,13442.49,,,13442.49,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Connecticare,Exchange,,13442.49,,,13442.49,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,Multiplan,Multiplan,,,29150.73,,29150.72,13442.49,31552.61,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W CC,MS194,DRG,,,inpatient,,,36383.54,21830.13,United Healthcare/Oxford,United Healthcare/Oxford,,19375.88,,,19375.88,13442.49,31552.61,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Aetna,Commerical,,22007.27,,,22007.27,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Aetna,Middlesex Employees,,19788.52,,,19788.52,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Anthem,Commerical,,13337.01,,,13337.01,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Anthem,Indemnity,,,13472.33,,13472.33,10669.61,14841.73,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Anthem,State Preferred,,13337.01,,,13337.01,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Anthem,Individual Exchange,,10669.61,,,10669.61,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Cigna,Cigna,,11361.74,,,11361.74,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Connecticare,Commerical,,13906.73,,,13906.73,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Connecticare,Exchange,,13906.73,,,13906.73,10669.61,14841.73,per diem,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,Multiplan,Multiplan,,,14841.73,,14841.73,10669.61,14841.73,percent of total billed charges,,
SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,MS195,DRG,,,inpatient,,,18524.23,11114.54,United Healthcare/Oxford,United Healthcare/Oxford,,14302.98,,,14302.98,10669.61,14841.73,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Aetna,Commerical,,29081.04,,,29081.04,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Aetna,Middlesex Employees,,26149.12,,,26149.12,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Anthem,Commerical,,23890.62,,,23890.62,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Anthem,Indemnity,,,25881.38,,25881.38,19112.5,28512.11,percent of total billed charges,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Anthem,State Preferred,,23890.62,,,23890.62,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Anthem,Individual Exchange,,19112.5,,,19112.5,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Cigna,Cigna,,22739.55,,,22739.55,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Connecticare,Commerical,,21779.86,,,21779.86,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Connecticare,Exchange,,21779.86,,,21779.86,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,Multiplan,Multiplan,,,28512.11,,28512.11,19112.5,28512.11,percent of total billed charges,,
BRONCHITIS & ASTHMA W CC/MCC,MS202,DRG,,,inpatient,,,35586.47,21351.88,United Healthcare/Oxford,United Healthcare/Oxford,,23128.72,,,23128.72,19112.5,28512.11,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Aetna,Commerical,,11005.63,,,11005.63,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Aetna,Middlesex Employees,,9905.07,,,9905.07,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Anthem,Commerical,,12103.24,,,12103.24,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Anthem,Indemnity,,,14319.05,,14319.05,9682.59,17095.76,percent of total billed charges,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Anthem,State Preferred,,12103.24,,,12103.24,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Anthem,Individual Exchange,,9682.59,,,9682.59,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Cigna,Cigna,,12071.26,,,12071.26,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Connecticare,Commerical,,10733.93,,,10733.93,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Connecticare,Exchange,,10733.93,,,10733.93,9682.59,17095.76,per diem,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,Multiplan,Multiplan,,,15774.52,,15774.52,9682.59,17095.76,percent of total billed charges,,
BRONCHITIS & ASTHMA W/O CC/MCC,MS203,DRG,,,inpatient,,,19688.46,11813.08,United Healthcare/Oxford,United Healthcare/Oxford,,17095.76,,,17095.76,9682.59,17095.76,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Aetna,Commerical,,16461.53,,,16461.53,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Aetna,Middlesex Employees,,14815.38,,,14815.38,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Anthem,Commerical,,72995.7,,,72995.7,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Anthem,Indemnity,,,63944.37,,63944.37,12493.81,72995.7,percent of total billed charges,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Anthem,State Preferred,,72995.7,,,72995.7,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Anthem,Individual Exchange,,58396.56,,,58396.56,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Cigna,Cigna,,24023.62,,,24023.62,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Connecticare,Commerical,,56572.59,,,56572.59,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Connecticare,Exchange,,56572.59,,,56572.59,12493.81,72995.7,per diem,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,Multiplan,Multiplan,,,70444.04,,70444.04,12493.81,72995.7,percent of total billed charges,,
RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,MS208,DRG,,,inpatient,,,87922.45,52753.47,United Healthcare/Oxford,United Healthcare/Oxford,,12493.81,,,12493.81,12493.81,72995.7,per diem,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Aetna,Commerical,,116784.45,,,116784.45,105010.74,271666.62,per diem,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Aetna,Middlesex Employees,,105010.74,,,105010.74,105010.74,271666.62,per diem,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Anthem,Commerical,,194007,,,194007,105010.74,271666.62,case rate ,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Anthem,Indemnity,,,246600.74,,246600.7,105010.74,271666.62,percent of total billed charges,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Anthem,State Preferred,,194007,,,194007,105010.74,271666.62,case rate ,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Anthem,Individual Exchange,,155205.6,,,155205.6,105010.74,271666.62,case rate ,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Cigna,Cigna,,230373,,,230373,105010.74,271666.62,case rate ,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Connecticare,Commerical,,126595.13,,,126595.13,105010.74,271666.62,per diem,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Connecticare,Exchange,,126595.13,,,126595.13,105010.74,271666.62,per diem,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,Multiplan,Multiplan,,,271666.62,,271666.6,105010.74,271666.62,percent of total billed charges,,
CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,MS216,DRG,,,inpatient,,,339071.9,203443.14,United Healthcare/Oxford,United Healthcare/Oxford,,126249.3,,,126249.3,105010.74,271666.62,per diem,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Aetna,Commerical,,73292.31,,,73292.31,30981,180659.21,per diem,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Aetna,Middlesex Employees,,65903.29,,,65903.29,30981,180659.21,per diem,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Anthem,Commerical,,98146,,,98146,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Anthem,Indemnity,,,163990.32,,163990.3,30981,180659.21,percent of total billed charges,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Anthem,State Preferred,,98146,,,98146,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Anthem,Individual Exchange,,78516.8,,,78516.8,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Cigna,Cigna,,115837,,,115837,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Connecticare,Commerical,,112874,,,112874,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Connecticare,Exchange,,112874,,,112874,30981,180659.21,case rate ,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,Multiplan,Multiplan,,,180659.21,,180659.2,30981,180659.21,percent of total billed charges,,
OTHER CARDIOTHORACIC PROCEDURES W MCC,MS228,DRG,,,inpatient,,,225483.95,135290.37,United Healthcare/Oxford,United Healthcare/Oxford,,30981,,,30981,30981,180659.21,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Aetna,Commerical,,23579.22,,,23579.22,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Aetna,Middlesex Employees,,21201.99,,,21201.99,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Anthem,Commerical,,70564.04,,,70564.04,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Anthem,Indemnity,,,43152.5,,43152.5,12387.68,79402.01,percent of total billed charges,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Anthem,State Preferred,,70564.04,,,70564.04,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Anthem,Individual Exchange,,56451.24,,,56451.24,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Cigna,Cigna,,79402.01,,,79402.01,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Connecticare,Commerical,,12387.68,,,12387.68,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Connecticare,Exchange,,12387.68,,,12387.68,12387.68,79402.01,per diem,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,Multiplan,Multiplan,,,47538.77,,47538.77,12387.68,79402.01,percent of total billed charges,,
CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,MS307,DRG,,,inpatient,,,59333.97,35600.38,United Healthcare/Oxford,United Healthcare/Oxford,,24070.6,,,24070.6,12387.68,79402.01,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Aetna,Commerical,,16505.45,,,16505.45,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Aetna,Middlesex Employees,,14841.39,,,14841.39,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Anthem,Commerical,,22339.84,,,22339.84,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Anthem,Indemnity,,,20432.56,,20432.56,11488.65,22509.45,percent of total billed charges,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Anthem,State Preferred,,22339.84,,,22339.84,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Anthem,Individual Exchange,,17871.87,,,17871.87,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Cigna,Cigna,,11488.65,,,11488.65,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Connecticare,Commerical,,11627.15,,,11627.15,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Connecticare,Exchange,,11627.15,,,11627.15,11488.65,22509.45,per diem,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,Multiplan,Multiplan,,,22509.45,,22509.45,11488.65,22509.45,percent of total billed charges,,
CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,MS310,DRG,,,inpatient,,,28094.43,16856.66,United Healthcare/Oxford,United Healthcare/Oxford,,15663.15,,,15663.15,11488.65,22509.45,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Aetna,Commerical,,27509.09,,,27509.09,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Aetna,Middlesex Employees,,24735.65,,,24735.65,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Anthem,Commerical,,28149.48,,,28149.48,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Anthem,Indemnity,,,29314.08,,29314.08,13815.13,38387.43,percent of total billed charges,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Anthem,State Preferred,,28149.48,,,28149.48,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Anthem,Individual Exchange,,22519.59,,,22519.59,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Cigna,Cigna,,13815.13,,,13815.13,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Connecticare,Commerical,,29118.25,,,29118.25,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Connecticare,Exchange,,29118.25,,,29118.25,13815.13,38387.43,per diem,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,Multiplan,Multiplan,,,32293.73,,32293.73,13815.13,38387.43,percent of total billed charges,,
OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,MS315,DRG,,,inpatient,,,40306.37,24183.82,United Healthcare/Oxford,United Healthcare/Oxford,,18887.79,,,18887.79,13815.13,38387.43,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Aetna,Commerical,,21746.07,,,21746.07,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Aetna,Middlesex Employees,,19553.72,,,19553.72,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Anthem,Commerical,,24807.96,,,24807.96,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Anthem,Indemnity,,,27015.08,,27015.08,17806.5,29761.04,percent of total billed charges,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Anthem,State Preferred,,24807.96,,,24807.96,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Anthem,Individual Exchange,,19846.36,,,19846.36,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Cigna,Cigna,,17806.5,,,17806.5,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Connecticare,Commerical,,24499.72,,,24499.72,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Connecticare,Exchange,,24499.72,,,24499.72,17806.5,29761.04,per diem,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,Multiplan,Multiplan,,,29761.04,,29761.04,17806.5,29761.04,percent of total billed charges,,
STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC,MS328,DRG,,,inpatient,,,37145.28,22287.17,United Healthcare/Oxford,United Healthcare/Oxford,,19119.99,,,19119.99,17806.5,29761.04,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Aetna,Commerical,,102287.07,,,102287.07,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Aetna,Middlesex Employees,,91974.92,,,91974.92,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Anthem,Commerical,,72797.4,,,72797.4,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Anthem,Indemnity,,,89661.83,,89661.83,58237.92,103465.02,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Anthem,State Preferred,,72797.4,,,72797.4,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Anthem,Individual Exchange,,58237.92,,,58237.92,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Cigna,Cigna,,77872.83,,,77872.83,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Connecticare,Commerical,,103465.02,,,103465.02,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Connecticare,Exchange,,103465.02,,,103465.02,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,Multiplan,Multiplan,,,98775.56,,98775.56,58237.92,103465.02,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,MS329,DRG,,,inpatient,,,123283.52,73970.11,United Healthcare/Oxford,United Healthcare/Oxford,,76479.96,,,76479.96,58237.92,103465.02,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Aetna,Commerical,,51546.24,,,51546.24,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Aetna,Middlesex Employees,,46349.57,,,46349.57,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Anthem,Commerical,,53917.7,,,53917.7,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Anthem,Indemnity,,,72463.93,,72463.93,26041.33,85483.41,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Anthem,State Preferred,,53917.7,,,53917.7,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Anthem,Individual Exchange,,43134.16,,,43134.16,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Cigna,Cigna,,85483.41,,,85483.41,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Connecticare,Commerical,,52745.73,,,52745.73,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Connecticare,Exchange,,52745.73,,,52745.73,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,Multiplan,Multiplan,,,79829.57,,79829.57,26041.33,85483.41,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,MS330,DRG,,,inpatient,,,99636.69,59782.01,United Healthcare/Oxford,United Healthcare/Oxford,,26041.33,,,26041.33,26041.33,85483.41,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Aetna,Commerical,,27383.94,,,27383.94,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Aetna,Middlesex Employees,,24623.21,,,24623.21,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Anthem,Commerical,,36321.92,,,36321.92,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Anthem,Indemnity,,,52355.4,,52355.4,24623.21,57677.1,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Anthem,State Preferred,,36321.92,,,36321.92,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Anthem,Individual Exchange,,29057.53,,,29057.53,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Cigna,Cigna,,40936.83,,,40936.83,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Connecticare,Commerical,,42312.51,,,42312.51,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Connecticare,Exchange,,42312.51,,,42312.51,24623.21,57677.1,per diem,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,Multiplan,Multiplan,,,57677.1,,57677.1,24623.21,57677.1,percent of total billed charges,,
MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,MS331,DRG,,,inpatient,,,71987.8,43192.68,United Healthcare/Oxford,United Healthcare/Oxford,,26174.09,,,26174.09,24623.21,57677.1,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Aetna,Commerical,,26661.82,,,26661.82,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Aetna,Middlesex Employees,,23995.64,,,23995.64,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Anthem,Commerical,,27269.83,,,27269.83,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Anthem,Indemnity,,,34151.26,,34151.26,14727.24,37622.59,percent of total billed charges,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Anthem,State Preferred,,27269.83,,,27269.83,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Anthem,Individual Exchange,,21815.86,,,21815.86,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Cigna,Cigna,,32574.17,,,32574.17,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Connecticare,Commerical,,14727.24,,,14727.24,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Connecticare,Exchange,,14727.24,,,14727.24,14727.24,37622.59,per diem,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,Multiplan,Multiplan,,,37622.59,,37622.59,14727.24,37622.59,percent of total billed charges,,
APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,MS340,DRG,,,inpatient,,,46957.42,28174.45,United Healthcare/Oxford,United Healthcare/Oxford,,30487.39,,,30487.39,14727.24,37622.59,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Aetna,Commerical,,36940.78,,,36940.78,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Aetna,Middlesex Employees,,33216.45,,,33216.45,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Anthem,Commerical,,27565.33,,,27565.33,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Anthem,Indemnity,,,27283.07,,27283.07,19610.59,38441.26,percent of total billed charges,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Anthem,State Preferred,,27565.33,,,27565.33,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Anthem,Individual Exchange,,22052.27,,,22052.27,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Cigna,Cigna,,34088.69,,,34088.69,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Connecticare,Commerical,,19610.59,,,19610.59,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Connecticare,Exchange,,19610.59,,,19610.59,19610.59,38441.26,per diem,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,Multiplan,Multiplan,,,30056.27,,300567.27,19610.59,38441.26,percent of total billed charges,,
MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,MS372,DRG,,,inpatient,,,37513.76,22508.26,United Healthcare/Oxford,United Healthcare/Oxford,,38441.26,,,38441.26,19610.59,38441.26,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Aetna,Commerical,,33796.88,,,33796.88,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Aetna,Middlesex Employees,,30389.52,,,30389.52,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Anthem,Commerical,,41046.16,,,41046.16,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Anthem,Indemnity,,,45643.54,,45643.54,27204.54,64048.39,percent of total billed charges,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Anthem,State Preferred,,41046.16,,,41046.16,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Anthem,Individual Exchange,,32836.93,,,32836.93,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Cigna,Cigna,,30955.74,,,30955.74,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Connecticare,Commerical,,64048.39,,,64048.39,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Connecticare,Exchange,,64048.39,,,64048.39,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,Multiplan,Multiplan,,,50283,,50283,27204.54,64048.39,percent of total billed charges,,
INFLAMMATORY BOWEL DISEASE W CC,MS386,DRG,,,inpatient,,,62759.09,37655.46,United Healthcare/Oxford,United Healthcare/Oxford,,27204.54,,,27204.54,27204.54,64048.39,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Aetna,Commerical,,25151.17,,,25151.17,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Aetna,Middlesex Employees,,22615.56,,,22615.56,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Anthem,Commerical,,25079.45,,,25079.45,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Anthem,Indemnity,,,31076.8,,31076.8,20063.56,34235.62,percent of total billed charges,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Anthem,State Preferred,,25079.45,,,25079.45,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Anthem,Individual Exchange,,20063.56,,,20063.56,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Cigna,Cigna,,31361.63,,,31361.63,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Connecticare,Commerical,,29725.29,,,29725.29,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Connecticare,Exchange,,29725.29,,,29725.29,20063.56,34235.62,per diem,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,Multiplan,Multiplan,,,34235.62,,34235.62,20063.56,34235.62,percent of total billed charges,,
INFLAMMATORY BOWEL DISEASE W/O CC/MCC,MS387,DRG,,,inpatient,,,42730.09,25638.05,United Healthcare/Oxford,United Healthcare/Oxford,,21504.87,,,21504.87,20063.56,34235.62,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Aetna,Commerical,,25937.14,,,25937.14,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Aetna,Middlesex Employees,,23322.19,,,23322.19,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Anthem,Commerical,,25636.14,,,25636.14,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Anthem,Indemnity,,,36304.07,,36304.07,20368.11,72867.54,percent of total billed charges,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Anthem,State Preferred,,25636.14,,,25636.14,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Anthem,Individual Exchange,,20508.92,,,20508.92,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Cigna,Cigna,,20368.11,,,20368.11,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Connecticare,Commerical,,25497.65,,,25497.65,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Connecticare,Exchange,,25497.65,,,25497.65,20368.11,72867.54,per diem,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,Multiplan,Multiplan,,,39994.22,,39994.22,20368.11,72867.54,percent of total billed charges,,
ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC,MS392,DRG,,,inpatient,,,49917.49,29950.49,United Healthcare/Oxford,United Healthcare/Oxford,,35311.11,,,35311.11,20368.11,72867.54,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Aetna,Commerical,,29867.01,,,29867.01,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Aetna,Middlesex Employees,,26855.85,,,26855.85,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Anthem,Commerical,,45024.08,,,45024.08,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Anthem,Indemnity,,,34041.38,,34041.38,14401.9,45024.08,percent of total billed charges,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Anthem,State Preferred,,45024.08,,,45024.08,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Anthem,Individual Exchange,,36019.26,,,36019.26,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Cigna,Cigna,,27174.51,,,27174.51,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Connecticare,Commerical,,14401.9,,,14401.9,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Connecticare,Exchange,,14401.9,,,14401.9,14401.9,45024.08,per diem,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,Multiplan,Multiplan,,,37501.54,,37501.54,14401.9,45024.08,percent of total billed charges,,
OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,MS394,DRG,,,inpatient,,,46806.33,28083.8,United Healthcare/Oxford,United Healthcare/Oxford,,28183.61,,,28183.61,14401.9,45024.08,per diem,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Aetna,Commerical,,108116.94,,,108116.94,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Aetna,Middlesex Employees,,97216.86,,,97216.86,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Anthem,Commerical,,120220,,,120220,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Anthem,Indemnity,,,113388.39,,113388.4,96176,152198,percent of total billed charges,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Anthem,State Preferred,,120220,,,120220,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Anthem,Individual Exchange,,96176,,,96176,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Cigna,Cigna,,152198,,,152198,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Connecticare,Commerical,,148379,,,148379,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Connecticare,Exchange,,148379,,,148379,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,Multiplan,Multiplan,,,124913.82,,124913.8,96176,152198,percent of total billed charges,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,MS457,DRG,,,inpatient,,,155907.14,93544.29,United Healthcare/Oxford,United Healthcare/Oxford,,131647,,,131647,96176,152198,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Aetna,Commerical,,100220.75,,,100220.75,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Aetna,Middlesex Employees,,90116.75,,,90116.75,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Anthem,Commerical,,108238,,,108238,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Anthem,Indemnity,,,105503.87,,105503.9,86590.4,133353,percent of total billed charges,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Anthem,State Preferred,,108238,,,108238,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Anthem,Individual Exchange,,86590.4,,,86590.4,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Cigna,Cigna,,133353,,,133353,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Connecticare,Commerical,,121518,,,121518,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Connecticare,Exchange,,121518,,,121518,86590.4,133353,case rate ,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,Multiplan,Multiplan,,,116227.87,,116227.9,86590.4,133353,percent of total billed charges,,
SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,MS458,DRG,,,inpatient,,,145066.05,87039.63,United Healthcare/Oxford,United Healthcare/Oxford,,112134,,,112134,86590.4,133353,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Aetna,Commerical,,75924.82,,,75924.82,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Aetna,Middlesex Employees,,57347.02,,,57347.02,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Anthem,Commerical,,101871,,,101871,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Anthem,Indemnity,,,113094.14,,113094.1,57347.02,124589.66,percent of total billed charges,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Anthem,State Preferred,,101871,,,101871,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Anthem,Individual Exchange,,81496.8,,,81496.8,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Cigna,Cigna,,104364,,,104364,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Connecticare,Commerical,,91255,,,91255,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Connecticare,Exchange,,91255,,,91255,57347.02,124589.66,case rate ,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,Multiplan,Multiplan,,,124589.66,,124589.7,57347.02,124589.66,percent of total billed charges,,
SPINAL FUSION EXCEPT CERVICAL W/O MCC,MS460,DRG,,,inpatient,,,155502.55,93301.53,United Healthcare/Oxford,United Healthcare/Oxford,,83629,,,83629,57347.02,124589.66,case rate ,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Aetna,Commerical,,16108.2,,,16108.2,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Aetna,Middlesex Employees,,14484.24,,,14484.24,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Anthem,Commerical,,19703.77,,,19703.77,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Anthem,Indemnity,,,223878.29,,223878.3,14484.24,246634.53,percent of total billed charges,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Anthem,State Preferred,,19703.77,,,19703.77,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Anthem,Individual Exchange,,15763.02,,,15763.02,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Cigna,Cigna,,17162.85,,,17162.85,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Connecticare,Commerical,,18989.27,,,18989.27,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Connecticare,Exchange,,18989.27,,,18989.27,14484.24,246634.53,per diem,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,Multiplan,Multiplan,,,246634.53,,246634.5,14484.24,246634.53,percent of total billed charges,,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,MS470,DRG,,,inpatient,,,307828.91,184697.35,United Healthcare/Oxford,United Healthcare/Oxford,,18937.39,,,18937.39,14484.24,246634.53,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Aetna,Commerical,,50616.55,,,50616.55,10925.5,43589.77,case rate ,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Aetna,Middlesex Employees,,38231.34,,,38231.34,10925.5,43589.77,case rate ,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Anthem,Commerical,,13656.88,,,13656.88,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Anthem,Indemnity,,,39567.87,,39567.87,10925.5,43589.77,percent of total billed charges,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Anthem,State Preferred,,13656.88,,,13656.88,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Anthem,Individual Exchange,,10925.5,,,10925.5,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Cigna,Cigna,,14246.48,,,14246.48,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Connecticare,Commerical,,14490.58,,,14490.58,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Connecticare,Exchange,,14490.58,,,14490.58,10925.5,43589.77,per diem,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,Multiplan,Multiplan,,,43589.77,,43589.77,10925.5,43589.77,percent of total billed charges,,
HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,MS482,DRG,,,inpatient,,,54405.16,32643.09,United Healthcare/Oxford,United Healthcare/Oxford,,21883.45,,,21883.45,10925.5,43589.77,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Aetna,Commerical,,23356.89,,,23356.89,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Aetna,Middlesex Employees,,21002.15,,,21002.15,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Anthem,Commerical,,18340.67,,,18340.67,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Anthem,Indemnity,,,35005.45,,35005.45,7553.01,38563.6,percent of total billed charges,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Anthem,State Preferred,,18340.67,,,18340.67,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Anthem,Individual Exchange,,14672.53,,,14672.53,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Cigna,Cigna,,18679.89,,,18679.89,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Connecticare,Commerical,,7553.01,,,7553.01,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Connecticare,Exchange,,7553.01,,,7553.01,7553.01,38563.6,per diem,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,Multiplan,Multiplan,,,38563.6,,38563.6,7553.01,38563.6,percent of total billed charges,,
OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,MS517,DRG,,,inpatient,,,48131.91,28879.15,United Healthcare/Oxford,United Healthcare/Oxford,,20625.59,,,20625.59,7553.01,38563.6,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Aetna,Commerical,,23579.22,,,23579.22,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Aetna,Middlesex Employees,,21201.99,,,21201.99,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Anthem,Commerical,,20502.23,,,20502.23,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Anthem,Indemnity,,,27686.23,,27686.23,16401.79,30925.63,percent of total billed charges,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Anthem,State Preferred,,20502.23,,,20502.23,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Anthem,Individual Exchange,,16401.79,,,16401.79,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Cigna,Cigna,,30925.63,,,30925.63,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Connecticare,Commerical,,23475.59,,,23475.59,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Connecticare,Exchange,,23475.59,,,23475.59,16401.79,30925.63,per diem,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,Multiplan,Multiplan,,,30500.41,,30500.41,16401.79,30925.63,percent of total billed charges,,
CONNECTIVE TISSUE DISORDERS W/O CC/MCC,MS547,DRG,,,inpatient,,,38068.11,22840.87,United Healthcare/Oxford,United Healthcare/Oxford,,24025.79,,,24025.79,16401.79,30925.63,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Aetna,Commerical,,30652.99,,,30652.99,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Aetna,Middlesex Employees,,27562.59,,,27562.59,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Anthem,Commerical,,24962.64,,,24962.64,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Anthem,Indemnity,,,19945.83,,19945.83,10034.13,24962.64,percent of total billed charges,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Anthem,State Preferred,,24962.64,,,24962.64,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Anthem,Individual Exchange,,19970.11,,,19970.11,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Cigna,Cigna,,17458.73,,,17458.73,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Connecticare,Commerical,,10034.13,,,10034.13,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Connecticare,Exchange,,10034.13,,,10034.13,10034.13,24962.64,per diem,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,Multiplan,Multiplan,,,21973.24,,21973.24,10034.13,24962.64,percent of total billed charges,,
CELLULITIS W/O MCC,MS603,DRG,,,inpatient,,,27425.19,16455.12,United Healthcare/Oxford,United Healthcare/Oxford,,12622.47,,,12622.47,10034.13,24962.64,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Aetna,Commerical,,7365.4,,,7365.4,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Aetna,Middlesex Employees,,6628.86,,,6628.86,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Anthem,Commerical,,14200.52,,,14200.52,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Anthem,Indemnity,,,17784.77,,17784.77,6628.86,45052.49,percent of total billed charges,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Anthem,State Preferred,,14200.52,,,14200.52,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Anthem,Individual Exchange,,11360.42,,,11360.42,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Cigna,Cigna,,45052.49,,,45052.49,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Connecticare,Commerical,,29950.19,,,29950.19,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Connecticare,Exchange,,29950.19,,,29950.19,6628.86,45052.49,per diem,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,Multiplan,Multiplan,,,19592.52,,19592.52,6628.86,45052.49,percent of total billed charges,,
DIABETES W CC,MS638,DRG,,,inpatient,,,24453.77,14672.26,United Healthcare/Oxford,United Healthcare/Oxford,,15246.82,,,15246.82,6628.86,45052.49,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Aetna,Commerical,,9058.7,,,9058.7,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Aetna,Middlesex Employees,,8152.84,,,8152.84,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Anthem,Commerical,,12396.37,,,12396.37,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Anthem,Indemnity,,,15781.41,,15781.41,8152.84,17385.52,percent of total billed charges,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Anthem,State Preferred,,12396.37,,,12396.37,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Anthem,Individual Exchange,,9917.1,,,9917.1,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Cigna,Cigna,,11269.46,,,11269.46,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Connecticare,Commerical,,12632.43,,,12632.43,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Connecticare,Exchange,,12632.43,,,12632.43,8152.84,17385.52,per diem,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,Multiplan,Multiplan,,,17385.52,,17385.52,8152.84,17385.52,percent of total billed charges,,
DIABETES W/O CC/MCC,MS639,DRG,,,inpatient,,,21699.17,13019.5,United Healthcare/Oxford,United Healthcare/Oxford,,10749,,,10749,8152.84,17385.52,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Aetna,Commerical,,40870.65,,,40870.65,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Aetna,Middlesex Employees,,36750.12,,,36750.12,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Anthem,Commerical,,35346.59,,,35346.59,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Anthem,Indemnity,,,43311.09,,43311.09,28277.27,96316.61,percent of total billed charges,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Anthem,State Preferred,,35346.59,,,35346.59,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Anthem,Individual Exchange,,28277.27,,,28277.27,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Cigna,Cigna,,39640.71,,,39640.71,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Connecticare,Commerical,,28448.32,,,28448.32,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Connecticare,Exchange,,28448.32,,,28448.32,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,Multiplan,Multiplan,,,47713.48,,47713.48,28277.27,96316.61,percent of total billed charges,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC,MS640,DRG,,,inpatient,,,59552.04,35731.22,United Healthcare/Oxford,United Healthcare/Oxford,,34526.24,,,34526.24,28277.27,96316.61,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Aetna,Commerical,,25194.88,,,25194.88,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Aetna,Middlesex Employees,,22654.85,,,22654.85,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Anthem,Commerical,,20989.62,,,20989.62,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Anthem,Indemnity,,,23564.52,,23564.52,16791.7,32898.55,percent of total billed charges,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Anthem,State Preferred,,20989.62,,,20989.62,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Anthem,Individual Exchange,,16791.7,,,16791.7,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Cigna,Cigna,,28059.47,,,28059.47,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Connecticare,Commerical,,32898.55,,,32898.55,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Connecticare,Exchange,,32898.55,,,32898.55,16791.7,32898.55,per diem,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,Multiplan,Multiplan,,,25959.75,,25959.75,16791.7,32898.55,percent of total billed charges,,
MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC,MS641,DRG,,,inpatient,,,32400.82,19440.49,United Healthcare/Oxford,United Healthcare/Oxford,,21525.6,,,21525.6,16791.7,32898.55,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Aetna,Commerical,,13721.31,,,13721.31,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Aetna,Middlesex Employees,,12349.18,,,12349.18,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Anthem,Commerical,,16989.4,,,16989.4,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Anthem,Indemnity,,,14116.58,,14116.58,11892.34,21735.88,percent of total billed charges,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Anthem,State Preferred,,16989.4,,,16989.4,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Anthem,Individual Exchange,,13591.52,,,13591.52,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Cigna,Cigna,,11892.34,,,11892.34,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Connecticare,Commerical,,21735.88,,,21735.88,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Connecticare,Exchange,,21735.88,,,21735.88,11892.34,21735.88,per diem,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,Multiplan,Multiplan,,,15551.47,,15551.47,11892.34,21735.88,percent of total billed charges,,
INBORN AND OTHER DISORDERS OF METABOLISM,MS642,DRG,,,inpatient,,,19410.07,11646.04,United Healthcare/Oxford,United Healthcare/Oxford,,13968.13,,,13968.13,11892.34,21735.88,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Aetna,Commerical,,30652.99,,,30652.99,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Aetna,Middlesex Employees,,27562.59,,,27562.59,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Anthem,Commerical,,23970.08,,,23970.08,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Anthem,Indemnity,,,39908.56,,39908.56,19176.07,58665.24,percent of total billed charges,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Anthem,State Preferred,,23970.08,,,23970.08,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Anthem,Individual Exchange,,19176.07,,,19176.07,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Cigna,Cigna,,58665.24,,,58665.24,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Connecticare,Commerical,,28981.17,,,28981.17,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Connecticare,Exchange,,28981.17,,,28981.17,19176.07,58665.24,per diem,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,Multiplan,Multiplan,,,43965.09,,43965.09,19176.07,58665.24,percent of total billed charges,,
RENAL FAILURE W CC,MS683,DRG,,,inpatient,,,54873.61,32924.17,United Healthcare/Oxford,United Healthcare/Oxford,,27944.86,,,27944.86,19176.07,58665.24,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Aetna,Commerical,,19425.43,,,19425.43,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Aetna,Middlesex Employees,,17482.89,,,17482.89,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Anthem,Commerical,,17383.89,,,17383.89,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Anthem,Indemnity,,,17978.79,,17978.79,13907.11,21437.67,percent of total billed charges,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Anthem,State Preferred,,17383.89,,,17383.89,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Anthem,Individual Exchange,,13907.11,,,13907.11,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Cigna,Cigna,,15296.01,,,15296.01,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Connecticare,Commerical,,17895.27,,,17895.27,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Connecticare,Exchange,,17895.27,,,17895.27,13907.11,21437.67,per diem,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,Multiplan,Multiplan,,,19806.25,,19806.25,13907.11,21437.67,percent of total billed charges,,
KIDNEY & URINARY TRACT INFECTIONS W/O MCC,MS690,DRG,,,inpatient,,,24720.53,14832.32,United Healthcare/Oxford,United Healthcare/Oxford,,21437.67,,,21437.67,13907.11,21437.67,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Aetna,Commerical,,14497.38,,,14497.38,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Aetna,Middlesex Employees,,13035.82,,,13035.82,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Anthem,Commerical,,15598.83,,,15598.83,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Anthem,Indemnity,,,42136.29,,42136.29,12479.06,46419.26,percent of total billed charges,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Anthem,State Preferred,,15598.83,,,15598.83,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Anthem,Individual Exchange,,12479.06,,,12479.06,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Cigna,Cigna,,13587.26,,,13587.26,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Connecticare,Commerical,,15033.17,,,15033.17,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Connecticare,Exchange,,15033.17,,,15033.17,12479.06,46419.26,per diem,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,Multiplan,Multiplan,,,46419.26,,46419.26,12479.06,46419.26,percent of total billed charges,,
UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,MS743,DRG,,,inpatient,,,57936.7,34762.02,United Healthcare/Oxford,United Healthcare/Oxford,,14992.1,,,14992.1,12479.06,46419.26,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Aetna,Commerical,,14147.53,,,14147.53,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Aetna,Middlesex Employees,,12721.19,,,12721.19,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Anthem,Commerical,,43817.48,,,43817.48,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Anthem,Indemnity,,,37009.36,,37009.36,12721.19,46108.98,percent of total billed charges,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Anthem,State Preferred,,43817.48,,,43817.48,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Anthem,Individual Exchange,,35053.98,,,35053.98,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Cigna,Cigna,,46108.98,,,46108.98,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Connecticare,Commerical,,25678.8,,,25678.8,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Connecticare,Exchange,,25678.8,,,25678.8,12721.19,46108.98,per diem,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,Multiplan,Multiplan,,,40771.2,,40771.2,12721.19,46108.98,percent of total billed charges,,
NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,MS789,DRG,,,inpatient,,,50887.25,30532.35,United Healthcare/Oxford,United Healthcare/Oxford,,23893.27,,,23893.27,12721.19,46108.98,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Aetna,Commerical,,305554.8,,,305554.8,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Aetna,Middlesex Employees,,274999.32,,,274999.32,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Anthem,Commerical,,376317.25,,,376317.25,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Anthem,Indemnity,,,330685.57,,330685.6,274999.32,417870.82,percent of total billed charges,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Anthem,State Preferred,,376317.25,,,376317.25,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Anthem,Individual Exchange,,301053.8,,,301053.8,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Cigna,Cigna,,417870.82,,,417870.82,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Connecticare,Commerical,,302121.76,,,302121.76,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Connecticare,Exchange,,302121.76,,,302121.76,274999.32,417870.82,per diem,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,Multiplan,Multiplan,,,364298.3,,364298.3,274999.32,417870.82,percent of total billed charges,,
EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE,MS790,DRG,,,inpatient,,,454687.14,272812.29,United Healthcare/Oxford,United Healthcare/Oxford,,364424.14,,,364424.14,274999.32,417870.82,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Aetna,Commerical,,167189.8,,,167189.8,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Aetna,Middlesex Employees,,150470.82,,,150470.82,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Anthem,Commerical,,165865.67,,,165865.67,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Anthem,Indemnity,,,120546.36,,120546.4,120546.36,167189.8,percent of total billed charges,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Anthem,State Preferred,,165865.67,,,165865.67,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Anthem,Individual Exchange,,132692.54,,,132692.54,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Cigna,Cigna,,121283.21,,,121283.21,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Connecticare,Commerical,,154784.07,,,154784.07,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Connecticare,Exchange,,154784.07,,,154784.07,120546.36,167189.8,per diem,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,Multiplan,Multiplan,,,132799.37,,132799.4,120546.36,167189.8,percent of total billed charges,,
PREMATURITY W MAJOR PROBLEMS,MS791,DRG,,,inpatient,,,165749.24,99449.54,United Healthcare/Oxford,United Healthcare/Oxford,,125534.41,,,125534.41,120546.36,167189.8,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Aetna,Commerical,,67593.76,,,67593.76,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Aetna,Middlesex Employees,,60779.04,,,60779.04,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Anthem,Commerical,,108704.34,,,108704.34,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Anthem,Indemnity,,,71115.1,,71115.1,57290.96,108704.34,percent of total billed charges,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Anthem,State Preferred,,108704.34,,,108704.34,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Anthem,Individual Exchange,,86963.47,,,86963.47,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Cigna,Cigna,,71041.97,,,71041.97,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Connecticare,Commerical,,57290.96,,,57290.96,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Connecticare,Exchange,,57290.96,,,57290.96,57290.96,108704.34,per diem,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,Multiplan,Multiplan,,,78343.64,,78343.64,57290.96,108704.34,percent of total billed charges,,
PREMATURITY W/O MAJOR PROBLEMS,MS792,DRG,,,inpatient,,,97782.08,58669.25,United Healthcare/Oxford,United Healthcare/Oxford,,69517.36,,,69517.36,57290.96,108704.34,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Aetna,Commerical,,36940.78,,,36940.78,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Aetna,Middlesex Employees,,33216.45,,,33216.45,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Anthem,Commerical,,55476.02,,,55476.02,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Anthem,Indemnity,,,49216.73,,49216.73,33216.45,62514.25,percent of total billed charges,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Anthem,State Preferred,,55476.02,,,55476.02,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Anthem,Individual Exchange,,44380.82,,,44380.82,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Cigna,Cigna,,43726.96,,,43726.96,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Connecticare,Commerical,,62514.25,,,62514.25,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Connecticare,Exchange,,62514.25,,,62514.25,33216.45,62514.25,per diem,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,Multiplan,Multiplan,,,54219.39,,54219.39,33216.45,62514.25,percent of total billed charges,,
FULL TERM NEONATE W MAJOR PROBLEMS,MS793,DRG,,,inpatient,,,67672.18,40603.31,United Healthcare/Oxford,United Healthcare/Oxford,,42007.49,,,42007.49,33216.45,62514.25,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Aetna,Commerical,,26723.12,,,26723.12,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Aetna,Middlesex Employees,,24028.92,,,24028.92,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Anthem,Commerical,,23794.69,,,23794.69,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Anthem,Indemnity,,,21415.74,,21415.74,19035.75,27658.55,percent of total billed charges,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Anthem,State Preferred,,23794.69,,,23794.69,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Anthem,Individual Exchange,,19035.75,,,19035.75,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Cigna,Cigna,,27658.55,,,27658.55,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Connecticare,Commerical,,23192.85,,,23192.85,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Connecticare,Exchange,,23192.85,,,23192.85,19035.75,27658.55,per diem,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,Multiplan,Multiplan,,,23592.56,,23592.56,19035.75,27658.55,percent of total billed charges,,
NEONATE W OTHER SIGNIFICANT PROBLEMS,MS794,DRG,,,inpatient,,,29446.29,17667.77,United Healthcare/Oxford,United Healthcare/Oxford,,22037.89,,,22037.89,19035.75,27658.55,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Aetna,Commerical,,7891.4,,,7891.4,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Aetna,Middlesex Employees,,7102.26,,,7102.26,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Anthem,Commerical,,8663.43,,,8663.43,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Anthem,Indemnity,,,6720.56,,6720.56,6720.56,10867.94,percent of total billed charges,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Anthem,State Preferred,,8663.43,,,8663.43,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Anthem,Individual Exchange,,6930.74,,,6930.74,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Cigna,Cigna,,7349.46,,,7349.46,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Connecticare,Commerical,,10867.94,,,10867.94,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Connecticare,Exchange,,10867.94,,,10867.94,6720.56,10867.94,per diem,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,Multiplan,Multiplan,,,7403.67,,7403.67,6720.56,10867.94,percent of total billed charges,,
NORMAL NEWBORN,MS795,DRG,,,inpatient,,,9240.66,5544.39,United Healthcare/Oxford,United Healthcare/Oxford,,8746.39,,,8746.39,6720.56,10867.94,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Aetna,Commerical,,40088.31,,,40088.31,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Aetna,Middlesex Employees,,36046.74,,,36046.74,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Anthem,Commerical,,37536.61,,,37536.61,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Anthem,Indemnity,,,42047.16,,42047.16,20344.79,49693.84,percent of total billed charges,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Anthem,State Preferred,,37536.61,,,37536.61,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Anthem,Individual Exchange,,30029.29,,,30029.29,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Cigna,Cigna,,33778.6,,,33778.6,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Connecticare,Commerical,,20344.79,,,20344.79,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Connecticare,Exchange,,20344.79,,,20344.79,20344.79,49693.84,per diem,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,Multiplan,Multiplan,,,46321.06,,46321.06,20344.79,49693.84,percent of total billed charges,,
MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,MS809,DRG,,,inpatient,,,57814.14,34688.48,United Healthcare/Oxford,United Healthcare/Oxford,,40179.85,,,40179.85,20344.79,49693.84,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Aetna,Commerical,,31924.91,,,31924.91,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Aetna,Middlesex Employees,,28706.29,,,28706.29,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Anthem,Commerical,,19807.01,,,19807.01,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Anthem,Indemnity,,,23649.22,,23649.22,14457.46,42105.6,percent of total billed charges,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Anthem,State Preferred,,19807.01,,,19807.01,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Anthem,Individual Exchange,,15845.61,,,15845.61,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Cigna,Cigna,,14457.46,,,14457.46,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Connecticare,Commerical,,39452.4,,,39452.4,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Connecticare,Exchange,,39452.4,,,39452.4,14457.46,42105.6,per diem,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,Multiplan,Multiplan,,,26053.06,,26053.06,14457.46,42105.6,percent of total billed charges,,
RED BLOOD CELL DISORDERS W/O MCC,MS812,DRG,,,inpatient,,,32517.29,19510.37,United Healthcare/Oxford,United Healthcare/Oxford,,42105.6,,,42105.6,14457.46,42105.6,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Aetna,Commerical,,50596.27,,,50596.27,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Aetna,Middlesex Employees,,45495.27,,,45495.27,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Anthem,Commerical,,12159.48,,,12159.48,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Anthem,Indemnity,,,23012.38,,23012.38,9727.58,68820.5,percent of total billed charges,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Anthem,State Preferred,,12159.48,,,12159.48,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Anthem,Individual Exchange,,9727.58,,,9727.58,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Cigna,Cigna,,56869.4,,,56869.4,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Connecticare,Commerical,,68820.5,,,68820.5,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Connecticare,Exchange,,68820.5,,,68820.5,9727.58,68820.5,per diem,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,Multiplan,Multiplan,,,25351.49,,25351.49,9727.58,68820.5,percent of total billed charges,,
COAGULATION DISORDERS,MS813,DRG,,,inpatient,,,31641.64,18984.98,United Healthcare/Oxford,United Healthcare/Oxford,,57310.4,,,57310.4,9727.58,68820.5,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Aetna,Commerical,,22793.25,,,22793.25,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Aetna,Middlesex Employees,,20495.26,,,20495.26,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Anthem,Commerical,,24950.07,,,24950.07,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Anthem,Indemnity,,,23519.19,,23519.19,10201.7,25909.81,percent of total billed charges,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Anthem,State Preferred,,24950.07,,,24950.07,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Anthem,Individual Exchange,,19960.06,,,19960.06,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Cigna,Cigna,,13195.77,,,13195.77,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Connecticare,Commerical,,21630.7,,,21630.7,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Connecticare,Exchange,,21630.7,,,21630.7,10201.7,25909.81,per diem,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,Multiplan,Multiplan,,,25909.81,,25909.81,10201.7,25909.81,percent of total billed charges,,
RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,MS816,DRG,,,inpatient,,,32338.49,19403.09,United Healthcare/Oxford,United Healthcare/Oxford,,10201.7,,,10201.7,10201.7,25909.81,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Aetna,Commerical,,57727.16,,,57727.16,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Aetna,Middlesex Employees,,51907.28,,,51907.28,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Anthem,Commerical,,20673.15,,,20673.15,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Anthem,Indemnity,,,66411.65,,66411.65,16538.52,218991.64,percent of total billed charges,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Anthem,State Preferred,,20673.15,,,20673.15,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Anthem,Individual Exchange,,16538.52,,,16538.52,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Cigna,Cigna,,58146,,,58146,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Connecticare,Commerical,,62396.24,,,62396.24,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Connecticare,Exchange,,62396.24,,,62396.24,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,Multiplan,Multiplan,,,73162.1,,73162.1,16538.52,218991.64,percent of total billed charges,,
CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,MS838,DRG,,,inpatient,,,91314.91,54788.94,United Healthcare/Oxford,United Healthcare/Oxford,,60064.47,,,60064.47,16538.52,218991.64,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Aetna,Commerical,,35368.83,,,35368.83,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Aetna,Middlesex Employees,,31802.96,,,31802.96,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Anthem,Commerical,,18413.52,,,18413.52,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Anthem,Indemnity,,,57908.51,,57908.51,14730.81,63794.65,percent of total billed charges,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Anthem,State Preferred,,18413.52,,,18413.52,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Anthem,Individual Exchange,,14730.81,,,14730.81,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Cigna,Cigna,,39645,,,39645,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Connecticare,Commerical,,16301.91,,,16301.91,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Connecticare,Exchange,,16301.91,,,16301.91,14730.81,63794.65,per diem,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,Multiplan,Multiplan,,,63794.65,,63794.65,14730.81,63794.65,percent of total billed charges,,
CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,MS839,DRG,,,inpatient,,,79623.23,47773.94,United Healthcare/Oxford,United Healthcare/Oxford,,24937.48,,,24937.48,14730.81,63794.65,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Aetna,Commerical,,69097.67,,,69097.67,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Aetna,Middlesex Employees,,62131.45,,,62131.45,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Anthem,Commerical,,27863.07,,,27863.07,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Anthem,Indemnity,,,29701.14,,29701.14,22290.45,92398.4,percent of total billed charges,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Anthem,State Preferred,,27863.07,,,27863.07,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Anthem,Individual Exchange,,22290.45,,,22290.45,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Cigna,Cigna,,58639.76,,,58639.76,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Connecticare,Commerical,,86576.1,,,86576.1,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Connecticare,Exchange,,86576.1,,,86576.1,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,Multiplan,Multiplan,,,32720.13,,32720.13,22290.45,92398.4,percent of total billed charges,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,MS846,DRG,,,inpatient,,,40838.57,24503.14,United Healthcare/Oxford,United Healthcare/Oxford,,92398.4,,,92398.4,22290.45,92398.4,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Aetna,Commerical,,36735.47,,,36735.47,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Aetna,Middlesex Employees,,33031.91,,,33031.91,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Anthem,Commerical,,24995.68,,,24995.68,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Anthem,Indemnity,,,37445.73,,37445.73,19996.55,49123.2,percent of total billed charges,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Anthem,State Preferred,,24995.68,,,24995.68,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Anthem,Individual Exchange,,19996.55,,,19996.55,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Cigna,Cigna,,26023.39,,,26023.39,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Connecticare,Commerical,,46027.8,,,46027.8,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Connecticare,Exchange,,46027.8,,,46027.8,19996.55,49123.2,per diem,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,Multiplan,Multiplan,,,41251.92,,41251.92,19996.55,49123.2,percent of total billed charges,,
CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,MS847,DRG,,,inpatient,,,51487.25,30892.35,United Healthcare/Oxford,United Healthcare/Oxford,,49123.2,,,49123.2,19996.55,49123.2,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Aetna,Commerical,,26723.12,,,26723.12,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Aetna,Middlesex Employees,,24028.92,,,24028.92,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Anthem,Commerical,,15040.82,,,15040.82,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Anthem,Indemnity,,,21424.52,,21424.52,12032.65,29874.77,percent of total billed charges,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Anthem,State Preferred,,15040.82,,,15040.82,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Anthem,Individual Exchange,,12032.65,,,12032.65,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Cigna,Cigna,,19931.97,,,19931.97,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Connecticare,Commerical,,27454.35,,,27454.35,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Connecticare,Exchange,,27454.35,,,27454.35,12032.65,29874.77,per diem,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,Multiplan,Multiplan,,,23602.23,,23602.23,12032.65,29874.77,percent of total billed charges,,
FEVER AND INFLAMMATORY CONDITIONS,MS864,DRG,,,inpatient,,,29458.36,17675.02,United Healthcare/Oxford,United Healthcare/Oxford,,28167.88,,,28167.88,12032.65,29874.77,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Aetna,Commerical,,29867.01,,,29867.01,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Aetna,Middlesex Employees,,26855.85,,,26855.85,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Anthem,Commerical,,16045.32,,,16045.32,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Anthem,Indemnity,,,17443.27,,17443.27,11862.43,26449.07,percent of total billed charges,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Anthem,State Preferred,,16045.32,,,16045.32,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Anthem,Individual Exchange,,12836.26,,,12836.26,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Cigna,Cigna,,14181.65,,,14181.65,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Connecticare,Commerical,,15031.79,,,15031.79,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Connecticare,Exchange,,15031.79,,,15031.79,11862.43,26449.07,per diem,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,Multiplan,Multiplan,,,19216.3,,19216.3,11862.43,26449.07,percent of total billed charges,,
VIRAL ILLNESS W/O MCC,MS866,DRG,,,inpatient,,,23984.2,14390.52,United Healthcare/Oxford,United Healthcare/Oxford,,11862.43,,,11862.43,11862.43,26449.07,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Aetna,Commerical,,54232.2,,,54232.2,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Aetna,Middlesex Employees,,48764.58,,,48764.58,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Anthem,Commerical,,52909.52,,,52909.52,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Anthem,Indemnity,,,67016.89,,67016.89,21705.66,73828.87,percent of total billed charges,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Anthem,State Preferred,,52909.52,,,52909.52,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Anthem,Individual Exchange,,42327.62,,,42327.62,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Cigna,Cigna,,43946.16,,,43946.16,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Connecticare,Commerical,,21705.66,,,21705.66,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Connecticare,Exchange,,21705.66,,,21705.66,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,Multiplan,Multiplan,,,73828.87,,73828.87,21705.66,73828.87,percent of total billed charges,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,MS871,DRG,,,inpatient,,,92147.11,55288.26,United Healthcare/Oxford,United Healthcare/Oxford,,38132.45,,,38132.45,21705.66,73828.87,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Aetna,Commerical,,33796.88,,,33796.88,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Aetna,Middlesex Employees,,30389.52,,,30389.52,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Anthem,Commerical,,26291.87,,,26291.87,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Anthem,Indemnity,,,27489.21,,27489.21,21033.5,56458.76,percent of total billed charges,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Anthem,State Preferred,,26291.87,,,26291.87,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Anthem,Individual Exchange,,21033.5,,,21033.5,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Cigna,Cigna,,27437.31,,,27437.31,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Connecticare,Commerical,,21735.88,,,21735.88,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Connecticare,Exchange,,21735.88,,,21735.88,21033.5,56458.76,per diem,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,Multiplan,Multiplan,,,30283.37,,30283.37,21033.5,56458.76,percent of total billed charges,,
SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,MS872,DRG,,,inpatient,,,37797.2,22678.32,United Healthcare/Oxford,United Healthcare/Oxford,,56458.76,,,56458.76,21033.5,56458.76,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Aetna,Commerical,,61223.08,,,61223.08,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Aetna,Middlesex Employees,,55100.78,,,55100.78,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Anthem,Commerical,,57214.44,,,57214.44,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Anthem,Indemnity,,,46145.91,,46145.91,33239.95,61223.08,percent of total billed charges,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Anthem,State Preferred,,57214.44,,,57214.44,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Anthem,Individual Exchange,,45771.55,,,45771.55,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Cigna,Cigna,,52341,,,52341,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Connecticare,Commerical,,33239.95,,,33239.95,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Connecticare,Exchange,,33239.95,,,33239.95,33239.95,61223.08,per diem,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,Multiplan,Multiplan,,,50836.43,,50836.43,33239.95,61223.08,percent of total billed charges,,
DISORDERS OF PERSONALITY & IMPULSE CONTROL,MS883,DRG,,,inpatient,,,63449.85,38069.91,United Healthcare/Oxford,United Healthcare/Oxford,,56783.34,,,56783.34,33239.95,61223.08,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Aetna,Commerical,,51088.31,,,51088.31,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Aetna,Middlesex Employees,,45937.65,,,45937.65,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Anthem,Commerical,,43279.2,,,43279.2,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Anthem,Indemnity,,,38355.75,,38355.75,30320.39,66853.97,percent of total billed charges,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Anthem,State Preferred,,43279.2,,,43279.2,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Anthem,Individual Exchange,,34623.36,,,34623.36,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Cigna,Cigna,,66853.97,,,66853.97,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Connecticare,Commerical,,40765.55,,,40765.55,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Connecticare,Exchange,,40765.55,,,40765.55,30320.39,66853.97,per diem,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,Multiplan,Multiplan,,,42254.44,,42254.44,30320.39,66853.97,percent of total billed charges,,
OTHER MENTAL DISORDER DIAGNOSES,MS887,DRG,,,inpatient,,,52738.51,31643.11,United Healthcare/Oxford,United Healthcare/Oxford,,30320.39,,,30320.39,30320.39,66853.97,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Aetna,Commerical,,44800.52,,,44800.52,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Aetna,Middlesex Employees,,40283.78,,,40283.78,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Anthem,Commerical,,46643.08,,,46643.08,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Anthem,Indemnity,,,57258.9,,57258.9,36226.46,63079.02,percent of total billed charges,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Anthem,State Preferred,,46643.08,,,46643.08,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Anthem,Individual Exchange,,37314.46,,,37314.46,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Cigna,Cigna,,41569.79,,,41569.79,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Connecticare,Commerical,,36226.46,,,36226.46,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Connecticare,Exchange,,36226.46,,,36226.46,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,Multiplan,Multiplan,,,63079.02,,63079.02,36226.46,63079.02,percent of total billed charges,,
POISONING & TOXIC EFFECTS OF DRUGS W MCC,MS917,DRG,,,inpatient,,,78730.04,47238.02,United Healthcare/Oxford,United Healthcare/Oxford,,51370.55,,,51370.55,36226.46,63079.02,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Aetna,Commerical,,27509.09,,,27509.09,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Aetna,Middlesex Employees,,24735.65,,,24735.65,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Anthem,Commerical,,30496.72,,,30496.72,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Anthem,Indemnity,,,23448.79,,23448.79,23448.79,30496.72,percent of total billed charges,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Anthem,State Preferred,,30496.72,,,30496.72,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Anthem,Individual Exchange,,24397.37,,,24397.37,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Cigna,Cigna,,24393.04,,,24393.04,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Connecticare,Commerical,,23706.59,,,23706.59,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Connecticare,Exchange,,23706.59,,,23706.59,23448.79,30496.72,per diem,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,Multiplan,Multiplan,,,25832.26,,25832.26,23448.79,30496.72,percent of total billed charges,,
POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,MS918,DRG,,,inpatient,,,32241.7,19345.02,United Healthcare/Oxford,United Healthcare/Oxford,,24963.19,,,24963.19,23448.79,30496.72,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Aetna,Commerical,,27509.09,,,27509.09,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Aetna,Middlesex Employees,,24735.65,,,24735.65,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Anthem,Commerical,,17850.12,,,17850.12,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Anthem,Indemnity,,,24597.45,,24597.45,7245.29,27097.68,percent of total billed charges,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Anthem,State Preferred,,17850.12,,,17850.12,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Anthem,Individual Exchange,,14280.09,,,14280.09,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Cigna,Cigna,,23931.27,,,23931.27,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Connecticare,Commerical,,7245.29,,,7245.29,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Connecticare,Exchange,,7245.29,,,7245.29,7245.29,27097.68,per diem,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,Multiplan,Multiplan,,,27097.68,,27097.68,7245.29,27097.68,percent of total billed charges,,
SIGNS & SYMPTOMS W/O MCC,MS948,DRG,,,inpatient,,,33821.09,20292.65,United Healthcare/Oxford,United Healthcare/Oxford,,23993.01,,,23993.01,7245.29,27097.68,per diem,,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Aetna,Commerical,,408.67,,,408.67,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Aetna,Middlesex Employees,,367.81,,,367.81,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Anthem,Commerical,,365.68,,,365.68,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Anthem,Indemnity,,,410.92,,410.92,292.54,452.68,percent of total billed charges,,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Anthem,State Preferred,,365.68,,,365.68,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Anthem,Individual Exchange,,292.54,,,292.54,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Cigna,Cigna,,357.12,,,357.12,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Connecticare,Commerical,,381.97,,,381.97,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Connecticare,Exchange,,381.97,,,381.97,292.54,452.68,other,Could be inpatient or outpatient,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,Multiplan,Multiplan,,,452.68,,452.68,292.54,452.68,percent of total billed charges,,
HC WHOLE BLOOD FOR TRANSFUSION 1UNIT,P9010,HCPCS,,,both,,,565.47,339.28,United Healthcare/Oxford,United Healthcare/Oxford,,367.52,,,367.52,292.54,452.68,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Commerical,,78.97,,,78.97,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Middlesex Employees,,71.07,,,71.07,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Commerical,,70.66,,,70.66,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Indemnity,,,79.4,,79.4,56.53,87.47,percent of total billed charges,,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,State Preferred,,70.66,,,70.66,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Individual Exchange,,56.53,,,56.53,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Cigna,Cigna,,69,,,69,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Commerical,,73.81,,,73.81,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Exchange,,73.81,,,73.81,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,Multiplan,Multiplan,,,87.47,,87.47,56.53,87.47,percent of total billed charges,,
HC SPLIT COMPONENT PLATELETS,P9011,HCPCS,,,both,,,506.76,304.06,United Healthcare/Oxford,United Healthcare/Oxford,,71.02,,,71.02,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Commerical,,78.97,,,78.97,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Middlesex Employees,,71.07,,,71.07,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Commerical,,70.66,,,70.66,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Indemnity,,,79.4,,79.4,56.53,87.47,percent of total billed charges,,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,State Preferred,,70.66,,,70.66,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Individual Exchange,,56.53,,,56.53,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Cigna,Cigna,,69,,,69,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Commerical,,73.81,,,73.81,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Exchange,,73.81,,,73.81,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,Multiplan,Multiplan,,,87.47,,87.47,56.53,87.47,percent of total billed charges,,
HC SPLIT COMPONENT RBC,P9011,HCPCS,,,both,,,506.76,304.06,United Healthcare/Oxford,United Healthcare/Oxford,,71.02,,,71.02,56.53,87.47,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Commerical,,366.34,,,366.34,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Aetna,Middlesex Employees,,329.71,,,329.71,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Commerical,,327.79,,,327.79,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Indemnity,,,368.36,,368.36,262.24,405.8,percent of total billed charges,,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,State Preferred,,327.79,,,327.79,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Anthem,Individual Exchange,,262.24,,,262.24,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Cigna,Cigna,,320.12,,,320.12,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Commerical,,342.4,,,342.4,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Connecticare,Exchange,,342.4,,,342.4,262.24,405.8,other,Could be inpatient or outpatient,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,Multiplan,Multiplan,,,405.8,,405.8,262.24,405.8,percent of total billed charges,,
HC SPLIT COMPONENTT FFP,P9011,HCPCS,,,both,,,506.76,304.06,United Healthcare/Oxford,United Healthcare/Oxford,,329.46,,,329.46,262.24,405.8,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Aetna,Commerical,,98.51,,,98.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Aetna,Middlesex Employees,,88.66,,,88.66,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Anthem,Commerical,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Anthem,Indemnity,,,99.05,,99.05,70.51,109.11,percent of total billed charges,,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Anthem,State Preferred,,88.14,,,88.14,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Anthem,Individual Exchange,,70.51,,,70.51,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Cigna,Cigna,,86.08,,,86.08,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Connecticare,Commerical,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Connecticare,Exchange,,92.06,,,92.06,70.51,109.11,other,Could be inpatient or outpatient,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,Multiplan,Multiplan,,,109.11,,109.11,70.51,109.11,percent of total billed charges,,
HC CRYOPRECIPITATE EACH UNIT,P9012,HCPCS,,,both,,,136.99,82.19,United Healthcare/Oxford,United Healthcare/Oxford,,88.59,,,88.59,70.51,109.11,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Aetna,Commerical,,389.95,,,389.95,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Aetna,Middlesex Employees,,350.96,,,350.96,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Anthem,Commerical,,348.92,,,348.92,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Anthem,Indemnity,,,392.09,,392.09,279.14,431.94,percent of total billed charges,,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Anthem,State Preferred,,348.92,,,348.92,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Anthem,Individual Exchange,,279.14,,,279.14,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Cigna,Cigna,,340.76,,,340.76,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Connecticare,Commerical,,364.47,,,364.47,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Connecticare,Exchange,,364.47,,,364.47,279.14,431.94,other,Could be inpatient or outpatient,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,Multiplan,Multiplan,,,431.94,,431.94,279.14,431.94,percent of total billed charges,,
HC RED BLOOD CELLS LEUKOCYTES EA UNIT,P9016,HCPCS,,,both,,,539.12,323.47,United Healthcare/Oxford,United Healthcare/Oxford,,350.68,,,350.68,279.14,431.94,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Aetna,Commerical,,94.44,,,94.44,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Aetna,Middlesex Employees,,85,,,85,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Anthem,Commerical,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Anthem,Indemnity,,,94.95,,94.95,67.6,104.6,percent of total billed charges,,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Anthem,State Preferred,,84.5,,,84.5,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Anthem,Individual Exchange,,67.6,,,67.6,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Cigna,Cigna,,82.52,,,82.52,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Connecticare,Commerical,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Connecticare,Exchange,,88.27,,,88.27,67.6,104.6,other,Could be inpatient or outpatient,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,Multiplan,Multiplan,,,104.6,,104.6,67.6,104.6,percent of total billed charges,,
HC FRESH FROZ PLASMA,P9017,HCPCS,,,both,,,130.55,78.33,United Healthcare/Oxford,United Healthcare/Oxford,,84.92,,,84.92,67.6,104.6,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Aetna,Commerical,,55.36,,,55.36,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Aetna,Middlesex Employees,,49.83,,,49.83,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Anthem,Commerical,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Anthem,Indemnity,,,55.66,,55.66,39.63,61.32,percent of total billed charges,,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Anthem,State Preferred,,49.54,,,49.54,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Anthem,Individual Exchange,,39.63,,,39.63,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Cigna,Cigna,,48.37,,,48.37,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Connecticare,Commerical,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Connecticare,Exchange,,51.74,,,51.74,39.63,61.32,other,Could be inpatient or outpatient,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,Multiplan,Multiplan,,,61.32,,61.32,39.63,61.32,percent of total billed charges,,
HC PEDI BLOOD COMP,P9017,HCPCS,,,both,,,76.53,45.92,United Healthcare/Oxford,United Healthcare/Oxford,,49.78,,,49.78,39.63,61.32,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Aetna,Commerical,,569.86,,,569.86,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Aetna,Middlesex Employees,,512.88,,,512.88,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Anthem,Commerical,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Anthem,Indemnity,,,572.99,,572.99,407.92,631.24,percent of total billed charges,,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Anthem,State Preferred,,509.9,,,509.9,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Anthem,Individual Exchange,,407.92,,,407.92,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Cigna,Cigna,,497.97,,,497.97,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Connecticare,Commerical,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Connecticare,Exchange,,532.63,,,532.63,407.92,631.24,other,Could be inpatient or outpatient,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,Multiplan,Multiplan,,,631.24,,631.24,407.92,631.24,percent of total billed charges,,
HC WASHED RED CELLS,P9022,HCPCS,,,both,,,787.86,472.71,United Healthcare/Oxford,United Healthcare/Oxford,,512.49,,,512.49,407.92,631.24,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Aetna,Commerical,,242.6,,,242.6,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Aetna,Middlesex Employees,,218.34,,,218.34,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Anthem,Commerical,,217.07,,,217.07,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Anthem,Indemnity,,,243.93,,243.93,173.65,268.73,percent of total billed charges,,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Anthem,State Preferred,,217.07,,,217.07,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Anthem,Individual Exchange,,173.65,,,173.65,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Cigna,Cigna,,211.99,,,211.99,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Connecticare,Commerical,,226.74,,,226.74,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Connecticare,Exchange,,226.74,,,226.74,173.65,268.73,other,Could be inpatient or outpatient,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,Multiplan,Multiplan,,,268.73,,268.73,173.65,268.73,percent of total billed charges,,
HC OCTAPLAS THAWED,P9023,HCPCS,,,both,,,335.4,201.24,United Healthcare/Oxford,United Healthcare/Oxford,,218.17,,,218.17,173.65,268.73,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Aetna,Commerical,,214.92,,,214.92,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Aetna,Middlesex Employees,,193.43,,,193.43,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Anthem,Commerical,,192.3,,,192.3,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Anthem,Indemnity,,,216.1,,216.1,153.84,238.07,percent of total billed charges,,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Anthem,State Preferred,,192.3,,,192.3,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Anthem,Individual Exchange,,153.84,,,153.84,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Cigna,Cigna,,187.8,,,187.8,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Connecticare,Commerical,,200.88,,,200.88,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Connecticare,Exchange,,200.88,,,200.88,153.84,238.07,other,Could be inpatient or outpatient,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,Multiplan,Multiplan,,,238.07,,238.07,153.84,238.07,percent of total billed charges,,
HC PLATELET LEUKORED,P9031,HCPCS,,,both,,,296.64,177.98,United Healthcare/Oxford,United Healthcare/Oxford,,193.28,,,193.28,153.84,238.07,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Aetna,Commerical,,288.19,,,288.19,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Aetna,Middlesex Employees,,259.37,,,259.37,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Anthem,Commerical,,257.86,,,257.86,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Anthem,Indemnity,,,289.77,,289.77,206.29,319.23,percent of total billed charges,,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Anthem,State Preferred,,257.86,,,257.86,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Anthem,Individual Exchange,,206.29,,,206.29,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Cigna,Cigna,,251.84,,,251.84,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Connecticare,Commerical,,269.36,,,269.36,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Connecticare,Exchange,,269.36,,,269.36,206.29,319.23,other,Could be inpatient or outpatient,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,Multiplan,Multiplan,,,319.23,,319.23,206.29,319.23,percent of total billed charges,,
HC IRRAD PLTS 5 DAY POOLED,P9033,HCPCS,,,both,,,398.61,239.17,United Healthcare/Oxford,United Healthcare/Oxford,,259.17,,,259.17,206.29,319.23,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Aetna,Commerical,,1129.15,,,1129.15,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Aetna,Middlesex Employees,,1016.23,,,1016.23,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Anthem,Commerical,,1010.34,,,1010.34,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Anthem,Indemnity,,,1135.35,,1135.35,808.27,1250.75,percent of total billed charges,,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Anthem,State Preferred,,1010.34,,,1010.34,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Anthem,Individual Exchange,,808.27,,,808.27,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Cigna,Cigna,,986.7,,,986.7,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Connecticare,Commerical,,1055.36,,,1055.36,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Connecticare,Exchange,,1055.36,,,1055.36,808.27,1250.75,other,Could be inpatient or outpatient,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,Multiplan,Multiplan,,,1250.75,,1250.75,808.27,1250.75,percent of total billed charges,,
HC PLATELET SD,P9035,HCPCS,,,both,,,1561.08,936.65,United Healthcare/Oxford,United Healthcare/Oxford,,1015.46,,,1015.46,808.27,1250.75,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Aetna,Commerical,,1199.97,,,1199.97,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Aetna,Middlesex Employees,,1079.98,,,1079.98,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Anthem,Commerical,,1073.71,,,1073.71,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Anthem,Indemnity,,,1206.56,,1206.56,858.97,1329.2,percent of total billed charges,,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Anthem,State Preferred,,1073.71,,,1073.71,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Anthem,Individual Exchange,,858.97,,,858.97,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Cigna,Cigna,,1048.59,,,1048.59,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Connecticare,Commerical,,1121.56,,,1121.56,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Connecticare,Exchange,,1121.56,,,1121.56,858.97,1329.2,other,Could be inpatient or outpatient,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,Multiplan,Multiplan,,,1329.2,,1329.2,858.97,1329.2,percent of total billed charges,,
HC IRRAD PHERESIS PLATELETS,P9037,HCPCS,,,both,,,1659.33,995.6,United Healthcare/Oxford,United Healthcare/Oxford,,1079.15,,,1079.15,858.97,1329.2,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Aetna,Commerical,,224.69,,,224.69,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Aetna,Middlesex Employees,,202.22,,,202.22,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Anthem,Commerical,,201.05,,,201.05,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Anthem,Indemnity,,,225.92,,225.92,160.84,248.89,percent of total billed charges,,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Anthem,State Preferred,,201.05,,,201.05,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Anthem,Individual Exchange,,160.84,,,160.84,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Cigna,Cigna,,196.34,,,196.34,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Connecticare,Commerical,,210.01,,,210.01,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Connecticare,Exchange,,210.01,,,210.01,160.84,248.89,other,Could be inpatient or outpatient,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,Multiplan,Multiplan,,,248.89,,248.89,160.84,248.89,percent of total billed charges,,
HC RBC DEGLYC,P9039,HCPCS,,,both,,,311.06,186.64,United Healthcare/Oxford,United Healthcare/Oxford,,202.07,,,202.07,160.84,248.89,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Aetna,Commerical,,490.08,,,490.08,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Aetna,Middlesex Employees,,441.08,,,441.08,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Anthem,Commerical,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Anthem,Indemnity,,,492.77,,492.77,350.81,542.86,percent of total billed charges,,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Anthem,State Preferred,,438.52,,,438.52,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Anthem,Individual Exchange,,350.81,,,350.81,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Cigna,Cigna,,428.26,,,428.26,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Connecticare,Commerical,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Connecticare,Exchange,,458.06,,,458.06,350.81,542.86,other,Could be inpatient or outpatient,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,Multiplan,Multiplan,,,542.86,,542.86,350.81,542.86,percent of total billed charges,,
HC IRRAD RED CELLS EA UNIT,P9040,HCPCS,,,both,,,677.74,406.64,United Healthcare/Oxford,United Healthcare/Oxford,,440.74,,,440.74,350.81,542.86,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Aetna,Commerical,,144.09,,,144.09,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Aetna,Middlesex Employees,,129.68,,,129.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Anthem,Commerical,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Anthem,Indemnity,,,144.89,,144.89,103.15,159.61,percent of total billed charges,,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Anthem,State Preferred,,128.93,,,128.93,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Anthem,Individual Exchange,,103.15,,,103.15,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Cigna,Cigna,,125.91,,,125.91,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Connecticare,Commerical,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Connecticare,Exchange,,134.68,,,134.68,103.15,159.61,other,Could be inpatient or outpatient,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,Multiplan,Multiplan,,,159.61,,159.61,103.15,159.61,percent of total billed charges,,
HC CRYO REDUCED PLASMA THAWED,P9044,HCPCS,,,both,,,199.21,119.53,United Healthcare/Oxford,United Healthcare/Oxford,,129.58,,,129.58,103.15,159.61,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Anthem,Indemnity,,,48.29,,49.29,34.38,53.2,percent of total billed charges,,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC SER ALBUMIN (HUMAN)  5%  250,P9045,HCPCS,,,both,,,66.4,39.84,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Aetna,Commerical,,48.03,,,48.03,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Aetna,Middlesex Employees,,43.23,,,43.23,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Anthem,Commerical,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Anthem,Indemnity,,,48.29,,48.29,34.38,53.2,percent of total billed charges,,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Anthem,State Preferred,,42.97,,,42.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Anthem,Individual Exchange,,34.38,,,34.38,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Cigna,Cigna,,41.97,,,41.97,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Connecticare,Commerical,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Connecticare,Exchange,,44.9,,,44.9,34.38,53.2,other,Could be inpatient or outpatient,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,Multiplan,Multiplan,,,53.2,,53.2,34.38,53.2,percent of total billed charges,,
HC SER ALB 12.5 GM,P9047,HCPCS,,,both,,,66.4,39.84,United Healthcare/Oxford,United Healthcare/Oxford,,43.2,,,43.2,34.38,53.2,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Aetna,Commerical,,2916.07,,,2916.07,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Aetna,Middlesex Employees,,2624.47,,,2624.47,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Anthem,Commerical,,2609.24,,,2609.24,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Anthem,Indemnity,,,2932.09,,2932.09,2087.39,3230.12,percent of total billed charges,,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Anthem,State Preferred,,2609.24,,,2609.24,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Anthem,Individual Exchange,,2087.39,,,2087.39,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Cigna,Cigna,,2548.21,,,2548.21,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Connecticare,Commerical,,2725.53,,,2725.53,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Connecticare,Exchange,,2725.53,,,2725.53,2087.39,3230.12,other,Could be inpatient or outpatient,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,Multiplan,Multiplan,,,3230.12,,3230.12,2087.39,3230.12,percent of total billed charges,,
HC GRANULOCYTES-PLTS,P9050,HCPCS,,,both,,,4031.42,2418.85,United Healthcare/Oxford,United Healthcare/Oxford,,2622.48,,,2622.48,2087.39,3230.12,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Aetna,Commerical,,1132.41,,,1132.41,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Aetna,Middlesex Employees,,1019.16,,,1019.16,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Anthem,Commerical,,1013.24,,,1013.24,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Anthem,Indemnity,,,1138.62,,1138.62,810.59,1254.35,percent of total billed charges,,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Anthem,State Preferred,,1013.24,,,1013.24,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Anthem,Individual Exchange,,810.59,,,810.59,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Cigna,Cigna,,989.55,,,989.55,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Connecticare,Commerical,,1058.41,,,1058.41,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Connecticare,Exchange,,1058.41,,,1058.41,810.59,1254.35,other,Could be inpatient or outpatient,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,Multiplan,Multiplan,,,1254.35,,1254.35,810.59,1254.35,percent of total billed charges,,
HC PLATELETS SD HLA,P9052,HCPCS,,,both,,,1565.6,939.36,United Healthcare/Oxford,United Healthcare/Oxford,,1018.39,,,1018.39,810.59,1254.35,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Aetna,Commerical,,822.23,,,822.23,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Aetna,Middlesex Employees,,740.01,,,740.01,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Anthem,Commerical,,735.71,,,735.71,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Anthem,Indemnity,,,826.75,,826.75,588.56,910.78,percent of total billed charges,,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Anthem,State Preferred,,735.71,,,735.71,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Anthem,Individual Exchange,,588.56,,,588.56,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Cigna,Cigna,,718.5,,,718.5,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Connecticare,Commerical,,768.5,,,768.5,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Connecticare,Exchange,,768.5,,,768.5,588.56,910.78,other,Could be inpatient or outpatient,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,Multiplan,Multiplan,,,910.78,,910.78,588.56,910.78,percent of total billed charges,,
HC IRRAD DEGLYC RBC,P9057,HCPCS,,,both,,,1136.09,681.65,United Healthcare/Oxford,United Healthcare/Oxford,,739.45,,,739.45,588.56,910.78,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Aetna,Commerical,,131.07,,,131.07,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Aetna,Middlesex Employees,,117.96,,,117.96,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Anthem,Commerical,,117.28,,,117.28,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Anthem,Indemnity,,,131.78,,131.78,93.82,145.18,percent of total billed charges,,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Anthem,State Preferred,,117.28,,,117.28,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Anthem,Individual Exchange,,93.82,,,93.82,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Cigna,Cigna,,114.54,,,114.54,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Connecticare,Commerical,,122.5,,,122.5,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Connecticare,Exchange,,122.5,,,122.5,93.82,145.18,other,Could be inpatient or outpatient,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,Multiplan,Multiplan,,,145.18,,145.18,93.82,145.18,percent of total billed charges,,
HC THAWED PLAS FROZEN W/I  8- 24 HRS,P9059,HCPCS,,,both,,,181.28,108.77,United Healthcare/Oxford,United Healthcare/Oxford,,117.87,,,117.87,93.82,145.18,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Aetna,Commerical,,1235.79,,,1235.79,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Aetna,Middlesex Employees,,1112.22,,,1112.22,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Anthem,Commerical,,1105.75,,,1105.75,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Anthem,Indemnity,,,1242.58,,1242.58,884.6,1368.88,percent of total billed charges,,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Anthem,State Preferred,,1105.75,,,1105.75,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Anthem,Individual Exchange,,884.6,,,884.6,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Cigna,Cigna,,1281.58,,,1281.58,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Connecticare,Commerical,,1193.1,,,1193.1,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Connecticare,Exchange,,1193.1,,,1193.1,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,Multiplan,Multiplan,,,1368.88,,1368.88,884.6,1368.88,percent of total billed charges,,
HC PLAT PHERESIS PATH RED/RAPID BAC TEST EA UNIT,P9072,HCPCS,,,both,,,1708.52,1025.11,United Healthcare/Oxford,United Healthcare/Oxford,,1040.84,,,1040.84,884.6,1368.88,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Aetna,Commerical,,1199.97,,,1199.97,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Aetna,Middlesex Employees,,1079.98,,,1079.98,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Anthem,Commerical,,1073.71,,,1073.71,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Anthem,Indemnity,,,1206.56,,1206.56,858.97,1329.2,percent of total billed charges,,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Anthem,State Preferred,,1073.71,,,1073.71,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Anthem,Individual Exchange,,858.97,,,858.97,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Cigna,Cigna,,1048.59,,,1048.59,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Connecticare,Commerical,,1121.56,,,1121.56,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Connecticare,Exchange,,1121.56,,,1121.56,858.97,1329.2,other,Could be inpatient or outpatient,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,Multiplan,Multiplan,,,1329.2,,1329.2,858.97,1329.2,percent of total billed charges,,
HC PLATELETS PHERESIS PATHOGEN-REDUCED EACH UNIT,P9073,HCPCS,,,both,,,1659,995.4,United Healthcare/Oxford,United Healthcare/Oxford,,1079.15,,,1079.15,858.97,1329.2,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Aetna,Commerical,,1231.72,,,1231.72,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Aetna,Middlesex Employees,,1108.55,,,1108.55,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Commerical,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Indemnity,,,1238.48,,1238.48,881.69,1364.37,percent of total billed charges,,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Anthem,State Preferred,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Individual Exchange,,881.69,,,881.69,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Cigna,Cigna,,1076.34,,,1076.34,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Connecticare,Commerical,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Connecticare,Exchange,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,Multiplan,Multiplan,,,1364.37,,1364.37,881.69,1364.37,percent of total billed charges,,
HC AET NEWONSET CARE,S0315,HCPCS,,,both,,,1653,963.08,United Healthcare/Oxford,United Healthcare/Oxford,,1107.7,,,1107.7,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Aetna,Commerical,,1231.72,,,1231.72,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Aetna,Middlesex Employees,,1108.55,,,1108.55,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Commerical,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Indemnity,,,1238.48,,1238.48,881.69,1364.37,percent of total billed charges,,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Anthem,State Preferred,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Anthem,Individual Exchange,,881.69,,,881.69,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Cigna,Cigna,,1076.34,,,1076.34,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Connecticare,Commerical,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Connecticare,Exchange,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,Multiplan,Multiplan,,,1364.37,,1364.37,881.69,1364.37,percent of total billed charges,,
HC HNI NEW ONSET,S0315,HCPCS,,,both,,,1653,963.08,United Healthcare/Oxford,United Healthcare/Oxford,,1107.7,,,1107.7,881.69,1364.37,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Anthem,Indemnity,,,194,,194,138.11,213.72,percent of total billed charges,,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC ESTABLISHED MAINTENANCE CARE,S0316,HCPCS,,,both,,,259,150.86,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Aetna,Commerical,,139.21,,,139.21,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Aetna,Middlesex Employees,,125.29,,,125.29,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Anthem,Commerical,,124.56,,,124.56,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Anthem,Indemnity,,,139.97,,139.97,99.65,154.2,percent of total billed charges,,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Anthem,State Preferred,,124.56,,,124.56,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Anthem,Individual Exchange,,99.65,,,99.65,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Cigna,Cigna,,121.65,,,121.65,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Connecticare,Commerical,,130.12,,,130.12,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Connecticare,Exchange,,130.12,,,130.12,99.65,154.2,other,Could be inpatient or outpatient,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,Multiplan,Multiplan,,,154.2,,154.2,99.65,154.2,percent of total billed charges,,
HC HNI EST OP CARE,S0316,HCPCS,,,both,,,186,108.85,United Healthcare/Oxford,United Healthcare/Oxford,,125.2,,,125.2,99.65,154.2,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Aetna,Commerical,,1231.72,,,1231.72,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Aetna,Middlesex Employees,,1108.55,,,1108.55,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Anthem,Commerical,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Anthem,Indemnity,,,1238.48,,1238.48,881.69,1364.37,percent of total billed charges,,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Anthem,State Preferred,,1102.11,,,1102.11,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Anthem,Individual Exchange,,881.69,,,881.69,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Cigna,Cigna,,1076.34,,,1076.34,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Connecticare,Commerical,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Connecticare,Exchange,,1151.24,,,1151.24,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,Multiplan,Multiplan,,,1364.37,,1364.37,881.69,1364.37,percent of total billed charges,,
HC CTC NEW ONSET,S9140,HCPCS,,,both,,,1653,963.08,United Healthcare/Oxford,United Healthcare/Oxford,,1107.7,,,1107.7,881.69,1364.37,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Aetna,Commerical,,192.94,,,192.94,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Aetna,Middlesex Employees,,173.65,,,173.65,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Anthem,Commerical,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Anthem,Indemnity,,,194,,194,138.11,213.72,percent of total billed charges,,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Anthem,State Preferred,,172.64,,,172.64,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Anthem,Individual Exchange,,138.11,,,138.11,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Cigna,Cigna,,168.6,,,168.6,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Connecticare,Commerical,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Connecticare,Exchange,,180.33,,,180.33,138.11,213.72,other,Could be inpatient or outpatient,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,Multiplan,Multiplan,,,213.72,,213.72,138.11,213.72,percent of total billed charges,,
HC CTC EST. CARE,S9141,HCPCS,,,both,,,259,150.86,United Healthcare/Oxford,United Healthcare/Oxford,,173.51,,,173.51,138.11,213.72,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Aetna,Commerical,,535.68,,,535.68,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Aetna,Middlesex Employees,,482.1,,,482.1,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Commerical,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Indemnity,,,538.61,,538.61,383.45,593.36,percent of total billed charges,,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,State Preferred,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Individual Exchange,,383.45,,,383.45,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Cigna,Cigna,,468.09,,,468.09,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Connecticare,Commerical,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Connecticare,Exchange,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Multiplan,Multiplan,,,593.36,,593.36,383.45,593.36,percent of total billed charges,,
HC AET INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,United Healthcare/Oxford,United Healthcare/Oxford,,481.74,,,481.74,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Aetna,Commerical,,535.68,,,535.68,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Aetna,Middlesex Employees,,482.1,,,482.1,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Commerical,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Indemnity,,,538.61,,538.61,383.45,593.36,percent of total billed charges,,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,State Preferred,,479.31,,,479.31,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Anthem,Individual Exchange,,383.45,,,383.45,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Cigna,Cigna,,468.09,,,468.09,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Connecticare,Commerical,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Connecticare,Exchange,,500.67,,,500.67,383.45,593.36,other,Could be inpatient or outpatient,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,Multiplan,Multiplan,,,593.36,,593.36,383.45,593.36,percent of total billed charges,,
HC HNI INSULIN PUMP,S9145,HCPCS,,,both,,,719,418.84,United Healthcare/Oxford,United Healthcare/Oxford,,481.74,,,481.74,383.45,593.36,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Aetna,Commerical,,33.54,,,33.54,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Aetna,Middlesex Employees,,30.19,,,30.19,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Anthem,Commerical,,30.02,,,30.02,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Anthem,Indemnity,,,33.73,,33.73,24.01,37.15,percent of total billed charges,,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Anthem,State Preferred,,30.02,,,30.02,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Anthem,Individual Exchange,,24.01,,,24.01,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Cigna,Cigna,,34.79,,,34.79,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Connecticare,Commerical,,32.38,,,32.38,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Connecticare,Exchange,,32.38,,,32.38,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,Multiplan,Multiplan,,,37.15,,37.15,24.01,37.15,percent of total billed charges,,
HC SARS-COV-2/2019 COVID-19 CDC LABS,U0001,HCPCS,,,both,,,45.02,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,28.25,,,28.25,24.01,37.15,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Indemnity,,,47.47,,47.47,33.8,52.3,percent of total billed charges,,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Cigna,Cigna,,48.96,,,48.96,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Commerical,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Exchange,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC SARS COVID-19 NEWINGTON/INHOUSE,U0002,HCPCS,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Indemnity,,,47.47,,47.47,33.8,52.3,percent of total billed charges,,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Cigna,Cigna,,48.96,,,48.96,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Commerical,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Exchange,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC SARS COVID-19 NUCL ACID AMPL (NAA),U0002,HCPCS,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Indemnity,,,47.47,,47.47,33.8,52.3,percent of total billed charges,,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Cigna,Cigna,,48.96,,,48.96,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Commerical,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Exchange,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC SARS-COV-2 QUAL RT PCR -JAXSN LAB,U0002,HCPCS,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Commerical,,47.22,,,47.22,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Aetna,Middlesex Employees,,42.5,,,42.5,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Commerical,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Indemnity,,,47.47,,47.47,33.8,52.3,percent of total billed charges,,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,State Preferred,,42.25,,,42.25,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Anthem,Individual Exchange,,33.8,,,33.8,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Cigna,Cigna,,48.96,,,48.96,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Commerical,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Connecticare,Exchange,,45.59,,,45.59,33.8,52.3,other,Could be inpatient or outpatient,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,Multiplan,Multiplan,,,52.3,,52.3,33.8,52.3,percent of total billed charges,,
HC SARS-COV-2/2019 NCOV COVID-19 NON-CDD LABS,U0002,HCPCS,,,both,,,63.86,38.32,United Healthcare/Oxford,United Healthcare/Oxford,,39.77,,,39.77,33.8,52.3,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Aetna,Commerical,,89.14,,,89.14,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Aetna,Middlesex Employees,,80.23,,,80.23,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Anthem,Commerical,,103.57,,,103.57,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Anthem,Indemnity,,,92.19,,92.19,80.23,132.08,percent of total billed charges,,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Anthem,State Preferred,,103.57,,,103.57,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Anthem,Individual Exchange,,82.86,,,82.86,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Cigna,Cigna,,132.08,,,132.08,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Connecticare,Commerical,,88.53,,,88.53,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Connecticare,Exchange,,88.53,,,88.53,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,Multiplan,Multiplan,,,101.56,,101.56,80.23,132.08,percent of total billed charges,,
Cov-19 amp prb hgh thruput,U0003,HCPCS,,,both,,,126.75,76.05,United Healthcare/Oxford,United Healthcare/Oxford,,127.31,,,127.31,80.23,132.08,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Aetna,Commerical,,91.99,,,91.99,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Aetna,Middlesex Employees,,82.79,,,82.79,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Anthem,Commerical,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Anthem,Indemnity,,,92.5,,92.5,65.85,101.9,percent of total billed charges,,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Anthem,State Preferred,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Anthem,Individual Exchange,,65.85,,,65.85,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Cigna,Cigna,,95.4,,,95.4,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Connecticare,Commerical,,88.81,,,88.81,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Connecticare,Exchange,,88.81,,,88.81,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,Multiplan,Multiplan,,,101.9,,101.9,65.85,101.9,percent of total billed charges,,
HC SARS-COVID-19 NUCL ACID AMP PROBE HGH THRGHPUT TECH,U0003,HCPCS,,,both,,,122.57,73.54,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,65.85,101.9,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Aetna,Commerical,,89.14,,,89.14,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Aetna,Middlesex Employees,,80.23,,,80.23,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Anthem,Commerical,,103.57,,,103.57,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Anthem,Indemnity,,,92.19,,92.19,80.23,132.08,percent of total billed charges,,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Anthem,State Preferred,,103.57,,,103.57,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Anthem,Individual Exchange,,82.86,,,82.86,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Cigna,Cigna,,132.08,,,132.08,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Connecticare,Commerical,,88.53,,,88.53,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Connecticare,Exchange,,88.53,,,88.53,80.23,132.08,other,Could be inpatient or outpatient,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,Multiplan,Multiplan,,,101.56,,101.56,80.23,132.08,percent of total billed charges,,
Cov-19 test non-cdc hgh thru,U0004,HCPCS,,,both,,,126.75,76.05,United Healthcare/Oxford,United Healthcare/Oxford,,127.31,,,127.31,80.23,132.08,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Aetna,Commerical,,91.99,,,91.99,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Aetna,Middlesex Employees,,82.79,,,82.79,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Anthem,Commerical,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Anthem,Indemnity,,,92.5,,92.5,65.85,101.9,percent of total billed charges,,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Anthem,State Preferred,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Anthem,Individual Exchange,,65.85,,,65.85,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Cigna,Cigna,,95.4,,,95.4,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Connecticare,Commerical,,88.81,,,88.81,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Connecticare,Exchange,,88.81,,,88.81,65.85,101.9,other,Could be inpatient or outpatient,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,Multiplan,Multiplan,,,101.9,,101.9,65.85,101.9,percent of total billed charges,,
HC SARS COVID-19 TEST NON-CDC HGH THROUGHPUT,U0004,HCPCS,,,both,,,122.57,73.54,United Healthcare/Oxford,United Healthcare/Oxford,,77.48,,,77.48,65.85,101.9,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Aetna,Commerical,,159.56,,,159.56,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Aetna,Middlesex Employees,,143.6,,,143.6,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Anthem,Commerical,,142.77,,,142.77,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Anthem,Indemnity,,,155.77,,155.77,114.21,176.75,percent of total billed charges,,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Anthem,State Preferred,,142.77,,,142.77,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Anthem,Individual Exchange,,114.21,,,114.21,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Cigna,Cigna,,139.43,,,139.43,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Connecticare,Commerical,,149.14,,,149.14,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Connecticare,Exchange,,149.14,,,149.14,114.21,176.75,other,Could be inpatient or outpatient,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,Multiplan,Multiplan,,,176.75,,176.75,114.21,176.75,percent of total billed charges,,
HC FIT/ORIENT/CHK/HA,V5011,HCPCS,,,both,,,214,124.76,United Healthcare/Oxford,United Healthcare/Oxford,,143.5,,,143.5,114.21,176.75,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC HA REPAIR,V5014,HCPCS,,,both,,,348,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Aetna,Commerical,,275.17,,,275.17,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Aetna,Middlesex Employees,,247.65,,,247.65,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Anthem,Commerical,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Anthem,Indemnity,,,268.61,,268.61,196.96,304.79,percent of total billed charges,,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Anthem,State Preferred,,246.21,,,246.21,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Anthem,Individual Exchange,,196.96,,,196.96,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Cigna,Cigna,,240.45,,,240.45,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Connecticare,Commerical,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Connecticare,Exchange,,257.18,,,257.18,196.96,304.79,other,Could be inpatient or outpatient,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,Multiplan,Multiplan,,,304.79,,304.79,196.96,304.79,percent of total billed charges,,
HC HA REPAIR AUDIO,V5014,HCPCS,,,both,,,369,215.15,United Healthcare/Oxford,United Healthcare/Oxford,,247.46,,,247.46,196.96,304.79,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Aetna,Commerical,,93.62,,,93.62,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Aetna,Middlesex Employees,,84.27,,,84.27,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Anthem,Commerical,,83.77,,,83.77,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Anthem,Indemnity,,,91.39,,91.39,67.02,103.7,percent of total billed charges,,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Anthem,State Preferred,,83.77,,,83.77,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Anthem,Individual Exchange,,67.02,,,67.02,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Cigna,Cigna,,81.81,,,81.81,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Connecticare,Commerical,,87.5,,,87.5,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Connecticare,Exchange,,87.5,,,87.5,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,Multiplan,Multiplan,,,103.7,,103.7,67.02,103.7,percent of total billed charges,,
HC INHOUSE REPAIR,V5014,HCPCS,,,both,,,126,73.2,United Healthcare/Oxford,United Healthcare/Oxford,,84.19,,,84.19,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Aetna,Commerical,,93.62,,,93.62,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Aetna,Middlesex Employees,,84.27,,,84.27,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Anthem,Commerical,,83.77,,,83.77,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Anthem,Indemnity,,,91.39,,91.39,67.02,103.7,percent of total billed charges,,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Anthem,State Preferred,,83.77,,,83.77,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Anthem,Individual Exchange,,67.02,,,67.02,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Cigna,Cigna,,81.81,,,81.81,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Connecticare,Commerical,,87.5,,,87.5,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Connecticare,Exchange,,87.5,,,87.5,67.02,103.7,other,Could be inpatient or outpatient,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,Multiplan,Multiplan,,,103.7,,103.7,67.02,103.7,percent of total billed charges,,
HC INHOUSE REPAIR HA,V5014,HCPCS,,,both,,,126,73.2,United Healthcare/Oxford,United Healthcare/Oxford,,84.19,,,84.19,67.02,103.7,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Aetna,Commerical,,27.64,,,27.64,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Aetna,Middlesex Employees,,24.88,,,24.88,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Anthem,Commerical,,24.73,,,24.73,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Anthem,Indemnity,,,26.98,,26.98,19.78,30.62,percent of total billed charges,,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Anthem,State Preferred,,24.73,,,24.73,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Anthem,Individual Exchange,,19.78,,,19.78,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Cigna,Cigna,,24.15,,,24.15,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Connecticare,Commerical,,25.83,,,25.83,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Connecticare,Exchange,,25.83,,,25.83,19.78,30.62,other,Could be inpatient or outpatient,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,Multiplan,Multiplan,,,30.62,,30.62,19.78,30.62,percent of total billed charges,,
HC H/A CONFRMTY EVAL,V5020,HCPCS,,,both,,,37.1,21.61,United Healthcare/Oxford,United Healthcare/Oxford,,24.85,,,24.85,19.78,30.62,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Aetna,Commerical,,251.56,,,251.56,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Aetna,Middlesex Employees,,226.41,,,226.41,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Anthem,Commerical,,225.08,,,225.08,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Anthem,Indemnity,,,245.57,,245.57,180.07,278.65,percent of total billed charges,,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Anthem,State Preferred,,225.08,,,225.08,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Anthem,Individual Exchange,,180.07,,,180.07,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Cigna,Cigna,,219.82,,,219.82,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Connecticare,Commerical,,235.11,,,235.11,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Connecticare,Exchange,,235.11,,,235.11,180.07,278.65,other,Could be inpatient or outpatient,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,Multiplan,Multiplan,,,278.65,,278.65,180.07,278.65,percent of total billed charges,,
HC ANALOG MONAURAL BTE,V5060,HCPCS,,,both,,,309,196.69,United Healthcare/Oxford,United Healthcare/Oxford,,226.23,,,226.23,180.07,278.65,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Aetna,Commerical,,1240.68,,,1240.68,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Aetna,Middlesex Employees,,1116.61,,,1116.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Commerical,,1110.13,,,1110.13,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Indemnity,,,1211.15,,1211.15,888.1,1374.29,percent of total billed charges,,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Anthem,State Preferred,,1110.13,,,1110.13,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Individual Exchange,,888.1,,,888.1,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Cigna,Cigna,,1084.16,,,1084.16,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Connecticare,Commerical,,1159.61,,,1159.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Connecticare,Exchange,,1159.61,,,1159.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,Multiplan,Multiplan,,,1374.29,,1374.29,888.1,1374.29,percent of total billed charges,,
HC DISPENSING FEE BI,V5090,HCPCS,,,both,,,1666,970.09,United Healthcare/Oxford,United Healthcare/Oxford,,1115.76,,,1115.76,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Aetna,Commerical,,1240.68,,,1240.68,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Aetna,Middlesex Employees,,1116.61,,,1116.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Commerical,,1110.13,,,1110.13,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Indemnity,,,1211.15,,1211.15,888.1,1374.29,percent of total billed charges,,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Anthem,State Preferred,,1110.13,,,1110.13,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Anthem,Individual Exchange,,888.1,,,888.1,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Cigna,Cigna,,1084.16,,,1084.16,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Connecticare,Commerical,,1159.61,,,1159.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Connecticare,Exchange,,1159.61,,,1159.61,888.1,1374.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,Multiplan,Multiplan,,,1374.29,,1374.29,888.1,1374.29,percent of total billed charges,,
HC DISPENSING FEE MO,V5090,HCPCS,,,both,,,1666,970.09,United Healthcare/Oxford,United Healthcare/Oxford,,1115.76,,,1115.76,888.1,1374.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Aetna,Commerical,,503.11,,,503.11,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Aetna,Middlesex Employees,,452.79,,,452.79,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Anthem,Commerical,,450.17,,,450.17,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Anthem,Indemnity,,,491.14,,491.14,360.14,557.29,percent of total billed charges,,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Anthem,State Preferred,,450.17,,,450.17,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Anthem,Individual Exchange,,360.14,,,360.14,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Cigna,Cigna,,439.64,,,439.64,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Connecticare,Commerical,,470.24,,,470.24,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Connecticare,Exchange,,470.24,,,470.24,360.14,557.29,other,Could be inpatient or outpatient,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,Multiplan,Multiplan,,,557.29,,557.29,360.14,557.29,percent of total billed charges,,
HC ANALOG BINAURL BTE,V5140,HCPCS,,,both,,,618,393.38,United Healthcare/Oxford,United Healthcare/Oxford,,452.46,,,452.46,360.14,557.29,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Aetna,Commerical,,643.13,,,643.13,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Aetna,Middlesex Employees,,578.82,,,578.82,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Anthem,Commerical,,575.46,,,575.46,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Anthem,Indemnity,,,627.83,,627.83,460.37,712.39,percent of total billed charges,,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Anthem,State Preferred,,575.46,,,575.46,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Anthem,Individual Exchange,,460.37,,,460.37,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Cigna,Cigna,,562,,,562,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Connecticare,Commerical,,601.11,,,601.11,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Connecticare,Exchange,,601.11,,,601.11,460.37,712.39,other,Could be inpatient or outpatient,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,Multiplan,Multiplan,,,712.39,,712.39,460.37,712.39,percent of total billed charges,,
HC DISPENSING FEE  BINAURAL,V5160,HCPCS,,,both,,,863,502.87,United Healthcare/Oxford,United Healthcare/Oxford,,578.38,,,578.38,460.37,712.39,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Aetna,Commerical,,2090.59,,,2090.59,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Aetna,Middlesex Employees,,1881.53,,,1881.53,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Anthem,Commerical,,1870.61,,,1870.61,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Anthem,Indemnity,,,2040.84,,2040.84,1496.49,2315.73,percent of total billed charges,,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Anthem,State Preferred,,1870.61,,,1870.61,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Anthem,Individual Exchange,,1496.49,,,1496.49,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Cigna,Cigna,,1826.85,,,1826.85,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Connecticare,Commerical,,1953.98,,,1953.98,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Connecticare,Exchange,,1953.98,,,1953.98,1496.49,2315.73,other,Could be inpatient or outpatient,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,Multiplan,Multiplan,,,2315.73,,2315.73,1496.49,2315.73,percent of total billed charges,,
HC HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,2568,1634.63,United Healthcare/Oxford,United Healthcare/Oxford,,1880.1,,,1880.1,1496.49,2315.73,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Aetna,Commerical,,267.03,,,267.03,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Aetna,Middlesex Employees,,240.32,,,240.32,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Anthem,Commerical,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Anthem,Indemnity,,,260.67,,260.67,191.14,295.78,percent of total billed charges,,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Anthem,State Preferred,,238.93,,,238.93,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Anthem,Individual Exchange,,191.14,,,191.14,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Cigna,Cigna,,233.33,,,233.33,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Connecticare,Commerical,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Connecticare,Exchange,,249.57,,,249.57,191.14,295.78,other,Could be inpatient or outpatient,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,Multiplan,Multiplan,,,295.78,,295.78,191.14,295.78,percent of total billed charges,,
HC REPAIR HEARING AID CROSS BTE,V5180,HCPCS,,,both,,,328,208.79,United Healthcare/Oxford,United Healthcare/Oxford,,240.13,,,240.13,191.14,295.78,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Aetna,Commerical,,1045.3,,,1045.3,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Aetna,Middlesex Employees,,940.77,,,940.77,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Anthem,Commerical,,935.31,,,935.31,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Anthem,Indemnity,,,1020.42,,1020.42,748.24,1157.87,percent of total billed charges,,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Anthem,State Preferred,,935.31,,,935.31,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Anthem,Individual Exchange,,748.24,,,748.24,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Cigna,Cigna,,913.43,,,913.43,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Connecticare,Commerical,,976.99,,,976.99,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Connecticare,Exchange,,976.99,,,976.99,748.24,1157.87,other,Could be inpatient or outpatient,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,Multiplan,Multiplan,,,1157.87,,1157.87,748.24,1157.87,percent of total billed charges,,
HC MONAURAL CONTRALAT ROUTING BTE B,V5181,HCPCS,,,both,,,1362.2,817.32,United Healthcare/Oxford,United Healthcare/Oxford,,940.05,,,940.05,748.24,1157.87,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Aetna,Commerical,,470.54,,,470.54,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Aetna,Middlesex Employees,,423.49,,,423.49,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Anthem,Commerical,,421.03,,,421.03,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Anthem,Indemnity,,,459.35,,459.35,336.82,521.22,percent of total billed charges,,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Anthem,State Preferred,,421.03,,,421.03,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Anthem,Individual Exchange,,336.82,,,336.82,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Cigna,Cigna,,411.18,,,411.18,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Connecticare,Commerical,,439.8,,,439.8,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Connecticare,Exchange,,439.8,,,439.8,336.82,521.22,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,Multiplan,Multiplan,,,521.22,,521.22,336.82,521.22,percent of total billed charges,,
HC DISPENSING FEE CONTRALATERAL MONAURAL,V5200,HCPCS,,,both,,,613.2,367.92,United Healthcare/Oxford,United Healthcare/Oxford,,423.17,,,423.17,336.82,521.22,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Aetna,Commerical,,1519.91,,,1519.91,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Aetna,Middlesex Employees,,1367.93,,,1367.93,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Anthem,Commerical,,1359.98,,,1359.98,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Anthem,Indemnity,,,1483.74,,1483.74,1087.98,1683.6,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Anthem,State Preferred,,1359.98,,,1359.98,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Anthem,Individual Exchange,,1087.98,,,1087.98,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Cigna,Cigna,,1328.17,,,1328.17,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Connecticare,Commerical,,1420.59,,,1420.59,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Connecticare,Exchange,,1420.59,,,1420.59,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,Multiplan,Multiplan,,,1683.6,,1683.6,1087.98,1683.6,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE A,V5221,HCPCS,,,both,,,1980.7,1188.42,United Healthcare/Oxford,United Healthcare/Oxford,,1366.88,,,1366.88,1087.98,1683.6,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Aetna,Commerical,,2089.77,,,2089.77,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Aetna,Middlesex Employees,,1880.8,,,1880.8,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Anthem,Commerical,,1869.88,,,1869.88,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Anthem,Indemnity,,,2040.05,,2040.05,1495.91,2314.83,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Anthem,State Preferred,,1869.88,,,1869.88,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Anthem,Individual Exchange,,1495.91,,,1495.91,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Cigna,Cigna,,1826.15,,,1826.15,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Connecticare,Commerical,,1953.22,,,1953.22,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Connecticare,Exchange,,1953.22,,,1953.22,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,Multiplan,Multiplan,,,2314.83,,2314.83,1495.91,2314.83,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE B,V5221,HCPCS,,,both,,,2723.33,1634,United Healthcare/Oxford,United Healthcare/Oxford,,1879.37,,,1879.37,1495.91,2314.83,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Aetna,Commerical,,2660.45,,,2660.45,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Aetna,Middlesex Employees,,2394.41,,,2394.41,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Anthem,Commerical,,2380.51,,,2380.51,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Anthem,Indemnity,,,2597.14,,2597.14,1904.41,2946.97,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Anthem,State Preferred,,2380.51,,,2380.51,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Anthem,Individual Exchange,,1904.41,,,1904.41,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Cigna,Cigna,,2324.83,,,2324.83,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Connecticare,Commerical,,2486.61,,,2486.61,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Connecticare,Exchange,,2486.61,,,2486.61,1904.41,2946.97,other,Could be inpatient or outpatient,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,Multiplan,Multiplan,,,2946.97,,2946.97,1904.41,2946.97,percent of total billed charges,,
HC BINAURAL CONTRALAT ROUTINGBTE/BTE C,V5221,HCPCS,,,both,,,3467.02,2080.21,United Healthcare/Oxford,United Healthcare/Oxford,,2392.59,,,2392.59,1904.41,2946.97,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Aetna,Commerical,,706.63,,,706.63,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Aetna,Middlesex Employees,,635.97,,,635.97,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Anthem,Commerical,,632.28,,,632.28,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Anthem,Indemnity,,,689.82,,689.82,505.83,782.73,percent of total billed charges,,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Anthem,State Preferred,,632.28,,,632.28,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Anthem,Individual Exchange,,505.83,,,505.83,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Cigna,Cigna,,617.49,,,617.49,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Connecticare,Commerical,,660.46,,,660.46,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Connecticare,Exchange,,660.46,,,660.46,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,Multiplan,Multiplan,,,782.73,,782.73,505.83,782.73,percent of total billed charges,,
HC DISPENSING FEE CONTRLATERAL ROUTING SYSTEM BINAURAL,V5240,HCPCS,,,both,,,920.86,552.52,United Healthcare/Oxford,United Healthcare/Oxford,,635.49,,,635.49,505.83,782.73,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Aetna,Commerical,,410.3,,,410.3,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Aetna,Middlesex Employees,,369.28,,,369.28,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Anthem,Commerical,,367.12,,,367.12,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Anthem,Indemnity,,,400.54,,400.54,293.7,454.49,percent of total billed charges,,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Anthem,State Preferred,,367.12,,,367.12,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Anthem,Individual Exchange,,293.7,,,293.7,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Cigna,Cigna,,358.54,,,358.54,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Connecticare,Commerical,,383.49,,,383.49,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Connecticare,Exchange,,383.49,,,383.49,293.7,454.49,other,Could be inpatient or outpatient,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,Multiplan,Multiplan,,,454.49,,454.49,293.7,454.49,percent of total billed charges,,
HC DISPENSING FEE MONAURAL,V5241,HCPCS,,,both,,,551,320.81,United Healthcare/Oxford,United Healthcare/Oxford,,368.99,,,368.99,293.7,454.49,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Aetna,Commerical,,2280.27,,,2280.27,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Aetna,Middlesex Employees,,2052.24,,,2052.24,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Anthem,Commerical,,2040.34,,,2040.34,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Anthem,Indemnity,,,2226.01,,2226.01,1632.27,2525.84,percent of total billed charges,,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Anthem,State Preferred,,2040.34,,,2040.34,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Anthem,Individual Exchange,,1632.27,,,1632.27,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Cigna,Cigna,,1992.61,,,1992.61,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Connecticare,Commerical,,2131.27,,,2131.27,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Connecticare,Exchange,,2131.27,,,2131.27,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,Multiplan,Multiplan,,,2525.84,,2525.84,1632.27,2525.84,percent of total billed charges,,
HC DIG MONO CIC E,V5254,HCPCS,,,both,,,2885,1782.95,United Healthcare/Oxford,United Healthcare/Oxford,,2050.69,,,2050.69,1632.27,2525.84,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Aetna,Commerical,,1044.48,,,1044.48,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Aetna,Middlesex Employees,,940.03,,,940.03,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Anthem,Commerical,,934.57,,,934.57,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Anthem,Indemnity,,,1019.62,,1019.62,747.66,1156.96,percent of total billed charges,,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Anthem,State Preferred,,934.57,,,934.57,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Anthem,Individual Exchange,,747.66,,,747.66,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Cigna,Cigna,,912.71,,,912.71,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Connecticare,Commerical,,976.23,,,976.23,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Connecticare,Exchange,,976.23,,,976.23,747.66,1156.96,other,Could be inpatient or outpatient,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,Multiplan,Multiplan,,,1156.96,,1156.96,747.66,1156.96,percent of total billed charges,,
HC DIG MONO ITE B,V5256,HCPCS,,,both,,,1361.13,816.68,United Healthcare/Oxford,United Healthcare/Oxford,,939.32,,,939.32,747.66,1156.96,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO ITE B,V5256,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Aetna,Commerical,,759.54,,,759.54,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Aetna,Middlesex Employees,,683.59,,,683.59,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Anthem,Commerical,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Anthem,Indemnity,,,741.47,,741.47,543.7,841.35,percent of total billed charges,,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Anthem,State Preferred,,679.62,,,679.62,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Anthem,Individual Exchange,,543.7,,,543.7,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Cigna,Cigna,,663.73,,,663.73,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Connecticare,Commerical,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Connecticare,Exchange,,709.92,,,709.92,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,Multiplan,Multiplan,,,841.35,,841.35,543.7,841.35,percent of total billed charges,,
HC DIG MONO BTE A,V5257,HCPCS,,,both,,,933,593.89,United Healthcare/Oxford,United Healthcare/Oxford,,683.08,,,683.08,543.7,841.35,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Aetna,Commerical,,1014.36,,,1014.36,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Aetna,Middlesex Employees,,912.92,,,912.92,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Anthem,Commerical,,907.62,,,907.62,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Anthem,Indemnity,,,990.22,,990.22,726.09,1123.6,percent of total billed charges,,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Anthem,State Preferred,,907.62,,,907.62,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Anthem,Individual Exchange,,726.09,,,726.09,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Cigna,Cigna,,886.39,,,886.39,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Connecticare,Commerical,,948.08,,,948.08,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Connecticare,Exchange,,948.08,,,948.08,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,Multiplan,Multiplan,,,1123.6,,1123.6,726.09,1123.6,percent of total billed charges,,
HC DIG MONO BTE B,V5257,HCPCS,,,both,,,1246,793.13,United Healthcare/Oxford,United Healthcare/Oxford,,912.23,,,912.23,726.09,1123.6,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Aetna,Commerical,,1291.15,,,1291.15,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Aetna,Middlesex Employees,,1162.03,,,1162.03,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Anthem,Commerical,,1155.29,,,1155.29,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Anthem,Indemnity,,,1260.43,,1260.43,924.23,1430.2,percent of total billed charges,,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Anthem,State Preferred,,1155.29,,,1155.29,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Anthem,Individual Exchange,,924.23,,,924.23,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Cigna,Cigna,,1128.26,,,1128.26,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Connecticare,Commerical,,1206.78,,,1206.78,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Connecticare,Exchange,,1206.78,,,1206.78,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,Multiplan,Multiplan,,,1430.2,,1430.2,924.23,1430.2,percent of total billed charges,,
HC DIG MONO BTE C,V5257,HCPCS,,,both,,,1586,1009.55,United Healthcare/Oxford,United Healthcare/Oxford,,1161.15,,,1161.15,924.23,1430.2,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Aetna,Commerical,,1844.73,,,1844.73,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Aetna,Middlesex Employees,,1660.26,,,1660.26,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Anthem,Commerical,,1650.62,,,1650.62,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Anthem,Indemnity,,,1800.84,,1800.84,1320.49,2043.4,percent of total billed charges,,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Anthem,State Preferred,,1650.62,,,1650.62,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Anthem,Individual Exchange,,1320.49,,,1320.49,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Cigna,Cigna,,1612.01,,,1612.01,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Connecticare,Commerical,,1724.18,,,1724.18,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Connecticare,Exchange,,1724.18,,,1724.18,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,Multiplan,Multiplan,,,2043.4,,2043.4,1320.49,2043.4,percent of total billed charges,,
HC DIG MONO BTE D,V5257,HCPCS,,,both,,,2266,1442.4,United Healthcare/Oxford,United Healthcare/Oxford,,1659,,,1659,1320.49,2043.4,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Aetna,Commerical,,2213.51,,,2213.51,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Aetna,Middlesex Employees,,1992.16,,,1992.16,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Anthem,Commerical,,1980.6,,,1980.6,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Anthem,Indemnity,,,2160.85,,2160.8,1584.48,2451.9,percent of total billed charges,,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Anthem,State Preferred,,1980.6,,,1980.6,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Anthem,Individual Exchange,,1584.48,,,1584.48,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Cigna,Cigna,,1934.28,,,1934.28,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Connecticare,Commerical,,2068.88,,,2068.88,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Connecticare,Exchange,,2068.88,,,2068.88,1584.48,2451.9,other,Could be inpatient or outpatient,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,Multiplan,Multiplan,,,2451.9,,2451.9,1584.48,2451.9,percent of total billed charges,,
HC DIG MONO BTE E,V5257,HCPCS,,,both,,,2719,1730.75,United Healthcare/Oxford,United Healthcare/Oxford,,1990.65,,,1990.65,1584.48,2451.9,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE A,V5257,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE B,V5257,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE C,V5257,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE D,V5257,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG MONO BTE E,V5257,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Aetna,Commerical,,4427.02,,,4427.02,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Aetna,Middlesex Employees,,3984.32,,,3984.32,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Anthem,Commerical,,3961.2,,,3961.2,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Anthem,Indemnity,,,4321.69,,4321.69,3168.96,4903.79,percent of total billed charges,,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Anthem,State Preferred,,3961.2,,,3961.2,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Anthem,Individual Exchange,,3168.96,,,3168.96,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Cigna,Cigna,,3868.55,,,3868.55,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Connecticare,Commerical,,4137.75,,,4137.75,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Connecticare,Exchange,,4137.75,,,4137.75,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,Multiplan,Multiplan,,,4903.79,,4903.79,3168.96,4903.79,percent of total billed charges,,
HC DIG BINAURL CIC E,V5258,HCPCS,,,both,,,5601,3461.5,United Healthcare/Oxford,United Healthcare/Oxford,,3981.31,,,3981.31,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Aetna,Commerical,,2090.59,,,2090.59,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Aetna,Middlesex Employees,,1881.53,,,1881.53,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Anthem,Commerical,,1870.61,,,1870.61,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Anthem,Indemnity,,,2040.84,,2040.84,1496.49,2315.73,percent of total billed charges,,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Anthem,State Preferred,,1870.61,,,1870.61,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Anthem,Individual Exchange,,1496.49,,,1496.49,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Cigna,Cigna,,1826.85,,,1826.85,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Connecticare,Commerical,,1953.98,,,1953.98,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Connecticare,Exchange,,1953.98,,,1953.98,1496.49,2315.73,other,Could be inpatient or outpatient,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,Multiplan,Multiplan,,,2315.73,,2315.73,1496.49,2315.73,percent of total billed charges,,
HC DIG BINAURL ITE B,V5260,HCPCS,,,both,,,2568,1634.63,United Healthcare/Oxford,United Healthcare/Oxford,,1880.1,,,1880.1,1496.49,2315.73,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL ITE B,V5260,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Aetna,Commerical,,1475.95,,,1475.95,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Aetna,Middlesex Employees,,1328.36,,,1328.36,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Anthem,Commerical,,1320.64,,,1320.64,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Anthem,Indemnity,,,1440.83,,1440.83,1056.51,1634.9,percent of total billed charges,,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Anthem,State Preferred,,1320.64,,,1320.64,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Anthem,Individual Exchange,,1056.51,,,1056.51,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Cigna,Cigna,,1289.76,,,1289.76,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Connecticare,Commerical,,1379.5,,,1379.5,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Connecticare,Exchange,,1379.5,,,1379.5,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,Multiplan,Multiplan,,,1634.9,,1634.9,1056.51,1634.9,percent of total billed charges,,
HC DIG BINAURL BTE A,V5261,HCPCS,,,both,,,1813,1154.05,United Healthcare/Oxford,United Healthcare/Oxford,,1327.35,,,1327.35,1056.51,1634.9,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Aetna,Commerical,,2029.53,,,2029.53,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Aetna,Middlesex Employees,,1826.58,,,1826.58,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Anthem,Commerical,,1815.98,,,1815.98,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Anthem,Indemnity,,,1981.23,,1981.23,1452.79,2248.1,percent of total billed charges,,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Anthem,State Preferred,,1815.98,,,1815.98,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Anthem,Individual Exchange,,1452.79,,,1452.79,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Cigna,Cigna,,1773.5,,,1773.5,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Connecticare,Commerical,,1896.92,,,1896.92,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Connecticare,Exchange,,1896.92,,,1896.92,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,Multiplan,Multiplan,,,2248.1,,2248.1,1452.79,2248.1,percent of total billed charges,,
HC DIG BINAURL BTE B,V5261,HCPCS,,,both,,,2493,1586.89,United Healthcare/Oxford,United Healthcare/Oxford,,1825.19,,,1825.19,1452.79,2248.1,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Aetna,Commerical,,2582.3,,,2582.3,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Aetna,Middlesex Employees,,2324.08,,,2324.08,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Anthem,Commerical,,2310.58,,,2310.58,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Anthem,Indemnity,,,2520.85,,2520.85,1848.46,2860.39,percent of total billed charges,,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Anthem,State Preferred,,2310.58,,,2310.58,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Anthem,Individual Exchange,,1848.46,,,1848.46,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Cigna,Cigna,,2256.54,,,2256.54,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Connecticare,Commerical,,2413.57,,,2413.57,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Connecticare,Exchange,,2413.57,,,2413.57,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,Multiplan,Multiplan,,,2860.39,,2860.39,1848.46,2860.39,percent of total billed charges,,
HC DIG BINAURL BTE C,V5261,HCPCS,,,both,,,3172,2019.1,United Healthcare/Oxford,United Healthcare/Oxford,,2322.31,,,2322.31,1848.46,2860.39,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Aetna,Commerical,,3504.66,,,3504.66,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Aetna,Middlesex Employees,,3154.19,,,3154.19,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Anthem,Commerical,,3135.89,,,3135.89,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Anthem,Indemnity,,,3421.27,,3421.27,2508.72,3882.09,percent of total billed charges,,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Anthem,State Preferred,,3135.89,,,3135.89,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Anthem,Individual Exchange,,2508.72,,,2508.72,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Cigna,Cigna,,3062.54,,,3062.54,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Connecticare,Commerical,,3275.66,,,3275.66,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Connecticare,Exchange,,3275.66,,,3275.66,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,Multiplan,Multiplan,,,3882.09,,3882.09,2508.72,3882.09,percent of total billed charges,,
HC DIG BINAURL BTE D,V5261,HCPCS,,,both,,,4305,2740.3,United Healthcare/Oxford,United Healthcare/Oxford,,3151.81,,,3151.81,2508.72,3882.09,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Aetna,Commerical,,4427.02,,,4427.02,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Aetna,Middlesex Employees,,3984.32,,,3984.32,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Anthem,Commerical,,3961.2,,,3961.2,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Anthem,Indemnity,,,4321.69,,4321.69,3168.96,4903.79,percent of total billed charges,,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Anthem,State Preferred,,3961.2,,,3961.2,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Anthem,Individual Exchange,,3168.96,,,3168.96,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Cigna,Cigna,,3868.55,,,3868.55,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Connecticare,Commerical,,4137.75,,,4137.75,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Connecticare,Exchange,,4137.75,,,4137.75,3168.96,4903.79,other,Could be inpatient or outpatient,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,Multiplan,Multiplan,,,4903.79,,4903.79,3168.96,4903.79,percent of total billed charges,,
HC DIG BINAURL BTE E,V5261,HCPCS,,,both,,,5438,3461.5,United Healthcare/Oxford,United Healthcare/Oxford,,3981.31,,,3981.31,3168.96,4903.79,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE A,V5261,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE B,V5261,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE C,V5261,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE D,V5261,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Aetna,Commerical,,258.89,,,258.89,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Aetna,Middlesex Employees,,232.99,,,232.99,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Anthem,Commerical,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Anthem,Indemnity,,,252.72,,252.72,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Anthem,State Preferred,,231.64,,,231.64,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Anthem,Individual Exchange,,185.32,,,185.32,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Cigna,Cigna,,226.22,,,226.22,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Commerical,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Connecticare,Exchange,,241.97,,,241.97,185.32,286.76,other,Could be inpatient or outpatient,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,Multiplan,Multiplan,,,286.76,,286.76,185.32,286.76,percent of total billed charges,,
HC REPAIR DIG BINAURL BTE E,V5261,HCPCS,,,both,,,318,202.42,United Healthcare/Oxford,United Healthcare/Oxford,,232.82,,,232.82,185.32,286.76,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Aetna,Commerical,,91.99,,,91.99,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Aetna,Middlesex Employees,,82.79,,,82.79,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Commerical,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Indemnity,,,89.8,,89.8,65.85,101.9,percent of total billed charges,,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Anthem,State Preferred,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Individual Exchange,,65.85,,,65.85,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Cigna,Cigna,,80.39,,,80.39,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Connecticare,Commerical,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Connecticare,Exchange,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,Multiplan,Multiplan,,,101.9,,101.9,65.85,101.9,percent of total billed charges,,
HC EARMOLD STANDARD,V5264,HCPCS,,,both,,,116,71.93,United Healthcare/Oxford,United Healthcare/Oxford,,82.73,,,82.73,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Aetna,Commerical,,91.99,,,91.99,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Aetna,Middlesex Employees,,82.79,,,82.79,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Commerical,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Indemnity,,,89.8,,89.8,65.85,101.9,percent of total billed charges,,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Anthem,State Preferred,,82.31,,,82.31,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Anthem,Individual Exchange,,65.85,,,65.85,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Cigna,Cigna,,80.39,,,80.39,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Connecticare,Commerical,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Connecticare,Exchange,,85.98,,,85.98,65.85,101.9,other,Could be inpatient or outpatient,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,Multiplan,Multiplan,,,101.9,,101.9,65.85,101.9,percent of total billed charges,,
HC SSWIMMOLD,V5264,HCPCS,,,both,,,116,71.93,United Healthcare/Oxford,United Healthcare/Oxford,,82.73,,,82.73,65.85,101.9,other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Aetna,Commerical,,,29.33,,29.33,28.12,32.31,percent of total billed charges,,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Aetna,Middlesex Employees,,,28.12,,28.12,28.12,32.31,percent of total billed charges,,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Anthem,Commerical,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Anthem,Indemnity,,,28.47,,28.47,28.12,32.31,percent of total billed charges,,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Anthem,Individual Exchange,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Anthem,State Preferred,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Cigna,Cigna,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Connecticare,Commerical,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Connecticare,Exchange,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,Multiplan,Multiplan,,,32.31,,32.31,28.12,32.31,percent of total billed charges,,
0.1N HYDROCHLORIC ACID FOR CVL OCCLUSION,J3490,HCPCS,40810-0014-96,NDC,both,2,mL,38.01,22.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.12,32.31,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,3.04,9.77,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,3.04,9.77,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Anthem,Commerical,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,3.04,9.77,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Anthem,State Preferred,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Cigna,Cigna,,3.04,,,3.04,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Connecticare,Commerical,,3.92,,,3.92,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Connecticare,Exchange,,3.92,,,3.92,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,3.04,9.77,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0264-9999-00,NDC,both,1000,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,9.77,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.92,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.92,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.92,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,3.04,,,3.04,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.92,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,2.83,3.92,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,3.04,13.02,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,3.04,13.02,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Commerical,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,3.04,13.02,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,State Preferred,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Cigna,Cigna,,3.04,,,3.04,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Connecticare,Commerical,,3.92,,,3.92,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Connecticare,Exchange,,3.92,,,3.92,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,3.04,13.02,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,13.02,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,1.53,6.51,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,1.53,6.51,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Commerical,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,1.53,6.51,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,State Preferred,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Cigna,Cigna,,1.53,,,1.53,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Connecticare,Commerical,,1.96,,,1.96,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Connecticare,Exchange,,1.96,,,1.96,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,1.53,6.51,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.65,,,1.65,1.53,6.51,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,1.53,16.28,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,1.53,16.28,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Commerical,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,1.53,16.28,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,State Preferred,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Cigna,Cigna,,1.53,,,1.53,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Commerical,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Exchange,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,1.53,16.28,percent of total billed charges,,
0.9% SODIUM CHLORIDE FOR CRRT,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.65,,,1.65,1.53,16.28,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Aetna,Commerical,,,20.69,,20.69,19.84,22.79,percent of total billed charges,,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Aetna,Middlesex Employees,,,19.84,,19.84,19.84,22.79,percent of total billed charges,,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Anthem,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Anthem,Indemnity,,,20.08,,20.08,19.84,22.79,percent of total billed charges,,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Anthem,Individual Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Anthem,State Preferred,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Cigna,Cigna,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Connecticare,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Connecticare,Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,Multiplan,Multiplan,,,22.79,,22.79,19.84,22.79,percent of total billed charges,,
ABACAVIR 150 MG ORAL TAB,J3490,HCPCS,40810-0000-06,NDC,both,1,ea,26.81,16.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Aetna,Commerical,,,356.76,,356.76,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Aetna,Middlesex Employees,,,342.1,,342.1,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Anthem,Commerical,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Anthem,Indemnity,,,346.35,,346.35,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Anthem,Individual Exchange,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Anthem,State Preferred,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Cigna,Cigna,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Connecticare,Commerical,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Connecticare,Exchange,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,Multiplan,Multiplan,,,393.01,,393.01,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,31722-562-24,NDC,both,1,mL,462.36,277.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Aetna,Commerical,,,356.76,,356.76,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Aetna,Middlesex Employees,,,342.1,,342.1,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Anthem,Commerical,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Anthem,Indemnity,,,346.35,,346.35,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Anthem,Individual Exchange,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Anthem,State Preferred,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Cigna,Cigna,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Connecticare,Commerical,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Connecticare,Exchange,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,Multiplan,Multiplan,,,393.01,,393.01,342.1,393.01,percent of total billed charges,,
ABACAVIR 20 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-405-24,NDC,both,1,mL,462.36,277.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,342.1,393.01,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,0378-4105-91,NDC,both,1,ea,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,40810-0009-58,NDC,both,1,ea,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
ABACAVIR 300 MG TABLET,J3490,HCPCS,65862-073-60,NDC,both,1,ea,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Aetna,Commerical,,,3924.99,,3924.99,49.41,4323.8,percent of total billed charges,,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Aetna,Middlesex Employees,,,3763.74,,3763.74,49.41,4323.8,percent of total billed charges,,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Anthem,Commerical,,,,,,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Anthem,Indemnity,,,3810.54,,3810.54,49.41,4323.8,percent of total billed charges,,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Anthem,Individual Exchange,,,,,,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Anthem,State Preferred,,,,,,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Cigna,Cigna,,49.41,,,49.41,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Connecticare,Commerical,,66.33,,,66.33,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Connecticare,Exchange,,66.33,,,66.33,49.41,4323.8,Other,Could be inpatient or outpatient,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,Multiplan,Multiplan,,,4323.8,,4323.8,49.41,4323.8,percent of total billed charges,,
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,J0129,HCPCS,0003-2187-13,NDC,both,0.04,ea,5086.82,3052.09,United Healthcare/Oxford,United Healthcare/Oxford,,53.35,,,53.35,49.41,4323.8,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Aetna,Commerical,,,1527.99,,1527.99,9.15,1683.25,percent of total billed charges,,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Aetna,Middlesex Employees,,,1465.22,,1465.22,9.15,1683.25,percent of total billed charges,,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Anthem,Commerical,,,,,,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Anthem,Indemnity,,,1483.44,,1483.44,9.15,1683.25,percent of total billed charges,,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Anthem,Individual Exchange,,,,,,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Anthem,State Preferred,,,,,,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Cigna,Cigna,,9.92,,,9.92,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Connecticare,Commerical,,13.18,,,13.18,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Connecticare,Exchange,,13.18,,,13.18,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,Multiplan,Multiplan,,,1683.25,,1683.25,9.15,1683.25,percent of total billed charges,,
ABOBOTULINUMTOXINA 300 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0530-6,NDC,both,0.017,ea,1980.29,1188.17,United Healthcare/Oxford,United Healthcare/Oxford,,9.15,,,9.15,9.15,1683.25,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Aetna,Commerical,,,2538.54,,2538.54,9.15,2796.47,percent of total billed charges,,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Aetna,Middlesex Employees,,,2434.25,,2434.25,9.15,2796.47,percent of total billed charges,,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Anthem,Commerical,,,,,,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Anthem,Indemnity,,,2464.52,,2464.52,9.15,2796.47,percent of total billed charges,,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Anthem,Individual Exchange,,,,,,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Anthem,State Preferred,,,,,,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Cigna,Cigna,,9.92,,,9.92,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Connecticare,Commerical,,13.18,,,13.18,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Connecticare,Exchange,,13.18,,,13.18,9.15,2796.47,Other,Could be inpatient or outpatient,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,Multiplan,Multiplan,,,2796.47,,2796.47,9.15,2796.47,percent of total billed charges,,
ABOBOTULINUMTOXINA 500 UNIT INTRAMUSCULAR SOLUTION,J0586,HCPCS,15054-0500-1,NDC,both,0.01,ea,3289.97,1973.98,United Healthcare/Oxford,United Healthcare/Oxford,,9.15,,,9.15,9.15,2796.47,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,36000-306-60,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,55150-307-01,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.06,0.24,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.06,0.24,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Commerical,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.06,0.24,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Individual Exchange,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,State Preferred,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Cigna,Cigna,,0.06,,,0.06,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Connecticare,Commerical,,0.07,,,0.07,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Connecticare,Exchange,,0.07,,,0.07,0.06,0.24,Other,Could be inpatient or outpatient,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.06,0.24,percent of total billed charges,,
"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,0781-3156-95,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-01,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,24201-100-24,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,43825-102-01,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0131,HCPCS,67457-940-10,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-00,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Cigna,Cigna,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Connecticare,Commerical,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Connecticare,Exchange,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.06,18.89,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0134,HCPCS,63323-434-41,NDC,both,1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,18.89,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.06,0.24,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.06,0.24,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Commerical,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.06,0.24,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,Individual Exchange,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Anthem,State Preferred,,,,,,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Cigna,Cigna,,0.06,,,0.06,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Connecticare,Commerical,,0.07,,,0.07,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Connecticare,Exchange,,0.07,,,0.07,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.06,0.24,percent of total billed charges,,
ACETAMINOPHEN 1000 MG/100 ML INTRAVENOUS SOLUTION CAROUSEL,J0136,HCPCS,0264-4100-90,NDC,both,1,mL,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,0.24,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-00,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-732-30,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-0,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Aetna,Commerical,,,2.08,,2.08,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Aetna,Middlesex Employees,,,1.99,,1.99,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Anthem,Commerical,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Anthem,Indemnity,,,2.02,,2.02,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Anthem,Individual Exchange,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Anthem,State Preferred,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Cigna,Cigna,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Connecticare,Commerical,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Connecticare,Exchange,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,Multiplan,Multiplan,,,2.29,,2.29,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2115-2,NDC,both,1,ea,2.69,1.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,0904-6645-24,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
ACETAMINOPHEN 160 MG CHEWABLE TABLET,J3490,HCPCS,70000-0309-1,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-00,NDC,both,5,mL,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Aetna,Commerical,,,1.27,,1.27,1.22,1.4,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Aetna,Middlesex Employees,,,1.22,,1.22,1.22,1.4,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Anthem,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Anthem,Indemnity,,,1.24,,1.24,1.22,1.4,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Anthem,Individual Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Anthem,State Preferred,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Cigna,Cigna,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Connecticare,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Connecticare,Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,Multiplan,Multiplan,,,1.4,,1.4,1.22,1.4,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-0657-05,NDC,both,5,mL,1.65,0.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-00,NDC,both,1,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-05,NDC,both,1,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-0966-94,NDC,both,1,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-00,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,0121-1781-05,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-59,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-61,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-015-62,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-061-59,NDC,both,1,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-59,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Aetna,Commerical,,,2.55,,2.55,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Aetna,Middlesex Employees,,,2.44,,2.44,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Anthem,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Anthem,Indemnity,,,2.47,,2.47,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Anthem,Individual Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Anthem,State Preferred,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Cigna,Cigna,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Connecticare,Commerical,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Connecticare,Exchange,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,Multiplan,Multiplan,,,2.81,,2.81,2.44,2.81,percent of total billed charges,,
ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION (GRAPE FLAVOR),J3490,HCPCS,68094-231-61,NDC,both,5,mL,3.3,1.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.44,2.81,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 162.5 MG ORAL TAB,J3490,HCPCS,40810-0000-04,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ACETAMINOPHEN 250 MG ORAL TAB,J3490,HCPCS,40810-0000-07,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Aetna,Commerical,,,2.08,,2.08,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Aetna,Middlesex Employees,,,1.99,,1.99,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Anthem,Commerical,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Anthem,Indemnity,,,2.02,,2.02,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Anthem,Individual Exchange,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Anthem,State Preferred,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Cigna,Cigna,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Connecticare,Commerical,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Connecticare,Exchange,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,Multiplan,Multiplan,,,2.29,,2.29,1.99,2.29,percent of total billed charges,,
ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,J3490,HCPCS,51672-2116-2,NDC,both,1,ea,2.69,1.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.99,2.29,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,45049660,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,0904-6773-61,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,49483-340-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
ACETAMINOPHEN 325 MG TABLET,J3490,HCPCS,50580-458-11,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
ACETAMINOPHEN 40 MG ORAL TBDL,J3490,HCPCS,40810-0000-09,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Aetna,Commerical,,,2.26,,2.26,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Aetna,Middlesex Employees,,,2.17,,2.17,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Anthem,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Anthem,Indemnity,,,2.19,,2.19,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Anthem,Individual Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Anthem,State Preferred,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Cigna,Cigna,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Connecticare,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Connecticare,Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,Multiplan,Multiplan,,,2.49,,2.49,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 40 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0536-1172-01,NDC,both,1,ea,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-60,NDC,both,1,ea,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
ACETAMINOPHEN 500 MG TABLET,J3490,HCPCS,0904-6730-61,NDC,both,1,ea,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-30,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,J3490,HCPCS,45802-730-33,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5791-46,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ACETAMINOPHEN 80 MG DISINTEGRATING TABLET,J3490,HCPCS,40810-0010-97,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Aetna,Commerical,,,2.26,,2.26,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Aetna,Middlesex Employees,,,2.17,,2.17,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Anthem,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Anthem,Indemnity,,,2.19,,2.19,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Anthem,Individual Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Anthem,State Preferred,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Cigna,Cigna,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Connecticare,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Connecticare,Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,Multiplan,Multiplan,,,2.49,,2.49,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0000-10,NDC,both,1,ea,2.93,1.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Aetna,Commerical,,,2.26,,2.26,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Aetna,Middlesex Employees,,,2.17,,2.17,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Anthem,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Anthem,Indemnity,,,2.19,,2.19,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Anthem,Individual Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Anthem,State Preferred,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Cigna,Cigna,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Connecticare,Commerical,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Connecticare,Exchange,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,Multiplan,Multiplan,,,2.49,,2.49,2.17,2.49,percent of total billed charges,,
ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-38,NDC,both,1,ea,2.93,1.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.17,2.49,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Aetna,Commerical,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Aetna,Middlesex Employees,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Anthem,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Anthem,Indemnity,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Anthem,Individual Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Anthem,State Preferred,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Cigna,Cigna,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Connecticare,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Connecticare,Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
ACETAMINOPHEN 81.25 MG ORAL TAB,J3490,HCPCS,40810-0000-12,NDC,both,1,ea,0.04,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0904-6738-70,NDC,both,1,mL,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
ACETAMINOPHEN DYE FREE 160 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,81033-002-05,NDC,both,1,mL,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Aetna,Commerical,,,1.33,,1.33,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Aetna,Middlesex Employees,,,1.28,,1.28,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Anthem,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Anthem,Indemnity,,,1.3,,1.3,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Anthem,Individual Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Anthem,State Preferred,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Cigna,Cigna,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Connecticare,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Connecticare,Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,Multiplan,Multiplan,,,1.47,,1.47,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 125 MG (SPLIT TABLET),J3490,HCPCS,40810-0000-14,NDC,both,1,ea,1.73,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,23155-287-01,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,40810-0020-69,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
ACETAZOLAMIDE 125 MG TABLET,J3490,HCPCS,51672-4022-1,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Aetna,Commerical,,,19.86,,19.86,19.05,21.88,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Aetna,Middlesex Employees,,,19.05,,19.05,19.05,21.88,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Anthem,Commerical,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Anthem,Indemnity,,,19.28,,19.28,19.05,21.88,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Anthem,Individual Exchange,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Anthem,State Preferred,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Cigna,Cigna,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Connecticare,Commerical,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Connecticare,Exchange,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,Multiplan,Multiplan,,,21.88,,21.88,19.05,21.88,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0004-02,NDC,both,1,mL,25.74,15.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Aetna,Commerical,,,9.93,,9.93,9.52,10.94,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Aetna,Middlesex Employees,,,9.52,,9.52,9.52,10.94,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Anthem,Commerical,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Anthem,Indemnity,,,9.64,,9.64,9.52,10.94,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Anthem,Individual Exchange,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Anthem,State Preferred,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Cigna,Cigna,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Connecticare,Commerical,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Connecticare,Exchange,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,Multiplan,Multiplan,,,10.94,,10.94,9.52,10.94,percent of total billed charges,,
ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-01,NDC,both,1,mL,12.87,7.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Aetna,Commerical,,,8.33,,8.33,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Aetna,Middlesex Employees,,,7.98,,7.98,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Anthem,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Anthem,Indemnity,,,8.08,,8.08,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Anthem,Individual Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Anthem,State Preferred,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Cigna,Cigna,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Connecticare,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Connecticare,Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,Multiplan,Multiplan,,,9.17,,9.17,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,0904-6663-61,NDC,both,1,ea,10.79,6.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Aetna,Commerical,,,8.33,,8.33,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Aetna,Middlesex Employees,,,7.98,,7.98,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Anthem,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Anthem,Indemnity,,,8.08,,8.08,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Anthem,Individual Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Anthem,State Preferred,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Cigna,Cigna,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Connecticare,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Connecticare,Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,Multiplan,Multiplan,,,9.17,,9.17,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,40810-0006-47,NDC,both,1,ea,10.79,6.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Aetna,Commerical,,,8.33,,8.33,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Aetna,Middlesex Employees,,,7.98,,7.98,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Anthem,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Anthem,Indemnity,,,8.08,,8.08,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Anthem,Individual Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Anthem,State Preferred,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Cigna,Cigna,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Connecticare,Commerical,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Connecticare,Exchange,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,Multiplan,Multiplan,,,9.17,,9.17,7.98,9.17,percent of total billed charges,,
ACETAZOLAMIDE 250 MG TABLET,J3490,HCPCS,51672-4023-1,NDC,both,1,ea,10.79,6.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.98,9.17,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Aetna,Commerical,,,355.51,,355.51,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Aetna,Middlesex Employees,,,340.91,,340.91,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Anthem,Commerical,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Anthem,Indemnity,,,345.15,,345.15,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Anthem,Individual Exchange,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Anthem,State Preferred,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Cigna,Cigna,,27.17,,,27.17,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Connecticare,Commerical,,36.11,,,36.11,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Connecticare,Exchange,,36.11,,,36.11,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,Multiplan,Multiplan,,,391.64,,391.64,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9006-01,NDC,both,5,ea,460.75,276.45,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Aetna,Commerical,,,71.1,,71.1,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Aetna,Middlesex Employees,,,68.18,,68.18,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Anthem,Commerical,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Anthem,Indemnity,,,69.03,,69.03,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Anthem,Individual Exchange,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Anthem,State Preferred,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Cigna,Cigna,,27.17,,,27.17,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Connecticare,Commerical,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Connecticare,Exchange,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,Multiplan,Multiplan,,,78.33,,78.33,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,0143-9503-01,NDC,both,1,ea,92.15,55.29,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Aetna,Commerical,,,355.51,,355.51,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Aetna,Middlesex Employees,,,340.91,,340.91,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Anthem,Commerical,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Anthem,Indemnity,,,345.15,,345.15,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Anthem,Individual Exchange,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Anthem,State Preferred,,,,,,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Cigna,Cigna,,27.17,,,27.17,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Connecticare,Commerical,,36.11,,,36.11,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Connecticare,Exchange,,36.11,,,36.11,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,Multiplan,Multiplan,,,391.64,,391.64,27.17,391.64,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,23155-313-31,NDC,both,5,ea,460.75,276.45,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,391.64,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Aetna,Commerical,,,71.1,,71.1,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Aetna,Middlesex Employees,,,68.18,,68.18,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Anthem,Commerical,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Anthem,Indemnity,,,69.03,,69.03,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Anthem,Individual Exchange,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Anthem,State Preferred,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Cigna,Cigna,,27.17,,,27.17,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Connecticare,Commerical,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Connecticare,Exchange,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,Multiplan,Multiplan,,,78.33,,78.33,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-1,NDC,both,1,ea,92.15,55.29,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Aetna,Commerical,,,71.1,,71.1,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Aetna,Middlesex Employees,,,68.18,,68.18,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Anthem,Commerical,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Anthem,Indemnity,,,69.03,,69.03,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Anthem,Individual Exchange,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Anthem,State Preferred,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Cigna,Cigna,,27.17,,,27.17,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Connecticare,Commerical,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Connecticare,Exchange,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,Multiplan,Multiplan,,,78.33,,78.33,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,39822-0190-7,NDC,both,1,ea,92.15,55.29,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Aetna,Commerical,,,71.1,,71.1,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Aetna,Middlesex Employees,,,68.18,,68.18,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Anthem,Commerical,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Anthem,Indemnity,,,69.03,,69.03,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Anthem,Individual Exchange,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Anthem,State Preferred,,,,,,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Cigna,Cigna,,27.17,,,27.17,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Connecticare,Commerical,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Connecticare,Exchange,,36.11,,,36.11,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,Multiplan,Multiplan,,,78.33,,78.33,27.17,78.33,percent of total billed charges,,
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,J1120,HCPCS,67457-853-50,NDC,both,1,ea,92.15,55.29,United Healthcare/Oxford,United Healthcare/Oxford,,29.33,,,29.33,27.17,78.33,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Aetna,Commerical,,,1.33,,1.33,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Aetna,Middlesex Employees,,,1.28,,1.28,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Anthem,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Anthem,Indemnity,,,1.3,,1.3,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Anthem,Individual Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Anthem,State Preferred,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Cigna,Cigna,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Connecticare,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Connecticare,Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,Multiplan,Multiplan,,,1.47,,1.47,1.28,1.47,percent of total billed charges,,
ACETAZOLAMIDE 62.5 MG (SPLIT TABLET),J3490,HCPCS,40810-0205-60,NDC,both,1,ea,1.73,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,State Preferred,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Cigna,Cigna,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Connecticare,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Connecticare,Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLN FOR ORAL USE,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Anthem,State Preferred,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Cigna,Cigna,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Connecticare,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Connecticare,Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,5.67,6.51,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0264-2304-10,NDC,both,500,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.58,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.58,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Anthem,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,39.67,45.58,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Anthem,State Preferred,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Cigna,Cigna,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Connecticare,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Connecticare,Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,39.67,45.58,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0338-0656-04,NDC,both,1000,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Aetna,Commerical,,,10.35,,10.35,9.92,11.4,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Aetna,Middlesex Employees,,,9.92,,9.92,9.92,11.4,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Anthem,Commerical,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Anthem,Indemnity,,,10.05,,10.05,9.92,11.4,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Anthem,Individual Exchange,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Anthem,State Preferred,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Cigna,Cigna,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Connecticare,Commerical,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Connecticare,Exchange,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,Multiplan,Multiplan,,,11.4,,11.4,9.92,11.4,percent of total billed charges,,
ACETIC ACID 0.25 % IRRIGATION SOLUTION,J3490,HCPCS,0990-6143-22,NDC,both,250,mL,13.41,8.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Aetna,Commerical,,,118.22,,118.22,113.37,130.24,percent of total billed charges,,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Aetna,Middlesex Employees,,,113.37,,113.37,113.37,130.24,percent of total billed charges,,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Anthem,Commerical,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Anthem,Indemnity,,,114.78,,114.78,113.37,130.24,percent of total billed charges,,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Anthem,Individual Exchange,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Anthem,State Preferred,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Cigna,Cigna,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Connecticare,Commerical,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Connecticare,Exchange,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,Multiplan,Multiplan,,,130.24,,130.24,113.37,130.24,percent of total billed charges,,
ACETIC ACID 2 % EAR SOLUTION,J3490,HCPCS,60432-741-15,NDC,both,15,mL,153.22,91.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.37,130.24,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
ACETONE (URINE) TEST STRIPS,J3490,HCPCS,193288050,NDC,both,50,ea,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Aetna,Commerical,,,227.85,,227.85,218.49,251.01,percent of total billed charges,,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Aetna,Middlesex Employees,,,218.49,,218.49,218.49,251.01,percent of total billed charges,,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Anthem,Commerical,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Anthem,Indemnity,,,221.21,,221.21,218.49,251.01,percent of total billed charges,,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Anthem,Individual Exchange,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Anthem,State Preferred,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Cigna,Cigna,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Connecticare,Commerical,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Connecticare,Exchange,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,Multiplan,Multiplan,,,251.01,,251.01,218.49,251.01,percent of total billed charges,,
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,J3490,HCPCS,24208-539-20,NDC,both,1,ea,295.3,177.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,218.49,251.01,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Commerical,,,75.6,,75.6,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Middlesex Employees,,,72.5,,72.5,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Commerical,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Indemnity,,,73.4,,73.4,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Individual Exchange,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,State Preferred,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Cigna,Cigna,,10.29,,,10.29,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Commerical,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Exchange,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Multiplan,Multiplan,,,83.28,,83.28,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,87.18,52.31,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Commerical,,,75.6,,75.6,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Middlesex Employees,,,72.5,,72.5,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Commerical,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Indemnity,,,73.4,,73.4,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Individual Exchange,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,State Preferred,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Cigna,Cigna,,10.29,,,10.29,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Commerical,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Exchange,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Multiplan,Multiplan,,,83.28,,83.28,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 10 % (100 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Aetna,Commerical,,,113.39,,113.39,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Aetna,Middlesex Employees,,,108.74,,108.74,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Anthem,Commerical,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Anthem,Indemnity,,,110.09,,110.09,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Anthem,Individual Exchange,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Anthem,State Preferred,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Cigna,Cigna,,10.29,,,10.29,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Connecticare,Commerical,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Connecticare,Exchange,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,Multiplan,Multiplan,,,124.92,,124.92,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0409-3307-03,NDC,both,10,mL,146.96,88.18,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-01,NDC,both,10,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7504-25,NDC,both,10,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,0517-7510-03,NDC,both,10,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-693-10,NDC,both,10,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Commerical,,,75.6,,75.6,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Aetna,Middlesex Employees,,,72.5,,72.5,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Commerical,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Indemnity,,,73.4,,73.4,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,Individual Exchange,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Anthem,State Preferred,,,,,,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Cigna,Cigna,,10.29,,,10.29,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Commerical,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Connecticare,Exchange,,11.87,,,11.87,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,Multiplan,Multiplan,,,83.28,,83.28,10.29,83.28,percent of total billed charges,,
ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,J7608,HCPCS,63323-695-04,NDC,both,10,mL,97.98,58.79,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,83.28,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20 % (200 MG/ML) RECTAL SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Aetna,Commerical,,,18.9,,18.9,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Aetna,Middlesex Employees,,,18.13,,18.13,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Anthem,Commerical,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Anthem,Indemnity,,,18.35,,18.35,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Anthem,Individual Exchange,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Anthem,State Preferred,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Cigna,Cigna,,10.29,,,10.29,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Connecticare,Commerical,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Connecticare,Exchange,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,Multiplan,Multiplan,,,20.83,,20.83,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,64.56,38.74,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,129.11,77.47,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Aetna,Commerical,,,113.39,,113.39,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Aetna,Middlesex Employees,,,108.74,,108.74,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Anthem,Commerical,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Anthem,Indemnity,,,110.09,,110.09,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Anthem,Individual Exchange,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Anthem,State Preferred,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Cigna,Cigna,,10.29,,,10.29,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Connecticare,Commerical,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Connecticare,Exchange,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,Multiplan,Multiplan,,,124.92,,124.92,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,387.33,232.4,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Aetna,Commerical,,,113.39,,113.39,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Aetna,Middlesex Employees,,,108.74,,108.74,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Anthem,Commerical,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Anthem,Indemnity,,,110.09,,110.09,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Anthem,Individual Exchange,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Anthem,State Preferred,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Cigna,Cigna,,10.29,,,10.29,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Connecticare,Commerical,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Connecticare,Exchange,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,Multiplan,Multiplan,,,124.92,,124.92,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-690-30,NDC,both,5,mL,387.33,232.4,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-692-10,NDC,both,5,mL,129.11,77.47,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Aetna,Commerical,,,18.9,,18.9,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Aetna,Middlesex Employees,,,18.13,,18.13,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Anthem,Commerical,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Anthem,Indemnity,,,18.35,,18.35,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Anthem,Individual Exchange,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Anthem,State Preferred,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Cigna,Cigna,,10.29,,,10.29,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Connecticare,Commerical,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Connecticare,Exchange,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,Multiplan,Multiplan,,,20.83,,20.83,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 20% (200 MG/ML) INHALATION SOLN,J7608,HCPCS,63323-694-04,NDC,both,5,mL,64.56,38.74,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Commerical,,,136.8,,136.8,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Middlesex Employees,,,131.18,,131.18,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Commerical,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Indemnity,,,132.82,,132.82,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Individual Exchange,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Anthem,State Preferred,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Cigna,Cigna,,0.64,,,0.64,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Commerical,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Exchange,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,Multiplan,Multiplan,,,150.71,,150.71,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,0574-0805-30,NDC,both,0.5,mL,177.3,106.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.7,,,0.7,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Commerical,,,136.8,,136.8,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Middlesex Employees,,,131.18,,131.18,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Commerical,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Indemnity,,,132.82,,132.82,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Individual Exchange,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Anthem,State Preferred,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Cigna,Cigna,,0.64,,,0.64,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Commerical,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Exchange,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,Multiplan,Multiplan,,,150.71,,150.71,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,25021-812-30,NDC,both,0.5,mL,177.3,106.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.7,,,0.7,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Aetna,Commerical,,,136.8,,136.8,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Aetna,Middlesex Employees,,,131.18,,131.18,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Anthem,Commerical,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Anthem,Indemnity,,,132.82,,132.82,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Anthem,Individual Exchange,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Anthem,State Preferred,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Cigna,Cigna,,0.64,,,0.64,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Connecticare,Commerical,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Connecticare,Exchange,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,Multiplan,Multiplan,,,150.71,,150.71,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,55150-259-30,NDC,both,15,mL,177.3,106.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.7,,,0.7,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Commerical,,,136.8,,136.8,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Middlesex Employees,,,131.18,,131.18,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Commerical,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Indemnity,,,132.82,,132.82,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Individual Exchange,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Anthem,State Preferred,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Cigna,Cigna,,0.64,,,0.64,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Commerical,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Exchange,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,Multiplan,Multiplan,,,150.71,,150.71,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,63323-963-30,NDC,both,0.5,mL,177.3,106.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.7,,,0.7,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Commerical,,,136.8,,136.8,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Aetna,Middlesex Employees,,,131.18,,131.18,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Commerical,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Indemnity,,,132.82,,132.82,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Anthem,Individual Exchange,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Anthem,State Preferred,,,,,,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Cigna,Cigna,,0.64,,,0.64,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Commerical,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Connecticare,Exchange,,0.87,,,0.87,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,Multiplan,Multiplan,,,150.71,,150.71,0.64,150.71,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,J0132,HCPCS,66220-207-30,NDC,both,0.5,mL,177.3,106.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.7,,,0.7,0.64,150.71,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Aetna,Commerical,,,18.9,,18.9,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Aetna,Middlesex Employees,,,18.13,,18.13,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Anthem,Commerical,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Anthem,Indemnity,,,18.35,,18.35,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Anthem,Individual Exchange,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Anthem,State Preferred,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Cigna,Cigna,,10.29,,,10.29,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Connecticare,Commerical,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Connecticare,Exchange,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,Multiplan,Multiplan,,,20.83,,20.83,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7604-25,NDC,both,5,mL,24.5,14.7,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7610-03,NDC,both,5,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Aetna,Commerical,,,113.39,,113.39,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Aetna,Middlesex Employees,,,108.74,,108.74,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Anthem,Commerical,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Anthem,Indemnity,,,110.09,,110.09,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Anthem,Individual Exchange,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Anthem,State Preferred,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Cigna,Cigna,,10.29,,,10.29,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Connecticare,Commerical,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Connecticare,Exchange,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,Multiplan,Multiplan,,,124.92,,124.92,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,0517-7630-03,NDC,both,5,mL,146.96,88.18,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Aetna,Commerical,,,113.39,,113.39,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Aetna,Middlesex Employees,,,108.74,,108.74,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Anthem,Commerical,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Anthem,Indemnity,,,110.09,,110.09,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Anthem,Individual Exchange,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Anthem,State Preferred,,,,,,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Cigna,Cigna,,10.29,,,10.29,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Connecticare,Commerical,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Connecticare,Exchange,,11.87,,,11.87,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,Multiplan,Multiplan,,,124.92,,124.92,10.29,124.92,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-690-30,NDC,both,5,mL,146.96,88.18,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,124.92,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Aetna,Commerical,,,37.8,,37.8,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Aetna,Middlesex Employees,,,36.25,,36.25,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Commerical,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Indemnity,,,36.7,,36.7,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,Individual Exchange,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Anthem,State Preferred,,,,,,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Cigna,Cigna,,10.29,,,10.29,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Connecticare,Commerical,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Connecticare,Exchange,,11.87,,,11.87,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,Multiplan,Multiplan,,,41.64,,41.64,10.29,41.64,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-692-10,NDC,both,5,mL,48.99,29.39,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,41.64,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Aetna,Commerical,,,18.9,,18.9,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Aetna,Middlesex Employees,,,18.13,,18.13,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Anthem,Commerical,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Anthem,Indemnity,,,18.35,,18.35,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Anthem,Individual Exchange,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Anthem,State Preferred,,,,,,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Cigna,Cigna,,10.29,,,10.29,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Connecticare,Commerical,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Connecticare,Exchange,,11.87,,,11.87,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,Multiplan,Multiplan,,,20.83,,20.83,10.29,20.83,percent of total billed charges,,
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,J7608,HCPCS,63323-694-04,NDC,both,5,mL,24.5,14.7,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,20.83,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Aetna,Commerical,,,186.18,,186.18,178.53,205.1,percent of total billed charges,,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Aetna,Middlesex Employees,,,178.53,,178.53,178.53,205.1,percent of total billed charges,,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Anthem,Commerical,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Anthem,Indemnity,,,180.75,,180.75,178.53,205.1,percent of total billed charges,,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Anthem,Individual Exchange,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Anthem,State Preferred,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Cigna,Cigna,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Connecticare,Commerical,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Connecticare,Exchange,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,Multiplan,Multiplan,,,205.1,,205.1,178.53,205.1,percent of total billed charges,,
ACETYLCYSTEINE 5 % (50 MG/ML) SOLUTION,J3490,HCPCS,40810-0017-42,NDC,both,1,mL,241.29,144.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,178.53,205.1,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ACETYLCYSTEINE 600 MG CAPSULE,J3490,HCPCS,9629514038,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Aetna,Commerical,,,37.95,,37.95,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Aetna,Middlesex Employees,,,36.39,,36.39,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Anthem,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Anthem,Indemnity,,,36.84,,36.84,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Anthem,Individual Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Anthem,State Preferred,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Cigna,Cigna,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Connecticare,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Connecticare,Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,Multiplan,Multiplan,,,41.8,,41.8,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-04,NDC,both,120,mL,49.18,29.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Aetna,Commerical,,,37.95,,37.95,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Aetna,Middlesex Employees,,,36.39,,36.39,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Anthem,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Anthem,Indemnity,,,36.84,,36.84,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Anthem,Individual Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Anthem,State Preferred,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Cigna,Cigna,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Connecticare,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Connecticare,Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,Multiplan,Multiplan,,,41.8,,41.8,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,0574-0521-74,NDC,both,120,mL,49.18,29.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Aetna,Commerical,,,37.95,,37.95,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Aetna,Middlesex Employees,,,36.39,,36.39,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Anthem,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Anthem,Indemnity,,,36.84,,36.84,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Anthem,Individual Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Anthem,State Preferred,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Cigna,Cigna,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Connecticare,Commerical,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Connecticare,Exchange,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,Multiplan,Multiplan,,,41.8,,41.8,36.39,41.8,percent of total billed charges,,
ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION,J3490,HCPCS,66689-202-04,NDC,both,120,mL,49.18,29.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.39,41.8,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Aetna,Commerical,,,70.22,,70.22,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Aetna,Middlesex Employees,,,67.34,,67.34,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Anthem,Commerical,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Anthem,Indemnity,,,68.18,,68.18,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Anthem,Individual Exchange,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Anthem,State Preferred,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Cigna,Cigna,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Connecticare,Commerical,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Connecticare,Exchange,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,Multiplan,Multiplan,,,77.36,,77.36,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,0574-0121-76,NDC,both,240,mL,91.01,54.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Aetna,Commerical,,,70.22,,70.22,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Aetna,Middlesex Employees,,,67.34,,67.34,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Anthem,Commerical,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Anthem,Indemnity,,,68.18,,68.18,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Anthem,Individual Exchange,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Anthem,State Preferred,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Cigna,Cigna,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Connecticare,Commerical,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Connecticare,Exchange,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,Multiplan,Multiplan,,,77.36,,77.36,67.34,77.36,percent of total billed charges,,
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION,J3490,HCPCS,66689-201-08,NDC,both,240,mL,91.01,54.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.34,77.36,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,0904-5789-61,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
ACYCLOVIR 200 MG CAPSULE,J8499,HCPCS,72578-002-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0472-0082-16,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,23155-485-51,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,31722-681-47,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,50383-810-16,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70954-188-10,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Aetna,Commerical,,,355.05,,355.05,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Aetna,Middlesex Employees,,,340.46,,340.46,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Anthem,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Anthem,Indemnity,,,344.7,,344.7,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Anthem,Individual Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Anthem,State Preferred,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Cigna,Cigna,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Connecticare,Commerical,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Connecticare,Exchange,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,Multiplan,Multiplan,,,391.13,,391.13,340.46,391.13,percent of total billed charges,,
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,72205-170-72,NDC,both,1,mL,460.15,276.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,340.46,391.13,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Aetna,Commerical,,,1.2,,1.2,1.15,1.33,percent of total billed charges,,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Aetna,Middlesex Employees,,,1.15,,1.15,1.15,1.33,percent of total billed charges,,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Anthem,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Anthem,Indemnity,,,1.17,,1.17,1.15,1.33,percent of total billed charges,,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Anthem,Individual Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Anthem,State Preferred,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Cigna,Cigna,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Connecticare,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Connecticare,Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,Multiplan,Multiplan,,,1.33,,1.33,1.15,1.33,percent of total billed charges,,
ACYCLOVIR 400 MG TABLET,J8499,HCPCS,0904-5790-61,NDC,both,1,ea,1.56,0.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Aetna,Commerical,,,213.36,,213.36,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Aetna,Middlesex Employees,,,204.59,,204.59,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Anthem,Commerical,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Anthem,Indemnity,,,207.13,,207.13,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Anthem,Individual Exchange,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Anthem,State Preferred,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Cigna,Cigna,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Connecticare,Commerical,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Connecticare,Exchange,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,Multiplan,Multiplan,,,235.03,,235.03,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0825-15,NDC,both,1,gm,276.51,165.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Aetna,Commerical,,,2985.26,,2985.26,2862.61,3288.58,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Aetna,Middlesex Employees,,,2862.61,,2862.61,2862.61,3288.58,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Anthem,Commerical,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Anthem,Indemnity,,,2898.21,,2898.21,2862.61,3288.58,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Anthem,Individual Exchange,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Anthem,State Preferred,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Cigna,Cigna,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Connecticare,Commerical,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Connecticare,Exchange,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,Multiplan,Multiplan,,,3288.58,,3288.58,2862.61,3288.58,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,0187-0993-95,NDC,both,1,gm,3868.92,2321.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2862.61,3288.58,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Aetna,Commerical,,,213.36,,213.36,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Aetna,Middlesex Employees,,,204.59,,204.59,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Anthem,Commerical,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Anthem,Indemnity,,,207.13,,207.13,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Anthem,Individual Exchange,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Anthem,State Preferred,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Cigna,Cigna,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Connecticare,Commerical,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Connecticare,Exchange,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,Multiplan,Multiplan,,,235.03,,235.03,204.59,235.03,percent of total billed charges,,
ACYCLOVIR 5 % TOPICAL OINTMENT,J3490,HCPCS,65162-835-94,NDC,both,1,gm,276.51,165.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,204.59,235.03,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Aetna,Commerical,,,103.9,,103.9,0.04,114.45,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Aetna,Middlesex Employees,,,99.63,,99.63,0.04,114.45,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Anthem,Commerical,,,,,,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Anthem,Indemnity,,,100.87,,100.87,0.04,114.45,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Anthem,Individual Exchange,,,,,,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Anthem,State Preferred,,,,,,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Cigna,Cigna,,0.05,,,0.05,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Connecticare,Commerical,,0.04,,,0.04,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Connecticare,Exchange,,0.04,,,0.04,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,Multiplan,Multiplan,,,114.45,,114.45,0.04,114.45,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D10W NICU ,J0133,HCPCS,40810-0004-26,NDC,both,0.715,mL,134.65,80.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,114.45,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Aetna,Commerical,,,178.69,,178.69,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Aetna,Middlesex Employees,,,171.35,,171.35,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Anthem,Commerical,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Anthem,Indemnity,,,173.48,,173.48,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Anthem,Individual Exchange,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Anthem,State Preferred,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Cigna,Cigna,,0.05,,,0.05,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Connecticare,Commerical,,0.04,,,0.04,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Connecticare,Exchange,,0.04,,,0.04,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,Multiplan,Multiplan,,,196.85,,196.85,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN D5W NICU,J0133,HCPCS,40810-0004-27,NDC,both,0.715,mL,231.59,138.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Aetna,Commerical,,,178.69,,178.69,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Aetna,Middlesex Employees,,,171.35,,171.35,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Anthem,Commerical,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Anthem,Indemnity,,,173.48,,173.48,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Anthem,Individual Exchange,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Anthem,State Preferred,,,,,,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Cigna,Cigna,,0.05,,,0.05,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Connecticare,Commerical,,0.04,,,0.04,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Connecticare,Exchange,,0.04,,,0.04,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,Multiplan,Multiplan,,,196.85,,196.85,0.04,196.85,percent of total billed charges,,
ACYCLOVIR 7 MG/ML IN NS NICU,J0133,HCPCS,40810-0004-28,NDC,both,0.715,mL,231.59,138.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,196.85,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Aetna,Commerical,,,16.61,,16.61,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Aetna,Middlesex Employees,,,15.93,,15.93,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Commerical,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Indemnity,,,16.13,,16.13,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Individual Exchange,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Anthem,State Preferred,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Cigna,Cigna,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Connecticare,Commerical,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Connecticare,Exchange,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,Multiplan,Multiplan,,,18.3,,18.3,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,55150-155-20,NDC,both,0.1,mL,21.53,12.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Anthem,Commerical,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Anthem,Individual Exchange,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Anthem,State Preferred,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Cigna,Cigna,,0.05,,,0.05,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Connecticare,Commerical,,0.04,,,0.04,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Connecticare,Exchange,,0.04,,,0.04,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-03,NDC,both,0.1,mL,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Aetna,Commerical,,,16.61,,16.61,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Aetna,Middlesex Employees,,,15.93,,15.93,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Anthem,Commerical,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Anthem,Indemnity,,,16.13,,16.13,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Anthem,Individual Exchange,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Anthem,State Preferred,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Cigna,Cigna,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Connecticare,Commerical,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Connecticare,Exchange,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,Multiplan,Multiplan,,,18.3,,18.3,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-09,NDC,both,0.1,mL,21.53,12.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Anthem,Commerical,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Anthem,Individual Exchange,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Anthem,State Preferred,,,,,,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Cigna,Cigna,,0.05,,,0.05,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Connecticare,Commerical,,0.04,,,0.04,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Connecticare,Exchange,,0.04,,,0.04,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,0.04,9.15,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-10,NDC,both,0.1,mL,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,9.15,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Aetna,Commerical,,,16.61,,16.61,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Aetna,Middlesex Employees,,,15.93,,15.93,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Commerical,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Indemnity,,,16.13,,16.13,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Anthem,Individual Exchange,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Anthem,State Preferred,,,,,,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Cigna,Cigna,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Connecticare,Commerical,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Connecticare,Exchange,,0.04,,,0.04,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,Multiplan,Multiplan,,,18.3,,18.3,0.04,18.3,percent of total billed charges,,
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J0133,HCPCS,63323-325-20,NDC,both,0.1,mL,21.53,12.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,18.3,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,0.04,3.13,percent of total billed charges,,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,0.04,3.13,percent of total billed charges,,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Anthem,Commerical,,,,,,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,0.04,3.13,percent of total billed charges,,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Anthem,Individual Exchange,,,,,,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Anthem,State Preferred,,,,,,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Cigna,Cigna,,0.05,,,0.05,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Connecticare,Commerical,,0.04,,,0.04,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Connecticare,Exchange,,0.04,,,0.04,0.04,3.13,Other,Could be inpatient or outpatient,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,0.04,3.13,percent of total billed charges,,
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J0133,HCPCS,55390-612-10,NDC,both,0.01,ea,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.04,3.13,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Aetna,Commerical,,,19658.06,,19658.06,1027.42,21655.46,percent of total billed charges,,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Aetna,Middlesex Employees,,,18850.44,,18850.44,1027.42,21655.46,percent of total billed charges,,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Anthem,Commerical,,,,,,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Anthem,Indemnity,,,19084.83,,19084.83,1027.42,21655.46,percent of total billed charges,,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Anthem,Individual Exchange,,,,,,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Anthem,State Preferred,,,,,,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Cigna,Cigna,,1027.42,,,1027.42,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Connecticare,Commerical,,1388.35,,,1388.35,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Connecticare,Exchange,,1388.35,,,1388.35,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,Multiplan,Multiplan,,,21655.46,,21655.46,1027.42,21655.46,percent of total billed charges,,
ADALIMUMAB 80 MG/0.8 ML SUBCUTANEOUS PEN KIT,J0135,HCPCS,0074-0124-02,NDC,both,0.25,ea,25477.01,15286.21,United Healthcare/Oxford,United Healthcare/Oxford,,2238.08,,,2238.08,1027.42,21655.46,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Anthem,Commerical,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Anthem,Individual Exchange,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Anthem,State Preferred,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Cigna,Cigna,,0.47,,,0.47,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Connecticare,Commerical,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Connecticare,Exchange,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-542-25,NDC,both,0.33,mL,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Commerical,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Individual Exchange,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Anthem,State Preferred,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Cigna,Cigna,,0.47,,,0.47,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Connecticare,Commerical,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Connecticare,Exchange,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,17478-953-02,NDC,both,0.33,mL,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Commerical,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Anthem,Individual Exchange,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Anthem,State Preferred,,,,,,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Cigna,Cigna,,0.47,,,0.47,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Connecticare,Commerical,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Connecticare,Exchange,,0.61,,,0.61,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,0.47,6.79,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,63323-651-02,NDC,both,0.33,mL,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,6.79,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Aetna,Commerical,,,5.33,,5.33,0.47,5.87,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Aetna,Middlesex Employees,,,5.11,,5.11,0.47,5.87,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Anthem,Commerical,,,,,,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Anthem,Indemnity,,,5.18,,5.18,0.47,5.87,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Anthem,Individual Exchange,,,,,,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Anthem,State Preferred,,,,,,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Cigna,Cigna,,0.47,,,0.47,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Connecticare,Commerical,,0.61,,,0.61,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Connecticare,Exchange,,0.61,,,0.61,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,Multiplan,Multiplan,,,5.87,,5.87,0.47,5.87,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,67457-855-00,NDC,both,0.2,mL,6.91,4.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,5.87,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Aetna,Commerical,,,5.35,,5.35,0.47,5.89,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Aetna,Middlesex Employees,,,5.13,,5.13,0.47,5.89,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Anthem,Commerical,,,,,,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Anthem,Indemnity,,,5.19,,5.19,0.47,5.89,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Anthem,Individual Exchange,,,,,,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Anthem,State Preferred,,,,,,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Cigna,Cigna,,0.47,,,0.47,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Connecticare,Commerical,,0.61,,,0.61,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Connecticare,Exchange,,0.61,,,0.61,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,Multiplan,Multiplan,,,5.89,,5.89,0.47,5.89,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-00,NDC,both,0.334,mL,6.93,4.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,5.89,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Aetna,Commerical,,,6.22,,6.22,0.47,6.85,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Aetna,Middlesex Employees,,,5.96,,5.96,0.47,6.85,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Anthem,Commerical,,,,,,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Anthem,Indemnity,,,6.04,,6.04,0.47,6.85,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Anthem,Individual Exchange,,,,,,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Anthem,State Preferred,,,,,,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Cigna,Cigna,,0.47,,,0.47,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Connecticare,Commerical,,0.61,,,0.61,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Connecticare,Exchange,,0.61,,,0.61,0.47,6.85,Other,Could be inpatient or outpatient,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,Multiplan,Multiplan,,,6.85,,6.85,0.47,6.85,percent of total billed charges,,
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,J0153,HCPCS,72078-033-02,NDC,both,0.333,mL,8.06,4.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.47,6.85,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,31722-935-02,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,40810-0201-38,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,43598-452-02,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,52054-550-22,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,70710-1021-8,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Aetna,Commerical,,,50.27,,50.27,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Aetna,Middlesex Employees,,,48.2,,48.2,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Anthem,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Anthem,Indemnity,,,48.8,,48.8,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Anthem,Individual Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Anthem,State Preferred,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Cigna,Cigna,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Connecticare,Commerical,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Connecticare,Exchange,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,Multiplan,Multiplan,,,55.38,,55.38,48.2,55.38,percent of total billed charges,,
ALBENDAZOLE 200 MG TABLET,J8499,HCPCS,72205-051-08,NDC,both,1,ea,65.15,39.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.2,55.38,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-05,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,44206-251-90,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-7,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68516-5216-9,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,68982-643-01,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-25,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",P9047,HCPCS,76125-792-26,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25 % SOLUTION FOR SCLEROTHERAPY",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Commerical,,,99.89,,99.89,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Aetna,Middlesex Employees,,,95.79,,95.79,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Commerical,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Indemnity,,,96.98,,96.98,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,Individual Exchange,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Anthem,State Preferred,,,,,,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Cigna,Cigna,,51.87,,,51.87,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Commerical,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Connecticare,Exchange,,81.59,,,81.59,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,Multiplan,Multiplan,,,110.04,,110.04,51.87,110.04,percent of total billed charges,,
"ALBUMIN, HUMAN 25% IV WEIGHT SPECIFIC FOR THERAPY PLANS",P9047,HCPCS,0944-0493-01,NDC,both,50,mL,129.46,77.68,United Healthcare/Oxford,United Healthcare/Oxford,,64.76,,,64.76,51.87,110.04,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-1,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",P9041,HCPCS,76125-790-26,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-7,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68516-5214-9,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% CONTINUOUS INFUSION",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,0944-0495-05,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,44206-310-25,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Commerical,,,99.74,,99.74,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Aetna,Middlesex Employees,,,95.65,,95.65,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Commerical,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Indemnity,,,96.84,,96.84,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,Individual Exchange,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Anthem,State Preferred,,,,,,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Cigna,Cigna,,37.8,,,37.8,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Commerical,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Connecticare,Exchange,,16.66,,,16.66,12.96,109.88,Other,Could be inpatient or outpatient,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,Multiplan,Multiplan,,,109.88,,109.88,12.96,109.88,percent of total billed charges,,
"ALBUMIN, HUMAN 5% WEIGHT SPECIFIC FOR THERAPY PLANS",P9041,HCPCS,68982-623-02,NDC,both,50,mL,129.27,77.56,United Healthcare/Oxford,United Healthcare/Oxford,,12.96,,,12.96,12.96,109.88,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Aetna,Commerical,,,147.76,,147.76,1.39,162.78,percent of total billed charges,,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Aetna,Middlesex Employees,,,141.69,,141.69,1.39,162.78,percent of total billed charges,,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Indemnity,,,143.45,,143.45,1.39,162.78,percent of total billed charges,,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Individual Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,State Preferred,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Cigna,Cigna,,1.39,,,1.39,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Connecticare,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Connecticare,Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Multiplan,Multiplan,,,162.78,,162.78,1.39,162.78,percent of total billed charges,,
ALBUTEROL 0.5% INHALATION SOLUTION PF (CONTINUOUS),J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Aetna,Commerical,,,72.69,,72.69,69.71,80.08,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Aetna,Middlesex Employees,,,69.71,,69.71,69.71,80.08,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Anthem,Commerical,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Anthem,Indemnity,,,70.57,,70.57,69.71,80.08,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Anthem,Individual Exchange,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Anthem,State Preferred,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Cigna,Cigna,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Connecticare,Commerical,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Connecticare,Exchange,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,Multiplan,Multiplan,,,80.08,,80.08,69.71,80.08,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0472-0825-16,NDC,both,1,mL,94.21,56.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,69.71,80.08,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Aetna,Commerical,,,69.89,,69.89,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Aetna,Middlesex Employees,,,67.02,,67.02,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Anthem,Commerical,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Anthem,Indemnity,,,67.85,,67.85,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Anthem,Individual Exchange,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Anthem,State Preferred,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Cigna,Cigna,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Connecticare,Commerical,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Connecticare,Exchange,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,Multiplan,Multiplan,,,76.99,,76.99,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,50383-740-16,NDC,both,1,mL,90.58,54.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Aetna,Commerical,,,69.89,,69.89,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Aetna,Middlesex Employees,,,67.02,,67.02,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Anthem,Commerical,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Anthem,Indemnity,,,67.85,,67.85,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Anthem,Individual Exchange,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Anthem,State Preferred,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Cigna,Cigna,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Connecticare,Commerical,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Connecticare,Exchange,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,Multiplan,Multiplan,,,76.99,,76.99,67.02,76.99,percent of total billed charges,,
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,70752-102-12,NDC,both,1,mL,90.58,54.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.02,76.99,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,0.19,,,0.19,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,0.28,,,0.28,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,0.28,,,0.28,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION-NICU,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.06,0.52,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.06,0.52,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Anthem,Commerical,,,,,,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.06,0.52,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Anthem,Individual Exchange,,,,,,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Anthem,State Preferred,,,,,,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Cigna,Cigna,,0.06,,,0.06,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Connecticare,Commerical,,0.11,,,0.11,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Connecticare,Exchange,,0.11,,,0.11,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.06,0.52,percent of total billed charges,,
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,J7613,HCPCS,0487-9501-01,NDC,both,3,mL,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,0.52,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,0.19,,,0.19,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,0.28,,,0.28,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,0.28,,,0.28,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,0.19,1.18,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7611,HCPCS,0487-9901-30,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,1.18,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Aetna,Commerical,,,147.76,,147.76,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Aetna,Middlesex Employees,,,141.69,,141.69,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Anthem,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Anthem,Indemnity,,,143.45,,143.45,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Anthem,Individual Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Anthem,State Preferred,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Cigna,Cigna,,1.39,,,1.39,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Connecticare,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Connecticare,Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,Multiplan,Multiplan,,,162.78,,162.78,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,69374-309-20,NDC,both,0.2,mL,191.5,114.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Aetna,Commerical,,,147.76,,147.76,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Aetna,Middlesex Employees,,,141.69,,141.69,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Indemnity,,,143.45,,143.45,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,Individual Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Anthem,State Preferred,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Cigna,Cigna,,1.39,,,1.39,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Connecticare,Commerical,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Connecticare,Exchange,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,Multiplan,Multiplan,,,162.78,,162.78,1.39,162.78,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7610,HCPCS,73177-146-33,NDC,both,0.2,mL,191.5,114.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,162.78,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Aetna,Commerical,,,43.03,,43.03,0.19,47.4,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Aetna,Middlesex Employees,,,41.26,,41.26,0.19,47.4,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Anthem,Commerical,,,,,,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Anthem,Indemnity,,,41.78,,41.78,0.19,47.4,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Anthem,Individual Exchange,,,,,,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Anthem,State Preferred,,,,,,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Cigna,Cigna,,0.19,,,0.19,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Connecticare,Commerical,,0.28,,,0.28,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Connecticare,Exchange,,0.28,,,0.28,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,Multiplan,Multiplan,,,47.4,,47.4,0.19,47.4,percent of total billed charges,,
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,J7611,HCPCS,50383-741-20,NDC,both,0.2,mL,55.77,33.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,47.4,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Aetna,Commerical,,,67.98,,67.98,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Aetna,Middlesex Employees,,,65.19,,65.19,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Anthem,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Anthem,Indemnity,,,66,,66,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Anthem,Individual Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Anthem,State Preferred,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Cigna,Cigna,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Connecticare,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Connecticare,Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,Multiplan,Multiplan,,,74.89,,74.89,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0093-3174-31,NDC,both,8.5,gm,88.1,52.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Aetna,Commerical,,,105.49,,105.49,101.15,116.2,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Aetna,Middlesex Employees,,,101.15,,101.15,101.15,116.2,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Anthem,Commerical,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Anthem,Indemnity,,,102.41,,102.41,101.15,116.2,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Anthem,Individual Exchange,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Anthem,State Preferred,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Cigna,Cigna,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Connecticare,Commerical,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Connecticare,Exchange,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,Multiplan,Multiplan,,,116.2,,116.2,101.15,116.2,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-20,NDC,both,18,gm,136.71,82.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.15,116.2,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Aetna,Commerical,,,45.02,,45.02,43.17,49.59,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Aetna,Middlesex Employees,,,43.17,,43.17,43.17,49.59,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Anthem,Commerical,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Anthem,Indemnity,,,43.7,,43.7,43.17,49.59,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Anthem,Individual Exchange,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Anthem,State Preferred,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Cigna,Cigna,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Connecticare,Commerical,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Connecticare,Exchange,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,Multiplan,Multiplan,,,49.59,,49.59,43.17,49.59,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0173-0682-24,NDC,both,8,gm,58.34,35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.17,49.59,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Aetna,Commerical,,,53.58,,53.58,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Aetna,Middlesex Employees,,,51.38,,51.38,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Anthem,Commerical,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Anthem,Indemnity,,,52.02,,52.02,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Anthem,Individual Exchange,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Anthem,State Preferred,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Cigna,Cigna,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Connecticare,Commerical,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Connecticare,Exchange,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,Multiplan,Multiplan,,,59.02,,59.02,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,0781-7296-85,NDC,both,6.7,gm,69.44,41.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Aetna,Commerical,,,67.98,,67.98,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Aetna,Middlesex Employees,,,65.19,,65.19,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Anthem,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Anthem,Indemnity,,,66,,66,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Anthem,Individual Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Anthem,State Preferred,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Cigna,Cigna,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Connecticare,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Connecticare,Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,Multiplan,Multiplan,,,74.89,,74.89,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,59310-579-22,NDC,both,8.5,gm,88.1,52.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Aetna,Commerical,,,67.98,,67.98,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Aetna,Middlesex Employees,,,65.19,,65.19,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Anthem,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Anthem,Indemnity,,,66,,66,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Anthem,Individual Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Anthem,State Preferred,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Cigna,Cigna,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Connecticare,Commerical,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Connecticare,Exchange,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,Multiplan,Multiplan,,,74.89,,74.89,65.19,74.89,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,68180-963-01,NDC,both,8.5,gm,88.1,52.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.19,74.89,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Aetna,Commerical,,,53.58,,53.58,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Aetna,Middlesex Employees,,,51.38,,51.38,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Anthem,Commerical,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Anthem,Indemnity,,,52.02,,52.02,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Anthem,Individual Exchange,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Anthem,State Preferred,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Cigna,Cigna,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Connecticare,Commerical,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Connecticare,Exchange,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,Multiplan,Multiplan,,,59.02,,59.02,51.38,59.02,percent of total billed charges,,
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,J3535,HCPCS,69097-142-60,NDC,both,6.7,gm,69.44,41.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.38,59.02,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Aetna,Commerical,,,16405.87,,16405.87,3222.89,18072.82,percent of total billed charges,,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Aetna,Middlesex Employees,,,15731.86,,15731.86,3222.89,18072.82,percent of total billed charges,,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Anthem,Commerical,,,,,,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Anthem,Indemnity,,,15927.47,,15927.47,3222.89,18072.82,percent of total billed charges,,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Anthem,Individual Exchange,,,,,,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Anthem,State Preferred,,,,,,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Cigna,Cigna,,7984.13,,,7984.13,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Connecticare,Commerical,,3222.89,,,3222.89,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Connecticare,Exchange,,3222.89,,,3222.89,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,Multiplan,Multiplan,,,18072.82,,18072.82,3222.89,18072.82,percent of total billed charges,,
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION,J9015,HCPCS,73776-022-01,NDC,both,1,ea,21262.14,12757.28,United Healthcare/Oxford,United Healthcare/Oxford,,4810.46,,,4810.46,3222.89,18072.82,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Aetna,Commerical,,,215.36,,215.36,206.51,237.24,percent of total billed charges,,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Aetna,Middlesex Employees,,,206.51,,206.51,206.51,237.24,percent of total billed charges,,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Anthem,Commerical,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Anthem,Indemnity,,,209.08,,209.08,206.51,237.24,percent of total billed charges,,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Anthem,Individual Exchange,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Anthem,State Preferred,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Cigna,Cigna,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Connecticare,Commerical,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Connecticare,Exchange,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,Multiplan,Multiplan,,,237.24,,237.24,206.51,237.24,percent of total billed charges,,
ALECTINIB 150 MG CAPSULE ONC0LOGY,J3490,HCPCS,50242-130-01,NDC,both,1,ea,279.11,167.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,206.51,237.24,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Aetna,Commerical,,,118681.96,,118681.96,2654.19,130740.88,percent of total billed charges,,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Aetna,Middlesex Employees,,,113806.09,,113806.09,2654.19,130740.88,percent of total billed charges,,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Anthem,Commerical,,,,,,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Anthem,Indemnity,,,115221.17,,115221.17,2654.19,130740.88,percent of total billed charges,,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Anthem,Individual Exchange,,,,,,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Anthem,State Preferred,,,,,,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Cigna,Cigna,,2654.19,,,2654.19,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Connecticare,Commerical,,3569.61,,,3569.61,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Connecticare,Exchange,,3569.61,,,3569.61,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,Multiplan,Multiplan,,,130740.88,,130740.88,2654.19,130740.88,percent of total billed charges,,
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,J0202,HCPCS,58468-0200-1,NDC,both,1,mL,153812.8,92287.68,United Healthcare/Oxford,United Healthcare/Oxford,,2865.58,,,2865.58,2654.19,130740.88,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Aetna,Commerical,,,2767.1,,2767.1,227.89,3048.26,percent of total billed charges,,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Aetna,Middlesex Employees,,,2653.42,,2653.42,227.89,3048.26,percent of total billed charges,,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Anthem,Commerical,,,,,,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Anthem,Indemnity,,,2686.41,,2686.41,227.89,3048.26,percent of total billed charges,,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Anthem,Individual Exchange,,,,,,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Anthem,State Preferred,,,,,,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Cigna,Cigna,,227.89,,,227.89,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Connecticare,Commerical,,308.4,,,308.4,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Connecticare,Exchange,,308.4,,,308.4,227.89,3048.26,Other,Could be inpatient or outpatient,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,Multiplan,Multiplan,,,3048.26,,3048.26,227.89,3048.26,percent of total billed charges,,
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION,J0221,HCPCS,58468-0160-1,NDC,both,0.2,ea,3586.19,2151.71,United Healthcare/Oxford,United Healthcare/Oxford,,246.04,,,246.04,227.89,3048.26,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,0904-7041-61,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,51079-205-20,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-01,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,60687-677-11,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-01,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,62584-988-11,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
ALLOPURINOL 100 MG TABLET,J3490,HCPCS,63739-410-10,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
ALLOPURINOL 150 MG ORAL TAB,J3490,HCPCS,40810-0000-20,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Aetna,Commerical,,,9.93,,9.93,9.52,10.94,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Aetna,Middlesex Employees,,,9.52,,9.52,9.52,10.94,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Anthem,Commerical,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Anthem,Indemnity,,,9.64,,9.64,9.52,10.94,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Anthem,Individual Exchange,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Anthem,State Preferred,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Cigna,Cigna,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Connecticare,Commerical,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Connecticare,Exchange,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,Multiplan,Multiplan,,,10.94,,10.94,9.52,10.94,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-21,NDC,both,1,mL,12.87,7.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.52,10.94,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Aetna,Commerical,,,19.86,,19.86,19.05,21.88,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Aetna,Middlesex Employees,,,19.05,,19.05,19.05,21.88,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Anthem,Commerical,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Anthem,Indemnity,,,19.28,,19.28,19.05,21.88,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Anthem,Individual Exchange,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Anthem,State Preferred,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Cigna,Cigna,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Connecticare,Commerical,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Connecticare,Exchange,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,Multiplan,Multiplan,,,21.88,,21.88,19.05,21.88,percent of total billed charges,,
ALLOPURINOL 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-02,NDC,both,1,mL,25.74,15.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.05,21.88,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0591-5544-05,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,0904-6572-61,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,51079-206-20,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-01,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
ALLOPURINOL 300 MG TABLET,J3490,HCPCS,62584-713-11,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Aetna,Commerical,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Aetna,Middlesex Employees,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Anthem,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Anthem,Indemnity,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Anthem,Individual Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Anthem,State Preferred,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Cigna,Cigna,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Connecticare,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Connecticare,Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,Multiplan,Multiplan,,,0.09,,0.09,0.08,0.09,percent of total billed charges,,
ALLOPURINOL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-22,NDC,both,1,ea,0.11,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Aetna,Commerical,,,7111.02,,7111.02,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Aetna,Middlesex Employees,,,6818.87,,6818.87,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Anthem,Commerical,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Anthem,Indemnity,,,6903.66,,6903.66,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Anthem,Individual Exchange,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Anthem,State Preferred,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Cigna,Cigna,,6.2,,,6.2,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Connecticare,Commerical,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Connecticare,Exchange,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,Multiplan,Multiplan,,,7833.55,,7833.55,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,0143-9533-01,NDC,both,1,ea,9215.94,5529.56,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Aetna,Commerical,,,7111.02,,7111.02,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Aetna,Middlesex Employees,,,6818.87,,6818.87,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Commerical,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Indemnity,,,6903.66,,6903.66,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Individual Exchange,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Anthem,State Preferred,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Cigna,Cigna,,6.2,,,6.2,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Connecticare,Commerical,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Connecticare,Exchange,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,Multiplan,Multiplan,,,7833.55,,7833.55,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,65219-380-30,NDC,both,0.002,ea,9215.94,5529.56,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Aetna,Commerical,,,7111.02,,7111.02,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Aetna,Middlesex Employees,,,6818.87,,6818.87,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Anthem,Commerical,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Anthem,Indemnity,,,6903.66,,6903.66,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Anthem,Individual Exchange,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Anthem,State Preferred,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Cigna,Cigna,,6.2,,,6.2,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Connecticare,Commerical,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Connecticare,Exchange,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,Multiplan,Multiplan,,,7833.55,,7833.55,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-187-50,NDC,both,1,ea,9215.94,5529.56,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Aetna,Commerical,,,7111.02,,7111.02,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Aetna,Middlesex Employees,,,6818.87,,6818.87,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Commerical,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Indemnity,,,6903.66,,6903.66,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Anthem,Individual Exchange,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Anthem,State Preferred,,,,,,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Cigna,Cigna,,6.2,,,6.2,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Connecticare,Commerical,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Connecticare,Exchange,,7.64,,,7.64,6.2,7833.55,Other,Could be inpatient or outpatient,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,Multiplan,Multiplan,,,7833.55,,7833.55,6.2,7833.55,percent of total billed charges,,
ALLOPURINOL 500 MG INTRAVENOUS SOLUTION,J0206,HCPCS,67457-978-50,NDC,both,0.002,ea,9215.94,5529.56,United Healthcare/Oxford,United Healthcare/Oxford,,6.7,,,6.7,6.2,7833.55,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,761012012,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
ALPHA LIPOIC ACID 100 MG CAPSULE,J3490,HCPCS,40810-0207-60,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
ALPRAZOLAM 0.25 MG TABLET,J3490,HCPCS,65862-676-01,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Aetna,Commerical,,,305.31,,305.31,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Aetna,Middlesex Employees,,,292.76,,292.76,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Indemnity,,,296.4,,296.4,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Individual Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Anthem,State Preferred,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Cigna,Cigna,,11.84,,,11.84,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Connecticare,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Connecticare,Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,Multiplan,Multiplan,,,336.33,,336.33,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-01,NDC,both,0.003,mL,395.68,237.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Aetna,Commerical,,,305.31,,305.31,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Aetna,Middlesex Employees,,,292.76,,292.76,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Anthem,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Anthem,Indemnity,,,296.4,,296.4,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Anthem,Individual Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Anthem,State Preferred,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Cigna,Cigna,,11.84,,,11.84,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Connecticare,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Connecticare,Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,Multiplan,Multiplan,,,336.33,,336.33,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-0215-05,NDC,both,0.003,mL,395.68,237.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Aetna,Commerical,,,304.7,,304.7,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Aetna,Middlesex Employees,,,292.18,,292.18,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Anthem,Commerical,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Anthem,Indemnity,,,295.81,,295.81,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Anthem,Individual Exchange,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Anthem,State Preferred,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Cigna,Cigna,,11.84,,,11.84,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Connecticare,Commerical,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Connecticare,Exchange,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,Multiplan,Multiplan,,,335.66,,335.66,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-01,NDC,both,0.002,mL,394.89,236.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Aetna,Commerical,,,304.7,,304.7,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Aetna,Middlesex Employees,,,292.18,,292.18,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Anthem,Commerical,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Anthem,Indemnity,,,295.81,,295.81,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Anthem,Individual Exchange,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Anthem,State Preferred,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Cigna,Cigna,,11.84,,,11.84,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Connecticare,Commerical,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Connecticare,Exchange,,,,,,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,Multiplan,Multiplan,,,335.66,,335.66,0.54,335.66,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0009-3169-06,NDC,both,0.002,mL,394.89,236.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.54,335.66,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Aetna,Commerical,,,305.31,,305.31,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Aetna,Middlesex Employees,,,292.76,,292.76,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Indemnity,,,296.4,,296.4,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Anthem,Individual Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Anthem,State Preferred,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Cigna,Cigna,,11.84,,,11.84,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Connecticare,Commerical,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Connecticare,Exchange,,,,,,0.54,336.33,Other,Could be inpatient or outpatient,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,Multiplan,Multiplan,,,336.33,,336.33,0.54,336.33,percent of total billed charges,,
ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,J0270,HCPCS,0703-1501-01,NDC,both,0.003,mL,395.68,237.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.54,336.33,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Aetna,Commerical,,,1671.63,,1671.63,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Aetna,Middlesex Employees,,,1602.95,,1602.95,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Anthem,Commerical,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Anthem,Indemnity,,,1622.88,,1622.88,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Anthem,Individual Exchange,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Anthem,State Preferred,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Cigna,Cigna,,103.21,,,103.21,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Connecticare,Commerical,,139.67,,,139.67,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Connecticare,Exchange,,139.67,,,139.67,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,Multiplan,Multiplan,,,1841.47,,1841.47,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG,J2997,HCPCS,40810-0020-82,NDC,both,1,mL,2166.44,1299.86,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Aetna,Commerical,,,1671.63,,1671.63,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Aetna,Middlesex Employees,,,1602.95,,1602.95,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Anthem,Commerical,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Anthem,Indemnity,,,1622.88,,1622.88,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Anthem,Individual Exchange,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Anthem,State Preferred,,,,,,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Cigna,Cigna,,103.21,,,103.21,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Connecticare,Commerical,,139.67,,,139.67,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Connecticare,Exchange,,139.67,,,139.67,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,Multiplan,Multiplan,,,1841.47,,1841.47,103.21,1841.47,percent of total billed charges,,
ALTEPLASE (ACTIVASE) LOW-DOSE THROMBOLYTIC INFUSION > 50 KG 4 HR,J2997,HCPCS,40810-0020-83,NDC,both,1,mL,2166.44,1299.86,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,1841.47,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML BOLUS (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (< 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (</= 55 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 1 MG/ML INFUSION FOR STROKE (>/= 100 KG PATIENT),J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Aetna,Commerical,,,20824.13,,20824.13,103.21,22940.01,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Aetna,Middlesex Employees,,,19968.61,,19968.61,103.21,22940.01,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Anthem,Commerical,,,,,,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Anthem,Indemnity,,,20216.9,,20216.9,103.21,22940.01,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Anthem,Individual Exchange,,,,,,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Anthem,State Preferred,,,,,,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Cigna,Cigna,,103.21,,,103.21,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Connecticare,Commerical,,139.67,,,139.67,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Connecticare,Exchange,,139.67,,,139.67,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,Multiplan,Multiplan,,,22940.01,,22940.01,103.21,22940.01,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-25,NDC,both,0.01,ea,26988.25,16192.95,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,22940.01,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Aetna,Commerical,,,25031.82,,25031.82,103.21,27575.23,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Aetna,Middlesex Employees,,,24003.43,,24003.43,103.21,27575.23,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Anthem,Commerical,,,,,,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Anthem,Indemnity,,,24301.89,,24301.89,103.21,27575.23,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Anthem,Individual Exchange,,,,,,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Anthem,State Preferred,,,,,,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Cigna,Cigna,,103.21,,,103.21,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Connecticare,Commerical,,139.67,,,139.67,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Connecticare,Exchange,,139.67,,,139.67,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,Multiplan,Multiplan,,,27575.23,,27575.23,103.21,27575.23,percent of total billed charges,,
ALTEPLASE 100 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-085-27,NDC,both,0.01,ea,32441.45,19464.87,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,27575.23,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Aetna,Commerical,,,477.71,,477.71,103.21,526.25,percent of total billed charges,,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Aetna,Middlesex Employees,,,458.09,,458.09,103.21,526.25,percent of total billed charges,,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Anthem,Commerical,,,,,,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Anthem,Indemnity,,,463.78,,463.78,103.21,526.25,percent of total billed charges,,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Anthem,Individual Exchange,,,,,,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Anthem,State Preferred,,,,,,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Cigna,Cigna,,103.21,,,103.21,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Connecticare,Commerical,,139.67,,,139.67,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Connecticare,Exchange,,139.67,,,139.67,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,Multiplan,Multiplan,,,526.25,,526.25,103.21,526.25,percent of total billed charges,,
ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,J2997,HCPCS,50242-041-64,NDC,both,0.5,ea,619.12,371.47,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,526.25,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE 50 MG INTRAVENOUS SOLUTION,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Commerical,,,12515.9,,12515.9,103.21,13787.6,percent of total billed charges,,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Aetna,Middlesex Employees,,,12001.7,,12001.7,103.21,13787.6,percent of total billed charges,,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Commerical,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Indemnity,,,12150.93,,12150.93,103.21,13787.6,percent of total billed charges,,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,Individual Exchange,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Anthem,State Preferred,,,,,,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Cigna,Cigna,,103.21,,,103.21,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Commerical,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Connecticare,Exchange,,139.67,,,139.67,103.21,13787.6,Other,Could be inpatient or outpatient,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,Multiplan,Multiplan,,,13787.6,,13787.6,103.21,13787.6,percent of total billed charges,,
ALTEPLASE SYSTEMIC INFUSION 1 MG/ML,J2997,HCPCS,50242-044-13,NDC,both,0.02,ea,16220.71,9732.43,United Healthcare/Oxford,United Healthcare/Oxford,,111.43,,,111.43,103.21,13787.6,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Aetna,Commerical,,,15.38,,15.38,14.75,16.94,percent of total billed charges,,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Aetna,Middlesex Employees,,,14.75,,14.75,14.75,16.94,percent of total billed charges,,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Anthem,Commerical,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Anthem,Indemnity,,,14.93,,14.93,14.75,16.94,percent of total billed charges,,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Anthem,Individual Exchange,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Anthem,State Preferred,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Cigna,Cigna,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Connecticare,Commerical,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Connecticare,Exchange,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,Multiplan,Multiplan,,,16.94,,16.94,14.75,16.94,percent of total billed charges,,
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-0091-85,NDC,both,1,mL,19.93,11.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.75,16.94,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Aetna,Commerical,,,100.72,,100.72,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Aetna,Middlesex Employees,,,96.58,,96.58,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Anthem,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Anthem,Indemnity,,,97.78,,97.78,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Anthem,Individual Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Anthem,State Preferred,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Cigna,Cigna,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Connecticare,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Connecticare,Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,Multiplan,Multiplan,,,110.95,,110.95,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-1293-83,NDC,both,1,mL,130.53,78.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Aetna,Commerical,,,8.52,,8.52,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Aetna,Middlesex Employees,,,8.17,,8.17,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Anthem,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Anthem,Indemnity,,,8.27,,8.27,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Anthem,Individual Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Anthem,State Preferred,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Cigna,Cigna,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Connecticare,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Connecticare,Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,Multiplan,Multiplan,,,9.38,,9.38,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-6838-73,NDC,both,30,mL,11.04,6.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Aetna,Commerical,,,8.52,,8.52,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Aetna,Middlesex Employees,,,8.17,,8.17,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Anthem,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Anthem,Indemnity,,,8.27,,8.27,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Anthem,Individual Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Anthem,State Preferred,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Cigna,Cigna,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Connecticare,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Connecticare,Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,Multiplan,Multiplan,,,9.38,,9.38,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-62,NDC,both,1,mL,11.04,6.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Aetna,Commerical,,,8.52,,8.52,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Aetna,Middlesex Employees,,,8.17,,8.17,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Anthem,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Anthem,Indemnity,,,8.27,,8.27,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Anthem,Individual Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Anthem,State Preferred,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Cigna,Cigna,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Connecticare,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Connecticare,Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,Multiplan,Multiplan,,,9.38,,9.38,8.17,9.38,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,0904-7325-73,NDC,both,1,mL,11.04,6.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Aetna,Commerical,,,100.72,,100.72,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Aetna,Middlesex Employees,,,96.58,,96.58,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Anthem,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Anthem,Indemnity,,,97.78,,97.78,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Anthem,Individual Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Anthem,State Preferred,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Cigna,Cigna,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Connecticare,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Connecticare,Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,Multiplan,Multiplan,,,110.95,,110.95,96.58,110.95,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,J3490,HCPCS,57896-629-12,NDC,both,355,mL,130.53,78.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Aetna,Commerical,,,10.49,,10.49,10.06,11.56,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Aetna,Middlesex Employees,,,10.06,,10.06,10.06,11.56,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Anthem,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Anthem,Indemnity,,,10.19,,10.19,10.06,11.56,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Anthem,Individual Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Anthem,State Preferred,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Cigna,Cigna,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Connecticare,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Connecticare,Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,Multiplan,Multiplan,,,11.56,,11.56,10.06,11.56,percent of total billed charges,,
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,J3490,HCPCS,0536-0015-83,NDC,both,1,mL,13.6,8.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-1760-30,NDC,both,1,mL,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-6630-61,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
AMANTADINE HCL 100 MG CAPSULE,J3490,HCPCS,0904-7042-61,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Aetna,Commerical,,,53.12,,53.12,50.94,58.52,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Aetna,Middlesex Employees,,,50.94,,50.94,50.94,58.52,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Anthem,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Anthem,Indemnity,,,51.58,,51.58,50.94,58.52,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Anthem,Individual Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Anthem,State Preferred,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Cigna,Cigna,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Connecticare,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Connecticare,Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,Multiplan,Multiplan,,,58.52,,58.52,50.94,58.52,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0646-16,NDC,both,1,mL,68.85,41.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Aetna,Commerical,,,47.53,,47.53,45.58,52.36,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Aetna,Middlesex Employees,,,45.58,,45.58,45.58,52.36,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Anthem,Commerical,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Anthem,Indemnity,,,46.14,,46.14,45.58,52.36,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Anthem,Individual Exchange,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Anthem,State Preferred,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Cigna,Cigna,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Connecticare,Commerical,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Connecticare,Exchange,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,Multiplan,Multiplan,,,52.36,,52.36,45.58,52.36,percent of total billed charges,,
AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-807-16,NDC,both,1,mL,61.6,36.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.58,52.36,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Aetna,Commerical,,,52.83,,52.83,50.66,58.2,percent of total billed charges,,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Aetna,Middlesex Employees,,,50.66,,50.66,50.66,58.2,percent of total billed charges,,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Anthem,Commerical,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Anthem,Indemnity,,,51.29,,51.29,50.66,58.2,percent of total billed charges,,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Anthem,Individual Exchange,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Anthem,State Preferred,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Cigna,Cigna,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Connecticare,Commerical,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Connecticare,Exchange,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,Multiplan,Multiplan,,,58.2,,58.2,50.66,58.2,percent of total billed charges,,
AMBRISENTAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0209-61,NDC,both,1,ea,68.47,41.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.66,58.2,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Aetna,Commerical,,,709.93,,709.93,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Aetna,Middlesex Employees,,,680.76,,680.76,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Anthem,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Anthem,Indemnity,,,689.22,,689.22,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Anthem,Individual Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Anthem,State Preferred,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Cigna,Cigna,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Connecticare,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Connecticare,Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,Multiplan,Multiplan,,,782.06,,782.06,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0378-4270-93,NDC,both,1,ea,920.07,552.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Aetna,Commerical,,,709.93,,709.93,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Aetna,Middlesex Employees,,,680.76,,680.76,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Anthem,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Anthem,Indemnity,,,689.22,,689.22,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Anthem,Individual Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Anthem,State Preferred,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Cigna,Cigna,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Connecticare,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Connecticare,Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,Multiplan,Multiplan,,,782.06,,782.06,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,0591-2405-30,NDC,both,1,ea,920.07,552.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Aetna,Commerical,,,709.93,,709.93,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Aetna,Middlesex Employees,,,680.76,,680.76,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Anthem,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Anthem,Indemnity,,,689.22,,689.22,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Anthem,Individual Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Anthem,State Preferred,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Cigna,Cigna,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Connecticare,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Connecticare,Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,Multiplan,Multiplan,,,782.06,,782.06,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,40810-0203-58,NDC,both,1,UN,920.07,552.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Aetna,Commerical,,,709.93,,709.93,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Aetna,Middlesex Employees,,,680.76,,680.76,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Anthem,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Anthem,Indemnity,,,689.22,,689.22,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Anthem,Individual Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Anthem,State Preferred,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Cigna,Cigna,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Connecticare,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Connecticare,Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,Multiplan,Multiplan,,,782.06,,782.06,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,47335-236-83,NDC,both,1,ea,920.07,552.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Aetna,Commerical,,,709.93,,709.93,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Aetna,Middlesex Employees,,,680.76,,680.76,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Anthem,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Anthem,Indemnity,,,689.22,,689.22,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Anthem,Individual Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Anthem,State Preferred,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Cigna,Cigna,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Connecticare,Commerical,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Connecticare,Exchange,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,Multiplan,Multiplan,,,782.06,,782.06,680.76,782.06,percent of total billed charges,,
AMBRISENTAN 5 MG TABLET,J3490,HCPCS,70710-1179-3,NDC,both,1,ea,920.07,552.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,680.76,782.06,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Aetna,Commerical,,,3.03,,3.03,0.89,3.34,percent of total billed charges,,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Aetna,Middlesex Employees,,,2.91,,2.91,0.89,3.34,percent of total billed charges,,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Anthem,Commerical,,,,,,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Anthem,Indemnity,,,2.94,,2.94,0.89,3.34,percent of total billed charges,,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Anthem,Individual Exchange,,,,,,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Anthem,State Preferred,,,,,,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Cigna,Cigna,,0.89,,,0.89,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Connecticare,Commerical,,1.17,,,1.17,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Connecticare,Exchange,,1.17,,,1.17,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,Multiplan,Multiplan,,,3.34,,3.34,0.89,3.34,percent of total billed charges,,
AMIKACIN (AMIKIN) 4 MG/ML DILUTION,J0278,HCPCS,40810-0201-20,NDC,both,25,mL,3.93,2.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,3.34,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Aetna,Commerical,,,160.69,,160.69,0.89,177.02,percent of total billed charges,,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Aetna,Middlesex Employees,,,154.09,,154.09,0.89,177.02,percent of total billed charges,,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Anthem,Commerical,,,,,,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Anthem,Indemnity,,,156.01,,156.01,0.89,177.02,percent of total billed charges,,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Anthem,Individual Exchange,,,,,,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Anthem,State Preferred,,,,,,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Cigna,Cigna,,0.89,,,0.89,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Connecticare,Commerical,,1.17,,,1.17,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Connecticare,Exchange,,1.17,,,1.17,0.89,177.02,Other,Could be inpatient or outpatient,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,Multiplan,Multiplan,,,177.02,,177.02,0.89,177.02,percent of total billed charges,,
AMIKACIN 0.4 MG/0.1 ML INTRAVITREAL,J0278,HCPCS,40810-0204-35,NDC,both,25,mL,208.26,124.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,177.02,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Aetna,Commerical,,,69.72,,69.72,0.89,76.81,percent of total billed charges,,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Aetna,Middlesex Employees,,,66.86,,66.86,0.89,76.81,percent of total billed charges,,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Anthem,Commerical,,,,,,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Anthem,Indemnity,,,67.69,,67.69,0.89,76.81,percent of total billed charges,,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Anthem,Individual Exchange,,,,,,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Anthem,State Preferred,,,,,,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Cigna,Cigna,,0.89,,,0.89,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Connecticare,Commerical,,1.17,,,1.17,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Connecticare,Exchange,,1.17,,,1.17,0.89,76.81,Other,Could be inpatient or outpatient,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,Multiplan,Multiplan,,,76.81,,76.81,0.89,76.81,percent of total billed charges,,
"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",J0278,HCPCS,0703-9040-03,NDC,both,0.4,mL,90.36,54.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,76.81,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Aetna,Commerical,,,46.2,,46.2,0.89,50.9,percent of total billed charges,,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Aetna,Middlesex Employees,,,44.31,,44.31,0.89,50.9,percent of total billed charges,,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Anthem,Commerical,,,,,,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Anthem,Indemnity,,,44.86,,44.86,0.89,50.9,percent of total billed charges,,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Anthem,Individual Exchange,,,,,,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Anthem,State Preferred,,,,,,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Cigna,Cigna,,0.89,,,0.89,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Connecticare,Commerical,,1.17,,,1.17,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Connecticare,Exchange,,1.17,,,1.17,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,Multiplan,Multiplan,,,50.9,,50.9,0.89,50.9,percent of total billed charges,,
AMIKACIN 10 MG/ML IN D10W NICU,J0278,HCPCS,40810-0004-29,NDC,both,10,mL,59.88,35.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,50.9,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Aetna,Commerical,,,33.12,,33.12,0.89,36.48,percent of total billed charges,,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Aetna,Middlesex Employees,,,31.76,,31.76,0.89,36.48,percent of total billed charges,,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Anthem,Commerical,,,,,,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Anthem,Indemnity,,,32.15,,32.15,0.89,36.48,percent of total billed charges,,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Anthem,Individual Exchange,,,,,,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Anthem,State Preferred,,,,,,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Cigna,Cigna,,0.89,,,0.89,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Connecticare,Commerical,,1.17,,,1.17,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Connecticare,Exchange,,1.17,,,1.17,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,Multiplan,Multiplan,,,36.48,,36.48,0.89,36.48,percent of total billed charges,,
AMIKACIN 250 MG/ML FOR INHALATION,J0278,HCPCS,63323-815-02,NDC,both,0.4,mL,42.92,25.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,36.48,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Anthem,Commerical,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Anthem,State Preferred,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Cigna,Cigna,,0.89,,,0.89,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Connecticare,Commerical,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Connecticare,Exchange,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-01,NDC,both,0.4,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Anthem,Commerical,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Anthem,State Preferred,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Cigna,Cigna,,0.89,,,0.89,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Connecticare,Commerical,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Connecticare,Exchange,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,0703-9032-03,NDC,both,0.4,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Anthem,Commerical,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Anthem,State Preferred,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Cigna,Cigna,,0.89,,,0.89,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Connecticare,Commerical,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Connecticare,Exchange,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-31,NDC,both,0.4,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Anthem,Commerical,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Anthem,State Preferred,,,,,,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Cigna,Cigna,,0.89,,,0.89,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Connecticare,Commerical,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Connecticare,Exchange,,1.17,,,1.17,0.89,7.52,Other,Could be inpatient or outpatient,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,0.89,7.52,percent of total billed charges,,
AMIKACIN 500 MG/2 ML INJECTION SOLUTION,J0278,HCPCS,23155-785-41,NDC,both,0.4,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,7.52,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Aetna,Commerical,,,31.3,,31.3,30.01,34.48,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Aetna,Middlesex Employees,,,30.01,,30.01,30.01,34.48,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Anthem,Commerical,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Anthem,Indemnity,,,30.38,,30.38,30.01,34.48,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Anthem,Individual Exchange,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Anthem,State Preferred,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Cigna,Cigna,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Connecticare,Commerical,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Connecticare,Exchange,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,Multiplan,Multiplan,,,34.48,,34.48,30.01,34.48,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-24,NDC,both,1,mL,40.56,24.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.01,34.48,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Aetna,Commerical,,,62.59,,62.59,60.02,68.95,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Aetna,Middlesex Employees,,,60.02,,60.02,60.02,68.95,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Anthem,Commerical,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Anthem,Indemnity,,,60.77,,60.77,60.02,68.95,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Anthem,Individual Exchange,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Anthem,State Preferred,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Cigna,Cigna,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Connecticare,Commerical,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Connecticare,Exchange,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,Multiplan,Multiplan,,,68.95,,68.95,60.02,68.95,percent of total billed charges,,
AMILORIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-44,NDC,both,1,mL,81.12,48.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.02,68.95,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Aetna,Commerical,,,3.82,,3.82,3.66,4.21,percent of total billed charges,,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Aetna,Middlesex Employees,,,3.66,,3.66,3.66,4.21,percent of total billed charges,,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Anthem,Commerical,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Anthem,Indemnity,,,3.71,,3.71,3.66,4.21,percent of total billed charges,,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Anthem,Individual Exchange,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Anthem,State Preferred,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Cigna,Cigna,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Connecticare,Commerical,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Connecticare,Exchange,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,Multiplan,Multiplan,,,4.21,,4.21,3.66,4.21,percent of total billed charges,,
AMILORIDE 2.5 MG TABLET,J3490,HCPCS,40810-0013-47,NDC,both,1,ea,4.95,2.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.66,4.21,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
AMILORIDE 5 MG TABLET,J3490,HCPCS,0574-0292-01,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Aetna,Commerical,,,88.66,,88.66,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Aetna,Middlesex Employees,,,85.01,,85.01,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Anthem,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Anthem,Indemnity,,,86.07,,86.07,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Anthem,Individual Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Anthem,State Preferred,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Cigna,Cigna,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Connecticare,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Connecticare,Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,Multiplan,Multiplan,,,97.67,,97.67,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1933-10,NDC,both,1,mL,114.9,68.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Aetna,Commerical,,,88.66,,88.66,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Aetna,Middlesex Employees,,,85.01,,85.01,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Anthem,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Anthem,Indemnity,,,86.07,,86.07,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Anthem,Individual Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Anthem,State Preferred,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Cigna,Cigna,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Connecticare,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Connecticare,Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,Multiplan,Multiplan,,,97.67,,97.67,85.01,97.67,percent of total billed charges,,
AMINO ACID 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0264-9341-55,NDC,both,1,mL,114.9,68.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Aetna,Commerical,,,5.96,,5.96,5.72,6.57,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Aetna,Middlesex Employees,,,5.72,,5.72,5.72,6.57,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Anthem,Commerical,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Anthem,Indemnity,,,5.79,,5.79,5.72,6.57,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Anthem,Individual Exchange,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Anthem,State Preferred,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Cigna,Cigna,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Connecticare,Commerical,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Connecticare,Exchange,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,Multiplan,Multiplan,,,6.57,,6.57,5.72,6.57,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG ORAL TAB,J3490,HCPCS,40810-0000-25,NDC,both,1,ea,7.73,4.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.72,6.57,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,17478-447-08,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Aetna,Commerical,,,1718.53,,1718.53,1647.93,1893.15,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Aetna,Middlesex Employees,,,1647.93,,1647.93,1647.93,1893.15,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Anthem,Commerical,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Anthem,Indemnity,,,1668.42,,1668.42,1647.93,1893.15,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Anthem,Individual Exchange,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Anthem,State Preferred,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Cigna,Cigna,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Connecticare,Commerical,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Connecticare,Exchange,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,Multiplan,Multiplan,,,1893.15,,1893.15,1647.93,1893.15,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,49411-052-08,NDC,both,1,mL,2227.23,1336.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1647.93,1893.15,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,52817-815-08,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,66689-330-08,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,69238-1596-8,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Aetna,Commerical,,,1524.05,,1524.05,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Aetna,Middlesex Employees,,,1461.44,,1461.44,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Indemnity,,,1479.61,,1479.61,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,Individual Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Anthem,State Preferred,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Cigna,Cigna,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Connecticare,Commerical,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Connecticare,Exchange,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,Multiplan,Multiplan,,,1678.9,,1678.9,1461.44,1678.9,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,J3490,HCPCS,70377-104-11,NDC,both,1,mL,1975.18,1185.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1461.44,1678.9,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Aetna,Commerical,,,24.83,,24.83,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Aetna,Middlesex Employees,,,23.81,,23.81,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Anthem,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Anthem,Indemnity,,,24.11,,24.11,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Anthem,Individual Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Anthem,State Preferred,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Cigna,Cigna,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Connecticare,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Connecticare,Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,Multiplan,Multiplan,,,27.35,,27.35,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-16,NDC,both,20,mL,32.18,19.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Aetna,Commerical,,,24.83,,24.83,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Aetna,Middlesex Employees,,,23.81,,23.81,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Anthem,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Anthem,Indemnity,,,24.11,,24.11,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Anthem,Individual Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Anthem,State Preferred,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Cigna,Cigna,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Connecticare,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Connecticare,Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,Multiplan,Multiplan,,,27.35,,27.35,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4346-73,NDC,both,20,mL,32.18,19.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Aetna,Commerical,,,24.83,,24.83,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Aetna,Middlesex Employees,,,23.81,,23.81,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Anthem,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Anthem,Indemnity,,,24.11,,24.11,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Anthem,Individual Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Anthem,State Preferred,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Cigna,Cigna,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Connecticare,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Connecticare,Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,Multiplan,Multiplan,,,27.35,,27.35,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-01,NDC,both,20,mL,32.18,19.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9120-25,NDC,both,20,mL,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Aetna,Commerical,,,24.83,,24.83,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Aetna,Middlesex Employees,,,23.81,,23.81,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Anthem,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Anthem,Indemnity,,,24.11,,24.11,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Anthem,Individual Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Anthem,State Preferred,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Cigna,Cigna,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Connecticare,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Connecticare,Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,Multiplan,Multiplan,,,27.35,,27.35,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-01,NDC,both,20,mL,32.18,19.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Aetna,Commerical,,,24.83,,24.83,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Aetna,Middlesex Employees,,,23.81,,23.81,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Anthem,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Anthem,Indemnity,,,24.11,,24.11,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Anthem,Individual Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Anthem,State Preferred,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Cigna,Cigna,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Connecticare,Commerical,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Connecticare,Exchange,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,Multiplan,Multiplan,,,27.35,,27.35,23.81,27.35,percent of total billed charges,,
AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-9191-25,NDC,both,20,mL,32.18,19.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.81,27.35,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Aetna,Commerical,,,11.74,,11.74,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Aetna,Middlesex Employees,,,11.25,,11.25,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Anthem,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Anthem,Indemnity,,,11.39,,11.39,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Anthem,Individual Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Anthem,State Preferred,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Cigna,Cigna,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Connecticare,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Connecticare,Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,Multiplan,Multiplan,,,12.93,,12.93,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,40810-0008-07,NDC,both,1,ea,15.21,9.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Aetna,Commerical,,,11.74,,11.74,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Aetna,Middlesex Employees,,,11.25,,11.25,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Anthem,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Anthem,Indemnity,,,11.39,,11.39,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Anthem,Individual Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Anthem,State Preferred,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Cigna,Cigna,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Connecticare,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Connecticare,Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,Multiplan,Multiplan,,,12.93,,12.93,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,49411-050-30,NDC,both,1,ea,15.21,9.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Aetna,Commerical,,,11.74,,11.74,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Aetna,Middlesex Employees,,,11.25,,11.25,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Indemnity,,,11.39,,11.39,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Individual Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,State Preferred,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Cigna,Cigna,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Connecticare,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Connecticare,Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,Multiplan,Multiplan,,,12.93,,12.93,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,60219-1637-3,NDC,both,1,ea,15.21,9.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Aetna,Commerical,,,11.74,,11.74,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Aetna,Middlesex Employees,,,11.25,,11.25,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Indemnity,,,11.39,,11.39,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,Individual Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Anthem,State Preferred,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Cigna,Cigna,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Connecticare,Commerical,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Connecticare,Exchange,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,Multiplan,Multiplan,,,12.93,,12.93,11.25,12.93,percent of total billed charges,,
AMINOCAPROIC ACID 500 MG TABLET,J3490,HCPCS,69238-1637-3,NDC,both,1,ea,15.21,9.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.25,12.93,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Aetna,Commerical,,,33.19,,33.19,9.9,36.57,percent of total billed charges,,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Aetna,Middlesex Employees,,,31.83,,31.83,9.9,36.57,percent of total billed charges,,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Anthem,Commerical,,,,,,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Anthem,Indemnity,,,32.23,,32.23,9.9,36.57,percent of total billed charges,,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Anthem,Individual Exchange,,,,,,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Anthem,State Preferred,,,,,,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Cigna,Cigna,,14.89,,,14.89,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Connecticare,Commerical,,9.9,,,9.9,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Connecticare,Exchange,,9.9,,,9.9,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,Multiplan,Multiplan,,,36.57,,36.57,9.9,36.57,percent of total billed charges,,
AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5921-01,NDC,both,10,mL,43.02,25.81,United Healthcare/Oxford,United Healthcare/Oxford,,16.08,,,16.08,9.9,36.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Aetna,Commerical,,,21.4,,21.4,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Aetna,Middlesex Employees,,,20.52,,20.52,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Anthem,Commerical,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Anthem,Indemnity,,,20.77,,20.77,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Anthem,Individual Exchange,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Anthem,State Preferred,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Cigna,Cigna,,14.89,,,14.89,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Connecticare,Commerical,,9.9,,,9.9,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Connecticare,Exchange,,9.9,,,9.9,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,Multiplan,Multiplan,,,23.57,,23.57,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-01,NDC,both,10,mL,27.73,16.64,United Healthcare/Oxford,United Healthcare/Oxford,,16.08,,,16.08,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Aetna,Commerical,,,21.4,,21.4,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Aetna,Middlesex Employees,,,20.52,,20.52,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Anthem,Commerical,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Anthem,Indemnity,,,20.77,,20.77,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Anthem,Individual Exchange,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Anthem,State Preferred,,,,,,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Cigna,Cigna,,14.89,,,14.89,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Connecticare,Commerical,,9.9,,,9.9,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Connecticare,Exchange,,9.9,,,9.9,9.9,23.57,Other,Could be inpatient or outpatient,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,Multiplan,Multiplan,,,23.57,,23.57,9.9,23.57,percent of total billed charges,,
AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,J0280,HCPCS,0409-5922-16,NDC,both,10,mL,27.73,16.64,United Healthcare/Oxford,United Healthcare/Oxford,,16.08,,,16.08,9.9,23.57,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
AMIODARONE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-26,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Aetna,Commerical,,,0.65,,0.65,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.62,,0.62,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Anthem,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Anthem,Indemnity,,,0.63,,0.63,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Cigna,Cigna,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Connecticare,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Connecticare,Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-01,NDC,both,1,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Aetna,Commerical,,,0.65,,0.65,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.62,,0.62,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Anthem,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Anthem,Indemnity,,,0.63,,0.63,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Cigna,Cigna,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Connecticare,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Connecticare,Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.62,0.71,percent of total billed charges,,
AMIODARONE 200 MG TABLET,J3490,HCPCS,0245-0147-89,NDC,both,1,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Aetna,Commerical,,,67.97,,67.97,65.18,74.88,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Aetna,Middlesex Employees,,,65.18,,65.18,65.18,74.88,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Anthem,Commerical,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Anthem,Indemnity,,,65.99,,65.99,65.18,74.88,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Anthem,Individual Exchange,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Anthem,State Preferred,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Cigna,Cigna,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Connecticare,Commerical,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Connecticare,Exchange,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,Multiplan,Multiplan,,,74.88,,74.88,65.18,74.88,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-17,NDC,both,1,mL,88.09,52.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.18,74.88,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Aetna,Commerical,,,135.94,,135.94,130.36,149.75,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Aetna,Middlesex Employees,,,130.36,,130.36,130.36,149.75,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Anthem,Commerical,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Anthem,Indemnity,,,131.98,,131.98,130.36,149.75,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Anthem,Individual Exchange,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Anthem,State Preferred,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Cigna,Cigna,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Connecticare,Commerical,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Connecticare,Exchange,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,Multiplan,Multiplan,,,149.75,,149.75,130.36,149.75,percent of total billed charges,,
AMIODARONE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-03,NDC,both,1,mL,176.18,105.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
AMIODARONE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-27,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Commerical,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Anthem,State Preferred,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Cigna,Cigna,,0.58,,,0.58,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Connecticare,Commerical,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Connecticare,Exchange,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-01,NDC,both,0.6,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Anthem,Commerical,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Anthem,State Preferred,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Cigna,Cigna,,0.58,,,0.58,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Connecticare,Commerical,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Connecticare,Exchange,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,0143-9875-25,NDC,both,0.6,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Commerical,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Anthem,State Preferred,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Cigna,Cigna,,0.58,,,0.58,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Connecticare,Commerical,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Connecticare,Exchange,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-01,NDC,both,0.6,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Anthem,Commerical,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Anthem,State Preferred,,,,,,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Cigna,Cigna,,0.58,,,0.58,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Connecticare,Commerical,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Connecticare,Exchange,,0.37,,,0.37,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,0.37,5.46,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,63323-616-03,NDC,both,0.6,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.37,5.46,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Aetna,Commerical,,,10.31,,10.31,0.37,11.36,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Aetna,Middlesex Employees,,,9.89,,9.89,0.37,11.36,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Anthem,Commerical,,,,,,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Anthem,Indemnity,,,10.01,,10.01,0.37,11.36,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Anthem,Individual Exchange,,,,,,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Anthem,State Preferred,,,,,,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Cigna,Cigna,,0.58,,,0.58,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Connecticare,Commerical,,0.37,,,0.37,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Connecticare,Exchange,,0.37,,,0.37,0.37,11.36,Other,Could be inpatient or outpatient,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,Multiplan,Multiplan,,,11.36,,11.36,0.37,11.36,percent of total billed charges,,
AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,J0282,HCPCS,67457-153-00,NDC,both,0.6,mL,13.36,8.02,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.37,11.36,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-29,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Aetna,Commerical,,,4.44,,4.44,4.25,4.89,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Aetna,Middlesex Employees,,,4.25,,4.25,4.25,4.89,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Anthem,Commerical,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Anthem,Indemnity,,,4.31,,4.31,4.25,4.89,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Anthem,Individual Exchange,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Anthem,State Preferred,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Cigna,Cigna,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Connecticare,Commerical,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Connecticare,Exchange,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,Multiplan,Multiplan,,,4.89,,4.89,4.25,4.89,percent of total billed charges,,
AMITRIPTYLINE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0011-90,NDC,both,1,mL,5.75,3.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Aetna,Commerical,,,0.42,,0.42,0.41,0.47,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Anthem,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Anthem,Indemnity,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Anthem,Individual Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Anthem,State Preferred,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Cigna,Cigna,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Connecticare,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Connecticare,Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,Multiplan,Multiplan,,,0.47,,0.47,0.41,0.47,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,16729-171-01,NDC,both,1,ea,0.55,0.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-01,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,51079-131-20,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
AMITRIPTYLINE 10 MG TABLET,J3490,HCPCS,70756-201-11,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
AMITRIPTYLINE 12.5 MG TABLET  ,J3490,HCPCS,40810-0013-48,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-30,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,0904-0201-61,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,16729-172-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,51079-107-20,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
AMITRIPTYLINE 25 MG TABLET,J3490,HCPCS,60687-433-11,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
AMITRIPTYLINE 5 MG ORAL TAB,J3490,HCPCS,40810-0000-31,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Aetna,Commerical,,,1342.72,,1342.72,1287.55,1479.14,percent of total billed charges,,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Aetna,Middlesex Employees,,,1287.55,,1287.55,1287.55,1479.14,percent of total billed charges,,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Anthem,Commerical,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Anthem,Indemnity,,,1303.56,,1303.56,1287.55,1479.14,percent of total billed charges,,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Anthem,Individual Exchange,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Anthem,State Preferred,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Cigna,Cigna,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Connecticare,Commerical,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Connecticare,Exchange,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,Multiplan,Multiplan,,,1479.14,,1479.14,1287.55,1479.14,percent of total billed charges,,
AMLODIPINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,46287-035-15,NDC,both,1,mL,1740.17,1044.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1287.55,1479.14,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,0904-6371-61,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-01,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
AMLODIPINE 10 MG TABLET,J3490,HCPCS,51079-452-20,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
AMLODIPINE 2.5 MG TABLET,J3490,HCPCS,0904-6369-61,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,0904-6370-61,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,51079-451-20,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,59762-1530-1,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMLODIPINE 5 MG TABLET,J3490,HCPCS,69097-127-05,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Aetna,Commerical,,,1417.63,,1417.63,1359.39,1561.67,percent of total billed charges,,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Aetna,Middlesex Employees,,,1359.39,,1359.39,1359.39,1561.67,percent of total billed charges,,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Anthem,Commerical,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Anthem,Indemnity,,,1376.29,,1376.29,1359.39,1561.67,percent of total billed charges,,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Anthem,Individual Exchange,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Anthem,State Preferred,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Cigna,Cigna,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Connecticare,Commerical,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Connecticare,Exchange,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,Multiplan,Multiplan,,,1561.67,,1561.67,1359.39,1561.67,percent of total billed charges,,
AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,52652-5001-1,NDC,both,0.01,mL,1837.26,1102.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1359.39,1561.67,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Aetna,Commerical,,,57.69,,57.69,55.32,63.55,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Aetna,Middlesex Employees,,,55.32,,55.32,55.32,63.55,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Anthem,Commerical,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Anthem,Indemnity,,,56.01,,56.01,55.32,63.55,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Anthem,Individual Exchange,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Anthem,State Preferred,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Cigna,Cigna,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Connecticare,Commerical,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Connecticare,Exchange,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,Multiplan,Multiplan,,,63.55,,63.55,55.32,63.55,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,4580252555,NDC,both,1,gm,74.77,44.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,55.32,63.55,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Aetna,Commerical,,,57.19,,57.19,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Aetna,Middlesex Employees,,,54.84,,54.84,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Anthem,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Anthem,Indemnity,,,55.52,,55.52,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Anthem,Individual Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Anthem,State Preferred,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Cigna,Cigna,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Connecticare,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Connecticare,Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,Multiplan,Multiplan,,,63,,63,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,7139901408,NDC,both,1,gm,74.12,44.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Aetna,Commerical,,,57.19,,57.19,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Aetna,Middlesex Employees,,,54.84,,54.84,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Anthem,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Anthem,Indemnity,,,55.52,,55.52,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Anthem,Individual Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Anthem,State Preferred,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Cigna,Cigna,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Connecticare,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Connecticare,Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,Multiplan,Multiplan,,,63,,63,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,0781-7098-79,NDC,both,1,gm,74.12,44.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Aetna,Commerical,,,57.19,,57.19,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Aetna,Middlesex Employees,,,54.84,,54.84,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Anthem,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Anthem,Indemnity,,,55.52,,55.52,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Anthem,Individual Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Anthem,State Preferred,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Cigna,Cigna,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Connecticare,Commerical,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Connecticare,Exchange,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,Multiplan,Multiplan,,,63,,63,54.84,63,percent of total billed charges,,
AMMONIUM LACTATE 12 % LOTION,J3490,HCPCS,45802-419-54,NDC,both,1,gm,74.12,44.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.84,63,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,0781-2020-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
AMOXICILLIN 250 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,65862-016-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2268-01,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
AMOXICILLIN 250 MG CHEWABLE TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0010-58,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Individual Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,State Preferred,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Cigna,Cigna,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Connecticare,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Connecticare,Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Aetna,Commerical,,,6.15,,6.15,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Aetna,Middlesex Employees,,,5.9,,5.9,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Commerical,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Indemnity,,,5.97,,5.97,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Individual Exchange,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,State Preferred,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Cigna,Cigna,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Connecticare,Commerical,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Connecticare,Exchange,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Multiplan,Multiplan,,,6.77,,6.77,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-01,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Aetna,Commerical,,,13.74,,13.74,13.18,15.14,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Aetna,Middlesex Employees,,,13.18,,13.18,13.18,15.14,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Anthem,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Anthem,Indemnity,,,13.34,,13.34,13.18,15.14,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Anthem,Individual Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Anthem,State Preferred,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Cigna,Cigna,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Connecticare,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Connecticare,Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,Multiplan,Multiplan,,,15.14,,15.14,13.18,15.14,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9889-15,NDC,both,1,mL,17.81,10.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Individual Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,State Preferred,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Cigna,Cigna,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Connecticare,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Connecticare,Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-707-55,NDC,both,1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,Individual Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Anthem,State Preferred,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Cigna,Cigna,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Connecticare,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Connecticare,Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-73,NDC,both,1,mL,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Aetna,Commerical,,,6.15,,6.15,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Aetna,Middlesex Employees,,,5.9,,5.9,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Commerical,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Indemnity,,,5.97,,5.97,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,Individual Exchange,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Anthem,State Preferred,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Cigna,Cigna,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Connecticare,Commerical,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Connecticare,Exchange,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,Multiplan,Multiplan,,,6.77,,6.77,5.9,6.77,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-79,NDC,both,1,mL,7.97,4.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.9,6.77,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0093-4155-80,NDC,both,1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,Individual Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Anthem,State Preferred,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Cigna,Cigna,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Connecticare,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Connecticare,Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,7.37,8.47,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-46,NDC,both,1,mL,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0781-6041-55,NDC,both,1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Aetna,Commerical,,,101.96,,101.96,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Aetna,Middlesex Employees,,,97.77,,97.77,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Anthem,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Anthem,Indemnity,,,98.99,,98.99,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Anthem,Individual Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Anthem,State Preferred,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Cigna,Cigna,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Connecticare,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Connecticare,Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,Multiplan,Multiplan,,,112.32,,112.32,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-01,NDC,both,1,mL,132.14,79.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-55,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Aetna,Commerical,,,76.47,,76.47,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Aetna,Middlesex Employees,,,73.33,,73.33,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Indemnity,,,74.24,,74.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Individual Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,State Preferred,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Cigna,Cigna,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Connecticare,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Connecticare,Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Multiplan,Multiplan,,,84.24,,84.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Aetna,Commerical,,,101.96,,101.96,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Aetna,Middlesex Employees,,,97.77,,97.77,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Indemnity,,,98.99,,98.99,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Individual Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,State Preferred,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Cigna,Cigna,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Connecticare,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Connecticare,Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Multiplan,Multiplan,,,112.32,,112.32,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Aetna,Commerical,,,76.47,,76.47,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Aetna,Middlesex Employees,,,73.33,,73.33,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Indemnity,,,74.24,,74.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Individual Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,State Preferred,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Cigna,Cigna,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Connecticare,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Connecticare,Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Multiplan,Multiplan,,,84.24,,84.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-004-15,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Aetna,Commerical,,,76.47,,76.47,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Aetna,Middlesex Employees,,,73.33,,73.33,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Indemnity,,,74.24,,74.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,Individual Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Anthem,State Preferred,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Cigna,Cigna,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Connecticare,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Connecticare,Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,Multiplan,Multiplan,,,84.24,,84.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59651-026-75,NDC,both,1,mL,99.11,59.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Aetna,Commerical,,,101.96,,101.96,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Aetna,Middlesex Employees,,,97.77,,97.77,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Indemnity,,,98.99,,98.99,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,Individual Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Anthem,State Preferred,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Cigna,Cigna,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Connecticare,Commerical,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Connecticare,Exchange,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,Multiplan,Multiplan,,,112.32,,112.32,97.77,112.32,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-00,NDC,both,1,mL,132.14,79.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.77,112.32,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-47,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Aetna,Commerical,,,76.47,,76.47,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Aetna,Middlesex Employees,,,73.33,,73.33,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Indemnity,,,74.24,,74.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,Individual Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Anthem,State Preferred,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Cigna,Cigna,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Connecticare,Commerical,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Connecticare,Exchange,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,Multiplan,Multiplan,,,84.24,,84.24,73.33,84.24,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,60432-065-75,NDC,both,1,mL,99.11,59.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,73.33,84.24,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Aetna,Commerical,,,152.94,,152.94,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Aetna,Middlesex Employees,,,146.66,,146.66,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Indemnity,,,148.48,,148.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,Individual Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Anthem,State Preferred,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Cigna,Cigna,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Connecticare,Commerical,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Connecticare,Exchange,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,Multiplan,Multiplan,,,168.48,,168.48,146.66,168.48,percent of total billed charges,,
AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,72508-204-15,NDC,both,1,mL,198.21,118.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.66,168.48,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Aetna,Commerical,,,9.57,,9.57,9.17,10.54,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Aetna,Middlesex Employees,,,9.17,,9.17,9.17,10.54,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Anthem,Commerical,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Anthem,Indemnity,,,9.29,,9.29,9.17,10.54,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Anthem,Individual Exchange,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Anthem,State Preferred,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Cigna,Cigna,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Connecticare,Commerical,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Connecticare,Exchange,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,Multiplan,Multiplan,,,10.54,,10.54,9.17,10.54,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0093-2272-34,NDC,both,1,ea,12.4,7.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.17,10.54,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Aetna,Commerical,,,6.2,,6.2,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Aetna,Middlesex Employees,,,5.94,,5.94,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Anthem,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Anthem,Indemnity,,,6.02,,6.02,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Anthem,Individual Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Anthem,State Preferred,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Cigna,Cigna,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Connecticare,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Connecticare,Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,Multiplan,Multiplan,,,6.83,,6.83,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,0781-1643-66,NDC,both,1,ea,8.03,4.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Aetna,Commerical,,,6.2,,6.2,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Aetna,Middlesex Employees,,,5.94,,5.94,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Anthem,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Anthem,Indemnity,,,6.02,,6.02,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Anthem,Individual Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Anthem,State Preferred,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Cigna,Cigna,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Connecticare,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Connecticare,Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,Multiplan,Multiplan,,,6.83,,6.83,5.94,6.83,percent of total billed charges,,
AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-71,NDC,both,1,ea,8.03,4.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3109-53,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,0781-2613-01,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,40810-0011-21,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
AMOXICILLIN 500 MG CAPSULE,J3490,HCPCS,57237-031-01,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Aetna,Commerical,,,11.19,,11.19,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Aetna,Middlesex Employees,,,10.73,,10.73,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Indemnity,,,10.86,,10.86,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Individual Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,State Preferred,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Cigna,Cigna,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Connecticare,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Connecticare,Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Multiplan,Multiplan,,,12.33,,12.33,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Aetna,Commerical,,,0.86,,0.86,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Aetna,Middlesex Employees,,,0.82,,0.82,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Indemnity,,,0.83,,0.83,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Individual Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,State Preferred,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Cigna,Cigna,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Connecticare,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Connecticare,Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Multiplan,Multiplan,,,0.94,,0.94,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Aetna,Commerical,,,11.19,,11.19,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Aetna,Middlesex Employees,,,10.73,,10.73,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Indemnity,,,10.86,,10.86,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,Individual Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Anthem,State Preferred,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Cigna,Cigna,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Connecticare,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Connecticare,Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,Multiplan,Multiplan,,,12.33,,12.33,10.73,12.33,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2274-34,NDC,both,1,ea,14.5,8.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Aetna,Commerical,,,0.86,,0.86,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Aetna,Middlesex Employees,,,0.82,,0.82,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Indemnity,,,0.83,,0.83,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,Individual Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Anthem,State Preferred,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Cigna,Cigna,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Connecticare,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Connecticare,Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,Multiplan,Multiplan,,,0.94,,0.94,0.82,0.94,percent of total billed charges,,
AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,65862-502-20,NDC,both,1,ea,1.11,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Aetna,Commerical,,,42.11,,42.11,40.38,46.39,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Aetna,Middlesex Employees,,,40.38,,40.38,40.38,46.39,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Anthem,Commerical,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Anthem,Indemnity,,,40.89,,40.89,40.38,46.39,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Anthem,Individual Exchange,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Anthem,State Preferred,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Cigna,Cigna,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Connecticare,Commerical,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Connecticare,Exchange,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,Multiplan,Multiplan,,,46.39,,46.39,40.38,46.39,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0143-9853-75,NDC,both,1,mL,54.58,32.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.38,46.39,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Aetna,Commerical,,,177.31,,177.31,170.03,195.33,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Aetna,Middlesex Employees,,,170.03,,170.03,170.03,195.33,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Anthem,Commerical,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Anthem,Indemnity,,,172.14,,172.14,170.03,195.33,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Anthem,Individual Exchange,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Anthem,State Preferred,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Cigna,Cigna,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Connecticare,Commerical,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Connecticare,Exchange,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,Multiplan,Multiplan,,,195.33,,195.33,170.03,195.33,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-48,NDC,both,1,mL,229.8,137.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Aetna,Commerical,,,28.6,,28.6,27.42,31.5,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Aetna,Middlesex Employees,,,27.42,,27.42,27.42,31.5,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Anthem,Commerical,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Anthem,Indemnity,,,27.76,,27.76,27.42,31.5,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Anthem,Individual Exchange,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Anthem,State Preferred,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Cigna,Cigna,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Connecticare,Commerical,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Connecticare,Exchange,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,Multiplan,Multiplan,,,31.5,,31.5,27.42,31.5,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6139-57,NDC,both,1,mL,37.06,22.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.42,31.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Aetna,Commerical,,,25.27,,25.27,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Aetna,Middlesex Employees,,,24.23,,24.23,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Indemnity,,,24.53,,24.53,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Individual Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,State Preferred,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Cigna,Cigna,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Connecticare,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Connecticare,Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Multiplan,Multiplan,,,27.84,,27.84,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Aetna,Commerical,,,25.27,,25.27,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Aetna,Middlesex Employees,,,24.23,,24.23,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Indemnity,,,24.53,,24.53,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,Individual Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Anthem,State Preferred,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Cigna,Cigna,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Connecticare,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Connecticare,Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,Multiplan,Multiplan,,,27.84,,27.84,24.23,27.84,percent of total billed charges,,
AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65862-535-75,NDC,both,1,mL,32.75,19.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0093-2264-01,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
AMOXICILLIN 875 MG TABLET,J3490,HCPCS,0781-5061-01,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,65862-503-20,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0093-2275-34,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0009-88,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,42571-162-42,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,43598-221-14,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,66685-1001-0,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Aetna,Commerical,,,13.02,,13.02,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Aetna,Middlesex Employees,,,12.49,,12.49,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Anthem,Commerical,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Anthem,Indemnity,,,12.64,,12.64,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Anthem,Individual Exchange,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Anthem,State Preferred,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Cigna,Cigna,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Connecticare,Commerical,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Connecticare,Exchange,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,Multiplan,Multiplan,,,14.35,,14.35,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-39,NDC,both,1,ea,16.88,10.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Aetna,Commerical,,,13.02,,13.02,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Aetna,Middlesex Employees,,,12.49,,12.49,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Anthem,Commerical,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Anthem,Indemnity,,,12.64,,12.64,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Anthem,Individual Exchange,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Anthem,State Preferred,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Cigna,Cigna,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Connecticare,Commerical,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Connecticare,Exchange,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,Multiplan,Multiplan,,,14.35,,14.35,12.49,14.35,percent of total billed charges,,
"AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12HR",J3490,HCPCS,0781-1943-82,NDC,both,1,ea,16.88,10.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.49,14.35,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Aetna,Commerical,,,354.16,,354.16,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Aetna,Middlesex Employees,,,339.61,,339.61,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Anthem,Commerical,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Anthem,Indemnity,,,343.84,,343.84,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Anthem,Individual Exchange,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Anthem,State Preferred,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Cigna,Cigna,,53,,,53,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Connecticare,Commerical,,74.76,,,74.76,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Connecticare,Exchange,,74.76,,,74.76,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,Multiplan,Multiplan,,,390.15,,390.15,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D10W NICU,J0285,HCPCS,40810-0004-30,NDC,both,500,mL,459,275.4,United Healthcare/Oxford,United Healthcare/Oxford,,57.22,,,57.22,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Aetna,Commerical,,,354.16,,354.16,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Aetna,Middlesex Employees,,,339.61,,339.61,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Anthem,Commerical,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Anthem,Indemnity,,,343.84,,343.84,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Anthem,Individual Exchange,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Anthem,State Preferred,,,,,,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Cigna,Cigna,,53,,,53,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Connecticare,Commerical,,74.76,,,74.76,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Connecticare,Exchange,,74.76,,,74.76,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,Multiplan,Multiplan,,,390.15,,390.15,53,390.15,percent of total billed charges,,
AMPHOTERICIN B 0.1 MG/ML IN D5W NICU,J0285,HCPCS,40810-0004-31,NDC,both,500,mL,459,275.4,United Healthcare/Oxford,United Healthcare/Oxford,,57.22,,,57.22,53,390.15,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Aetna,Commerical,,,107.95,,107.95,53,118.92,percent of total billed charges,,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Aetna,Middlesex Employees,,,103.52,,103.52,53,118.92,percent of total billed charges,,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Anthem,Commerical,,,,,,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Anthem,Indemnity,,,104.81,,104.81,53,118.92,percent of total billed charges,,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Anthem,Individual Exchange,,,,,,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Anthem,State Preferred,,,,,,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Cigna,Cigna,,53,,,53,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Connecticare,Commerical,,74.76,,,74.76,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Connecticare,Exchange,,74.76,,,74.76,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,Multiplan,Multiplan,,,118.92,,118.92,53,118.92,percent of total billed charges,,
AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,J0285,HCPCS,39822-1055-5,NDC,both,1,ea,139.91,83.95,United Healthcare/Oxford,United Healthcare/Oxford,,57.22,,,57.22,53,118.92,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Aetna,Commerical,,,42.85,,42.85,41.09,74.76,percent of total billed charges,,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Aetna,Middlesex Employees,,,41.09,,41.09,41.09,74.76,percent of total billed charges,,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Anthem,Commerical,,,,,,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Anthem,Indemnity,,,41.61,,41.61,41.09,74.76,percent of total billed charges,,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Anthem,Individual Exchange,,,,,,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Anthem,State Preferred,,,,,,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Cigna,Cigna,,53,,,53,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Connecticare,Commerical,,74.76,,,74.76,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Connecticare,Exchange,,74.76,,,74.76,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,Multiplan,Multiplan,,,47.21,,47.21,41.09,74.76,percent of total billed charges,,
AMPHOTERICIN B 50 MG/L IN STERILE WATER FOR BLADDER IRRIGATION,J0285,HCPCS,40810-0019-72,NDC,both,500,mL,55.54,33.32,United Healthcare/Oxford,United Healthcare/Oxford,,57.22,,,57.22,41.09,74.76,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Aetna,Commerical,,,179.22,,179.22,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Aetna,Middlesex Employees,,,171.86,,171.86,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Anthem,Commerical,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Anthem,Indemnity,,,173.99,,173.99,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Anthem,Individual Exchange,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Anthem,State Preferred,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Cigna,Cigna,,24.44,,,24.44,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Connecticare,Commerical,,35.62,,,35.62,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Connecticare,Exchange,,35.62,,,35.62,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,Multiplan,Multiplan,,,197.43,,197.43,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D10W NICU,J0289,HCPCS,40810-0004-32,NDC,both,10,mL,232.27,139.36,United Healthcare/Oxford,United Healthcare/Oxford,,26.39,,,26.39,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Aetna,Commerical,,,179.22,,179.22,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Aetna,Middlesex Employees,,,171.86,,171.86,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Anthem,Commerical,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Anthem,Indemnity,,,173.99,,173.99,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Anthem,Individual Exchange,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Anthem,State Preferred,,,,,,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Cigna,Cigna,,24.44,,,24.44,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Connecticare,Commerical,,35.62,,,35.62,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Connecticare,Exchange,,35.62,,,35.62,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,Multiplan,Multiplan,,,197.43,,197.43,24.44,197.43,percent of total billed charges,,
AMPHOTERICIN B LIPOSOMAL 1 MG/ML IN D5W NICU,J0289,HCPCS,40810-0004-33,NDC,both,10,mL,232.27,139.36,United Healthcare/Oxford,United Healthcare/Oxford,,26.39,,,26.39,24.44,197.43,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Aetna,Commerical,,,285.39,,285.39,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Aetna,Middlesex Employees,,,273.67,,273.67,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Anthem,Commerical,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Anthem,Indemnity,,,277.07,,277.07,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Anthem,Individual Exchange,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Anthem,State Preferred,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Cigna,Cigna,,24.44,,,24.44,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Connecticare,Commerical,,35.62,,,35.62,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Connecticare,Exchange,,35.62,,,35.62,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,Multiplan,Multiplan,,,314.39,,314.39,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,0469-3051-30,NDC,both,0.2,ea,369.87,221.92,United Healthcare/Oxford,United Healthcare/Oxford,,26.39,,,26.39,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Aetna,Commerical,,,285.39,,285.39,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Aetna,Middlesex Employees,,,273.67,,273.67,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Anthem,Commerical,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Anthem,Indemnity,,,277.07,,277.07,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Anthem,Individual Exchange,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Anthem,State Preferred,,,,,,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Cigna,Cigna,,24.44,,,24.44,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Connecticare,Commerical,,35.62,,,35.62,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Connecticare,Exchange,,35.62,,,35.62,24.44,314.39,Other,Could be inpatient or outpatient,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,Multiplan,Multiplan,,,314.39,,314.39,24.44,314.39,percent of total billed charges,,
AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,J0289,HCPCS,62756-233-01,NDC,both,0.2,ea,369.87,221.92,United Healthcare/Oxford,United Healthcare/Oxford,,26.39,,,26.39,24.44,314.39,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Aetna,Commerical,,,27557.5,,27557.5,0.99,30357.54,percent of total billed charges,,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Aetna,Middlesex Employees,,,26425.34,,26425.34,0.99,30357.54,percent of total billed charges,,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Anthem,Commerical,,,,,,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Anthem,Indemnity,,,26753.92,,26753.92,0.99,30357.54,percent of total billed charges,,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Anthem,Individual Exchange,,,,,,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Anthem,State Preferred,,,,,,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Cigna,Cigna,,0.99,,,0.99,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Connecticare,Commerical,,1.2,,,1.2,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Connecticare,Exchange,,1.2,,,1.2,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,Multiplan,Multiplan,,,30357.54,,30357.54,0.99,30357.54,percent of total billed charges,,
AMPICILLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0290,HCPCS,40810-0208-20,NDC,both,12500,mL,35714.75,21428.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,30357.54,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-01,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3726-10,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3404-95,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-136-10,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-01,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-351-10,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-00,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Commerical,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Anthem,Individual Exchange,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Anthem,State Preferred,,,,,,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Cigna,Cigna,,0.99,,,0.99,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Commerical,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Connecticare,Exchange,,1.2,,,1.2,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,0.99,7.39,percent of total billed charges,,
AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-021-10,NDC,both,0.5,ea,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,7.39,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Aetna,Commerical,,,54.06,,54.06,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Aetna,Middlesex Employees,,,51.84,,51.84,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Anthem,Commerical,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Anthem,Indemnity,,,52.48,,52.48,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Anthem,Individual Exchange,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Anthem,State Preferred,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Cigna,Cigna,,0.99,,,0.99,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Connecticare,Commerical,,1.2,,,1.2,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Connecticare,Exchange,,1.2,,,1.2,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,Multiplan,Multiplan,,,59.55,,59.55,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-01,NDC,both,0.05,ea,70.06,42.04,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Aetna,Commerical,,,206.87,,206.87,0.99,227.89,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Aetna,Middlesex Employees,,,198.37,,198.37,0.99,227.89,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Anthem,Commerical,,,,,,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Anthem,Indemnity,,,200.83,,200.83,0.99,227.89,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Anthem,Individual Exchange,,,,,,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Anthem,State Preferred,,,,,,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Cigna,Cigna,,0.99,,,0.99,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Connecticare,Commerical,,1.2,,,1.2,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Connecticare,Exchange,,1.2,,,1.2,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,Multiplan,Multiplan,,,227.89,,227.89,0.99,227.89,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,44567-104-10,NDC,both,0.05,ea,268.1,160.86,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,227.89,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Aetna,Commerical,,,54.06,,54.06,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Aetna,Middlesex Employees,,,51.84,,51.84,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Anthem,Commerical,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Anthem,Indemnity,,,52.48,,52.48,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Anthem,Individual Exchange,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Anthem,State Preferred,,,,,,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Cigna,Cigna,,0.99,,,0.99,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Connecticare,Commerical,,1.2,,,1.2,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Connecticare,Exchange,,1.2,,,1.2,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,Multiplan,Multiplan,,,59.55,,59.55,0.99,59.55,percent of total billed charges,,
AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70860-118-99,NDC,both,0.05,ea,70.06,42.04,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,59.55,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Aetna,Commerical,,,5.78,,5.78,0.99,6.37,percent of total billed charges,,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Aetna,Middlesex Employees,,,5.54,,5.54,0.99,6.37,percent of total billed charges,,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Anthem,Commerical,,,,,,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Anthem,Indemnity,,,5.61,,5.61,0.99,6.37,percent of total billed charges,,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Anthem,Individual Exchange,,,,,,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Anthem,State Preferred,,,,,,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Cigna,Cigna,,0.99,,,0.99,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Connecticare,Commerical,,1.2,,,1.2,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Connecticare,Exchange,,1.2,,,1.2,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,Multiplan,Multiplan,,,6.37,,6.37,0.99,6.37,percent of total billed charges,,
AMPICILLIN 100 MG/ML IN STERILE WATER NICU,J0290,HCPCS,40810-0004-34,NDC,both,1,ea,7.49,4.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,6.37,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Aetna,Commerical,,,2.23,,2.23,0.99,2.46,percent of total billed charges,,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Aetna,Middlesex Employees,,,2.14,,2.14,0.99,2.46,percent of total billed charges,,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Anthem,Commerical,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Anthem,Indemnity,,,2.16,,2.16,0.99,2.46,percent of total billed charges,,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Anthem,Individual Exchange,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Anthem,State Preferred,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Cigna,Cigna,,0.99,,,0.99,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Connecticare,Commerical,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Connecticare,Exchange,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,Multiplan,Multiplan,,,2.46,,2.46,0.99,2.46,percent of total billed charges,,
AMPICILLIN 100 MG/ML IV (FOR FLUID SHORTAGE),J0290,HCPCS,0781-9407-95,NDC,both,1,ea,40.59,24.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Aetna,Commerical,,,82.16,,82.16,0.99,90.51,percent of total billed charges,,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Aetna,Middlesex Employees,,,78.78,,78.78,0.99,90.51,percent of total billed charges,,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Anthem,Commerical,,,,,,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Anthem,Indemnity,,,79.76,,79.76,0.99,90.51,percent of total billed charges,,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Anthem,Individual Exchange,,,,,,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Anthem,State Preferred,,,,,,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Cigna,Cigna,,0.99,,,0.99,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Connecticare,Commerical,,1.2,,,1.2,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Connecticare,Exchange,,1.2,,,1.2,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,Multiplan,Multiplan,,,90.51,,90.51,0.99,90.51,percent of total billed charges,,
AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,J0290,HCPCS,0781-9413-92,NDC,both,0.25,ea,106.48,63.89,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,90.51,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0409-3720-01,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-80,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Aetna,Commerical,,,39.61,,39.61,0.99,43.63,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Aetna,Middlesex Employees,,,37.98,,37.98,0.99,43.63,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Anthem,Commerical,,,,,,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Anthem,Indemnity,,,38.45,,38.45,0.99,43.63,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Anthem,Individual Exchange,,,,,,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Anthem,State Preferred,,,,,,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Cigna,Cigna,,0.99,,,0.99,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Connecticare,Commerical,,1.2,,,1.2,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Connecticare,Exchange,,1.2,,,1.2,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,Multiplan,Multiplan,,,43.63,,43.63,0.99,43.63,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-3408-95,NDC,both,0.25,ea,51.33,30.8,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,43.63,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9273-80,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,0781-9408-80,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,25021-137-20,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,55150-114-20,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-02,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67457-352-10,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,67850-022-00,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Aetna,Commerical,,,7.5,,7.5,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Aetna,Middlesex Employees,,,7.19,,7.19,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Commerical,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Indemnity,,,7.28,,7.28,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Anthem,Individual Exchange,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Anthem,State Preferred,,,,,,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Cigna,Cigna,,0.99,,,0.99,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Connecticare,Commerical,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Connecticare,Exchange,,1.2,,,1.2,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,Multiplan,Multiplan,,,8.26,,8.26,0.99,8.26,percent of total billed charges,,
AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,J0290,HCPCS,70594-087-01,NDC,both,0.25,ea,9.72,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,8.26,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Aetna,Commerical,,,1.8,,1.8,0.99,1.98,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Aetna,Middlesex Employees,,,1.72,,1.72,0.99,1.98,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Anthem,Commerical,,,,,,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Anthem,Indemnity,,,1.75,,1.75,0.99,1.98,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Anthem,Individual Exchange,,,,,,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Anthem,State Preferred,,,,,,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Cigna,Cigna,,0.99,,,0.99,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Connecticare,Commerical,,1.2,,,1.2,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Connecticare,Exchange,,1.2,,,1.2,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,Multiplan,Multiplan,,,1.98,,1.98,0.99,1.98,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-78,NDC,both,1,ea,2.33,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,1.98,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Aetna,Commerical,,,3.59,,3.59,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Aetna,Middlesex Employees,,,3.44,,3.44,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Anthem,Commerical,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Anthem,Indemnity,,,3.48,,3.48,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Anthem,Individual Exchange,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Anthem,State Preferred,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Cigna,Cigna,,0.99,,,0.99,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Connecticare,Commerical,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Connecticare,Exchange,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,Multiplan,Multiplan,,,3.95,,3.95,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3402-95,NDC,both,2,ea,4.65,2.79,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Aetna,Commerical,,,3.59,,3.59,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Aetna,Middlesex Employees,,,3.44,,3.44,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Anthem,Commerical,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Anthem,Indemnity,,,3.48,,3.48,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Anthem,Individual Exchange,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Anthem,State Preferred,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Cigna,Cigna,,0.99,,,0.99,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Connecticare,Commerical,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Connecticare,Exchange,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,Multiplan,Multiplan,,,3.95,,3.95,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-78,NDC,both,2,ea,4.65,2.79,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Aetna,Commerical,,,3.59,,3.59,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Aetna,Middlesex Employees,,,3.44,,3.44,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Anthem,Commerical,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Anthem,Indemnity,,,3.48,,3.48,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Anthem,Individual Exchange,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Anthem,State Preferred,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Cigna,Cigna,,0.99,,,0.99,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Connecticare,Commerical,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Connecticare,Exchange,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,Multiplan,Multiplan,,,3.95,,3.95,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9402-95,NDC,both,2,ea,4.65,2.79,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Aetna,Commerical,,,3.59,,3.59,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Aetna,Middlesex Employees,,,3.44,,3.44,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Anthem,Commerical,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Anthem,Indemnity,,,3.48,,3.48,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Anthem,Individual Exchange,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Anthem,State Preferred,,,,,,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Cigna,Cigna,,0.99,,,0.99,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Connecticare,Commerical,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Connecticare,Exchange,,1.2,,,1.2,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,Multiplan,Multiplan,,,3.95,,3.95,0.99,3.95,percent of total billed charges,,
AMPICILLIN 250 MG SOLUTION FOR INJECTION,J0290,HCPCS,25021-134-10,NDC,both,2,ea,4.65,2.79,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,3.95,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Aetna,Commerical,,,138.53,,138.53,0.99,152.61,percent of total billed charges,,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Aetna,Middlesex Employees,,,132.84,,132.84,0.99,152.61,percent of total billed charges,,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Anthem,Commerical,,,,,,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Anthem,Indemnity,,,134.49,,134.49,0.99,152.61,percent of total billed charges,,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Anthem,Individual Exchange,,,,,,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Anthem,State Preferred,,,,,,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Cigna,Cigna,,0.99,,,0.99,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Connecticare,Commerical,,1.2,,,1.2,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Connecticare,Exchange,,1.2,,,1.2,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,Multiplan,Multiplan,,,152.61,,152.61,0.99,152.61,percent of total billed charges,,
AMPICILLIN 4 MG/ML DILUTION FOR DESENSIZITATION,J0290,HCPCS,40810-0208-22,NDC,both,125,mL,179.54,107.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,152.61,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,0.99,,,0.99,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-01,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,0.99,,,0.99,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0409-3718-10,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,0.99,,,0.99,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-78,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Aetna,Commerical,,,10.42,,10.42,0.99,11.48,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Aetna,Middlesex Employees,,,9.99,,9.99,0.99,11.48,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Anthem,Commerical,,,,,,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Anthem,Indemnity,,,10.11,,10.11,0.99,11.48,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Anthem,Individual Exchange,,,,,,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Anthem,State Preferred,,,,,,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Cigna,Cigna,,0.99,,,0.99,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Connecticare,Commerical,,1.2,,,1.2,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Connecticare,Exchange,,1.2,,,1.2,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,Multiplan,Multiplan,,,11.48,,11.48,0.99,11.48,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-3407-95,NDC,both,1,ea,13.5,8.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,11.48,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,0.99,,,0.99,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-78,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,0.99,,,0.99,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,1.2,,,1.2,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,0.99,2.46,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,0781-9407-95,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.46,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,0.99,9.77,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,0.99,9.77,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Anthem,Commerical,,,,,,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,0.99,9.77,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Anthem,Individual Exchange,,,,,,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Anthem,State Preferred,,,,,,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Cigna,Cigna,,0.99,,,0.99,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Connecticare,Commerical,,1.2,,,1.2,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Connecticare,Exchange,,1.2,,,1.2,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,0.99,9.77,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,44567-101-10,NDC,both,1,ea,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,9.77,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,0.99,,,0.99,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-01,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,0.99,,,0.99,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,1.2,,,1.2,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,0.99,2.43,percent of total billed charges,,
AMPICILLIN 500 MG SOLUTION FOR INJECTION,J0290,HCPCS,65219-016-10,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.07,,,1.07,0.99,2.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Aetna,Commerical,,,7.57,,7.57,2.19,8.34,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Aetna,Middlesex Employees,,,7.26,,7.26,2.19,8.34,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Anthem,Commerical,,,,,,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Anthem,Indemnity,,,7.35,,7.35,2.19,8.34,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Anthem,Individual Exchange,,,,,,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Anthem,State Preferred,,,,,,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Cigna,Cigna,,2.19,,,2.19,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Connecticare,Commerical,,3.08,,,3.08,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Connecticare,Exchange,,3.08,,,3.08,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,Multiplan,Multiplan,,,8.34,,8.34,2.19,8.34,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-81,NDC,both,1,ea,9.81,5.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.34,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0013-83,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-142-20,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-210-10,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-01,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-10,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-116-20,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,63323-368-20,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-02,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-206-41,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Anthem,Commerical,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Anthem,Individual Exchange,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Anthem,State Preferred,,,,,,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Cigna,Cigna,,2.19,,,2.19,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Connecticare,Commerical,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Connecticare,Exchange,,3.08,,,3.08,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,2.19,8.47,percent of total billed charges,,
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-005-20,NDC,both,1,ea,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.47,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Aetna,Commerical,,,164.02,,164.02,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Aetna,Middlesex Employees,,,157.28,,157.28,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Anthem,Commerical,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Anthem,Indemnity,,,159.24,,159.24,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Anthem,Individual Exchange,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Anthem,State Preferred,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Cigna,Cigna,,2.19,,,2.19,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Connecticare,Commerical,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Connecticare,Exchange,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,Multiplan,Multiplan,,,180.68,,180.68,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0024-28,NDC,both,0.1,ea,212.57,127.54,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Aetna,Commerical,,,118.21,,118.21,2.19,130.22,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Aetna,Middlesex Employees,,,113.35,,113.35,2.19,130.22,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Anthem,Commerical,,,,,,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Anthem,Indemnity,,,114.76,,114.76,2.19,130.22,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Anthem,Individual Exchange,,,,,,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Anthem,State Preferred,,,,,,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Cigna,Cigna,,2.19,,,2.19,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Connecticare,Commerical,,3.08,,,3.08,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Connecticare,Exchange,,3.08,,,3.08,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,Multiplan,Multiplan,,,130.22,,130.22,2.19,130.22,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-144-99,NDC,both,0.1,ea,153.2,91.92,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,130.22,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Aetna,Commerical,,,97.52,,97.52,2.19,107.43,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Aetna,Middlesex Employees,,,93.52,,93.52,2.19,107.43,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Commerical,,,,,,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Indemnity,,,94.68,,94.68,2.19,107.43,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Individual Exchange,,,,,,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Anthem,State Preferred,,,,,,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Cigna,Cigna,,2.19,,,2.19,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Connecticare,Commerical,,3.08,,,3.08,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Connecticare,Exchange,,3.08,,,3.08,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,Multiplan,Multiplan,,,107.43,,107.43,2.19,107.43,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-212-01,NDC,both,0.1,ea,126.39,75.83,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,107.43,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Aetna,Commerical,,,164.02,,164.02,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Aetna,Middlesex Employees,,,157.28,,157.28,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Anthem,Commerical,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Anthem,Indemnity,,,159.24,,159.24,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Anthem,Individual Exchange,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Anthem,State Preferred,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Cigna,Cigna,,2.19,,,2.19,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Connecticare,Commerical,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Connecticare,Exchange,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,Multiplan,Multiplan,,,180.68,,180.68,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-243-15,NDC,both,0.1,ea,212.57,127.54,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Aetna,Commerical,,,164.02,,164.02,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Aetna,Middlesex Employees,,,157.28,,157.28,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Anthem,Commerical,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Anthem,Indemnity,,,159.24,,159.24,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Anthem,Individual Exchange,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Anthem,State Preferred,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Cigna,Cigna,,2.19,,,2.19,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Connecticare,Commerical,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Connecticare,Exchange,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,Multiplan,Multiplan,,,180.68,,180.68,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-75,NDC,both,0.1,ea,212.57,127.54,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Aetna,Commerical,,,164.02,,164.02,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Aetna,Middlesex Employees,,,157.28,,157.28,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Anthem,Commerical,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Anthem,Indemnity,,,159.24,,159.24,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Anthem,Individual Exchange,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Anthem,State Preferred,,,,,,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Cigna,Cigna,,2.19,,,2.19,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Connecticare,Commerical,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Connecticare,Exchange,,3.08,,,3.08,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,Multiplan,Multiplan,,,180.68,,180.68,2.19,180.68,percent of total billed charges,,
AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-033-91,NDC,both,0.1,ea,212.57,127.54,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,180.68,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-02,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,66794-207-41,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-03,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,67457-349-10,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-20,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,71288-032-21,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-01,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,J0295,HCPCS,72485-417-10,NDC,both,0.5,ea,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0049-0014-83,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,0641-6117-10,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,25021-143-30,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,44567-211-10,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,55150-117-20,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,11.52,,11.52,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,11.05,,11.05,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,11.18,,11.18,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,12.69,,12.69,2.19,12.69,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-30,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.69,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Aetna,Commerical,,,7.72,,7.72,2.19,8.51,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Aetna,Middlesex Employees,,,7.41,,7.41,2.19,8.51,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Anthem,Commerical,,,,,,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Anthem,Indemnity,,,7.5,,7.5,2.19,8.51,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Anthem,Individual Exchange,,,,,,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Anthem,State Preferred,,,,,,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Cigna,Cigna,,2.19,,,2.19,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Connecticare,Commerical,,3.08,,,3.08,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Connecticare,Exchange,,3.08,,,3.08,2.19,8.51,Other,Could be inpatient or outpatient,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,Multiplan,Multiplan,,,8.51,,8.51,2.19,8.51,percent of total billed charges,,
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION NO SECOND SIGN,J0295,HCPCS,71288-006-31,NDC,both,0.5,ea,10.01,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,8.51,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Aetna,Commerical,,,69.37,,69.37,66.52,76.42,percent of total billed charges,,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Aetna,Middlesex Employees,,,66.52,,66.52,66.52,76.42,percent of total billed charges,,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Anthem,Commerical,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Anthem,Indemnity,,,67.34,,67.34,66.52,76.42,percent of total billed charges,,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Anthem,Individual Exchange,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Anthem,State Preferred,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Cigna,Cigna,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Connecticare,Commerical,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Connecticare,Exchange,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,Multiplan,Multiplan,,,76.42,,76.42,66.52,76.42,percent of total billed charges,,
AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,J3490,HCPCS,46414-2222-1,NDC,both,1,ea,89.9,53.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,66.52,76.42,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Aetna,Commerical,,,2.29,,2.29,2.2,2.52,percent of total billed charges,,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Aetna,Middlesex Employees,,,2.2,,2.2,2.2,2.52,percent of total billed charges,,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Anthem,Commerical,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Anthem,Indemnity,,,2.22,,2.22,2.2,2.52,percent of total billed charges,,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Anthem,Individual Exchange,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Anthem,State Preferred,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Cigna,Cigna,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Connecticare,Commerical,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Connecticare,Exchange,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.2,2.52,percent of total billed charges,,
ANAGRELIDE 0.5 MG CAPSULE,J3490,HCPCS,0172-5241-60,NDC,both,1,ea,2.97,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Aetna,Commerical,,,572.91,,572.91,549.38,631.13,percent of total billed charges,,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Aetna,Middlesex Employees,,,549.38,,549.38,549.38,631.13,percent of total billed charges,,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Indemnity,,,556.21,,556.21,549.38,631.13,percent of total billed charges,,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Individual Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,State Preferred,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Cigna,Cigna,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Connecticare,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Connecticare,Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Multiplan,Multiplan,,,631.13,,631.13,549.38,631.13,percent of total billed charges,,
ANAKINRA (KINERET) INJECTION PARTIAL DOSES,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Aetna,Commerical,,,572.91,,572.91,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Aetna,Middlesex Employees,,,549.38,,549.38,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Anthem,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Anthem,Indemnity,,,556.21,,556.21,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Anthem,Individual Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Anthem,State Preferred,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Cigna,Cigna,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Connecticare,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Connecticare,Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,Multiplan,Multiplan,,,631.13,,631.13,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-01,NDC,both,0.67,mL,742.5,445.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Aetna,Commerical,,,572.91,,572.91,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Aetna,Middlesex Employees,,,549.38,,549.38,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Indemnity,,,556.21,,556.21,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,Individual Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Anthem,State Preferred,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Cigna,Cigna,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Connecticare,Commerical,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Connecticare,Exchange,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,Multiplan,Multiplan,,,631.13,,631.13,549.38,631.13,percent of total billed charges,,
ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,J3590,HCPCS,66658-234-07,NDC,both,0.67,mL,742.5,445.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,549.38,631.13,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Aetna,Commerical,,,246.97,,246.97,0.6,272.07,percent of total billed charges,,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Aetna,Middlesex Employees,,,236.83,,236.83,0.6,272.07,percent of total billed charges,,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Anthem,Commerical,,,,,,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Anthem,Indemnity,,,239.77,,239.77,0.6,272.07,percent of total billed charges,,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Anthem,Individual Exchange,,,,,,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Anthem,State Preferred,,,,,,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Cigna,Cigna,,0.6,,,0.6,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Connecticare,Commerical,,0.7,,,0.7,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Connecticare,Exchange,,0.7,,,0.7,0.6,272.07,Other,Could be inpatient or outpatient,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,Multiplan,Multiplan,,,272.07,,272.07,0.6,272.07,percent of total billed charges,,
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION,J0348,HCPCS,0049-0116-28,NDC,both,0.01,ea,320.08,192.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.6,272.07,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Aetna,Commerical,,,4.32,,4.32,1.6,4.76,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Aetna,Middlesex Employees,,,4.14,,4.14,1.6,4.76,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Anthem,Commerical,,,,,,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Anthem,Indemnity,,,4.19,,4.19,1.6,4.76,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Anthem,Individual Exchange,,,,,,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Anthem,State Preferred,,,,,,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Cigna,Cigna,,1.6,,,1.6,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Connecticare,Commerical,,2.26,,,2.26,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Connecticare,Exchange,,2.26,,,2.26,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,Multiplan,Multiplan,,,4.76,,4.76,1.6,4.76,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION",J7185,HCPCS,0944-2845-10,NDC,both,0.001,ea,5.6,3.36,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,4.76,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Aetna,Commerical,,,2.03,,2.03,1.22,2.24,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.22,2.24,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Anthem,Commerical,,,,,,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Anthem,Indemnity,,,1.97,,1.97,1.22,2.24,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Anthem,Individual Exchange,,,,,,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Anthem,State Preferred,,,,,,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Cigna,Cigna,,1.22,,,1.22,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Connecticare,Commerical,,1.79,,,1.79,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Connecticare,Exchange,,1.79,,,1.79,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.22,2.24,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR 1,000 (+/-) UNIT INTRAVENOUS POWDER FOR SOLUTION",J7190,HCPCS,76125-676-50,NDC,both,1,ea,2.63,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.32,,,1.32,1.22,2.24,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Aetna,Commerical,,,10.79,,10.79,3.64,11.88,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Aetna,Middlesex Employees,,,10.34,,10.34,3.64,11.88,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Anthem,Commerical,,,,,,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Anthem,Indemnity,,,10.47,,10.47,3.64,11.88,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Anthem,Individual Exchange,,,,,,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Anthem,State Preferred,,,,,,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Cigna,Cigna,,3.64,,,3.64,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Connecticare,Commerical,,4.92,,,4.92,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Connecticare,Exchange,,4.92,,,4.92,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,Multiplan,Multiplan,,,11.88,,11.88,3.64,11.88,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,PORCINE REC 500(+/-) UNIT RANGE IV SOLUTION",J7188,HCPCS,0944-5001-01,NDC,both,0.002,ea,13.98,8.39,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.64,11.88,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Aetna,Commerical,,,2630.15,,2630.15,1.6,2897.4,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Aetna,Middlesex Employees,,,2522.1,,2522.1,1.6,2897.4,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Anthem,Commerical,,,,,,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Anthem,Indemnity,,,2553.46,,2553.46,1.6,2897.4,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Anthem,Individual Exchange,,,,,,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Anthem,State Preferred,,,,,,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Cigna,Cigna,,1.6,,,1.6,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Connecticare,Commerical,,2.26,,,2.26,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Connecticare,Exchange,,2.26,,,2.26,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,Multiplan,Multiplan,,,2897.4,,2897.4,1.6,2897.4,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 1,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-014-01,NDC,both,0.001,ea,3408.7,2045.22,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,2897.4,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Aetna,Commerical,,,9338.52,,9338.52,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Aetna,Middlesex Employees,,,8954.86,,8954.86,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Commerical,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Indemnity,,,9066.21,,9066.21,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Individual Exchange,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,State Preferred,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Cigna,Cigna,,1.6,,,1.6,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Connecticare,Commerical,,2.26,,,2.26,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Connecticare,Exchange,,2.26,,,2.26,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,Multiplan,Multiplan,,,10287.38,,10287.38,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-015-01,NDC,both,0.001,ea,12102.8,7261.68,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Aetna,Commerical,,,9338.52,,9338.52,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Aetna,Middlesex Employees,,,8954.86,,8954.86,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Commerical,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Indemnity,,,9066.21,,9066.21,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,Individual Exchange,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Anthem,State Preferred,,,,,,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Cigna,Cigna,,1.6,,,1.6,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Connecticare,Commerical,,2.26,,,2.26,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Connecticare,Exchange,,2.26,,,2.26,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,Multiplan,Multiplan,,,10287.38,,10287.38,1.6,10287.38,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELET 2,000 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-115-01,NDC,both,0.001,ea,12102.8,7261.68,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,10287.38,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Aetna,Commerical,,,1122.99,,1122.99,1.6,1237.09,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Aetna,Middlesex Employees,,,1076.85,,1076.85,1.6,1237.09,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Anthem,Commerical,,,,,,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Anthem,Indemnity,,,1090.24,,1090.24,1.6,1237.09,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Anthem,Individual Exchange,,,,,,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Anthem,State Preferred,,,,,,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Cigna,Cigna,,1.6,,,1.6,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Connecticare,Commerical,,2.26,,,2.26,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Connecticare,Exchange,,2.26,,,2.26,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,Multiplan,Multiplan,,,1237.09,,1237.09,1.6,1237.09,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 250 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-012-01,NDC,both,0.004,ea,1455.4,873.24,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,1237.09,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Aetna,Commerical,,,1318.03,,1318.03,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Aetna,Middlesex Employees,,,1263.88,,1263.88,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Anthem,Commerical,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Anthem,Indemnity,,,1279.6,,1279.6,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Anthem,Individual Exchange,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Anthem,State Preferred,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Cigna,Cigna,,1.6,,,1.6,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Connecticare,Commerical,,2.26,,,2.26,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Connecticare,Exchange,,2.26,,,2.26,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,Multiplan,Multiplan,,,1451.95,,1451.95,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR VIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SOLN",J7185,HCPCS,58394-013-01,NDC,both,0.002,ea,1708.18,1024.91,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Aetna,Commerical,,,2.68,,2.68,2.57,2.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Aetna,Middlesex Employees,,,2.57,,2.57,2.57,2.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Anthem,Commerical,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Anthem,Indemnity,,,2.6,,2.6,2.57,2.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Anthem,Individual Exchange,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Anthem,State Preferred,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Cigna,Cigna,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Connecticare,Commerical,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Connecticare,Exchange,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,Multiplan,Multiplan,,,2.95,,2.95,2.57,2.95,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLN",J3490,HCPCS,68516-4618-2,NDC,both,0.001,ea,3.47,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.57,2.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Aetna,Commerical,,,7589.03,,7589.03,1.58,8360.12,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Aetna,Middlesex Employees,,,7277.24,,7277.24,1.58,8360.12,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Anthem,Commerical,,,,,,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Anthem,Indemnity,,,7367.73,,7367.73,1.58,8360.12,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Anthem,Individual Exchange,,,,,,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Anthem,State Preferred,,,,,,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Cigna,Cigna,,1.58,,,1.58,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Connecticare,Commerical,,2.13,,,2.13,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Connecticare,Exchange,,2.13,,,2.13,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,Multiplan,Multiplan,,,8360.12,,8360.12,1.58,8360.12,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-617-02,NDC,both,1,ea,9835.44,5901.26,United Healthcare/Oxford,United Healthcare/Oxford,,1.71,,,1.71,1.58,8360.12,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,1.44,3.2,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,1.44,3.2,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,1.44,3.2,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,1.44,,,1.44,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,1.95,,,1.95,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,1.95,,,1.95,1.44,3.2,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,1.44,3.2,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 1,000(VWF 1,000) UNIT/10 ML INTRAVENOUS SOLN",J7183,HCPCS,68982-182-02,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,1.55,,,1.55,1.44,3.2,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Aetna,Commerical,,,628.96,,628.96,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Aetna,Middlesex Employees,,,603.12,,603.12,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Anthem,Commerical,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Anthem,Indemnity,,,610.62,,610.62,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Anthem,Individual Exchange,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Anthem,State Preferred,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Cigna,Cigna,,1.34,,,1.34,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Connecticare,Commerical,,1.87,,,1.87,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Connecticare,Exchange,,1.87,,,1.87,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,Multiplan,Multiplan,,,692.87,,692.87,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4611-1,NDC,both,1,ea,815.14,489.08,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Aetna,Commerical,,,628.96,,628.96,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Aetna,Middlesex Employees,,,603.12,,603.12,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Anthem,Commerical,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Anthem,Indemnity,,,610.62,,610.62,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Anthem,Individual Exchange,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Anthem,State Preferred,,,,,,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Cigna,Cigna,,1.34,,,1.34,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Connecticare,Commerical,,1.87,,,1.87,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Connecticare,Exchange,,1.87,,,1.87,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,Multiplan,Multiplan,,,692.87,,692.87,1.34,692.87,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 (100 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4616-1,NDC,both,1,ea,815.14,489.08,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,692.87,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Aetna,Commerical,,,1897.26,,1897.26,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Aetna,Middlesex Employees,,,1819.31,,1819.31,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Anthem,Commerical,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Anthem,Indemnity,,,1841.93,,1841.93,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Anthem,Individual Exchange,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Anthem,State Preferred,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Cigna,Cigna,,1.58,,,1.58,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Connecticare,Commerical,,2.13,,,2.13,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Connecticare,Exchange,,2.13,,,2.13,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,Multiplan,Multiplan,,,2090.03,,2090.03,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-615-02,NDC,both,1,ea,2458.86,1475.32,United Healthcare/Oxford,United Healthcare/Oxford,,1.71,,,1.71,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Aetna,Commerical,,,1897.26,,1897.26,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Aetna,Middlesex Employees,,,1819.31,,1819.31,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Anthem,Commerical,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Anthem,Indemnity,,,1841.93,,1841.93,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Anthem,Individual Exchange,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Anthem,State Preferred,,,,,,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Cigna,Cigna,,1.58,,,1.58,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Connecticare,Commerical,,2.13,,,2.13,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Connecticare,Exchange,,2.13,,,2.13,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,Multiplan,Multiplan,,,2090.03,,2090.03,1.58,2090.03,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,J7187,HCPCS,63833-625-01,NDC,both,1,ea,2458.86,1475.32,United Healthcare/Oxford,United Healthcare/Oxford,,1.71,,,1.71,1.58,2090.03,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Aetna,Commerical,,,1336.53,,1336.53,1.34,1472.34,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Aetna,Middlesex Employees,,,1281.63,,1281.63,1.34,1472.34,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Anthem,Commerical,,,,,,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Anthem,Indemnity,,,1297.56,,1297.56,1.34,1472.34,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Anthem,Individual Exchange,,,,,,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Anthem,State Preferred,,,,,,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Cigna,Cigna,,1.34,,,1.34,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Connecticare,Commerical,,1.87,,,1.87,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Connecticare,Exchange,,1.87,,,1.87,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,Multiplan,Multiplan,,,1472.34,,1472.34,1.34,1472.34,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7186,HCPCS,68516-4612-1,NDC,both,1,ea,1732.16,1039.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,1472.34,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Aetna,Commerical,,,1160.14,,1160.14,1.44,1278.02,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Aetna,Middlesex Employees,,,1112.48,,1112.48,1.44,1278.02,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Anthem,Commerical,,,,,,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Anthem,Indemnity,,,1126.31,,1126.31,1.44,1278.02,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Anthem,Individual Exchange,,,,,,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Anthem,State Preferred,,,,,,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Cigna,Cigna,,1.44,,,1.44,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Connecticare,Commerical,,1.95,,,1.95,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Connecticare,Exchange,,1.95,,,1.95,1.44,1278.02,Other,Could be inpatient or outpatient,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,Multiplan,Multiplan,,,1278.02,,1278.02,1.44,1278.02,percent of total billed charges,,
ANTIHEMOPHILIC FACTOR-VWF 500 (500 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,J7183,HCPCS,68982-182-01,NDC,both,1,ea,1503.55,902.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.55,,,1.55,1.44,1278.02,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Aetna,Commerical,,,3794.51,,3794.51,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Aetna,Middlesex Employees,,,3638.62,,3638.62,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Anthem,Commerical,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Anthem,Indemnity,,,3683.86,,3683.86,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Anthem,Individual Exchange,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Anthem,State Preferred,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Cigna,Cigna,,1.58,,,1.58,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Connecticare,Commerical,,2.13,,,2.13,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Connecticare,Exchange,,2.13,,,2.13,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,Multiplan,Multiplan,,,4180.06,,4180.06,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-616-02,NDC,both,1,ea,4917.72,2950.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.71,,,1.71,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Aetna,Commerical,,,3794.51,,3794.51,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Aetna,Middlesex Employees,,,3638.62,,3638.62,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Anthem,Commerical,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Anthem,Indemnity,,,3683.86,,3683.86,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Anthem,Individual Exchange,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Anthem,State Preferred,,,,,,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Cigna,Cigna,,1.58,,,1.58,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Connecticare,Commerical,,2.13,,,2.13,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Connecticare,Exchange,,2.13,,,2.13,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,Multiplan,Multiplan,,,4180.06,,4180.06,1.58,4180.06,percent of total billed charges,,
"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",J7187,HCPCS,63833-626-01,NDC,both,0.001,ea,4917.72,2950.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.71,,,1.71,1.58,4180.06,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Aetna,Commerical,,,26375.41,,26375.41,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Aetna,Middlesex Employees,,,25291.82,,25291.82,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Anthem,Commerical,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Anthem,Indemnity,,,25606.3,,25606.3,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Anthem,Individual Exchange,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Anthem,State Preferred,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Cigna,Cigna,,1.6,,,1.6,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Connecticare,Commerical,,2.26,,,2.26,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Connecticare,Exchange,,2.26,,,2.26,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,Multiplan,Multiplan,,,29055.34,,29055.34,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-024-03,NDC,both,1,ea,34182.75,20509.65,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Aetna,Commerical,,,26375.41,,26375.41,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Aetna,Middlesex Employees,,,25291.82,,25291.82,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Anthem,Commerical,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Anthem,Indemnity,,,25606.3,,25606.3,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Anthem,Individual Exchange,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Anthem,State Preferred,,,,,,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Cigna,Cigna,,1.6,,,1.6,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Connecticare,Commerical,,2.26,,,2.26,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Connecticare,Exchange,,2.26,,,2.26,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,Multiplan,Multiplan,,,29055.34,,29055.34,1.6,29055.34,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 1,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-124-03,NDC,both,0.001,ea,34182.75,20509.65,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,29055.34,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Aetna,Commerical,,,5260.31,,5260.31,1.6,5794.79,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Aetna,Middlesex Employees,,,5044.19,,5044.19,1.6,5794.79,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Anthem,Commerical,,,,,,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Anthem,Indemnity,,,5106.91,,5106.91,1.6,5794.79,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Anthem,Individual Exchange,,,,,,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Anthem,State Preferred,,,,,,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Cigna,Cigna,,1.6,,,1.6,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Connecticare,Commerical,,2.26,,,2.26,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Connecticare,Exchange,,2.26,,,2.26,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,Multiplan,Multiplan,,,5794.79,,5794.79,1.6,5794.79,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 2,000 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-025-03,NDC,both,1,ea,6817.4,4090.44,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,5794.79,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Aetna,Commerical,,,1318.03,,1318.03,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Aetna,Middlesex Employees,,,1263.88,,1263.88,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Anthem,Commerical,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Anthem,Indemnity,,,1279.6,,1279.6,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Anthem,Individual Exchange,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Anthem,State Preferred,,,,,,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Cigna,Cigna,,1.6,,,1.6,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Connecticare,Commerical,,2.26,,,2.26,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Connecticare,Exchange,,2.26,,,2.26,1.6,1451.95,Other,Could be inpatient or outpatient,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,Multiplan,Multiplan,,,1451.95,,1451.95,1.6,1451.95,percent of total billed charges,,
"ANTIHEMOPHILIC FVIII,REC B-DOMAIN DELETED 500 (+/-) UNIT IV SYRINGE",J7185,HCPCS,58394-023-03,NDC,both,1,ea,1708.18,1024.91,United Healthcare/Oxford,United Healthcare/Oxford,,1.73,,,1.73,1.6,1451.95,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Aetna,Commerical,,,9.52,,9.52,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Aetna,Middlesex Employees,,,9.13,,9.13,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Anthem,Commerical,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Anthem,Indemnity,,,9.24,,9.24,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Anthem,Individual Exchange,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Anthem,State Preferred,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Cigna,Cigna,,4.4,,,4.4,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Connecticare,Commerical,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Connecticare,Exchange,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,Multiplan,Multiplan,,,10.49,,10.49,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-602-50,NDC,both,0.002,ea,12.34,7.4,United Healthcare/Oxford,United Healthcare/Oxford,,4.75,,,4.75,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Aetna,Commerical,,,4757.92,,4757.92,4.4,5241.36,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Aetna,Middlesex Employees,,,4562.45,,4562.45,4.4,5241.36,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Anthem,Commerical,,,,,,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Anthem,Indemnity,,,4619.18,,4619.18,4.4,5241.36,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Anthem,Individual Exchange,,,,,,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Anthem,State Preferred,,,,,,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Cigna,Cigna,,4.4,,,4.4,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Connecticare,Commerical,,5.88,,,5.88,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Connecticare,Exchange,,5.88,,,5.88,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,Multiplan,Multiplan,,,5241.36,,5241.36,4.4,5241.36,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-603-20,NDC,both,1,un ,6166.3,3699.78,United Healthcare/Oxford,United Healthcare/Oxford,,4.75,,,4.75,4.4,5241.36,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Aetna,Commerical,,,9.52,,9.52,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Aetna,Middlesex Employees,,,9.13,,9.13,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Anthem,Commerical,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Anthem,Indemnity,,,9.24,,9.24,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Anthem,Individual Exchange,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Anthem,State Preferred,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Cigna,Cigna,,4.4,,,4.4,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Connecticare,Commerical,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Connecticare,Exchange,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,Multiplan,Multiplan,,,10.49,,10.49,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-605-21,NDC,both,0.002,ea,12.34,7.4,United Healthcare/Oxford,United Healthcare/Oxford,,4.75,,,4.75,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Aetna,Commerical,,,9.52,,9.52,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Aetna,Middlesex Employees,,,9.13,,9.13,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Anthem,Commerical,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Anthem,Indemnity,,,9.24,,9.24,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Anthem,Individual Exchange,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Anthem,State Preferred,,,,,,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Cigna,Cigna,,4.4,,,4.4,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Connecticare,Commerical,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Connecticare,Exchange,,5.88,,,5.88,4.4,10.49,Other,Could be inpatient or outpatient,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,Multiplan,Multiplan,,,10.49,,10.49,4.4,10.49,percent of total billed charges,,
ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,J7197,HCPCS,13533-606-12,NDC,both,0.002,ea,12.34,7.4,United Healthcare/Oxford,United Healthcare/Oxford,,4.75,,,4.75,4.4,10.49,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Aetna,Commerical,,,3016.52,,3016.52,1080.29,3323.02,percent of total billed charges,,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Aetna,Middlesex Employees,,,2892.59,,2892.59,1080.29,3323.02,percent of total billed charges,,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Anthem,Commerical,,,,,,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Anthem,Indemnity,,,2928.56,,2928.56,1080.29,3323.02,percent of total billed charges,,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Anthem,Individual Exchange,,,,,,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Anthem,State Preferred,,,,,,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Cigna,Cigna,,1080.29,,,1080.29,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Connecticare,Commerical,,1460.92,,,1460.92,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Connecticare,Exchange,,1460.92,,,1460.92,1080.29,3323.02,Other,Could be inpatient or outpatient,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,Multiplan,Multiplan,,,3323.02,,3323.02,1080.29,3323.02,percent of total billed charges,,
ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,J7511,HCPCS,58468-0080-1,NDC,both,1,ea,3909.44,2345.66,United Healthcare/Oxford,United Healthcare/Oxford,,1166.33,,,1166.33,1080.29,3323.02,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Aetna,Commerical,,,81.89,,81.89,78.53,90.21,percent of total billed charges,,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Aetna,Middlesex Employees,,,78.53,,78.53,78.53,90.21,percent of total billed charges,,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Anthem,Commerical,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Anthem,Indemnity,,,79.5,,79.5,78.53,90.21,percent of total billed charges,,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Anthem,Individual Exchange,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Anthem,State Preferred,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Cigna,Cigna,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Connecticare,Commerical,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Connecticare,Exchange,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,Multiplan,Multiplan,,,90.21,,90.21,78.53,90.21,percent of total billed charges,,
"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,0006-5424-02,NDC,both,1,ea,106.13,63.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,78.53,90.21,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Aetna,Commerical,,,320.11,,320.11,306.96,352.64,percent of total billed charges,,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Aetna,Middlesex Employees,,,306.96,,306.96,306.96,352.64,percent of total billed charges,,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Anthem,Commerical,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Anthem,Indemnity,,,310.78,,310.78,306.96,352.64,percent of total billed charges,,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Anthem,Individual Exchange,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Anthem,State Preferred,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Cigna,Cigna,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Connecticare,Commerical,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Connecticare,Exchange,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,Multiplan,Multiplan,,,352.64,,352.64,306.96,352.64,percent of total billed charges,,
APIXABAN 0.25 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-64,NDC,both,1,mL,414.87,248.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.96,352.64,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Aetna,Commerical,,,15.79,,15.79,15.15,17.4,percent of total billed charges,,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Aetna,Middlesex Employees,,,15.15,,15.15,15.15,17.4,percent of total billed charges,,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Anthem,Commerical,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Anthem,Indemnity,,,15.33,,15.33,15.15,17.4,percent of total billed charges,,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Anthem,Individual Exchange,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Anthem,State Preferred,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Cigna,Cigna,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Connecticare,Commerical,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Connecticare,Exchange,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,Multiplan,Multiplan,,,17.4,,17.4,15.15,17.4,percent of total billed charges,,
APIXABAN 1.25 MG SPLIT TABLET,J3490,HCPCS,40810-0206-05,NDC,both,1,ea,20.47,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Aetna,Commerical,,,15.79,,15.79,15.15,17.4,percent of total billed charges,,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Aetna,Middlesex Employees,,,15.15,,15.15,15.15,17.4,percent of total billed charges,,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Anthem,Commerical,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Anthem,Indemnity,,,15.33,,15.33,15.15,17.4,percent of total billed charges,,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Anthem,Individual Exchange,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Anthem,State Preferred,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Cigna,Cigna,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Connecticare,Commerical,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Connecticare,Exchange,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,Multiplan,Multiplan,,,17.4,,17.4,15.15,17.4,percent of total billed charges,,
APIXABAN 2.5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-73,NDC,both,1,ea,20.47,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.15,17.4,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Aetna,Commerical,,,19.95,,19.95,19.13,21.97,percent of total billed charges,,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Aetna,Middlesex Employees,,,19.13,,19.13,19.13,21.97,percent of total billed charges,,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Anthem,Commerical,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Anthem,Indemnity,,,19.36,,19.36,19.13,21.97,percent of total billed charges,,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Anthem,Individual Exchange,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Anthem,State Preferred,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Cigna,Cigna,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Connecticare,Commerical,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Connecticare,Exchange,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,Multiplan,Multiplan,,,21.97,,21.97,19.13,21.97,percent of total billed charges,,
APIXABAN 5 MG TABLET,J3490,HCPCS,0003-0894-31,NDC,both,1,ea,25.85,15.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.13,21.97,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Aetna,Commerical,,,693.27,,693.27,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Aetna,Middlesex Employees,,,664.79,,664.79,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Anthem,Commerical,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Anthem,Indemnity,,,673.05,,673.05,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Anthem,Individual Exchange,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Anthem,State Preferred,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Cigna,Cigna,,3.84,,,3.84,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Connecticare,Commerical,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Connecticare,Exchange,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,Multiplan,Multiplan,,,763.71,,763.71,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-06,NDC,both,0.04,ea,898.48,539.09,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Aetna,Commerical,,,715.09,,715.09,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Aetna,Middlesex Employees,,,685.71,,685.71,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Anthem,Commerical,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Anthem,Indemnity,,,694.24,,694.24,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Anthem,Individual Exchange,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Anthem,State Preferred,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Cigna,Cigna,,3.84,,,3.84,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Connecticare,Commerical,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Connecticare,Exchange,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,Multiplan,Multiplan,,,787.75,,787.75,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,0781-2323-68,NDC,both,0.04,ea,926.76,556.06,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Aetna,Commerical,,,715.09,,715.09,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Aetna,Middlesex Employees,,,685.71,,685.71,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Anthem,Commerical,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Anthem,Indemnity,,,694.24,,694.24,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Anthem,Individual Exchange,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Anthem,State Preferred,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Cigna,Cigna,,3.84,,,3.84,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Connecticare,Commerical,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Connecticare,Exchange,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,Multiplan,Multiplan,,,787.75,,787.75,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-80,NDC,both,0.04,ea,926.76,556.06,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Aetna,Commerical,,,715.09,,715.09,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Aetna,Middlesex Employees,,,685.71,,685.71,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Anthem,Commerical,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Anthem,Indemnity,,,694.24,,694.24,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Anthem,Individual Exchange,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Anthem,State Preferred,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Cigna,Cigna,,3.84,,,3.84,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Connecticare,Commerical,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Connecticare,Exchange,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,Multiplan,Multiplan,,,787.75,,787.75,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,13668-593-86,NDC,both,0.04,ea,926.76,556.06,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Aetna,Commerical,,,693.27,,693.27,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Aetna,Middlesex Employees,,,664.79,,664.79,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Anthem,Commerical,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Anthem,Indemnity,,,673.05,,673.05,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Anthem,Individual Exchange,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Anthem,State Preferred,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Cigna,Cigna,,3.84,,,3.84,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Connecticare,Commerical,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Connecticare,Exchange,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,Multiplan,Multiplan,,,763.71,,763.71,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,40810-0005-86,NDC,both,0.04,ea,898.48,539.09,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Aetna,Commerical,,,693.27,,693.27,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Aetna,Middlesex Employees,,,664.79,,664.79,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Anthem,Commerical,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Anthem,Indemnity,,,673.05,,673.05,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Anthem,Individual Exchange,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Anthem,State Preferred,,,,,,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Cigna,Cigna,,3.84,,,3.84,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Connecticare,Commerical,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Connecticare,Exchange,,5,,,5,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,Multiplan,Multiplan,,,763.71,,763.71,3.84,763.71,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-40,NDC,both,0.04,ea,898.48,539.09,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,763.71,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Aetna,Commerical,,,715.09,,715.09,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Aetna,Middlesex Employees,,,685.71,,685.71,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Anthem,Commerical,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Anthem,Indemnity,,,694.24,,694.24,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Anthem,Individual Exchange,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Anthem,State Preferred,,,,,,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Cigna,Cigna,,3.84,,,3.84,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Connecticare,Commerical,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Connecticare,Exchange,,5,,,5,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,Multiplan,Multiplan,,,787.75,,787.75,3.84,787.75,percent of total billed charges,,
APREPITANT 125 MG CAPSULE,J8501,HCPCS,68462-585-76,NDC,both,0.04,ea,926.76,556.06,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,787.75,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Aetna,Commerical,,,4137.32,,4137.32,3.84,4557.7,percent of total billed charges,,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Aetna,Middlesex Employees,,,3967.34,,3967.34,3.84,4557.7,percent of total billed charges,,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Anthem,Commerical,,,,,,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Anthem,Indemnity,,,4016.67,,4016.67,3.84,4557.7,percent of total billed charges,,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Anthem,Individual Exchange,,,,,,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Anthem,State Preferred,,,,,,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Cigna,Cigna,,3.84,,,3.84,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Connecticare,Commerical,,5,,,5,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Connecticare,Exchange,,5,,,5,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,Multiplan,Multiplan,,,4557.7,,4557.7,3.84,4557.7,percent of total billed charges,,
APREPITANT 20 MG/ML ORAL SUSPENSION,J8501,HCPCS,40810-0018-31,NDC,both,0.25,mL,5362,3217.2,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,4557.7,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-01,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0006-0464-05,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,0781-2321-51,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-80,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-81,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Aetna,Commerical,,,140.26,,140.26,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Aetna,Middlesex Employees,,,134.5,,134.5,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Anthem,Commerical,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Anthem,Indemnity,,,136.17,,136.17,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Anthem,Individual Exchange,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Anthem,State Preferred,,,,,,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Cigna,Cigna,,3.84,,,3.84,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Connecticare,Commerical,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Connecticare,Exchange,,5,,,5,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,Multiplan,Multiplan,,,154.51,,154.51,3.84,154.51,percent of total billed charges,,
APREPITANT 40 MG CAPSULE,J8501,HCPCS,13668-591-82,NDC,both,0.125,ea,181.78,109.07,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,154.51,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0006-0461-02,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Aetna,Commerical,,,296.6,,296.6,3.84,326.73,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Aetna,Middlesex Employees,,,284.41,,284.41,3.84,326.73,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Anthem,Commerical,,,,,,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Anthem,Indemnity,,,287.95,,287.95,3.84,326.73,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Anthem,Individual Exchange,,,,,,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Anthem,State Preferred,,,,,,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Cigna,Cigna,,3.84,,,3.84,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Connecticare,Commerical,,5,,,5,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Connecticare,Exchange,,5,,,5,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,Multiplan,Multiplan,,,326.73,,326.73,3.84,326.73,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-46,NDC,both,1,ea,384.39,230.63,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,326.73,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,0781-2322-68,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-83,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-84,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-85,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Aetna,Commerical,,,298.97,,298.97,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Aetna,Middlesex Employees,,,286.69,,286.69,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Anthem,Commerical,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Anthem,Indemnity,,,290.25,,290.25,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Anthem,Individual Exchange,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Anthem,State Preferred,,,,,,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Cigna,Cigna,,3.84,,,3.84,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Connecticare,Commerical,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Connecticare,Exchange,,5,,,5,3.84,329.35,Other,Could be inpatient or outpatient,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,Multiplan,Multiplan,,,329.35,,329.35,3.84,329.35,percent of total billed charges,,
APREPITANT 80 MG CAPSULE,J8501,HCPCS,13668-592-86,NDC,both,0.063,ea,387.47,232.48,United Healthcare/Oxford,United Healthcare/Oxford,,4.15,,,4.15,3.84,329.35,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Aetna,Commerical,,,220.31,,220.31,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Aetna,Middlesex Employees,,,211.26,,211.26,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Commerical,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Indemnity,,,213.89,,213.89,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Individual Exchange,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,State Preferred,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Cigna,Cigna,,4.5,,,4.5,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Connecticare,Commerical,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Connecticare,Exchange,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Multiplan,Multiplan,,,242.7,,242.7,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Aetna,Commerical,,,440.63,,440.63,1.7,485.4,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Aetna,Middlesex Employees,,,422.53,,422.53,1.7,485.4,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Anthem,Commerical,,,,,,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Anthem,Indemnity,,,427.78,,427.78,1.7,485.4,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Anthem,Individual Exchange,,,,,,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Anthem,State Preferred,,,,,,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Cigna,Cigna,,4.5,,,4.5,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Connecticare,Commerical,,2.51,,,2.51,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Connecticare,Exchange,,2.51,,,2.51,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,Multiplan,Multiplan,,,485.4,,485.4,1.7,485.4,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-53,NDC,both,1,mL,571.06,342.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,485.4,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Aetna,Commerical,,,881.25,,881.25,1.7,970.79,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Aetna,Middlesex Employees,,,845.05,,845.05,1.7,970.79,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Anthem,Commerical,,,,,,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Anthem,Indemnity,,,855.55,,855.55,1.7,970.79,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Anthem,Individual Exchange,,,,,,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Anthem,State Preferred,,,,,,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Cigna,Cigna,,4.5,,,4.5,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Connecticare,Commerical,,2.51,,,2.51,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Connecticare,Exchange,,2.51,,,2.51,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,Multiplan,Multiplan,,,970.79,,970.79,1.7,970.79,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-55,NDC,both,1,mL,1142.11,685.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,970.79,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Aetna,Commerical,,,1101.57,,1101.57,1.7,1213.49,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Aetna,Middlesex Employees,,,1056.31,,1056.31,1.7,1213.49,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Anthem,Commerical,,,,,,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Anthem,Indemnity,,,1069.45,,1069.45,1.7,1213.49,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Anthem,Individual Exchange,,,,,,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Anthem,State Preferred,,,,,,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Cigna,Cigna,,4.5,,,4.5,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Connecticare,Commerical,,2.51,,,2.51,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Connecticare,Exchange,,2.51,,,2.51,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,Multiplan,Multiplan,,,1213.49,,1213.49,1.7,1213.49,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-56,NDC,both,1,mL,1427.64,856.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,1213.49,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Aetna,Commerical,,,220.31,,220.31,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Aetna,Middlesex Employees,,,211.26,,211.26,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Anthem,Commerical,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Anthem,Indemnity,,,213.89,,213.89,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Anthem,Individual Exchange,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Anthem,State Preferred,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Cigna,Cigna,,4.5,,,4.5,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Connecticare,Commerical,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Connecticare,Exchange,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,Multiplan,Multiplan,,,242.7,,242.7,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-57,NDC,both,1,mL,285.53,171.32,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Aetna,Commerical,,,660.94,,660.94,1.7,728.09,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Aetna,Middlesex Employees,,,633.78,,633.78,1.7,728.09,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Anthem,Commerical,,,,,,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Anthem,Indemnity,,,641.66,,641.66,1.7,728.09,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Anthem,Individual Exchange,,,,,,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Anthem,State Preferred,,,,,,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Cigna,Cigna,,4.5,,,4.5,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Connecticare,Commerical,,2.51,,,2.51,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Connecticare,Exchange,,2.51,,,2.51,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,Multiplan,Multiplan,,,728.09,,728.09,1.7,728.09,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-58,NDC,both,1,mL,856.58,513.95,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,728.09,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Aetna,Commerical,,,13.23,,13.23,1.7,14.57,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Aetna,Middlesex Employees,,,12.68,,12.68,1.7,14.57,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Anthem,Commerical,,,,,,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Anthem,Indemnity,,,12.84,,12.84,1.7,14.57,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Anthem,Individual Exchange,,,,,,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Anthem,State Preferred,,,,,,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Cigna,Cigna,,4.5,,,4.5,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Connecticare,Commerical,,2.51,,,2.51,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Connecticare,Exchange,,2.51,,,2.51,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,Multiplan,Multiplan,,,14.57,,14.57,1.7,14.57,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,40810-0209-59,NDC,both,1,mL,17.14,10.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,14.57,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Aetna,Commerical,,,220.31,,220.31,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Aetna,Middlesex Employees,,,211.26,,211.26,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Commerical,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Indemnity,,,213.89,,213.89,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,Individual Exchange,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Anthem,State Preferred,,,,,,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Cigna,Cigna,,4.5,,,4.5,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Connecticare,Commerical,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Connecticare,Exchange,,2.51,,,2.51,1.7,242.7,Other,Could be inpatient or outpatient,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,Multiplan,Multiplan,,,242.7,,242.7,1.7,242.7,percent of total billed charges,,
ARGATROBAN 1 MG/ML INFUSION,J0898,HCPCS,55150-241-01,NDC,both,1,mL,285.53,171.32,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.7,242.7,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Aetna,Commerical,,,115.98,,115.98,111.21,127.76,percent of total billed charges,,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Aetna,Middlesex Employees,,,111.21,,111.21,111.21,127.76,percent of total billed charges,,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Anthem,Commerical,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Anthem,Indemnity,,,112.6,,112.6,111.21,127.76,percent of total billed charges,,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Anthem,Individual Exchange,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Anthem,State Preferred,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Cigna,Cigna,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Connecticare,Commerical,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Connecticare,Exchange,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,Multiplan,Multiplan,,,127.76,,127.76,111.21,127.76,percent of total billed charges,,
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0009-0436-01,NDC,both,1,mL,150.31,90.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,111.21,127.76,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Aetna,Commerical,,,86.89,,86.89,83.32,95.72,percent of total billed charges,,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Aetna,Middlesex Employees,,,83.32,,83.32,83.32,95.72,percent of total billed charges,,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Anthem,Commerical,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Anthem,Indemnity,,,84.36,,84.36,83.32,95.72,percent of total billed charges,,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Anthem,Individual Exchange,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Anthem,State Preferred,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Cigna,Cigna,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Connecticare,Commerical,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Connecticare,Exchange,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,Multiplan,Multiplan,,,95.72,,95.72,83.32,95.72,percent of total billed charges,,
ARGININE HCL 100 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-05,NDC,both,1,mL,112.61,67.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,83.32,95.72,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Aetna,Commerical,,,54.75,,54.75,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Aetna,Middlesex Employees,,,52.5,,52.5,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Anthem,Commerical,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Anthem,Indemnity,,,53.16,,53.16,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Anthem,Individual Exchange,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Anthem,State Preferred,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Cigna,Cigna,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Connecticare,Commerical,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Connecticare,Exchange,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,Multiplan,Multiplan,,,60.32,,60.32,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE  7.5 MG ORAL TAB,J3490,HCPCS,40810-0000-38,NDC,both,1,ea,70.96,42.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Aetna,Commerical,,,57.38,,57.38,55.03,63.21,percent of total billed charges,,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Aetna,Middlesex Employees,,,55.03,,55.03,55.03,63.21,percent of total billed charges,,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Anthem,Commerical,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Anthem,Indemnity,,,55.71,,55.71,55.03,63.21,percent of total billed charges,,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Anthem,Individual Exchange,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Anthem,State Preferred,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Cigna,Cigna,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Connecticare,Commerical,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Connecticare,Exchange,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,Multiplan,Multiplan,,,63.21,,63.21,55.03,63.21,percent of total billed charges,,
ARIPIPRAZOLE 1 MG TABLET,J3490,HCPCS,40810-0017-60,NDC,both,0.5,ea,74.37,44.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,55.03,63.21,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Aetna,Commerical,,,838.25,,838.25,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Aetna,Middlesex Employees,,,803.81,,803.81,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Anthem,Commerical,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Anthem,Indemnity,,,813.81,,813.81,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Anthem,Individual Exchange,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Anthem,State Preferred,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Cigna,Cigna,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Connecticare,Commerical,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Connecticare,Exchange,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,Multiplan,Multiplan,,,923.42,,923.42,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-570-59,NDC,both,1,mL,1086.38,651.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Aetna,Commerical,,,838.25,,838.25,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Aetna,Middlesex Employees,,,803.81,,803.81,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Anthem,Commerical,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Anthem,Indemnity,,,813.81,,813.81,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Anthem,Individual Exchange,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Anthem,State Preferred,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Cigna,Cigna,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Connecticare,Commerical,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Connecticare,Exchange,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,Multiplan,Multiplan,,,923.42,,923.42,803.81,923.42,percent of total billed charges,,
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-893-74,NDC,both,1,mL,1086.38,651.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,803.81,923.42,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,59148-008-13,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,60505-2674-3,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
ARIPIPRAZOLE 10 MG TABLET,J3490,HCPCS,65162-898-03,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,60505-2675-3,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
ARIPIPRAZOLE 15 MG TABLET,J3490,HCPCS,65162-899-03,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,40810-0010-06,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,59148-006-13,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
ARIPIPRAZOLE 2 MG TABLET,J3490,HCPCS,65162-896-03,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Aetna,Commerical,,,54.75,,54.75,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Aetna,Middlesex Employees,,,52.5,,52.5,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Anthem,Commerical,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Anthem,Indemnity,,,53.16,,53.16,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Anthem,Individual Exchange,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Anthem,State Preferred,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Cigna,Cigna,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Connecticare,Commerical,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Connecticare,Exchange,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,Multiplan,Multiplan,,,60.32,,60.32,52.5,60.32,percent of total billed charges,,
ARIPIPRAZOLE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-40,NDC,both,1,ea,70.96,42.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.5,60.32,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,43598-558-30,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,60505-2676-3,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
ARIPIPRAZOLE 20 MG TABLET,J3490,HCPCS,65162-901-03,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,60505-2673-3,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-03,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
ARIPIPRAZOLE 5 MG TABLET,J3490,HCPCS,65162-897-09,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,15.07,,,15.07,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,63323-637-10,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.04,,,13.04,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,15.07,,,15.07,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-01,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.04,,,13.04,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,15.07,,,15.07,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,68382-997-10,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.04,,,13.04,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,15.07,,,15.07,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-1,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.04,,,13.04,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,15.07,,,15.07,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,10.99,,,10.99,10.99,172.35,Other,Could be inpatient or outpatient,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,10.99,172.35,percent of total billed charges,,
ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,J9017,HCPCS,70121-1483-7,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,13.04,,,13.04,10.99,172.35,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Aetna,Commerical,,,11.38,,11.38,10.91,12.54,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Aetna,Middlesex Employees,,,10.91,,10.91,10.91,12.54,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Anthem,Commerical,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Anthem,Indemnity,,,11.05,,11.05,10.91,12.54,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Anthem,Individual Exchange,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Anthem,State Preferred,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Cigna,Cigna,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Connecticare,Commerical,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Connecticare,Exchange,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,Multiplan,Multiplan,,,12.54,,12.54,10.91,12.54,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,0078-0568-45,NDC,both,1,ea,14.75,8.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.91,12.54,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Aetna,Commerical,,,15.98,,15.98,15.32,17.6,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Aetna,Middlesex Employees,,,15.32,,15.32,15.32,17.6,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Anthem,Commerical,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Anthem,Indemnity,,,15.51,,15.51,15.32,17.6,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Anthem,Individual Exchange,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Anthem,State Preferred,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Cigna,Cigna,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Connecticare,Commerical,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Connecticare,Exchange,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,Multiplan,Multiplan,,,17.6,,17.6,15.32,17.6,percent of total billed charges,,
ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,J8499,HCPCS,40810-0205-75,NDC,both,1,ea,20.71,12.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.32,17.6,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Aetna,Commerical,,,14717.04,,14717.04,52.18,16212.39,percent of total billed charges,,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Aetna,Middlesex Employees,,,14112.41,,14112.41,52.18,16212.39,percent of total billed charges,,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Anthem,Commerical,,,,,,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Anthem,Indemnity,,,14287.88,,14287.88,52.18,16212.39,percent of total billed charges,,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Anthem,Individual Exchange,,,,,,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Anthem,State Preferred,,,,,,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Cigna,Cigna,,52.18,,,52.18,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Connecticare,Commerical,,,,,,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Connecticare,Exchange,,,,,,52.18,16212.39,Other,Could be inpatient or outpatient,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,Multiplan,Multiplan,,,16212.39,,16212.39,52.18,16212.39,percent of total billed charges,,
ARTESUNATE 110 MG INTRAVENOUS SOLUTION,J0391,HCPCS,73607-001-11,NDC,both,1,ea,19073.4,11444.04,United Healthcare/Oxford,United Healthcare/Oxford,,63.23,,,63.23,52.18,16212.39,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
"ARTICAINE 4 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66312-601-16,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 250 MG TABLET,J3490,HCPCS,2055500100,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG TABLET,J3490,HCPCS,904052361,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Aetna,Commerical,,,35.32,,35.32,33.87,38.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Aetna,Middlesex Employees,,,33.87,,33.87,33.87,38.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Anthem,Commerical,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Anthem,Indemnity,,,34.29,,34.29,33.87,38.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Anthem,Individual Exchange,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Anthem,State Preferred,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Cigna,Cigna,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Connecticare,Commerical,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Connecticare,Exchange,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,Multiplan,Multiplan,,,38.9,,38.9,33.87,38.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67157-101-50,NDC,both,1,mL,45.77,27.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Aetna,Commerical,,,769.69,,769.69,738.07,847.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Aetna,Middlesex Employees,,,738.07,,738.07,738.07,847.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Anthem,Commerical,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Anthem,Indemnity,,,747.25,,747.25,738.07,847.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Anthem,Individual Exchange,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Anthem,State Preferred,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Cigna,Cigna,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Connecticare,Commerical,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Connecticare,Exchange,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,Multiplan,Multiplan,,,847.9,,847.9,738.07,847.9,percent of total billed charges,,
ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-118-50,NDC,both,1,mL,997.53,598.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,738.07,847.9,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Aetna,Commerical,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Anthem,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Anthem,Indemnity,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Anthem,Individual Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Anthem,State Preferred,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Cigna,Cigna,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Connecticare,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Connecticare,Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,Multiplan,Multiplan,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
ASCORBIC ACID 125 MG ORAL TAB,J3490,HCPCS,40810-0000-41,NDC,both,1,ea,0.05,0.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Aetna,Commerical,,,9685.47,,9685.47,579.72,10669.58,percent of total billed charges,,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Aetna,Middlesex Employees,,,9287.56,,9287.56,579.72,10669.58,percent of total billed charges,,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Anthem,Commerical,,,,,,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Anthem,Indemnity,,,9403.04,,9403.04,579.72,10669.58,percent of total billed charges,,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Anthem,Individual Exchange,,,,,,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Anthem,State Preferred,,,,,,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Cigna,Cigna,,579.72,,,579.72,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Connecticare,Commerical,,652.43,,,652.43,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Connecticare,Exchange,,652.43,,,652.43,579.72,10669.58,Other,Could be inpatient or outpatient,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,Multiplan,Multiplan,,,10669.58,,10669.58,579.72,10669.58,percent of total billed charges,,
"ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT SOLUTION FOR INJECTION",J9019,HCPCS,57902-249-05,NDC,both,0.1,ea,12552.45,7531.47,United Healthcare/Oxford,United Healthcare/Oxford,,590.11,,,590.11,579.72,10669.58,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Aetna,Commerical,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Aetna,Middlesex Employees,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Commerical,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Indemnity,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Individual Exchange,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Anthem,State Preferred,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Cigna,Cigna,,74.17,,,74.17,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Connecticare,Commerical,,80.61,,,80.61,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Connecticare,Exchange,,80.61,,,80.61,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,Multiplan,Multiplan,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-01,NDC,both,0.005,mL,18498.9,11099.34,United Healthcare/Oxford,United Healthcare/Oxford,,64.17,,,64.17,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Aetna,Commerical,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Aetna,Middlesex Employees,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Commerical,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Indemnity,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Anthem,Individual Exchange,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Anthem,State Preferred,,,,,,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Cigna,Cigna,,74.17,,,74.17,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Connecticare,Commerical,,80.61,,,80.61,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Connecticare,Exchange,,80.61,,,80.61,64.17,80.61,Other,Could be inpatient or outpatient,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,Multiplan,Multiplan,,,,,,64.17,80.61,percent of total billed charges,,
ASPARAGINASE ERWINIA CHRYSANTHEMI-RYWN CHEMO,J9021,HCPCS,68727-900-03,NDC,both,0.005,mL,18498.9,11099.34,United Healthcare/Oxford,United Healthcare/Oxford,,64.17,,,64.17,64.17,80.61,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Aetna,Commerical,,,4.31,,4.31,4.14,4.75,percent of total billed charges,,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Aetna,Middlesex Employees,,,4.14,,4.14,4.14,4.75,percent of total billed charges,,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Anthem,Commerical,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Anthem,Indemnity,,,4.19,,4.19,4.14,4.75,percent of total billed charges,,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Anthem,Individual Exchange,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Anthem,State Preferred,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Cigna,Cigna,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Connecticare,Commerical,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Connecticare,Exchange,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,Multiplan,Multiplan,,,4.75,,4.75,4.14,4.75,percent of total billed charges,,
ASPIRIN 150 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-49,NDC,both,1,ea,5.59,3.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.14,4.75,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
ASPIRIN 162.5 MG TABLET,J3490,HCPCS,40810-0013-50,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
ASPIRIN 20.25 MG ORAL CHEW,J3490,HCPCS,40810-0000-42,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Aetna,Commerical,,,3.33,,3.33,3.19,3.66,percent of total billed charges,,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Aetna,Middlesex Employees,,,3.19,,3.19,3.19,3.66,percent of total billed charges,,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Anthem,Commerical,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Anthem,Indemnity,,,3.23,,3.23,3.19,3.66,percent of total billed charges,,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Anthem,Individual Exchange,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Anthem,State Preferred,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Cigna,Cigna,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Connecticare,Commerical,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Connecticare,Exchange,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,Multiplan,Multiplan,,,3.66,,3.66,3.19,3.66,percent of total billed charges,,
ASPIRIN 300 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7034-12,NDC,both,1,ea,4.31,2.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.19,3.66,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,0536-1054-29,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,40810-0006-56,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
ASPIRIN 325 MG TABLET,J3490,HCPCS,51645-716-01,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1232-01,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0010-82,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
"ASPIRIN 325 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57896-921-01,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
ASPIRIN 40.5 MG ORAL CHEW,J3490,HCPCS,40810-0000-43,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
ASPIRIN 75 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0204-94,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,0536-1008-36,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,57896-911-36,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,63739-434-02,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
ASPIRIN 81 MG CHEWABLE TABLET,J3490,HCPCS,66553-002-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0363-0414-12,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0536-1234-41,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
"ASPIRIN 81 MG TABLET,DELAYED RELEASE",J3490,HCPCS,63739-522-10,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,0904-2015-59,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
"ASPIRIN,BUFFERED (CALCIUM CARBONATE-MAGNESIUM) 325 MG TABLET",J3490,HCPCS,70000-0147-1,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Aetna,Commerical,,,52.37,,52.37,50.22,57.69,percent of total billed charges,,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Aetna,Middlesex Employees,,,50.22,,50.22,50.22,57.69,percent of total billed charges,,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Anthem,Commerical,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Anthem,Indemnity,,,50.84,,50.84,50.22,57.69,percent of total billed charges,,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Anthem,Individual Exchange,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Anthem,State Preferred,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Cigna,Cigna,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Connecticare,Commerical,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Connecticare,Exchange,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,Multiplan,Multiplan,,,57.69,,57.69,50.22,57.69,percent of total billed charges,,
ATAZANAVIR 200 MG CAPSULE,J3490,HCPCS,0003-3631-12,NDC,both,1,ea,67.87,40.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.22,57.69,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
ATENOLOL 12.5 MG ORAL TAB,J3490,HCPCS,40810-0000-44,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,15.59,17.91,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,15.59,17.91,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Anthem,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,15.59,17.91,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Anthem,State Preferred,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Cigna,Cigna,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Connecticare,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Connecticare,Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,15.59,17.91,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0000-45,NDC,both,1,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-48,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,46.76,53.72,percent of total billed charges,,
ATENOLOL 2 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-210-10,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0378-0218-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,0904-7187-61,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ATENOLOL 25 MG TABLET,J3490,HCPCS,51079-759-20,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
ATENOLOL 50 MG TABLET,J3490,HCPCS,51079-684-20,NDC,both,1,ea,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Aetna,Commerical,,,3.46,,3.46,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Aetna,Middlesex Employees,,,3.32,,3.32,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Anthem,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Anthem,Indemnity,,,3.36,,3.36,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Anthem,Individual Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Anthem,State Preferred,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Cigna,Cigna,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Connecticare,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Connecticare,Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,Multiplan,Multiplan,,,3.82,,3.82,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,0002-3227-30,NDC,both,1,ea,4.49,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Aetna,Commerical,,,3.46,,3.46,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Aetna,Middlesex Employees,,,3.32,,3.32,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Anthem,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Anthem,Indemnity,,,3.36,,3.36,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Anthem,Individual Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Anthem,State Preferred,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Cigna,Cigna,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Connecticare,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Connecticare,Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,Multiplan,Multiplan,,,3.82,,3.82,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,55111-519-30,NDC,both,1,ea,4.49,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Aetna,Commerical,,,3.46,,3.46,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Aetna,Middlesex Employees,,,3.32,,3.32,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Anthem,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Anthem,Indemnity,,,3.36,,3.36,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Anthem,Individual Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Anthem,State Preferred,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Cigna,Cigna,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Connecticare,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Connecticare,Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,Multiplan,Multiplan,,,3.82,,3.82,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,64980-373-03,NDC,both,1,ea,4.49,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Aetna,Commerical,,,3.46,,3.46,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Aetna,Middlesex Employees,,,3.32,,3.32,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Anthem,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Anthem,Indemnity,,,3.36,,3.36,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Anthem,Individual Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Anthem,State Preferred,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Cigna,Cigna,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Connecticare,Commerical,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Connecticare,Exchange,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,Multiplan,Multiplan,,,3.82,,3.82,3.32,3.82,percent of total billed charges,,
ATOMOXETINE 10 MG CAPSULE,J3490,HCPCS,68462-265-30,NDC,both,1,ea,4.49,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.32,3.82,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Aetna,Commerical,,,4.51,,4.51,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Aetna,Middlesex Employees,,,4.33,,4.33,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Anthem,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Anthem,Indemnity,,,4.38,,4.38,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Anthem,Individual Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Anthem,State Preferred,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Cigna,Cigna,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Connecticare,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Connecticare,Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,Multiplan,Multiplan,,,4.97,,4.97,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,0002-3238-30,NDC,both,1,ea,5.85,3.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Aetna,Commerical,,,4.51,,4.51,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Aetna,Middlesex Employees,,,4.33,,4.33,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Anthem,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Anthem,Indemnity,,,4.38,,4.38,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Anthem,Individual Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Anthem,State Preferred,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Cigna,Cigna,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Connecticare,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Connecticare,Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,Multiplan,Multiplan,,,4.97,,4.97,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,64980-374-03,NDC,both,1,ea,5.85,3.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Aetna,Commerical,,,4.51,,4.51,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Aetna,Middlesex Employees,,,4.33,,4.33,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Anthem,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Anthem,Indemnity,,,4.38,,4.38,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Anthem,Individual Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Anthem,State Preferred,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Cigna,Cigna,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Connecticare,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Connecticare,Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,Multiplan,Multiplan,,,4.97,,4.97,4.33,4.97,percent of total billed charges,,
ATOMOXETINE 18 MG CAPSULE,J3490,HCPCS,68462-266-30,NDC,both,1,ea,5.85,3.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,0002-3228-30,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,40810-0005-82,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,64980-375-03,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
ATOMOXETINE 25 MG CAPSULE,J3490,HCPCS,68462-267-30,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Aetna,Commerical,,,3.02,,3.02,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Aetna,Middlesex Employees,,,2.9,,2.9,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Anthem,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Anthem,Indemnity,,,2.94,,2.94,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Anthem,Individual Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Anthem,State Preferred,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Cigna,Cigna,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Connecticare,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Connecticare,Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,Multiplan,Multiplan,,,3.33,,3.33,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0002-3229-30,NDC,both,1,ea,3.92,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Aetna,Commerical,,,3.02,,3.02,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Aetna,Middlesex Employees,,,2.9,,2.9,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Anthem,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Anthem,Indemnity,,,2.94,,2.94,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Anthem,Individual Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Anthem,State Preferred,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Cigna,Cigna,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Connecticare,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Connecticare,Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,Multiplan,Multiplan,,,3.33,,3.33,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,0904-6908-04,NDC,both,1,ea,3.92,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Aetna,Commerical,,,3.02,,3.02,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Aetna,Middlesex Employees,,,2.9,,2.9,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Anthem,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Anthem,Indemnity,,,2.94,,2.94,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Anthem,Individual Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Anthem,State Preferred,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Cigna,Cigna,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Connecticare,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Connecticare,Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,Multiplan,Multiplan,,,3.33,,3.33,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,40810-0005-83,NDC,both,1,ea,3.92,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Aetna,Commerical,,,3.02,,3.02,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Aetna,Middlesex Employees,,,2.9,,2.9,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Anthem,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Anthem,Indemnity,,,2.94,,2.94,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Anthem,Individual Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Anthem,State Preferred,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Cigna,Cigna,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Connecticare,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Connecticare,Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,Multiplan,Multiplan,,,3.33,,3.33,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,64980-376-03,NDC,both,1,ea,3.92,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Aetna,Commerical,,,3.02,,3.02,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Aetna,Middlesex Employees,,,2.9,,2.9,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Anthem,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Anthem,Indemnity,,,2.94,,2.94,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Anthem,Individual Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Anthem,State Preferred,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Cigna,Cigna,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Connecticare,Commerical,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Connecticare,Exchange,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,Multiplan,Multiplan,,,3.33,,3.33,2.9,3.33,percent of total billed charges,,
ATOMOXETINE 40 MG CAPSULE,J3490,HCPCS,68462-268-30,NDC,both,1,ea,3.92,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.9,3.33,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Aetna,Commerical,,,4.94,,4.94,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Aetna,Middlesex Employees,,,4.74,,4.74,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Anthem,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Anthem,Indemnity,,,4.79,,4.79,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Anthem,Individual Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Anthem,State Preferred,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Cigna,Cigna,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Connecticare,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Connecticare,Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,Multiplan,Multiplan,,,5.44,,5.44,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,0002-3239-30,NDC,both,1,ea,6.4,3.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Aetna,Commerical,,,4.94,,4.94,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Aetna,Middlesex Employees,,,4.74,,4.74,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Anthem,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Anthem,Indemnity,,,4.79,,4.79,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Anthem,Individual Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Anthem,State Preferred,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Cigna,Cigna,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Connecticare,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Connecticare,Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,Multiplan,Multiplan,,,5.44,,5.44,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,40810-0005-84,NDC,both,1,ea,6.4,3.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Aetna,Commerical,,,4.94,,4.94,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Aetna,Middlesex Employees,,,4.74,,4.74,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Anthem,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Anthem,Indemnity,,,4.79,,4.79,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Anthem,Individual Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Anthem,State Preferred,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Cigna,Cigna,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Connecticare,Commerical,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Connecticare,Exchange,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,Multiplan,Multiplan,,,5.44,,5.44,4.74,5.44,percent of total billed charges,,
ATOMOXETINE 60 MG CAPSULE,J3490,HCPCS,68462-269-30,NDC,both,1,ea,6.4,3.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.74,5.44,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
ATORVASTATIN 10 MG TABLET,J3490,HCPCS,68084-097-01,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Aetna,Commerical,,,0.9,,0.9,0.86,0.99,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Aetna,Middlesex Employees,,,0.86,,0.86,0.86,0.99,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Anthem,Commerical,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Anthem,Indemnity,,,0.87,,0.87,0.86,0.99,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Anthem,Individual Exchange,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Anthem,State Preferred,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Cigna,Cigna,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Connecticare,Commerical,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Connecticare,Exchange,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.86,0.99,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,0904-6291-61,NDC,both,1,ea,1.16,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.86,0.99,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
ATORVASTATIN 20 MG TABLET,J3490,HCPCS,51079-209-20,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Aetna,Commerical,,,6.6,,6.6,6.33,7.28,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Aetna,Middlesex Employees,,,6.33,,6.33,6.33,7.28,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Anthem,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Anthem,Indemnity,,,6.41,,6.41,6.33,7.28,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Anthem,Individual Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Anthem,State Preferred,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Cigna,Cigna,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Connecticare,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Connecticare,Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,Multiplan,Multiplan,,,7.28,,7.28,6.33,7.28,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,8.56,5.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Aetna,Commerical,,,18.25,,18.25,17.5,20.1,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Aetna,Middlesex Employees,,,17.5,,17.5,17.5,20.1,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Anthem,Commerical,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Anthem,Indemnity,,,17.72,,17.72,17.5,20.1,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Anthem,Individual Exchange,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Anthem,State Preferred,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Cigna,Cigna,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Connecticare,Commerical,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Connecticare,Exchange,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,Multiplan,Multiplan,,,20.1,,20.1,17.5,20.1,percent of total billed charges,,
ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,J3490,HCPCS,66993-060-27,NDC,both,1,ea,23.65,14.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.5,20.1,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0665-18,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,31722-629-21,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Aetna,Commerical,,,762.72,,762.72,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Aetna,Middlesex Employees,,,731.38,,731.38,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Indemnity,,,740.48,,740.48,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,Individual Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Anthem,State Preferred,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Cigna,Cigna,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Connecticare,Commerical,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Connecticare,Exchange,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,Multiplan,Multiplan,,,840.22,,840.22,731.38,840.22,percent of total billed charges,,
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,68180-282-01,NDC,both,1,mL,988.49,593.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,731.38,840.22,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
ATOVAQUONE-PROGUANIL (PEDIATRIC) 62.5 MG-25 MG TABLET,J3490,HCPCS,0173-0676-01,NDC,both,1,ea,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Aetna,Commerical,,,19.24,,19.24,18.45,21.2,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Aetna,Middlesex Employees,,,18.45,,18.45,18.45,21.2,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Anthem,Commerical,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Anthem,Indemnity,,,18.68,,18.68,18.45,21.2,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Anthem,Individual Exchange,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Anthem,State Preferred,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Cigna,Cigna,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Connecticare,Commerical,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Connecticare,Exchange,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,Multiplan,Multiplan,,,21.2,,21.2,18.45,21.2,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 125-50 MG ORAL TAB,J3490,HCPCS,40810-0000-46,NDC,both,1,ea,24.94,14.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.45,21.2,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Aetna,Commerical,,,6.6,,6.6,6.33,7.28,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Aetna,Middlesex Employees,,,6.33,,6.33,6.33,7.28,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Anthem,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Anthem,Indemnity,,,6.41,,6.41,6.33,7.28,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Anthem,Individual Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Anthem,State Preferred,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Cigna,Cigna,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Connecticare,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Connecticare,Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,Multiplan,Multiplan,,,7.28,,7.28,6.33,7.28,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0173-0675-02,NDC,both,1,ea,25.32,15.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Aetna,Commerical,,,17.25,,17.25,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Aetna,Middlesex Employees,,,16.54,,16.54,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Anthem,Commerical,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Anthem,Indemnity,,,16.75,,16.75,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Anthem,Individual Exchange,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Anthem,State Preferred,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Cigna,Cigna,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Connecticare,Commerical,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Connecticare,Exchange,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,Multiplan,Multiplan,,,19.01,,19.01,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-44,NDC,both,1,ea,22.36,13.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Aetna,Commerical,,,17.25,,17.25,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Aetna,Middlesex Employees,,,16.54,,16.54,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Anthem,Commerical,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Anthem,Indemnity,,,16.75,,16.75,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Anthem,Individual Exchange,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Anthem,State Preferred,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Cigna,Cigna,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Connecticare,Commerical,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Connecticare,Exchange,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,Multiplan,Multiplan,,,19.01,,19.01,16.54,19.01,percent of total billed charges,,
ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-404-67,NDC,both,1,ea,22.36,13.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.54,19.01,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Aetna,Commerical,,,173.32,,173.32,166.2,190.94,percent of total billed charges,,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Aetna,Middlesex Employees,,,166.2,,166.2,166.2,190.94,percent of total billed charges,,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Anthem,Commerical,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Anthem,Indemnity,,,168.27,,168.27,166.2,190.94,percent of total billed charges,,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Anthem,Individual Exchange,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Anthem,State Preferred,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Cigna,Cigna,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Connecticare,Commerical,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Connecticare,Exchange,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,Multiplan,Multiplan,,,190.94,,190.94,166.2,190.94,percent of total billed charges,,
ATROPINE 0.01% OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-61,NDC,both,1,mL,224.63,134.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,166.2,190.94,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Aetna,Commerical,,,22.58,,22.58,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Aetna,Middlesex Employees,,,21.66,,21.66,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Anthem,Commerical,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Anthem,Indemnity,,,21.93,,21.93,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Anthem,Individual Exchange,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Anthem,State Preferred,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Cigna,Cigna,,0.09,,,0.09,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Connecticare,Commerical,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Connecticare,Exchange,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,Multiplan,Multiplan,,,24.88,,24.88,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-1630-10,NDC,both,10,mL,29.27,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Aetna,Commerical,,,22.58,,22.58,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Aetna,Middlesex Employees,,,21.66,,21.66,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Anthem,Commerical,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Anthem,Indemnity,,,21.93,,21.93,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Anthem,Individual Exchange,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Anthem,State Preferred,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Cigna,Cigna,,0.09,,,0.09,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Connecticare,Commerical,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Connecticare,Exchange,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,Multiplan,Multiplan,,,24.88,,24.88,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4910-34,NDC,both,10,mL,29.27,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Aetna,Commerical,,,22.58,,22.58,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Aetna,Middlesex Employees,,,21.66,,21.66,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Anthem,Commerical,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Anthem,Indemnity,,,21.93,,21.93,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Anthem,Individual Exchange,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Anthem,State Preferred,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Cigna,Cigna,,0.09,,,0.09,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Connecticare,Commerical,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Connecticare,Exchange,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,Multiplan,Multiplan,,,24.88,,24.88,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,0409-4911-34,NDC,both,10,mL,29.27,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Aetna,Commerical,,,22.58,,22.58,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Aetna,Middlesex Employees,,,21.66,,21.66,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Anthem,Commerical,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Anthem,Indemnity,,,21.93,,21.93,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Anthem,Individual Exchange,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Anthem,State Preferred,,,,,,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Cigna,Cigna,,0.09,,,0.09,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Connecticare,Commerical,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Connecticare,Exchange,,0.16,,,0.16,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,Multiplan,Multiplan,,,24.88,,24.88,0.09,24.88,percent of total billed charges,,
ATROPINE 0.1 MG/ML INJECTION SYRINGE,J0461,HCPCS,76329-3339-1,NDC,both,10,mL,29.27,17.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,24.88,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Anthem,Commerical,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Anthem,Individual Exchange,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Anthem,State Preferred,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Cigna,Cigna,,0.09,,,0.09,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Connecticare,Commerical,,0.16,,,0.16,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Connecticare,Exchange,,0.16,,,0.16,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Aetna,Commerical,,,0.23,,0.23,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Aetna,Middlesex Employees,,,0.22,,0.22,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Commerical,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Indemnity,,,0.22,,0.22,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Individual Exchange,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Anthem,State Preferred,,,,,,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Cigna,Cigna,,0.09,,,0.09,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Connecticare,Commerical,,0.16,,,0.16,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Connecticare,Exchange,,0.16,,,0.16,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,Multiplan,Multiplan,,,0.26,,0.26,0.09,0.26,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-0401-25,NDC,both,0.025,mL,23.95,14.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.26,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Aetna,Commerical,,,18.48,,18.48,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Aetna,Middlesex Employees,,,17.72,,17.72,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Anthem,Commerical,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Anthem,Indemnity,,,17.94,,17.94,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Anthem,Individual Exchange,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Anthem,State Preferred,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Cigna,Cigna,,0.09,,,0.09,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Connecticare,Commerical,,0.16,,,0.16,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Connecticare,Exchange,,0.16,,,0.16,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,Multiplan,Multiplan,,,20.36,,20.36,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-01,NDC,both,0.025,mL,23.95,14.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Aetna,Commerical,,,18.48,,18.48,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Aetna,Middlesex Employees,,,17.72,,17.72,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Commerical,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Indemnity,,,17.94,,17.94,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Anthem,Individual Exchange,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Anthem,State Preferred,,,,,,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Cigna,Cigna,,0.09,,,0.09,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Connecticare,Commerical,,0.16,,,0.16,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Connecticare,Exchange,,0.16,,,0.16,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,Multiplan,Multiplan,,,20.36,,20.36,0.09,20.36,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0517-1004-25,NDC,both,0.025,mL,23.95,14.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,20.36,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Aetna,Commerical,,,4.55,,4.55,0.09,5.02,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Aetna,Middlesex Employees,,,4.37,,4.37,0.09,5.02,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Anthem,Commerical,,,,,,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Anthem,Indemnity,,,4.42,,4.42,0.09,5.02,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Anthem,Individual Exchange,,,,,,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Anthem,State Preferred,,,,,,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Cigna,Cigna,,0.09,,,0.09,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Connecticare,Commerical,,0.16,,,0.16,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Connecticare,Exchange,,0.16,,,0.16,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,Multiplan,Multiplan,,,5.02,,5.02,0.09,5.02,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,0641-6006-01,NDC,both,0.025,mL,5.9,3.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,5.02,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,70092-1173-43,NDC,both,0.025,mL,47.89,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,71266-2010-1,NDC,both,0.025,mL,47.89,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Aetna,Commerical,,,0.46,,0.46,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Aetna,Middlesex Employees,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Anthem,Commerical,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Anthem,Indemnity,,,0.44,,0.44,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Anthem,Individual Exchange,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Anthem,State Preferred,,,,,,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Cigna,Cigna,,0.09,,,0.09,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Connecticare,Commerical,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Connecticare,Exchange,,0.16,,,0.16,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,Multiplan,Multiplan,,,0.5,,0.5,0.09,0.5,percent of total billed charges,,
ATROPINE 0.4 MG/ML INJECTION SOLUTION,J0461,HCPCS,73177-122-01,NDC,both,0.025,mL,47.89,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,0.5,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Aetna,Commerical,,,174.81,,174.81,167.62,192.57,percent of total billed charges,,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Aetna,Middlesex Employees,,,167.62,,167.62,167.62,192.57,percent of total billed charges,,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Anthem,Commerical,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Anthem,Indemnity,,,169.71,,169.71,167.62,192.57,percent of total billed charges,,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Anthem,Individual Exchange,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Anthem,State Preferred,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Cigna,Cigna,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Connecticare,Commerical,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Connecticare,Exchange,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,Multiplan,Multiplan,,,192.57,,192.57,167.62,192.57,percent of total billed charges,,
ATROPINE 0.5 % OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-62,NDC,both,1,mL,226.55,135.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.62,192.57,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,139.3,83.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % (OPTH) SOLUTION FOR SUBLINGUAL USE,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,139.3,83.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Aetna,Commerical,,,223.79,,223.79,214.59,246.53,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Aetna,Middlesex Employees,,,214.59,,214.59,214.59,246.53,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Anthem,Commerical,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Anthem,Indemnity,,,217.26,,217.26,214.59,246.53,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Anthem,Individual Exchange,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Anthem,State Preferred,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Cigna,Cigna,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Connecticare,Commerical,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Connecticare,Exchange,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,Multiplan,Multiplan,,,246.53,,246.53,214.59,246.53,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0303-55,NDC,both,1,mL,290.03,174.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.59,246.53,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,0065-0817-02,NDC,both,1,mL,116.02,69.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,17478-215-02,NDC,both,2,mL,116.02,69.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60219-1748-2,NDC,both,1,mL,116.02,69.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Aetna,Commerical,,,89.52,,89.52,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Aetna,Middlesex Employees,,,85.84,,85.84,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Anthem,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Anthem,Indemnity,,,86.91,,86.91,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Anthem,Individual Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Anthem,State Preferred,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Cigna,Cigna,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Connecticare,Commerical,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Connecticare,Exchange,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,Multiplan,Multiplan,,,98.62,,98.62,85.84,98.62,percent of total billed charges,,
ATROPINE 1 % EYE DROPS,J3490,HCPCS,60505-6226-0,NDC,both,1,mL,116.02,69.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.84,98.62,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,16729-306-10,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Aetna,Commerical,,,1460.18,,1460.18,0.49,1608.55,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Aetna,Middlesex Employees,,,1400.19,,1400.19,0.49,1608.55,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Anthem,Commerical,,,,,,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Anthem,Indemnity,,,1417.6,,1417.6,0.49,1608.55,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Anthem,Individual Exchange,,,,,,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Anthem,State Preferred,,,,,,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Cigna,Cigna,,0.62,,,0.62,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Connecticare,Commerical,,0.49,,,0.49,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Connecticare,Exchange,,0.49,,,0.49,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,Multiplan,Multiplan,,,1608.55,,1608.55,0.49,1608.55,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,43598-305-62,NDC,both,0.01,ea,1892.41,1135.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,1608.55,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 100 MG SOLUTION FOR INJECTION,J9025,HCPCS,71288-115-30,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3253-94,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Commerical,,,288.85,,288.85,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Aetna,Middlesex Employees,,,276.98,,276.98,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Commerical,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Indemnity,,,280.43,,280.43,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,Individual Exchange,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Anthem,State Preferred,,,,,,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Cigna,Cigna,,0.62,,,0.62,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Commerical,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Connecticare,Exchange,,0.49,,,0.49,0.49,318.2,Other,Could be inpatient or outpatient,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,Multiplan,Multiplan,,,318.2,,318.2,0.49,318.2,percent of total billed charges,,
AZACITIDINE 25 MG/ML INJECTION CHEMO,J9025,HCPCS,0781-3491-94,NDC,both,0.01,ea,374.35,224.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.49,318.2,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Aetna,Commerical,,,1.6,,1.6,1.53,1.76,percent of total billed charges,,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Aetna,Middlesex Employees,,,1.53,,1.53,1.53,1.76,percent of total billed charges,,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Anthem,Commerical,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Anthem,Indemnity,,,1.55,,1.55,1.53,1.76,percent of total billed charges,,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Anthem,Individual Exchange,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Anthem,State Preferred,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Cigna,Cigna,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Connecticare,Commerical,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Connecticare,Exchange,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,Multiplan,Multiplan,,,1.76,,1.76,1.53,1.76,percent of total billed charges,,
AZATHIOPRINE 25 MG ORAL TAB,J3490,HCPCS,40810-0000-50,NDC,both,1,ea,2.07,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,2.07,,,2.07,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,51079-620-06,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,2.07,,,2.07,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,60219-1076-1,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,2.07,,,2.07,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,2.47,,,2.47,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,2.47,percent of total billed charges,,
AZATHIOPRINE 50 MG TABLET,J7500,HCPCS,68084-229-11,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,0.77,2.47,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Aetna,Commerical,,,190.79,,190.79,2.07,210.18,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Aetna,Middlesex Employees,,,182.96,,182.96,2.07,210.18,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Anthem,Commerical,,,,,,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Anthem,Indemnity,,,185.23,,185.23,2.07,210.18,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Anthem,Individual Exchange,,,,,,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Anthem,State Preferred,,,,,,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Cigna,Cigna,,2.07,,,2.07,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Connecticare,Commerical,,2.47,,,2.47,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Connecticare,Exchange,,2.47,,,2.47,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,Multiplan,Multiplan,,,210.18,,210.18,2.07,210.18,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0000-49,NDC,both,1,mL,247.27,148.36,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,2.07,210.18,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Aetna,Commerical,,,381.58,,381.58,2.07,420.35,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Aetna,Middlesex Employees,,,365.9,,365.9,2.07,420.35,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Anthem,Commerical,,,,,,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Anthem,Indemnity,,,370.45,,370.45,2.07,420.35,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Anthem,Individual Exchange,,,,,,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Anthem,State Preferred,,,,,,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Cigna,Cigna,,2.07,,,2.07,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Connecticare,Commerical,,2.47,,,2.47,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Connecticare,Exchange,,2.47,,,2.47,2.07,420.35,Other,Could be inpatient or outpatient,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,Multiplan,Multiplan,,,420.35,,420.35,2.07,420.35,percent of total billed charges,,
AZATHIOPRINE 50 MG/ML ORAL SUSP,J7500,HCPCS,40810-0003-47,NDC,both,1,mL,494.53,296.72,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,2.07,420.35,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Aetna,Commerical,,,13.19,,13.19,12.65,14.54,percent of total billed charges,,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Aetna,Middlesex Employees,,,12.65,,12.65,12.65,14.54,percent of total billed charges,,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Anthem,Commerical,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Anthem,Indemnity,,,12.81,,12.81,12.65,14.54,percent of total billed charges,,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Anthem,Individual Exchange,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Anthem,State Preferred,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Cigna,Cigna,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Connecticare,Commerical,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Connecticare,Exchange,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,Multiplan,Multiplan,,,14.54,,14.54,12.65,14.54,percent of total billed charges,,
AZITHROMYCIN 125 MG ORAL TAB,J8499,HCPCS,40810-0000-51,NDC,both,4,ea,17.1,10.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.65,14.54,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59651-008-30,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,0093-2026-31,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,42806-151-34,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,59762-3140-1,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Aetna,Commerical,,,30.32,,30.32,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Aetna,Middlesex Employees,,,29.08,,29.08,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Indemnity,,,29.44,,29.44,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,Individual Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Anthem,State Preferred,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Cigna,Cigna,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Connecticare,Commerical,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Connecticare,Exchange,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,Multiplan,Multiplan,,,33.41,,33.41,29.08,33.41,percent of total billed charges,,
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J8499,HCPCS,70710-1460-2,NDC,both,1,mL,39.3,23.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.08,33.41,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-1,NDC,both,2,ea,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,59762-2198-3,NDC,both,2,ea,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET,J8499,HCPCS,68180-160-06,NDC,both,2,ea,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
AZITHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J8499,HCPCS,0781-8089-31,NDC,both,2,ea,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,0069-3150-83,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,55150-174-10,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,62756-512-44,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-10,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,63323-398-12,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-100-10,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-41,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Anthem,Commerical,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Anthem,State Preferred,,,,,,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Cigna,Cigna,,2.46,,,2.46,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Connecticare,Commerical,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Connecticare,Exchange,,3.14,,,3.14,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,2.46,9.15,percent of total billed charges,,
AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,J0456,HCPCS,70860-125-66,NDC,both,1,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.66,,,2.66,2.46,9.15,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,0904-7351-04,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,0069-3070-86,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50111-788-10,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,50268-099-13,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,62332-252-30,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
AZITHROMYCIN 500 MG TABLET NO SECOND SIGN,J8499,HCPCS,68180-161-06,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Aetna,Commerical,,,68.27,,68.27,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Aetna,Middlesex Employees,,,65.47,,65.47,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Anthem,Commerical,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Anthem,Indemnity,,,66.28,,66.28,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Anthem,Individual Exchange,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Anthem,State Preferred,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Cigna,Cigna,,2.41,,,2.41,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Connecticare,Commerical,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Connecticare,Exchange,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,Multiplan,Multiplan,,,75.21,,75.21,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,0003-2560-16,NDC,both,1,ea,88.48,53.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Aetna,Commerical,,,68.27,,68.27,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Aetna,Middlesex Employees,,,65.47,,65.47,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Anthem,Commerical,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Anthem,Indemnity,,,66.28,,66.28,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Anthem,Individual Exchange,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Anthem,State Preferred,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Cigna,Cigna,,2.41,,,2.41,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Connecticare,Commerical,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Connecticare,Exchange,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,Multiplan,Multiplan,,,75.21,,75.21,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-01,NDC,both,0.001,ea,88.48,53.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Aetna,Commerical,,,68.27,,68.27,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Aetna,Middlesex Employees,,,65.47,,65.47,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Anthem,Commerical,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Anthem,Indemnity,,,66.28,,66.28,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Anthem,Individual Exchange,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Anthem,State Preferred,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Cigna,Cigna,,2.41,,,2.41,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Connecticare,Commerical,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Connecticare,Exchange,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,Multiplan,Multiplan,,,75.21,,75.21,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-20,NDC,both,1,ea,88.48,53.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Aetna,Commerical,,,68.15,,68.15,2.41,75.07,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Aetna,Middlesex Employees,,,65.35,,65.35,2.41,75.07,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Anthem,Commerical,,,,,,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Anthem,Indemnity,,,66.16,,66.16,2.41,75.07,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Anthem,Individual Exchange,,,,,,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Anthem,State Preferred,,,,,,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Cigna,Cigna,,2.41,,,2.41,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Connecticare,Commerical,,3.01,,,3.01,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Connecticare,Exchange,,3.01,,,3.01,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,Multiplan,Multiplan,,,75.07,,75.07,2.41,75.07,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-24,NDC,both,1,ea,88.32,52.99,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,75.07,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Aetna,Commerical,,,68.27,,68.27,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Aetna,Middlesex Employees,,,65.47,,65.47,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Anthem,Commerical,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Anthem,Indemnity,,,66.28,,66.28,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Anthem,Individual Exchange,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Anthem,State Preferred,,,,,,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Cigna,Cigna,,2.41,,,2.41,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Connecticare,Commerical,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Connecticare,Exchange,,3.01,,,3.01,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,Multiplan,Multiplan,,,75.21,,75.21,2.41,75.21,percent of total billed charges,,
AZTREONAM 1 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-401-26,NDC,both,1,ea,88.48,53.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,75.21,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,2.41,,,2.41,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-01,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Anthem,Commerical,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Anthem,State Preferred,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Cigna,Cigna,,2.41,,,2.41,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Connecticare,Commerical,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Connecticare,Exchange,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-03,NDC,both,0.001,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,2.41,,,2.41,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-20,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,2.41,,,2.41,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,3.01,,,3.01,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,2.41,153.54,percent of total billed charges,,
AZTREONAM 2 GRAM SOLUTION FOR INJECTION,J0457,HCPCS,63323-402-30,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.6,,,2.6,2.41,153.54,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Aetna,Commerical,,,84.36,,84.36,80.89,92.93,percent of total billed charges,,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Aetna,Middlesex Employees,,,80.89,,80.89,80.89,92.93,percent of total billed charges,,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Anthem,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Anthem,Indemnity,,,81.9,,81.9,80.89,92.93,percent of total billed charges,,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Anthem,Individual Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Anthem,State Preferred,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Cigna,Cigna,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Connecticare,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Connecticare,Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,Multiplan,Multiplan,,,92.93,,92.93,80.89,92.93,percent of total billed charges,,
AZTREONAM 20 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-35,NDC,both,1,mL,109.33,65.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Aetna,Commerical,,,421.56,,421.56,404.24,464.4,percent of total billed charges,,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Aetna,Middlesex Employees,,,404.24,,404.24,404.24,464.4,percent of total billed charges,,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Anthem,Commerical,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Anthem,Indemnity,,,409.27,,409.27,404.24,464.4,percent of total billed charges,,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Anthem,Individual Exchange,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Anthem,State Preferred,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Cigna,Cigna,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Connecticare,Commerical,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Connecticare,Exchange,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,Multiplan,Multiplan,,,464.4,,464.4,404.24,464.4,percent of total billed charges,,
AZTREONAM LYSINE 75 MG/ML SOLUTION FOR NEBULIZATION,J3490,HCPCS,61958-0901-1,NDC,both,1,mL,546.35,327.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,404.24,464.4,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Aetna,Commerical,,,39.34,,39.34,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Aetna,Middlesex Employees,,,37.72,,37.72,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Anthem,Commerical,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Anthem,Indemnity,,,38.19,,38.19,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Anthem,Individual Exchange,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Anthem,State Preferred,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Cigna,Cigna,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Connecticare,Commerical,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Connecticare,Exchange,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,Multiplan,Multiplan,,,43.33,,43.33,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,0009-0233-01,NDC,both,1,ea,50.98,30.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Aetna,Commerical,,,39.34,,39.34,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Aetna,Middlesex Employees,,,37.72,,37.72,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Anthem,Commerical,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Anthem,Indemnity,,,38.19,,38.19,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Anthem,Individual Exchange,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Anthem,State Preferred,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Cigna,Cigna,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Connecticare,Commerical,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Connecticare,Exchange,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,Multiplan,Multiplan,,,43.33,,43.33,37.72,43.33,percent of total billed charges,,
"BACITRACIN 50,000 UNIT INTRAMUSCULAR SOLUTION",J3490,HCPCS,70594-026-01,NDC,both,1,ea,50.98,30.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.72,43.33,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Aetna,Commerical,,,307.44,,307.44,294.81,338.67,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Aetna,Middlesex Employees,,,294.81,,294.81,294.81,338.67,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Anthem,Commerical,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Anthem,Indemnity,,,298.47,,298.47,294.81,338.67,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Anthem,Individual Exchange,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Anthem,State Preferred,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Cigna,Cigna,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Connecticare,Commerical,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Connecticare,Exchange,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,Multiplan,Multiplan,,,338.67,,338.67,294.81,338.67,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM EYE OINTMENT,J3490,HCPCS,0574-4022-35,NDC,both,3.5,gm,398.44,239.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,294.81,338.67,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Aetna,Commerical,,,9.85,,9.85,9.44,10.85,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Aetna,Middlesex Employees,,,9.44,,9.44,9.44,10.85,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Anthem,Commerical,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Anthem,Indemnity,,,9.56,,9.56,9.44,10.85,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Anthem,Individual Exchange,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Anthem,State Preferred,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Cigna,Cigna,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Connecticare,Commerical,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Connecticare,Exchange,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,Multiplan,Multiplan,,,10.85,,10.85,9.44,10.85,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0536-1256-28,NDC,both,1,gm,12.76,7.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Aetna,Commerical,,,9.32,,9.32,8.94,10.27,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Aetna,Middlesex Employees,,,8.94,,8.94,8.94,10.27,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Anthem,Commerical,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Anthem,Indemnity,,,9.05,,9.05,8.94,10.27,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Anthem,Individual Exchange,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Anthem,State Preferred,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Cigna,Cigna,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Connecticare,Commerical,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Connecticare,Exchange,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,Multiplan,Multiplan,,,10.27,,10.27,8.94,10.27,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,0713-0280-31,NDC,both,28.4,gm,12.08,7.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.94,10.27,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Aetna,Commerical,,,4.6,,4.6,4.41,5.07,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Aetna,Middlesex Employees,,,4.41,,4.41,4.41,5.07,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Anthem,Commerical,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Anthem,Indemnity,,,4.46,,4.46,4.41,5.07,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Anthem,Individual Exchange,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Anthem,State Preferred,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Cigna,Cigna,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Connecticare,Commerical,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Connecticare,Exchange,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,Multiplan,Multiplan,,,5.07,,5.07,4.41,5.07,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-01,NDC,both,14,gm,5.96,3.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Aetna,Commerical,,,9.19,,9.19,8.81,10.12,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Aetna,Middlesex Employees,,,8.81,,8.81,8.81,10.12,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Anthem,Commerical,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Anthem,Indemnity,,,8.92,,8.92,8.81,10.12,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Anthem,Individual Exchange,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Anthem,State Preferred,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Cigna,Cigna,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Connecticare,Commerical,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Connecticare,Exchange,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,Multiplan,Multiplan,,,10.12,,10.12,8.81,10.12,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,45802-060-03,NDC,both,28,gm,11.91,7.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.81,10.12,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,45802-060-70,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,J3490,HCPCS,67777-219-07,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,67777-220-07,NDC,both,1,gm,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Aetna,Commerical,,,62.33,,62.33,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Aetna,Middlesex Employees,,,59.77,,59.77,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Indemnity,,,60.51,,60.51,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Individual Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Anthem,State Preferred,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Cigna,Cigna,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Connecticare,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Connecticare,Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,Multiplan,Multiplan,,,68.66,,68.66,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,0574-4021-35,NDC,both,3.5,gm,80.78,48.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Aetna,Commerical,,,62.33,,62.33,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Aetna,Middlesex Employees,,,59.77,,59.77,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Indemnity,,,60.51,,60.51,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Anthem,Individual Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Anthem,State Preferred,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Cigna,Cigna,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Connecticare,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Connecticare,Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,Multiplan,Multiplan,,,68.66,,68.66,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,17478-238-35,NDC,both,3.5,gm,80.78,48.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Aetna,Commerical,,,62.33,,62.33,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Aetna,Middlesex Employees,,,59.77,,59.77,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Anthem,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Anthem,Indemnity,,,60.51,,60.51,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Anthem,Individual Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Anthem,State Preferred,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Cigna,Cigna,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Connecticare,Commerical,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Connecticare,Exchange,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,Multiplan,Multiplan,,,68.66,,68.66,59.77,68.66,percent of total billed charges,,
"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",J3490,HCPCS,24208-555-55,NDC,both,3.5,gm,80.78,48.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.77,68.66,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
BACLOFEN 1.25 MG TAB,J3490,HCPCS,40810-0204-86,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0172-4096-60,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0527-1330-01,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,0904-6475-61,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,68084-855-11,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,1.03,1.18,percent of total billed charges,,
BACLOFEN 10 MG TABLET,J3490,HCPCS,72888-010-01,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Aetna,Commerical,,,73.06,,73.06,70.05,80.48,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Aetna,Middlesex Employees,,,70.05,,70.05,70.05,80.48,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Anthem,Commerical,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Anthem,Indemnity,,,70.92,,70.92,70.05,80.48,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Anthem,Individual Exchange,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Anthem,State Preferred,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Cigna,Cigna,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Connecticare,Commerical,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Connecticare,Exchange,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,Multiplan,Multiplan,,,80.48,,80.48,70.05,80.48,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-54,NDC,both,1,mL,94.68,56.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Aetna,Commerical,,,36.53,,36.53,35.03,40.24,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Aetna,Middlesex Employees,,,35.03,,35.03,35.03,40.24,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Anthem,Commerical,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Anthem,Indemnity,,,35.46,,35.46,35.03,40.24,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Anthem,Individual Exchange,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Anthem,State Preferred,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Cigna,Cigna,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Connecticare,Commerical,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Connecticare,Exchange,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,Multiplan,Multiplan,,,40.24,,40.24,35.03,40.24,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-06,NDC,both,1,mL,47.34,28.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Aetna,Commerical,,,146.11,,146.11,140.11,160.96,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Aetna,Middlesex Employees,,,140.11,,140.11,140.11,160.96,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Anthem,Commerical,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Anthem,Indemnity,,,141.85,,141.85,140.11,160.96,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Anthem,Individual Exchange,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Anthem,State Preferred,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Cigna,Cigna,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Connecticare,Commerical,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Connecticare,Exchange,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,Multiplan,Multiplan,,,160.96,,160.96,140.11,160.96,percent of total billed charges,,
BACLOFEN 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-07,NDC,both,1,mL,189.36,113.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Aetna,Commerical,,,497.37,,497.37,200.67,547.9,percent of total billed charges,,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Aetna,Middlesex Employees,,,476.93,,476.93,200.67,547.9,percent of total billed charges,,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Anthem,Commerical,,,,,,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Anthem,Indemnity,,,482.86,,482.86,200.67,547.9,percent of total billed charges,,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Anthem,Individual Exchange,,,,,,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Anthem,State Preferred,,,,,,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Cigna,Cigna,,200.67,,,200.67,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Connecticare,Commerical,,266.9,,,266.9,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Connecticare,Exchange,,266.9,,,266.9,200.67,547.9,Other,Could be inpatient or outpatient,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,Multiplan,Multiplan,,,547.9,,547.9,200.67,547.9,percent of total billed charges,,
"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-155-02,NDC,both,20,mL,644.59,386.75,United Healthcare/Oxford,United Healthcare/Oxford,,216.65,,,216.65,200.67,547.9,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
BACLOFEN 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-52,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0172-4097-60,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0603-2407-28,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,0904-6476-61,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,40810-0006-60,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-01,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
BACLOFEN 20 MG TABLET,J3490,HCPCS,68084-868-11,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Aetna,Commerical,,,994.73,,994.73,200.67,1095.8,percent of total billed charges,,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Aetna,Middlesex Employees,,,953.86,,953.86,200.67,1095.8,percent of total billed charges,,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Anthem,Commerical,,,,,,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Anthem,Indemnity,,,965.72,,965.72,200.67,1095.8,percent of total billed charges,,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Anthem,Individual Exchange,,,,,,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Anthem,State Preferred,,,,,,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Cigna,Cigna,,200.67,,,200.67,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Connecticare,Commerical,,266.9,,,266.9,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Connecticare,Exchange,,266.9,,,266.9,200.67,1095.8,Other,Could be inpatient or outpatient,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,Multiplan,Multiplan,,,1095.8,,1095.8,200.67,1095.8,percent of total billed charges,,
"BACLOFEN 20,000 MCG/20 ML (1,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-156-02,NDC,both,10,mL,1289.18,773.51,United Healthcare/Oxford,United Healthcare/Oxford,,216.65,,,216.65,200.67,1095.8,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Aetna,Commerical,,,2065,,2065,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Aetna,Middlesex Employees,,,1980.16,,1980.16,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Anthem,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Anthem,Indemnity,,,2004.79,,2004.79,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Anthem,Individual Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Anthem,State Preferred,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Cigna,Cigna,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Connecticare,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Connecticare,Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,Multiplan,Multiplan,,,2274.82,,2274.82,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52536-600-11,NDC,both,1,mL,2676.26,1605.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Aetna,Commerical,,,2065,,2065,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Aetna,Middlesex Employees,,,1980.16,,1980.16,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Indemnity,,,2004.79,,2004.79,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Individual Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,State Preferred,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Cigna,Cigna,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Connecticare,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Connecticare,Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Multiplan,Multiplan,,,2274.82,,2274.82,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Aetna,Commerical,,,5162.49,,5162.49,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Aetna,Middlesex Employees,,,4950.4,,4950.4,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Commerical,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Indemnity,,,5011.95,,5011.95,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Individual Exchange,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,State Preferred,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Cigna,Cigna,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Connecticare,Commerical,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Connecticare,Exchange,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Multiplan,Multiplan,,,5687.04,,5687.04,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Aetna,Commerical,,,1896.02,,1896.02,200.67,2088.67,percent of total billed charges,,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Aetna,Middlesex Employees,,,1818.13,,1818.13,200.67,2088.67,percent of total billed charges,,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Anthem,Commerical,,,,,,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Anthem,Indemnity,,,1840.73,,1840.73,200.67,2088.67,percent of total billed charges,,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Anthem,Individual Exchange,,,,,,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Anthem,State Preferred,,,,,,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Cigna,Cigna,,200.67,,,200.67,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Connecticare,Commerical,,266.9,,,266.9,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Connecticare,Exchange,,266.9,,,266.9,200.67,2088.67,Other,Could be inpatient or outpatient,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,Multiplan,Multiplan,,,2088.67,,2088.67,200.67,2088.67,percent of total billed charges,,
"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",J0475,HCPCS,66794-157-02,NDC,both,5,mL,2457.26,1474.36,United Healthcare/Oxford,United Healthcare/Oxford,,216.65,,,216.65,200.67,2088.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,40810-0000-53,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Aetna,Commerical,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Anthem,Indemnity,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,70710-1609-1,NDC,both,1,ea,0.36,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Aetna,Commerical,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Anthem,Indemnity,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,72888-009-01,NDC,both,1,ea,0.36,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Aetna,Commerical,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Anthem,Indemnity,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
BACLOFEN 5 MG ORAL TAB,J3490,HCPCS,73320-001-02,NDC,both,1,ea,0.36,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Aetna,Commerical,,,2065,,2065,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Aetna,Middlesex Employees,,,1980.16,,1980.16,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Indemnity,,,2004.79,,2004.79,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,Individual Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Anthem,State Preferred,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Cigna,Cigna,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Connecticare,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Connecticare,Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,Multiplan,Multiplan,,,2274.82,,2274.82,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-1,NDC,both,1,mL,2676.26,1605.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Aetna,Commerical,,,5162.49,,5162.49,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Aetna,Middlesex Employees,,,4950.4,,4950.4,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Commerical,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Indemnity,,,5011.95,,5011.95,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,Individual Exchange,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Anthem,State Preferred,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Cigna,Cigna,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Connecticare,Commerical,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Connecticare,Exchange,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,Multiplan,Multiplan,,,5687.04,,5687.04,4950.4,5687.04,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,52652-6001-2,NDC,both,1,mL,6690.63,4014.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4950.4,5687.04,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Aetna,Commerical,,,1032.5,,1032.5,990.08,1137.41,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Aetna,Middlesex Employees,,,990.08,,990.08,990.08,1137.41,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Anthem,Commerical,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Anthem,Indemnity,,,1002.39,,1002.39,990.08,1137.41,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Anthem,Individual Exchange,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Anthem,State Preferred,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Cigna,Cigna,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Connecticare,Commerical,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Connecticare,Exchange,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,Multiplan,Multiplan,,,1137.41,,1137.41,990.08,1137.41,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-02,NDC,both,1,mL,1338.13,802.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,990.08,1137.41,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Aetna,Commerical,,,2065,,2065,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Aetna,Middlesex Employees,,,1980.16,,1980.16,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Anthem,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Anthem,Indemnity,,,2004.79,,2004.79,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Anthem,Individual Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Anthem,State Preferred,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Cigna,Cigna,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Connecticare,Commerical,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Connecticare,Exchange,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,Multiplan,Multiplan,,,2274.82,,2274.82,1980.16,2274.82,percent of total billed charges,,
BACLOFEN 5 MG/ML ORAL SUSP,J3490,HCPCS,65628-0101-04,NDC,both,1,mL,2676.26,1605.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1980.16,2274.82,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Aetna,Commerical,,,217.04,,217.04,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Aetna,Middlesex Employees,,,208.12,,208.12,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Anthem,Commerical,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Anthem,Indemnity,,,210.71,,210.71,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Anthem,Individual Exchange,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Anthem,State Preferred,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Cigna,Cigna,,51.91,,,51.91,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Connecticare,Commerical,,59.42,,,59.42,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Connecticare,Exchange,,59.42,,,59.42,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,Multiplan,Multiplan,,,239.09,,239.09,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,25021-681-71,NDC,both,1,mL,281.28,168.77,United Healthcare/Oxford,United Healthcare/Oxford,,56.05,,,56.05,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Aetna,Commerical,,,217.04,,217.04,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Aetna,Middlesex Employees,,,208.12,,208.12,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Anthem,Commerical,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Anthem,Indemnity,,,210.71,,210.71,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Anthem,Individual Exchange,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Anthem,State Preferred,,,,,,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Cigna,Cigna,,51.91,,,51.91,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Connecticare,Commerical,,59.42,,,59.42,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Connecticare,Exchange,,59.42,,,59.42,51.91,239.09,Other,Could be inpatient or outpatient,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,Multiplan,Multiplan,,,239.09,,239.09,51.91,239.09,percent of total billed charges,,
BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,J0476,HCPCS,66794-151-01,NDC,both,1,mL,281.28,168.77,United Healthcare/Oxford,United Healthcare/Oxford,,56.05,,,56.05,51.91,239.09,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Aetna,Commerical,,,16.14,,16.14,15.48,17.78,percent of total billed charges,,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Aetna,Middlesex Employees,,,15.48,,15.48,15.48,17.78,percent of total billed charges,,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Anthem,Commerical,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Anthem,Indemnity,,,15.67,,15.67,15.48,17.78,percent of total billed charges,,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Anthem,Individual Exchange,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Anthem,State Preferred,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Cigna,Cigna,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Connecticare,Commerical,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Connecticare,Exchange,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,Multiplan,Multiplan,,,17.78,,17.78,15.48,17.78,percent of total billed charges,,
BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,J3490,HCPCS,0065-0795-15,NDC,both,15,mL,20.92,12.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.48,17.78,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Aetna,Commerical,,,213.34,,213.34,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Aetna,Middlesex Employees,,,204.57,,204.57,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Anthem,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Anthem,Indemnity,,,207.12,,207.12,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Anthem,Individual Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Anthem,State Preferred,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Cigna,Cigna,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Connecticare,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Connecticare,Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,Multiplan,Multiplan,,,235.02,,235.02,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 10 MG TABLET,J3490,HCPCS,40810-0204-14,NDC,both,1,ea,276.49,165.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Aetna,Commerical,,,213.34,,213.34,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Aetna,Middlesex Employees,,,204.57,,204.57,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Anthem,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Anthem,Indemnity,,,207.12,,207.12,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Anthem,Individual Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Anthem,State Preferred,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Cigna,Cigna,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Connecticare,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Connecticare,Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,Multiplan,Multiplan,,,235.02,,235.02,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 20 MG TABLET,J3490,HCPCS,50242-828-02,NDC,both,1,ea,276.49,165.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Aetna,Commerical,,,452.66,,452.66,434.06,498.65,percent of total billed charges,,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Aetna,Middlesex Employees,,,434.06,,434.06,434.06,498.65,percent of total billed charges,,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Anthem,Commerical,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Anthem,Indemnity,,,439.46,,439.46,434.06,498.65,percent of total billed charges,,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Anthem,Individual Exchange,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Anthem,State Preferred,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Cigna,Cigna,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Connecticare,Commerical,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Connecticare,Exchange,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,Multiplan,Multiplan,,,498.65,,498.65,434.06,498.65,percent of total billed charges,,
BALOXAVIR MARBOXIL 40 MG TABLET,J3490,HCPCS,50242-860-01,NDC,both,1,ea,586.65,351.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,434.06,498.65,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Aetna,Commerical,,,213.34,,213.34,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Aetna,Middlesex Employees,,,204.57,,204.57,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Anthem,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Anthem,Indemnity,,,207.12,,207.12,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Anthem,Individual Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Anthem,State Preferred,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Cigna,Cigna,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Connecticare,Commerical,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Connecticare,Exchange,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,Multiplan,Multiplan,,,235.02,,235.02,204.57,235.02,percent of total billed charges,,
BALOXAVIR MARBOXIL 5 MG TABLET,J3490,HCPCS,40810-0204-15,NDC,both,1,ea,276.49,165.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,204.57,235.02,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
BALSALAZIDE 750 MG CAPSULE,J3490,HCPCS,0378-6750-82,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Aetna,Commerical,,,244.87,,244.87,234.81,269.76,percent of total billed charges,,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Aetna,Middlesex Employees,,,234.81,,234.81,234.81,269.76,percent of total billed charges,,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Anthem,Commerical,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Anthem,Indemnity,,,237.73,,237.73,234.81,269.76,percent of total billed charges,,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Anthem,Individual Exchange,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Anthem,State Preferred,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Cigna,Cigna,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Connecticare,Commerical,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Connecticare,Exchange,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,Multiplan,Multiplan,,,269.76,,269.76,234.81,269.76,percent of total billed charges,,
BARICITINIB 1 MG TABLET,J3490,HCPCS,0002-4732-30,NDC,both,1,ea,317.36,190.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Aetna,Commerical,,,244.87,,244.87,234.81,269.76,percent of total billed charges,,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Aetna,Middlesex Employees,,,234.81,,234.81,234.81,269.76,percent of total billed charges,,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Anthem,Commerical,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Anthem,Indemnity,,,237.73,,237.73,234.81,269.76,percent of total billed charges,,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Anthem,Individual Exchange,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Anthem,State Preferred,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Cigna,Cigna,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Connecticare,Commerical,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Connecticare,Exchange,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,Multiplan,Multiplan,,,269.76,,269.76,234.81,269.76,percent of total billed charges,,
BARICITINIB 2 MG TABLET,J3490,HCPCS,0002-4182-30,NDC,both,1,ea,317.36,190.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,234.81,269.76,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Aetna,Commerical,,,81.27,,81.27,77.93,89.53,percent of total billed charges,,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Aetna,Middlesex Employees,,,77.93,,77.93,77.93,89.53,percent of total billed charges,,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Anthem,Commerical,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Anthem,Indemnity,,,78.9,,78.9,77.93,89.53,percent of total billed charges,,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Anthem,Individual Exchange,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Anthem,State Preferred,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Cigna,Cigna,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Connecticare,Commerical,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Connecticare,Exchange,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,Multiplan,Multiplan,,,89.53,,89.53,77.93,89.53,percent of total billed charges,,
"BARIUM SULFATE 40 % (W/V), 29% (W/W) ORAL SUSPENSION",J3490,HCPCS,32909-122-07,NDC,both,1,mL,105.33,63.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,77.93,89.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Aetna,Commerical,,,7.75,,7.75,7.44,8.54,percent of total billed charges,,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Aetna,Middlesex Employees,,,7.44,,7.44,7.44,8.54,percent of total billed charges,,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Anthem,Commerical,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Anthem,Indemnity,,,7.53,,7.53,7.44,8.54,percent of total billed charges,,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Anthem,Individual Exchange,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Anthem,State Preferred,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Cigna,Cigna,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Connecticare,Commerical,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Connecticare,Exchange,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,Multiplan,Multiplan,,,8.54,,8.54,7.44,8.54,percent of total billed charges,,
BARIUM SULFATE 700 MG TABLET,J3490,HCPCS,10361-778-31,NDC,both,1,ea,10.05,6.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.44,8.54,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Aetna,Commerical,,,14.1,,14.1,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Aetna,Middlesex Employees,,,13.52,,13.52,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Indemnity,,,13.69,,13.69,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Individual Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,State Preferred,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Cigna,Cigna,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Connecticare,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Connecticare,Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,Multiplan,Multiplan,,,15.53,,15.53,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,10361-750-03,NDC,both,0.96,gm,18.27,10.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Aetna,Commerical,,,95.76,,95.76,91.82,105.49,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Aetna,Middlesex Employees,,,91.82,,91.82,91.82,105.49,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Anthem,Commerical,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Anthem,Indemnity,,,92.96,,92.96,91.82,105.49,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Anthem,Individual Exchange,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Anthem,State Preferred,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Cigna,Cigna,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Connecticare,Commerical,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Connecticare,Exchange,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,Multiplan,Multiplan,,,105.49,,105.49,91.82,105.49,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-01,NDC,both,0.96,gm,124.1,74.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.82,105.49,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Aetna,Commerical,,,14.1,,14.1,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Aetna,Middlesex Employees,,,13.52,,13.52,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Indemnity,,,13.69,,13.69,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,Individual Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Anthem,State Preferred,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Cigna,Cigna,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Connecticare,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Connecticare,Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,Multiplan,Multiplan,,,15.53,,15.53,13.52,15.53,percent of total billed charges,,
BARIUM SULFATE 96 % (W/W) ORAL POWDER FOR SUSPENSION,J3490,HCPCS,32909-750-03,NDC,both,0.96,gm,18.27,10.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Aetna,Commerical,,,12220.17,,12220.17,5176.78,13461.82,percent of total billed charges,,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Aetna,Middlesex Employees,,,11718.12,,11718.12,5176.78,13461.82,percent of total billed charges,,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Anthem,Commerical,,,,,,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Anthem,Indemnity,,,11863.83,,11863.83,5176.78,13461.82,percent of total billed charges,,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Anthem,Individual Exchange,,,,,,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Anthem,State Preferred,,,,,,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Cigna,Cigna,,5176.78,,,5176.78,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Connecticare,Commerical,,7006.97,,,7006.97,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Connecticare,Exchange,,7006.97,,,7006.97,5176.78,13461.82,Other,Could be inpatient or outpatient,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,Multiplan,Multiplan,,,13461.82,,13461.82,5176.78,13461.82,percent of total billed charges,,
BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,J0480,HCPCS,0078-0331-84,NDC,both,1,ea,15837.44,9502.46,United Healthcare/Oxford,United Healthcare/Oxford,,5589.09,,,5589.09,5176.78,13461.82,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
BEACON DEX 5% IN 0.2 SODIUM CHLORIDE (ML/M2/HR),J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,1.31,6.51,percent of total billed charges,,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,1.31,6.51,percent of total billed charges,,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Anthem,Commerical,,,,,,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,1.31,6.51,percent of total billed charges,,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Anthem,State Preferred,,,,,,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Cigna,Cigna,,1.31,,,1.31,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Connecticare,Commerical,,1.74,,,1.74,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Connecticare,Exchange,,1.74,,,1.74,1.31,6.51,Other,Could be inpatient or outpatient,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,1.31,6.51,percent of total billed charges,,
BEACON DEXTROSE 5% AND SODIUM CHLORIDE 0.9% (ML/M2/HOUR),J7042,HCPCS,0338-0089-04,NDC,both,500,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,6.51,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,22.87,13.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Aetna,Commerical,,,4.37,,4.37,4.2,4.82,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.82,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Anthem,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Anthem,Indemnity,,,4.25,,4.25,4.2,4.82,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Anthem,Individual Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Anthem,State Preferred,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Cigna,Cigna,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Connecticare,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Connecticare,Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,Multiplan,Multiplan,,,4.82,,4.82,4.2,4.82,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,7.63,4.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,22.87,13.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BEELINE PUMP - BUPIVACAINE 0.5%-EPINEPHRINE 1:200,000 ",J3490,HCPCS,63323-462-37,NDC,both,1,mL,22.87,13.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Aetna,Commerical,,,6039.22,,6039.22,61.17,6652.85,percent of total billed charges,,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Aetna,Middlesex Employees,,,5791.11,,5791.11,61.17,6652.85,percent of total billed charges,,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Anthem,Commerical,,,,,,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Anthem,Indemnity,,,5863.12,,5863.12,61.17,6652.85,percent of total billed charges,,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Anthem,Individual Exchange,,,,,,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Anthem,State Preferred,,,,,,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Cigna,Cigna,,61.17,,,61.17,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Connecticare,Commerical,,82.68,,,82.68,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Connecticare,Exchange,,82.68,,,82.68,61.17,6652.85,Other,Could be inpatient or outpatient,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,Multiplan,Multiplan,,,6652.85,,6652.85,61.17,6652.85,percent of total billed charges,,
BELIMUMAB 400 MG INTRAVENOUS SOLUTION,J0490,HCPCS,49401-102-01,NDC,both,0.025,ea,7826.88,4696.13,United Healthcare/Oxford,United Healthcare/Oxford,,66.04,,,66.04,61.17,6652.85,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Aetna,Commerical,,,5.66,,5.66,5.43,6.24,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Aetna,Middlesex Employees,,,5.43,,5.43,5.43,6.24,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Anthem,Commerical,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Anthem,Indemnity,,,5.5,,5.5,5.43,6.24,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Anthem,Individual Exchange,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Anthem,State Preferred,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Cigna,Cigna,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Connecticare,Commerical,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Connecticare,Exchange,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,Multiplan,Multiplan,,,6.24,,6.24,5.43,6.24,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7040-12,NDC,both,1,ea,7.34,4.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Aetna,Commerical,,,56.13,,56.13,53.82,61.83,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Aetna,Middlesex Employees,,,53.82,,53.82,53.82,61.83,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Anthem,Commerical,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Anthem,Indemnity,,,54.49,,54.49,53.82,61.83,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Anthem,Individual Exchange,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Anthem,State Preferred,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Cigna,Cigna,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Connecticare,Commerical,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Connecticare,Exchange,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,Multiplan,Multiplan,,,61.83,,61.83,53.82,61.83,percent of total billed charges,,
BELLADONNA ALKALOIDS-OPIUM 8.1-30 MG RECT SUPP,J3490,HCPCS,40810-0000-55,NDC,both,1,ea,72.74,43.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.82,61.83,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Aetna,Commerical,,,5917.11,,5917.11,6.54,6518.33,percent of total billed charges,,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Aetna,Middlesex Employees,,,5674.01,,5674.01,6.54,6518.33,percent of total billed charges,,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Anthem,Commerical,,,,,,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Anthem,Indemnity,,,5744.56,,5744.56,6.54,6518.33,percent of total billed charges,,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Anthem,Individual Exchange,,,,,,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Anthem,State Preferred,,,,,,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Cigna,Cigna,,7.56,,,7.56,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Connecticare,Commerical,,8.29,,,8.29,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Connecticare,Exchange,,8.29,,,8.29,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,Multiplan,Multiplan,,,6518.33,,6518.33,6.54,6518.33,percent of total billed charges,,
BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-391-20,NDC,both,0.01,ea,7668.62,4601.17,United Healthcare/Oxford,United Healthcare/Oxford,,6.54,,,6.54,6.54,6518.33,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Aetna,Commerical,,,1479.3,,1479.3,6.54,1629.61,percent of total billed charges,,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Aetna,Middlesex Employees,,,1418.53,,1418.53,6.54,1629.61,percent of total billed charges,,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Anthem,Commerical,,,,,,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Anthem,Indemnity,,,1436.17,,1436.17,6.54,1629.61,percent of total billed charges,,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Anthem,Individual Exchange,,,,,,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Anthem,State Preferred,,,,,,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Cigna,Cigna,,7.56,,,7.56,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Connecticare,Commerical,,8.29,,,8.29,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Connecticare,Exchange,,8.29,,,8.29,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,Multiplan,Multiplan,,,1629.61,,1629.61,6.54,1629.61,percent of total billed charges,,
BENDAMUSTINE 25 MG INTRAVENOUS POWDER FOR SOLUTION,J9033,HCPCS,63459-390-08,NDC,both,0.04,ea,1917.19,1150.31,United Healthcare/Oxford,United Healthcare/Oxford,,6.54,,,6.54,6.54,1629.61,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Aetna,Commerical,,,4221.9,,4221.9,16.6,4650.88,percent of total billed charges,,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Aetna,Middlesex Employees,,,4048.45,,4048.45,16.6,4650.88,percent of total billed charges,,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Anthem,Commerical,,,,,,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Anthem,Indemnity,,,4098.79,,4098.79,16.6,4650.88,percent of total billed charges,,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Anthem,Individual Exchange,,,,,,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Anthem,State Preferred,,,,,,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Cigna,Cigna,,19.19,,,19.19,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Connecticare,Commerical,,19.77,,,19.77,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Connecticare,Exchange,,19.77,,,19.77,16.6,4650.88,Other,Could be inpatient or outpatient,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,Multiplan,Multiplan,,,4650.88,,4650.88,16.6,4650.88,percent of total billed charges,,
BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,J9034,HCPCS,63459-348-04,NDC,both,0.04,mL,5471.62,3282.97,United Healthcare/Oxford,United Healthcare/Oxford,,16.6,,,16.6,16.6,4650.88,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Aetna,Commerical,,,22.61,,22.61,21.68,24.91,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Aetna,Middlesex Employees,,,21.68,,21.68,21.68,24.91,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Anthem,Commerical,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Anthem,Indemnity,,,21.95,,21.95,21.68,24.91,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Anthem,Individual Exchange,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Anthem,State Preferred,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Cigna,Cigna,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Connecticare,Commerical,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Connecticare,Exchange,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,Multiplan,Multiplan,,,24.91,,24.91,21.68,24.91,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0222-13,NDC,both,9,gm,29.3,17.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.68,24.91,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Aetna,Commerical,,,12.56,,12.56,12.05,13.84,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Aetna,Middlesex Employees,,,12.05,,12.05,12.05,13.84,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Anthem,Commerical,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Anthem,Indemnity,,,12.2,,12.2,12.05,13.84,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Anthem,Individual Exchange,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Anthem,State Preferred,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Cigna,Cigna,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Connecticare,Commerical,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Connecticare,Exchange,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,Multiplan,Multiplan,,,13.84,,13.84,12.05,13.84,percent of total billed charges,,
BENZOCAINE 10 % MUCOSAL GEL,J3490,HCPCS,10310-0339-40,NDC,both,1,gm,16.28,9.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.05,13.84,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,0904-6255-49,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
BENZOCAINE 15 MG-MENTHOL 3.6 MG LOZENGES,J3490,HCPCS,40810-0206-20,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Aetna,Commerical,,,83.56,,83.56,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Aetna,Middlesex Employees,,,80.12,,80.12,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Anthem,Commerical,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Anthem,Indemnity,,,81.12,,81.12,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Anthem,Individual Exchange,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Anthem,State Preferred,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Cigna,Cigna,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Connecticare,Commerical,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Connecticare,Exchange,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,Multiplan,Multiplan,,,92.05,,92.05,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0679-60,NDC,both,57,gm,108.29,64.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Aetna,Commerical,,,83.56,,83.56,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Aetna,Middlesex Employees,,,80.12,,80.12,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Anthem,Commerical,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Anthem,Indemnity,,,81.12,,81.12,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Anthem,Individual Exchange,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Anthem,State Preferred,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Cigna,Cigna,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Connecticare,Commerical,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Connecticare,Exchange,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,Multiplan,Multiplan,,,92.05,,92.05,80.12,92.05,percent of total billed charges,,
BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,0283-0914-02,NDC,both,1,gm,108.29,64.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.12,92.05,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Aetna,Commerical,,,0.74,,0.74,0.71,0.82,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Aetna,Middlesex Employees,,,0.71,,0.71,0.71,0.82,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Anthem,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Anthem,Indemnity,,,0.72,,0.72,0.71,0.82,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Anthem,Individual Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Anthem,State Preferred,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Cigna,Cigna,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Connecticare,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Connecticare,Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.71,0.82,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,1191703010,NDC,both,1,ea,0.96,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201106,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811201266,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,7811280125,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,J3490,HCPCS,40810-0207-38,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTURE,J3490,HCPCS,0395-0243-92,NDC,both,60,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Anthem,Indemnity,,,1.42,,1.42,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,0904-6564-61,NDC,both,1,ea,1.9,1.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Anthem,Indemnity,,,1.42,,1.42,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,62332-426-31,NDC,both,1,ea,1.9,1.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Anthem,Indemnity,,,1.42,,1.42,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
BENZONATATE 100 MG CAPSULE,J3490,HCPCS,67877-573-01,NDC,both,1,ea,1.9,1.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Aetna,Commerical,,,6.57,,6.57,6.3,7.23,percent of total billed charges,,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Aetna,Middlesex Employees,,,6.3,,6.3,6.3,7.23,percent of total billed charges,,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Anthem,Commerical,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Anthem,Indemnity,,,6.37,,6.37,6.3,7.23,percent of total billed charges,,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Anthem,Individual Exchange,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Anthem,State Preferred,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Cigna,Cigna,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Connecticare,Commerical,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Connecticare,Exchange,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,Multiplan,Multiplan,,,7.23,,7.23,6.3,7.23,percent of total billed charges,,
BENZOYL PEROXIDE 10 % LOTION,J3490,HCPCS,0536-1058-75,NDC,both,1,mL,8.51,5.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.3,7.23,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Aetna,Commerical,,,5.76,,5.76,5.53,6.35,percent of total billed charges,,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Aetna,Middlesex Employees,,,5.53,,5.53,5.53,6.35,percent of total billed charges,,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Anthem,Commerical,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Anthem,Indemnity,,,5.6,,5.6,5.53,6.35,percent of total billed charges,,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Anthem,Individual Exchange,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Anthem,State Preferred,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Cigna,Cigna,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Connecticare,Commerical,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Connecticare,Exchange,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,Multiplan,Multiplan,,,6.35,,6.35,5.53,6.35,percent of total billed charges,,
BENZOYL PEROXIDE 5 % LOTION,J3490,HCPCS,0536-1057-75,NDC,both,1,mL,7.47,4.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.53,6.35,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Aetna,Commerical,,,10.29,,10.29,9.87,11.34,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Aetna,Middlesex Employees,,,9.87,,9.87,9.87,11.34,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Anthem,Commerical,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Anthem,Indemnity,,,9.99,,9.99,9.87,11.34,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Anthem,Individual Exchange,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Anthem,State Preferred,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Cigna,Cigna,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Connecticare,Commerical,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Connecticare,Exchange,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,Multiplan,Multiplan,,,11.34,,11.34,9.87,11.34,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,0536-1055-56,NDC,both,1,gm,13.34,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.87,11.34,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Aetna,Commerical,,,14.37,,14.37,13.78,15.83,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Aetna,Middlesex Employees,,,13.78,,13.78,13.78,15.83,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Anthem,Commerical,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Anthem,Indemnity,,,13.95,,13.95,13.78,15.83,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Anthem,Individual Exchange,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Anthem,State Preferred,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Cigna,Cigna,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Connecticare,Commerical,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Connecticare,Exchange,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,Multiplan,Multiplan,,,15.83,,15.83,13.78,15.83,percent of total billed charges,,
BENZOYL PEROXIDE 5 % TOPICAL GEL,J3490,HCPCS,45802-216-96,NDC,both,1,gm,18.62,11.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.78,15.83,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
BENZTROPINE 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-56,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-6788-61,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,0904-7288-61,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,60687-356-01,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-01,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
BENZTROPINE 0.5 MG TABLET,J3490,HCPCS,68084-381-11,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Aetna,Commerical,,,1.45,,1.45,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Aetna,Middlesex Employees,,,1.39,,1.39,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Anthem,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Anthem,Indemnity,,,1.41,,1.41,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Anthem,Individual Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Anthem,State Preferred,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Cigna,Cigna,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Connecticare,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Connecticare,Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,Multiplan,Multiplan,,,1.6,,1.6,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,60687-368-01,NDC,both,1,ea,1.88,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Aetna,Commerical,,,1.45,,1.45,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Aetna,Middlesex Employees,,,1.39,,1.39,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Anthem,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Anthem,Indemnity,,,1.41,,1.41,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Anthem,Individual Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Anthem,State Preferred,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Cigna,Cigna,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Connecticare,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Connecticare,Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,Multiplan,Multiplan,,,1.6,,1.6,1.39,1.6,percent of total billed charges,,
BENZTROPINE 1 MG TABLET,J3490,HCPCS,69315-137-01,NDC,both,1,ea,1.88,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Aetna,Commerical,,,177.31,,177.31,18.41,195.33,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Aetna,Middlesex Employees,,,170.03,,170.03,18.41,195.33,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Anthem,Commerical,,,,,,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Anthem,Indemnity,,,172.14,,172.14,18.41,195.33,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Anthem,Individual Exchange,,,,,,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Anthem,State Preferred,,,,,,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Cigna,Cigna,,18.41,,,18.41,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Connecticare,Commerical,,25.29,,,25.29,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Connecticare,Exchange,,25.29,,,25.29,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,Multiplan,Multiplan,,,195.33,,195.33,18.41,195.33,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-01,NDC,both,1,mL,229.8,137.88,United Healthcare/Oxford,United Healthcare/Oxford,,19.87,,,19.87,18.41,195.33,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Aetna,Commerical,,,153.6,,153.6,18.41,169.21,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Aetna,Middlesex Employees,,,147.29,,147.29,18.41,169.21,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Anthem,Commerical,,,,,,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Anthem,Indemnity,,,149.12,,149.12,18.41,169.21,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Anthem,Individual Exchange,,,,,,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Anthem,State Preferred,,,,,,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Cigna,Cigna,,18.41,,,18.41,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Connecticare,Commerical,,25.29,,,25.29,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Connecticare,Exchange,,25.29,,,25.29,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,Multiplan,Multiplan,,,169.21,,169.21,18.41,169.21,percent of total billed charges,,
BENZTROPINE 1 MG/ML INJECTION SOLUTION,J0515,HCPCS,0143-9729-05,NDC,both,1,mL,199.07,119.44,United Healthcare/Oxford,United Healthcare/Oxford,,19.87,,,19.87,18.41,169.21,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,69315-138-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
BENZTROPINE 2 MG TABLET,J3490,HCPCS,76385-105-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Aetna,Commerical,,,1349.74,,1349.74,1294.28,1486.88,percent of total billed charges,,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Aetna,Middlesex Employees,,,1294.28,,1294.28,1294.28,1486.88,percent of total billed charges,,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Anthem,Commerical,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Anthem,Indemnity,,,1310.38,,1310.38,1294.28,1486.88,percent of total billed charges,,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Anthem,Individual Exchange,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Anthem,State Preferred,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Cigna,Cigna,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Connecticare,Commerical,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Connecticare,Exchange,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,Multiplan,Multiplan,,,1486.88,,1486.88,1294.28,1486.88,percent of total billed charges,,
BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION,J3490,HCPCS,0074-1040-08,NDC,both,8,mL,1749.27,1049.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1294.28,1486.88,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Aetna,Commerical,,,63.25,,63.25,60.65,69.67,percent of total billed charges,,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Aetna,Middlesex Employees,,,60.65,,60.65,60.65,69.67,percent of total billed charges,,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Anthem,Commerical,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Anthem,Indemnity,,,61.4,,61.4,60.65,69.67,percent of total billed charges,,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Anthem,Individual Exchange,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Anthem,State Preferred,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Cigna,Cigna,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Connecticare,Commerical,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Connecticare,Exchange,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,Multiplan,Multiplan,,,69.67,,69.67,60.65,69.67,percent of total billed charges,,
BETAINE (BULK) 100 % POWDER,J3490,HCPCS,5155210985,NDC,both,1,gm,81.97,49.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.65,69.67,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Commerical,,,130.24,,130.24,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Middlesex Employees,,,124.89,,124.89,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Commerical,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Indemnity,,,126.44,,126.44,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Individual Exchange,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Anthem,State Preferred,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Cigna,Cigna,,8.23,,,8.23,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Commerical,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Exchange,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,Multiplan,Multiplan,,,143.47,,143.47,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0720-01,NDC,both,0.5,mL,168.79,101.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.88,,,8.88,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Commerical,,,130.24,,130.24,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Middlesex Employees,,,124.89,,124.89,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Commerical,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Indemnity,,,126.44,,126.44,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Individual Exchange,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Anthem,State Preferred,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Cigna,Cigna,,8.23,,,8.23,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Commerical,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Exchange,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,Multiplan,Multiplan,,,143.47,,143.47,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,0517-0791-01,NDC,both,0.5,mL,168.79,101.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.88,,,8.88,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Commerical,,,130.24,,130.24,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Aetna,Middlesex Employees,,,124.89,,124.89,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Commerical,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Indemnity,,,126.44,,126.44,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Anthem,Individual Exchange,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Anthem,State Preferred,,,,,,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Cigna,Cigna,,8.23,,,8.23,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Commerical,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Connecticare,Exchange,,11.3,,,11.3,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,Multiplan,Multiplan,,,143.47,,143.47,8.23,143.47,percent of total billed charges,,
BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,J0702,HCPCS,78206-118-01,NDC,both,0.5,mL,168.79,101.27,United Healthcare/Oxford,United Healthcare/Oxford,,8.88,,,8.88,8.23,143.47,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Aetna,Commerical,,,43.18,,43.18,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Aetna,Middlesex Employees,,,41.4,,41.4,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Anthem,Commerical,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Anthem,Indemnity,,,41.92,,41.92,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Anthem,Individual Exchange,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Anthem,State Preferred,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Cigna,Cigna,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Connecticare,Commerical,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Connecticare,Exchange,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,Multiplan,Multiplan,,,47.57,,47.57,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0055-15,NDC,both,15,gm,55.96,33.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Aetna,Commerical,,,43.18,,43.18,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Aetna,Middlesex Employees,,,41.4,,41.4,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Anthem,Commerical,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Anthem,Indemnity,,,41.92,,41.92,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Anthem,Individual Exchange,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Anthem,State Preferred,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Cigna,Cigna,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Connecticare,Commerical,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Connecticare,Exchange,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,Multiplan,Multiplan,,,47.57,,47.57,41.4,47.57,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,J3490,HCPCS,70710-1233-1,NDC,both,1,gm,55.96,33.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,41.4,47.57,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Aetna,Commerical,,,66.54,,66.54,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Aetna,Middlesex Employees,,,63.81,,63.81,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Anthem,Commerical,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Anthem,Indemnity,,,64.6,,64.6,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Anthem,Individual Exchange,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Anthem,State Preferred,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Cigna,Cigna,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Connecticare,Commerical,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Connecticare,Exchange,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,Multiplan,Multiplan,,,73.3,,73.3,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0472-0381-15,NDC,both,15,gm,86.24,51.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Aetna,Commerical,,,66.54,,66.54,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Aetna,Middlesex Employees,,,63.81,,63.81,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Anthem,Commerical,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Anthem,Indemnity,,,64.6,,64.6,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Anthem,Individual Exchange,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Anthem,State Preferred,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Cigna,Cigna,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Connecticare,Commerical,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Connecticare,Exchange,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,Multiplan,Multiplan,,,73.3,,73.3,63.81,73.3,percent of total billed charges,,
BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,72578-093-01,NDC,both,1,gm,86.24,51.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.81,73.3,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Aetna,Commerical,,,170.76,,170.76,163.74,188.11,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Aetna,Middlesex Employees,,,163.74,,163.74,163.74,188.11,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Anthem,Commerical,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Anthem,Indemnity,,,165.78,,165.78,163.74,188.11,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Anthem,Individual Exchange,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Anthem,State Preferred,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Cigna,Cigna,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Connecticare,Commerical,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Connecticare,Exchange,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,Multiplan,Multiplan,,,188.11,,188.11,163.74,188.11,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % LOTION,J3490,HCPCS,0168-0041-60,NDC,both,60,mL,221.3,132.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,163.74,188.11,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Aetna,Commerical,,,62.82,,62.82,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Aetna,Middlesex Employees,,,60.24,,60.24,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Anthem,Commerical,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Anthem,Indemnity,,,60.98,,60.98,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Anthem,Individual Exchange,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Anthem,State Preferred,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Cigna,Cigna,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Connecticare,Commerical,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Connecticare,Exchange,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,Multiplan,Multiplan,,,69.2,,69.2,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0040-15,NDC,both,1,gm,81.41,48.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Aetna,Commerical,,,62.82,,62.82,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Aetna,Middlesex Employees,,,60.24,,60.24,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Anthem,Commerical,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Anthem,Indemnity,,,60.98,,60.98,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Anthem,Individual Exchange,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Anthem,State Preferred,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Cigna,Cigna,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Connecticare,Commerical,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Connecticare,Exchange,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,Multiplan,Multiplan,,,69.2,,69.2,60.24,69.2,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0326-15,NDC,both,1,gm,81.41,48.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.24,69.2,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Aetna,Commerical,,,111.58,,111.58,107,122.92,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Aetna,Middlesex Employees,,,107,,107,107,122.92,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Anthem,Commerical,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Anthem,Indemnity,,,108.33,,108.33,107,122.92,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Anthem,Individual Exchange,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Anthem,State Preferred,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Cigna,Cigna,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Connecticare,Commerical,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Connecticare,Exchange,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,Multiplan,Multiplan,,,122.92,,122.92,107,122.92,percent of total billed charges,,
BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0472-0371-45,NDC,both,45,gm,144.61,86.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107,122.92,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-01,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
BETHANECHOL CHLORIDE 10 MG TABLET,J3490,HCPCS,0832-0511-89,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
BETHANECHOL CHLORIDE 2.5 MG TABLET,J3490,HCPCS,40810-208-72,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Aetna,Commerical,,,1.55,,1.55,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Anthem,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Anthem,Individual Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Anthem,State Preferred,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Cigna,Cigna,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Connecticare,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Connecticare,Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,Multiplan,Multiplan,,,1.71,,1.71,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-01,NDC,both,1,ea,2.01,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Aetna,Commerical,,,1.55,,1.55,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Anthem,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Anthem,Individual Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Anthem,State Preferred,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Cigna,Cigna,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Connecticare,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Connecticare,Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,Multiplan,Multiplan,,,1.71,,1.71,1.49,1.71,percent of total billed charges,,
BETHANECHOL CHLORIDE 25 MG TABLET,J3490,HCPCS,0832-0512-89,NDC,both,1,ea,2.01,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0510-00,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Aetna,Commerical,,,82.63,,82.63,79.24,91.03,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Aetna,Middlesex Employees,,,79.24,,79.24,79.24,91.03,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Anthem,Commerical,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Anthem,Indemnity,,,80.22,,80.22,79.24,91.03,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Anthem,Individual Exchange,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Anthem,State Preferred,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Cigna,Cigna,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Connecticare,Commerical,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Connecticare,Exchange,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,Multiplan,Multiplan,,,91.03,,91.03,79.24,91.03,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-57,NDC,both,1,mL,107.09,64.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.24,91.03,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Aetna,Commerical,,,41.32,,41.32,39.62,45.52,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Aetna,Middlesex Employees,,,39.62,,39.62,39.62,45.52,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Anthem,Commerical,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Anthem,Indemnity,,,40.11,,40.11,39.62,45.52,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Anthem,Individual Exchange,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Anthem,State Preferred,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Cigna,Cigna,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Connecticare,Commerical,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Connecticare,Exchange,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,Multiplan,Multiplan,,,45.52,,45.52,39.62,45.52,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-08,NDC,both,1,mL,53.55,32.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Aetna,Commerical,,,165.26,,165.26,158.47,182.05,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Aetna,Middlesex Employees,,,158.47,,158.47,158.47,182.05,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Anthem,Commerical,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Anthem,Indemnity,,,160.44,,160.44,158.47,182.05,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Anthem,Individual Exchange,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Anthem,State Preferred,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Cigna,Cigna,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Connecticare,Commerical,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Connecticare,Exchange,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,Multiplan,Multiplan,,,182.05,,182.05,158.47,182.05,percent of total billed charges,,
BETHANECHOL CHLORIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-09,NDC,both,1,mL,214.18,128.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,158.47,182.05,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Aetna,Commerical,,,1863.81,,1863.81,88.4,2053.18,percent of total billed charges,,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Aetna,Middlesex Employees,,,1787.24,,1787.24,88.4,2053.18,percent of total billed charges,,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Anthem,Commerical,,,,,,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Anthem,Indemnity,,,1809.46,,1809.46,88.4,2053.18,percent of total billed charges,,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Anthem,Individual Exchange,,,,,,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Anthem,State Preferred,,,,,,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Cigna,Cigna,,102.17,,,102.17,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Connecticare,Commerical,,111.02,,,111.02,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Connecticare,Exchange,,111.02,,,111.02,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,Multiplan,Multiplan,,,2053.18,,2053.18,88.4,2053.18,percent of total billed charges,,
BEVACIZUMAB 2.5 MG/1 ML INTRAVITREAL,J9035,HCPCS,40810-0204-82,NDC,both,4,mL,2415.51,1449.31,United Healthcare/Oxford,United Healthcare/Oxford,,88.4,,,88.4,88.4,2053.18,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Aetna,Commerical,,,2355.15,,2355.15,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Aetna,Middlesex Employees,,,2258.39,,2258.39,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Commerical,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Indemnity,,,2286.47,,2286.47,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Individual Exchange,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,State Preferred,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Cigna,Cigna,,102.17,,,102.17,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Connecticare,Commerical,,111.02,,,111.02,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Connecticare,Exchange,,111.02,,,111.02,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Multiplan,Multiplan,,,2594.45,,2594.45,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,United Healthcare/Oxford,United Healthcare/Oxford,,88.4,,,88.4,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Aetna,Commerical,,,9420.56,,9420.56,88.4,10377.76,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Aetna,Middlesex Employees,,,9033.54,,9033.54,88.4,10377.76,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Anthem,Commerical,,,,,,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Anthem,Indemnity,,,9145.86,,9145.86,88.4,10377.76,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Anthem,Individual Exchange,,,,,,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Anthem,State Preferred,,,,,,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Cigna,Cigna,,102.17,,,102.17,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Connecticare,Commerical,,111.02,,,111.02,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Connecticare,Exchange,,111.02,,,111.02,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,Multiplan,Multiplan,,,10377.76,,10377.76,88.4,10377.76,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9035,HCPCS,50242-061-01,NDC,both,0.4,mL,12209.13,7325.48,United Healthcare/Oxford,United Healthcare/Oxford,,88.4,,,88.4,88.4,10377.76,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Aetna,Commerical,,,2355.15,,2355.15,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Aetna,Middlesex Employees,,,2258.39,,2258.39,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Commerical,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Indemnity,,,2286.47,,2286.47,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,Individual Exchange,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Anthem,State Preferred,,,,,,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Cigna,Cigna,,102.17,,,102.17,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Connecticare,Commerical,,111.02,,,111.02,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Connecticare,Exchange,,111.02,,,111.02,88.4,2594.45,Other,Could be inpatient or outpatient,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,Multiplan,Multiplan,,,2594.45,,2594.45,88.4,2594.45,percent of total billed charges,,
BEVACIZUMAB 25 MG/ML INTRAVITREAL VIAL,J9035,HCPCS,50242-060-01,NDC,both,0.4,mL,3052.29,1831.37,United Healthcare/Oxford,United Healthcare/Oxford,,88.4,,,88.4,88.4,2594.45,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Aetna,Commerical,,,162.54,,162.54,155.86,179.05,percent of total billed charges,,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Aetna,Middlesex Employees,,,155.86,,155.86,155.86,179.05,percent of total billed charges,,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Anthem,Commerical,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Anthem,Indemnity,,,157.8,,157.8,155.86,179.05,percent of total billed charges,,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Anthem,Individual Exchange,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Anthem,State Preferred,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Cigna,Cigna,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Connecticare,Commerical,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Connecticare,Exchange,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,Multiplan,Multiplan,,,179.05,,179.05,155.86,179.05,percent of total billed charges,,
BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,J3490,HCPCS,24571-111-06,NDC,both,5000,mL,210.65,126.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,155.86,179.05,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Aetna,Commerical,,,88.66,,88.66,85.01,97.67,percent of total billed charges,,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Aetna,Middlesex Employees,,,85.01,,85.01,85.01,97.67,percent of total billed charges,,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Anthem,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Anthem,Indemnity,,,86.07,,86.07,85.01,97.67,percent of total billed charges,,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Anthem,Individual Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Anthem,State Preferred,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Cigna,Cigna,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Connecticare,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Connecticare,Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,Multiplan,Multiplan,,,97.67,,97.67,85.01,97.67,percent of total billed charges,,
BICARBONATE DIALYSIS SOLN WITHOUT CALCIUM NO15 POT 4 MEQ-MAG 1.2 MEQ/L,J3490,HCPCS,24571-114-06,NDC,both,5000,mL,114.9,68.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Aetna,Commerical,,,103.43,,103.43,99.18,113.94,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Aetna,Middlesex Employees,,,99.18,,99.18,99.18,113.94,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Anthem,Commerical,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Anthem,Indemnity,,,100.42,,100.42,99.18,113.94,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Anthem,Individual Exchange,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Anthem,State Preferred,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Cigna,Cigna,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Connecticare,Commerical,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Connecticare,Exchange,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,Multiplan,Multiplan,,,113.94,,113.94,99.18,113.94,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,J3490,HCPCS,24571-102-06,NDC,both,5000,mL,134.05,80.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,99.18,113.94,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Aetna,Commerical,,,44.33,,44.33,42.51,48.83,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Aetna,Middlesex Employees,,,42.51,,42.51,42.51,48.83,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Anthem,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Anthem,Indemnity,,,43.04,,43.04,42.51,48.83,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Anthem,Individual Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Anthem,State Preferred,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Cigna,Cigna,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Connecticare,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Connecticare,Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,Multiplan,Multiplan,,,48.83,,48.83,42.51,48.83,percent of total billed charges,,
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,J3490,HCPCS,24571-105-06,NDC,both,5000,mL,57.45,34.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
BIOTIN 1 MG TABLET,J3490,HCPCS,7985403985,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,1184515615,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Aetna,Commerical,,,18.62,,18.62,17.85,20.51,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Aetna,Middlesex Employees,,,17.85,,17.85,17.85,20.51,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Anthem,Commerical,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Anthem,Indemnity,,,18.08,,18.08,17.85,20.51,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Anthem,Individual Exchange,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Anthem,State Preferred,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Cigna,Cigna,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Connecticare,Commerical,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Connecticare,Exchange,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,Multiplan,Multiplan,,,20.51,,20.51,17.85,20.51,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,35046-0001-86,NDC,both,1,UN,24.13,14.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.85,20.51,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
BIOTIN 5 MG TABLET,J3490,HCPCS,54022-1075-01,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,8142102102,NDC,both,1,ea,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Aetna,Commerical,,,0.69,,0.69,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Aetna,Middlesex Employees,,,0.66,,0.66,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Anthem,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Anthem,Indemnity,,,0.67,,0.67,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Anthem,Individual Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Anthem,State Preferred,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Cigna,Cigna,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Connecticare,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Connecticare,Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,Multiplan,Multiplan,,,0.76,,0.76,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0574-7050-12,NDC,both,1,ea,0.89,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Aetna,Commerical,,,0.69,,0.69,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Aetna,Middlesex Employees,,,0.66,,0.66,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Anthem,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Anthem,Indemnity,,,0.67,,0.67,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Anthem,Individual Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Anthem,State Preferred,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Cigna,Cigna,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Connecticare,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Connecticare,Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,Multiplan,Multiplan,,,0.76,,0.76,0.66,0.76,percent of total billed charges,,
BISACODYL 10 MG RECTAL SUPPOSITORY,J3490,HCPCS,0904-7142-12,NDC,both,1,ea,0.89,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
BISACODYL 5 MG RECT SUPP,J3490,HCPCS,40810-0000-59,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6407-61,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
"BISACODYL 5 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-7927-60,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Aetna,Commerical,,,55.68,,55.68,30.67,61.34,percent of total billed charges,,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Aetna,Middlesex Employees,,,53.39,,53.39,30.67,61.34,percent of total billed charges,,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Anthem,Commerical,,,,,,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Anthem,Indemnity,,,54.06,,54.06,30.67,61.34,percent of total billed charges,,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Anthem,Individual Exchange,,,,,,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Anthem,State Preferred,,,,,,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Cigna,Cigna,,35.45,,,35.45,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Connecticare,Commerical,,37.69,,,37.69,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Connecticare,Exchange,,37.69,,,37.69,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,Multiplan,Multiplan,,,61.34,,61.34,30.67,61.34,percent of total billed charges,,
BLEOMYCIN 15 UNIT INJECTION FOR SCLEROTHERAPY,J9040,HCPCS,0143-9240-01,NDC,both,1,ea,72.16,43.3,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,61.34,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Aetna,Commerical,,,69.69,,69.69,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Aetna,Middlesex Employees,,,66.83,,66.83,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Anthem,Commerical,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Anthem,Indemnity,,,67.66,,67.66,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Anthem,Individual Exchange,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Anthem,State Preferred,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Cigna,Cigna,,35.45,,,35.45,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Connecticare,Commerical,,37.69,,,37.69,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Connecticare,Exchange,,37.69,,,37.69,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,Multiplan,Multiplan,,,76.77,,76.77,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-332-18,NDC,both,1,ea,90.32,54.19,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Aetna,Commerical,,,69.69,,69.69,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Aetna,Middlesex Employees,,,66.83,,66.83,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Anthem,Commerical,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Anthem,Indemnity,,,67.66,,67.66,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Anthem,Individual Exchange,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Anthem,State Preferred,,,,,,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Cigna,Cigna,,35.45,,,35.45,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Connecticare,Commerical,,37.69,,,37.69,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Connecticare,Exchange,,37.69,,,37.69,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,Multiplan,Multiplan,,,76.77,,76.77,30.67,76.77,percent of total billed charges,,
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-136-10,NDC,both,1,ea,90.32,54.19,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,76.77,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,229.8,137.88,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 3 UNITS/ML IV,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,1149,689.4,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0409-0323-20,NDC,both,0.5,ea,219.35,131.61,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,0703-3155-01,NDC,both,0.5,ea,219.35,131.61,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,61703-323-22,NDC,both,0.5,ea,219.35,131.61,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,63323-137-20,NDC,both,0.5,ea,219.35,131.61,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Commerical,,,169.25,,169.25,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Aetna,Middlesex Employees,,,162.3,,162.3,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Commerical,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Indemnity,,,164.32,,164.32,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Anthem,Individual Exchange,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Anthem,State Preferred,,,,,,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Cigna,Cigna,,35.45,,,35.45,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Commerical,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Connecticare,Exchange,,37.69,,,37.69,30.67,186.45,Other,Could be inpatient or outpatient,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,Multiplan,Multiplan,,,186.45,,186.45,30.67,186.45,percent of total billed charges,,
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,J9040,HCPCS,71288-107-20,NDC,both,0.5,ea,219.35,131.61,United Healthcare/Oxford,United Healthcare/Oxford,,30.67,,,30.67,30.67,186.45,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Aetna,Commerical,,,14696.81,,14696.81,185.39,16190.11,percent of total billed charges,,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Aetna,Middlesex Employees,,,14093.02,,14093.02,185.39,16190.11,percent of total billed charges,,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Anthem,Commerical,,,,,,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Anthem,Indemnity,,,14268.25,,14268.25,185.39,16190.11,percent of total billed charges,,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Anthem,Individual Exchange,,,,,,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Anthem,State Preferred,,,,,,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Cigna,Cigna,,214.26,,,214.26,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Connecticare,Commerical,,232.37,,,232.37,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Connecticare,Exchange,,232.37,,,232.37,185.39,16190.11,Other,Could be inpatient or outpatient,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,Multiplan,Multiplan,,,16190.11,,16190.11,185.39,16190.11,percent of total billed charges,,
BLINATUMOMAB 35 MCG INTRAVENOUS VIAL,J9039,HCPCS,55513-160-01,NDC,both,0.029,ea,19047.19,11428.31,United Healthcare/Oxford,United Healthcare/Oxford,,185.39,,,185.39,185.39,16190.11,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Commerical,,,3702.38,,3702.38,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Middlesex Employees,,,3550.28,,3550.28,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Commerical,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Indemnity,,,3594.42,,3594.42,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Individual Exchange,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,State Preferred,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Cigna,Cigna,,2.44,,,2.44,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Commerical,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Exchange,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,Multiplan,Multiplan,,,4078.57,,4078.57,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,10019-991-01,NDC,both,0.029,ea,4798.32,2878.99,United Healthcare/Oxford,United Healthcare/Oxford,,2.11,,,2.11,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Commerical,,,3702.38,,3702.38,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Middlesex Employees,,,3550.28,,3550.28,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Commerical,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Indemnity,,,3594.42,,3594.42,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Individual Exchange,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,State Preferred,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Cigna,Cigna,,2.44,,,2.44,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Commerical,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Exchange,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,Multiplan,Multiplan,,,4078.57,,4078.57,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,50742-484-01,NDC,both,0.029,ea,4798.32,2878.99,United Healthcare/Oxford,United Healthcare/Oxford,,2.11,,,2.11,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Commerical,,,3702.38,,3702.38,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Aetna,Middlesex Employees,,,3550.28,,3550.28,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Commerical,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Indemnity,,,3594.42,,3594.42,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,Individual Exchange,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Anthem,State Preferred,,,,,,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Cigna,Cigna,,2.44,,,2.44,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Commerical,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Connecticare,Exchange,,2.4,,,2.4,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,Multiplan,Multiplan,,,4078.57,,4078.57,2.11,4078.57,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,55150-337-01,NDC,both,0.029,ea,4798.32,2878.99,United Healthcare/Oxford,United Healthcare/Oxford,,2.11,,,2.11,2.11,4078.57,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Aetna,Commerical,,,4599.38,,4599.38,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Aetna,Middlesex Employees,,,4410.42,,4410.42,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Commerical,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Indemnity,,,4465.26,,4465.26,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Individual Exchange,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,State Preferred,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Cigna,Cigna,,2.44,,,2.44,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Connecticare,Commerical,,2.4,,,2.4,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Connecticare,Exchange,,2.4,,,2.4,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Multiplan,Multiplan,,,5066.71,,5066.71,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,United Healthcare/Oxford,United Healthcare/Oxford,,2.11,,,2.11,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Aetna,Commerical,,,3676.85,,3676.85,4.09,4050.45,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Aetna,Middlesex Employees,,,3525.79,,3525.79,4.09,4050.45,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Anthem,Commerical,,,,,,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Anthem,Indemnity,,,3569.63,,3569.63,4.09,4050.45,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Anthem,Individual Exchange,,,,,,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Anthem,State Preferred,,,,,,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Cigna,Cigna,,65.88,,,65.88,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Connecticare,Commerical,,4.09,,,4.09,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Connecticare,Exchange,,4.09,,,4.09,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,Multiplan,Multiplan,,,4050.45,,4050.45,4.09,4050.45,percent of total billed charges,,
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,J9048,HCPCS,63323-721-10,NDC,both,0.028,ea,4765.23,2859.14,United Healthcare/Oxford,United Healthcare/Oxford,,6.15,,,6.15,4.09,4050.45,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Aetna,Commerical,,,4599.38,,4599.38,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Aetna,Middlesex Employees,,,4410.42,,4410.42,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Commerical,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Indemnity,,,4465.26,,4465.26,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,Individual Exchange,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Anthem,State Preferred,,,,,,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Cigna,Cigna,,2.44,,,2.44,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Connecticare,Commerical,,2.4,,,2.4,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Connecticare,Exchange,,2.4,,,2.4,2.11,5066.71,Other,Could be inpatient or outpatient,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,Multiplan,Multiplan,,,5066.71,,5066.71,2.11,5066.71,percent of total billed charges,,
BORTEZOMIB CHEMO IV 1 MG/ML,J9041,HCPCS,63020-049-01,NDC,both,0.028,ea,5960.83,3576.5,United Healthcare/Oxford,United Healthcare/Oxford,,2.11,,,2.11,2.11,5066.71,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Aetna,Commerical,,,328.03,,328.03,314.55,361.36,percent of total billed charges,,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Aetna,Middlesex Employees,,,314.55,,314.55,314.55,361.36,percent of total billed charges,,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Anthem,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Anthem,Indemnity,,,318.46,,318.46,314.55,361.36,percent of total billed charges,,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Anthem,Individual Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Anthem,State Preferred,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Cigna,Cigna,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Connecticare,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Connecticare,Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,Multiplan,Multiplan,,,361.36,,361.36,314.55,361.36,percent of total billed charges,,
BOSENTAN 15.625 MG ORAL TAB,J3490,HCPCS,40810-0018-46,NDC,both,1,ea,425.13,255.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Aetna,Commerical,,,328.03,,328.03,314.55,361.36,percent of total billed charges,,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Aetna,Middlesex Employees,,,314.55,,314.55,314.55,361.36,percent of total billed charges,,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Anthem,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Anthem,Indemnity,,,318.46,,318.46,314.55,361.36,percent of total billed charges,,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Anthem,Individual Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Anthem,State Preferred,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Cigna,Cigna,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Connecticare,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Connecticare,Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,Multiplan,Multiplan,,,361.36,,361.36,314.55,361.36,percent of total billed charges,,
BOSENTAN 31.25 MG ORAL TAB,J3490,HCPCS,40810-0018-45,NDC,both,1,ea,425.13,255.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Aetna,Commerical,,,984.09,,984.09,943.66,1084.08,percent of total billed charges,,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Aetna,Middlesex Employees,,,943.66,,943.66,943.66,1084.08,percent of total billed charges,,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Anthem,Commerical,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Anthem,Indemnity,,,955.39,,955.39,943.66,1084.08,percent of total billed charges,,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Anthem,Individual Exchange,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Anthem,State Preferred,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Cigna,Cigna,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Connecticare,Commerical,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Connecticare,Exchange,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,Multiplan,Multiplan,,,1084.08,,1084.08,943.66,1084.08,percent of total billed charges,,
BOSENTAN 6.25 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-10,NDC,both,1,mL,1275.39,765.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,943.66,1084.08,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Aetna,Commerical,,,55.15,,55.15,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Aetna,Middlesex Employees,,,52.88,,52.88,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Anthem,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Anthem,Indemnity,,,53.54,,53.54,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Anthem,Individual Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Anthem,State Preferred,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Cigna,Cigna,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Connecticare,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Connecticare,Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,Multiplan,Multiplan,,,60.75,,60.75,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,0591-2511-60,NDC,both,1,ea,71.47,42.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Aetna,Commerical,,,55.15,,55.15,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Aetna,Middlesex Employees,,,52.88,,52.88,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Anthem,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Anthem,Indemnity,,,53.54,,53.54,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Anthem,Individual Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Anthem,State Preferred,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Cigna,Cigna,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Connecticare,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Connecticare,Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,Multiplan,Multiplan,,,60.75,,60.75,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-03,NDC,both,1,ea,71.47,42.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Aetna,Commerical,,,55.15,,55.15,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Aetna,Middlesex Employees,,,52.88,,52.88,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Anthem,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Anthem,Indemnity,,,53.54,,53.54,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Anthem,Individual Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Anthem,State Preferred,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Cigna,Cigna,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Connecticare,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Connecticare,Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,Multiplan,Multiplan,,,60.75,,60.75,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,66215-101-06,NDC,both,1,ea,71.47,42.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Aetna,Commerical,,,55.15,,55.15,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Aetna,Middlesex Employees,,,52.88,,52.88,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Anthem,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Anthem,Indemnity,,,53.54,,53.54,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Anthem,Individual Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Anthem,State Preferred,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Cigna,Cigna,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Connecticare,Commerical,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Connecticare,Exchange,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,Multiplan,Multiplan,,,60.75,,60.75,52.88,60.75,percent of total billed charges,,
BOSENTAN 62.5 MG TABLET,J3490,HCPCS,68382-446-14,NDC,both,1,ea,71.47,42.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.88,60.75,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Aetna,Commerical,,,41434.92,,41434.92,39732.63,45645,percent of total billed charges,,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Aetna,Middlesex Employees,,,39732.63,,39732.63,39732.63,45645,percent of total billed charges,,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Anthem,Commerical,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Anthem,Indemnity,,,40226.67,,40226.67,39732.63,45645,percent of total billed charges,,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Anthem,Individual Exchange,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Anthem,State Preferred,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Cigna,Cigna,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Connecticare,Commerical,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Connecticare,Exchange,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,Multiplan,Multiplan,,,45645,,45645,39732.63,45645,percent of total billed charges,,
"BOTULISM IMMUNE GLOBULIN, HUMAN 100 MG INTRAVENOUS SOLUTION",90288,HCPCS,68403-1100-6,NDC,both,1,ea,53700,32220,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39732.63,45645,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Aetna,Commerical,,,32146.97,,32146.97,292.31,35413.33,percent of total billed charges,,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Aetna,Middlesex Employees,,,30826.26,,30826.26,292.31,35413.33,percent of total billed charges,,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Anthem,Commerical,,,,,,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Anthem,Indemnity,,,31209.56,,31209.56,292.31,35413.33,percent of total billed charges,,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Anthem,Individual Exchange,,,,,,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Anthem,State Preferred,,,,,,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Cigna,Cigna,,337.84,,,337.84,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Connecticare,Commerical,,366.26,,,366.26,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Connecticare,Exchange,,366.26,,,366.26,292.31,35413.33,Other,Could be inpatient or outpatient,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,Multiplan,Multiplan,,,35413.33,,35413.33,292.31,35413.33,percent of total billed charges,,
BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,J9042,HCPCS,51144-050-01,NDC,both,0.02,ea,41662.74,24997.64,United Healthcare/Oxford,United Healthcare/Oxford,,292.31,,,292.31,292.31,35413.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Aetna,Commerical,,,3448.75,,3448.75,3307.06,3799.17,percent of total billed charges,,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Aetna,Middlesex Employees,,,3307.06,,3307.06,3307.06,3799.17,percent of total billed charges,,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Anthem,Commerical,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Anthem,Indemnity,,,3348.18,,3348.18,3307.06,3799.17,percent of total billed charges,,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Anthem,Individual Exchange,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Anthem,State Preferred,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Cigna,Cigna,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Connecticare,Commerical,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Connecticare,Exchange,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,Multiplan,Multiplan,,,3799.17,,3799.17,3307.06,3799.17,percent of total billed charges,,
BRIVARACETAM 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50474-870-15,NDC,both,1,mL,4469.61,2681.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3307.06,3799.17,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Aetna,Commerical,,,83.83,,83.83,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Aetna,Middlesex Employees,,,80.38,,80.38,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Anthem,Commerical,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Anthem,Indemnity,,,81.38,,81.38,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Anthem,Individual Exchange,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Anthem,State Preferred,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Cigna,Cigna,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Connecticare,Commerical,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Connecticare,Exchange,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,Multiplan,Multiplan,,,92.34,,92.34,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-63,NDC,both,1,mL,108.64,65.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Aetna,Commerical,,,83.83,,83.83,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Aetna,Middlesex Employees,,,80.38,,80.38,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Anthem,Commerical,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Anthem,Indemnity,,,81.38,,81.38,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Anthem,Individual Exchange,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Anthem,State Preferred,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Cigna,Cigna,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Connecticare,Commerical,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Connecticare,Exchange,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,Multiplan,Multiplan,,,92.34,,92.34,80.38,92.34,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,50474-970-75,NDC,both,1,mL,108.64,65.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.38,92.34,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Aetna,Commerical,,,57.48,,57.48,55.12,63.33,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Aetna,Middlesex Employees,,,55.12,,55.12,55.12,63.33,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Anthem,Commerical,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Anthem,Indemnity,,,55.81,,55.81,55.12,63.33,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Anthem,Individual Exchange,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Anthem,State Preferred,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Cigna,Cigna,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Connecticare,Commerical,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Connecticare,Exchange,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,Multiplan,Multiplan,,,63.33,,63.33,55.12,63.33,percent of total billed charges,,
BRIVARACETAM 50 MG/5 ML ORAL SYRINGE,J3490,HCPCS,40810-0205-72,NDC,both,1,mL,74.5,44.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,55.12,63.33,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,1.35,1.55,percent of total billed charges,,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,1.35,1.55,percent of total billed charges,,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Anthem,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,1.35,1.55,percent of total billed charges,,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Anthem,Individual Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Anthem,State Preferred,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Cigna,Cigna,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Connecticare,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Connecticare,Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,1.35,1.55,percent of total billed charges,,
BROMOCRIPTINE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0000-60,NDC,both,1,ea,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,0574-0106-03,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
BROMOCRIPTINE 2.5 MG TABLET,J3490,HCPCS,40810-0008-13,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-19,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Aetna,Commerical,,,16.46,,16.46,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Aetna,Middlesex Employees,,,15.78,,15.78,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Anthem,Commerical,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Anthem,Indemnity,,,15.98,,15.98,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Anthem,Individual Exchange,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Anthem,State Preferred,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Cigna,Cigna,,1.34,,,1.34,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Connecticare,Commerical,,1.88,,,1.88,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Connecticare,Exchange,,1.88,,,1.88,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,Multiplan,Multiplan,,,18.13,,18.13,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-45,NDC,both,2,mL,21.33,12.8,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-55,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Aetna,Commerical,,,16.46,,16.46,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Aetna,Middlesex Employees,,,15.78,,15.78,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Anthem,Commerical,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Anthem,Indemnity,,,15.98,,15.98,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Anthem,Individual Exchange,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Anthem,State Preferred,,,,,,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Cigna,Cigna,,1.34,,,1.34,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Connecticare,Commerical,,1.88,,,1.88,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Connecticare,Exchange,,1.88,,,1.88,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,Multiplan,Multiplan,,,18.13,,18.13,1.34,18.13,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6815-73,NDC,both,2,mL,21.33,12.8,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,18.13,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Aetna,Commerical,,,32.92,,32.92,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Aetna,Middlesex Employees,,,31.56,,31.56,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Commerical,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Indemnity,,,31.96,,31.96,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,Individual Exchange,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Anthem,State Preferred,,,,,,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Cigna,Cigna,,1.34,,,1.34,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Connecticare,Commerical,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Connecticare,Exchange,,1.88,,,1.88,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,Multiplan,Multiplan,,,36.26,,36.26,1.34,36.26,percent of total billed charges,,
BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9601-01,NDC,both,4,mL,42.66,25.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,36.26,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,12.97,7.78,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,12.97,7.78,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,12.97,7.78,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-45,NDC,both,2,mL,35.64,21.38,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6816-73,NDC,both,2,mL,35.64,21.38,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1989-04,NDC,both,2,mL,35.64,21.38,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Aetna,Commerical,,,27.5,,27.5,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Aetna,Middlesex Employees,,,26.37,,26.37,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Anthem,Commerical,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Anthem,Indemnity,,,26.7,,26.7,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Anthem,Individual Exchange,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Anthem,State Preferred,,,,,,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Cigna,Cigna,,1.34,,,1.34,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Connecticare,Commerical,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Connecticare,Exchange,,1.88,,,1.88,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,Multiplan,Multiplan,,,30.29,,30.29,1.34,30.29,percent of total billed charges,,
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0487-9701-01,NDC,both,2,mL,35.64,21.38,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,30.29,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-32,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR ENTERAL USE,J7626,HCPCS,69097-321-53,NDC,both,2,mL,65.05,39.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,00781-7517-87,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-19,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-45,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0093-6817-73,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0186-1990-04,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-14,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,0781-7517-87,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-32,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Aetna,Commerical,,,9.96,,9.96,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Aetna,Middlesex Employees,,,9.55,,9.55,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Anthem,Commerical,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Anthem,Indemnity,,,9.67,,9.67,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Anthem,Individual Exchange,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Anthem,State Preferred,,,,,,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Cigna,Cigna,,1.34,,,1.34,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Connecticare,Commerical,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Connecticare,Exchange,,1.88,,,1.88,1.34,10.97,Other,Could be inpatient or outpatient,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,Multiplan,Multiplan,,,10.97,,10.97,1.34,10.97,percent of total billed charges,,
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,J7626,HCPCS,69097-321-53,NDC,both,2,mL,12.91,7.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.45,,,1.45,1.34,10.97,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Aetna,Commerical,,,2,,2,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Anthem,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Anthem,Individual Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Anthem,State Preferred,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Cigna,Cigna,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Connecticare,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Connecticare,Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,0378-7155-01,NDC,both,1,ea,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Aetna,Commerical,,,2,,2,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Anthem,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Anthem,Individual Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Anthem,State Preferred,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Cigna,Cigna,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Connecticare,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Connecticare,Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,1.92,2.2,percent of total billed charges,,
"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",J3490,HCPCS,65162-778-10,NDC,both,1,ea,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Aetna,Commerical,,,518.43,,518.43,497.13,571.11,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Aetna,Middlesex Employees,,,497.13,,497.13,497.13,571.11,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Anthem,Commerical,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Anthem,Indemnity,,,503.31,,503.31,497.13,571.11,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Anthem,Individual Exchange,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Anthem,State Preferred,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Cigna,Cigna,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Connecticare,Commerical,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Connecticare,Exchange,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,Multiplan,Multiplan,,,571.11,,571.11,497.13,571.11,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0370-28,NDC,both,6,gm,671.89,403.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,497.13,571.11,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Aetna,Commerical,,,889.79,,889.79,853.23,980.19,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Aetna,Middlesex Employees,,,853.23,,853.23,853.23,980.19,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Anthem,Commerical,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Anthem,Indemnity,,,863.84,,863.84,853.23,980.19,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Anthem,Individual Exchange,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Anthem,State Preferred,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Cigna,Cigna,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Connecticare,Commerical,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Connecticare,Exchange,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,Multiplan,Multiplan,,,980.19,,980.19,853.23,980.19,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-20,NDC,both,6.9,gm,1153.17,691.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,853.23,980.19,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Aetna,Commerical,,,518.45,,518.45,497.15,571.12,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Aetna,Middlesex Employees,,,497.15,,497.15,497.15,571.12,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Anthem,Commerical,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Anthem,Indemnity,,,503.33,,503.33,497.15,571.12,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Anthem,Individual Exchange,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Anthem,State Preferred,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Cigna,Cigna,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Connecticare,Commerical,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Connecticare,Exchange,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,Multiplan,Multiplan,,,571.12,,571.12,497.15,571.12,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0186-0372-28,NDC,both,6.9,gm,671.91,403.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,497.15,571.12,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Aetna,Commerical,,,1036.89,,1036.89,994.29,1142.25,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Aetna,Middlesex Employees,,,994.29,,994.29,994.29,1142.25,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Anthem,Commerical,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Anthem,Indemnity,,,1006.66,,1006.66,994.29,1142.25,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Anthem,Individual Exchange,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Anthem,State Preferred,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Cigna,Cigna,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Connecticare,Commerical,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Connecticare,Exchange,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,Multiplan,Multiplan,,,1142.25,,1142.25,994.29,1142.25,percent of total billed charges,,
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,J3490,HCPCS,0310-7372-20,NDC,both,6.9,gm,1343.82,806.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,994.29,1142.25,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,21.26,24.42,percent of total billed charges,,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,21.26,24.42,percent of total billed charges,,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,21.26,24.42,percent of total billed charges,,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,21.26,24.42,percent of total billed charges,,
BUFFERED LIDOCAINE,J3490,HCPCS,05446-520-10,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Aetna,Commerical,,,29.71,,29.71,28.49,32.73,percent of total billed charges,,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Aetna,Middlesex Employees,,,28.49,,28.49,28.49,32.73,percent of total billed charges,,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Anthem,Commerical,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Anthem,Indemnity,,,28.85,,28.85,28.49,32.73,percent of total billed charges,,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Anthem,Individual Exchange,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Anthem,State Preferred,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Cigna,Cigna,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Connecticare,Commerical,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Connecticare,Exchange,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,Multiplan,Multiplan,,,32.73,,32.73,28.49,32.73,percent of total billed charges,,
BUMETANIDE 0.04 MG/ML IN D5W NICU,J3490,HCPCS,40810-0004-36,NDC,both,1,mL,38.51,23.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.49,32.73,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0409-1412-04,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Aetna,Commerical,,,8.77,,8.77,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Aetna,Middlesex Employees,,,8.41,,8.41,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Anthem,Commerical,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Anthem,Indemnity,,,8.51,,8.51,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Anthem,Individual Exchange,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Anthem,State Preferred,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Cigna,Cigna,,0.7,,,0.7,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Connecticare,Commerical,,0.95,,,0.95,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Connecticare,Exchange,,0.95,,,0.95,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,Multiplan,Multiplan,,,9.66,,9.66,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-01,NDC,both,4,mL,11.36,6.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Aetna,Commerical,,,8.77,,8.77,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Aetna,Middlesex Employees,,,8.41,,8.41,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Anthem,Commerical,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Anthem,Indemnity,,,8.51,,8.51,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Anthem,Individual Exchange,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Anthem,State Preferred,,,,,,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Cigna,Cigna,,0.7,,,0.7,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Connecticare,Commerical,,0.95,,,0.95,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Connecticare,Exchange,,0.95,,,0.95,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,Multiplan,Multiplan,,,9.66,,9.66,0.7,9.66,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6007-10,NDC,both,4,mL,11.36,6.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,9.66,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-01,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6008-10,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,0641-6161-10,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Aetna,Commerical,,,2.75,,2.75,0.7,3.03,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Aetna,Middlesex Employees,,,2.64,,2.64,0.7,3.03,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Anthem,Commerical,,,,,,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Anthem,Indemnity,,,2.67,,2.67,0.7,3.03,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Anthem,Individual Exchange,,,,,,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Anthem,State Preferred,,,,,,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Cigna,Cigna,,0.7,,,0.7,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Connecticare,Commerical,,0.95,,,0.95,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Connecticare,Exchange,,0.95,,,0.95,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,Multiplan,Multiplan,,,3.03,,3.03,0.7,3.03,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-02,NDC,both,1,mL,3.57,2.14,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,3.03,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-05,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Aetna,Commerical,,,16.5,,16.5,0.7,18.17,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Aetna,Middlesex Employees,,,15.82,,15.82,0.7,18.17,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Anthem,Commerical,,,,,,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Anthem,Indemnity,,,16.02,,16.02,0.7,18.17,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Anthem,Individual Exchange,,,,,,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Anthem,State Preferred,,,,,,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Cigna,Cigna,,0.7,,,0.7,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Connecticare,Commerical,,0.95,,,0.95,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Connecticare,Exchange,,0.95,,,0.95,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,Multiplan,Multiplan,,,18.17,,18.17,0.7,18.17,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,55390-500-10,NDC,both,4,mL,21.38,12.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,18.17,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-01,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,65219-570-04,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-40,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,68462-469-54,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-04,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,70860-405-41,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-01,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Anthem,Commerical,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Anthem,State Preferred,,,,,,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Cigna,Cigna,,0.7,,,0.7,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Connecticare,Commerical,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Connecticare,Exchange,,0.95,,,0.95,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,0.7,6.06,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,J1939,HCPCS,72205-101-07,NDC,both,4,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.76,,,0.76,0.7,6.06,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Anthem,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Anthem,Individual Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Anthem,State Preferred,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Cigna,Cigna,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Connecticare,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Connecticare,Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,0409-1412-04,NDC,both,1,mL,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-02,NDC,both,1,mL,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Anthem,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Anthem,Individual Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Anthem,State Preferred,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Cigna,Cigna,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Connecticare,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Connecticare,Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.48,0.55,percent of total billed charges,,
BUMETANIDE 0.25 MG/ML ORAL SOLN,J3490,HCPCS,55390-500-05,NDC,both,1,mL,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
BUMETANIDE 0.5 MG TABLET,J3490,HCPCS,40810-0015-38,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,0185-0129-01,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
BUMETANIDE 1 MG TABLET,J3490,HCPCS,69238-1490-1,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Commerical,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Individual Exchange,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Anthem,State Preferred,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Cigna,Cigna,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Connecticare,Commerical,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Connecticare,Exchange,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-01,NDC,both,0.2,mL,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Anthem,Commerical,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Anthem,Individual Exchange,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Anthem,State Preferred,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Cigna,Cigna,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Connecticare,Commerical,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Connecticare,Exchange,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9330-10,NDC,both,0.2,mL,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Commerical,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Anthem,Individual Exchange,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Anthem,State Preferred,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Cigna,Cigna,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Connecticare,Commerical,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Connecticare,Exchange,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-01,NDC,both,0.2,mL,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Anthem,Commerical,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Anthem,Individual Exchange,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Anthem,State Preferred,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Cigna,Cigna,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Connecticare,Commerical,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Connecticare,Exchange,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-02,NDC,both,1,mL,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Anthem,Commerical,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Anthem,Individual Exchange,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Anthem,State Preferred,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Cigna,Cigna,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Connecticare,Commerical,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Connecticare,Exchange,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1159-10,NDC,both,1,mL,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Anthem,Commerical,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Anthem,Individual Exchange,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Anthem,State Preferred,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Cigna,Cigna,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Connecticare,Commerical,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Connecticare,Exchange,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1559-18,NDC,both,0.2,mL,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Aetna,Commerical,,,14.87,,14.87,0.01,16.38,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Aetna,Middlesex Employees,,,14.26,,14.26,0.01,16.38,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Anthem,Commerical,,,,,,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Anthem,Indemnity,,,14.44,,14.44,0.01,16.38,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Anthem,Individual Exchange,,,,,,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Anthem,State Preferred,,,,,,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Cigna,Cigna,,0.01,,,0.01,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Connecticare,Commerical,,0.02,,,0.02,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Connecticare,Exchange,,0.02,,,0.02,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,Multiplan,Multiplan,,,16.38,,16.38,0.01,16.38,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-17,NDC,both,1,mL,19.27,11.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.38,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Anthem,Commerical,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Anthem,Individual Exchange,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Anthem,State Preferred,,,,,,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Cigna,Cigna,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Connecticare,Commerical,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Connecticare,Exchange,,0.02,,,0.02,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,0.01,9.87,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-464-37,NDC,both,1,mL,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,9.87,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Anthem,Commerical,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Anthem,Individual Exchange,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Anthem,State Preferred,,,,,,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Cigna,Cigna,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Connecticare,Commerical,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Connecticare,Exchange,,0.02,,,0.02,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,0.01,3.29,percent of total billed charges,,
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,81483-0003-0,NDC,both,0.2,mL,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.29,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0143-9331-10,NDC,both,0.1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-01,NDC,both,10,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1162-18,NDC,both,0.1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-19,NDC,both,0.1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,0.02,,,0.02,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.01,3.91,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Anthem,Commerical,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Cigna,Cigna,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Connecticare,Commerical,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Connecticare,Exchange,,0.02,,,0.02,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.01,1.31,percent of total billed charges,,
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,71288-724-11,NDC,both,0.1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Aetna,Commerical,,,12.9,,12.9,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Aetna,Middlesex Employees,,,12.37,,12.37,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Anthem,Commerical,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Anthem,Indemnity,,,12.52,,12.52,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Anthem,Individual Exchange,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Anthem,State Preferred,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Cigna,Cigna,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Connecticare,Commerical,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Connecticare,Exchange,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,Multiplan,Multiplan,,,14.21,,14.21,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-05,NDC,both,0.067,mL,16.72,10.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Aetna,Commerical,,,12.9,,12.9,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Aetna,Middlesex Employees,,,12.37,,12.37,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Anthem,Commerical,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Anthem,Indemnity,,,12.52,,12.52,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Anthem,Individual Exchange,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Anthem,State Preferred,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Cigna,Cigna,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Connecticare,Commerical,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Connecticare,Exchange,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,Multiplan,Multiplan,,,14.21,,14.21,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-10,NDC,both,0.067,mL,16.72,10.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Aetna,Commerical,,,12.9,,12.9,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Aetna,Middlesex Employees,,,12.37,,12.37,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Anthem,Commerical,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Anthem,Indemnity,,,12.52,,12.52,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Anthem,Individual Exchange,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Anthem,State Preferred,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Cigna,Cigna,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Connecticare,Commerical,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Connecticare,Exchange,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,Multiplan,Multiplan,,,14.21,,14.21,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-1761-18,NDC,both,0.067,mL,16.72,10.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Aetna,Commerical,,,12.9,,12.9,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Aetna,Middlesex Employees,,,12.37,,12.37,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Anthem,Commerical,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Anthem,Indemnity,,,12.52,,12.52,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Anthem,Individual Exchange,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Anthem,State Preferred,,,,,,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Cigna,Cigna,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Connecticare,Commerical,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Connecticare,Exchange,,0.02,,,0.02,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,Multiplan,Multiplan,,,14.21,,14.21,0.01,14.21,percent of total billed charges,,
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,J0665,HCPCS,0409-3613-01,NDC,both,0.067,mL,16.72,10.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,14.21,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-02,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-09,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1162-10,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-10,NDC,both,0.1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-1560-29,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-169-10,NDC,both,10,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,55150-170-30,NDC,both,30,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
BUPIVACAINE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-466-37,NDC,both,1,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Aetna,Commerical,,,6.95,,6.95,0.01,7.66,percent of total billed charges,,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Aetna,Middlesex Employees,,,6.67,,6.67,0.01,7.66,percent of total billed charges,,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Anthem,Commerical,,,,,,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Anthem,Indemnity,,,6.75,,6.75,0.01,7.66,percent of total billed charges,,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Anthem,Individual Exchange,,,,,,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Anthem,State Preferred,,,,,,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Cigna,Cigna,,0.01,,,0.01,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Connecticare,Commerical,,0.02,,,0.02,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Connecticare,Exchange,,0.02,,,0.02,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,Multiplan,Multiplan,,,7.66,,7.66,0.01,7.66,percent of total billed charges,,
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1160-01,NDC,both,0.2,mL,9.01,5.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,7.66,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.01,0.17,percent of total billed charges,,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.01,0.17,percent of total billed charges,,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Anthem,Commerical,,,,,,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.01,0.17,percent of total billed charges,,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Anthem,Individual Exchange,,,,,,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Anthem,State Preferred,,,,,,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Cigna,Cigna,,0.01,,,0.01,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Connecticare,Commerical,,0.02,,,0.02,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Connecticare,Exchange,,0.02,,,0.02,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.01,0.17,percent of total billed charges,,
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,J0665,HCPCS,0409-1163-01,NDC,both,0.1,mL,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.17,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Aetna,Commerical,,,634.64,,634.64,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Aetna,Middlesex Employees,,,608.57,,608.57,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Anthem,Commerical,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Anthem,Indemnity,,,616.13,,616.13,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Anthem,Individual Exchange,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Anthem,State Preferred,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Cigna,Cigna,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Connecticare,Commerical,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Connecticare,Exchange,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,Multiplan,Multiplan,,,699.13,,699.13,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-04,NDC,both,1,mL,822.5,493.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Aetna,Commerical,,,634.64,,634.64,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Aetna,Middlesex Employees,,,608.57,,608.57,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Anthem,Commerical,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Anthem,Indemnity,,,616.13,,616.13,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Anthem,Individual Exchange,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Anthem,State Preferred,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Cigna,Cigna,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Connecticare,Commerical,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Connecticare,Exchange,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,Multiplan,Multiplan,,,699.13,,699.13,608.57,699.13,percent of total billed charges,,
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,J3490,HCPCS,65250-133-09,NDC,both,1,mL,822.5,493.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,608.57,699.13,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Aetna,Commerical,,,62.06,,62.06,59.51,68.37,percent of total billed charges,,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Aetna,Middlesex Employees,,,59.51,,59.51,59.51,68.37,percent of total billed charges,,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Anthem,Commerical,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Anthem,Indemnity,,,60.25,,60.25,59.51,68.37,percent of total billed charges,,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Anthem,Individual Exchange,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Anthem,State Preferred,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Cigna,Cigna,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Connecticare,Commerical,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Connecticare,Exchange,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,Multiplan,Multiplan,,,68.37,,68.37,59.51,68.37,percent of total billed charges,,
"BUPIVACAINE-EPI (PF) 0.5 %-1:200,000 ON Q PUMP",J3490,HCPCS,40810-0019-11,NDC,both,120,mL,80.43,48.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.51,68.37,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-01,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1541-10,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1746-30,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Aetna,Commerical,,,9.67,,9.67,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Aetna,Middlesex Employees,,,9.27,,9.27,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Anthem,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Anthem,Indemnity,,,9.39,,9.39,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Anthem,Individual Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Anthem,State Preferred,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Cigna,Cigna,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Connecticare,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Connecticare,Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,Multiplan,Multiplan,,,10.65,,10.65,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-01,NDC,both,1,mL,12.53,7.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Aetna,Commerical,,,9.67,,9.67,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Aetna,Middlesex Employees,,,9.27,,9.27,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Anthem,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Anthem,Indemnity,,,9.39,,9.39,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Anthem,Individual Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Anthem,State Preferred,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Cigna,Cigna,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Connecticare,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Connecticare,Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,Multiplan,Multiplan,,,10.65,,10.65,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-5738-10,NDC,both,1,mL,12.53,7.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Aetna,Commerical,,,9.67,,9.67,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Aetna,Middlesex Employees,,,9.27,,9.27,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Anthem,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Anthem,Indemnity,,,9.39,,9.39,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Anthem,Individual Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Anthem,State Preferred,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Cigna,Cigna,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Connecticare,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Connecticare,Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,Multiplan,Multiplan,,,10.65,,10.65,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-01,NDC,both,1,mL,12.53,7.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9042-17,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-02,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Aetna,Commerical,,,9.67,,9.67,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Aetna,Middlesex Employees,,,9.27,,9.27,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Anthem,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Anthem,Indemnity,,,9.39,,9.39,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Anthem,Individual Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Anthem,State Preferred,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Cigna,Cigna,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Connecticare,Commerical,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Connecticare,Exchange,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,Multiplan,Multiplan,,,10.65,,10.65,9.27,10.65,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-17,NDC,both,1,mL,12.53,7.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.27,10.65,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Aetna,Commerical,,,29,,29,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Aetna,Middlesex Employees,,,27.81,,27.81,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Anthem,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Anthem,Indemnity,,,28.15,,28.15,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Anthem,Individual Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Anthem,State Preferred,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Cigna,Cigna,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Connecticare,Commerical,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Connecticare,Exchange,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,Multiplan,Multiplan,,,31.94,,31.94,27.81,31.94,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-468-37,NDC,both,1,mL,37.58,22.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.81,31.94,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1749-29,NDC,both,1,mL,17.01,10.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-01,NDC,both,1,mL,17.01,10.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-4208-10,NDC,both,1,mL,17.01,10.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Aetna,Commerical,,,4.37,,4.37,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Anthem,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Anthem,Indemnity,,,4.25,,4.25,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Anthem,Individual Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Anthem,State Preferred,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Cigna,Cigna,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Connecticare,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Connecticare,Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,Multiplan,Multiplan,,,4.82,,4.82,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-01,NDC,both,1,mL,5.67,3.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Aetna,Commerical,,,4.37,,4.37,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Anthem,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Anthem,Indemnity,,,4.25,,4.25,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Anthem,Individual Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Anthem,State Preferred,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Cigna,Cigna,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Connecticare,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Connecticare,Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,Multiplan,Multiplan,,,4.82,,4.82,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-8126-10,NDC,both,1,mL,5.67,3.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Aetna,Commerical,,,4.37,,4.37,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Anthem,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Anthem,Indemnity,,,4.25,,4.25,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Anthem,Individual Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Anthem,State Preferred,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Cigna,Cigna,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Connecticare,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Connecticare,Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,Multiplan,Multiplan,,,4.82,,4.82,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-01,NDC,both,1,mL,5.67,3.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9045-17,NDC,both,1,mL,17.01,10.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Aetna,Commerical,,,4.37,,4.37,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Anthem,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Anthem,Indemnity,,,4.25,,4.25,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Anthem,Individual Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Anthem,State Preferred,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Cigna,Cigna,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Connecticare,Commerical,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Connecticare,Exchange,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,Multiplan,Multiplan,,,4.82,,4.82,4.2,4.82,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-17,NDC,both,1,mL,5.67,3.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.82,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Aetna,Commerical,,,13.12,,13.12,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Aetna,Middlesex Employees,,,12.59,,12.59,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Anthem,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Anthem,Indemnity,,,12.74,,12.74,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Anthem,Individual Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Anthem,State Preferred,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Cigna,Cigna,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Connecticare,Commerical,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Connecticare,Exchange,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,Multiplan,Multiplan,,,14.46,,14.46,12.59,14.46,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-462-37,NDC,both,1,mL,17.01,10.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.59,14.46,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Aetna,Commerical,,,15.82,,15.82,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Aetna,Middlesex Employees,,,15.17,,15.17,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Anthem,Commerical,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Anthem,Indemnity,,,15.36,,15.36,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Anthem,Individual Exchange,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Anthem,State Preferred,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Cigna,Cigna,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Connecticare,Commerical,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Connecticare,Exchange,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,Multiplan,Multiplan,,,17.43,,17.43,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1752-50,NDC,both,1,mL,20.5,12.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Aetna,Commerical,,,15.82,,15.82,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Aetna,Middlesex Employees,,,15.17,,15.17,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Anthem,Commerical,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Anthem,Indemnity,,,15.36,,15.36,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Anthem,Individual Exchange,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Anthem,State Preferred,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Cigna,Cigna,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Connecticare,Commerical,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Connecticare,Exchange,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,Multiplan,Multiplan,,,17.43,,17.43,15.17,17.43,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-9043-01,NDC,both,1,mL,20.5,12.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.17,17.43,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Aetna,Commerical,,,28.52,,28.52,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Aetna,Middlesex Employees,,,27.35,,27.35,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Anthem,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Anthem,Indemnity,,,27.69,,27.69,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Anthem,Individual Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Anthem,State Preferred,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Cigna,Cigna,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Connecticare,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Connecticare,Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,Multiplan,Multiplan,,,31.42,,31.42,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-1755-50,NDC,both,1,mL,36.96,22.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Aetna,Commerical,,,28.52,,28.52,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Aetna,Middlesex Employees,,,27.35,,27.35,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Anthem,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Anthem,Indemnity,,,27.69,,27.69,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Anthem,Individual Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Anthem,State Preferred,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Cigna,Cigna,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Connecticare,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Connecticare,Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,Multiplan,Multiplan,,,31.42,,31.42,27.35,31.42,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-01,NDC,both,1,mL,36.96,22.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Aetna,Commerical,,,10.94,,10.94,10.49,12.05,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Aetna,Middlesex Employees,,,10.49,,10.49,10.49,12.05,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Anthem,Commerical,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Anthem,Indemnity,,,10.62,,10.62,10.49,12.05,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Anthem,Individual Exchange,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Anthem,State Preferred,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Cigna,Cigna,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Connecticare,Commerical,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Connecticare,Exchange,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,Multiplan,Multiplan,,,12.05,,12.05,10.49,12.05,percent of total billed charges,,
"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-463-57,NDC,both,1,mL,14.18,8.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Aetna,Commerical,,,12.42,,12.42,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Aetna,Middlesex Employees,,,11.9,,11.9,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Anthem,Commerical,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Anthem,Indemnity,,,12.05,,12.05,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Anthem,Individual Exchange,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Anthem,State Preferred,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Cigna,Cigna,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Connecticare,Commerical,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Connecticare,Exchange,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,Multiplan,Multiplan,,,13.68,,13.68,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,J390,HCPCS,40810-0020-06,NDC,both,1,ea,16.09,9.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Aetna,Commerical,,,12.42,,12.42,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Aetna,Middlesex Employees,,,11.9,,11.9,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Anthem,Commerical,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Anthem,Indemnity,,,12.05,,12.05,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Anthem,Individual Exchange,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Anthem,State Preferred,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Cigna,Cigna,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Connecticare,Commerical,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Connecticare,Exchange,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,Multiplan,Multiplan,,,13.68,,13.68,11.9,13.68,percent of total billed charges,,
BUPRENORPHINE 4 MG- NALOXONE 1 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0020-05,NDC,both,1,ea,16.09,9.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.9,13.68,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,J3490,HCPCS,0054-0189-13,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Aetna,Commerical,,,4.97,,4.97,4.28,6.15,percent of total billed charges,,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Aetna,Middlesex Employees,,,4.76,,4.76,4.28,6.15,percent of total billed charges,,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Anthem,Commerical,,,,,,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Anthem,Indemnity,,,4.82,,4.82,4.28,6.15,percent of total billed charges,,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Anthem,Individual Exchange,,,,,,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Anthem,State Preferred,,,,,,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Cigna,Cigna,,4.28,,,4.28,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Connecticare,Commerical,,6.15,,,6.15,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Connecticare,Exchange,,6.15,,,6.15,4.28,6.15,Other,Could be inpatient or outpatient,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,Multiplan,Multiplan,,,5.47,,5.47,4.28,6.15,percent of total billed charges,,
BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,J0592,HCPCS,12496-0757-1,NDC,both,1,mL,6.44,3.86,United Healthcare/Oxford,United Healthcare/Oxford,,4.62,,,4.62,4.28,6.15,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,0904-6636-61,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-01,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 100 MG TABLET,J3490,HCPCS,51079-944-20,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
BUPROPION HCL 37.5 MG ORAL TAB,J3490,HCPCS,40810-0000-63,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
BUPROPION HCL 50 MG ORAL TAB,J3490,HCPCS,40810-0000-64,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Aetna,Commerical,,,2.58,,2.58,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Aetna,Middlesex Employees,,,2.48,,2.48,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Anthem,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Anthem,Indemnity,,,2.51,,2.51,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Anthem,Individual Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Anthem,State Preferred,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Cigna,Cigna,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Connecticare,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Connecticare,Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,Multiplan,Multiplan,,,2.85,,2.85,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,0904-6635-61,NDC,both,1,ea,3.35,2.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Aetna,Commerical,,,2.58,,2.58,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Aetna,Middlesex Employees,,,2.48,,2.48,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Anthem,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Anthem,Indemnity,,,2.51,,2.51,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Anthem,Individual Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Anthem,State Preferred,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Cigna,Cigna,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Connecticare,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Connecticare,Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,Multiplan,Multiplan,,,2.85,,2.85,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-01,NDC,both,1,ea,3.35,2.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Aetna,Commerical,,,2.58,,2.58,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Aetna,Middlesex Employees,,,2.48,,2.48,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Anthem,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Anthem,Indemnity,,,2.51,,2.51,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Anthem,Individual Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Anthem,State Preferred,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Cigna,Cigna,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Connecticare,Commerical,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Connecticare,Exchange,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,Multiplan,Multiplan,,,2.85,,2.85,2.48,2.85,percent of total billed charges,,
BUPROPION HCL 75 MG TABLET,J3490,HCPCS,51079-943-20,NDC,both,1,ea,3.35,2.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.48,2.85,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0410-60,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-01,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,51079-391-20,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-01,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,68084-697-11,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Aetna,Commerical,,,4.99,,4.99,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Aetna,Middlesex Employees,,,4.79,,4.79,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Anthem,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Anthem,Indemnity,,,4.85,,4.85,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Anthem,Individual Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Anthem,State Preferred,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Cigna,Cigna,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Connecticare,Commerical,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Connecticare,Exchange,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,Multiplan,Multiplan,,,5.5,,5.5,4.79,5.5,percent of total billed charges,,
"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-058-01,NDC,both,1,ea,6.47,3.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.79,5.5,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0185-0415-60,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,0591-3541-60,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,50228-175-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",J3490,HCPCS,70436-059-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Aetna,Commerical,,,2.93,,2.93,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Aetna,Middlesex Employees,,,2.81,,2.81,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Anthem,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Anthem,Indemnity,,,2.85,,2.85,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Anthem,Individual Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Anthem,State Preferred,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Cigna,Cigna,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Connecticare,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Connecticare,Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,Multiplan,Multiplan,,,3.23,,3.23,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-7084-04,NDC,both,1,ea,3.8,2.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Aetna,Commerical,,,2.93,,2.93,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Aetna,Middlesex Employees,,,2.81,,2.81,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Anthem,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Anthem,Indemnity,,,2.85,,2.85,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Anthem,Individual Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Anthem,State Preferred,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Cigna,Cigna,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Connecticare,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Connecticare,Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,Multiplan,Multiplan,,,3.23,,3.23,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,40810-0010-50,NDC,both,1,ea,3.8,2.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Aetna,Commerical,,,2.93,,2.93,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Aetna,Middlesex Employees,,,2.81,,2.81,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Anthem,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Anthem,Indemnity,,,2.85,,2.85,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Anthem,Individual Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Anthem,State Preferred,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Cigna,Cigna,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Connecticare,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Connecticare,Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,Multiplan,Multiplan,,,3.23,,3.23,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,43598-655-30,NDC,both,1,ea,3.8,2.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Aetna,Commerical,,,2.93,,2.93,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Aetna,Middlesex Employees,,,2.81,,2.81,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Anthem,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Anthem,Indemnity,,,2.85,,2.85,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Anthem,Individual Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Anthem,State Preferred,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Cigna,Cigna,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Connecticare,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Connecticare,Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,Multiplan,Multiplan,,,3.23,,3.23,2.81,3.23,percent of total billed charges,,
"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-319-06,NDC,both,1,ea,3.8,2.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,0904-6573-04,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68084-252-21,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",J3490,HCPCS,68180-320-06,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,0904-7121-61,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,23155-024-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,40810-0008-18,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
BUSPIRONE 10 MG TABLET,J3490,HCPCS,51079-986-20,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
BUSPIRONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-65,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0093-0053-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,0378-1140-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,23155-023-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
BUSPIRONE 5 MG TABLET,J3490,HCPCS,51079-985-20,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Aetna,Commerical,,,31.68,,31.68,30.38,422.8,percent of total billed charges,,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Aetna,Middlesex Employees,,,30.38,,30.38,30.38,422.8,percent of total billed charges,,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Anthem,Commerical,,,,,,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Anthem,Indemnity,,,30.76,,30.76,30.38,422.8,percent of total billed charges,,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Anthem,Individual Exchange,,,,,,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Anthem,State Preferred,,,,,,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Cigna,Cigna,,158.32,,,158.32,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Connecticare,Commerical,,36.92,,,36.92,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Connecticare,Exchange,,36.92,,,36.92,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,Multiplan,Multiplan,,,34.9,,34.9,30.38,422.8,percent of total billed charges,,
BUSULFAN 2 MG TABLET,J8510,HCPCS,76388-713-25,NDC,both,1,ea,41.06,24.64,United Healthcare/Oxford,United Healthcare/Oxford,,422.8,,,422.8,30.38,422.8,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Aetna,Commerical,,,1480.57,,1480.57,1.17,1631.01,percent of total billed charges,,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Aetna,Middlesex Employees,,,1419.74,,1419.74,1.17,1631.01,percent of total billed charges,,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Anthem,Commerical,,,,,,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Anthem,Indemnity,,,1437.4,,1437.4,1.17,1631.01,percent of total billed charges,,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Anthem,Individual Exchange,,,,,,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Anthem,State Preferred,,,,,,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Cigna,Cigna,,1.35,,,1.35,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Connecticare,Commerical,,1.94,,,1.94,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Connecticare,Exchange,,1.94,,,1.94,1.17,1631.01,Other,Could be inpatient or outpatient,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,Multiplan,Multiplan,,,1631.01,,1631.01,1.17,1631.01,percent of total billed charges,,
BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,J0594,HCPCS,59148-047-90,NDC,both,0.167,mL,1918.83,1151.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.17,,,1.17,1.17,1631.01,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0527-1695-01,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,0603-2544-21,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,J3490,HCPCS,40810-0008-05,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Aetna,Commerical,,,156.51,,156.51,150.08,172.41,percent of total billed charges,,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Aetna,Middlesex Employees,,,150.08,,150.08,150.08,172.41,percent of total billed charges,,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Anthem,Commerical,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Anthem,Indemnity,,,151.95,,151.95,150.08,172.41,percent of total billed charges,,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Anthem,Individual Exchange,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Anthem,State Preferred,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Cigna,Cigna,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Connecticare,Commerical,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Connecticare,Exchange,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,Multiplan,Multiplan,,,172.41,,172.41,150.08,172.41,percent of total billed charges,,
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,J3490,HCPCS,10223-0201-3,NDC,both,1,gm,202.84,121.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,150.08,172.41,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Aetna,Commerical,,,16.24,,16.24,4.32,17.89,percent of total billed charges,,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Aetna,Middlesex Employees,,,15.57,,15.57,4.32,17.89,percent of total billed charges,,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Anthem,Commerical,,,,,,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Anthem,Indemnity,,,15.77,,15.77,4.32,17.89,percent of total billed charges,,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Anthem,Individual Exchange,,,,,,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Anthem,State Preferred,,,,,,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Cigna,Cigna,,4.32,,,4.32,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Connecticare,Commerical,,6.2,,,6.2,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Connecticare,Exchange,,6.2,,,6.2,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,Multiplan,Multiplan,,,17.89,,17.89,4.32,17.89,percent of total billed charges,,
BUTORPHANOL 1 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1623-01,NDC,both,1,mL,21.05,12.63,United Healthcare/Oxford,United Healthcare/Oxford,,4.66,,,4.66,4.32,17.89,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Aetna,Commerical,,,106.04,,106.04,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Aetna,Middlesex Employees,,,101.68,,101.68,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Anthem,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Anthem,Indemnity,,,102.95,,102.95,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Anthem,Individual Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Anthem,State Preferred,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Cigna,Cigna,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Connecticare,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Connecticare,Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,Multiplan,Multiplan,,,116.82,,116.82,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0054-3090-36,NDC,both,1,mL,137.43,82.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Aetna,Commerical,,,106.04,,106.04,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Aetna,Middlesex Employees,,,101.68,,101.68,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Anthem,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Anthem,Indemnity,,,102.95,,102.95,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Anthem,Individual Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Anthem,State Preferred,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Cigna,Cigna,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Connecticare,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Connecticare,Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,Multiplan,Multiplan,,,116.82,,116.82,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,0378-9639-43,NDC,both,1,mL,137.43,82.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Aetna,Commerical,,,106.04,,106.04,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Aetna,Middlesex Employees,,,101.68,,101.68,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Anthem,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Anthem,Indemnity,,,102.95,,102.95,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Anthem,Individual Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Anthem,State Preferred,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Cigna,Cigna,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Connecticare,Commerical,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Connecticare,Exchange,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,Multiplan,Multiplan,,,116.82,,116.82,101.68,116.82,percent of total billed charges,,
BUTORPHANOL 10 MG/ML NASAL SPRAY,J3490,HCPCS,60505-0813-1,NDC,both,1,mL,137.43,82.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.68,116.82,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Aetna,Commerical,,,19.97,,19.97,4.32,22,percent of total billed charges,,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Aetna,Middlesex Employees,,,19.15,,19.15,4.32,22,percent of total billed charges,,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Anthem,Commerical,,,,,,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Anthem,Indemnity,,,19.39,,19.39,4.32,22,percent of total billed charges,,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Anthem,Individual Exchange,,,,,,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Anthem,State Preferred,,,,,,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Cigna,Cigna,,4.32,,,4.32,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Connecticare,Commerical,,6.2,,,6.2,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Connecticare,Exchange,,6.2,,,6.2,4.32,22,Other,Could be inpatient or outpatient,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,Multiplan,Multiplan,,,22,,22,4.32,22,percent of total billed charges,,
BUTORPHANOL 2 MG/ML INJECTION SOLUTION,J0595,HCPCS,0409-1626-01,NDC,both,0.5,mL,25.88,15.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.66,,,4.66,4.32,22,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Aetna,Commerical,,,9089.4,,9089.4,76.58,10012.95,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Aetna,Middlesex Employees,,,8715.98,,8715.98,76.58,10012.95,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Anthem,Commerical,,,,,,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Anthem,Indemnity,,,8824.35,,8824.35,76.58,10012.95,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Anthem,Individual Exchange,,,,,,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Anthem,State Preferred,,,,,,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Cigna,Cigna,,76.58,,,76.58,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Connecticare,Commerical,,104.39,,,104.39,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Connecticare,Exchange,,104.39,,,104.39,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,Multiplan,Multiplan,,,10012.95,,10012.95,76.58,10012.95,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (10 ML)(BERINERT) INTRAVENOUS KIT,J0597,HCPCS,63833-825-02,NDC,both,0.02,ea,11779.94,7067.96,United Healthcare/Oxford,United Healthcare/Oxford,,82.68,,,82.68,76.58,10012.95,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Commerical,,,9176.11,,9176.11,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Middlesex Employees,,,8799.12,,8799.12,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Commerical,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Indemnity,,,8908.53,,8908.53,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Individual Exchange,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,State Preferred,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Cigna,Cigna,,72.64,,,72.64,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Commerical,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Exchange,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,Multiplan,Multiplan,,,10108.46,,10108.46,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-01,NDC,both,0.1,ea,11892.31,7135.39,United Healthcare/Oxford,United Healthcare/Oxford,,78.42,,,78.42,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Commerical,,,9176.11,,9176.11,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Middlesex Employees,,,8799.12,,8799.12,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Commerical,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Indemnity,,,8908.53,,8908.53,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Individual Exchange,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Anthem,State Preferred,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Cigna,Cigna,,72.64,,,72.64,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Commerical,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Exchange,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,Multiplan,Multiplan,,,10108.46,,10108.46,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-081-05,NDC,both,0.1,ea,11892.31,7135.39,United Healthcare/Oxford,United Healthcare/Oxford,,78.42,,,78.42,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Commerical,,,9176.11,,9176.11,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Aetna,Middlesex Employees,,,8799.12,,8799.12,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Commerical,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Indemnity,,,8908.53,,8908.53,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,Individual Exchange,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Anthem,State Preferred,,,,,,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Cigna,Cigna,,72.64,,,72.64,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Commerical,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Connecticare,Exchange,,98.05,,,98.05,72.64,10108.46,Other,Could be inpatient or outpatient,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,Multiplan,Multiplan,,,10108.46,,10108.46,72.64,10108.46,percent of total billed charges,,
C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLUTION,J0598,HCPCS,42227-083-01,NDC,both,0.1,ea,11892.31,7135.39,United Healthcare/Oxford,United Healthcare/Oxford,,78.42,,,78.42,72.64,10108.46,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,38.19,43.87,percent of total billed charges,,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,38.19,43.87,percent of total billed charges,,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Anthem,Commerical,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,38.19,43.87,percent of total billed charges,,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Anthem,Individual Exchange,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Anthem,State Preferred,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Cigna,Cigna,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Connecticare,Commerical,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Connecticare,Exchange,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,38.19,43.87,percent of total billed charges,,
CABERGOLINE 0.25 MG TABLET,J3490,HCPCS,40810-1111-98,NDC,both,1,ea,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.19,43.87,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Aetna,Commerical,,,46.23,,46.23,44.33,50.92,percent of total billed charges,,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Aetna,Middlesex Employees,,,44.33,,44.33,44.33,50.92,percent of total billed charges,,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Anthem,Commerical,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Anthem,Indemnity,,,44.88,,44.88,44.33,50.92,percent of total billed charges,,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Anthem,Individual Exchange,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Anthem,State Preferred,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Cigna,Cigna,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Connecticare,Commerical,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Connecticare,Exchange,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,Multiplan,Multiplan,,,50.92,,50.92,44.33,50.92,percent of total billed charges,,
CABERGOLINE 0.5 MG TABLET,J3490,HCPCS,0093-5420-88,NDC,both,1,ea,59.91,35.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.33,50.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Aetna,Commerical,,,6333.4,,6333.4,6073.2,6976.92,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Aetna,Middlesex Employees,,,6073.2,,6073.2,6073.2,6976.92,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Anthem,Commerical,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Anthem,Indemnity,,,6148.72,,6148.72,6073.2,6976.92,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Anthem,Individual Exchange,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Anthem,State Preferred,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Cigna,Cigna,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Connecticare,Commerical,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Connecticare,Exchange,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,Multiplan,Multiplan,,,6976.92,,6976.92,6073.2,6976.92,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-245-01,NDC,both,2,mL,8208.14,4924.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Aetna,Commerical,,,12666.79,,12666.79,25.9,13953.83,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Aetna,Middlesex Employees,,,12146.4,,12146.4,25.9,13953.83,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Anthem,Commerical,,,,,,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Anthem,Indemnity,,,12297.43,,12297.43,25.9,13953.83,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Anthem,Individual Exchange,,,,,,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Anthem,State Preferred,,,,,,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Cigna,Cigna,,25.9,,,25.9,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Connecticare,Commerical,,34.97,,,34.97,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Connecticare,Exchange,,34.97,,,34.97,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,Multiplan,Multiplan,,,13953.83,,13953.83,25.9,13953.83,percent of total billed charges,,
"CABOTEGRAVIR ER 400 MG/2 ML-RILPIVIRINE ER 600 MG/2ML IM SUSPENSION,ER",J0741,HCPCS,49702-253-15,NDC,both,1,mL,16416.27,9849.76,United Healthcare/Oxford,United Healthcare/Oxford,,27.96,,,27.96,25.9,13953.83,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Aetna,Commerical,,,9500.09,,9500.09,9109.79,10465.36,percent of total billed charges,,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Aetna,Middlesex Employees,,,9109.79,,9109.79,9109.79,10465.36,percent of total billed charges,,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Anthem,Commerical,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Anthem,Indemnity,,,9223.06,,9223.06,9109.79,10465.36,percent of total billed charges,,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Anthem,Individual Exchange,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Anthem,State Preferred,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Cigna,Cigna,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Connecticare,Commerical,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Connecticare,Exchange,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,Multiplan,Multiplan,,,10465.36,,10465.36,9109.79,10465.36,percent of total billed charges,,
"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",J3490,HCPCS,49702-238-01,NDC,both,3,mL,12312.19,7387.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Aetna,Commerical,,,51.18,,51.18,1.72,56.38,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Aetna,Middlesex Employees,,,49.08,,49.08,1.72,56.38,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Anthem,Commerical,,,,,,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Anthem,Indemnity,,,49.69,,49.69,1.72,56.38,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Anthem,Individual Exchange,,,,,,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Anthem,State Preferred,,,,,,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Cigna,Cigna,,1.72,,,1.72,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Connecticare,Commerical,,,,,,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Connecticare,Exchange,,,,,,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,Multiplan,Multiplan,,,56.38,,56.38,1.72,56.38,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0200-99,NDC,both,0.25,mL,66.33,39.8,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,56.38,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Aetna,Commerical,,,102.35,,102.35,1.72,112.75,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Aetna,Middlesex Employees,,,98.15,,98.15,1.72,112.75,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Anthem,Commerical,,,,,,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Anthem,Indemnity,,,99.37,,99.37,1.72,112.75,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Anthem,Individual Exchange,,,,,,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Anthem,State Preferred,,,,,,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Cigna,Cigna,,1.72,,,1.72,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Connecticare,Commerical,,,,,,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Connecticare,Exchange,,,,,,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,Multiplan,Multiplan,,,112.75,,112.75,1.72,112.75,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-03,NDC,both,0.25,mL,132.65,79.59,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,112.75,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Aetna,Commerical,,,153.53,,153.53,1.72,169.12,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Aetna,Middlesex Employees,,,147.22,,147.22,1.72,169.12,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Anthem,Commerical,,,,,,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Anthem,Indemnity,,,149.05,,149.05,1.72,169.12,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Anthem,Individual Exchange,,,,,,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Anthem,State Preferred,,,,,,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Cigna,Cigna,,1.72,,,1.72,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Connecticare,Commerical,,,,,,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Connecticare,Exchange,,,,,,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,Multiplan,Multiplan,,,169.12,,169.12,1.72,169.12,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,40810-0201-04,NDC,both,0.25,mL,198.97,119.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,169.12,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,55150-187-03,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-01,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE 20 MG/ML ORAL SOLUTION,J0706,HCPCS,72485-104-10,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Aetna,Commerical,,,40.3,,40.3,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Aetna,Middlesex Employees,,,38.64,,38.64,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Commerical,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Indemnity,,,39.13,,39.13,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Individual Exchange,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,State Preferred,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Cigna,Cigna,,1.72,,,1.72,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Connecticare,Commerical,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Connecticare,Exchange,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Multiplan,Multiplan,,,44.4,,44.4,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Aetna,Commerical,,,40.3,,40.3,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Aetna,Middlesex Employees,,,38.64,,38.64,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Commerical,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Indemnity,,,39.13,,39.13,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,Individual Exchange,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Anthem,State Preferred,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Cigna,Cigna,,1.72,,,1.72,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Connecticare,Commerical,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Connecticare,Exchange,,,,,,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,Multiplan,Multiplan,,,44.4,,44.4,1.72,44.4,percent of total billed charges,,
CAFFEINE CITRATE 5 MG/ML IN D10W NICU BOLUS,J0706,HCPCS,40810-0004-37,NDC,both,1,mL,52.23,31.34,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,44.4,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-01,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,0641-6164-10,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,25021-601-03,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,42571-244-69,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,47335-289-40,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0500-1,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,51754-0502-1,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-03,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Anthem,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Anthem,Individual Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Anthem,State Preferred,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Cigna,Cigna,,1.72,,,1.72,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Connecticare,Commerical,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Connecticare,Exchange,,,,,,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,1.72,14.1,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,J0706,HCPCS,63323-407-04,NDC,both,0.25,mL,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.1,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Aetna,Commerical,,,59.11,,59.11,1.72,65.12,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Aetna,Middlesex Employees,,,56.68,,56.68,1.72,65.12,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Anthem,Commerical,,,,,,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Anthem,Indemnity,,,57.39,,57.39,1.72,65.12,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Anthem,Individual Exchange,,,,,,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Anthem,State Preferred,,,,,,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Cigna,Cigna,,1.72,,,1.72,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Connecticare,Commerical,,,,,,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Connecticare,Exchange,,,,,,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,Multiplan,Multiplan,,,65.12,,65.12,1.72,65.12,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,25021-602-03,NDC,both,0.25,mL,76.61,45.97,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,65.12,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,1.72,14.42,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,1.72,14.42,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Anthem,Commerical,,,,,,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,1.72,14.42,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Anthem,State Preferred,,,,,,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Cigna,Cigna,,1.72,,,1.72,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Connecticare,Commerical,,,,,,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Connecticare,Exchange,,,,,,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,1.72,14.42,percent of total billed charges,,
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,J0706,HCPCS,47335-290-44,NDC,both,0.25,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.72,14.42,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Aetna,Commerical,,,75.76,,75.76,72.64,83.45,percent of total billed charges,,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Aetna,Middlesex Employees,,,72.64,,72.64,72.64,83.45,percent of total billed charges,,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Anthem,Commerical,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Anthem,Indemnity,,,73.55,,73.55,72.64,83.45,percent of total billed charges,,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Anthem,Individual Exchange,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Anthem,State Preferred,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Cigna,Cigna,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Connecticare,Commerical,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Connecticare,Exchange,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,Multiplan,Multiplan,,,83.45,,83.45,72.64,83.45,percent of total billed charges,,
CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,J3490,HCPCS,0517-2502-10,NDC,both,1,mL,98.18,58.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,72.64,83.45,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Aetna,Commerical,,,4.19,,4.19,4.02,4.62,percent of total billed charges,,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Aetna,Middlesex Employees,,,4.02,,4.02,4.02,4.62,percent of total billed charges,,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Anthem,Commerical,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Anthem,Indemnity,,,4.07,,4.07,4.02,4.62,percent of total billed charges,,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Anthem,Individual Exchange,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Anthem,State Preferred,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Cigna,Cigna,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Connecticare,Commerical,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Connecticare,Exchange,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,Multiplan,Multiplan,,,4.62,,4.62,4.02,4.62,percent of total billed charges,,
CALAMINE 8 %-ZINC OXIDE 8 % LOTION,J3490,HCPCS,0904-2533-21,NDC,both,1,mL,5.43,3.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.02,4.62,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Aetna,Commerical,,,39790.04,,39790.04,93.2,43832.99,percent of total billed charges,,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Aetna,Middlesex Employees,,,38155.33,,38155.33,93.2,43832.99,percent of total billed charges,,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Anthem,Commerical,,,,,,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Anthem,Indemnity,,,38629.75,,38629.75,93.2,43832.99,percent of total billed charges,,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Anthem,Individual Exchange,,,,,,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Anthem,State Preferred,,,,,,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Cigna,Cigna,,107.71,,,107.71,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Connecticare,Commerical,,116.86,,,116.86,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Connecticare,Exchange,,116.86,,,116.86,93.2,43832.99,Other,Could be inpatient or outpatient,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,Multiplan,Multiplan,,,43832.99,,43832.99,93.2,43832.99,percent of total billed charges,,
CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION,J9118,HCPCS,72694-515-01,NDC,both,0.01,mL,51568.22,30940.93,United Healthcare/Oxford,United Healthcare/Oxford,,93.2,,,93.2,93.2,43832.99,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Aetna,Commerical,,,106.07,,106.07,101.71,116.85,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Aetna,Middlesex Employees,,,101.71,,101.71,101.71,116.85,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Anthem,Commerical,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Anthem,Indemnity,,,102.98,,102.98,101.71,116.85,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Anthem,Individual Exchange,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Anthem,State Preferred,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Cigna,Cigna,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Connecticare,Commerical,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Connecticare,Exchange,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,Multiplan,Multiplan,,,116.85,,116.85,101.71,116.85,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,49884-161-11,NDC,both,1,mL,137.47,82.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Aetna,Commerical,,,239.2,,239.2,229.38,263.51,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Aetna,Middlesex Employees,,,229.38,,229.38,229.38,263.51,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Anthem,Commerical,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Anthem,Indemnity,,,232.23,,232.23,229.38,263.51,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Anthem,Individual Exchange,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Anthem,State Preferred,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Cigna,Cigna,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Connecticare,Commerical,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Connecticare,Exchange,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,Multiplan,Multiplan,,,263.51,,263.51,229.38,263.51,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,J3490,HCPCS,60505-0823-6,NDC,both,1,mL,310.01,186.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.38,263.51,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Aetna,Commerical,,,3242.06,,3242.06,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Aetna,Middlesex Employees,,,3108.87,,3108.87,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Anthem,Commerical,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Anthem,Indemnity,,,3147.52,,3147.52,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Anthem,Individual Exchange,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Anthem,State Preferred,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Cigna,Cigna,,1211.33,,,1211.33,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Connecticare,Commerical,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Connecticare,Exchange,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,Multiplan,Multiplan,,,3571.48,,3571.48,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,42023-205-01,NDC,both,2,mL,4201.74,2521.04,United Healthcare/Oxford,United Healthcare/Oxford,,1307.8,,,1307.8,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Commerical,,,3242.06,,3242.06,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Middlesex Employees,,,3108.87,,3108.87,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Commerical,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Indemnity,,,3147.52,,3147.52,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Individual Exchange,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Anthem,State Preferred,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Cigna,Cigna,,1211.33,,,1211.33,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Commerical,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Exchange,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,Multiplan,Multiplan,,,3571.48,,3571.48,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,67457-675-02,NDC,both,2,mL,4201.74,2521.04,United Healthcare/Oxford,United Healthcare/Oxford,,1307.8,,,1307.8,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Commerical,,,3242.06,,3242.06,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Middlesex Employees,,,3108.87,,3108.87,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Commerical,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Indemnity,,,3147.52,,3147.52,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Individual Exchange,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Anthem,State Preferred,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Cigna,Cigna,,1211.33,,,1211.33,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Commerical,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Exchange,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,Multiplan,Multiplan,,,3571.48,,3571.48,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-038-02,NDC,both,2,mL,4201.74,2521.04,United Healthcare/Oxford,United Healthcare/Oxford,,1307.8,,,1307.8,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Commerical,,,3242.06,,3242.06,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Aetna,Middlesex Employees,,,3108.87,,3108.87,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Commerical,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Indemnity,,,3147.52,,3147.52,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Anthem,Individual Exchange,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Anthem,State Preferred,,,,,,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Cigna,Cigna,,1211.33,,,1211.33,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Commerical,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Connecticare,Exchange,,1791.24,,,1791.24,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,Multiplan,Multiplan,,,3571.48,,3571.48,1211.33,3571.48,percent of total billed charges,,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,J0630,HCPCS,72078-039-02,NDC,both,2,mL,4201.74,2521.04,United Healthcare/Oxford,United Healthcare/Oxford,,1307.8,,,1307.8,1211.33,3571.48,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
CALCITRIOL 0.02 MCG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-80,NDC,both,1,mL,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,0054-0007-25,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
CALCITRIOL 0.25 MCG CAPSULE,J3490,HCPCS,23155-662-03,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,1.14,,,1.14,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,1.21,,,1.21,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,1.21,,,1.21,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,1.31,,,1.31,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,1.14,,,1.14,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,1.21,,,1.21,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,1.21,,,1.21,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,1.14,24.42,percent of total billed charges,,
CALCITRIOL 1 MCG/ML IV ORDER SPECIFIC WEIGHT,J0636,HCPCS,17478-931-01,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,1.31,,,1.31,1.14,24.42,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Aetna,Commerical,,,233.88,,233.88,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Aetna,Middlesex Employees,,,224.27,,224.27,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Anthem,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Anthem,Indemnity,,,227.06,,227.06,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Anthem,Individual Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Anthem,State Preferred,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Cigna,Cigna,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Connecticare,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Connecticare,Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,Multiplan,Multiplan,,,257.64,,257.64,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,0054-3120-41,NDC,both,1,mL,303.11,181.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Aetna,Commerical,,,233.88,,233.88,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Aetna,Middlesex Employees,,,224.27,,224.27,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Anthem,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Anthem,Indemnity,,,227.06,,227.06,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Anthem,Individual Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Anthem,State Preferred,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Cigna,Cigna,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Connecticare,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Connecticare,Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,Multiplan,Multiplan,,,257.64,,257.64,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,63304-241-59,NDC,both,1,mL,303.11,181.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Aetna,Commerical,,,233.88,,233.88,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Aetna,Middlesex Employees,,,224.27,,224.27,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Anthem,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Anthem,Indemnity,,,227.06,,227.06,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Anthem,Individual Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Anthem,State Preferred,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Cigna,Cigna,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Connecticare,Commerical,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Connecticare,Exchange,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,Multiplan,Multiplan,,,257.64,,257.64,224.27,257.64,percent of total billed charges,,
CALCITRIOL 1 MCG/ML ORAL SOLUTION,J3490,HCPCS,64980-447-15,NDC,both,1,mL,303.11,181.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,224.27,257.64,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,66553-004-01,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-32,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,J3490,HCPCS,68084-988-33,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,904506260,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,J3490,HCPCS,8068114000,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,904188261,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,J3490,HCPCS,5164582699,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET",J3490,HCPCS,5026814913,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",J3490,HCPCS,904188361,NDC,both,1,ea,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,3786408289,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582806,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,J3490,HCPCS,5164582899,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Aetna,Commerical,,,28.08,,28.08,26.92,30.93,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Aetna,Middlesex Employees,,,26.92,,26.92,26.92,30.93,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Anthem,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Anthem,Indemnity,,,27.26,,27.26,26.92,30.93,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Anthem,Individual Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Anthem,State Preferred,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Cigna,Cigna,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Connecticare,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Connecticare,Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,Multiplan,Multiplan,,,30.93,,30.93,26.92,30.93,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,54311763,NDC,both,1,mL,36.39,21.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Aetna,Commerical,,,26.57,,26.57,25.47,29.27,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Aetna,Middlesex Employees,,,25.47,,25.47,25.47,29.27,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Anthem,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Anthem,Indemnity,,,25.79,,25.79,25.47,29.27,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Anthem,Individual Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Anthem,State Preferred,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Cigna,Cigna,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Connecticare,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Connecticare,Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,Multiplan,Multiplan,,,29.27,,29.27,25.47,29.27,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-0766-16,NDC,both,1,mL,34.43,20.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,0121-4766-05,NDC,both,1,mL,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Aetna,Commerical,,,2.81,,2.81,2.69,3.09,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Aetna,Middlesex Employees,,,2.69,,2.69,2.69,3.09,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Anthem,Commerical,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Anthem,Indemnity,,,2.73,,2.73,2.69,3.09,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Anthem,Individual Exchange,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Anthem,State Preferred,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Cigna,Cigna,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Connecticare,Commerical,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Connecticare,Exchange,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,Multiplan,Multiplan,,,3.09,,3.09,2.69,3.09,percent of total billed charges,,
"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",J3490,HCPCS,40810-0208-33,NDC,both,1,mL,3.64,2.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.69,3.09,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
CALCIUM 500 MG-VITAMIN D3 100 UNIT-VITAMIN K 40 MCG CHEWABLE TABLET,J3490,HCPCS,30045-0219-60,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3160401237,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,3786473299,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 10 MCG (400 UNIT) TABLET,J3490,HCPCS,40810-0014-06,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
CALCIUM 600 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) CAPSULE,J3490,HCPCS,4098522653,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,5952803312,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,7132180320,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
CALCIUM ACETATE 667 MG TABLET,J3490,HCPCS,40810-0204-27,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",J3490,HCPCS,5707400177,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Aetna,Commerical,,,1.62,,1.62,1.55,1.79,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Aetna,Middlesex Employees,,,1.55,,1.55,1.55,1.79,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Anthem,Commerical,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Anthem,Indemnity,,,1.57,,1.57,1.55,1.79,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Anthem,Individual Exchange,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Anthem,State Preferred,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Cigna,Cigna,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Connecticare,Commerical,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Connecticare,Exchange,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,Multiplan,Multiplan,,,1.79,,1.79,1.55,1.79,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,J8499,HCPCS,0054-0088-26,NDC,both,1,ea,2.1,1.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.55,1.79,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Aetna,Commerical,,,1.25,,1.25,1.2,1.38,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Aetna,Middlesex Employees,,,1.2,,1.2,1.2,1.38,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Anthem,Commerical,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Anthem,Indemnity,,,1.21,,1.21,1.2,1.38,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Anthem,Individual Exchange,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Anthem,State Preferred,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Cigna,Cigna,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Connecticare,Commerical,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Connecticare,Exchange,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,Multiplan,Multiplan,,,1.38,,1.38,1.2,1.38,percent of total billed charges,,
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG TABLET,J8499,HCPCS,0574-0113-02,NDC,both,1,ea,1.62,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
CALCIUM CARBONATE 100 MG CALCIUM (250 MG) ORAL CHEW,J3490,HCPCS,40810-0000-67,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Aetna,Commerical,,,57.45,,57.45,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Aetna,Middlesex Employees,,,55.09,,55.09,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Commerical,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Indemnity,,,55.78,,55.78,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Individual Exchange,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,State Preferred,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Cigna,Cigna,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Connecticare,Commerical,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Connecticare,Exchange,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Multiplan,Multiplan,,,63.29,,63.29,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Aetna,Commerical,,,27.87,,27.87,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Aetna,Middlesex Employees,,,26.73,,26.73,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Anthem,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Anthem,Indemnity,,,27.06,,27.06,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Anthem,Individual Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Anthem,State Preferred,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Cigna,Cigna,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Connecticare,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Connecticare,Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,Multiplan,Multiplan,,,30.7,,30.7,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-1631-10,NDC,both,10,mL,36.12,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Aetna,Commerical,,,27.87,,27.87,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Aetna,Middlesex Employees,,,26.73,,26.73,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Anthem,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Anthem,Indemnity,,,27.06,,27.06,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Anthem,Individual Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Anthem,State Preferred,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Cigna,Cigna,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Connecticare,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Connecticare,Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,Multiplan,Multiplan,,,30.7,,30.7,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-11,NDC,both,10,mL,36.12,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Aetna,Commerical,,,27.87,,27.87,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Aetna,Middlesex Employees,,,26.73,,26.73,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Anthem,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Anthem,Indemnity,,,27.06,,27.06,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Anthem,Individual Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Anthem,State Preferred,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Cigna,Cigna,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Connecticare,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Connecticare,Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,Multiplan,Multiplan,,,30.7,,30.7,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4928-34,NDC,both,10,mL,36.12,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Aetna,Commerical,,,27.87,,27.87,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Aetna,Middlesex Employees,,,26.73,,26.73,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Anthem,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Anthem,Indemnity,,,27.06,,27.06,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Anthem,Individual Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Anthem,State Preferred,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Cigna,Cigna,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Connecticare,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Connecticare,Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,Multiplan,Multiplan,,,30.7,,30.7,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-30,NDC,both,10,mL,36.12,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Aetna,Commerical,,,27.87,,27.87,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Aetna,Middlesex Employees,,,26.73,,26.73,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Anthem,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Anthem,Indemnity,,,27.06,,27.06,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Anthem,Individual Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Anthem,State Preferred,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Cigna,Cigna,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Connecticare,Commerical,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Connecticare,Exchange,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,Multiplan,Multiplan,,,30.7,,30.7,26.73,30.7,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,J3490,HCPCS,64253-900-91,NDC,both,10,mL,36.12,21.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.73,30.7,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Aetna,Commerical,,,57.45,,57.45,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Aetna,Middlesex Employees,,,55.09,,55.09,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Commerical,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Indemnity,,,55.78,,55.78,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,Individual Exchange,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Anthem,State Preferred,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Cigna,Cigna,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Connecticare,Commerical,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Connecticare,Exchange,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,Multiplan,Multiplan,,,63.29,,63.29,55.09,63.29,percent of total billed charges,,
CALCIUM CHLORIDE 100 MG/ML ORAL SOLN,J3490,HCPCS,0517-6710-10,NDC,both,1,mL,74.46,44.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,55.09,63.29,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Aetna,Commerical,,,23.47,,23.47,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Aetna,Middlesex Employees,,,22.51,,22.51,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Commerical,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Indemnity,,,22.79,,22.79,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Individual Exchange,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,State Preferred,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Cigna,Cigna,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Connecticare,Commerical,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Connecticare,Exchange,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Multiplan,Multiplan,,,25.86,,25.86,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Aetna,Commerical,,,135.21,,135.21,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Aetna,Middlesex Employees,,,129.65,,129.65,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Anthem,Commerical,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Anthem,Indemnity,,,131.26,,131.26,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Anthem,Individual Exchange,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Anthem,State Preferred,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Cigna,Cigna,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Connecticare,Commerical,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Connecticare,Exchange,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,Multiplan,Multiplan,,,148.95,,148.95,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-03,NDC,both,10,mL,175.23,105.14,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Aetna,Commerical,,,270.41,,270.41,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Aetna,Middlesex Employees,,,259.3,,259.3,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Anthem,Commerical,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Anthem,Indemnity,,,262.52,,262.52,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Anthem,Individual Exchange,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Anthem,State Preferred,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Cigna,Cigna,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Connecticare,Commerical,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Connecticare,Exchange,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,Multiplan,Multiplan,,,297.88,,297.88,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-05,NDC,both,10,mL,350.45,210.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Aetna,Commerical,,,23.47,,23.47,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Aetna,Middlesex Employees,,,22.51,,22.51,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Commerical,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Indemnity,,,22.79,,22.79,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Individual Exchange,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,State Preferred,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Cigna,Cigna,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Connecticare,Commerical,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Connecticare,Exchange,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Multiplan,Multiplan,,,25.86,,25.86,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Aetna,Commerical,,,135.21,,135.21,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Aetna,Middlesex Employees,,,129.65,,129.65,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Anthem,Commerical,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Anthem,Indemnity,,,131.26,,131.26,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Anthem,Individual Exchange,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Anthem,State Preferred,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Cigna,Cigna,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Connecticare,Commerical,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Connecticare,Exchange,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,Multiplan,Multiplan,,,148.95,,148.95,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-59,NDC,both,10,mL,175.23,105.14,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Commerical,,,586.62,,586.62,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Middlesex Employees,,,562.52,,562.52,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Commerical,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Indemnity,,,569.51,,569.51,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Individual Exchange,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,State Preferred,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Cigna,Cigna,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Commerical,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Exchange,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Multiplan,Multiplan,,,646.22,,646.22,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,35.05,21.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,35.05,21.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Aetna,Commerical,,,135.21,,135.21,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Aetna,Middlesex Employees,,,129.65,,129.65,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Commerical,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Indemnity,,,131.26,,131.26,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Individual Exchange,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,State Preferred,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Cigna,Cigna,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Connecticare,Commerical,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Connecticare,Exchange,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Multiplan,Multiplan,,,148.95,,148.95,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Aetna,Commerical,,,270.41,,270.41,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Aetna,Middlesex Employees,,,259.3,,259.3,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Commerical,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Indemnity,,,262.52,,262.52,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,State Preferred,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Cigna,Cigna,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Connecticare,Commerical,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Connecticare,Exchange,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Multiplan,Multiplan,,,297.88,,297.88,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Commerical,,,586.62,,586.62,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Middlesex Employees,,,562.52,,562.52,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Commerical,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Indemnity,,,569.51,,569.51,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Individual Exchange,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,State Preferred,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Cigna,Cigna,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Commerical,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Exchange,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Multiplan,Multiplan,,,646.22,,646.22,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML (10%) PLASMAPHERESIS,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Aetna,Commerical,,,23.47,,23.47,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Aetna,Middlesex Employees,,,22.51,,22.51,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Commerical,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Indemnity,,,22.79,,22.79,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,Individual Exchange,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Anthem,State Preferred,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Cigna,Cigna,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Connecticare,Commerical,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Connecticare,Exchange,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,Multiplan,Multiplan,,,25.86,,25.86,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-01,NDC,both,10,mL,30.42,18.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Aetna,Commerical,,,135.21,,135.21,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Aetna,Middlesex Employees,,,129.65,,129.65,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Commerical,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Indemnity,,,131.26,,131.26,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,Individual Exchange,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Anthem,State Preferred,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Cigna,Cigna,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Connecticare,Commerical,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Connecticare,Exchange,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,Multiplan,Multiplan,,,148.95,,148.95,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-03,NDC,both,10,mL,74.69,44.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Aetna,Commerical,,,270.41,,270.41,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Aetna,Middlesex Employees,,,259.3,,259.3,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Commerical,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Indemnity,,,262.52,,262.52,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Anthem,State Preferred,,,,,,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Cigna,Cigna,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Connecticare,Commerical,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Connecticare,Exchange,,0.06,,,0.06,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,Multiplan,Multiplan,,,297.88,,297.88,0.05,297.88,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-05,NDC,both,10,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,297.88,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Aetna,Commerical,,,23.47,,23.47,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Aetna,Middlesex Employees,,,22.51,,22.51,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Commerical,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Indemnity,,,22.79,,22.79,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,Individual Exchange,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Anthem,State Preferred,,,,,,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Cigna,Cigna,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Connecticare,Commerical,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Connecticare,Exchange,,0.06,,,0.06,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,Multiplan,Multiplan,,,25.86,,25.86,0.05,25.86,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-19,NDC,both,10,mL,30.42,18.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,25.86,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Aetna,Commerical,,,135.21,,135.21,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Aetna,Middlesex Employees,,,129.65,,129.65,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Anthem,Commerical,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Anthem,Indemnity,,,131.26,,131.26,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Anthem,Individual Exchange,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Anthem,State Preferred,,,,,,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Cigna,Cigna,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Connecticare,Commerical,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Connecticare,Exchange,,0.06,,,0.06,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,Multiplan,Multiplan,,,148.95,,148.95,0.05,148.95,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-59,NDC,both,10,mL,74.69,44.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,148.95,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Commerical,,,586.62,,586.62,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Aetna,Middlesex Employees,,,562.52,,562.52,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Commerical,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Indemnity,,,569.51,,569.51,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,Individual Exchange,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Anthem,State Preferred,,,,,,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Cigna,Cigna,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Commerical,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Connecticare,Exchange,,0.06,,,0.06,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,Multiplan,Multiplan,,,646.22,,646.22,0.05,646.22,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,63323-360-61,NDC,both,10,mL,760.26,456.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,646.22,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-01,NDC,both,0.1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Aetna,Commerical,,,27.04,,27.04,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Aetna,Middlesex Employees,,,25.93,,25.93,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Commerical,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Indemnity,,,26.26,,26.26,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Anthem,State Preferred,,,,,,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Cigna,Cigna,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Connecticare,Commerical,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Connecticare,Exchange,,0.06,,,0.06,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,Multiplan,Multiplan,,,29.79,,29.79,0.05,29.79,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J0612,HCPCS,75834-171-19,NDC,both,0.1,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.05,,,0.05,0.05,29.79,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Aetna,Commerical,,,115.25,,115.25,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Aetna,Middlesex Employees,,,110.52,,110.52,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Anthem,Commerical,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Anthem,Indemnity,,,111.89,,111.89,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Anthem,State Preferred,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Cigna,Cigna,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Connecticare,Commerical,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Connecticare,Exchange,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,Multiplan,Multiplan,,,126.96,,126.96,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-01,NDC,both,1,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Aetna,Commerical,,,115.25,,115.25,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Aetna,Middlesex Employees,,,110.52,,110.52,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Anthem,Commerical,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Anthem,Indemnity,,,111.89,,111.89,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Anthem,State Preferred,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Cigna,Cigna,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Connecticare,Commerical,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Connecticare,Exchange,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,Multiplan,Multiplan,,,126.96,,126.96,110.52,126.96,percent of total billed charges,,
CALCIUM GLUCONATE 100 MG/ML ORAL SOLN,J3490,HCPCS,70069-728-20,NDC,both,1,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,110.52,126.96,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Aetna,Commerical,,,46.4,,46.4,44.5,51.12,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Aetna,Middlesex Employees,,,44.5,,44.5,44.5,51.12,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Anthem,Commerical,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Anthem,Indemnity,,,45.05,,45.05,44.5,51.12,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Anthem,Individual Exchange,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Anthem,State Preferred,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Cigna,Cigna,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Connecticare,Commerical,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Connecticare,Exchange,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,Multiplan,Multiplan,,,51.12,,51.12,44.5,51.12,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-01,NDC,both,1,mL,60.14,36.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.5,51.12,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Aetna,Commerical,,,27.84,,27.84,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Aetna,Middlesex Employees,,,26.7,,26.7,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Anthem,Commerical,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Anthem,Indemnity,,,27.03,,27.03,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Anthem,Individual Exchange,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Anthem,State Preferred,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Cigna,Cigna,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Connecticare,Commerical,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Connecticare,Exchange,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,Multiplan,Multiplan,,,30.67,,30.67,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-06,NDC,both,1,mL,36.08,21.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Aetna,Commerical,,,3649.71,,3649.71,3499.76,4020.54,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Aetna,Middlesex Employees,,,3499.76,,3499.76,3499.76,4020.54,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Anthem,Commerical,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Anthem,Indemnity,,,3543.28,,3543.28,3499.76,4020.54,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Anthem,Individual Exchange,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Anthem,State Preferred,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Cigna,Cigna,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Connecticare,Commerical,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Connecticare,Exchange,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,Multiplan,Multiplan,,,4020.54,,4020.54,3499.76,4020.54,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-10,NDC,both,1,mL,4730.05,2838.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3499.76,4020.54,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Aetna,Commerical,,,27.84,,27.84,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Aetna,Middlesex Employees,,,26.7,,26.7,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Anthem,Commerical,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Anthem,Indemnity,,,27.03,,27.03,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Anthem,Individual Exchange,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Anthem,State Preferred,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Cigna,Cigna,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Connecticare,Commerical,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Connecticare,Exchange,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,Multiplan,Multiplan,,,30.67,,30.67,26.7,30.67,percent of total billed charges,,
CANNABIDIOL 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70127-100-60,NDC,both,1,mL,36.08,21.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.7,30.67,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Aetna,Commerical,,,1153.02,,1153.02,1105.65,1270.17,percent of total billed charges,,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Aetna,Middlesex Employees,,,1105.65,,1105.65,1105.65,1270.17,percent of total billed charges,,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Anthem,Commerical,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Anthem,Indemnity,,,1119.4,,1119.4,1105.65,1270.17,percent of total billed charges,,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Anthem,Individual Exchange,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Anthem,State Preferred,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Cigna,Cigna,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Connecticare,Commerical,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Connecticare,Exchange,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,Multiplan,Multiplan,,,1270.17,,1270.17,1105.65,1270.17,percent of total billed charges,,
CANTHARIDIN (BULK) POWDER,J3490,HCPCS,38779-0389-0,NDC,both,0.5,gm,1494.32,896.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1105.65,1270.17,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Aetna,Commerical,,,3.5,,3.5,0.1,3.85,percent of total billed charges,,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Aetna,Middlesex Employees,,,3.35,,3.35,0.1,3.85,percent of total billed charges,,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Anthem,Commerical,,,,,,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Anthem,Indemnity,,,3.39,,3.39,0.1,3.85,percent of total billed charges,,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Anthem,Individual Exchange,,,,,,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Anthem,State Preferred,,,,,,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Cigna,Cigna,,,,,,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Connecticare,Commerical,,0.1,,,0.1,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Connecticare,Exchange,,0.1,,,0.1,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,Multiplan,Multiplan,,,3.85,,3.85,0.1,3.85,percent of total billed charges,,
CAPECITABINE 150 MG TABLET,J8522,HCPCS,0093-7473-06,NDC,both,0.334,ea,4.53,2.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,3.85,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Aetna,Commerical,,,4.92,,4.92,0.1,5.41,percent of total billed charges,,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Aetna,Middlesex Employees,,,4.71,,4.71,0.1,5.41,percent of total billed charges,,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Anthem,Commerical,,,,,,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Anthem,Indemnity,,,4.77,,4.77,0.1,5.41,percent of total billed charges,,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Anthem,Individual Exchange,,,,,,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Anthem,State Preferred,,,,,,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Cigna,Cigna,,,,,,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Connecticare,Commerical,,0.1,,,0.1,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Connecticare,Exchange,,0.1,,,0.1,0.1,5.41,Other,Could be inpatient or outpatient,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,Multiplan,Multiplan,,,5.41,,5.41,0.1,5.41,percent of total billed charges,,
CAPECITABINE 500 MG TABLET,J8522,HCPCS,0093-7474-89,NDC,both,0.1,ea,6.37,3.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,5.41,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Anthem,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Anthem,Individual Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Anthem,State Preferred,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Cigna,Cigna,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Connecticare,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Connecticare,Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,41167-0192-01,NDC,both,1,ea,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Anthem,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Anthem,Individual Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Anthem,State Preferred,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Cigna,Cigna,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Connecticare,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Connecticare,Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,46581-700-03,NDC,both,1,ea,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Anthem,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Anthem,Individual Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Anthem,State Preferred,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Cigna,Cigna,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Connecticare,Commerical,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Connecticare,Exchange,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,3.77,4.34,percent of total billed charges,,
CAPSAICIN 0.025 % TOPICAL PATCH,J3490,HCPCS,70000-0556-1,NDC,both,1,ea,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.34,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Aetna,Commerical,,,27.79,,27.79,26.64,30.61,percent of total billed charges,,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Aetna,Middlesex Employees,,,26.64,,26.64,26.64,30.61,percent of total billed charges,,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Anthem,Commerical,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Anthem,Indemnity,,,26.98,,26.98,26.64,30.61,percent of total billed charges,,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Anthem,Individual Exchange,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Anthem,State Preferred,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Cigna,Cigna,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Connecticare,Commerical,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Connecticare,Exchange,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,Multiplan,Multiplan,,,30.61,,30.61,26.64,30.61,percent of total billed charges,,
CAPTOPRIL 0.03 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0017-46,NDC,both,1,mL,36.01,21.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.64,30.61,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Aetna,Commerical,,,13.9,,13.9,13.33,15.31,percent of total billed charges,,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Aetna,Middlesex Employees,,,13.33,,13.33,13.33,15.31,percent of total billed charges,,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Anthem,Commerical,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Anthem,Indemnity,,,13.49,,13.49,13.33,15.31,percent of total billed charges,,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Anthem,Individual Exchange,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Anthem,State Preferred,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Cigna,Cigna,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Connecticare,Commerical,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Connecticare,Exchange,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,Multiplan,Multiplan,,,15.31,,15.31,13.33,15.31,percent of total billed charges,,
CAPTOPRIL 1 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0004-21,NDC,both,1,mL,18.01,10.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.33,15.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,0904-7105-61,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
CAPTOPRIL 12.5 MG TABLET,J3490,HCPCS,51079-863-20,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Aetna,Commerical,,,3.72,,3.72,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Aetna,Middlesex Employees,,,3.57,,3.57,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Anthem,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Anthem,Indemnity,,,3.61,,3.61,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Anthem,Individual Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Anthem,State Preferred,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Cigna,Cigna,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Connecticare,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Connecticare,Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,Multiplan,Multiplan,,,4.1,,4.1,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,0904-7106-61,NDC,both,1,ea,4.82,2.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Aetna,Commerical,,,3.72,,3.72,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Aetna,Middlesex Employees,,,3.57,,3.57,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Anthem,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Anthem,Indemnity,,,3.61,,3.61,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Anthem,Individual Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Anthem,State Preferred,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Cigna,Cigna,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Connecticare,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Connecticare,Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,Multiplan,Multiplan,,,4.1,,4.1,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-01,NDC,both,1,ea,4.82,2.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Aetna,Commerical,,,3.72,,3.72,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Aetna,Middlesex Employees,,,3.57,,3.57,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Anthem,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Anthem,Indemnity,,,3.61,,3.61,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Anthem,Individual Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Anthem,State Preferred,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Cigna,Cigna,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Connecticare,Commerical,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Connecticare,Exchange,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,Multiplan,Multiplan,,,4.1,,4.1,3.57,4.1,percent of total billed charges,,
CAPTOPRIL 25 MG TABLET,J3490,HCPCS,51079-864-20,NDC,both,1,ea,4.82,2.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.57,4.1,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Aetna,Commerical,,,5.19,,5.19,4.97,5.71,percent of total billed charges,,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Aetna,Middlesex Employees,,,4.97,,4.97,4.97,5.71,percent of total billed charges,,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Anthem,Commerical,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Anthem,Indemnity,,,5.03,,5.03,4.97,5.71,percent of total billed charges,,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Anthem,Individual Exchange,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Anthem,State Preferred,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Cigna,Cigna,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Connecticare,Commerical,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Connecticare,Exchange,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,Multiplan,Multiplan,,,5.71,,5.71,4.97,5.71,percent of total billed charges,,
CAPTOPRIL 50 MG TABLET,J3490,HCPCS,0143-1173-01,NDC,both,1,ea,6.72,4.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
CAPTOPRIL 6.25 MG ORAL TAB,J3490,HCPCS,40810-0000-71,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Aetna,Commerical,,,40.25,,40.25,38.59,44.34,percent of total billed charges,,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Aetna,Middlesex Employees,,,38.59,,38.59,38.59,44.34,percent of total billed charges,,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Anthem,Commerical,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Anthem,Indemnity,,,39.07,,39.07,38.59,44.34,percent of total billed charges,,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Anthem,Individual Exchange,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Anthem,State Preferred,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Cigna,Cigna,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Connecticare,Commerical,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Connecticare,Exchange,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,Multiplan,Multiplan,,,44.34,,44.34,38.59,44.34,percent of total billed charges,,
CARBACHOL 0.01 % INTRAOCULAR SOLUTION,J3490,HCPCS,0065-0023-15,NDC,both,1.5,mL,52.16,31.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.59,44.34,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,0904-3854-61,NDC,both,1,ea,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,40810-0010-60,NDC,both,1,ea,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
CARBAMAZEPINE 100 MG CHEWABLE TABLET,J3490,HCPCS,51079-870-20,NDC,both,1,ea,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 100 MG ORAL TAB,J3490,HCPCS,40810-0000-72,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Aetna,Commerical,,,285.92,,285.92,274.18,314.98,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Aetna,Middlesex Employees,,,274.18,,274.18,274.18,314.98,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Anthem,Commerical,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Anthem,Indemnity,,,277.59,,277.59,274.18,314.98,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Anthem,Individual Exchange,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Anthem,State Preferred,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Cigna,Cigna,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Connecticare,Commerical,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Connecticare,Exchange,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,Multiplan,Multiplan,,,314.98,,314.98,274.18,314.98,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0078-0508-83,NDC,both,1,mL,370.56,222.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,274.18,314.98,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Aetna,Commerical,,,140.97,,140.97,135.18,155.3,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Aetna,Middlesex Employees,,,135.18,,135.18,135.18,155.3,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Anthem,Commerical,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Anthem,Indemnity,,,136.86,,136.86,135.18,155.3,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Anthem,Individual Exchange,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Anthem,State Preferred,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Cigna,Cigna,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Connecticare,Commerical,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Connecticare,Exchange,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,Multiplan,Multiplan,,,155.3,,155.3,135.18,155.3,percent of total billed charges,,
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4047-9,NDC,both,1,mL,182.7,109.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,135.18,155.3,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,0904-6172-61,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Aetna,Commerical,,,1.56,,1.56,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Anthem,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Anthem,Individual Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Anthem,State Preferred,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Cigna,Cigna,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Connecticare,Commerical,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Connecticare,Exchange,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,Multiplan,Multiplan,,,1.72,,1.72,1.49,1.72,percent of total billed charges,,
CARBAMAZEPINE 200 MG TABLET,J3490,HCPCS,51079-385-20,NDC,both,1,ea,2.02,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.72,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL CHEW,J3490,HCPCS,40810-0000-73,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
CARBAMAZEPINE 50 MG ORAL TAB,J3490,HCPCS,40810-0000-74,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Aetna,Commerical,,,3.63,,3.63,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Aetna,Middlesex Employees,,,3.48,,3.48,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Anthem,Commerical,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Anthem,Indemnity,,,3.52,,3.52,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Anthem,Individual Exchange,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Anthem,State Preferred,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Cigna,Cigna,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Connecticare,Commerical,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Connecticare,Exchange,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,Multiplan,Multiplan,,,4,,4,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,29033-019-12,NDC,both,1,ea,4.7,2.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Aetna,Commerical,,,3.63,,3.63,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Aetna,Middlesex Employees,,,3.48,,3.48,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Anthem,Commerical,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Anthem,Indemnity,,,3.52,,3.52,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Anthem,Individual Exchange,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Anthem,State Preferred,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Cigna,Cigna,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Connecticare,Commerical,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Connecticare,Exchange,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,Multiplan,Multiplan,,,4,,4,3.48,4,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-83,NDC,both,1,ea,4.7,2.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.48,4,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2805-7,NDC,both,1,ea,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Anthem,Commerical,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Anthem,Individual Exchange,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Anthem,State Preferred,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Cigna,Cigna,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Connecticare,Commerical,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Connecticare,Exchange,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0510-05,NDC,both,1,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Anthem,Commerical,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Anthem,Individual Exchange,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Anthem,State Preferred,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Cigna,Cigna,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Connecticare,Commerical,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Connecticare,Exchange,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,1.23,1.41,percent of total billed charges,,
"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4123-1,NDC,both,1,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.23,1.41,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2806-7,NDC,both,1,ea,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Aetna,Commerical,,,4.6,,4.6,4.41,5.07,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Aetna,Middlesex Employees,,,4.41,,4.41,4.41,5.07,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Anthem,Commerical,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Anthem,Indemnity,,,4.46,,4.46,4.41,5.07,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Anthem,Individual Exchange,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Anthem,State Preferred,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Cigna,Cigna,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Connecticare,Commerical,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Connecticare,Exchange,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,Multiplan,Multiplan,,,5.07,,5.07,4.41,5.07,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-408-32,NDC,both,1,ea,5.96,3.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.41,5.07,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,0078-0511-05,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Aetna,Commerical,,,3.8,,3.8,3.65,4.19,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Aetna,Middlesex Employees,,,3.65,,3.65,3.65,4.19,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Anthem,Commerical,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Anthem,Indemnity,,,3.69,,3.69,3.65,4.19,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Anthem,Individual Exchange,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Anthem,State Preferred,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Cigna,Cigna,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Connecticare,Commerical,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Connecticare,Exchange,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,Multiplan,Multiplan,,,4.19,,4.19,3.65,4.19,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,51672-4124-1,NDC,both,1,ea,4.93,2.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68084-561-11,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Aetna,Commerical,,,3.49,,3.49,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Aetna,Middlesex Employees,,,3.34,,3.34,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Anthem,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Anthem,Indemnity,,,3.39,,3.39,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Anthem,Individual Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Anthem,State Preferred,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Cigna,Cigna,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Connecticare,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Connecticare,Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,Multiplan,Multiplan,,,3.84,,3.84,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,40810-0004-82,NDC,both,1,ea,4.52,2.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Aetna,Commerical,,,3.49,,3.49,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Aetna,Middlesex Employees,,,3.34,,3.34,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Anthem,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Anthem,Indemnity,,,3.39,,3.39,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Anthem,Individual Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Anthem,State Preferred,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Cigna,Cigna,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Connecticare,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Connecticare,Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,Multiplan,Multiplan,,,3.84,,3.84,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,54092-173-12,NDC,both,1,ea,4.52,2.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,60505-2807-7,NDC,both,1,ea,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Aetna,Commerical,,,3.49,,3.49,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Aetna,Middlesex Employees,,,3.34,,3.34,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Anthem,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Anthem,Indemnity,,,3.39,,3.39,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Anthem,Individual Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Anthem,State Preferred,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Cigna,Cigna,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Connecticare,Commerical,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Connecticare,Exchange,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,Multiplan,Multiplan,,,3.84,,3.84,3.34,3.84,percent of total billed charges,,
"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",J3490,HCPCS,66993-409-32,NDC,both,1,ea,4.52,2.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.34,3.84,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Aetna,Commerical,,,14.95,,14.95,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Aetna,Middlesex Employees,,,14.33,,14.33,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Anthem,Commerical,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Anthem,Indemnity,,,14.51,,14.51,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Anthem,Individual Exchange,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Anthem,State Preferred,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Cigna,Cigna,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Connecticare,Commerical,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Connecticare,Exchange,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,Multiplan,Multiplan,,,16.46,,16.46,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710478,NDC,both,1,mL,19.37,11.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Aetna,Commerical,,,15.39,,15.39,14.75,16.95,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Aetna,Middlesex Employees,,,14.75,,14.75,14.75,16.95,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Anthem,Commerical,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Anthem,Indemnity,,,14.94,,14.94,14.75,16.95,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Anthem,Individual Exchange,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Anthem,State Preferred,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Cigna,Cigna,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Connecticare,Commerical,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Connecticare,Exchange,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,Multiplan,Multiplan,,,16.95,,16.95,14.75,16.95,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,4203710479,NDC,both,1,mL,19.94,11.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Aetna,Commerical,,,16.32,,16.32,15.65,17.98,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Aetna,Middlesex Employees,,,15.65,,15.65,15.65,17.98,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Anthem,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Anthem,Indemnity,,,15.84,,15.84,15.65,17.98,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Anthem,Individual Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Anthem,State Preferred,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Cigna,Cigna,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Connecticare,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Connecticare,Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,Multiplan,Multiplan,,,17.98,,17.98,15.65,17.98,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273621,NDC,both,1,mL,21.15,12.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Aetna,Commerical,,,14.95,,14.95,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Aetna,Middlesex Employees,,,14.33,,14.33,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Anthem,Commerical,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Anthem,Indemnity,,,14.51,,14.51,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Anthem,Individual Exchange,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Anthem,State Preferred,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Cigna,Cigna,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Connecticare,Commerical,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Connecticare,Exchange,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,Multiplan,Multiplan,,,16.46,,16.46,14.33,16.46,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273623,NDC,both,1,mL,19.37,11.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.33,16.46,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Aetna,Commerical,,,14.79,,14.79,14.18,16.29,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Aetna,Middlesex Employees,,,14.18,,14.18,14.18,16.29,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Anthem,Commerical,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Anthem,Indemnity,,,14.36,,14.36,14.18,16.29,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Anthem,Individual Exchange,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Anthem,State Preferred,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Cigna,Cigna,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Connecticare,Commerical,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Connecticare,Exchange,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,Multiplan,Multiplan,,,16.29,,16.29,14.18,16.29,percent of total billed charges,,
CARBAMIDE PEROXIDE 6.5 % EAR DROPS,J3490,HCPCS,7811273632,NDC,both,1,mL,19.17,11.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.18,16.29,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0378-0078-01,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,50228-457-01,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Aetna,Commerical,,,0.78,,0.78,0.75,0.86,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.86,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Anthem,Commerical,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.86,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Anthem,Individual Exchange,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Anthem,State Preferred,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Cigna,Cigna,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Connecticare,Commerical,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Connecticare,Exchange,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,Multiplan,Multiplan,,,0.86,,0.86,0.75,0.86,percent of total billed charges,,
CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,62756-517-88,NDC,both,1,ea,1.01,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.86,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0228-2539-10,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-6237-61,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7257-61,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,0904-7501-61,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,J3490,HCPCS,40810-0008-23,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,J3490,HCPCS,0228-2540-10,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Aetna,Commerical,,,2.58,,2.58,2.47,2.84,percent of total billed charges,,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Aetna,Middlesex Employees,,,2.47,,2.47,2.47,2.84,percent of total billed charges,,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Anthem,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Anthem,Indemnity,,,2.5,,2.5,2.47,2.84,percent of total billed charges,,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Anthem,Individual Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Anthem,State Preferred,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Cigna,Cigna,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Connecticare,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Connecticare,Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,Multiplan,Multiplan,,,2.84,,2.84,2.47,2.84,percent of total billed charges,,
CARBIDOPA 6.25 MG-LEVODOPA 25 MG SPLIT TABLET,J3490,HCPCS,40810-0202-62,NDC,both,1,ea,3.34,2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Aetna,Commerical,,,1.07,,1.07,1.03,1.18,percent of total billed charges,,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Aetna,Middlesex Employees,,,1.03,,1.03,1.03,1.18,percent of total billed charges,,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Anthem,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Anthem,Indemnity,,,1.04,,1.04,1.03,1.18,percent of total billed charges,,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Anthem,Individual Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Anthem,State Preferred,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Cigna,Cigna,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Connecticare,Commerical,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Connecticare,Exchange,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,Multiplan,Multiplan,,,1.18,,1.18,1.03,1.18,percent of total billed charges,,
"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-461-88,NDC,both,1,ea,1.39,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.03,1.18,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Aetna,Commerical,,,1.99,,1.99,1.91,2.19,percent of total billed charges,,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Aetna,Middlesex Employees,,,1.91,,1.91,1.91,2.19,percent of total billed charges,,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Anthem,Commerical,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Anthem,Indemnity,,,1.93,,1.93,1.91,2.19,percent of total billed charges,,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Anthem,Individual Exchange,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Anthem,State Preferred,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Cigna,Cigna,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Connecticare,Commerical,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Connecticare,Exchange,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,Multiplan,Multiplan,,,2.19,,2.19,1.91,2.19,percent of total billed charges,,
"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,62756-457-88,NDC,both,1,ea,2.58,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.91,2.19,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
CARBIDOPA-LEVODOPA 12.5-50 MG ORAL TAB,J3490,HCPCS,40810-0203-72,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 2.5-25 MG ORAL TAB,J3490,HCPCS,40810-0000-75,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
CARBIDOPA-LEVODOPA 5-50 MG ORAL TAB,J3490,HCPCS,40810-0000-76,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Aetna,Commerical,,,19.31,,19.31,4.5,21.28,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Aetna,Middlesex Employees,,,18.52,,18.52,4.5,21.28,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Anthem,Commerical,,,,,,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Anthem,Indemnity,,,18.75,,18.75,4.5,21.28,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Anthem,Individual Exchange,,,,,,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Anthem,State Preferred,,,,,,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Cigna,Cigna,,5.2,,,5.2,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Connecticare,Commerical,,5.19,,,5.19,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Connecticare,Exchange,,5.19,,,5.19,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,Multiplan,Multiplan,,,21.28,,21.28,4.5,21.28,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4244-01,NDC,both,5,mL,25.03,15.02,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,21.28,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Aetna,Commerical,,,62.06,,62.06,4.5,68.37,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Aetna,Middlesex Employees,,,59.51,,59.51,4.5,68.37,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Anthem,Commerical,,,,,,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Anthem,Indemnity,,,60.25,,60.25,4.5,68.37,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Anthem,Individual Exchange,,,,,,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Anthem,State Preferred,,,,,,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Cigna,Cigna,,5.2,,,5.2,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Connecticare,Commerical,,5.19,,,5.19,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Connecticare,Exchange,,5.19,,,5.19,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,Multiplan,Multiplan,,,68.37,,68.37,4.5,68.37,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4246-01,NDC,both,5,mL,80.43,48.26,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,68.37,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Aetna,Commerical,,,173.82,,173.82,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Aetna,Middlesex Employees,,,166.68,,166.68,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Anthem,Commerical,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Anthem,Indemnity,,,168.75,,168.75,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Anthem,Individual Exchange,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Anthem,State Preferred,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Cigna,Cigna,,5.2,,,5.2,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Connecticare,Commerical,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Connecticare,Exchange,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,Multiplan,Multiplan,,,191.48,,191.48,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,0703-4248-01,NDC,both,5,mL,225.27,135.16,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Aetna,Commerical,,,173.82,,173.82,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Aetna,Middlesex Employees,,,166.68,,166.68,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Anthem,Commerical,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Anthem,Indemnity,,,168.75,,168.75,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Anthem,Individual Exchange,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Anthem,State Preferred,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Cigna,Cigna,,5.2,,,5.2,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Connecticare,Commerical,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Connecticare,Exchange,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,Multiplan,Multiplan,,,191.48,,191.48,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,55150-335-01,NDC,both,5,mL,225.27,135.16,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Aetna,Commerical,,,57.94,,57.94,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Aetna,Middlesex Employees,,,55.56,,55.56,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Anthem,Commerical,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Anthem,Indemnity,,,56.25,,56.25,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Anthem,Individual Exchange,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Anthem,State Preferred,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Cigna,Cigna,,5.2,,,5.2,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Connecticare,Commerical,,5.19,,,5.19,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Connecticare,Exchange,,5.19,,,5.19,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,Multiplan,Multiplan,,,63.83,,63.83,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-150-05,NDC,both,5,mL,75.09,45.05,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Aetna,Commerical,,,173.82,,173.82,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Aetna,Middlesex Employees,,,166.68,,166.68,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Anthem,Commerical,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Anthem,Indemnity,,,168.75,,168.75,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Anthem,Individual Exchange,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Anthem,State Preferred,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Cigna,Cigna,,5.2,,,5.2,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Connecticare,Commerical,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Connecticare,Exchange,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,Multiplan,Multiplan,,,191.48,,191.48,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-262-05,NDC,both,5,mL,225.27,135.16,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Aetna,Commerical,,,57.94,,57.94,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Aetna,Middlesex Employees,,,55.56,,55.56,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Anthem,Commerical,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Anthem,Indemnity,,,56.25,,56.25,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Anthem,Individual Exchange,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Anthem,State Preferred,,,,,,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Cigna,Cigna,,5.2,,,5.2,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Connecticare,Commerical,,5.19,,,5.19,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Connecticare,Exchange,,5.19,,,5.19,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,Multiplan,Multiplan,,,63.83,,63.83,4.5,63.83,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-22,NDC,both,5,mL,75.09,45.05,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,63.83,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Aetna,Commerical,,,173.82,,173.82,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Aetna,Middlesex Employees,,,166.68,,166.68,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Anthem,Commerical,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Anthem,Indemnity,,,168.75,,168.75,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Anthem,Individual Exchange,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Anthem,State Preferred,,,,,,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Cigna,Cigna,,5.2,,,5.2,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Connecticare,Commerical,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Connecticare,Exchange,,5.19,,,5.19,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,Multiplan,Multiplan,,,191.48,,191.48,4.5,191.48,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-50,NDC,both,5,mL,225.27,135.16,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,191.48,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Aetna,Commerical,,,231.75,,231.75,4.5,255.3,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Aetna,Middlesex Employees,,,222.23,,222.23,4.5,255.3,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Anthem,Commerical,,,,,,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Anthem,Indemnity,,,224.99,,224.99,4.5,255.3,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Anthem,Individual Exchange,,,,,,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Anthem,State Preferred,,,,,,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Cigna,Cigna,,5.2,,,5.2,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Connecticare,Commerical,,5.19,,,5.19,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Connecticare,Exchange,,5.19,,,5.19,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,Multiplan,Multiplan,,,255.3,,255.3,4.5,255.3,percent of total billed charges,,
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,J9045,HCPCS,61703-339-56,NDC,both,5,mL,300.35,180.21,United Healthcare/Oxford,United Healthcare/Oxford,,4.5,,,4.5,4.5,255.3,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Aetna,Commerical,,,347.05,,347.05,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Aetna,Middlesex Employees,,,332.79,,332.79,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Anthem,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Anthem,Indemnity,,,336.93,,336.93,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Anthem,Individual Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Anthem,State Preferred,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Cigna,Cigna,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Connecticare,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Connecticare,Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,Multiplan,Multiplan,,,382.31,,382.31,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,0009-0856-08,NDC,both,1,mL,449.78,269.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Aetna,Commerical,,,347.05,,347.05,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Aetna,Middlesex Employees,,,332.79,,332.79,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Anthem,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Anthem,Indemnity,,,336.93,,336.93,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Anthem,Individual Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Anthem,State Preferred,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Cigna,Cigna,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Connecticare,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Connecticare,Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,Multiplan,Multiplan,,,382.31,,382.31,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-1,NDC,both,1,mL,449.78,269.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Aetna,Commerical,,,347.05,,347.05,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Aetna,Middlesex Employees,,,332.79,,332.79,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Anthem,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Anthem,Indemnity,,,336.93,,336.93,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Anthem,Individual Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Anthem,State Preferred,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Cigna,Cigna,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Connecticare,Commerical,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Connecticare,Exchange,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,Multiplan,Multiplan,,,382.31,,382.31,332.79,382.31,percent of total billed charges,,
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,J3490,HCPCS,81298-5010-5,NDC,both,1,mL,449.78,269.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,332.79,382.31,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Aetna,Commerical,,,209.82,,209.82,201.2,231.14,percent of total billed charges,,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Aetna,Middlesex Employees,,,201.2,,201.2,201.2,231.14,percent of total billed charges,,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Anthem,Commerical,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Anthem,Indemnity,,,203.7,,203.7,201.2,231.14,percent of total billed charges,,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Anthem,Individual Exchange,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Anthem,State Preferred,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Cigna,Cigna,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Connecticare,Commerical,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Connecticare,Exchange,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,Multiplan,Multiplan,,,231.14,,231.14,201.2,231.14,percent of total billed charges,,
CARDIOPLEGIA 1000 ML,J3490,HCPCS,40810-0017-27,NDC,both,1000,mL,271.93,163.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,201.2,231.14,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Aetna,Commerical,,,407.81,,407.81,391.05,449.24,percent of total billed charges,,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Aetna,Middlesex Employees,,,391.05,,391.05,391.05,449.24,percent of total billed charges,,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Anthem,Commerical,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Anthem,Indemnity,,,395.91,,395.91,391.05,449.24,percent of total billed charges,,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Anthem,Individual Exchange,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Anthem,State Preferred,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Cigna,Cigna,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Connecticare,Commerical,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Connecticare,Exchange,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,Multiplan,Multiplan,,,449.24,,449.24,391.05,449.24,percent of total billed charges,,
CARGLUMIC ACID 200 MG DISPERSIBLE TABLET,J3490,HCPCS,35573-459-60,NDC,both,1,ea,528.52,317.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,391.05,449.24,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Aetna,Commerical,,,129.98,,129.98,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Aetna,Middlesex Employees,,,124.64,,124.64,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Anthem,Commerical,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Anthem,Indemnity,,,126.19,,126.19,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Anthem,Individual Exchange,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Anthem,State Preferred,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Cigna,Cigna,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Connecticare,Commerical,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Connecticare,Exchange,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,Multiplan,Multiplan,,,143.18,,143.18,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-20,NDC,both,1,ea,168.45,101.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Aetna,Commerical,,,129.98,,129.98,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Aetna,Middlesex Employees,,,124.64,,124.64,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Anthem,Commerical,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Anthem,Indemnity,,,126.19,,126.19,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Anthem,Individual Exchange,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Anthem,State Preferred,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Cigna,Cigna,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Connecticare,Commerical,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Connecticare,Exchange,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,Multiplan,Multiplan,,,143.18,,143.18,124.64,143.18,percent of total billed charges,,
CARIPRAZINE 1.5 MG CAPSULE,J3490,HCPCS,61874-115-30,NDC,both,1,ea,168.45,101.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,124.64,143.18,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Aetna,Commerical,,,3936.96,,3936.96,461.38,4336.98,percent of total billed charges,,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Aetna,Middlesex Employees,,,3775.21,,3775.21,461.38,4336.98,percent of total billed charges,,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Anthem,Commerical,,,,,,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Anthem,Indemnity,,,3822.16,,3822.16,461.38,4336.98,percent of total billed charges,,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Anthem,Individual Exchange,,,,,,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Anthem,State Preferred,,,,,,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Cigna,Cigna,,533.23,,,533.23,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Connecticare,Commerical,,505.23,,,505.23,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Connecticare,Exchange,,505.23,,,505.23,461.38,4336.98,Other,Could be inpatient or outpatient,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,Multiplan,Multiplan,,,4336.98,,4336.98,461.38,4336.98,percent of total billed charges,,
CARMUSTINE 100 MG INTRAVENOUS SOLUTION,J9050,HCPCS,23155-261-41,NDC,both,1,ea,5102.33,3061.4,United Healthcare/Oxford,United Healthcare/Oxford,,461.38,,,461.38,461.38,4336.98,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CARVEDILOL 1.5625 MG SPLIT TABLET,J3490,HCPCS,40810-0207-90,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Aetna,Commerical,,,12.77,,12.77,12.25,14.07,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Aetna,Middlesex Employees,,,12.25,,12.25,12.25,14.07,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Anthem,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Anthem,Indemnity,,,12.4,,12.4,12.25,14.07,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Anthem,Individual Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Anthem,State Preferred,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Cigna,Cigna,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Connecticare,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Connecticare,Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,Multiplan,Multiplan,,,14.07,,14.07,12.25,14.07,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-77,NDC,both,1,mL,16.55,9.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Aetna,Commerical,,,25.54,,25.54,24.49,28.14,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Aetna,Middlesex Employees,,,24.49,,24.49,24.49,28.14,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Anthem,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Anthem,Indemnity,,,24.8,,24.8,24.49,28.14,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Anthem,Individual Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Anthem,State Preferred,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Cigna,Cigna,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Connecticare,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Connecticare,Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,Multiplan,Multiplan,,,28.14,,28.14,24.49,28.14,percent of total billed charges,,
CARVEDILOL 1.67 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-51,NDC,both,1,mL,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0093-7295-01,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,0904-6302-61,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-01,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
CARVEDILOL 12.5 MG TABLET,J3490,HCPCS,51079-931-20,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,0378-3631-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CARVEDILOL 3.125 MG TABLET,J3490,HCPCS,51079-771-20,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Aetna,Commerical,,,443.28,,443.28,425.07,488.33,percent of total billed charges,,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Aetna,Middlesex Employees,,,425.07,,425.07,425.07,488.33,percent of total billed charges,,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Anthem,Commerical,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Anthem,Indemnity,,,430.36,,430.36,425.07,488.33,percent of total billed charges,,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Anthem,Individual Exchange,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Anthem,State Preferred,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Cigna,Cigna,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Connecticare,Commerical,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Connecticare,Exchange,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,Multiplan,Multiplan,,,488.33,,488.33,425.07,488.33,percent of total billed charges,,
CCMC DIABETIC TEACHING KIT,J3490,HCPCS,40810-0011-47,NDC,both,1,UN,574.5,344.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,425.07,488.33,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Aetna,Commerical,,,1.46,,1.46,1.4,1.61,percent of total billed charges,,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Aetna,Middlesex Employees,,,1.4,,1.4,1.4,1.61,percent of total billed charges,,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Anthem,Commerical,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Anthem,Indemnity,,,1.42,,1.42,1.4,1.61,percent of total billed charges,,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Anthem,Individual Exchange,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Anthem,State Preferred,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Cigna,Cigna,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Connecticare,Commerical,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Connecticare,Exchange,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,Multiplan,Multiplan,,,1.61,,1.61,1.4,1.61,percent of total billed charges,,
CEFADROXIL 500 MG CAPSULE,J3490,HCPCS,0093-3196-01,NDC,both,1,ea,1.89,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Aetna,Commerical,,,2245.51,,2245.51,0.93,2473.67,percent of total billed charges,,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Aetna,Middlesex Employees,,,2153.26,,2153.26,0.93,2473.67,percent of total billed charges,,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Anthem,Commerical,,,,,,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Anthem,Indemnity,,,2180.03,,2180.03,0.93,2473.67,percent of total billed charges,,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Anthem,Individual Exchange,,,,,,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Anthem,State Preferred,,,,,,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Cigna,Cigna,,0.93,,,0.93,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Connecticare,Commerical,,1.23,,,1.23,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Connecticare,Exchange,,1.23,,,1.23,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,Multiplan,Multiplan,,,2473.67,,2473.67,0.93,2473.67,percent of total billed charges,,
CEFAZOLIN 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-13,NDC,both,12500,mL,2910.2,1746.12,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,2473.67,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Aetna,Commerical,,,250.73,,250.73,0.93,276.21,percent of total billed charges,,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Aetna,Middlesex Employees,,,240.43,,240.43,0.93,276.21,percent of total billed charges,,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Anthem,Commerical,,,,,,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Anthem,Indemnity,,,243.42,,243.42,0.93,276.21,percent of total billed charges,,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Anthem,Individual Exchange,,,,,,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Anthem,State Preferred,,,,,,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Cigna,Cigna,,0.93,,,0.93,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Connecticare,Commerical,,1.23,,,1.23,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Connecticare,Exchange,,1.23,,,1.23,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,Multiplan,Multiplan,,,276.21,,276.21,0.93,276.21,percent of total billed charges,,
CEFAZOLIN 0.4 MG/ML DILUITON FOR DESENSITIZATION,J0690,HCPCS,40810-0019-14,NDC,both,1250,mL,324.95,194.97,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,276.21,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,1.22,3.59,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,1.22,3.59,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Anthem,Commerical,,,,,,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,1.22,3.59,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Anthem,State Preferred,,,,,,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Cigna,Cigna,,1.22,,,1.22,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Connecticare,Commerical,,1.58,,,1.58,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Connecticare,Exchange,,1.58,,,1.58,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,1.22,3.59,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-707-25,NDC,both,0.5,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.32,,,1.32,1.22,3.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Anthem,Commerical,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Cigna,Cigna,,0.93,,,0.93,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Connecticare,Commerical,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Connecticare,Exchange,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-01,NDC,both,0.5,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Anthem,Commerical,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Cigna,Cigna,,0.93,,,0.93,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Connecticare,Commerical,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Connecticare,Exchange,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9262-25,NDC,both,0.5,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Aetna,Commerical,,,3.01,,3.01,0.93,3.32,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Aetna,Middlesex Employees,,,2.89,,2.89,0.93,3.32,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Anthem,Commerical,,,,,,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Anthem,Indemnity,,,2.92,,2.92,0.93,3.32,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Anthem,Individual Exchange,,,,,,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Anthem,State Preferred,,,,,,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Cigna,Cigna,,0.93,,,0.93,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Connecticare,Commerical,,1.23,,,1.23,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Connecticare,Exchange,,1.23,,,1.23,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,Multiplan,Multiplan,,,3.32,,3.32,0.93,3.32,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3451-96,NDC,both,0.5,ea,3.9,2.34,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,3.32,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Aetna,Commerical,,,3.35,,3.35,0.93,3.69,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Aetna,Middlesex Employees,,,3.21,,3.21,0.93,3.69,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Anthem,Commerical,,,,,,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Anthem,Indemnity,,,3.25,,3.25,0.93,3.69,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Anthem,Individual Exchange,,,,,,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Anthem,State Preferred,,,,,,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Cigna,Cigna,,0.93,,,0.93,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Connecticare,Commerical,,1.23,,,1.23,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Connecticare,Exchange,,1.23,,,1.23,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,Multiplan,Multiplan,,,3.69,,3.69,0.93,3.69,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,25021-101-10,NDC,both,0.5,ea,4.34,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,3.69,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Anthem,Commerical,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Cigna,Cigna,,0.93,,,0.93,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Connecticare,Commerical,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Connecticare,Exchange,,1.23,,,1.23,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.93,1.92,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6142-0,NDC,both,0.5,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,1.92,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Aetna,Commerical,,,4.7,,4.7,0.93,5.18,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Aetna,Middlesex Employees,,,4.51,,4.51,0.93,5.18,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Anthem,Commerical,,,,,,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Anthem,Indemnity,,,4.56,,4.56,0.93,5.18,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Anthem,Individual Exchange,,,,,,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Anthem,State Preferred,,,,,,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Cigna,Cigna,,0.93,,,0.93,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Connecticare,Commerical,,1.23,,,1.23,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Connecticare,Exchange,,1.23,,,1.23,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,Multiplan,Multiplan,,,5.18,,5.18,0.93,5.18,percent of total billed charges,,
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,63323-237-10,NDC,both,0.5,ea,6.09,3.65,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,5.18,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,1.22,35.81,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,1.22,35.81,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Anthem,Commerical,,,,,,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,1.22,35.81,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Anthem,Individual Exchange,,,,,,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Anthem,State Preferred,,,,,,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Cigna,Cigna,,1.22,,,1.22,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Connecticare,Commerical,,1.58,,,1.58,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Connecticare,Exchange,,1.58,,,1.58,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,1.22,35.81,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0687,HCPCS,44567-708-10,NDC,both,0.05,ea,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.32,,,1.32,1.22,35.81,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Aetna,Commerical,,,14.51,,14.51,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Aetna,Middlesex Employees,,,13.92,,13.92,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Anthem,Commerical,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Anthem,Indemnity,,,14.09,,14.09,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Anthem,Individual Exchange,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Anthem,State Preferred,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Cigna,Cigna,,0.93,,,0.93,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Connecticare,Commerical,,1.23,,,1.23,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Connecticare,Exchange,,1.23,,,1.23,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,Multiplan,Multiplan,,,15.99,,15.99,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-01,NDC,both,0.05,ea,18.81,11.29,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Aetna,Commerical,,,14.51,,14.51,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Aetna,Middlesex Employees,,,13.92,,13.92,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Anthem,Commerical,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Anthem,Indemnity,,,14.09,,14.09,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Anthem,Individual Exchange,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Anthem,State Preferred,,,,,,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Cigna,Cigna,,0.93,,,0.93,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Connecticare,Commerical,,1.23,,,1.23,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Connecticare,Exchange,,1.23,,,1.23,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,Multiplan,Multiplan,,,15.99,,15.99,0.93,15.99,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9261-10,NDC,both,0.05,ea,18.81,11.29,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,15.99,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Aetna,Commerical,,,25.12,,25.12,0.93,27.68,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Aetna,Middlesex Employees,,,24.09,,24.09,0.93,27.68,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Anthem,Commerical,,,,,,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Anthem,Indemnity,,,24.39,,24.39,0.93,27.68,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Anthem,Individual Exchange,,,,,,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Anthem,State Preferred,,,,,,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Cigna,Cigna,,0.93,,,0.93,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Connecticare,Commerical,,1.23,,,1.23,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Connecticare,Exchange,,1.23,,,1.23,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,Multiplan,Multiplan,,,27.68,,27.68,0.93,27.68,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-03,NDC,both,0.05,ea,32.56,19.54,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,27.68,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.93,7.82,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.93,7.82,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Anthem,Commerical,,,,,,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.93,7.82,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Anthem,Individual Exchange,,,,,,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Anthem,State Preferred,,,,,,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Cigna,Cigna,,0.93,,,0.93,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Connecticare,Commerical,,1.23,,,1.23,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Connecticare,Exchange,,1.23,,,1.23,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.93,7.82,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0143-9983-91,NDC,both,0.05,ea,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,7.82,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Aetna,Commerical,,,141.85,,141.85,0.93,156.26,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Aetna,Middlesex Employees,,,136.02,,136.02,0.93,156.26,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Anthem,Commerical,,,,,,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Anthem,Indemnity,,,137.71,,137.71,0.93,156.26,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Anthem,Individual Exchange,,,,,,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Anthem,State Preferred,,,,,,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Cigna,Cigna,,0.93,,,0.93,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Connecticare,Commerical,,1.23,,,1.23,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Connecticare,Exchange,,1.23,,,1.23,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,Multiplan,Multiplan,,,156.26,,156.26,0.93,156.26,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-46,NDC,both,0.05,ea,183.84,110.3,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,156.26,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Aetna,Commerical,,,13.02,,13.02,0.93,14.35,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Aetna,Middlesex Employees,,,12.49,,12.49,0.93,14.35,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Anthem,Commerical,,,,,,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Anthem,Indemnity,,,12.64,,12.64,0.93,14.35,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Anthem,Individual Exchange,,,,,,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Anthem,State Preferred,,,,,,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Cigna,Cigna,,0.93,,,0.93,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Connecticare,Commerical,,1.23,,,1.23,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Connecticare,Exchange,,1.23,,,1.23,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,Multiplan,Multiplan,,,14.35,,14.35,0.93,14.35,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,0781-3452-95,NDC,both,0.05,ea,16.88,10.13,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,14.35,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Aetna,Commerical,,,12.26,,12.26,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Aetna,Middlesex Employees,,,11.76,,11.76,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Anthem,Commerical,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Anthem,Indemnity,,,11.9,,11.9,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Anthem,Individual Exchange,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Anthem,State Preferred,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Cigna,Cigna,,0.93,,,0.93,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Connecticare,Commerical,,1.23,,,1.23,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Connecticare,Exchange,,1.23,,,1.23,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,Multiplan,Multiplan,,,13.51,,13.51,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-0,NDC,both,0.05,ea,15.89,9.53,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Aetna,Commerical,,,12.26,,12.26,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Aetna,Middlesex Employees,,,11.76,,11.76,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Anthem,Commerical,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Anthem,Indemnity,,,11.9,,11.9,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Anthem,Individual Exchange,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Anthem,State Preferred,,,,,,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Cigna,Cigna,,0.93,,,0.93,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Connecticare,Commerical,,1.23,,,1.23,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Connecticare,Exchange,,1.23,,,1.23,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,Multiplan,Multiplan,,,13.51,,13.51,0.93,13.51,percent of total billed charges,,
CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,J0690,HCPCS,60505-6143-4,NDC,both,0.05,ea,15.89,9.53,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,13.51,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,0.93,3.91,percent of total billed charges,,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,0.93,3.91,percent of total billed charges,,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Anthem,Commerical,,,,,,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,0.93,3.91,percent of total billed charges,,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Anthem,State Preferred,,,,,,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Cigna,Cigna,,0.93,,,0.93,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Connecticare,Commerical,,1.23,,,1.23,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Connecticare,Exchange,,1.23,,,1.23,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,0.93,3.91,percent of total billed charges,,
CEFAZOLIN 10 MG/ML INTRACAMERAL,J0690,HCPCS,40810-0202-72,NDC,both,50,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,3.91,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Aetna,Commerical,,,0.02,,0.02,0.01,1.23,percent of total billed charges,,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,1.23,percent of total billed charges,,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Anthem,Commerical,,,,,,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,1.23,percent of total billed charges,,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Anthem,Individual Exchange,,,,,,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Anthem,State Preferred,,,,,,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Cigna,Cigna,,0.93,,,0.93,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Connecticare,Commerical,,1.23,,,1.23,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Connecticare,Exchange,,1.23,,,1.23,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,Multiplan,Multiplan,,,0.02,,0.02,0.01,1.23,percent of total billed charges,,
CEFAZOLIN 2.25 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-33,NDC,both,1,mL,0.02,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.01,1.23,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Aetna,Commerical,,,206.4,,206.4,0.93,227.38,percent of total billed charges,,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Aetna,Middlesex Employees,,,197.92,,197.92,0.93,227.38,percent of total billed charges,,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Anthem,Commerical,,,,,,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Anthem,Indemnity,,,200.38,,200.38,0.93,227.38,percent of total billed charges,,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Anthem,Individual Exchange,,,,,,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Anthem,State Preferred,,,,,,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Cigna,Cigna,,0.93,,,0.93,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Connecticare,Commerical,,1.23,,,1.23,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Connecticare,Exchange,,1.23,,,1.23,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,Multiplan,Multiplan,,,227.38,,227.38,0.93,227.38,percent of total billed charges,,
CEFAZOLIN 20 MG/ML,J0690,HCPCS,40810-0013-11,NDC,both,25,mL,267.5,160.5,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,227.38,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Aetna,Commerical,,,51.26,,51.26,0.93,56.47,percent of total billed charges,,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Aetna,Middlesex Employees,,,49.15,,49.15,0.93,56.47,percent of total billed charges,,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Anthem,Commerical,,,,,,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Anthem,Indemnity,,,49.76,,49.76,0.93,56.47,percent of total billed charges,,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Anthem,Individual Exchange,,,,,,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Anthem,State Preferred,,,,,,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Cigna,Cigna,,0.93,,,0.93,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Connecticare,Commerical,,1.23,,,1.23,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Connecticare,Exchange,,1.23,,,1.23,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,Multiplan,Multiplan,,,56.47,,56.47,0.93,56.47,percent of total billed charges,,
CEFAZOLIN 4 MG/ML DILUTION FOR DESENSITIZATION,J0690,HCPCS,40810-0019-15,NDC,both,125,mL,66.43,39.86,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,56.47,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Aetna,Commerical,,,38.66,,38.66,0.93,42.59,percent of total billed charges,,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Aetna,Middlesex Employees,,,37.08,,37.08,0.93,42.59,percent of total billed charges,,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Anthem,Commerical,,,,,,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Anthem,Indemnity,,,37.54,,37.54,0.93,42.59,percent of total billed charges,,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Anthem,Individual Exchange,,,,,,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Anthem,State Preferred,,,,,,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Cigna,Cigna,,0.93,,,0.93,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Connecticare,Commerical,,1.23,,,1.23,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Connecticare,Exchange,,1.23,,,1.23,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,Multiplan,Multiplan,,,42.59,,42.59,0.93,42.59,percent of total billed charges,,
CEFAZOLIN 50 MG/ML IN D10W NICU,J0690,HCPCS,40810-0004-39,NDC,both,10,mL,50.11,30.07,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,42.59,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Aetna,Commerical,,,4.55,,4.55,0.93,5.02,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Aetna,Middlesex Employees,,,4.37,,4.37,0.93,5.02,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Anthem,Commerical,,,,,,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Anthem,Indemnity,,,4.42,,4.42,0.93,5.02,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Anthem,Individual Exchange,,,,,,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Anthem,State Preferred,,,,,,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Cigna,Cigna,,0.93,,,0.93,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Connecticare,Commerical,,1.23,,,1.23,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Connecticare,Exchange,,1.23,,,1.23,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,Multiplan,Multiplan,,,5.02,,5.02,0.93,5.02,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0143-9923-90,NDC,both,1,ea,5.9,3.54,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,5.02,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,0.93,3.94,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,0.93,3.94,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,0.93,3.94,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,0.93,,,0.93,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,1.23,,,1.23,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,1.23,,,1.23,0.93,3.94,Other,Could be inpatient or outpatient,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,0.93,3.94,percent of total billed charges,,
CEFAZOLIN 500 MG SOLUTION FOR INJECTION,J0690,HCPCS,0781-3450-95,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,3.94,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4137-73,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-46,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Aetna,Commerical,,,25.54,,25.54,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Aetna,Middlesex Employees,,,24.49,,24.49,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Anthem,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Anthem,Indemnity,,,24.8,,24.8,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Anthem,Individual Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Anthem,State Preferred,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Cigna,Cigna,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Connecticare,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Connecticare,Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,Multiplan,Multiplan,,,28.14,,28.14,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0781-6078-61,NDC,both,1,mL,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Aetna,Commerical,,,349.31,,349.31,334.96,384.8,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Aetna,Middlesex Employees,,,334.96,,334.96,334.96,384.8,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Anthem,Commerical,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Anthem,Indemnity,,,339.13,,339.13,334.96,384.8,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Anthem,Individual Exchange,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Anthem,State Preferred,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Cigna,Cigna,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Connecticare,Commerical,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Connecticare,Exchange,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,Multiplan,Multiplan,,,384.8,,384.8,334.96,384.8,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-219-01,NDC,both,1,mL,452.71,271.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,334.96,384.8,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-548-88,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Aetna,Commerical,,,25.54,,25.54,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Aetna,Middlesex Employees,,,24.49,,24.49,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Anthem,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Anthem,Indemnity,,,24.8,,24.8,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Anthem,Individual Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Anthem,State Preferred,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Cigna,Cigna,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Connecticare,Commerical,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Connecticare,Exchange,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,Multiplan,Multiplan,,,28.14,,28.14,24.49,28.14,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-04,NDC,both,1,mL,33.1,19.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.49,28.14,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-05,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
CEFDINIR 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-723-10,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Aetna,Commerical,,,1.45,,1.45,1.39,1.6,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Aetna,Middlesex Employees,,,1.39,,1.39,1.39,1.6,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Anthem,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Anthem,Indemnity,,,1.41,,1.41,1.39,1.6,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Anthem,Individual Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Anthem,State Preferred,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Cigna,Cigna,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Connecticare,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Connecticare,Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,Multiplan,Multiplan,,,1.6,,1.6,1.39,1.6,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,0781-2176-60,NDC,both,1,ea,1.88,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Aetna,Commerical,,,7.55,,7.55,7.24,8.31,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Aetna,Middlesex Employees,,,7.24,,7.24,7.24,8.31,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Anthem,Commerical,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Anthem,Indemnity,,,7.33,,7.33,7.24,8.31,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Anthem,Individual Exchange,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Anthem,State Preferred,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Cigna,Cigna,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Connecticare,Commerical,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Connecticare,Exchange,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,Multiplan,Multiplan,,,8.31,,8.31,7.24,8.31,percent of total billed charges,,
CEFDINIR 300 MG CAPSULE,J3490,HCPCS,65862-177-60,NDC,both,1,ea,9.78,5.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.24,8.31,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Aetna,Commerical,,,5836.58,,5836.58,1.45,6429.61,percent of total billed charges,,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Aetna,Middlesex Employees,,,5596.79,,5596.79,1.45,6429.61,percent of total billed charges,,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Anthem,Commerical,,,,,,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Anthem,Indemnity,,,5666.38,,5666.38,1.45,6429.61,percent of total billed charges,,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Anthem,Individual Exchange,,,,,,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Anthem,State Preferred,,,,,,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Cigna,Cigna,,1.45,,,1.45,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Connecticare,Commerical,,1.86,,,1.86,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Connecticare,Exchange,,1.86,,,1.86,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,Multiplan,Multiplan,,,6429.61,,6429.61,1.45,6429.61,percent of total billed charges,,
CEFEPIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-23,NDC,both,12500,mL,7564.25,4538.55,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,6429.61,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Aetna,Commerical,,,583.66,,583.66,1.45,642.97,percent of total billed charges,,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Aetna,Middlesex Employees,,,559.68,,559.68,1.45,642.97,percent of total billed charges,,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Anthem,Commerical,,,,,,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Anthem,Indemnity,,,566.64,,566.64,1.45,642.97,percent of total billed charges,,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Anthem,Individual Exchange,,,,,,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Anthem,State Preferred,,,,,,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Cigna,Cigna,,1.45,,,1.45,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Connecticare,Commerical,,1.86,,,1.86,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Connecticare,Exchange,,1.86,,,1.86,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,Multiplan,Multiplan,,,642.97,,642.97,1.45,642.97,percent of total billed charges,,
CEFEPIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0692,HCPCS,40810-0208-24,NDC,both,1250,mL,756.43,453.86,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,642.97,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Aetna,Commerical,,,15.66,,15.66,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Aetna,Middlesex Employees,,,15.02,,15.02,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Commerical,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Indemnity,,,15.21,,15.21,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Individual Exchange,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Anthem,State Preferred,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Cigna,Cigna,,1.45,,,1.45,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Connecticare,Commerical,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Connecticare,Exchange,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,Multiplan,Multiplan,,,17.26,,17.26,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-121-20,NDC,both,0.5,ea,20.3,12.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Aetna,Commerical,,,15.66,,15.66,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Aetna,Middlesex Employees,,,15.02,,15.02,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Anthem,Commerical,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Anthem,Indemnity,,,15.21,,15.21,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Anthem,Individual Exchange,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Anthem,State Preferred,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Cigna,Cigna,,1.45,,,1.45,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Connecticare,Commerical,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Connecticare,Exchange,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,Multiplan,Multiplan,,,17.26,,17.26,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6146-4,NDC,both,0.5,ea,20.3,12.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Aetna,Commerical,,,15.66,,15.66,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Aetna,Middlesex Employees,,,15.02,,15.02,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Commerical,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Indemnity,,,15.21,,15.21,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Anthem,Individual Exchange,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Anthem,State Preferred,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Cigna,Cigna,,1.45,,,1.45,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Connecticare,Commerical,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Connecticare,Exchange,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,Multiplan,Multiplan,,,17.26,,17.26,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-326-20,NDC,both,0.5,ea,20.3,12.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Aetna,Commerical,,,15.66,,15.66,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Aetna,Middlesex Employees,,,15.02,,15.02,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Anthem,Commerical,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Anthem,Indemnity,,,15.21,,15.21,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Anthem,Individual Exchange,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Anthem,State Preferred,,,,,,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Cigna,Cigna,,1.45,,,1.45,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Connecticare,Commerical,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Connecticare,Exchange,,1.86,,,1.86,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,Multiplan,Multiplan,,,17.26,,17.26,1.45,17.26,percent of total billed charges,,
CEFEPIME 1 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,71288-008-15,NDC,both,0.5,ea,20.3,12.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,17.26,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Aetna,Commerical,,,13.45,,13.45,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Aetna,Middlesex Employees,,,12.9,,12.9,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Anthem,Commerical,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Anthem,Indemnity,,,13.06,,13.06,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Anthem,Individual Exchange,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Anthem,State Preferred,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Cigna,Cigna,,1.45,,,1.45,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Connecticare,Commerical,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Connecticare,Exchange,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,Multiplan,Multiplan,,,14.82,,14.82,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,25021-122-50,NDC,both,0.25,ea,17.43,10.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Aetna,Commerical,,,13.45,,13.45,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Aetna,Middlesex Employees,,,12.9,,12.9,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Anthem,Commerical,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Anthem,Indemnity,,,13.06,,13.06,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Anthem,Individual Exchange,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Anthem,State Preferred,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Cigna,Cigna,,1.45,,,1.45,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Connecticare,Commerical,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Connecticare,Exchange,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,Multiplan,Multiplan,,,14.82,,14.82,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,44567-241-10,NDC,both,0.25,ea,17.43,10.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Aetna,Commerical,,,13.45,,13.45,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Aetna,Middlesex Employees,,,12.9,,12.9,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Anthem,Commerical,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Anthem,Indemnity,,,13.06,,13.06,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Anthem,Individual Exchange,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Anthem,State Preferred,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Cigna,Cigna,,1.45,,,1.45,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Connecticare,Commerical,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Connecticare,Exchange,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,Multiplan,Multiplan,,,14.82,,14.82,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-0,NDC,both,0.25,ea,17.43,10.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Aetna,Commerical,,,13.45,,13.45,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Aetna,Middlesex Employees,,,12.9,,12.9,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Anthem,Commerical,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Anthem,Indemnity,,,13.06,,13.06,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Anthem,Individual Exchange,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Anthem,State Preferred,,,,,,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Cigna,Cigna,,1.45,,,1.45,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Connecticare,Commerical,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Connecticare,Exchange,,1.86,,,1.86,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,Multiplan,Multiplan,,,14.82,,14.82,1.45,14.82,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,60505-6147-4,NDC,both,0.25,ea,17.43,10.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,14.82,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Aetna,Commerical,,,29.26,,29.26,1.45,32.23,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Aetna,Middlesex Employees,,,28.06,,28.06,1.45,32.23,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Anthem,Commerical,,,,,,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Anthem,Indemnity,,,28.41,,28.41,1.45,32.23,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Anthem,Individual Exchange,,,,,,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Anthem,State Preferred,,,,,,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Cigna,Cigna,,1.45,,,1.45,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Connecticare,Commerical,,1.86,,,1.86,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Connecticare,Exchange,,1.86,,,1.86,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,Multiplan,Multiplan,,,32.23,,32.23,1.45,32.23,percent of total billed charges,,
CEFEPIME 2 GRAM SOLUTION FOR INJECTION,J0692,HCPCS,63323-340-20,NDC,both,0.25,ea,37.92,22.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,32.23,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Aetna,Commerical,,,40.76,,40.76,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Aetna,Middlesex Employees,,,39.09,,39.09,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Anthem,Commerical,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Anthem,Indemnity,,,39.57,,39.57,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Anthem,Individual Exchange,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Anthem,State Preferred,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Cigna,Cigna,,1.45,,,1.45,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Connecticare,Commerical,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Connecticare,Exchange,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,Multiplan,Multiplan,,,44.91,,44.91,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D10W NICU,J0692,HCPCS,40810-0004-40,NDC,both,12.5,mL,52.83,31.7,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Aetna,Commerical,,,40.76,,40.76,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Aetna,Middlesex Employees,,,39.09,,39.09,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Anthem,Commerical,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Anthem,Indemnity,,,39.57,,39.57,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Anthem,Individual Exchange,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Anthem,State Preferred,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Cigna,Cigna,,1.45,,,1.45,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Connecticare,Commerical,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Connecticare,Exchange,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,Multiplan,Multiplan,,,44.91,,44.91,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN D5W NICU,J0692,HCPCS,40810-0004-41,NDC,both,12.5,mL,52.83,31.7,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Aetna,Commerical,,,40.76,,40.76,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Aetna,Middlesex Employees,,,39.09,,39.09,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Anthem,Commerical,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Anthem,Indemnity,,,39.57,,39.57,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Anthem,Individual Exchange,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Anthem,State Preferred,,,,,,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Cigna,Cigna,,1.45,,,1.45,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Connecticare,Commerical,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Connecticare,Exchange,,1.86,,,1.86,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,Multiplan,Multiplan,,,44.91,,44.91,1.45,44.91,percent of total billed charges,,
CEFEPIME 40 MG/ML IN NS NICU,J0692,HCPCS,40810-0004-42,NDC,both,12.5,mL,52.83,31.7,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,44.91,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Aetna,Commerical,,,649.69,,649.69,1.45,715.7,percent of total billed charges,,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Aetna,Middlesex Employees,,,623,,623,1.45,715.7,percent of total billed charges,,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Anthem,Commerical,,,,,,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Anthem,Indemnity,,,630.74,,630.74,1.45,715.7,percent of total billed charges,,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Anthem,Individual Exchange,,,,,,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Anthem,State Preferred,,,,,,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Cigna,Cigna,,1.45,,,1.45,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Connecticare,Commerical,,1.86,,,1.86,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Connecticare,Exchange,,1.86,,,1.86,1.45,715.7,Other,Could be inpatient or outpatient,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,Multiplan,Multiplan,,,715.7,,715.7,1.45,715.7,percent of total billed charges,,
CEFEPIME CONTINUOUS INFUSION,J0692,HCPCS,40810-0013-12,NDC,both,12.5,mL,842,505.2,United Healthcare/Oxford,United Healthcare/Oxford,,1.56,,,1.56,1.45,715.7,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Aetna,Commerical,,,595.05,,595.05,2.57,655.51,percent of total billed charges,,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Aetna,Middlesex Employees,,,570.6,,570.6,2.57,655.51,percent of total billed charges,,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Anthem,Commerical,,,,,,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Anthem,Indemnity,,,577.7,,577.7,2.57,655.51,percent of total billed charges,,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Anthem,Individual Exchange,,,,,,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Anthem,State Preferred,,,,,,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Cigna,Cigna,,2.57,,,2.57,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Connecticare,Commerical,,3.48,,,3.48,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Connecticare,Exchange,,3.48,,,3.48,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,Multiplan,Multiplan,,,655.51,,655.51,2.57,655.51,percent of total billed charges,,
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,J0699,HCPCS,59630-266-10,NDC,both,0.01,ea,771.19,462.71,United Healthcare/Oxford,United Healthcare/Oxford,,2.77,,,2.77,2.57,655.51,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Aetna,Commerical,,,325.82,,325.82,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Aetna,Middlesex Employees,,,312.43,,312.43,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Anthem,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Anthem,Indemnity,,,316.31,,316.31,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Anthem,Individual Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Anthem,State Preferred,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Cigna,Cigna,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Connecticare,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Connecticare,Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,Multiplan,Multiplan,,,358.92,,358.92,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,43598-673-50,NDC,both,1,mL,422.26,253.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Aetna,Commerical,,,325.82,,325.82,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Aetna,Middlesex Employees,,,312.43,,312.43,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Anthem,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Anthem,Indemnity,,,316.31,,316.31,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Anthem,Individual Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Anthem,State Preferred,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Cigna,Cigna,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Connecticare,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Connecticare,Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,Multiplan,Multiplan,,,358.92,,358.92,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-751-50,NDC,both,1,mL,422.26,253.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Aetna,Commerical,,,325.82,,325.82,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Aetna,Middlesex Employees,,,312.43,,312.43,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Anthem,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Anthem,Indemnity,,,316.31,,316.31,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Anthem,Individual Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Anthem,State Preferred,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Cigna,Cigna,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Connecticare,Commerical,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Connecticare,Exchange,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,Multiplan,Multiplan,,,358.92,,358.92,312.43,358.92,percent of total billed charges,,
CEFIXIME 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-405-01,NDC,both,1,mL,422.26,253.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,312.43,358.92,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Aetna,Commerical,,,34.14,,34.14,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Aetna,Middlesex Employees,,,32.73,,32.73,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Anthem,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Anthem,Indemnity,,,33.14,,33.14,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Anthem,Individual Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Anthem,State Preferred,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Cigna,Cigna,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Connecticare,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Connecticare,Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,Multiplan,Multiplan,,,37.6,,37.6,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,27437-208-11,NDC,both,1,ea,44.24,26.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Aetna,Commerical,,,34.14,,34.14,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Aetna,Middlesex Employees,,,32.73,,32.73,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Anthem,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Anthem,Indemnity,,,33.14,,33.14,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Anthem,Individual Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Anthem,State Preferred,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Cigna,Cigna,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Connecticare,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Connecticare,Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,Multiplan,Multiplan,,,37.6,,37.6,32.73,37.6,percent of total billed charges,,
CEFIXIME 400 MG CAPSULE,J8499,HCPCS,68180-423-11,NDC,both,1,ea,44.24,26.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Aetna,Commerical,,,56.13,,56.13,4.24,61.83,percent of total billed charges,,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Aetna,Middlesex Employees,,,53.82,,53.82,4.24,61.83,percent of total billed charges,,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Anthem,Commerical,,,,,,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Anthem,Indemnity,,,54.49,,54.49,4.24,61.83,percent of total billed charges,,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Anthem,Individual Exchange,,,,,,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Anthem,State Preferred,,,,,,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Cigna,Cigna,,11.3,,,11.3,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Connecticare,Commerical,,4.24,,,4.24,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Connecticare,Exchange,,4.24,,,4.24,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,Multiplan,Multiplan,,,61.83,,61.83,4.24,61.83,percent of total billed charges,,
CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0020-01,NDC,both,0.1,ea,72.74,43.64,United Healthcare/Oxford,United Healthcare/Oxford,,7.37,,,7.37,4.24,61.83,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Aetna,Commerical,,,12.22,,12.22,4.24,13.46,percent of total billed charges,,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Aetna,Middlesex Employees,,,11.72,,11.72,4.24,13.46,percent of total billed charges,,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Anthem,Commerical,,,,,,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Anthem,Indemnity,,,11.87,,11.87,4.24,13.46,percent of total billed charges,,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Anthem,Individual Exchange,,,,,,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Anthem,State Preferred,,,,,,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Cigna,Cigna,,11.3,,,11.3,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Connecticare,Commerical,,4.24,,,4.24,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Connecticare,Exchange,,4.24,,,4.24,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,Multiplan,Multiplan,,,13.46,,13.46,4.24,13.46,percent of total billed charges,,
CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,J0698,HCPCS,0039-0019-10,NDC,both,0.5,ea,15.84,9.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.37,,,7.37,4.24,13.46,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Aetna,Commerical,,,265.51,,265.51,4.24,292.49,percent of total billed charges,,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Aetna,Middlesex Employees,,,254.6,,254.6,4.24,292.49,percent of total billed charges,,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Anthem,Commerical,,,,,,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Anthem,Indemnity,,,257.77,,257.77,4.24,292.49,percent of total billed charges,,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Anthem,Individual Exchange,,,,,,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Anthem,State Preferred,,,,,,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Cigna,Cigna,,11.3,,,11.3,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Connecticare,Commerical,,4.24,,,4.24,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Connecticare,Exchange,,4.24,,,4.24,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,Multiplan,Multiplan,,,292.49,,292.49,4.24,292.49,percent of total billed charges,,
CEFOTAXIME 25 MG/ML,J0698,HCPCS,40810-0013-14,NDC,both,40,mL,344.1,206.46,United Healthcare/Oxford,United Healthcare/Oxford,,7.37,,,7.37,4.24,292.49,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Aetna,Commerical,,,33.11,,33.11,4.24,36.47,percent of total billed charges,,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Aetna,Middlesex Employees,,,31.75,,31.75,4.24,36.47,percent of total billed charges,,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Anthem,Commerical,,,,,,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Anthem,Indemnity,,,32.14,,32.14,4.24,36.47,percent of total billed charges,,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Anthem,Individual Exchange,,,,,,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Anthem,State Preferred,,,,,,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Cigna,Cigna,,11.3,,,11.3,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Connecticare,Commerical,,4.24,,,4.24,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Connecticare,Exchange,,4.24,,,4.24,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,Multiplan,Multiplan,,,36.47,,36.47,4.24,36.47,percent of total billed charges,,
CEFOTAXIME 25 MG/ML IN D10W NICU,J0698,HCPCS,40810-0004-43,NDC,both,40,mL,42.91,25.75,United Healthcare/Oxford,United Healthcare/Oxford,,7.37,,,7.37,4.24,36.47,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Aetna,Commerical,,,10.49,,10.49,5.06,11.55,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Aetna,Middlesex Employees,,,10.06,,10.06,5.06,11.55,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Anthem,Commerical,,,,,,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Anthem,Indemnity,,,10.18,,10.18,5.06,11.55,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Anthem,Individual Exchange,,,,,,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Anthem,State Preferred,,,,,,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Cigna,Cigna,,5.06,,,5.06,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Connecticare,Commerical,,6.89,,,6.89,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Connecticare,Exchange,,6.89,,,6.89,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,Multiplan,Multiplan,,,11.55,,11.55,5.06,11.55,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-109-10,NDC,both,1,ea,13.59,8.15,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,11.55,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Aetna,Commerical,,,11.1,,11.1,5.06,12.22,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Aetna,Middlesex Employees,,,10.64,,10.64,5.06,12.22,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Anthem,Commerical,,,,,,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Anthem,Indemnity,,,10.77,,10.77,5.06,12.22,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Anthem,Individual Exchange,,,,,,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Anthem,State Preferred,,,,,,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Cigna,Cigna,,5.06,,,5.06,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Connecticare,Commerical,,6.89,,,6.89,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Connecticare,Exchange,,6.89,,,6.89,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,Multiplan,Multiplan,,,12.22,,12.22,5.06,12.22,percent of total billed charges,,
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-245-85,NDC,both,1,ea,14.38,8.63,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,12.22,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Aetna,Commerical,,,21.62,,21.62,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Aetna,Middlesex Employees,,,20.73,,20.73,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Anthem,Commerical,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Anthem,Indemnity,,,20.99,,20.99,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Anthem,Individual Exchange,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Anthem,State Preferred,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Cigna,Cigna,,5.06,,,5.06,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Connecticare,Commerical,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Connecticare,Exchange,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,Multiplan,Multiplan,,,23.82,,23.82,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,0143-9877-01,NDC,both,1,ea,28.02,16.81,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Aetna,Commerical,,,29.55,,29.55,5.06,32.56,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Aetna,Middlesex Employees,,,28.34,,28.34,5.06,32.56,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Anthem,Commerical,,,,,,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Anthem,Indemnity,,,28.69,,28.69,5.06,32.56,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Anthem,Individual Exchange,,,,,,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Anthem,State Preferred,,,,,,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Cigna,Cigna,,5.06,,,5.06,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Connecticare,Commerical,,6.89,,,6.89,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Connecticare,Exchange,,6.89,,,6.89,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,Multiplan,Multiplan,,,32.56,,32.56,5.06,32.56,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,25021-110-20,NDC,both,0.5,ea,38.3,22.98,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,32.56,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Aetna,Commerical,,,21.62,,21.62,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Aetna,Middlesex Employees,,,20.73,,20.73,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Anthem,Commerical,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Anthem,Indemnity,,,20.99,,20.99,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Anthem,Individual Exchange,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Anthem,State Preferred,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Cigna,Cigna,,5.06,,,5.06,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Connecticare,Commerical,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Connecticare,Exchange,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,Multiplan,Multiplan,,,23.82,,23.82,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-25,NDC,both,0.5,ea,28.02,16.81,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Aetna,Commerical,,,21.62,,21.62,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Aetna,Middlesex Employees,,,20.73,,20.73,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Anthem,Commerical,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Anthem,Indemnity,,,20.99,,20.99,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Anthem,Individual Exchange,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Anthem,State Preferred,,,,,,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Cigna,Cigna,,5.06,,,5.06,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Connecticare,Commerical,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Connecticare,Exchange,,6.89,,,6.89,5.06,23.82,Other,Could be inpatient or outpatient,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,Multiplan,Multiplan,,,23.82,,23.82,5.06,23.82,percent of total billed charges,,
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,J0694,HCPCS,44567-246-85,NDC,both,0.5,ea,28.02,16.81,United Healthcare/Oxford,United Healthcare/Oxford,,5.47,,,5.47,5.06,23.82,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Aetna,Commerical,,,7.15,,7.15,6.85,7.87,percent of total billed charges,,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Aetna,Middlesex Employees,,,6.85,,6.85,6.85,7.87,percent of total billed charges,,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Anthem,Commerical,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Anthem,Indemnity,,,6.94,,6.94,6.85,7.87,percent of total billed charges,,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Anthem,Individual Exchange,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Anthem,State Preferred,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Cigna,Cigna,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Connecticare,Commerical,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Connecticare,Exchange,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,Multiplan,Multiplan,,,7.87,,7.87,6.85,7.87,percent of total billed charges,,
CEFPROZIL 250 MG (SPLIT TABLET),J8499,HCPCS,40810-0013-80,NDC,both,2,ea,9.26,5.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.85,7.87,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Aetna,Commerical,,,145.69,,145.69,139.71,160.5,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Aetna,Middlesex Employees,,,139.71,,139.71,139.71,160.5,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Anthem,Commerical,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Anthem,Indemnity,,,141.45,,141.45,139.71,160.5,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Anthem,Individual Exchange,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Anthem,State Preferred,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Cigna,Cigna,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Connecticare,Commerical,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Connecticare,Exchange,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,Multiplan,Multiplan,,,160.5,,160.5,139.71,160.5,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-01,NDC,both,1,mL,188.82,113.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,139.71,160.5,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Aetna,Commerical,,,110.39,,110.39,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Aetna,Middlesex Employees,,,105.85,,105.85,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Anthem,Commerical,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Anthem,Indemnity,,,107.17,,107.17,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Anthem,Individual Exchange,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Anthem,State Preferred,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Cigna,Cigna,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Connecticare,Commerical,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Connecticare,Exchange,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,Multiplan,Multiplan,,,121.6,,121.6,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,57237-035-75,NDC,both,1,mL,143.06,85.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Aetna,Commerical,,,110.39,,110.39,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Aetna,Middlesex Employees,,,105.85,,105.85,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Anthem,Commerical,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Anthem,Indemnity,,,107.17,,107.17,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Anthem,Individual Exchange,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Anthem,State Preferred,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Cigna,Cigna,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Connecticare,Commerical,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Connecticare,Exchange,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,Multiplan,Multiplan,,,121.6,,121.6,105.85,121.6,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,65862-100-75,NDC,both,1,mL,143.06,85.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,105.85,121.6,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Aetna,Commerical,,,68.49,,68.49,65.68,75.45,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Aetna,Middlesex Employees,,,65.68,,65.68,65.68,75.45,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Anthem,Commerical,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Anthem,Indemnity,,,66.5,,66.5,65.68,75.45,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Anthem,Individual Exchange,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Anthem,State Preferred,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Cigna,Cigna,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Connecticare,Commerical,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Connecticare,Exchange,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,Multiplan,Multiplan,,,75.45,,75.45,65.68,75.45,percent of total billed charges,,
CEFPROZIL 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,68180-402-02,NDC,both,1,mL,88.77,53.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.68,75.45,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Aetna,Commerical,,,12.35,,12.35,11.85,13.61,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Aetna,Middlesex Employees,,,11.85,,11.85,11.85,13.61,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Anthem,Commerical,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Anthem,Indemnity,,,11.99,,11.99,11.85,13.61,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Anthem,Individual Exchange,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Anthem,State Preferred,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Cigna,Cigna,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Connecticare,Commerical,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Connecticare,Exchange,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,Multiplan,Multiplan,,,13.61,,13.61,11.85,13.61,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,57237-037-50,NDC,both,1,ea,16.01,9.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.85,13.61,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
CEFPROZIL 500 MG TABLET,J8499,HCPCS,68180-404-01,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Aetna,Commerical,,,617.74,,617.74,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Aetna,Middlesex Employees,,,592.36,,592.36,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Anthem,Commerical,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Anthem,Indemnity,,,599.73,,599.73,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Anthem,Individual Exchange,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Anthem,State Preferred,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Cigna,Cigna,,4.55,,,4.55,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Connecticare,Commerical,,6.01,,,6.01,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Connecticare,Exchange,,6.01,,,6.01,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,Multiplan,Multiplan,,,680.51,,680.51,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-01,NDC,both,0.025,ea,800.6,480.36,United Healthcare/Oxford,United Healthcare/Oxford,,4.92,,,4.92,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Aetna,Commerical,,,617.74,,617.74,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Aetna,Middlesex Employees,,,592.36,,592.36,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Anthem,Commerical,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Anthem,Indemnity,,,599.73,,599.73,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Anthem,Individual Exchange,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Anthem,State Preferred,,,,,,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Cigna,Cigna,,4.55,,,4.55,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Connecticare,Commerical,,6.01,,,6.01,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Connecticare,Exchange,,6.01,,,6.01,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,Multiplan,Multiplan,,,680.51,,680.51,4.55,680.51,percent of total billed charges,,
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0400-10,NDC,both,0.025,ea,800.6,480.36,United Healthcare/Oxford,United Healthcare/Oxford,,4.92,,,4.92,4.55,680.51,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Aetna,Commerical,,,622.69,,622.69,4.55,685.96,percent of total billed charges,,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Aetna,Middlesex Employees,,,597.11,,597.11,4.55,685.96,percent of total billed charges,,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Anthem,Commerical,,,,,,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Anthem,Indemnity,,,604.53,,604.53,4.55,685.96,percent of total billed charges,,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Anthem,Individual Exchange,,,,,,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Anthem,State Preferred,,,,,,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Cigna,Cigna,,4.55,,,4.55,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Connecticare,Commerical,,6.01,,,6.01,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Connecticare,Exchange,,6.01,,,6.01,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,Multiplan,Multiplan,,,685.96,,685.96,4.55,685.96,percent of total billed charges,,
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,J0712,HCPCS,0456-0600-10,NDC,both,0.016,ea,807.01,484.21,United Healthcare/Oxford,United Healthcare/Oxford,,4.92,,,4.92,4.55,685.96,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Aetna,Commerical,,,139.91,,139.91,1.83,154.13,percent of total billed charges,,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Aetna,Middlesex Employees,,,134.17,,134.17,1.83,154.13,percent of total billed charges,,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Anthem,Commerical,,,,,,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Anthem,Indemnity,,,135.83,,135.83,1.83,154.13,percent of total billed charges,,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Anthem,Individual Exchange,,,,,,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Anthem,State Preferred,,,,,,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Cigna,Cigna,,1.83,,,1.83,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Connecticare,Commerical,,2.53,,,2.53,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Connecticare,Exchange,,2.53,,,2.53,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,Multiplan,Multiplan,,,154.13,,154.13,1.83,154.13,percent of total billed charges,,
CEFTAZIDIME 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-21,NDC,both,12500,mL,181.33,108.8,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,154.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Aetna,Commerical,,,40.18,,40.18,38.53,44.26,percent of total billed charges,,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Aetna,Middlesex Employees,,,38.53,,38.53,38.53,44.26,percent of total billed charges,,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Anthem,Commerical,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Anthem,Indemnity,,,39.01,,39.01,38.53,44.26,percent of total billed charges,,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Anthem,Individual Exchange,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Anthem,State Preferred,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Cigna,Cigna,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Connecticare,Commerical,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Connecticare,Exchange,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,Multiplan,Multiplan,,,44.26,,44.26,38.53,44.26,percent of total billed charges,,
CEFTAZIDIME 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0713 ,HCPCS,40810-0018-22,NDC,both,1250,mL,52.07,31.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.53,44.26,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Aetna,Commerical,,,8.31,,8.31,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Aetna,Middlesex Employees,,,7.97,,7.97,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Anthem,Commerical,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Anthem,Indemnity,,,8.07,,8.07,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Anthem,Individual Exchange,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Anthem,State Preferred,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Cigna,Cigna,,1.83,,,1.83,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Connecticare,Commerical,,2.53,,,2.53,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Connecticare,Exchange,,2.53,,,2.53,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,Multiplan,Multiplan,,,9.15,,9.15,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GM IV SOLUTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Aetna,Commerical,,,8.31,,8.31,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Aetna,Middlesex Employees,,,7.97,,7.97,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Anthem,Commerical,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Anthem,Indemnity,,,8.07,,8.07,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Anthem,Individual Exchange,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Anthem,State Preferred,,,,,,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Cigna,Cigna,,1.83,,,1.83,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Connecticare,Commerical,,2.53,,,2.53,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Connecticare,Exchange,,2.53,,,2.53,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,Multiplan,Multiplan,,,9.15,,9.15,1.83,9.15,percent of total billed charges,,
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5082-16,NDC,both,0.5,ea,10.77,6.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,9.15,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Aetna,Commerical,,,11.92,,11.92,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Aetna,Middlesex Employees,,,11.43,,11.43,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Anthem,Commerical,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Anthem,Indemnity,,,11.57,,11.57,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Anthem,Individual Exchange,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Anthem,State Preferred,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Cigna,Cigna,,1.83,,,1.83,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Connecticare,Commerical,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Connecticare,Exchange,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,Multiplan,Multiplan,,,13.13,,13.13,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5084-11,NDC,both,0.25,ea,15.45,9.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Aetna,Commerical,,,11.92,,11.92,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Aetna,Middlesex Employees,,,11.43,,11.43,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Anthem,Commerical,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Anthem,Indemnity,,,11.57,,11.57,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Anthem,Individual Exchange,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Anthem,State Preferred,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Cigna,Cigna,,1.83,,,1.83,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Connecticare,Commerical,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Connecticare,Exchange,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,Multiplan,Multiplan,,,13.13,,13.13,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-128-50,NDC,both,0.25,ea,15.45,9.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Aetna,Commerical,,,11.92,,11.92,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Aetna,Middlesex Employees,,,11.43,,11.43,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Anthem,Commerical,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Anthem,Indemnity,,,11.57,,11.57,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Anthem,Individual Exchange,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Anthem,State Preferred,,,,,,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Cigna,Cigna,,1.83,,,1.83,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Connecticare,Commerical,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Connecticare,Exchange,,2.53,,,2.53,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,Multiplan,Multiplan,,,13.13,,13.13,1.83,13.13,percent of total billed charges,,
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-236-10,NDC,both,0.25,ea,15.45,9.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,13.13,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Aetna,Commerical,,,267.46,,267.46,1.83,294.64,percent of total billed charges,,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Aetna,Middlesex Employees,,,256.47,,256.47,1.83,294.64,percent of total billed charges,,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Anthem,Commerical,,,,,,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Anthem,Indemnity,,,259.66,,259.66,1.83,294.64,percent of total billed charges,,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Anthem,Individual Exchange,,,,,,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Anthem,State Preferred,,,,,,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Cigna,Cigna,,1.83,,,1.83,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Connecticare,Commerical,,2.53,,,2.53,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Connecticare,Exchange,,2.53,,,2.53,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,Multiplan,Multiplan,,,294.64,,294.64,1.83,294.64,percent of total billed charges,,
CEFTAZIDIME 25 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-46,NDC,both,20,mL,346.63,207.98,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,294.64,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Aetna,Commerical,,,46.46,,46.46,1.83,51.18,percent of total billed charges,,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Aetna,Middlesex Employees,,,44.55,,44.55,1.83,51.18,percent of total billed charges,,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Anthem,Commerical,,,,,,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Anthem,Indemnity,,,45.1,,45.1,1.83,51.18,percent of total billed charges,,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Anthem,Individual Exchange,,,,,,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Anthem,State Preferred,,,,,,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Cigna,Cigna,,1.83,,,1.83,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Connecticare,Commerical,,2.53,,,2.53,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Connecticare,Exchange,,2.53,,,2.53,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,Multiplan,Multiplan,,,51.18,,51.18,1.83,51.18,percent of total billed charges,,
CEFTAZIDIME 4 MG/ML DILUTION FOR DESENSITIZATION,J0713,HCPCS,40810-0018-23,NDC,both,125,mL,60.21,36.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,51.18,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Aetna,Commerical,,,44.58,,44.58,1.83,49.1,percent of total billed charges,,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Aetna,Middlesex Employees,,,42.74,,42.74,1.83,49.1,percent of total billed charges,,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Anthem,Commerical,,,,,,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Anthem,Indemnity,,,43.28,,43.28,1.83,49.1,percent of total billed charges,,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Anthem,Individual Exchange,,,,,,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Anthem,State Preferred,,,,,,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Cigna,Cigna,,1.83,,,1.83,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Connecticare,Commerical,,2.53,,,2.53,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Connecticare,Exchange,,2.53,,,2.53,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,Multiplan,Multiplan,,,49.1,,49.1,1.83,49.1,percent of total billed charges,,
CEFTAZIDIME 50 MG/ML IN D5W NICU,J0713,HCPCS,40810-0205-47,NDC,both,10,mL,57.77,34.66,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,49.1,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Aetna,Commerical,,,74.2,,74.2,1.83,81.74,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Aetna,Middlesex Employees,,,71.16,,71.16,1.83,81.74,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Anthem,Commerical,,,,,,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Anthem,Indemnity,,,72.04,,72.04,1.83,81.74,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Anthem,Individual Exchange,,,,,,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Anthem,State Preferred,,,,,,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Cigna,Cigna,,1.83,,,1.83,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Connecticare,Commerical,,2.53,,,2.53,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Connecticare,Exchange,,2.53,,,2.53,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,Multiplan,Multiplan,,,81.74,,81.74,1.83,81.74,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,0409-5086-11,NDC,both,0.084,ea,96.17,57.7,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,81.74,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Aetna,Commerical,,,28.39,,28.39,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Aetna,Middlesex Employees,,,27.22,,27.22,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Anthem,Commerical,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Anthem,Indemnity,,,27.56,,27.56,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Anthem,Individual Exchange,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Anthem,State Preferred,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Cigna,Cigna,,1.83,,,1.83,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Connecticare,Commerical,,2.53,,,2.53,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Connecticare,Exchange,,2.53,,,2.53,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,Multiplan,Multiplan,,,31.27,,31.27,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,25021-129-99,NDC,both,0.084,ea,36.79,22.07,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Aetna,Commerical,,,28.39,,28.39,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Aetna,Middlesex Employees,,,27.22,,27.22,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Anthem,Commerical,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Anthem,Indemnity,,,27.56,,27.56,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Anthem,Individual Exchange,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Anthem,State Preferred,,,,,,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Cigna,Cigna,,1.83,,,1.83,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Connecticare,Commerical,,2.53,,,2.53,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Connecticare,Exchange,,2.53,,,2.53,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,Multiplan,Multiplan,,,31.27,,31.27,1.83,31.27,percent of total billed charges,,
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION,J0713,HCPCS,44567-237-06,NDC,both,0.084,ea,36.79,22.07,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,31.27,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Aetna,Commerical,,,1071.1,,1071.1,113.23,1179.93,percent of total billed charges,,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Aetna,Middlesex Employees,,,1027.09,,1027.09,113.23,1179.93,percent of total billed charges,,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Anthem,Commerical,,,,,,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Anthem,Indemnity,,,1039.86,,1039.86,113.23,1179.93,percent of total billed charges,,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Anthem,Individual Exchange,,,,,,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Anthem,State Preferred,,,,,,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Cigna,Cigna,,113.23,,,113.23,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Connecticare,Commerical,,153.59,,,153.59,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Connecticare,Exchange,,153.59,,,153.59,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,Multiplan,Multiplan,,,1179.93,,1179.93,113.23,1179.93,percent of total billed charges,,
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,J0714,HCPCS,0456-2700-10,NDC,both,0.25,ea,1388.15,832.89,United Healthcare/Oxford,United Healthcare/Oxford,,122.24,,,122.24,113.23,1179.93,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Aetna,Commerical,,,478.23,,478.23,9.31,526.82,percent of total billed charges,,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Aetna,Middlesex Employees,,,458.58,,458.58,9.31,526.82,percent of total billed charges,,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Anthem,Commerical,,,,,,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Anthem,Indemnity,,,464.28,,464.28,9.31,526.82,percent of total billed charges,,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Anthem,Individual Exchange,,,,,,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Anthem,State Preferred,,,,,,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Cigna,Cigna,,9.31,,,9.31,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Connecticare,Commerical,,12.57,,,12.57,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Connecticare,Exchange,,12.57,,,12.57,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,Multiplan,Multiplan,,,526.82,,526.82,9.31,526.82,percent of total billed charges,,
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,J0695,HCPCS,67919-030-01,NDC,both,0.034,ea,619.79,371.87,United Healthcare/Oxford,United Healthcare/Oxford,,10.05,,,10.05,9.31,526.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Aetna,Commerical,,,4702.05,,4702.05,0.52,5179.81,percent of total billed charges,,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Aetna,Middlesex Employees,,,4508.87,,4508.87,0.52,5179.81,percent of total billed charges,,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Anthem,Commerical,,,,,,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Anthem,Indemnity,,,4564.93,,4564.93,0.52,5179.81,percent of total billed charges,,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Anthem,Individual Exchange,,,,,,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Anthem,State Preferred,,,,,,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Cigna,Cigna,,0.52,,,0.52,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Connecticare,Commerical,,0.68,,,0.68,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Connecticare,Exchange,,0.68,,,0.68,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,Multiplan,Multiplan,,,5179.81,,5179.81,0.52,5179.81,percent of total billed charges,,
CEFTRIAXONE 0.04 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-09,NDC,both,6250,mL,6093.89,3656.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,5179.81,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Aetna,Commerical,,,496.39,,496.39,0.52,546.82,percent of total billed charges,,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Aetna,Middlesex Employees,,,475.99,,475.99,0.52,546.82,percent of total billed charges,,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Anthem,Commerical,,,,,,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Anthem,Indemnity,,,481.91,,481.91,0.52,546.82,percent of total billed charges,,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Anthem,Individual Exchange,,,,,,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Anthem,State Preferred,,,,,,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Cigna,Cigna,,0.52,,,0.52,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Connecticare,Commerical,,0.68,,,0.68,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Connecticare,Exchange,,0.68,,,0.68,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,Multiplan,Multiplan,,,546.82,,546.82,0.52,546.82,percent of total billed charges,,
CEFTRIAXONE 0.4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-10,NDC,both,625,mL,643.32,385.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,546.82,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Aetna,Commerical,,,2.8,,2.8,0.52,3.09,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Aetna,Middlesex Employees,,,2.69,,2.69,0.52,3.09,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Anthem,Commerical,,,,,,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Anthem,Indemnity,,,2.72,,2.72,0.52,3.09,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Anthem,Individual Exchange,,,,,,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Anthem,State Preferred,,,,,,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Cigna,Cigna,,0.52,,,0.52,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Connecticare,Commerical,,0.68,,,0.68,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Connecticare,Exchange,,0.68,,,0.68,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,Multiplan,Multiplan,,,3.09,,3.09,0.52,3.09,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7332-20,NDC,both,0.25,ea,3.63,2.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,3.09,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,0.52,9.77,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,0.52,9.77,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Anthem,Commerical,,,,,,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,0.52,9.77,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Anthem,Individual Exchange,,,,,,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Anthem,State Preferred,,,,,,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Cigna,Cigna,,0.52,,,0.52,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Connecticare,Commerical,,0.68,,,0.68,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Connecticare,Exchange,,0.68,,,0.68,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,0.52,9.77,percent of total billed charges,,
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-701-25,NDC,both,0.25,ea,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,9.77,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Aetna,Commerical,,,27.99,,27.99,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Aetna,Middlesex Employees,,,26.84,,26.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Anthem,Commerical,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Anthem,Indemnity,,,27.18,,27.18,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Anthem,Individual Exchange,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Anthem,State Preferred,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Cigna,Cigna,,0.52,,,0.52,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Connecticare,Commerical,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Connecticare,Exchange,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,Multiplan,Multiplan,,,30.84,,30.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7334-10,NDC,both,0.025,ea,36.28,21.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Aetna,Commerical,,,27.99,,27.99,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Aetna,Middlesex Employees,,,26.84,,26.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Anthem,Commerical,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Anthem,Indemnity,,,27.18,,27.18,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Anthem,Individual Exchange,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Anthem,State Preferred,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Cigna,Cigna,,0.52,,,0.52,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Connecticare,Commerical,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Connecticare,Exchange,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,Multiplan,Multiplan,,,30.84,,30.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0781-3210-46,NDC,both,0.025,ea,36.28,21.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Aetna,Commerical,,,27.99,,27.99,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Aetna,Middlesex Employees,,,26.84,,26.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Commerical,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Indemnity,,,27.18,,27.18,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Individual Exchange,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Anthem,State Preferred,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Cigna,Cigna,,0.52,,,0.52,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Connecticare,Commerical,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Connecticare,Exchange,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,Multiplan,Multiplan,,,30.84,,30.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,44567-703-01,NDC,both,0.025,ea,36.28,21.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Aetna,Commerical,,,27.99,,27.99,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Aetna,Middlesex Employees,,,26.84,,26.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Commerical,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Indemnity,,,27.18,,27.18,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Anthem,Individual Exchange,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Anthem,State Preferred,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Cigna,Cigna,,0.52,,,0.52,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Connecticare,Commerical,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Connecticare,Exchange,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,Multiplan,Multiplan,,,30.84,,30.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,55390-316-01,NDC,both,0.025,ea,36.28,21.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Aetna,Commerical,,,27.99,,27.99,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Aetna,Middlesex Employees,,,26.84,,26.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Anthem,Commerical,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Anthem,Indemnity,,,27.18,,27.18,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Anthem,Individual Exchange,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Anthem,State Preferred,,,,,,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Cigna,Cigna,,0.52,,,0.52,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Connecticare,Commerical,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Connecticare,Exchange,,0.68,,,0.68,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,Multiplan,Multiplan,,,30.84,,30.84,0.52,30.84,percent of total billed charges,,
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,60505-6150-5,NDC,both,0.025,ea,36.28,21.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,30.84,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Aetna,Commerical,,,6.88,,6.88,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Aetna,Middlesex Employees,,,6.6,,6.6,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Anthem,Commerical,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Anthem,Indemnity,,,6.68,,6.68,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Anthem,Individual Exchange,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Anthem,State Preferred,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Cigna,Cigna,,0.52,,,0.52,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Connecticare,Commerical,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Connecticare,Exchange,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,Multiplan,Multiplan,,,7.58,,7.58,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-01,NDC,both,0.125,ea,8.92,5.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Aetna,Commerical,,,3.7,,3.7,0.52,4.07,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Aetna,Middlesex Employees,,,3.54,,3.54,0.52,4.07,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Anthem,Commerical,,,,,,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Anthem,Indemnity,,,3.59,,3.59,0.52,4.07,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Anthem,Individual Exchange,,,,,,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Anthem,State Preferred,,,,,,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Cigna,Cigna,,0.52,,,0.52,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Connecticare,Commerical,,0.68,,,0.68,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Connecticare,Exchange,,0.68,,,0.68,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,Multiplan,Multiplan,,,4.07,,4.07,0.52,4.07,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0143-9856-25,NDC,both,0.125,ea,4.79,2.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,4.07,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Aetna,Commerical,,,6.88,,6.88,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Aetna,Middlesex Employees,,,6.6,,6.6,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Anthem,Commerical,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Anthem,Indemnity,,,6.68,,6.68,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Anthem,Individual Exchange,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Anthem,State Preferred,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Cigna,Cigna,,0.52,,,0.52,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Connecticare,Commerical,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Connecticare,Exchange,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,Multiplan,Multiplan,,,7.58,,7.58,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-03,NDC,both,0.125,ea,8.92,5.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Aetna,Commerical,,,6.88,,6.88,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Aetna,Middlesex Employees,,,6.6,,6.6,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Anthem,Commerical,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Anthem,Indemnity,,,6.68,,6.68,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Anthem,Individual Exchange,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Anthem,State Preferred,,,,,,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Cigna,Cigna,,0.52,,,0.52,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Connecticare,Commerical,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Connecticare,Exchange,,0.68,,,0.68,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,Multiplan,Multiplan,,,7.58,,7.58,0.52,7.58,percent of total billed charges,,
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,J0696,HCPCS,0409-7335-13,NDC,both,0.125,ea,8.92,5.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,7.58,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Aetna,Commerical,,,36.04,,36.04,0.52,39.7,percent of total billed charges,,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Aetna,Middlesex Employees,,,34.56,,34.56,0.52,39.7,percent of total billed charges,,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Anthem,Commerical,,,,,,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Anthem,Indemnity,,,34.99,,34.99,0.52,39.7,percent of total billed charges,,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Anthem,Individual Exchange,,,,,,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Anthem,State Preferred,,,,,,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Cigna,Cigna,,0.52,,,0.52,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Connecticare,Commerical,,0.68,,,0.68,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Connecticare,Exchange,,0.68,,,0.68,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,Multiplan,Multiplan,,,39.7,,39.7,0.52,39.7,percent of total billed charges,,
CEFTRIAXONE 20 MG/ML IN D10W NICU,J0696,HCPCS,40810-0004-45,NDC,both,12.5,mL,46.71,28.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,39.7,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,0.52,1.73,percent of total billed charges,,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,0.52,1.73,percent of total billed charges,,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,0.52,1.73,percent of total billed charges,,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,0.52,,,0.52,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,0.68,,,0.68,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,0.68,,,0.68,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,0.52,1.73,percent of total billed charges,,
CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7337-01,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,1.73,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Aetna,Commerical,,,75.83,,75.83,0.52,83.53,percent of total billed charges,,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Aetna,Middlesex Employees,,,72.71,,72.71,0.52,83.53,percent of total billed charges,,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Anthem,Commerical,,,,,,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Anthem,Indemnity,,,73.61,,73.61,0.52,83.53,percent of total billed charges,,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Anthem,Individual Exchange,,,,,,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Anthem,State Preferred,,,,,,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Cigna,Cigna,,0.52,,,0.52,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Connecticare,Commerical,,0.68,,,0.68,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Connecticare,Exchange,,0.68,,,0.68,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,Multiplan,Multiplan,,,83.53,,83.53,0.52,83.53,percent of total billed charges,,
CEFTRIAXONE 4 MG/ML DILUTION FOR DESENSITIZATION,J0696,HCPCS,40810-0208-11,NDC,both,62.5,mL,98.27,58.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,83.53,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Aetna,Commerical,,,324.61,,324.61,0.52,357.6,percent of total billed charges,,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Aetna,Middlesex Employees,,,311.28,,311.28,0.52,357.6,percent of total billed charges,,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Anthem,Commerical,,,,,,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Anthem,Indemnity,,,315.15,,315.15,0.52,357.6,percent of total billed charges,,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Anthem,Individual Exchange,,,,,,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Anthem,State Preferred,,,,,,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Cigna,Cigna,,0.52,,,0.52,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Connecticare,Commerical,,0.68,,,0.68,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Connecticare,Exchange,,0.68,,,0.68,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,Multiplan,Multiplan,,,357.6,,357.6,0.52,357.6,percent of total billed charges,,
CEFTRIAXONE 40 MG/ML,J0696,HCPCS,40810-0013-16,NDC,both,6.25,mL,420.7,252.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,357.6,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.52,,,0.52,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-01,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.52,,,0.52,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-11,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.52,,,0.52,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-20,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.52,,,0.52,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0409-7338-21,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.52,,,0.52,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,0.68,,,0.68,0.52,2.13,Other,Could be inpatient or outpatient,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.52,2.13,percent of total billed charges,,
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,J0696,HCPCS,0781-3207-95,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.13,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Aetna,Commerical,,,10.82,,10.82,2.11,11.92,percent of total billed charges,,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Aetna,Middlesex Employees,,,10.37,,10.37,2.11,11.92,percent of total billed charges,,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Anthem,Commerical,,,,,,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Anthem,Indemnity,,,10.5,,10.5,2.11,11.92,percent of total billed charges,,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Anthem,Individual Exchange,,,,,,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Anthem,State Preferred,,,,,,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Cigna,Cigna,,2.11,,,2.11,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Connecticare,Commerical,,2.88,,,2.88,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Connecticare,Exchange,,2.88,,,2.88,2.11,11.92,Other,Could be inpatient or outpatient,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,Multiplan,Multiplan,,,11.92,,11.92,2.11,11.92,percent of total billed charges,,
CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,J0697,HCPCS,25021-119-20,NDC,both,1,ea,14.02,8.41,United Healthcare/Oxford,United Healthcare/Oxford,,2.28,,,2.28,2.11,11.92,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Individual Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,State Preferred,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Cigna,Cigna,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Connecticare,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Connecticare,Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Individual Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,State Preferred,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Cigna,Cigna,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Connecticare,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Connecticare,Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,Individual Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Anthem,State Preferred,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Cigna,Cigna,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Connecticare,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Connecticare,Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0025-1520-34,NDC,both,1,ea,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,Individual Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Anthem,State Preferred,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Cigna,Cigna,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Connecticare,Commerical,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Connecticare,Exchange,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,2.18,2.51,percent of total billed charges,,
CELECOXIB 100 MG CAPSULE CHEMO,J3490,HCPCS,0904-6502-61,NDC,both,1,ea,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.18,2.51,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Aetna,Commerical,,,44.48,,44.48,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Aetna,Middlesex Employees,,,42.66,,42.66,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Commerical,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Indemnity,,,43.19,,43.19,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Individual Exchange,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,State Preferred,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Cigna,Cigna,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Connecticare,Commerical,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Connecticare,Exchange,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Multiplan,Multiplan,,,49,,49,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Aetna,Commerical,,,44.48,,44.48,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Aetna,Middlesex Employees,,,42.66,,42.66,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Commerical,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Indemnity,,,43.19,,43.19,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,Individual Exchange,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Anthem,State Preferred,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Cigna,Cigna,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Connecticare,Commerical,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Connecticare,Exchange,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,Multiplan,Multiplan,,,49,,49,42.66,49,percent of total billed charges,,
CELECOXIB 200 MG CAPSULE CHEMO,J3490,HCPCS,0025-1525-34,NDC,both,1,ea,57.65,34.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.66,49,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE,J3490,HCPCS,69097-423-03,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
CELECOXIB 50 MG CAPSULE CHEMO,J3490,HCPCS,0025-1515-01,NDC,both,1,ea,16.43,9.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Aetna,Commerical,,,351.73,,351.73,337.28,387.47,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Aetna,Middlesex Employees,,,337.28,,337.28,337.28,387.47,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Anthem,Commerical,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Anthem,Indemnity,,,341.48,,341.48,337.28,387.47,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Anthem,Individual Exchange,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Anthem,State Preferred,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Cigna,Cigna,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Connecticare,Commerical,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Connecticare,Exchange,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,Multiplan,Multiplan,,,387.47,,387.47,337.28,387.47,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 1"" X 1"" PADS",J3490,HCPCS,63713-001961,NDC,both,1,ea,455.85,273.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,337.28,387.47,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Aetna,Commerical,,,3.8,,3.8,3.65,4.19,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Aetna,Middlesex Employees,,,3.65,,3.65,3.65,4.19,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Anthem,Commerical,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Anthem,Indemnity,,,3.69,,3.69,3.65,4.19,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Anthem,Individual Exchange,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Anthem,State Preferred,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Cigna,Cigna,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Connecticare,Commerical,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Connecticare,Exchange,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,Multiplan,Multiplan,,,4.19,,4.19,3.65,4.19,percent of total billed charges,,
"CELLULOSE, OXIDIZED 2"" X 3"" MISC",J3490,HCPCS,6371301953,NDC,both,1,ea,4.93,2.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.65,4.19,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Aetna,Commerical,,,608.72,,608.72,583.71,670.57,percent of total billed charges,,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Aetna,Middlesex Employees,,,583.71,,583.71,583.71,670.57,percent of total billed charges,,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Anthem,Commerical,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Anthem,Indemnity,,,590.96,,590.96,583.71,670.57,percent of total billed charges,,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Anthem,Individual Exchange,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Anthem,State Preferred,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Cigna,Cigna,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Connecticare,Commerical,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Connecticare,Exchange,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,Multiplan,Multiplan,,,670.57,,670.57,583.71,670.57,percent of total billed charges,,
"CELLULOSE, OXIDIZED 4"" X 8"" PADS",J3490,HCPCS,58819-2500-00,NDC,both,1,ea,788.9,473.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,583.71,670.57,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,0093-3145-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,40810-0005-16,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,67877-220-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.48,0.55,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.48,0.55,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Anthem,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.48,0.55,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Anthem,Individual Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Anthem,State Preferred,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Cigna,Cigna,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Connecticare,Commerical,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Connecticare,Exchange,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.48,0.55,percent of total billed charges,,
CEPHALEXIN 250 MG CAPSULE,J3490,HCPCS,68180-121-01,NDC,both,1,ea,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.48,0.55,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Aetna,Commerical,,,35.17,,35.17,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Aetna,Middlesex Employees,,,33.72,,33.72,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Anthem,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Anthem,Indemnity,,,34.14,,34.14,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Anthem,Individual Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Anthem,State Preferred,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Cigna,Cigna,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Connecticare,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Connecticare,Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,Multiplan,Multiplan,,,38.74,,38.74,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-73,NDC,both,1,mL,45.58,27.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Aetna,Commerical,,,70.34,,70.34,67.45,77.49,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Aetna,Middlesex Employees,,,67.45,,67.45,67.45,77.49,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Anthem,Commerical,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Anthem,Indemnity,,,68.29,,68.29,67.45,77.49,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Anthem,Individual Exchange,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Anthem,State Preferred,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Cigna,Cigna,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Connecticare,Commerical,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Connecticare,Exchange,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,Multiplan,Multiplan,,,77.49,,77.49,67.45,77.49,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0093-4177-74,NDC,both,1,mL,91.16,54.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Aetna,Commerical,,,35.17,,35.17,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Aetna,Middlesex Employees,,,33.72,,33.72,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Anthem,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Anthem,Indemnity,,,34.14,,34.14,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Anthem,Individual Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Anthem,State Preferred,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Cigna,Cigna,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Connecticare,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Connecticare,Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,Multiplan,Multiplan,,,38.74,,38.74,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-92,NDC,both,1,mL,45.58,27.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Aetna,Commerical,,,35.17,,35.17,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Aetna,Middlesex Employees,,,33.72,,33.72,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Anthem,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Anthem,Indemnity,,,34.14,,34.14,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Anthem,Individual Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Anthem,State Preferred,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Cigna,Cigna,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Connecticare,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Connecticare,Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,Multiplan,Multiplan,,,38.74,,38.74,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67877-545-88,NDC,both,1,mL,45.58,27.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Aetna,Commerical,,,35.17,,35.17,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Aetna,Middlesex Employees,,,33.72,,33.72,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Anthem,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Anthem,Indemnity,,,34.14,,34.14,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Anthem,Individual Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Anthem,State Preferred,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Cigna,Cigna,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Connecticare,Commerical,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Connecticare,Exchange,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,Multiplan,Multiplan,,,38.74,,38.74,33.72,38.74,percent of total billed charges,,
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-441-01,NDC,both,1,mL,45.58,27.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.72,38.74,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Aetna,Commerical,,,0.36,,0.36,0.35,0.4,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Aetna,Middlesex Employees,,,0.35,,0.35,0.35,0.4,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Anthem,Commerical,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Anthem,Indemnity,,,0.35,,0.35,0.35,0.4,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Anthem,Individual Exchange,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Anthem,State Preferred,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Cigna,Cigna,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Connecticare,Commerical,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Connecticare,Exchange,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,Multiplan,Multiplan,,,0.4,,0.4,0.35,0.4,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,0093-3147-01,NDC,both,1,ea,0.47,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Aetna,Commerical,,,5.83,,5.83,5.59,6.42,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.42,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Anthem,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Anthem,Indemnity,,,5.66,,5.66,5.59,6.42,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Anthem,Individual Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Anthem,State Preferred,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Cigna,Cigna,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Connecticare,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Connecticare,Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,Multiplan,Multiplan,,,6.42,,6.42,5.59,6.42,percent of total billed charges,,
CEPHALEXIN 500 MG CAPSULE,J3490,HCPCS,67877-219-01,NDC,both,1,ea,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Aetna,Commerical,,,15991.81,,15991.81,5.04,17616.69,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Aetna,Middlesex Employees,,,15334.81,,15334.81,5.04,17616.69,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Anthem,Commerical,,,,,,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Anthem,Indemnity,,,15525.49,,15525.49,5.04,17616.69,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Anthem,Individual Exchange,,,,,,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Anthem,State Preferred,,,,,,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Cigna,Cigna,,5.04,,,5.04,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Connecticare,Commerical,,7.1,,,7.1,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Connecticare,Exchange,,7.1,,,7.1,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,Multiplan,Multiplan,,,17616.69,,17616.69,5.04,17616.69,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,J0717,HCPCS,50474-700-62,NDC,both,0.003,ea,20725.52,12435.31,United Healthcare/Oxford,United Healthcare/Oxford,,5.44,,,5.44,5.04,17616.69,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Aetna,Commerical,,,16935.32,,16935.32,5.04,18656.06,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Aetna,Middlesex Employees,,,16239.55,,16239.55,5.04,18656.06,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Anthem,Commerical,,,,,,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Anthem,Indemnity,,,16441.48,,16441.48,5.04,18656.06,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Anthem,Individual Exchange,,,,,,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Anthem,State Preferred,,,,,,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Cigna,Cigna,,5.04,,,5.04,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Connecticare,Commerical,,7.1,,,7.1,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Connecticare,Exchange,,7.1,,,7.1,5.04,18656.06,Other,Could be inpatient or outpatient,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,Multiplan,Multiplan,,,18656.06,,18656.06,5.04,18656.06,percent of total billed charges,,
CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT,J0717,HCPCS,50474-710-79,NDC,both,0.003,ea,21948.31,13168.99,United Healthcare/Oxford,United Healthcare/Oxford,,5.44,,,5.44,5.04,18656.06,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Aetna,Commerical,,,26.85,,26.85,25.75,29.58,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Aetna,Middlesex Employees,,,25.75,,25.75,25.75,29.58,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Anthem,Commerical,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Anthem,Indemnity,,,26.07,,26.07,25.75,29.58,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Anthem,Individual Exchange,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Anthem,State Preferred,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Cigna,Cigna,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Connecticare,Commerical,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Connecticare,Exchange,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,Multiplan,Multiplan,,,29.58,,29.58,25.75,29.58,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45020504,NDC,both,1,mL,34.8,20.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.75,29.58,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,9629513034,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0904-6765-20,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Aetna,Commerical,,,12.06,,12.06,11.56,13.29,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Aetna,Middlesex Employees,,,11.56,,11.56,11.56,13.29,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Anthem,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Anthem,Indemnity,,,11.71,,11.71,11.56,13.29,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Anthem,Individual Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Anthem,State Preferred,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Cigna,Cigna,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Connecticare,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Connecticare,Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,Multiplan,Multiplan,,,13.29,,13.29,11.56,13.29,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-626-26,NDC,both,1,mL,15.63,9.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Aetna,Commerical,,,24.07,,24.07,23.08,26.51,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Aetna,Middlesex Employees,,,23.08,,23.08,23.08,26.51,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Anthem,Commerical,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Anthem,Indemnity,,,23.36,,23.36,23.08,26.51,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Anthem,Individual Exchange,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Anthem,State Preferred,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Cigna,Cigna,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Connecticare,Commerical,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Connecticare,Exchange,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,Multiplan,Multiplan,,,26.51,,26.51,23.08,26.51,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,45802-974-26,NDC,both,1,mL,31.19,18.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.08,26.51,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Aetna,Commerical,,,18.8,,18.8,18.02,20.71,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Aetna,Middlesex Employees,,,18.02,,18.02,18.02,20.71,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Anthem,Commerical,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Anthem,Indemnity,,,18.25,,18.25,18.02,20.71,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Anthem,Individual Exchange,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Anthem,State Preferred,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Cigna,Cigna,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Connecticare,Commerical,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Connecticare,Exchange,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,Multiplan,Multiplan,,,20.71,,20.71,18.02,20.71,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51672-2102-8,NDC,both,1,mL,24.36,14.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.02,20.71,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Aetna,Commerical,,,45.39,,45.39,43.53,50.01,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Aetna,Middlesex Employees,,,43.53,,43.53,43.53,50.01,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Anthem,Commerical,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Anthem,Indemnity,,,44.07,,44.07,43.53,50.01,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Anthem,Individual Exchange,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Anthem,State Preferred,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Cigna,Cigna,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Connecticare,Commerical,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Connecticare,Exchange,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,Multiplan,Multiplan,,,50.01,,50.01,43.53,50.01,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-837-16,NDC,both,1,mL,58.83,35.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.53,50.01,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0186-1,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0214-1,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70000-0215-1,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Aetna,Commerical,,,11.17,,11.17,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Anthem,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Anthem,Indemnity,,,10.84,,10.84,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Anthem,Individual Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Anthem,State Preferred,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Cigna,Cigna,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Connecticare,Commerical,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Connecticare,Exchange,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,Multiplan,Multiplan,,,12.3,,12.3,10.71,12.3,percent of total billed charges,,
CETIRIZINE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,70752-104-06,NDC,both,1,mL,14.47,8.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.3,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0378-3637-01,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,0904-6717-61,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
CETIRIZINE 10 MG TABLET,J3490,HCPCS,51079-597-20,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
CETIRIZINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-79,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,0378-3635-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,16571-401-10,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,40810-0009-16,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CETIRIZINE 5 MG TABLET,J3490,HCPCS,49483-682-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Aetna,Commerical,,,6.76,,6.76,6.48,7.45,percent of total billed charges,,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Aetna,Middlesex Employees,,,6.48,,6.48,6.48,7.45,percent of total billed charges,,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Anthem,Commerical,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Anthem,Indemnity,,,6.56,,6.56,6.48,7.45,percent of total billed charges,,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Anthem,Individual Exchange,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Anthem,State Preferred,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Cigna,Cigna,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Connecticare,Commerical,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Connecticare,Exchange,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,Multiplan,Multiplan,,,7.45,,7.45,6.48,7.45,percent of total billed charges,,
CETIRIZINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,68094-004-62,NDC,both,5,mL,8.76,5.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.48,7.45,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Aetna,Commerical,,,2176.97,,2176.97,92.27,2398.16,percent of total billed charges,,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Aetna,Middlesex Employees,,,2087.53,,2087.53,92.27,2398.16,percent of total billed charges,,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Anthem,Commerical,,,,,,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Anthem,Indemnity,,,2113.49,,2113.49,92.27,2398.16,percent of total billed charges,,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Anthem,Individual Exchange,,,,,,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Anthem,State Preferred,,,,,,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Cigna,Cigna,,106.64,,,106.64,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Connecticare,Commerical,,115.26,,,115.26,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Connecticare,Exchange,,115.26,,,115.26,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,Multiplan,Multiplan,,,2398.16,,2398.16,92.27,2398.16,percent of total billed charges,,
CETUXIMAB 100 MG/50 ML IV CHEMO,J9055,HCPCS,66733-948-23,NDC,both,5,mL,2821.37,1692.82,United Healthcare/Oxford,United Healthcare/Oxford,,92.27,,,92.27,92.27,2398.16,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Aetna,Commerical,,,4353.94,,4353.94,92.27,4796.33,percent of total billed charges,,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Aetna,Middlesex Employees,,,4175.06,,4175.06,92.27,4796.33,percent of total billed charges,,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Anthem,Commerical,,,,,,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Anthem,Indemnity,,,4226.98,,4226.98,92.27,4796.33,percent of total billed charges,,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Anthem,Individual Exchange,,,,,,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Anthem,State Preferred,,,,,,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Cigna,Cigna,,106.64,,,106.64,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Connecticare,Commerical,,115.26,,,115.26,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Connecticare,Exchange,,115.26,,,115.26,92.27,4796.33,Other,Could be inpatient or outpatient,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,Multiplan,Multiplan,,,4796.33,,4796.33,92.27,4796.33,percent of total billed charges,,
CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,J9055,HCPCS,66733-958-23,NDC,both,5,mL,5642.74,3385.64,United Healthcare/Oxford,United Healthcare/Oxford,,92.27,,,92.27,92.27,4796.33,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Aetna,Commerical,,,34.95,,34.95,33.51,38.5,percent of total billed charges,,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Aetna,Middlesex Employees,,,33.51,,33.51,33.51,38.5,percent of total billed charges,,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Anthem,Commerical,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Anthem,Indemnity,,,33.93,,33.93,33.51,38.5,percent of total billed charges,,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Anthem,Individual Exchange,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Anthem,State Preferred,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Cigna,Cigna,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Connecticare,Commerical,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Connecticare,Exchange,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,Multiplan,Multiplan,,,38.5,,38.5,33.51,38.5,percent of total billed charges,,
CHERRY FLAVOR (BULK) ORAL LIQUID,J3490,HCPCS,395266216,NDC,both,1,mL,45.29,27.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.51,38.5,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Aetna,Commerical,,,78.37,,78.37,75.15,86.33,percent of total billed charges,,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Aetna,Middlesex Employees,,,75.15,,75.15,75.15,86.33,percent of total billed charges,,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Anthem,Commerical,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Anthem,Indemnity,,,76.09,,76.09,75.15,86.33,percent of total billed charges,,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Anthem,Individual Exchange,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Anthem,State Preferred,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Cigna,Cigna,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Connecticare,Commerical,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Connecticare,Exchange,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,Multiplan,Multiplan,,,86.33,,86.33,75.15,86.33,percent of total billed charges,,
CHLORAMBUCIL 2 MG TABLET,J8999,HCPCS,76388-635-25,NDC,both,1,ea,101.57,60.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,75.15,86.33,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Aetna,Commerical,,,5.59,,5.59,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Anthem,Commerical,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Anthem,Indemnity,,,5.43,,5.43,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Anthem,Individual Exchange,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Anthem,State Preferred,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Cigna,Cigna,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Connecticare,Commerical,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Connecticare,Exchange,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,Multiplan,Multiplan,,,6.16,,6.16,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,0116-2001-16,NDC,both,1,mL,7.25,4.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Aetna,Commerical,,,5.59,,5.59,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Anthem,Commerical,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Anthem,Indemnity,,,5.43,,5.43,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Anthem,Individual Exchange,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Anthem,State Preferred,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Cigna,Cigna,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Connecticare,Commerical,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Connecticare,Exchange,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,Multiplan,Multiplan,,,6.16,,6.16,5.36,6.16,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,J3490,HCPCS,52376-021-02,NDC,both,1,mL,7.25,4.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.16,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Anthem,Commerical,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Anthem,Individual Exchange,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Anthem,State Preferred,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Cigna,Cigna,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Connecticare,Commerical,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Connecticare,Exchange,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,0234-0575-04,NDC,both,1,mL,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Anthem,Commerical,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Anthem,Individual Exchange,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Anthem,State Preferred,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Cigna,Cigna,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Connecticare,Commerical,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Connecticare,Exchange,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,12.71,14.6,percent of total billed charges,,
CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,J3490,HCPCS,52380-1272-4,NDC,both,118,mL,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.71,14.6,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Aetna,Commerical,,,60.55,,60.55,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Aetna,Middlesex Employees,,,58.06,,58.06,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Commerical,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Indemnity,,,58.78,,58.78,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Individual Exchange,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Anthem,State Preferred,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Cigna,Cigna,,0.03,,,0.03,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Connecticare,Commerical,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Connecticare,Exchange,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,Multiplan,Multiplan,,,66.7,,66.7,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-01,NDC,both,0.034,mL,78.47,47.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Aetna,Commerical,,,60.55,,60.55,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Aetna,Middlesex Employees,,,58.06,,58.06,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Anthem,Commerical,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Anthem,Indemnity,,,58.78,,58.78,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Anthem,Individual Exchange,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Anthem,State Preferred,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Cigna,Cigna,,0.03,,,0.03,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Connecticare,Commerical,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Connecticare,Exchange,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,Multiplan,Multiplan,,,66.7,,66.7,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,0143-9210-10,NDC,both,0.034,mL,78.47,47.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Aetna,Commerical,,,60.55,,60.55,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Aetna,Middlesex Employees,,,58.06,,58.06,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Commerical,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Indemnity,,,58.78,,58.78,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Anthem,Individual Exchange,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Anthem,State Preferred,,,,,,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Cigna,Cigna,,0.03,,,0.03,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Connecticare,Commerical,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Connecticare,Exchange,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,Multiplan,Multiplan,,,66.7,,66.7,0.03,66.7,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-01,NDC,both,0.034,mL,78.47,47.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,66.7,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Aetna,Commerical,,,60.47,,60.47,0.03,66.61,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Aetna,Middlesex Employees,,,57.99,,57.99,0.03,66.61,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Anthem,Commerical,,,,,,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Anthem,Indemnity,,,58.71,,58.71,0.03,66.61,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Anthem,Individual Exchange,,,,,,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Anthem,State Preferred,,,,,,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Cigna,Cigna,,0.03,,,0.03,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Connecticare,Commerical,,0.04,,,0.04,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Connecticare,Exchange,,0.04,,,0.04,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,Multiplan,Multiplan,,,66.61,,66.61,0.03,66.61,percent of total billed charges,,
CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,J2401,HCPCS,63323-478-27,NDC,both,20,mL,78.37,47.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,66.61,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Aetna,Commerical,,,5.55,,5.55,5.32,6.11,percent of total billed charges,,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Aetna,Middlesex Employees,,,5.32,,5.32,5.32,6.11,percent of total billed charges,,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Anthem,Commerical,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Anthem,Indemnity,,,5.39,,5.39,5.32,6.11,percent of total billed charges,,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Anthem,Individual Exchange,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Anthem,State Preferred,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Cigna,Cigna,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Connecticare,Commerical,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Connecticare,Exchange,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,Multiplan,Multiplan,,,6.11,,6.11,5.32,6.11,percent of total billed charges,,
CHLOROQUINE 125 MG SPLIT TABLET,J3490,HCPCS,40810-0020-75,NDC,both,1,ea,7.19,4.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.32,6.11,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Aetna,Commerical,,,8.52,,8.52,8.17,9.38,percent of total billed charges,,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Aetna,Middlesex Employees,,,8.17,,8.17,8.17,9.38,percent of total billed charges,,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Anthem,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Anthem,Indemnity,,,8.27,,8.27,8.17,9.38,percent of total billed charges,,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Anthem,Individual Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Anthem,State Preferred,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Cigna,Cigna,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Connecticare,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Connecticare,Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,Multiplan,Multiplan,,,9.38,,9.38,8.17,9.38,percent of total billed charges,,
CHLOROQUINE 250 MG TABLET,J3490,HCPCS,64980-177-50,NDC,both,1,ea,11.04,6.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.58,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.58,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Anthem,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,39.67,45.58,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Anthem,State Preferred,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Cigna,Cigna,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Connecticare,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Connecticare,Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,39.67,45.58,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-37,NDC,both,1,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Aetna,Commerical,,,82.75,,82.75,79.35,91.15,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Aetna,Middlesex Employees,,,79.35,,79.35,79.35,91.15,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Anthem,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Anthem,Indemnity,,,80.33,,80.33,79.35,91.15,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Anthem,Individual Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Anthem,State Preferred,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Cigna,Cigna,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Connecticare,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Connecticare,Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,Multiplan,Multiplan,,,91.15,,91.15,79.35,91.15,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0201-91,NDC,both,1,mL,107.24,64.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Aetna,Commerical,,,149.88,,149.88,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Aetna,Middlesex Employees,,,143.73,,143.73,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Commerical,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Indemnity,,,145.51,,145.51,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Individual Exchange,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,State Preferred,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Cigna,Cigna,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Connecticare,Commerical,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Connecticare,Exchange,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Multiplan,Multiplan,,,165.11,,165.11,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Aetna,Commerical,,,149.88,,149.88,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Aetna,Middlesex Employees,,,143.73,,143.73,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Commerical,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Indemnity,,,145.51,,145.51,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,Individual Exchange,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Anthem,State Preferred,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Cigna,Cigna,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Connecticare,Commerical,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Connecticare,Exchange,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,Multiplan,Multiplan,,,165.11,,165.11,143.73,165.11,percent of total billed charges,,
CHLOROTHIAZIDE ORAL SUSPENSION ORDERABLE,J3490,HCPCS,65649-311-12,NDC,both,1,mL,194.25,116.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.73,165.11,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Aetna,Commerical,,,89.9,,89.9,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Aetna,Middlesex Employees,,,86.21,,86.21,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Anthem,Commerical,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Anthem,Indemnity,,,87.28,,87.28,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Anthem,Individual Exchange,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Anthem,State Preferred,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Cigna,Cigna,,72.08,,,72.08,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Connecticare,Commerical,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Connecticare,Exchange,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,Multiplan,Multiplan,,,99.03,,99.03,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,17478-419-40,NDC,both,1,ea,116.51,69.91,United Healthcare/Oxford,United Healthcare/Oxford,,77.82,,,77.82,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Aetna,Commerical,,,89.9,,89.9,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Aetna,Middlesex Employees,,,86.21,,86.21,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Anthem,Commerical,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Anthem,Indemnity,,,87.28,,87.28,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Anthem,Individual Exchange,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Anthem,State Preferred,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Cigna,Cigna,,72.08,,,72.08,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Connecticare,Commerical,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Connecticare,Exchange,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,Multiplan,Multiplan,,,99.03,,99.03,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,25021-305-20,NDC,both,1,ea,116.51,69.91,United Healthcare/Oxford,United Healthcare/Oxford,,77.82,,,77.82,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Aetna,Commerical,,,89.9,,89.9,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Aetna,Middlesex Employees,,,86.21,,86.21,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Anthem,Commerical,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Anthem,Indemnity,,,87.28,,87.28,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Anthem,Individual Exchange,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Anthem,State Preferred,,,,,,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Cigna,Cigna,,72.08,,,72.08,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Connecticare,Commerical,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Connecticare,Exchange,,60.92,,,60.92,60.92,99.03,Other,Could be inpatient or outpatient,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,Multiplan,Multiplan,,,99.03,,99.03,60.92,99.03,percent of total billed charges,,
CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,J1205,HCPCS,63323-658-27,NDC,both,1,ea,116.51,69.91,United Healthcare/Oxford,United Healthcare/Oxford,,77.82,,,77.82,60.92,99.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.41,,,0.41,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0527-2961-37,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.41,,,0.41,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,0832-0300-00,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.41,,,0.41,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-11,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.41,,,0.41,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,50268-162-15,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Anthem,Individual Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Anthem,State Preferred,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Cigna,Cigna,,0.41,,,0.41,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Connecticare,Commerical,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Connecticare,Exchange,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.41,2.13,percent of total billed charges,,
CHLORPROMAZINE 10 MG TABLET,Q0161,HCPCS,51079-518-20,NDC,both,0.5,ea,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.13,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Aetna,Commerical,,,2.42,,2.42,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Aetna,Middlesex Employees,,,2.32,,2.32,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Anthem,Commerical,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Anthem,Indemnity,,,2.34,,2.34,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Anthem,Individual Exchange,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Anthem,State Preferred,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Cigna,Cigna,,0.41,,,0.41,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Connecticare,Commerical,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Connecticare,Exchange,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,Multiplan,Multiplan,,,2.66,,2.66,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,0832-0303-00,NDC,both,0.05,ea,3.13,1.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Aetna,Commerical,,,2.42,,2.42,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Aetna,Middlesex Employees,,,2.32,,2.32,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Anthem,Commerical,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Anthem,Indemnity,,,2.34,,2.34,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Anthem,Individual Exchange,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Anthem,State Preferred,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Cigna,Cigna,,0.41,,,0.41,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Connecticare,Commerical,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Connecticare,Exchange,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,Multiplan,Multiplan,,,2.66,,2.66,0.41,2.66,percent of total billed charges,,
CHLORPROMAZINE 100 MG TABLET,Q0161,HCPCS,51079-516-20,NDC,both,0.05,ea,3.13,1.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,2.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,0904-7130-61,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-11,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,50268-163-15,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,51079-519-20,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-01,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Aetna,Commerical,,,7.01,,7.01,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Aetna,Middlesex Employees,,,6.72,,6.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Indemnity,,,6.8,,6.8,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Anthem,Individual Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Anthem,State Preferred,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Cigna,Cigna,,0.41,,,0.41,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Connecticare,Commerical,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Connecticare,Exchange,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,Multiplan,Multiplan,,,7.72,,7.72,0.41,7.72,percent of total billed charges,,
CHLORPROMAZINE 25 MG TABLET,Q0161,HCPCS,60687-430-11,NDC,both,0.2,ea,9.08,5.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,7.72,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Aetna,Commerical,,,65.96,,65.96,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Aetna,Middlesex Employees,,,63.25,,63.25,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Anthem,Commerical,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Anthem,Indemnity,,,64.03,,64.03,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Anthem,Individual Exchange,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Anthem,State Preferred,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Cigna,Cigna,,34,,,34,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Connecticare,Commerical,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Connecticare,Exchange,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,Multiplan,Multiplan,,,72.66,,72.66,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,0641-1398-35,NDC,both,2,mL,85.48,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,36.71,,,36.71,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Aetna,Commerical,,,65.96,,65.96,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Aetna,Middlesex Employees,,,63.25,,63.25,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Anthem,Commerical,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Anthem,Indemnity,,,64.03,,64.03,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Anthem,Individual Exchange,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Anthem,State Preferred,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Cigna,Cigna,,34,,,34,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Connecticare,Commerical,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Connecticare,Exchange,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,Multiplan,Multiplan,,,72.66,,72.66,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-01,NDC,both,2,mL,85.48,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,36.71,,,36.71,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Aetna,Commerical,,,65.96,,65.96,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Aetna,Middlesex Employees,,,63.25,,63.25,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Anthem,Commerical,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Anthem,Indemnity,,,64.03,,64.03,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Anthem,Individual Exchange,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Anthem,State Preferred,,,,,,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Cigna,Cigna,,34,,,34,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Connecticare,Commerical,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Connecticare,Exchange,,42.31,,,42.31,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,Multiplan,Multiplan,,,72.66,,72.66,34,72.66,percent of total billed charges,,
CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,J3230,HCPCS,55150-319-25,NDC,both,2,mL,85.48,51.29,United Healthcare/Oxford,United Healthcare/Oxford,,36.71,,,36.71,34,72.66,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Aetna,Commerical,,,1322.76,,1322.76,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Aetna,Middlesex Employees,,,1268.42,,1268.42,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Anthem,Commerical,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Anthem,Indemnity,,,1284.19,,1284.19,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Anthem,Individual Exchange,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Anthem,State Preferred,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Cigna,Cigna,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Connecticare,Commerical,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Connecticare,Exchange,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,Multiplan,Multiplan,,,1457.16,,1457.16,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0781-4027-53,NDC,both,1,mL,1714.31,1028.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Aetna,Commerical,,,1322.76,,1322.76,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Aetna,Middlesex Employees,,,1268.42,,1268.42,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Anthem,Commerical,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Anthem,Indemnity,,,1284.19,,1284.19,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Anthem,Individual Exchange,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Anthem,State Preferred,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Cigna,Cigna,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Connecticare,Commerical,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Connecticare,Exchange,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,Multiplan,Multiplan,,,1457.16,,1457.16,1268.42,1457.16,percent of total billed charges,,
CHLORPROMAZINE 30 MG/ML ORAL CONCENTRATE,J3490,HCPCS,24338-403-12,NDC,both,1,mL,1714.31,1028.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1268.42,1457.16,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Aetna,Commerical,,,27.26,,27.26,0.41,30.03,percent of total billed charges,,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Aetna,Middlesex Employees,,,26.14,,26.14,0.41,30.03,percent of total billed charges,,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Anthem,Commerical,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Anthem,Indemnity,,,26.47,,26.47,0.41,30.03,percent of total billed charges,,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Anthem,Individual Exchange,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Anthem,State Preferred,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Cigna,Cigna,,0.41,,,0.41,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Connecticare,Commerical,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Connecticare,Exchange,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,Multiplan,Multiplan,,,30.03,,30.03,0.41,30.03,percent of total billed charges,,
CHLORPROMAZINE 50 MG TABLET,Q0161,HCPCS,51079-130-20,NDC,both,0.1,ea,35.33,21.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,30.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Aetna,Commerical,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Aetna,Middlesex Employees,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Anthem,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Anthem,Indemnity,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Anthem,Individual Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Anthem,State Preferred,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Cigna,Cigna,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Connecticare,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Connecticare,Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,Multiplan,Multiplan,,,0.09,,0.09,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,4098527380,NDC,both,1,ea,0.11,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Aetna,Commerical,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Aetna,Middlesex Employees,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Anthem,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Anthem,Indemnity,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Anthem,Individual Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Anthem,State Preferred,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Cigna,Cigna,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Connecticare,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Connecticare,Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,Multiplan,Multiplan,,,0.09,,0.09,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,7985408982,NDC,both,1,ea,0.11,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Aetna,Commerical,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Aetna,Middlesex Employees,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Anthem,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Anthem,Indemnity,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Anthem,Individual Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Anthem,State Preferred,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Cigna,Cigna,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Connecticare,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Connecticare,Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,Multiplan,Multiplan,,,0.09,,0.09,0.08,0.09,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) CHEWABLE TABLET,J3490,HCPCS,40810-0010-76,NDC,both,1,ea,0.11,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,87086644,NDC,both,1,mL,11.88,7.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,5483800650,NDC,both,1,mL,11.88,7.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,6961801959,NDC,both,1,mL,11.88,7.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Aetna,Commerical,,,13.99,,13.99,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Aetna,Middlesex Employees,,,13.41,,13.41,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Commerical,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Indemnity,,,13.58,,13.58,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Individual Exchange,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,State Preferred,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Cigna,Cigna,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Connecticare,Commerical,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Connecticare,Exchange,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Multiplan,Multiplan,,,15.41,,15.41,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,5319124401,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) CAPSULE",J3490,HCPCS,8068113100,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Aetna,Commerical,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Aetna,Middlesex Employees,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Anthem,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Anthem,Indemnity,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Anthem,Individual Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Anthem,State Preferred,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Cigna,Cigna,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Connecticare,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Connecticare,Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.02,0.03,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-36,NDC,both,0.5,mL,0.03,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Aetna,Commerical,,,13.99,,13.99,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Aetna,Middlesex Employees,,,13.41,,13.41,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Commerical,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Indemnity,,,13.58,,13.58,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,Individual Exchange,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Anthem,State Preferred,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Cigna,Cigna,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Connecticare,Commerical,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Connecticare,Exchange,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,Multiplan,Multiplan,,,15.41,,15.41,13.41,15.41,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 200 UNIT/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,54629-0772-32,NDC,both,1,mL,18.13,10.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.41,15.41,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,2055503300,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",J3490,HCPCS,8068116900,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,6961801959,NDC,both,1,mL,33.33,20,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,00087-0866-01,NDC,both,1,mL,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0013-37,NDC,both,1,mL,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 250 UNITS TABLET,J3490,HCPCS,40810-0204-19,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
CHOLECALCIFEROL 500 UNITS TABLET,J3490,HCPCS,40810-0013-79,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-95,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Aetna,Commerical,,,144.16,,144.16,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Aetna,Middlesex Employees,,,138.24,,138.24,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Commerical,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Indemnity,,,139.95,,139.95,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Individual Exchange,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,State Preferred,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Cigna,Cigna,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Connecticare,Commerical,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Connecticare,Exchange,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Multiplan,Multiplan,,,158.81,,158.81,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Aetna,Commerical,,,5.58,,5.58,5.35,6.15,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Aetna,Middlesex Employees,,,5.35,,5.35,5.35,6.15,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Anthem,Commerical,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Anthem,Indemnity,,,5.42,,5.42,5.35,6.15,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Anthem,Individual Exchange,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Anthem,State Preferred,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Cigna,Cigna,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Connecticare,Commerical,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Connecticare,Exchange,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.35,6.15,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0015-69,NDC,both,1,ea,7.23,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.35,6.15,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,42806-266-98,NDC,both,1,ea,7.23,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,49884-465-64,NDC,both,1,ea,7.23,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 1 GRAM POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.23,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,5.57,,5.57,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,5.34,,5.34,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,5.41,,5.41,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,6.14,,6.14,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,40810-0019-65,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 250 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Aetna,Commerical,,,144.16,,144.16,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Aetna,Middlesex Employees,,,138.24,,138.24,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Commerical,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Indemnity,,,139.95,,139.95,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,Individual Exchange,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Anthem,State Preferred,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Cigna,Cigna,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Connecticare,Commerical,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Connecticare,Exchange,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,Multiplan,Multiplan,,,158.81,,158.81,138.24,158.81,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,49884-465-65,NDC,both,60,ea,186.83,112.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.24,158.81,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 4 GRAM TOPICAL PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,5.57,,5.57,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,5.34,,5.34,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,5.41,,5.41,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,6.14,,6.14,5.34,6.14,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,40810-1111-99,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.34,6.14,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-09,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
CHOLESTYRAMINE-SUCROSE 500 MG POWDER PACKET,J3490,HCPCS,67877-298-60,NDC,both,1,ea,7.22,4.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Aetna,Commerical,,,81.3,,81.3,24.66,89.56,percent of total billed charges,,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Aetna,Middlesex Employees,,,77.96,,77.96,24.66,89.56,percent of total billed charges,,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Anthem,Commerical,,,,,,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Anthem,Indemnity,,,78.93,,78.93,24.66,89.56,percent of total billed charges,,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Anthem,Individual Exchange,,,,,,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Anthem,State Preferred,,,,,,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Cigna,Cigna,,24.66,,,24.66,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Connecticare,Commerical,,29.29,,,29.29,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Connecticare,Exchange,,29.29,,,29.29,24.66,89.56,Other,Could be inpatient or outpatient,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,Multiplan,Multiplan,,,89.56,,89.56,24.66,89.56,percent of total billed charges,,
"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",J0725,HCPCS,63323-025-10,NDC,both,0.1,ea,105.37,63.22,United Healthcare/Oxford,United Healthcare/Oxford,,26.62,,,26.62,24.66,89.56,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Aetna,Commerical,,,51.98,,51.98,49.85,57.26,percent of total billed charges,,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Aetna,Middlesex Employees,,,49.85,,49.85,49.85,57.26,percent of total billed charges,,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Anthem,Commerical,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Anthem,Indemnity,,,50.47,,50.47,49.85,57.26,percent of total billed charges,,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Anthem,Individual Exchange,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Anthem,State Preferred,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Cigna,Cigna,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Connecticare,Commerical,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Connecticare,Exchange,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,Multiplan,Multiplan,,,57.26,,57.26,49.85,57.26,percent of total billed charges,,
CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4093-01,NDC,both,1,mL,67.37,40.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.85,57.26,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Aetna,Commerical,,,2104.86,,2104.86,615.54,2318.73,percent of total billed charges,,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Aetna,Middlesex Employees,,,2018.39,,2018.39,615.54,2318.73,percent of total billed charges,,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Anthem,Commerical,,,,,,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Anthem,Indemnity,,,2043.48,,2043.48,615.54,2318.73,percent of total billed charges,,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Anthem,Individual Exchange,,,,,,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Anthem,State Preferred,,,,,,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Cigna,Cigna,,615.54,,,615.54,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Connecticare,Commerical,,806.25,,,806.25,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Connecticare,Exchange,,806.25,,,806.25,615.54,2318.73,Other,Could be inpatient or outpatient,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,Multiplan,Multiplan,,,2318.73,,2318.73,615.54,2318.73,percent of total billed charges,,
CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,J0740,HCPCS,23155-216-31,NDC,both,5,mL,2727.92,1636.75,United Healthcare/Oxford,United Healthcare/Oxford,,664.57,,,664.57,615.54,2318.73,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Aetna,Commerical,,,49.72,,49.72,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Aetna,Middlesex Employees,,,47.68,,47.68,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Anthem,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Anthem,Indemnity,,,48.27,,48.27,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Anthem,Individual Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Anthem,State Preferred,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Cigna,Cigna,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Connecticare,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Connecticare,Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,Multiplan,Multiplan,,,54.77,,54.77,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,55513-073-30,NDC,both,1,ea,64.44,38.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Aetna,Commerical,,,49.72,,49.72,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Aetna,Middlesex Employees,,,47.68,,47.68,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Anthem,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Anthem,Indemnity,,,48.27,,48.27,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Anthem,Individual Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Anthem,State Preferred,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Cigna,Cigna,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Connecticare,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Connecticare,Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,Multiplan,Multiplan,,,54.77,,54.77,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,64380-883-04,NDC,both,1,ea,64.44,38.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Aetna,Commerical,,,49.72,,49.72,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Aetna,Middlesex Employees,,,47.68,,47.68,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Anthem,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Anthem,Indemnity,,,48.27,,48.27,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Anthem,Individual Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Anthem,State Preferred,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Cigna,Cigna,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Connecticare,Commerical,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Connecticare,Exchange,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,Multiplan,Multiplan,,,54.77,,54.77,47.68,54.77,percent of total billed charges,,
CINACALCET 30 MG TABLET,J3490,HCPCS,70436-007-04,NDC,both,1,ea,64.44,38.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.68,54.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Aetna,Commerical,,,17.31,,17.31,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Aetna,Middlesex Employees,,,16.6,,16.6,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Anthem,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Anthem,Indemnity,,,16.8,,16.8,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Anthem,Individual Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Anthem,State Preferred,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Cigna,Cigna,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Connecticare,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Connecticare,Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,Multiplan,Multiplan,,,19.07,,19.07,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,61314-656-25,NDC,both,1,mL,22.43,13.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Aetna,Commerical,,,17.31,,17.31,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Aetna,Middlesex Employees,,,16.6,,16.6,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Anthem,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Anthem,Indemnity,,,16.8,,16.8,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Anthem,Individual Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Anthem,State Preferred,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Cigna,Cigna,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Connecticare,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Connecticare,Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,Multiplan,Multiplan,,,19.07,,19.07,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-02,NDC,both,1,mL,22.43,13.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Aetna,Commerical,,,28.85,,28.85,27.66,31.78,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Aetna,Middlesex Employees,,,27.66,,27.66,27.66,31.78,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Anthem,Commerical,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Anthem,Indemnity,,,28.01,,28.01,27.66,31.78,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Anthem,Individual Exchange,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Anthem,State Preferred,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Cigna,Cigna,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Connecticare,Commerical,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Connecticare,Exchange,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,Multiplan,Multiplan,,,31.78,,31.78,27.66,31.78,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,69315-308-05,NDC,both,1,mL,37.39,22.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.66,31.78,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Aetna,Commerical,,,59.76,,59.76,57.31,65.83,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Aetna,Middlesex Employees,,,57.31,,57.31,57.31,65.83,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Anthem,Commerical,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Anthem,Indemnity,,,58.02,,58.02,57.31,65.83,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Anthem,Individual Exchange,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Anthem,State Preferred,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Cigna,Cigna,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Connecticare,Commerical,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Connecticare,Exchange,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,Multiplan,Multiplan,,,65.83,,65.83,57.31,65.83,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-05,NDC,both,5,mL,77.45,46.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.31,65.83,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Aetna,Commerical,,,17.31,,17.31,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Aetna,Middlesex Employees,,,16.6,,16.6,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Anthem,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Anthem,Indemnity,,,16.8,,16.8,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Anthem,Individual Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Anthem,State Preferred,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Cigna,Cigna,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Connecticare,Commerical,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Connecticare,Exchange,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,Multiplan,Multiplan,,,19.07,,19.07,16.6,19.07,percent of total billed charges,,
CIPROFLOXACIN 0.3 % EYE DROPS-FOR OTIC USE,J3490,HCPCS,61314-656-25,NDC,both,1,mL,46.47,27.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.6,19.07,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0078-0799-75,NDC,both,7.5,mL,446.39,267.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,0781-6186-67,NDC,both,7.5,mL,446.39,267.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,43598-326-75,NDC,both,7.5,mL,446.39,267.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,446.39,267.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",J3490,HCPCS,72485-625-13,NDC,both,7.5,mL,446.39,267.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Anthem,Commerical,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Anthem,State Preferred,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Cigna,Cigna,,2.09,,,2.09,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Connecticare,Commerical,,2.84,,,2.84,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Connecticare,Exchange,,2.84,,,2.84,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Aetna,Commerical,,,0.59,,0.59,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Anthem,Commerical,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Anthem,Indemnity,,,0.58,,0.58,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Anthem,Individual Exchange,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Anthem,State Preferred,,,,,,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Cigna,Cigna,,2.09,,,2.09,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Connecticare,Commerical,,2.84,,,2.84,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Connecticare,Exchange,,2.84,,,2.84,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,Multiplan,Multiplan,,,0.65,,0.65,0.57,2.84,percent of total billed charges,,
CIPROFLOXACIN 2 MG/ML ANTIBIOTIC LOCK,J0744,HCPCS,40810-0020-28,NDC,both,200,ME,38.47,23.08,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,0.57,2.84,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Aetna,Commerical,,,35.3,,35.3,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Aetna,Middlesex Employees,,,33.85,,33.85,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Commerical,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Indemnity,,,34.27,,34.27,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Individual Exchange,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,State Preferred,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Cigna,Cigna,,2.09,,,2.09,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Connecticare,Commerical,,2.84,,,2.84,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Connecticare,Exchange,,2.84,,,2.84,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Multiplan,Multiplan,,,38.89,,38.89,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-01,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-2300-24,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-11,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-23,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Aetna,Commerical,,,35.3,,35.3,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Aetna,Middlesex Employees,,,33.85,,33.85,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Commerical,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Indemnity,,,34.27,,34.27,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,Individual Exchange,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Anthem,State Preferred,,,,,,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Cigna,Cigna,,2.09,,,2.09,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Connecticare,Commerical,,2.84,,,2.84,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Connecticare,Exchange,,2.84,,,2.84,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,Multiplan,Multiplan,,,38.89,,38.89,2.09,38.89,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-82,NDC,both,100,mL,45.75,27.45,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,38.89,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Aetna,Commerical,,,36.77,,36.77,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Aetna,Middlesex Employees,,,35.26,,35.26,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Commerical,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Indemnity,,,35.7,,35.7,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,Individual Exchange,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Anthem,State Preferred,,,,,,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Cigna,Cigna,,2.09,,,2.09,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Connecticare,Commerical,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Connecticare,Exchange,,2.84,,,2.84,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,Multiplan,Multiplan,,,40.51,,40.51,2.09,40.51,percent of total billed charges,,
CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-192-82,NDC,both,100,mL,47.66,28.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,40.51,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Aetna,Commerical,,,0.43,,0.43,0.41,0.48,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.48,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Anthem,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Anthem,Indemnity,,,0.42,,0.42,0.41,0.48,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Anthem,Individual Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Anthem,State Preferred,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Cigna,Cigna,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Connecticare,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Connecticare,Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.41,0.48,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,0143-9927-01,NDC,both,1,ea,0.56,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,63739-700-10,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Aetna,Commerical,,,0.67,,0.67,0.64,0.74,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.74,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Anthem,Commerical,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Anthem,Indemnity,,,0.65,,0.65,0.64,0.74,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Anthem,Individual Exchange,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Anthem,State Preferred,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Cigna,Cigna,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Connecticare,Commerical,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Connecticare,Exchange,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,Multiplan,Multiplan,,,0.74,,0.74,0.64,0.74,percent of total billed charges,,
CIPROFLOXACIN 250 MG TABLET,J3490,HCPCS,65862-076-01,NDC,both,1,ea,0.87,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.74,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Aetna,Commerical,,,370.88,,370.88,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Aetna,Middlesex Employees,,,355.65,,355.65,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Anthem,Commerical,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Anthem,Indemnity,,,360.07,,360.07,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Anthem,Individual Exchange,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Anthem,State Preferred,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Cigna,Cigna,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Connecticare,Commerical,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Connecticare,Exchange,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,Multiplan,Multiplan,,,408.57,,408.57,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0013-93,NDC,both,1,mL,480.67,288.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Aetna,Commerical,,,370.88,,370.88,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Aetna,Middlesex Employees,,,355.65,,355.65,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Anthem,Commerical,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Anthem,Indemnity,,,360.07,,360.07,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Anthem,Individual Exchange,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Anthem,State Preferred,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Cigna,Cigna,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Connecticare,Commerical,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Connecticare,Exchange,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,Multiplan,Multiplan,,,408.57,,408.57,355.65,408.57,percent of total billed charges,,
CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50419-777-01,NDC,both,1,mL,480.67,288.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,355.65,408.57,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,25021-114-87,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-009-24,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0744,HCPCS,36000-298-24,NDC,both,100,mL,51.49,30.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-01,NDC,both,100,mL,48.43,29.06,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-3300-24,NDC,both,100,mL,48.43,29.06,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,0409-4777-02,NDC,both,100,mL,48.43,29.06,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Aetna,Commerical,,,39.73,,39.73,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Aetna,Middlesex Employees,,,38.1,,38.1,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Anthem,Commerical,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Anthem,Indemnity,,,38.57,,38.57,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Anthem,Individual Exchange,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Anthem,State Preferred,,,,,,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Cigna,Cigna,,2.09,,,2.09,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Connecticare,Commerical,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Connecticare,Exchange,,2.84,,,2.84,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,Multiplan,Multiplan,,,43.77,,43.77,2.09,43.77,percent of total billed charges,,
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0744,HCPCS,25021-114-87,NDC,both,100,mL,48.43,29.06,United Healthcare/Oxford,United Healthcare/Oxford,,2.26,,,2.26,2.09,43.77,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0143-9928-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6378-61,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7083-61,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-7243-61,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,51079-182-20,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,63739-559-10,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
CIPROFLOXACIN 500 MG TABLET,J3490,HCPCS,68084-070-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Aetna,Commerical,,,0.95,,0.95,0.91,1.05,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Aetna,Middlesex Employees,,,0.91,,0.91,0.91,1.05,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Anthem,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Anthem,Indemnity,,,0.92,,0.92,0.91,1.05,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Anthem,Individual Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Anthem,State Preferred,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Cigna,Cigna,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Connecticare,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Connecticare,Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.91,1.05,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,0143-9929-50,NDC,both,1,ea,1.23,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Aetna,Commerical,,,2.12,,2.12,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Anthem,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Anthem,Indemnity,,,2.06,,2.06,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Anthem,Individual Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Anthem,State Preferred,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Cigna,Cigna,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Connecticare,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Connecticare,Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,Multiplan,Multiplan,,,2.34,,2.34,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0009-63,NDC,both,1,ea,2.75,1.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Aetna,Commerical,,,2.12,,2.12,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Anthem,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Anthem,Indemnity,,,2.06,,2.06,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Anthem,Individual Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Anthem,State Preferred,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Cigna,Cigna,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Connecticare,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Connecticare,Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,Multiplan,Multiplan,,,2.34,,2.34,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-128-50,NDC,both,1,ea,2.75,1.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Aetna,Commerical,,,2.12,,2.12,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Anthem,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Anthem,Indemnity,,,2.06,,2.06,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Anthem,Individual Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Anthem,State Preferred,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Cigna,Cigna,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Connecticare,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Connecticare,Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,Multiplan,Multiplan,,,2.34,,2.34,2.03,2.34,percent of total billed charges,,
CIPROFLOXACIN 750 MG TABLET,J3490,HCPCS,68084-071-01,NDC,both,1,ea,2.75,1.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
CIPROFLOXACIN FEEDING TUBE SUSP 250 MG/5 ML,J3490,HCPCS,40810-0019-09,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Aetna,Commerical,,,455.28,,455.28,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Aetna,Middlesex Employees,,,436.58,,436.58,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Commerical,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Indemnity,,,442.01,,442.01,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Individual Exchange,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,State Preferred,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Cigna,Cigna,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Connecticare,Commerical,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Connecticare,Exchange,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Multiplan,Multiplan,,,501.54,,501.54,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Aetna,Commerical,,,344.43,,344.43,330.28,379.43,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Aetna,Middlesex Employees,,,330.28,,330.28,330.28,379.43,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Anthem,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Anthem,Indemnity,,,334.39,,334.39,330.28,379.43,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Anthem,Individual Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Anthem,State Preferred,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Cigna,Cigna,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Connecticare,Commerical,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Connecticare,Exchange,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,Multiplan,Multiplan,,,379.43,,379.43,330.28,379.43,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % TOPICAL DRPS,J3490,HCPCS,62756-427-90,NDC,both,7.5,mL,590.05,354.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.28,379.43,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Aetna,Commerical,,,455.28,,455.28,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Aetna,Middlesex Employees,,,436.58,,436.58,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Commerical,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Indemnity,,,442.01,,442.01,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,Individual Exchange,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Anthem,State Preferred,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Cigna,Cigna,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Connecticare,Commerical,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Connecticare,Exchange,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,Multiplan,Multiplan,,,501.54,,501.54,436.58,501.54,percent of total billed charges,,
CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1% NEBULIZATION,J3490,HCPCS,0065-8533-02,NDC,both,7.5,mL,590.05,354.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,436.58,501.54,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Aetna,Commerical,,,78.23,,78.23,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Aetna,Middlesex Employees,,,75.02,,75.02,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Anthem,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Anthem,Indemnity,,,75.95,,75.95,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Anthem,Individual Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Anthem,State Preferred,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Cigna,Cigna,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Connecticare,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Connecticare,Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,Multiplan,Multiplan,,,86.18,,86.18,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0074-4380-10,NDC,both,1,mL,101.39,60.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Aetna,Commerical,,,78.23,,78.23,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Aetna,Middlesex Employees,,,75.02,,75.02,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Anthem,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Anthem,Indemnity,,,75.95,,75.95,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Anthem,Individual Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Anthem,State Preferred,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Cigna,Cigna,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Connecticare,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Connecticare,Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,Multiplan,Multiplan,,,86.18,,86.18,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-417-10,NDC,both,1,mL,101.39,60.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Aetna,Commerical,,,78.23,,78.23,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Aetna,Middlesex Employees,,,75.02,,75.02,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Anthem,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Anthem,Indemnity,,,75.95,,75.95,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Anthem,Individual Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Anthem,State Preferred,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Cigna,Cigna,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Connecticare,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Connecticare,Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,Multiplan,Multiplan,,,86.18,,86.18,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-10,NDC,both,1,mL,101.39,60.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Aetna,Commerical,,,78.23,,78.23,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Aetna,Middlesex Employees,,,75.02,,75.02,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Anthem,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Anthem,Indemnity,,,75.95,,75.95,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Anthem,Individual Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Anthem,State Preferred,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Cigna,Cigna,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Connecticare,Commerical,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Connecticare,Exchange,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,Multiplan,Multiplan,,,86.18,,86.18,75.02,86.18,percent of total billed charges,,
CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-714-11,NDC,both,1,mL,101.39,60.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,75.02,86.18,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,3.62,53.72,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,3.62,53.72,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Anthem,Commerical,,,,,,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,3.62,53.72,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Anthem,State Preferred,,,,,,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Cigna,Cigna,,5.29,,,5.29,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Connecticare,Commerical,,3.62,,,3.62,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Connecticare,Exchange,,3.62,,,3.62,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,3.62,53.72,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5747-11,NDC,both,10,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,4.58,,,4.58,3.62,53.72,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Aetna,Commerical,,,97.52,,97.52,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Aetna,Middlesex Employees,,,93.52,,93.52,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Anthem,Commerical,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Anthem,Indemnity,,,94.68,,94.68,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Anthem,Individual Exchange,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Anthem,State Preferred,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Cigna,Cigna,,5.29,,,5.29,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Connecticare,Commerical,,3.62,,,3.62,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Connecticare,Exchange,,3.62,,,3.62,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,Multiplan,Multiplan,,,107.43,,107.43,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,0703-5748-11,NDC,both,10,mL,126.39,75.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.58,,,4.58,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Aetna,Commerical,,,27.34,,27.34,3.62,30.12,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Aetna,Middlesex Employees,,,26.21,,26.21,3.62,30.12,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Anthem,Commerical,,,,,,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Anthem,Indemnity,,,26.54,,26.54,3.62,30.12,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Anthem,Individual Exchange,,,,,,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Anthem,State Preferred,,,,,,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Cigna,Cigna,,5.29,,,5.29,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Connecticare,Commerical,,3.62,,,3.62,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Connecticare,Exchange,,3.62,,,3.62,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,Multiplan,Multiplan,,,30.12,,30.12,3.62,30.12,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-51,NDC,both,10,mL,35.43,21.26,United Healthcare/Oxford,United Healthcare/Oxford,,4.58,,,4.58,3.62,30.12,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Aetna,Commerical,,,97.52,,97.52,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Aetna,Middlesex Employees,,,93.52,,93.52,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Anthem,Commerical,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Anthem,Indemnity,,,94.68,,94.68,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Anthem,Individual Exchange,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Anthem,State Preferred,,,,,,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Cigna,Cigna,,5.29,,,5.29,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Connecticare,Commerical,,3.62,,,3.62,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Connecticare,Exchange,,3.62,,,3.62,3.62,107.43,Other,Could be inpatient or outpatient,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,Multiplan,Multiplan,,,107.43,,107.43,3.62,107.43,percent of total billed charges,,
CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,J9060,HCPCS,63323-103-65,NDC,both,10,mL,126.39,75.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.58,,,4.58,3.62,107.43,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Aetna,Commerical,,,0.16,,0.16,0.16,0.18,percent of total billed charges,,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.18,percent of total billed charges,,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Anthem,Commerical,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.18,percent of total billed charges,,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Anthem,Individual Exchange,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Anthem,State Preferred,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Cigna,Cigna,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Connecticare,Commerical,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Connecticare,Exchange,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,Multiplan,Multiplan,,,0.18,,0.18,0.16,0.18,percent of total billed charges,,
CITALOPRAM 10 MG TABLET,J3490,HCPCS,0904-6084-61,NDC,both,1,ea,0.21,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.18,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Aetna,Commerical,,,129.09,,129.09,123.79,142.21,percent of total billed charges,,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Aetna,Middlesex Employees,,,123.79,,123.79,123.79,142.21,percent of total billed charges,,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Anthem,Commerical,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Anthem,Indemnity,,,125.32,,125.32,123.79,142.21,percent of total billed charges,,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Anthem,Individual Exchange,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Anthem,State Preferred,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Cigna,Cigna,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Connecticare,Commerical,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Connecticare,Exchange,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,Multiplan,Multiplan,,,142.21,,142.21,123.79,142.21,percent of total billed charges,,
CITALOPRAM 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-564-24,NDC,both,1,mL,167.3,100.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,123.79,142.21,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0378-6232-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CITALOPRAM 20 MG TABLET,J3490,HCPCS,0904-6085-61,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
CITALOPRAM 40 MG TABLET,J3490,HCPCS,0378-6233-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CITALOPRAM 5 MG ORAL TAB,J3490,HCPCS,40810-0000-82,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Aetna,Commerical,,,38.07,,38.07,36.51,41.94,percent of total billed charges,,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Aetna,Middlesex Employees,,,36.51,,36.51,36.51,41.94,percent of total billed charges,,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Anthem,Commerical,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Anthem,Indemnity,,,36.96,,36.96,36.51,41.94,percent of total billed charges,,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Anthem,Individual Exchange,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Anthem,State Preferred,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Cigna,Cigna,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Connecticare,Commerical,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Connecticare,Exchange,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,Multiplan,Multiplan,,,41.94,,41.94,36.51,41.94,percent of total billed charges,,
CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,J3490,HCPCS,0395-0605-94,NDC,both,1,gm,49.34,29.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.51,41.94,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Aetna,Commerical,,,70.34,,70.34,67.45,77.49,percent of total billed charges,,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Aetna,Middlesex Employees,,,67.45,,67.45,67.45,77.49,percent of total billed charges,,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Anthem,Commerical,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Anthem,Indemnity,,,68.29,,68.29,67.45,77.49,percent of total billed charges,,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Anthem,Individual Exchange,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Anthem,State Preferred,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Cigna,Cigna,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Connecticare,Commerical,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Connecticare,Exchange,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,Multiplan,Multiplan,,,77.49,,77.49,67.45,77.49,percent of total billed charges,,
CITRIC ACID MONOHYDRATE (BULK) 100 % GRANULES,J3490,HCPCS,51552-0076-4,NDC,both,1,gm,91.16,54.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,67.45,77.49,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Commerical,,,1503.33,,1503.33,1441.57,1656.08,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Middlesex Employees,,,1441.57,,1441.57,1441.57,1656.08,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Indemnity,,,1459.49,,1459.49,1441.57,1656.08,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Individual Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,State Preferred,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Cigna,Cigna,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Multiplan,Multiplan,,,1656.08,,1656.08,1441.57,1656.08,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Aetna,Commerical,,,7516.63,,7516.63,7207.82,8280.37,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Aetna,Middlesex Employees,,,7207.82,,7207.82,7207.82,8280.37,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Anthem,Commerical,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Anthem,Indemnity,,,7297.44,,7297.44,7207.82,8280.37,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Anthem,Individual Exchange,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Anthem,State Preferred,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Cigna,Cigna,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Connecticare,Commerical,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Connecticare,Exchange,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,Multiplan,Multiplan,,,8280.37,,8280.37,7207.82,8280.37,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,3877911868,NDC,both,1,gm,9741.61,5844.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7207.82,8280.37,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Commerical,,,450.68,,450.68,432.16,496.47,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Middlesex Employees,,,432.16,,432.16,432.16,496.47,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Indemnity,,,437.53,,437.53,432.16,496.47,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Individual Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,State Preferred,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Cigna,Cigna,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Multiplan,Multiplan,,,496.47,,496.47,432.16,496.47,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
CITRULLINE (BULK) POWDER,J3490,HCPCS,6299127531,NDC,both,1,gm,137.88,82.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Commerical,,,1503.33,,1503.33,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Middlesex Employees,,,1441.57,,1441.57,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Indemnity,,,1459.49,,1459.49,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Individual Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,State Preferred,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Cigna,Cigna,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Multiplan,Multiplan,,,1656.08,,1656.08,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Commerical,,,450.68,,450.68,432.16,496.47,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Middlesex Employees,,,432.16,,432.16,432.16,496.47,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Indemnity,,,437.53,,437.53,432.16,496.47,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Individual Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,State Preferred,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Cigna,Cigna,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Multiplan,Multiplan,,,496.47,,496.47,432.16,496.47,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Aetna,Commerical,,,4.51,,4.51,4.33,4.97,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Aetna,Middlesex Employees,,,4.33,,4.33,4.33,4.97,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Anthem,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Anthem,Indemnity,,,4.38,,4.38,4.33,4.97,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Anthem,Individual Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Anthem,State Preferred,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Cigna,Cigna,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Connecticare,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Connecticare,Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,Multiplan,Multiplan,,,4.97,,4.97,4.33,4.97,percent of total billed charges,,
CITRULLINE 0.5 GRAM POWDER PACKET,J3490,HCPCS,40810-0017-37,NDC,both,1,gm,5.85,3.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Commerical,,,1503.33,,1503.33,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Aetna,Middlesex Employees,,,1441.57,,1441.57,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Indemnity,,,1459.49,,1459.49,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,Individual Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Anthem,State Preferred,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Cigna,Cigna,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Commerical,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Connecticare,Exchange,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,Multiplan,Multiplan,,,1656.08,,1656.08,1441.57,1656.08,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,3877911865,NDC,both,1,gm,1948.33,1169,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1441.57,1656.08,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Commerical,,,450.68,,450.68,432.16,496.47,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Aetna,Middlesex Employees,,,432.16,,432.16,432.16,496.47,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Indemnity,,,437.53,,437.53,432.16,496.47,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,Individual Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Anthem,State Preferred,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Cigna,Cigna,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Commerical,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Connecticare,Exchange,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,Multiplan,Multiplan,,,496.47,,496.47,432.16,496.47,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,5155206655,NDC,both,1,gm,584.08,350.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,432.16,496.47,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,6299127531,NDC,both,1,gm,584.08,350.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Aetna,Commerical,,,4.51,,4.51,4.33,4.97,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Aetna,Middlesex Employees,,,4.33,,4.33,4.33,4.97,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Anthem,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Anthem,Indemnity,,,4.38,,4.38,4.33,4.97,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Anthem,Individual Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Anthem,State Preferred,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Cigna,Cigna,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Connecticare,Commerical,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Connecticare,Exchange,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,Multiplan,Multiplan,,,4.97,,4.97,4.33,4.97,percent of total billed charges,,
CITRULLINE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0201-67,NDC,both,1,gm,5.85,3.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.33,4.97,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Aetna,Commerical,,,307.2,,307.2,16.2,338.41,percent of total billed charges,,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Aetna,Middlesex Employees,,,294.58,,294.58,16.2,338.41,percent of total billed charges,,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Anthem,Commerical,,,,,,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Anthem,Indemnity,,,298.24,,298.24,16.2,338.41,percent of total billed charges,,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Anthem,Individual Exchange,,,,,,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Anthem,State Preferred,,,,,,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Cigna,Cigna,,18.72,,,18.72,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Connecticare,Commerical,,21.75,,,21.75,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Connecticare,Exchange,,21.75,,,21.75,16.2,338.41,Other,Could be inpatient or outpatient,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,Multiplan,Multiplan,,,338.41,,338.41,16.2,338.41,percent of total billed charges,,
CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,J9065,HCPCS,63323-140-10,NDC,both,1,mL,398.13,238.88,United Healthcare/Oxford,United Healthcare/Oxford,,16.2,,,16.2,16.2,338.41,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Aetna,Commerical,,,451.86,,451.86,433.29,497.77,percent of total billed charges,,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Aetna,Middlesex Employees,,,433.29,,433.29,433.29,497.77,percent of total billed charges,,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Anthem,Commerical,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Anthem,Indemnity,,,438.68,,438.68,433.29,497.77,percent of total billed charges,,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Anthem,Individual Exchange,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Anthem,State Preferred,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Cigna,Cigna,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Connecticare,Commerical,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Connecticare,Exchange,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,Multiplan,Multiplan,,,497.77,,497.77,433.29,497.77,percent of total billed charges,,
CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,J8499,HCPCS,0781-6023-46,NDC,both,1,mL,585.61,351.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,433.29,497.77,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Anthem,Indemnity,,,1.42,,1.42,1.41,1.62,percent of total billed charges,,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
CLARITHROMYCIN 500 MG TABLET,J8499,HCPCS,0781-1962-60,NDC,both,1,ea,1.9,1.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Aetna,Commerical,,,34.41,,34.41,33,37.91,percent of total billed charges,,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Aetna,Middlesex Employees,,,33,,33,33,37.91,percent of total billed charges,,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Anthem,Commerical,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Anthem,Indemnity,,,33.41,,33.41,33,37.91,percent of total billed charges,,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Anthem,Individual Exchange,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Anthem,State Preferred,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Cigna,Cigna,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Connecticare,Commerical,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Connecticare,Exchange,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,Multiplan,Multiplan,,,37.91,,37.91,33,37.91,percent of total billed charges,,
CLINDAMYCIN 12 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-47,NDC,both,1,mL,44.6,26.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33,37.91,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-20,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-05,NDC,both,2,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,0009-5095-06,NDC,both,2,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-02,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-02,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0775-26,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-21,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0870-26,NDC,both,1,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-0902-11,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,0009-4073-03,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-04,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Aetna,Commerical,,,67.92,,67.92,2.7,74.82,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Aetna,Middlesex Employees,,,65.13,,65.13,2.7,74.82,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Anthem,Commerical,,,,,,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Anthem,Indemnity,,,65.94,,65.94,2.7,74.82,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Anthem,Individual Exchange,,,,,,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Anthem,State Preferred,,,,,,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Cigna,Cigna,,2.7,,,2.7,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Connecticare,Commerical,,3.76,,,3.76,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Connecticare,Exchange,,3.76,,,3.76,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,Multiplan,Multiplan,,,74.82,,74.82,2.7,74.82,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,25021-115-51,NDC,both,2,mL,88.02,52.81,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,74.82,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-04,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Aetna,Commerical,,,69.34,,69.34,2.7,76.38,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Aetna,Middlesex Employees,,,66.49,,66.49,2.7,76.38,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Anthem,Commerical,,,,,,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Anthem,Indemnity,,,67.31,,67.31,2.7,76.38,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Anthem,Individual Exchange,,,,,,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Anthem,State Preferred,,,,,,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Cigna,Cigna,,2.7,,,2.7,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Connecticare,Commerical,,3.76,,,3.76,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Connecticare,Exchange,,3.76,,,3.76,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,Multiplan,Multiplan,,,76.38,,76.38,2.7,76.38,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,63323-282-60,NDC,both,2,mL,89.86,53.92,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,76.38,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-815-04,NDC,both,2,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,67457-816-06,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-01,NDC,both,2,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Aetna,Commerical,,,4.75,,4.75,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Aetna,Middlesex Employees,,,4.56,,4.56,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Commerical,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Indemnity,,,4.61,,4.61,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,Individual Exchange,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Anthem,State Preferred,,,,,,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Cigna,Cigna,,2.7,,,2.7,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Connecticare,Commerical,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Connecticare,Exchange,,3.76,,,3.76,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,Multiplan,Multiplan,,,5.24,,5.24,2.7,5.24,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-634-25,NDC,both,2,mL,6.16,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,5.24,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-01,NDC,both,2,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Aetna,Commerical,,,9.51,,9.51,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Aetna,Middlesex Employees,,,9.12,,9.12,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Commerical,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Indemnity,,,9.23,,9.23,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,Individual Exchange,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Anthem,State Preferred,,,,,,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Cigna,Cigna,,2.7,,,2.7,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Connecticare,Commerical,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Connecticare,Exchange,,3.76,,,3.76,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,Multiplan,Multiplan,,,10.47,,10.47,2.7,10.47,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-639-25,NDC,both,1,mL,12.32,7.39,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,10.47,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-01,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Aetna,Commerical,,,14.26,,14.26,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Aetna,Middlesex Employees,,,13.67,,13.67,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Anthem,Commerical,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Anthem,Indemnity,,,13.84,,13.84,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Anthem,Individual Exchange,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Anthem,State Preferred,,,,,,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Cigna,Cigna,,2.7,,,2.7,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Connecticare,Commerical,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Connecticare,Exchange,,3.76,,,3.76,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,Multiplan,Multiplan,,,15.71,,15.71,2.7,15.71,percent of total billed charges,,
CLINDAMYCIN 150 MG/ML INTRA-AMNIOTIC INJECTION,J0736,HCPCS,72611-642-25,NDC,both,1,mL,18.48,11.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,15.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,2.7,,,2.7,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Anthem,Commerical,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Anthem,State Preferred,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Cigna,Cigna,,2.7,,,2.7,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Connecticare,Commerical,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Connecticare,Exchange,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J0736,HCPCS,43066-993-24,NDC,both,25,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,2.7,,,2.7,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,3.76,,,3.76,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,2.7,13.02,percent of total billed charges,,
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J0736,HCPCS,0338-3612-50,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,13.02,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0009-0760-04,NDC,both,1,mL,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0574-0129-01,NDC,both,1,mL,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,23155-603-51,NDC,both,1,mL,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-0016-1,NDC,both,1,mL,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Aetna,Commerical,,,55.27,,55.27,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Aetna,Middlesex Employees,,,53,,53,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Anthem,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Anthem,Indemnity,,,53.66,,53.66,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Anthem,Individual Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Anthem,State Preferred,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Cigna,Cigna,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Connecticare,Commerical,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Connecticare,Exchange,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,Multiplan,Multiplan,,,60.89,,60.89,53,60.89,percent of total billed charges,,
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65862-596-01,NDC,both,1,mL,71.63,42.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53,60.89,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,0904-5959-61,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,42292-018-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63304-692-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
CLINDAMYCIN HCL 150 MG CAPSULE,J3490,HCPCS,63739-059-10,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,0904-7194-61,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,65862-186-01,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-01,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
CLINDAMYCIN HCL 300 MG CAPSULE,J3490,HCPCS,68084-244-11,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Aetna,Commerical,,,0.64,,0.64,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Anthem,Commerical,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Anthem,Indemnity,,,0.62,,0.62,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Anthem,Individual Exchange,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Anthem,State Preferred,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Cigna,Cigna,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Connecticare,Commerical,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Connecticare,Exchange,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,0009-0331-02,NDC,both,1,ea,0.83,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Aetna,Commerical,,,0.64,,0.64,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Anthem,Commerical,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Anthem,Indemnity,,,0.62,,0.62,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Anthem,Individual Exchange,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Anthem,State Preferred,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Cigna,Cigna,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Connecticare,Commerical,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Connecticare,Exchange,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.61,0.71,percent of total billed charges,,
CLINDAMYCIN HCL 75 MG CAPSULE,J3490,HCPCS,40810-0011-24,NDC,both,1,ea,0.83,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.71,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Aetna,Commerical,,,15.16,,15.16,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Aetna,Middlesex Employees,,,14.54,,14.54,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Anthem,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Anthem,Indemnity,,,14.72,,14.72,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Anthem,Individual Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Anthem,State Preferred,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Cigna,Cigna,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Connecticare,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Connecticare,Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,Multiplan,Multiplan,,,16.7,,16.7,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,0168-0201-30,NDC,both,1,mL,19.65,11.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Aetna,Commerical,,,15.16,,15.16,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Aetna,Middlesex Employees,,,14.54,,14.54,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Anthem,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Anthem,Indemnity,,,14.72,,14.72,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Anthem,Individual Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Anthem,State Preferred,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Cigna,Cigna,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Connecticare,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Connecticare,Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,Multiplan,Multiplan,,,16.7,,16.7,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,21922-002-21,NDC,both,1,mL,19.65,11.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Aetna,Commerical,,,15.16,,15.16,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Aetna,Middlesex Employees,,,14.54,,14.54,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Anthem,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Anthem,Indemnity,,,14.72,,14.72,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Anthem,Individual Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Anthem,State Preferred,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Cigna,Cigna,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Connecticare,Commerical,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Connecticare,Exchange,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,Multiplan,Multiplan,,,16.7,,16.7,14.54,16.7,percent of total billed charges,,
CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,J3490,HCPCS,45802-562-01,NDC,both,1,mL,19.65,11.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.54,16.7,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,0832-0580-11,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,40810-0015-19,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
CLOBAZAM 10 MG TABLET,J8499,HCPCS,67386-314-01,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Aetna,Commerical,,,46.03,,46.03,44.14,50.71,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Aetna,Middlesex Employees,,,44.14,,44.14,44.14,50.71,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Indemnity,,,44.69,,44.69,44.14,50.71,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Individual Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,State Preferred,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Cigna,Cigna,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Connecticare,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Connecticare,Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Multiplan,Multiplan,,,50.71,,50.71,44.14,50.71,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Aetna,Commerical,,,1380.92,,1380.92,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Aetna,Middlesex Employees,,,1324.19,,1324.19,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Anthem,Commerical,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Anthem,Indemnity,,,1340.66,,1340.66,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Anthem,Individual Exchange,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Anthem,State Preferred,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Cigna,Cigna,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Connecticare,Commerical,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Connecticare,Exchange,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,Multiplan,Multiplan,,,1521.24,,1521.24,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 10 MG/4 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,67877-658-61,NDC,both,1,mL,1789.69,1073.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Aetna,Commerical,,,42.28,,42.28,40.54,46.57,percent of total billed charges,,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Aetna,Middlesex Employees,,,40.54,,40.54,40.54,46.57,percent of total billed charges,,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Anthem,Commerical,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Anthem,Indemnity,,,41.04,,41.04,40.54,46.57,percent of total billed charges,,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Anthem,Individual Exchange,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Anthem,State Preferred,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Cigna,Cigna,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Connecticare,Commerical,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Connecticare,Exchange,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,Multiplan,Multiplan,,,46.57,,46.57,40.54,46.57,percent of total billed charges,,
CLOBAZAM 2.5 MG TABLET,J8499,HCPCS,40810-0015-25,NDC,both,4,ea,54.79,32.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.54,46.57,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Aetna,Commerical,,,134.41,,134.41,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Aetna,Middlesex Employees,,,128.88,,128.88,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Anthem,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Anthem,Indemnity,,,130.49,,130.49,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Anthem,Individual Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Anthem,State Preferred,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Cigna,Cigna,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Connecticare,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Connecticare,Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,Multiplan,Multiplan,,,148.06,,148.06,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,0378-8043-21,NDC,both,1,mL,174.19,104.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Aetna,Commerical,,,46.03,,46.03,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Aetna,Middlesex Employees,,,44.14,,44.14,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Anthem,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Anthem,Indemnity,,,44.69,,44.69,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Anthem,Individual Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Anthem,State Preferred,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Cigna,Cigna,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Connecticare,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Connecticare,Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,Multiplan,Multiplan,,,50.71,,50.71,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,5.81,3.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Aetna,Commerical,,,134.41,,134.41,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Aetna,Middlesex Employees,,,128.88,,128.88,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Anthem,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Anthem,Indemnity,,,130.49,,130.49,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Anthem,Individual Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Anthem,State Preferred,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Cigna,Cigna,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Connecticare,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Connecticare,Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,Multiplan,Multiplan,,,148.06,,148.06,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67386-313-21,NDC,both,1,mL,174.19,104.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Aetna,Commerical,,,1380.92,,1380.92,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Aetna,Middlesex Employees,,,1324.19,,1324.19,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Anthem,Commerical,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Anthem,Indemnity,,,1340.66,,1340.66,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Anthem,Individual Exchange,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Anthem,State Preferred,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Cigna,Cigna,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Connecticare,Commerical,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Connecticare,Exchange,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,Multiplan,Multiplan,,,1521.24,,1521.24,1324.19,1521.24,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,67877-658-61,NDC,both,1,mL,174.19,104.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1324.19,1521.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Aetna,Commerical,,,134.41,,134.41,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Aetna,Middlesex Employees,,,128.88,,128.88,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Anthem,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Anthem,Indemnity,,,130.49,,130.49,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Anthem,Individual Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Anthem,State Preferred,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Cigna,Cigna,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Connecticare,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Connecticare,Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,Multiplan,Multiplan,,,148.06,,148.06,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,68180-156-01,NDC,both,1,mL,174.19,104.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Aetna,Commerical,,,134.41,,134.41,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Aetna,Middlesex Employees,,,128.88,,128.88,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Anthem,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Anthem,Indemnity,,,130.49,,130.49,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Anthem,Individual Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Anthem,State Preferred,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Cigna,Cigna,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Connecticare,Commerical,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Connecticare,Exchange,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,Multiplan,Multiplan,,,148.06,,148.06,128.88,148.06,percent of total billed charges,,
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,J8499,HCPCS,69238-1535-2,NDC,both,1,mL,174.19,104.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,128.88,148.06,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0014-03,NDC,both,1,mL,14.92,8.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Aetna,Commerical,,,46.03,,46.03,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Aetna,Middlesex Employees,,,44.14,,44.14,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Indemnity,,,44.69,,44.69,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,Individual Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Anthem,State Preferred,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Cigna,Cigna,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Connecticare,Commerical,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Connecticare,Exchange,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,Multiplan,Multiplan,,,50.71,,50.71,44.14,50.71,percent of total billed charges,,
CLOBAZAM 2.5MG/1ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0019-87,NDC,both,1,mL,59.66,35.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.14,50.71,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Aetna,Commerical,,,42.27,,42.27,40.53,46.56,percent of total billed charges,,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Aetna,Middlesex Employees,,,40.53,,40.53,40.53,46.56,percent of total billed charges,,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Anthem,Commerical,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Anthem,Indemnity,,,41.04,,41.04,40.53,46.56,percent of total billed charges,,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Anthem,Individual Exchange,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Anthem,State Preferred,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Cigna,Cigna,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Connecticare,Commerical,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Connecticare,Exchange,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,Multiplan,Multiplan,,,46.56,,46.56,40.53,46.56,percent of total billed charges,,
CLOBAZAM 5 MG TABLET,J8499,HCPCS,40810-0010-26,NDC,both,2,ea,54.78,32.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.53,46.56,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Aetna,Commerical,,,85.34,,85.34,81.83,94.01,percent of total billed charges,,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Aetna,Middlesex Employees,,,81.83,,81.83,81.83,94.01,percent of total billed charges,,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Anthem,Commerical,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Anthem,Indemnity,,,82.85,,82.85,81.83,94.01,percent of total billed charges,,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Anthem,Individual Exchange,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Anthem,State Preferred,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Cigna,Cigna,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Connecticare,Commerical,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Connecticare,Exchange,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,Multiplan,Multiplan,,,94.01,,94.01,81.83,94.01,percent of total billed charges,,
CLOBETASOL 0.05 % SCALP SOLUTION,J3490,HCPCS,51672-1293-2,NDC,both,1,mL,110.6,66.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,81.83,94.01,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Aetna,Commerical,,,14.14,,14.14,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Aetna,Middlesex Employees,,,13.56,,13.56,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Anthem,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Anthem,Indemnity,,,13.73,,13.73,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Anthem,Individual Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Anthem,State Preferred,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Cigna,Cigna,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Connecticare,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Connecticare,Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,Multiplan,Multiplan,,,15.58,,15.58,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0163-15,NDC,both,1,gm,18.33,11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Aetna,Commerical,,,14.14,,14.14,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Aetna,Middlesex Employees,,,13.56,,13.56,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Anthem,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Anthem,Indemnity,,,13.73,,13.73,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Anthem,Individual Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Anthem,State Preferred,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Cigna,Cigna,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Connecticare,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Connecticare,Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,Multiplan,Multiplan,,,15.58,,15.58,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,21922-016-04,NDC,both,1,gm,18.33,11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Aetna,Commerical,,,14.14,,14.14,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Aetna,Middlesex Employees,,,13.56,,13.56,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Anthem,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Anthem,Indemnity,,,13.73,,13.73,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Anthem,Individual Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Anthem,State Preferred,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Cigna,Cigna,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Connecticare,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Connecticare,Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,Multiplan,Multiplan,,,15.58,,15.58,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,51672-1258-1,NDC,both,1,gm,18.33,11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Aetna,Commerical,,,14.14,,14.14,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Aetna,Middlesex Employees,,,13.56,,13.56,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Anthem,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Anthem,Indemnity,,,13.73,,13.73,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Anthem,Individual Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Anthem,State Preferred,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Cigna,Cigna,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Connecticare,Commerical,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Connecticare,Exchange,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,Multiplan,Multiplan,,,15.58,,15.58,13.56,15.58,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL CREAM,J3490,HCPCS,70700-109-15,NDC,both,1,gm,18.33,11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.56,15.58,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Aetna,Commerical,,,39.01,,39.01,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Aetna,Middlesex Employees,,,37.41,,37.41,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Anthem,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Anthem,Indemnity,,,37.87,,37.87,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Anthem,Individual Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Anthem,State Preferred,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Cigna,Cigna,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Connecticare,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Connecticare,Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,Multiplan,Multiplan,,,42.98,,42.98,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,0168-0162-15,NDC,both,1,gm,50.56,30.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Aetna,Commerical,,,39.01,,39.01,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Aetna,Middlesex Employees,,,37.41,,37.41,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Anthem,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Anthem,Indemnity,,,37.87,,37.87,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Anthem,Individual Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Anthem,State Preferred,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Cigna,Cigna,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Connecticare,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Connecticare,Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,Multiplan,Multiplan,,,42.98,,42.98,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,50383-268-15,NDC,both,1,gm,50.56,30.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Aetna,Commerical,,,39.01,,39.01,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Aetna,Middlesex Employees,,,37.41,,37.41,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Anthem,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Anthem,Indemnity,,,37.87,,37.87,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Anthem,Individual Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Anthem,State Preferred,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Cigna,Cigna,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Connecticare,Commerical,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Connecticare,Exchange,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,Multiplan,Multiplan,,,42.98,,42.98,37.41,42.98,percent of total billed charges,,
CLOBETASOL 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1259-1,NDC,both,1,gm,50.56,30.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.41,42.98,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Aetna,Commerical,,,8412.71,,8412.71,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Aetna,Middlesex Employees,,,8067.09,,8067.09,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Anthem,Commerical,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Anthem,Indemnity,,,8167.39,,8167.39,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Anthem,Individual Exchange,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Anthem,State Preferred,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Cigna,Cigna,,12.96,,,12.96,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Connecticare,Commerical,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Connecticare,Exchange,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,Multiplan,Multiplan,,,9267.5,,9267.5,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,0024-5860-01,NDC,both,1,mL,10902.94,6541.76,United Healthcare/Oxford,United Healthcare/Oxford,,11.21,,,11.21,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Aetna,Commerical,,,8412.71,,8412.71,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Aetna,Middlesex Employees,,,8067.09,,8067.09,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Anthem,Commerical,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Anthem,Indemnity,,,8167.39,,8167.39,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Anthem,Individual Exchange,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Anthem,State Preferred,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Cigna,Cigna,,12.96,,,12.96,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Connecticare,Commerical,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Connecticare,Exchange,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,Multiplan,Multiplan,,,9267.5,,9267.5,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,63323-572-70,NDC,both,1,mL,10902.94,6541.76,United Healthcare/Oxford,United Healthcare/Oxford,,11.21,,,11.21,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Aetna,Commerical,,,8412.71,,8412.71,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Aetna,Middlesex Employees,,,8067.09,,8067.09,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Anthem,Commerical,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Anthem,Indemnity,,,8167.39,,8167.39,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Anthem,Individual Exchange,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Anthem,State Preferred,,,,,,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Cigna,Cigna,,12.96,,,12.96,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Connecticare,Commerical,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Connecticare,Exchange,,21.95,,,21.95,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,Multiplan,Multiplan,,,9267.5,,9267.5,11.21,9267.5,percent of total billed charges,,
CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,J9027,HCPCS,70121-1236-1,NDC,both,1,mL,10902.94,6541.76,United Healthcare/Oxford,United Healthcare/Oxford,,11.21,,,11.21,11.21,9267.5,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Anthem,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Anthem,Individual Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Anthem,State Preferred,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Cigna,Cigna,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Connecticare,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Connecticare,Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,40810-0205-55,NDC,both,1,ea,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Anthem,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Anthem,Individual Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Anthem,State Preferred,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Cigna,Cigna,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Connecticare,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Connecticare,Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,1.35,1.55,percent of total billed charges,,
CLOMIPRAMINE 25 MG CAPSULE,J3490,HCPCS,52817-280-10,NDC,both,1,ea,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0000-83,NDC,both,10,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,19.73,22.66,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,19.73,22.66,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Anthem,Commerical,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,19.73,22.66,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Anthem,Individual Exchange,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Anthem,State Preferred,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Cigna,Cigna,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Connecticare,Commerical,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Connecticare,Exchange,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,19.73,22.66,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-12,NDC,both,10,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Aetna,Commerical,,,41.14,,41.14,39.45,45.32,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Aetna,Middlesex Employees,,,39.45,,39.45,39.45,45.32,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Anthem,Commerical,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Anthem,Indemnity,,,39.94,,39.94,39.45,45.32,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Anthem,Individual Exchange,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Anthem,State Preferred,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Cigna,Cigna,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Connecticare,Commerical,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Connecticare,Exchange,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,Multiplan,Multiplan,,,45.32,,45.32,39.45,45.32,percent of total billed charges,,
CLONAZEPAM 0.1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0016-90,NDC,both,10,mL,53.32,31.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.45,45.32,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Anthem,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Anthem,Individual Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Anthem,State Preferred,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Cigna,Cigna,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Connecticare,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Connecticare,Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0094-96,NDC,both,1,ea,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Anthem,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Anthem,Individual Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Anthem,State Preferred,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Cigna,Cigna,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Connecticare,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Connecticare,Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-02,NDC,both,1,ea,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Anthem,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Anthem,Individual Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Anthem,State Preferred,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Cigna,Cigna,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Connecticare,Commerical,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Connecticare,Exchange,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,1.75,2.01,percent of total billed charges,,
CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-306-52,NDC,both,1,ea,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.75,2.01,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0095-96,NDC,both,1,ea,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-307-52,NDC,both,1,ea,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,57664-784-86,NDC,both,1,ea,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-365-06,NDC,both,1,ea,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
CLONAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0000-85,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Aetna,Commerical,,,1.69,,1.69,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Aetna,Middlesex Employees,,,1.62,,1.62,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Anthem,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Anthem,Indemnity,,,1.64,,1.64,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Anthem,Individual Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Anthem,State Preferred,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Cigna,Cigna,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Connecticare,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Connecticare,Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,Multiplan,Multiplan,,,1.86,,1.86,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0096-96,NDC,both,1,ea,2.19,1.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.45,1.67,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.45,1.67,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Anthem,Commerical,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.45,1.67,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Anthem,Individual Exchange,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Anthem,State Preferred,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Cigna,Cigna,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Connecticare,Commerical,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Connecticare,Exchange,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.45,1.67,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-02,NDC,both,1,ea,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Aetna,Commerical,,,1.69,,1.69,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Aetna,Middlesex Employees,,,1.62,,1.62,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Anthem,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Anthem,Indemnity,,,1.64,,1.64,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Anthem,Individual Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Anthem,State Preferred,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Cigna,Cigna,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Connecticare,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Connecticare,Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,Multiplan,Multiplan,,,1.86,,1.86,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-308-52,NDC,both,1,ea,2.19,1.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Aetna,Commerical,,,1.69,,1.69,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Aetna,Middlesex Employees,,,1.62,,1.62,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Anthem,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Anthem,Indemnity,,,1.64,,1.64,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Anthem,Individual Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Anthem,State Preferred,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Cigna,Cigna,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Connecticare,Commerical,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Connecticare,Exchange,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,Multiplan,Multiplan,,,1.86,,1.86,1.62,1.86,percent of total billed charges,,
CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,J3490,HCPCS,62332-366-06,NDC,both,1,ea,2.19,1.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.62,1.86,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Anthem,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Anthem,Indemnity,,,1.13,,1.13,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Anthem,Individual Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Anthem,State Preferred,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Cigna,Cigna,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Connecticare,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Connecticare,Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,Multiplan,Multiplan,,,1.28,,1.28,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-7227-61,NDC,both,1,ea,1.51,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Anthem,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Anthem,Indemnity,,,1.13,,1.13,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Anthem,Individual Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Anthem,State Preferred,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Cigna,Cigna,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Connecticare,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Connecticare,Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,Multiplan,Multiplan,,,1.28,,1.28,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,43547-406-10,NDC,both,1,ea,1.51,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Anthem,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Anthem,Indemnity,,,1.13,,1.13,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Anthem,Individual Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Anthem,State Preferred,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Cigna,Cigna,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Connecticare,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Connecticare,Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,Multiplan,Multiplan,,,1.28,,1.28,1.12,1.28,percent of total billed charges,,
CLONAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-544-01,NDC,both,1,ea,1.51,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
CLONAZEPAM 0.5 MG/5 ML SUSPENSION SYRINGE,J3490,HCPCS,40810-0014-23,NDC,both,5,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Aetna,Commerical,,,2.33,,2.33,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Aetna,Middlesex Employees,,,2.23,,2.23,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Anthem,Commerical,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Anthem,Indemnity,,,2.26,,2.26,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Anthem,Individual Exchange,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Anthem,State Preferred,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Cigna,Cigna,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Connecticare,Commerical,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Connecticare,Exchange,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,Multiplan,Multiplan,,,2.57,,2.57,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0097-96,NDC,both,1,ea,3.02,1.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Aetna,Commerical,,,2.33,,2.33,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Aetna,Middlesex Employees,,,2.23,,2.23,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Anthem,Commerical,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Anthem,Indemnity,,,2.26,,2.26,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Anthem,Individual Exchange,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Anthem,State Preferred,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Cigna,Cigna,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Connecticare,Commerical,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Connecticare,Exchange,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,Multiplan,Multiplan,,,2.57,,2.57,2.23,2.57,percent of total billed charges,,
CLONAZEPAM 1 MG DISINTEGRATING TABLET,J3490,HCPCS,49884-309-02,NDC,both,1,ea,3.02,1.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.23,2.57,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Aetna,Commerical,,,1.26,,1.26,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Anthem,Indemnity,,,1.22,,1.22,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-01,NDC,both,1,ea,1.63,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Aetna,Commerical,,,1.26,,1.26,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Anthem,Indemnity,,,1.22,,1.22,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
CLONAZEPAM 1 MG TABLET,J3490,HCPCS,60687-555-11,NDC,both,1,ea,1.63,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Aetna,Commerical,,,3.23,,3.23,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Aetna,Middlesex Employees,,,3.1,,3.1,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Anthem,Commerical,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Anthem,Indemnity,,,3.14,,3.14,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Anthem,Individual Exchange,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Anthem,State Preferred,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Cigna,Cigna,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Connecticare,Commerical,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Connecticare,Exchange,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,Multiplan,Multiplan,,,3.56,,3.56,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0093-9294-19,NDC,both,1,ea,4.19,2.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Aetna,Commerical,,,3.23,,3.23,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Aetna,Middlesex Employees,,,3.1,,3.1,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Anthem,Commerical,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Anthem,Indemnity,,,3.14,,3.14,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Anthem,Individual Exchange,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Anthem,State Preferred,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Cigna,Cigna,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Connecticare,Commerical,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Connecticare,Exchange,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,Multiplan,Multiplan,,,3.56,,3.56,3.1,3.56,percent of total billed charges,,
CLONAZEPAM 2 MG DISINTEGRATING TABLET,J3490,HCPCS,0555-0098-96,NDC,both,1,ea,4.19,2.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.1,3.56,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Aetna,Commerical,,,49.06,,49.06,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Aetna,Middlesex Employees,,,47.04,,47.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Anthem,Commerical,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Anthem,Indemnity,,,47.63,,47.63,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Anthem,Individual Exchange,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Anthem,State Preferred,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Cigna,Cigna,,19.63,,,19.63,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Connecticare,Commerical,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Connecticare,Exchange,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,Multiplan,Multiplan,,,54.04,,54.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,0143-9724-01,NDC,both,10,mL,63.58,38.15,United Healthcare/Oxford,United Healthcare/Oxford,,21.19,,,21.19,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Aetna,Commerical,,,49.06,,49.06,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Aetna,Middlesex Employees,,,47.04,,47.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Anthem,Commerical,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Anthem,Indemnity,,,47.63,,47.63,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Anthem,Individual Exchange,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Anthem,State Preferred,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Cigna,Cigna,,19.63,,,19.63,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Connecticare,Commerical,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Connecticare,Exchange,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,Multiplan,Multiplan,,,54.04,,54.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,39822-2000-1,NDC,both,0.01,mL,63.58,38.15,United Healthcare/Oxford,United Healthcare/Oxford,,21.19,,,21.19,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Aetna,Commerical,,,49.06,,49.06,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Aetna,Middlesex Employees,,,47.04,,47.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Anthem,Commerical,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Anthem,Indemnity,,,47.63,,47.63,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Anthem,Individual Exchange,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Anthem,State Preferred,,,,,,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Cigna,Cigna,,19.63,,,19.63,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Connecticare,Commerical,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Connecticare,Exchange,,28.05,,,28.05,19.63,54.04,Other,Could be inpatient or outpatient,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,Multiplan,Multiplan,,,54.04,,54.04,19.63,54.04,percent of total billed charges,,
"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",J0735,HCPCS,67457-218-10,NDC,both,10,mL,63.58,38.15,United Healthcare/Oxford,United Healthcare/Oxford,,21.19,,,21.19,19.63,54.04,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CLONIDINE 0.025 MG ORAL TAB,J3490,HCPCS,40810-0000-86,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Aetna,Commerical,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Aetna,Middlesex Employees,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Anthem,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Anthem,Indemnity,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Anthem,Individual Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Anthem,State Preferred,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Cigna,Cigna,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Connecticare,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Connecticare,Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.12,0.14,percent of total billed charges,,
CLONIDINE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0000-87,NDC,both,1,ea,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Aetna,Commerical,,,24.53,,24.53,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Aetna,Middlesex Employees,,,23.52,,23.52,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Anthem,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Anthem,Indemnity,,,23.81,,23.81,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Anthem,Individual Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Anthem,State Preferred,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Cigna,Cigna,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Connecticare,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Connecticare,Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,Multiplan,Multiplan,,,27.02,,27.02,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0871-99,NDC,both,1,ea,31.79,19.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Aetna,Commerical,,,24.53,,24.53,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Aetna,Middlesex Employees,,,23.52,,23.52,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Anthem,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Anthem,Indemnity,,,23.81,,23.81,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Anthem,Individual Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Anthem,State Preferred,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Cigna,Cigna,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Connecticare,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Connecticare,Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,Multiplan,Multiplan,,,27.02,,27.02,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-01,NDC,both,1,ea,31.79,19.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Aetna,Commerical,,,24.53,,24.53,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Aetna,Middlesex Employees,,,23.52,,23.52,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Anthem,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Anthem,Indemnity,,,23.81,,23.81,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Anthem,Individual Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Anthem,State Preferred,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Cigna,Cigna,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Connecticare,Commerical,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Connecticare,Exchange,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,Multiplan,Multiplan,,,27.02,,27.02,23.52,27.02,percent of total billed charges,,
CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,51862-453-04,NDC,both,1,ea,31.79,19.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.52,27.02,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Aetna,Commerical,,,41.02,,41.02,39.33,45.19,percent of total billed charges,,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Aetna,Middlesex Employees,,,39.33,,39.33,39.33,45.19,percent of total billed charges,,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Anthem,Commerical,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Anthem,Indemnity,,,39.82,,39.82,39.33,45.19,percent of total billed charges,,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Anthem,Individual Exchange,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Anthem,State Preferred,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Cigna,Cigna,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Connecticare,Commerical,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Connecticare,Exchange,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,Multiplan,Multiplan,,,45.19,,45.19,39.33,45.19,percent of total billed charges,,
CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0872-99,NDC,both,1,ea,53.16,31.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.33,45.19,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Aetna,Commerical,,,52.63,,52.63,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Aetna,Middlesex Employees,,,50.47,,50.47,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Anthem,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Anthem,Indemnity,,,51.1,,51.1,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Anthem,Individual Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Anthem,State Preferred,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Cigna,Cigna,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Connecticare,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Connecticare,Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,Multiplan,Multiplan,,,57.98,,57.98,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0378-0873-99,NDC,both,1,ea,68.21,40.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Aetna,Commerical,,,182.9,,182.9,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Aetna,Middlesex Employees,,,175.39,,175.39,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Anthem,Commerical,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Anthem,Indemnity,,,177.57,,177.57,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Anthem,Individual Exchange,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Anthem,State Preferred,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Cigna,Cigna,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Connecticare,Commerical,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Connecticare,Exchange,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,Multiplan,Multiplan,,,201.48,,201.48,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-04,NDC,both,1,ea,237.04,142.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Aetna,Commerical,,,182.9,,182.9,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Aetna,Middlesex Employees,,,175.39,,175.39,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Anthem,Commerical,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Anthem,Indemnity,,,177.57,,177.57,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Anthem,Individual Exchange,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Anthem,State Preferred,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Cigna,Cigna,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Connecticare,Commerical,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Connecticare,Exchange,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,Multiplan,Multiplan,,,201.48,,201.48,175.39,201.48,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,0591-3510-54,NDC,both,1,ea,237.04,142.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.39,201.48,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Aetna,Commerical,,,52.63,,52.63,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Aetna,Middlesex Employees,,,50.47,,50.47,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Anthem,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Anthem,Indemnity,,,51.1,,51.1,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Anthem,Individual Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Anthem,State Preferred,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Cigna,Cigna,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Connecticare,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Connecticare,Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,Multiplan,Multiplan,,,57.98,,57.98,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-11,NDC,both,1,ea,68.21,40.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Aetna,Commerical,,,52.63,,52.63,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Aetna,Middlesex Employees,,,50.47,,50.47,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Anthem,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Anthem,Indemnity,,,51.1,,51.1,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Anthem,Individual Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Anthem,State Preferred,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Cigna,Cigna,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Connecticare,Commerical,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Connecticare,Exchange,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,Multiplan,Multiplan,,,57.98,,57.98,50.47,57.98,percent of total billed charges,,
CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,J3490,HCPCS,75907-025-48,NDC,both,1,ea,68.21,40.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.47,57.98,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Aetna,Commerical,,,21.73,,21.73,20.84,23.94,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Aetna,Middlesex Employees,,,20.84,,20.84,20.84,23.94,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Anthem,Commerical,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Anthem,Indemnity,,,21.09,,21.09,20.84,23.94,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Anthem,Individual Exchange,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Anthem,State Preferred,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Cigna,Cigna,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Connecticare,Commerical,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Connecticare,Exchange,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,Multiplan,Multiplan,,,23.94,,23.94,20.84,23.94,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0000-88,NDC,both,1,mL,28.16,16.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.84,23.94,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Aetna,Commerical,,,10.86,,10.86,10.42,11.97,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Aetna,Middlesex Employees,,,10.42,,10.42,10.42,11.97,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Anthem,Commerical,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Anthem,Indemnity,,,10.55,,10.55,10.42,11.97,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Anthem,Individual Exchange,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Anthem,State Preferred,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Cigna,Cigna,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Connecticare,Commerical,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Connecticare,Exchange,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,Multiplan,Multiplan,,,11.97,,11.97,10.42,11.97,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0012-13,NDC,both,1,mL,14.08,8.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.42,11.97,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Aetna,Commerical,,,65.17,,65.17,62.49,71.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Aetna,Middlesex Employees,,,62.49,,62.49,62.49,71.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Anthem,Commerical,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Anthem,Indemnity,,,63.27,,63.27,62.49,71.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Anthem,Individual Exchange,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Anthem,State Preferred,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Cigna,Cigna,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Connecticare,Commerical,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Connecticare,Exchange,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,Multiplan,Multiplan,,,71.79,,71.79,62.49,71.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0207-67,NDC,both,1,mL,84.46,50.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.49,71.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
CLONIDINE 20 MCG/ML ORAL SUSP,J3490,HCPCS,40810-0208-31,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,0228-2127-10,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-01,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,51079-299-20,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,58657-647-01,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-01,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,60687-113-11,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
CLONIDINE HCL 0.1 MG TABLET,J3490,HCPCS,63739-060-10,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,0228-2128-10,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-01,NDC,both,1,ea,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,51079-300-20,NDC,both,1,ea,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-01,NDC,both,1,ea,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
CLONIDINE HCL 0.2 MG TABLET,J3490,HCPCS,60687-124-11,NDC,both,1,ea,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,0228-2129-10,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,29300-137-01,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,40810-0006-74,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,43547-567-10,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
CLONIDINE HCL 0.3 MG TABLET,J3490,HCPCS,52817-182-10,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,27241-108-06,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,43547-435-06,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-11,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,60687-462-21,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
"CLONIDINE HCL ER 0.1 MG TABLET,EXTENDED RELEASE,12 HR",J3490,HCPCS,68180-606-07,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
CLOPIDOGREL 37.5 MG TABLET,J3490,HCPCS,40810-0020-77,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Aetna,Commerical,,,202.47,,202.47,194.15,223.04,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Aetna,Middlesex Employees,,,194.15,,194.15,194.15,223.04,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Anthem,Commerical,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Anthem,Indemnity,,,196.56,,196.56,194.15,223.04,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Anthem,Individual Exchange,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Anthem,State Preferred,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Cigna,Cigna,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Connecticare,Commerical,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Connecticare,Exchange,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,Multiplan,Multiplan,,,223.04,,223.04,194.15,223.04,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-14,NDC,both,14.926,mL,262.4,157.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.15,223.04,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Aetna,Commerical,,,382.44,,382.44,366.72,421.29,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Aetna,Middlesex Employees,,,366.72,,366.72,366.72,421.29,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Anthem,Commerical,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Anthem,Indemnity,,,371.28,,371.28,366.72,421.29,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Anthem,Individual Exchange,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Anthem,State Preferred,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Cigna,Cigna,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Connecticare,Commerical,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Connecticare,Exchange,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,Multiplan,Multiplan,,,421.29,,421.29,366.72,421.29,percent of total billed charges,,
CLOPIDOGREL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-87,NDC,both,14.926,mL,495.64,297.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,366.72,421.29,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Aetna,Commerical,,,0.43,,0.43,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Anthem,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Anthem,Indemnity,,,0.42,,0.42,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Anthem,Individual Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Anthem,State Preferred,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Cigna,Cigna,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Connecticare,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Connecticare,Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,0904-6294-61,NDC,both,1,ea,0.56,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Aetna,Commerical,,,0.43,,0.43,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Anthem,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Anthem,Indemnity,,,0.42,,0.42,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Anthem,Individual Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Anthem,State Preferred,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Cigna,Cigna,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Connecticare,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Connecticare,Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.41,0.48,percent of total billed charges,,
CLOPIDOGREL 75 MG TABLET,J3490,HCPCS,16729-218-10,NDC,both,1,ea,0.56,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Aetna,Commerical,,,6.33,,6.33,6.07,6.97,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Aetna,Middlesex Employees,,,6.07,,6.07,6.07,6.97,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Anthem,Commerical,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Anthem,Indemnity,,,6.14,,6.14,6.07,6.97,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Anthem,Individual Exchange,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Anthem,State Preferred,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Cigna,Cigna,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Connecticare,Commerical,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Connecticare,Exchange,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,Multiplan,Multiplan,,,6.97,,6.97,6.07,6.97,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,0904-7822-36,NDC,both,14.17,gm,8.2,4.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.07,6.97,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,6.42,7.38,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,6.42,7.38,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Anthem,Commerical,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,6.42,7.38,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Anthem,Individual Exchange,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Anthem,State Preferred,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Cigna,Cigna,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Connecticare,Commerical,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Connecticare,Exchange,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,6.42,7.38,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,45802-434-01,NDC,both,15,gm,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.42,7.38,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,33.16,38.1,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,33.16,38.1,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Anthem,Commerical,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,33.16,38.1,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Anthem,Individual Exchange,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Anthem,State Preferred,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Cigna,Cigna,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Connecticare,Commerical,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Connecticare,Exchange,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,33.16,38.1,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL CREAM,J3490,HCPCS,51672-1275-1,NDC,both,1,gm,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.16,38.1,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Aetna,Commerical,,,65.52,,65.52,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Aetna,Middlesex Employees,,,62.83,,62.83,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Anthem,Commerical,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Anthem,Indemnity,,,63.61,,63.61,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Anthem,Individual Exchange,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Anthem,State Preferred,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Cigna,Cigna,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Connecticare,Commerical,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Connecticare,Exchange,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,Multiplan,Multiplan,,,72.18,,72.18,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,51672-1260-3,NDC,both,1,mL,84.92,50.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Aetna,Commerical,,,65.52,,65.52,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Aetna,Middlesex Employees,,,62.83,,62.83,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Anthem,Commerical,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Anthem,Indemnity,,,63.61,,63.61,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Anthem,Individual Exchange,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Anthem,State Preferred,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Cigna,Cigna,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Connecticare,Commerical,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Connecticare,Exchange,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,Multiplan,Multiplan,,,72.18,,72.18,62.83,72.18,percent of total billed charges,,
CLOTRIMAZOLE 1 % TOPICAL SOLUTION,J3490,HCPCS,52817-800-30,NDC,both,1,mL,84.92,50.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.83,72.18,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Aetna,Commerical,,,3.26,,3.26,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Aetna,Middlesex Employees,,,3.13,,3.13,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Anthem,Commerical,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Anthem,Indemnity,,,3.17,,3.17,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Anthem,Individual Exchange,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Anthem,State Preferred,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Cigna,Cigna,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Connecticare,Commerical,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Connecticare,Exchange,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,Multiplan,Multiplan,,,3.6,,3.6,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-4146-23,NDC,both,1,ea,4.23,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Aetna,Commerical,,,3.26,,3.26,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Aetna,Middlesex Employees,,,3.13,,3.13,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Anthem,Commerical,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Anthem,Indemnity,,,3.17,,3.17,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Anthem,Individual Exchange,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Anthem,State Preferred,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Cigna,Cigna,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Connecticare,Commerical,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Connecticare,Exchange,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,Multiplan,Multiplan,,,3.6,,3.6,3.13,3.6,percent of total billed charges,,
CLOTRIMAZOLE 10 MG TROCHE,J3490,HCPCS,0054-8146-22,NDC,both,1,ea,4.23,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.13,3.6,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Aetna,Commerical,,,13.53,,13.53,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Aetna,Middlesex Employees,,,12.97,,12.97,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Anthem,Commerical,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Anthem,Indemnity,,,13.13,,13.13,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Anthem,Individual Exchange,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Anthem,State Preferred,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Cigna,Cigna,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Connecticare,Commerical,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Connecticare,Exchange,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,Multiplan,Multiplan,,,14.9,,14.9,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,0168-0258-15,NDC,both,15,gm,17.53,10.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Aetna,Commerical,,,13.53,,13.53,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Aetna,Middlesex Employees,,,12.97,,12.97,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Anthem,Commerical,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Anthem,Indemnity,,,13.13,,13.13,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Anthem,Individual Exchange,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Anthem,State Preferred,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Cigna,Cigna,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Connecticare,Commerical,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Connecticare,Exchange,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,Multiplan,Multiplan,,,14.9,,14.9,12.97,14.9,percent of total billed charges,,
CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,J3490,HCPCS,68462-298-17,NDC,both,1,gm,17.53,10.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.97,14.9,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0093-7772-93,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,0904-7087-61,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
CLOZAPINE 100 MG TABLET,J3490,HCPCS,51079-922-01,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Aetna,Commerical,,,1.96,,1.96,1.88,2.16,percent of total billed charges,,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Aetna,Middlesex Employees,,,1.88,,1.88,1.88,2.16,percent of total billed charges,,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Anthem,Commerical,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Anthem,Indemnity,,,1.9,,1.9,1.88,2.16,percent of total billed charges,,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Anthem,Individual Exchange,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Anthem,State Preferred,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Cigna,Cigna,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Connecticare,Commerical,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Connecticare,Exchange,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,Multiplan,Multiplan,,,2.16,,2.16,1.88,2.16,percent of total billed charges,,
CLOZAPINE 12.5 MG TABLET,J3490,HCPCS,40810-0017-40,NDC,both,1,ea,2.54,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.88,2.16,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0093-4359-93,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,0904-7089-61,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
CLOZAPINE 25 MG TABLET,J3490,HCPCS,51079-921-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Aetna,Commerical,,,4.88,,4.88,4.68,5.37,percent of total billed charges,,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Aetna,Middlesex Employees,,,4.68,,4.68,4.68,5.37,percent of total billed charges,,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Anthem,Commerical,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Anthem,Indemnity,,,4.73,,4.73,4.68,5.37,percent of total billed charges,,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Anthem,Individual Exchange,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Anthem,State Preferred,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Cigna,Cigna,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Connecticare,Commerical,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Connecticare,Exchange,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,Multiplan,Multiplan,,,5.37,,5.37,4.68,5.37,percent of total billed charges,,
CLOZAPINE 50 MG TABLET(SPLIT TABLET),J3490,HCPCS,40810-0104-36,NDC,both,1,ea,6.32,3.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.68,5.37,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,2.08,3.68,percent of total billed charges,,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,2.08,3.68,percent of total billed charges,,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Anthem,Commerical,,,,,,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,2.08,3.68,percent of total billed charges,,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Anthem,State Preferred,,,,,,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Cigna,Cigna,,2.08,,,2.08,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Connecticare,Commerical,,2.83,,,2.83,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Connecticare,Exchange,,2.83,,,2.83,2.08,3.68,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,2.08,3.68,percent of total billed charges,,
"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",J7195,HCPCS,58394-635-03,NDC,both,0.001,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.24,,,2.24,2.08,3.68,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,2.08,4.23,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,2.08,4.23,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Anthem,Commerical,,,,,,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,2.08,4.23,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Anthem,State Preferred,,,,,,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Cigna,Cigna,,2.08,,,2.08,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Connecticare,Commerical,,2.83,,,2.83,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Connecticare,Exchange,,2.83,,,2.83,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,2.08,4.23,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-633-03,NDC,both,0.004,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,2.24,,,2.24,2.08,4.23,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Aetna,Commerical,,,4.23,,4.23,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Aetna,Middlesex Employees,,,4.05,,4.05,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Anthem,Commerical,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Anthem,Indemnity,,,4.11,,4.11,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Anthem,Individual Exchange,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Anthem,State Preferred,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Cigna,Cigna,,1.83,,,1.83,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Connecticare,Commerical,,2.56,,,2.56,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Connecticare,Exchange,,2.56,,,2.56,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,Multiplan,Multiplan,,,4.66,,4.66,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3026-02,NDC,both,0.004,ea,5.48,3.29,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Aetna,Commerical,,,1489.43,,1489.43,2.08,1640.77,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Aetna,Middlesex Employees,,,1428.24,,1428.24,2.08,1640.77,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Anthem,Commerical,,,,,,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Anthem,Indemnity,,,1446,,1446,2.08,1640.77,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Anthem,Individual Exchange,,,,,,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Anthem,State Preferred,,,,,,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Cigna,Cigna,,2.08,,,2.08,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Connecticare,Commerical,,2.83,,,2.83,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Connecticare,Exchange,,2.83,,,2.83,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,Multiplan,Multiplan,,,1640.77,,1640.77,2.08,1640.77,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7195,HCPCS,58394-634-03,NDC,both,0.002,ea,1930.32,1158.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.24,,,2.24,2.08,1640.77,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Aetna,Commerical,,,4.23,,4.23,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Aetna,Middlesex Employees,,,4.05,,4.05,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Anthem,Commerical,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Anthem,Indemnity,,,4.11,,4.11,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Anthem,Individual Exchange,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Anthem,State Preferred,,,,,,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Cigna,Cigna,,1.83,,,1.83,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Connecticare,Commerical,,2.56,,,2.56,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Connecticare,Exchange,,2.56,,,2.56,1.83,4.66,Other,Could be inpatient or outpatient,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,Multiplan,Multiplan,,,4.66,,4.66,1.83,4.66,percent of total billed charges,,
COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,J7200,HCPCS,0944-3028-02,NDC,both,0.002,ea,5.48,3.29,United Healthcare/Oxford,United Healthcare/Oxford,,1.98,,,1.98,1.83,4.66,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Aetna,Commerical,,,5880.9,,5880.9,2.87,6478.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Aetna,Middlesex Employees,,,5639.3,,5639.3,2.87,6478.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Anthem,Commerical,,,,,,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Anthem,Indemnity,,,5709.42,,5709.42,2.87,6478.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Anthem,Individual Exchange,,,,,,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Anthem,State Preferred,,,,,,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Cigna,Cigna,,2.87,,,2.87,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Connecticare,Commerical,,3.84,,,3.84,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Connecticare,Exchange,,3.84,,,3.84,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,Multiplan,Multiplan,,,6478.45,,6478.45,2.87,6478.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7201-01,NDC,both,0.001,ea,7621.7,4573.02,United Healthcare/Oxford,United Healthcare/Oxford,,3.1,,,3.1,2.87,6478.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Aetna,Commerical,,,13285.83,,13285.83,2.87,14635.76,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Aetna,Middlesex Employees,,,12740,,12740,2.87,14635.76,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Anthem,Commerical,,,,,,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Anthem,Indemnity,,,12898.41,,12898.41,2.87,14635.76,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Anthem,Individual Exchange,,,,,,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Anthem,State Preferred,,,,,,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Cigna,Cigna,,2.87,,,2.87,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Connecticare,Commerical,,3.84,,,3.84,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Connecticare,Exchange,,3.84,,,3.84,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,Multiplan,Multiplan,,,14635.76,,14635.76,2.87,14635.76,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",J7189,HCPCS,0169-7202-01,NDC,both,0.001,ea,17218.54,10331.12,United Healthcare/Oxford,United Healthcare/Oxford,,3.1,,,3.1,2.87,14635.76,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Aetna,Commerical,,,4975.87,,4975.87,2.57,5481.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Aetna,Middlesex Employees,,,4771.44,,4771.44,2.57,5481.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Anthem,Commerical,,,,,,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Anthem,Indemnity,,,4830.77,,4830.77,2.57,5481.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Anthem,Individual Exchange,,,,,,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Anthem,State Preferred,,,,,,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Cigna,Cigna,,2.57,,,2.57,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Connecticare,Commerical,,3.51,,,3.51,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Connecticare,Exchange,,3.51,,,3.51,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,Multiplan,Multiplan,,,5481.45,,5481.45,2.57,5481.45,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 1 MG (1,000 MCG) IV SOLUTION",J7212,HCPCS,71127-1000-1,NDC,both,0.001,ea,6448.77,3869.26,United Healthcare/Oxford,United Healthcare/Oxford,,2.77,,,2.77,2.57,5481.45,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Aetna,Commerical,,,24879.39,,24879.39,2.57,27407.31,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Aetna,Middlesex Employees,,,23857.25,,23857.25,2.57,27407.31,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Anthem,Commerical,,,,,,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Anthem,Indemnity,,,24153.9,,24153.9,2.57,27407.31,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Anthem,Individual Exchange,,,,,,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Anthem,State Preferred,,,,,,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Cigna,Cigna,,2.57,,,2.57,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Connecticare,Commerical,,3.51,,,3.51,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Connecticare,Exchange,,3.51,,,3.51,2.57,27407.31,Other,Could be inpatient or outpatient,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,Multiplan,Multiplan,,,27407.31,,27407.31,2.57,27407.31,percent of total billed charges,,
"COAGULATION FACTOR VIIA RECOMBINANT-JNCW 5 MG (5,000 MCG) IV SOLUTION",J7212,HCPCS,71127-5000-1,NDC,both,0.001,ea,32243.89,19346.33,United Healthcare/Oxford,United Healthcare/Oxford,,2.77,,,2.77,2.57,27407.31,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Aetna,Commerical,,,20.42,,20.42,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Aetna,Middlesex Employees,,,19.59,,19.59,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Anthem,Commerical,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Anthem,Indemnity,,,19.83,,19.83,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Anthem,Individual Exchange,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Anthem,State Preferred,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Cigna,Cigna,,10.29,,,10.29,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Connecticare,Commerical,,13.91,,,13.91,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Connecticare,Exchange,,13.91,,,13.91,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,Multiplan,Multiplan,,,22.5,,22.5,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7752-1,NDC,both,1,ea,26.47,15.88,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Aetna,Commerical,,,20.42,,20.42,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Aetna,Middlesex Employees,,,19.59,,19.59,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Anthem,Commerical,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Anthem,Indemnity,,,19.83,,19.83,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Anthem,Individual Exchange,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Anthem,State Preferred,,,,,,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Cigna,Cigna,,10.29,,,10.29,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Connecticare,Commerical,,13.91,,,13.91,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Connecticare,Exchange,,13.91,,,13.91,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,Multiplan,Multiplan,,,22.5,,22.5,10.29,22.5,percent of total billed charges,,
COAGULATION FACTOR X 250 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7754-1,NDC,both,0.004,ea,26.47,15.88,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,22.5,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Aetna,Commerical,,,26.45,,26.45,10.29,29.14,percent of total billed charges,,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Aetna,Middlesex Employees,,,25.36,,25.36,10.29,29.14,percent of total billed charges,,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Anthem,Commerical,,,,,,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Anthem,Indemnity,,,25.68,,25.68,10.29,29.14,percent of total billed charges,,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Anthem,Individual Exchange,,,,,,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Anthem,State Preferred,,,,,,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Cigna,Cigna,,10.29,,,10.29,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Connecticare,Commerical,,13.91,,,13.91,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Connecticare,Exchange,,13.91,,,13.91,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,Multiplan,Multiplan,,,29.14,,29.14,10.29,29.14,percent of total billed charges,,
COAGULATION FACTOR X 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,J7175,HCPCS,64208-7756-1,NDC,both,0.002,ea,34.28,20.57,United Healthcare/Oxford,United Healthcare/Oxford,,11.11,,,11.11,10.29,29.14,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,0.9,23.28,percent of total billed charges,,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,0.9,23.28,percent of total billed charges,,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Anthem,Commerical,,,,,,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,0.9,23.28,percent of total billed charges,,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Anthem,Individual Exchange,,,,,,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Anthem,State Preferred,,,,,,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Cigna,Cigna,,0.9,,,0.9,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Connecticare,Commerical,,1.29,,,1.29,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Connecticare,Exchange,,1.29,,,1.29,0.9,23.28,Other,Could be inpatient or outpatient,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,0.9,23.28,percent of total billed charges,,
COAGULATION FACTOR X INTRAVENOUS,J7515,HCPCS,64208-7753-1,NDC,both,1,ea,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.98,,,0.98,0.9,23.28,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Aetna,Commerical,,,16.32,,16.32,15.65,17.98,percent of total billed charges,,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Aetna,Middlesex Employees,,,15.65,,15.65,15.65,17.98,percent of total billed charges,,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Anthem,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Anthem,Indemnity,,,15.84,,15.84,15.65,17.98,percent of total billed charges,,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Anthem,Individual Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Anthem,State Preferred,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Cigna,Cigna,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Connecticare,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Connecticare,Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,Multiplan,Multiplan,,,17.98,,17.98,15.65,17.98,percent of total billed charges,,
COAL TAR 0.5 % SHAMPOO,J3490,HCPCS,0096-0728-04,NDC,both,120,mL,21.15,12.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Aetna,Commerical,,,60.68,,60.68,58.19,66.84,percent of total billed charges,,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Aetna,Middlesex Employees,,,58.19,,58.19,58.19,66.84,percent of total billed charges,,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Anthem,Commerical,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Anthem,Indemnity,,,58.91,,58.91,58.19,66.84,percent of total billed charges,,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Anthem,Individual Exchange,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Anthem,State Preferred,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Cigna,Cigna,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Connecticare,Commerical,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Connecticare,Exchange,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,Multiplan,Multiplan,,,66.84,,66.84,58.19,66.84,percent of total billed charges,,
COAL TAR 7.5 % TOPICAL EMULSION,J3490,HCPCS,11086-105-01,NDC,both,1,mL,78.64,47.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.19,66.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % NASAL SOLUTION,J7699,HCPCS,70839-362-04,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR INHALATION,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,0527-1971-74,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Commerical,,,651.63,,651.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Aetna,Middlesex Employees,,,624.86,,624.86,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Indemnity,,,632.63,,632.63,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,Individual Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Anthem,State Preferred,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Cigna,Cigna,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Commerical,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Connecticare,Exchange,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,Multiplan,Multiplan,,,717.84,,717.84,624.86,717.84,percent of total billed charges,,
COCAINE 4 % SOLN FOR PULMONARY HEMORRHAGE,J7699,HCPCS,64950-362-04,NDC,both,1,mL,844.52,506.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,624.86,717.84,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Aetna,Commerical,,,2.52,,2.52,2.42,2.78,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Aetna,Middlesex Employees,,,2.42,,2.42,2.42,2.78,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Anthem,Commerical,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Anthem,Indemnity,,,2.45,,2.45,2.42,2.78,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Anthem,Individual Exchange,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Anthem,State Preferred,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Cigna,Cigna,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Connecticare,Commerical,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Connecticare,Exchange,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,Multiplan,Multiplan,,,2.78,,2.78,2.42,2.78,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,1184513198,NDC,both,1,ea,3.27,1.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,3720555065,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,8068101000,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629511765,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,9629513865,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
COENZYME Q10 100 MG CAPSULE,J3490,HCPCS,40810-0005-65,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Anthem,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Anthem,Individual Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Anthem,State Preferred,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Cigna,Cigna,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Connecticare,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Connecticare,Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818611,NDC,both,1,ea,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Anthem,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Anthem,Individual Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Anthem,State Preferred,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Cigna,Cigna,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Connecticare,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Connecticare,Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,5026818615,NDC,both,1,ea,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Anthem,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Anthem,Individual Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Anthem,State Preferred,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Cigna,Cigna,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Connecticare,Commerical,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Connecticare,Exchange,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.52,1.74,percent of total billed charges,,
COENZYME Q10 30 MG CAPSULE,J3490,HCPCS,40810-0005-49,NDC,both,1,ea,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.52,1.74,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Anthem,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Anthem,State Preferred,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Cigna,Cigna,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Connecticare,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Connecticare,Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,1184514608,NDC,both,1,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Anthem,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Anthem,State Preferred,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Cigna,Cigna,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Connecticare,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Connecticare,Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,1.67,1.92,percent of total billed charges,,
COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE,J3490,HCPCS,40810-0005-99,NDC,both,1,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,40810-0202-52,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.3 MG SPLIT TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,0254-2008-01,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,64764-119-01,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Aetna,Commerical,,,2.1,,2.1,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Aetna,Middlesex Employees,,,2.01,,2.01,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Indemnity,,,2.04,,2.04,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,Individual Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Anthem,State Preferred,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Cigna,Cigna,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Connecticare,Commerical,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Connecticare,Exchange,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,Multiplan,Multiplan,,,2.31,,2.31,2.01,2.31,percent of total billed charges,,
COLCHICINE 0.6 MG TABLET,J3490,HCPCS,70710-1351-3,NDC,both,1,ea,2.72,1.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.01,2.31,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Commerical,,,31.24,,31.24,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Middlesex Employees,,,29.96,,29.96,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Commerical,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Indemnity,,,30.33,,30.33,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Individual Exchange,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,State Preferred,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Cigna,Cigna,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Commerical,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Exchange,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Multiplan,Multiplan,,,34.42,,34.42,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 150 MG INH SOLN,J7699,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Commerical,,,31.24,,31.24,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Middlesex Employees,,,29.96,,29.96,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Commerical,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Indemnity,,,30.33,,30.33,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Individual Exchange,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,State Preferred,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Cigna,Cigna,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Commerical,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Exchange,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Multiplan,Multiplan,,,34.42,,34.42,29.96,34.42,percent of total billed charges,,
COLISTIMETHATE SODIUM 75 MG/ML ORAL SOLN,J3490,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.96,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Commerical,,,31.24,,31.24,12.32,34.42,percent of total billed charges,,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Aetna,Middlesex Employees,,,29.96,,29.96,12.32,34.42,percent of total billed charges,,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Commerical,,,,,,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Indemnity,,,30.33,,30.33,12.32,34.42,percent of total billed charges,,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,Individual Exchange,,,,,,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Anthem,State Preferred,,,,,,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Cigna,Cigna,,12.32,,,12.32,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Commerical,,18.75,,,18.75,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Connecticare,Exchange,,18.75,,,18.75,12.32,34.42,Other,Could be inpatient or outpatient,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,Multiplan,Multiplan,,,34.42,,34.42,12.32,34.42,percent of total billed charges,,
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,J0770,HCPCS,63323-393-06,NDC,both,1,ea,40.49,24.29,United Healthcare/Oxford,United Healthcare/Oxford,,13.3,,,13.3,12.32,34.42,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Aetna,Commerical,,,764.93,,764.93,733.51,842.66,percent of total billed charges,,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Aetna,Middlesex Employees,,,733.51,,733.51,733.51,842.66,percent of total billed charges,,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Anthem,Commerical,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Anthem,Indemnity,,,742.63,,742.63,733.51,842.66,percent of total billed charges,,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Anthem,Individual Exchange,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Anthem,State Preferred,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Cigna,Cigna,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Connecticare,Commerical,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Connecticare,Exchange,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,Multiplan,Multiplan,,,842.66,,842.66,733.51,842.66,percent of total billed charges,,
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,J3490,HCPCS,50484-010-30,NDC,both,1,gm,991.36,594.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,733.51,842.66,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Aetna,Commerical,,,56.15,,56.15,53.84,61.85,percent of total billed charges,,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,53.84,61.85,percent of total billed charges,,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Anthem,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Anthem,Indemnity,,,54.51,,54.51,53.84,61.85,percent of total billed charges,,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Anthem,Individual Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Anthem,State Preferred,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Cigna,Cigna,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Connecticare,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Connecticare,Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,Multiplan,Multiplan,,,61.85,,61.85,53.84,61.85,percent of total billed charges,,
COLLODION (BULK) LIQUID,J3490,HCPCS,5155202035,NDC,both,100,mL,72.77,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
COLLOIDAL OATMEAL TOPICAL PACKET,J3490,HCPCS,8137003640,NDC,both,1,ea,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Aetna,Commerical,,,46.13,,46.13,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Aetna,Middlesex Employees,,,44.24,,44.24,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Anthem,Commerical,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Anthem,Indemnity,,,44.79,,44.79,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Anthem,Individual Exchange,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Anthem,State Preferred,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Cigna,Cigna,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Connecticare,Commerical,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Connecticare,Exchange,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,Multiplan,Multiplan,,,50.82,,50.82,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,574030416,NDC,both,1,mL,59.79,35.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Aetna,Commerical,,,46.13,,46.13,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Aetna,Middlesex Employees,,,44.24,,44.24,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Anthem,Commerical,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Anthem,Indemnity,,,44.79,,44.79,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Anthem,Individual Exchange,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Anthem,State Preferred,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Cigna,Cigna,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Connecticare,Commerical,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Connecticare,Exchange,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,Multiplan,Multiplan,,,50.82,,50.82,44.24,50.82,percent of total billed charges,,
COMPOUNDING VEHICLE SYRUP NO.23,J3490,HCPCS,3172295901,NDC,both,1,mL,59.79,35.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.24,50.82,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Aetna,Commerical,,,19.07,,19.07,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Aetna,Middlesex Employees,,,18.29,,18.29,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Anthem,Commerical,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Anthem,Indemnity,,,18.52,,18.52,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Anthem,Individual Exchange,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Anthem,State Preferred,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Cigna,Cigna,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Connecticare,Commerical,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Connecticare,Exchange,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,Multiplan,Multiplan,,,21.01,,21.01,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.3 MG TABLET,J3490,HCPCS,0046-1100-81,NDC,both,1,ea,24.72,14.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Aetna,Commerical,,,19.07,,19.07,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Aetna,Middlesex Employees,,,18.29,,18.29,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Anthem,Commerical,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Anthem,Indemnity,,,18.52,,18.52,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Anthem,Individual Exchange,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Anthem,State Preferred,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Cigna,Cigna,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Connecticare,Commerical,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Connecticare,Exchange,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,Multiplan,Multiplan,,,21.01,,21.01,18.29,21.01,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG TABLET,J3490,HCPCS,0046-1102-81,NDC,both,1,ea,24.72,14.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.29,21.01,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Aetna,Commerical,,,1242.79,,1242.79,1191.73,1369.07,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Aetna,Middlesex Employees,,,1191.73,,1191.73,1191.73,1369.07,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Anthem,Commerical,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Anthem,Indemnity,,,1206.55,,1206.55,1191.73,1369.07,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Anthem,Individual Exchange,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Anthem,State Preferred,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Cigna,Cigna,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Connecticare,Commerical,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Connecticare,Exchange,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,Multiplan,Multiplan,,,1369.07,,1369.07,1191.73,1369.07,percent of total billed charges,,
CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,J3490,HCPCS,0046-0872-21,NDC,both,1,gm,1610.67,966.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1191.73,1369.07,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Aetna,Commerical,,,1016.4,,1016.4,433.95,1119.67,percent of total billed charges,,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Aetna,Middlesex Employees,,,974.64,,974.64,433.95,1119.67,percent of total billed charges,,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Anthem,Commerical,,,,,,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Anthem,Indemnity,,,986.76,,986.76,433.95,1119.67,percent of total billed charges,,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Anthem,Individual Exchange,,,,,,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Anthem,State Preferred,,,,,,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Cigna,Cigna,,433.95,,,433.95,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Connecticare,Commerical,,584.51,,,584.51,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Connecticare,Exchange,,584.51,,,584.51,433.95,1119.67,Other,Could be inpatient or outpatient,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,Multiplan,Multiplan,,,1119.67,,1119.67,433.95,1119.67,percent of total billed charges,,
CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,J1410,HCPCS,0046-0749-05,NDC,both,1,ea,1317.26,790.36,United Healthcare/Oxford,United Healthcare/Oxford,,468.52,,,468.52,433.95,1119.67,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Aetna,Commerical,,,45.81,,45.81,43.93,50.46,percent of total billed charges,,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Aetna,Middlesex Employees,,,43.93,,43.93,43.93,50.46,percent of total billed charges,,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Anthem,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Anthem,Indemnity,,,44.47,,44.47,43.93,50.46,percent of total billed charges,,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Anthem,Individual Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Anthem,State Preferred,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Cigna,Cigna,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Connecticare,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Connecticare,Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,Multiplan,Multiplan,,,50.46,,50.46,43.93,50.46,percent of total billed charges,,
CORN OIL (BULK),J3490,HCPCS,3877920388,NDC,both,1,mL,59.37,35.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Aetna,Commerical,,,130011.84,,130011.84,3933.52,143221.96,percent of total billed charges,,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Aetna,Middlesex Employees,,,124670.5,,124670.5,3933.52,143221.96,percent of total billed charges,,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Anthem,Commerical,,,,,,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Anthem,Indemnity,,,126220.67,,126220.67,3933.52,143221.96,percent of total billed charges,,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Anthem,Individual Exchange,,,,,,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Anthem,State Preferred,,,,,,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Cigna,Cigna,,3933.52,,,3933.52,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Connecticare,Commerical,,5217.65,,,5217.65,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Connecticare,Exchange,,5217.65,,,5217.65,3933.52,143221.96,Other,Could be inpatient or outpatient,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,Multiplan,Multiplan,,,143221.96,,143221.96,3933.52,143221.96,percent of total billed charges,,
CORTICOTROPIN 80 UNIT/ML INJECTION GEL,J0802,HCPCS,63004-8710-1,NDC,both,0.5,mL,168496.42,101097.85,United Healthcare/Oxford,United Healthcare/Oxford,,4246.81,,,4246.81,3933.52,143221.96,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Aetna,Commerical,,,90.6,,90.6,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Aetna,Middlesex Employees,,,86.88,,86.88,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Anthem,Commerical,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Anthem,Indemnity,,,87.96,,87.96,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Anthem,Individual Exchange,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Anthem,State Preferred,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Cigna,Cigna,,24.55,,,24.55,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Connecticare,Commerical,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Connecticare,Exchange,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,Multiplan,Multiplan,,,99.81,,99.81,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,117.42,70.45,United Healthcare/Oxford,United Healthcare/Oxford,,26.51,,,26.51,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Aetna,Commerical,,,90.6,,90.6,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Aetna,Middlesex Employees,,,86.88,,86.88,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Anthem,Commerical,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Anthem,Indemnity,,,87.96,,87.96,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Anthem,Individual Exchange,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Anthem,State Preferred,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Cigna,Cigna,,24.55,,,24.55,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Connecticare,Commerical,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Connecticare,Exchange,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,Multiplan,Multiplan,,,99.81,,99.81,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,J0834,HCPCS,0781-3440-95,NDC,both,1,ea,117.42,70.45,United Healthcare/Oxford,United Healthcare/Oxford,,26.51,,,26.51,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Aetna,Commerical,,,90.6,,90.6,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Aetna,Middlesex Employees,,,86.88,,86.88,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Anthem,Commerical,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Anthem,Indemnity,,,87.96,,87.96,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Anthem,Individual Exchange,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Anthem,State Preferred,,,,,,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Cigna,Cigna,,24.55,,,24.55,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Connecticare,Commerical,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Connecticare,Exchange,,38.31,,,38.31,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,Multiplan,Multiplan,,,99.81,,99.81,24.55,99.81,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS,J0834,HCPCS,0548-5900-00,NDC,both,1,ea,111.43,66.86,United Healthcare/Oxford,United Healthcare/Oxford,,26.51,,,26.51,24.55,99.81,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Aetna,Commerical,,,181.29,,181.29,24.55,199.71,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Aetna,Middlesex Employees,,,173.84,,173.84,24.55,199.71,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Anthem,Commerical,,,,,,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Anthem,Indemnity,,,176,,176,24.55,199.71,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Anthem,Individual Exchange,,,,,,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Anthem,State Preferred,,,,,,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Cigna,Cigna,,24.55,,,24.55,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Connecticare,Commerical,,38.31,,,38.31,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Connecticare,Exchange,,38.31,,,38.31,24.55,199.71,Other,Could be inpatient or outpatient,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,Multiplan,Multiplan,,,199.71,,199.71,24.55,199.71,percent of total billed charges,,
COSYNTROPIN 5 MCG/ML IN NS NICU,J0834,HCPCS,40810-0004-48,NDC,both,50,mL,234.95,140.97,United Healthcare/Oxford,United Healthcare/Oxford,,26.51,,,26.51,24.55,199.71,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Aetna,Commerical,,,95.31,,95.31,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Aetna,Middlesex Employees,,,91.39,,91.39,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Anthem,Commerical,,224.5,,,224.5,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Anthem,Indemnity,,,92.53,,92.53,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Anthem,Individual Exchange,,179.6,,,179.6,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Anthem,State Preferred,,224.5,,,224.5,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Cigna,Cigna,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Connecticare,Commerical,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Connecticare,Exchange,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,Multiplan,Multiplan,,,104.99,,104.99,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-09,NDC,both,0.25,mL,123.52,74.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Aetna,Commerical,,,95.31,,95.31,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Aetna,Middlesex Employees,,,91.39,,91.39,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Anthem,Commerical,,224.5,,,224.5,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Anthem,Indemnity,,,92.53,,92.53,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Anthem,Individual Exchange,,179.6,,,179.6,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Anthem,State Preferred,,224.5,,,224.5,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Cigna,Cigna,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Connecticare,Commerical,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Connecticare,Exchange,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,Multiplan,Multiplan,,,104.99,,104.99,91.39,224.5,percent of total billed charges,,
COVID VAC 2024-25 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYR (EUA),91321,HCPCS,80777-291-80,NDC,both,0.25,mL,123.52,74.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.39,224.5,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Aetna,Commerical,,,209.53,,209.53,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Aetna,Middlesex Employees,,,200.92,,200.92,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Anthem,Commerical,,246.77,,,246.77,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Anthem,Indemnity,,,203.42,,203.42,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Anthem,Individual Exchange,,197.42,,,197.42,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Anthem,State Preferred,,246.77,,,246.77,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Cigna,Cigna,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Connecticare,Commerical,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Connecticare,Exchange,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,Multiplan,Multiplan,,,230.82,,230.82,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-01,NDC,both,0.5,mL,271.55,162.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Aetna,Commerical,,,209.53,,209.53,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Aetna,Middlesex Employees,,,200.92,,200.92,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Anthem,Commerical,,246.77,,,246.77,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Anthem,Indemnity,,,203.42,,203.42,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Anthem,Individual Exchange,,197.42,,,197.42,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Anthem,State Preferred,,246.77,,,246.77,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Cigna,Cigna,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Connecticare,Commerical,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Connecticare,Exchange,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,Multiplan,Multiplan,,,230.82,,230.82,197.42,246.77,percent of total billed charges,,
COVID VACC 2024-25 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE,91322,HCPCS,80777-110-93,NDC,both,0.5,mL,271.55,162.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,197.42,246.77,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Aetna,Commerical,,,590.46,,590.46,566.2,650.45,percent of total billed charges,,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Aetna,Middlesex Employees,,,566.2,,566.2,566.2,650.45,percent of total billed charges,,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Anthem,Commerical,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Anthem,Indemnity,,,573.24,,573.24,566.2,650.45,percent of total billed charges,,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Anthem,Individual Exchange,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Anthem,State Preferred,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Cigna,Cigna,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Connecticare,Commerical,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Connecticare,Exchange,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,Multiplan,Multiplan,,,650.45,,650.45,566.2,650.45,percent of total billed charges,,
CREATINE MONOHYDRATE (BULK) 100 % POWDER,J3490,HCPCS,3877908355,NDC,both,1,gm,765.24,459.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,566.2,650.45,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Aetna,Commerical,,,11.26,,11.26,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Aetna,Middlesex Employees,,,10.8,,10.8,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Anthem,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Anthem,Indemnity,,,10.93,,10.93,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Anthem,Individual Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Anthem,State Preferred,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Cigna,Cigna,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Connecticare,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Connecticare,Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,Multiplan,Multiplan,,,12.4,,12.4,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-01,NDC,both,1,ea,14.59,8.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Aetna,Commerical,,,11.26,,11.26,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Aetna,Middlesex Employees,,,10.8,,10.8,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Anthem,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Anthem,Indemnity,,,10.93,,10.93,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Anthem,Individual Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Anthem,State Preferred,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Cigna,Cigna,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Connecticare,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Connecticare,Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,Multiplan,Multiplan,,,12.4,,12.4,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1212-07,NDC,both,1,ea,14.59,8.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Aetna,Commerical,,,11.26,,11.26,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Aetna,Middlesex Employees,,,10.8,,10.8,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Anthem,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Anthem,Indemnity,,,10.93,,10.93,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Anthem,Individual Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Anthem,State Preferred,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Cigna,Cigna,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Connecticare,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Connecticare,Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,Multiplan,Multiplan,,,12.4,,12.4,10.8,12.4,percent of total billed charges,,
"CREON 12,000-38,000-60,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-09,NDC,both,1,ea,14.59,8.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Aetna,Commerical,,,22.31,,22.31,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Aetna,Middlesex Employees,,,21.39,,21.39,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Anthem,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Anthem,Indemnity,,,21.66,,21.66,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Anthem,Individual Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Anthem,State Preferred,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Cigna,Cigna,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Connecticare,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Connecticare,Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,Multiplan,Multiplan,,,24.57,,24.57,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-01,NDC,both,1,ea,28.91,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Aetna,Commerical,,,22.31,,22.31,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Aetna,Middlesex Employees,,,21.39,,21.39,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Anthem,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Anthem,Indemnity,,,21.66,,21.66,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Anthem,Individual Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Anthem,State Preferred,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Cigna,Cigna,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Connecticare,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Connecticare,Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,Multiplan,Multiplan,,,24.57,,24.57,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1224-07,NDC,both,1,ea,28.91,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Aetna,Commerical,,,22.31,,22.31,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Aetna,Middlesex Employees,,,21.39,,21.39,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Anthem,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Anthem,Indemnity,,,21.66,,21.66,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Anthem,Individual Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Anthem,State Preferred,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Cigna,Cigna,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Connecticare,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Connecticare,Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,Multiplan,Multiplan,,,24.57,,24.57,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-2636-01,NDC,both,1,ea,28.91,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Aetna,Commerical,,,22.31,,22.31,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Aetna,Middlesex Employees,,,21.39,,21.39,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Anthem,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Anthem,Indemnity,,,21.66,,21.66,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Anthem,Individual Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Anthem,State Preferred,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Cigna,Cigna,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Connecticare,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Connecticare,Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,Multiplan,Multiplan,,,24.57,,24.57,21.39,24.57,percent of total billed charges,,
"CREON 24,000-76,000-120,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-10,NDC,both,1,ea,28.91,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Aetna,Commerical,,,4.76,,4.76,4.57,5.24,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Aetna,Middlesex Employees,,,4.57,,4.57,4.57,5.24,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Anthem,Commerical,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Anthem,Indemnity,,,4.62,,4.62,4.57,5.24,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Anthem,Individual Exchange,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Anthem,State Preferred,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Cigna,Cigna,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Connecticare,Commerical,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Connecticare,Exchange,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,Multiplan,Multiplan,,,5.24,,5.24,4.57,5.24,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1203-70,NDC,both,1,ea,6.17,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.57,5.24,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,2.79,3.2,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,2.79,3.2,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,2.79,3.2,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.79,3.2,percent of total billed charges,,
"CREON 3,000-9,500-15,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-57,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Aetna,Commerical,,,5.63,,5.63,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Aetna,Middlesex Employees,,,5.4,,5.4,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Anthem,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Anthem,Indemnity,,,5.47,,5.47,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Anthem,Individual Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Anthem,State Preferred,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Cigna,Cigna,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Connecticare,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Connecticare,Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,Multiplan,Multiplan,,,6.21,,6.21,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,0032-1206-01,NDC,both,1,ea,7.3,4.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Aetna,Commerical,,,5.63,,5.63,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Aetna,Middlesex Employees,,,5.4,,5.4,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Anthem,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Anthem,Indemnity,,,5.47,,5.47,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Anthem,Individual Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Anthem,State Preferred,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Cigna,Cigna,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Connecticare,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Connecticare,Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,Multiplan,Multiplan,,,6.21,,6.21,5.4,6.21,percent of total billed charges,,
"CREON 6,000-19,000-30,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-08,NDC,both,1,ea,7.3,4.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Aetna,Commerical,,,7249,,7249,143.95,7985.55,percent of total billed charges,,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Aetna,Middlesex Employees,,,6951.19,,6951.19,143.95,7985.55,percent of total billed charges,,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Anthem,Commerical,,,,,,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Anthem,Indemnity,,,7037.62,,7037.62,143.95,7985.55,percent of total billed charges,,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Anthem,Individual Exchange,,,,,,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Anthem,State Preferred,,,,,,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Cigna,Cigna,,143.95,,,143.95,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Connecticare,Commerical,,196.28,,,196.28,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Connecticare,Exchange,,196.28,,,196.28,143.95,7985.55,Other,Could be inpatient or outpatient,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,Multiplan,Multiplan,,,7985.55,,7985.55,143.95,7985.55,percent of total billed charges,,
CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,J0791,HCPCS,0078-0883-61,NDC,both,0.1,mL,9394.77,5636.86,United Healthcare/Oxford,United Healthcare/Oxford,,155.42,,,155.42,143.95,7985.55,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,15.14,17.39,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,15.14,17.39,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Anthem,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,15.14,17.39,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Anthem,Individual Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Anthem,State Preferred,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Cigna,Cigna,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Connecticare,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Connecticare,Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,15.14,17.39,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,16571-600-96,NDC,both,1,mL,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Aetna,Commerical,,,6.44,,6.44,6.18,7.1,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Aetna,Middlesex Employees,,,6.18,,6.18,6.18,7.1,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Anthem,Commerical,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Anthem,Indemnity,,,6.25,,6.25,6.18,7.1,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Anthem,Individual Exchange,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Anthem,State Preferred,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Cigna,Cigna,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Connecticare,Commerical,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Connecticare,Exchange,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,Multiplan,Multiplan,,,7.1,,7.1,6.18,7.1,percent of total billed charges,,
CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,J3490,HCPCS,76204-025-96,NDC,both,1,mL,8.35,5.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.18,7.1,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Aetna,Commerical,,,15.47,,15.47,0.58,17.04,percent of total billed charges,,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Aetna,Middlesex Employees,,,14.83,,14.83,0.58,17.04,percent of total billed charges,,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Anthem,Commerical,,,,,,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Anthem,Indemnity,,,15.02,,15.02,0.58,17.04,percent of total billed charges,,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Anthem,Individual Exchange,,,,,,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Anthem,State Preferred,,,,,,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Cigna,Cigna,,0.58,,,0.58,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Connecticare,Commerical,,0.67,,,0.67,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Connecticare,Exchange,,0.67,,,0.67,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,Multiplan,Multiplan,,,17.04,,17.04,0.58,17.04,percent of total billed charges,,
CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,J7631,HCPCS,0172-6406-49,NDC,both,2,mL,20.05,12.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.62,,,0.62,0.58,17.04,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Aetna,Commerical,,,13.54,,13.54,12.99,14.92,percent of total billed charges,,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Aetna,Middlesex Employees,,,12.99,,12.99,12.99,14.92,percent of total billed charges,,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Anthem,Commerical,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Anthem,Indemnity,,,13.15,,13.15,12.99,14.92,percent of total billed charges,,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Anthem,Individual Exchange,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Anthem,State Preferred,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Cigna,Cigna,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Connecticare,Commerical,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Connecticare,Exchange,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,Multiplan,Multiplan,,,14.92,,14.92,12.99,14.92,percent of total billed charges,,
CROMOLYN 4 % EYE DROPS,J3490,HCPCS,61314-237-10,NDC,both,1,mL,17.55,10.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.99,14.92,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Aetna,Commerical,,,3603.9,,3603.9,2140.39,3970.09,percent of total billed charges,,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Aetna,Middlesex Employees,,,3455.84,,3455.84,2140.39,3970.09,percent of total billed charges,,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Anthem,Commerical,,,,,,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Anthem,Indemnity,,,3498.81,,3498.81,2140.39,3970.09,percent of total billed charges,,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Anthem,Individual Exchange,,,,,,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Anthem,State Preferred,,,,,,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Cigna,Cigna,,2140.39,,,2140.39,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Connecticare,Commerical,,2691.07,,,2691.07,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Connecticare,Exchange,,2691.07,,,2691.07,2140.39,3970.09,Other,Could be inpatient or outpatient,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,Multiplan,Multiplan,,,3970.09,,3970.09,2140.39,3970.09,percent of total billed charges,,
CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,J0840,HCPCS,50633-110-12,NDC,both,1,ea,4670.69,2802.41,United Healthcare/Oxford,United Healthcare/Oxford,,2310.86,,,2310.86,2140.39,3970.09,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,69.85,80.25,percent of total billed charges,,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,69.85,80.25,percent of total billed charges,,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Anthem,Commerical,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,69.85,80.25,percent of total billed charges,,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Anthem,State Preferred,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Cigna,Cigna,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Connecticare,Commerical,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Connecticare,Exchange,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,69.85,80.25,percent of total billed charges,,
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4092-01,NDC,both,1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,69.85,80.25,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,3786491401,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",J3490,HCPCS,40810-0006-79,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Aetna,Commerical,,,780.54,,780.54,1.25,859.84,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Aetna,Middlesex Employees,,,748.47,,748.47,1.25,859.84,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Anthem,Commerical,,,,,,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Anthem,Indemnity,,,757.77,,757.77,1.25,859.84,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Anthem,Individual Exchange,,,,,,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Anthem,State Preferred,,,,,,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Cigna,Cigna,,1.25,,,1.25,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Connecticare,Commerical,,1.75,,,1.75,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Connecticare,Exchange,,1.75,,,1.75,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,Multiplan,Multiplan,,,859.84,,859.84,1.25,859.84,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION KIT",J3420,HCPCS,7642052701,NDC,both,1,ea,1011.58,606.95,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,859.84,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Anthem,Commerical,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Anthem,Individual Exchange,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Anthem,State Preferred,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Cigna,Cigna,,1.25,,,1.25,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Connecticare,Commerical,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Connecticare,Exchange,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,0517-0031-25,NDC,both,1,mL,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Anthem,Commerical,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Anthem,Individual Exchange,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Anthem,State Preferred,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Cigna,Cigna,,1.25,,,1.25,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Connecticare,Commerical,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Connecticare,Exchange,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-00,NDC,both,1,mL,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Aetna,Commerical,,,11.56,,11.56,1.25,12.73,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Aetna,Middlesex Employees,,,11.08,,11.08,1.25,12.73,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Anthem,Commerical,,,,,,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Anthem,Indemnity,,,11.22,,11.22,1.25,12.73,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Anthem,Individual Exchange,,,,,,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Anthem,State Preferred,,,,,,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Cigna,Cigna,,1.25,,,1.25,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Connecticare,Commerical,,1.75,,,1.75,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Connecticare,Exchange,,1.75,,,1.75,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,Multiplan,Multiplan,,,12.73,,12.73,1.25,12.73,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,63323-044-01,NDC,both,1,mL,14.98,8.99,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,12.73,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Anthem,Commerical,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Anthem,Individual Exchange,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Anthem,State Preferred,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Cigna,Cigna,,1.25,,,1.25,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Connecticare,Commerical,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Connecticare,Exchange,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,69680-112-25,NDC,both,1,mL,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Anthem,Commerical,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Anthem,Individual Exchange,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Anthem,State Preferred,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Cigna,Cigna,,1.25,,,1.25,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Connecticare,Commerical,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Connecticare,Exchange,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-01,NDC,both,1,mL,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Anthem,Commerical,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Anthem,Individual Exchange,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Anthem,State Preferred,,,,,,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Cigna,Cigna,,1.25,,,1.25,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Connecticare,Commerical,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Connecticare,Exchange,,1.75,,,1.75,1.25,5.11,Other,Could be inpatient or outpatient,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,1.25,5.11,percent of total billed charges,,
"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",J3420,HCPCS,71288-303-02,NDC,both,1,mL,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.25,5.11,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,51079-644-20,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
CYCLOBENZAPRINE 10 MG TABLET,J3490,HCPCS,69097-846-07,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
CYCLOBENZAPRINE 5 MG ORAL TAB,J3490,HCPCS,40810-0017-76,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Aetna,Commerical,,,181.8,,181.8,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Aetna,Middlesex Employees,,,174.33,,174.33,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Anthem,Commerical,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Anthem,Indemnity,,,176.5,,176.5,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Anthem,Individual Exchange,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Anthem,State Preferred,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Cigna,Cigna,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Connecticare,Commerical,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Connecticare,Exchange,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,Multiplan,Multiplan,,,200.27,,200.27,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,0065-0395-15,NDC,both,1,mL,235.61,141.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Aetna,Commerical,,,181.8,,181.8,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Aetna,Middlesex Employees,,,174.33,,174.33,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Anthem,Commerical,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Anthem,Indemnity,,,176.5,,176.5,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Anthem,Individual Exchange,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Anthem,State Preferred,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Cigna,Cigna,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Connecticare,Commerical,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Connecticare,Exchange,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,Multiplan,Multiplan,,,200.27,,200.27,174.33,200.27,percent of total billed charges,,
CYCLOPENTOLATE 0.5 % EYE DROPS,J3490,HCPCS,17478-096-15,NDC,both,1,mL,235.61,141.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.33,200.27,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Aetna,Commerical,,,62.8,,62.8,60.22,69.18,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Aetna,Middlesex Employees,,,60.22,,60.22,60.22,69.18,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Anthem,Commerical,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Anthem,Indemnity,,,60.97,,60.97,60.22,69.18,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Anthem,Individual Exchange,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Anthem,State Preferred,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Cigna,Cigna,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Connecticare,Commerical,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Connecticare,Exchange,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,Multiplan,Multiplan,,,69.18,,69.18,60.22,69.18,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-02,NDC,both,1,mL,81.39,48.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.22,69.18,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Aetna,Commerical,,,113.04,,113.04,108.4,124.53,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Aetna,Middlesex Employees,,,108.4,,108.4,108.4,124.53,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Anthem,Commerical,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Anthem,Indemnity,,,109.74,,109.74,108.4,124.53,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Anthem,Individual Exchange,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Anthem,State Preferred,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Cigna,Cigna,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Connecticare,Commerical,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Connecticare,Exchange,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,Multiplan,Multiplan,,,124.53,,124.53,108.4,124.53,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,0065-0396-05,NDC,both,1,mL,146.5,87.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.4,124.53,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Aetna,Commerical,,,34.94,,34.94,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Aetna,Middlesex Employees,,,33.5,,33.5,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Anthem,Commerical,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Anthem,Indemnity,,,33.92,,33.92,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Anthem,Individual Exchange,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Anthem,State Preferred,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Cigna,Cigna,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Connecticare,Commerical,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Connecticare,Exchange,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,Multiplan,Multiplan,,,38.49,,38.49,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,17478-100-02,NDC,both,2,mL,45.28,27.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Aetna,Commerical,,,34.94,,34.94,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Aetna,Middlesex Employees,,,33.5,,33.5,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Anthem,Commerical,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Anthem,Indemnity,,,33.92,,33.92,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Anthem,Individual Exchange,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Anthem,State Preferred,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Cigna,Cigna,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Connecticare,Commerical,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Connecticare,Exchange,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,Multiplan,Multiplan,,,38.49,,38.49,33.5,38.49,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-01,NDC,both,1,mL,45.28,27.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.5,38.49,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Aetna,Commerical,,,83.79,,83.79,80.35,92.3,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Aetna,Middlesex Employees,,,80.35,,80.35,80.35,92.3,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Anthem,Commerical,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Anthem,Indemnity,,,81.34,,81.34,80.35,92.3,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Anthem,Individual Exchange,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Anthem,State Preferred,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Cigna,Cigna,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Connecticare,Commerical,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Connecticare,Exchange,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,Multiplan,Multiplan,,,92.3,,92.3,80.35,92.3,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,24208-735-06,NDC,both,1,mL,108.59,65.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.35,92.3,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Aetna,Commerical,,,35.32,,35.32,33.87,38.9,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Aetna,Middlesex Employees,,,33.87,,33.87,33.87,38.9,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Anthem,Commerical,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Anthem,Indemnity,,,34.29,,34.29,33.87,38.9,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Anthem,Individual Exchange,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Anthem,State Preferred,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Cigna,Cigna,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Connecticare,Commerical,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Connecticare,Exchange,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,Multiplan,Multiplan,,,38.9,,38.9,33.87,38.9,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-01,NDC,both,1,mL,45.77,27.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.87,38.9,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Aetna,Commerical,,,82.76,,82.76,79.36,91.17,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Aetna,Middlesex Employees,,,79.36,,79.36,79.36,91.17,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Anthem,Commerical,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Anthem,Indemnity,,,80.35,,80.35,79.36,91.17,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Anthem,Individual Exchange,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Anthem,State Preferred,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Cigna,Cigna,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Connecticare,Commerical,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Connecticare,Exchange,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,Multiplan,Multiplan,,,91.17,,91.17,79.36,91.17,percent of total billed charges,,
CYCLOPENTOLATE 1 % EYE DROPS,J3490,HCPCS,61314-396-03,NDC,both,1,mL,107.26,64.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.36,91.17,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Aetna,Commerical,,,86.5,,86.5,82.95,95.29,percent of total billed charges,,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Aetna,Middlesex Employees,,,82.95,,82.95,82.95,95.29,percent of total billed charges,,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Anthem,Commerical,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Anthem,Indemnity,,,83.98,,83.98,82.95,95.29,percent of total billed charges,,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Anthem,Individual Exchange,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Anthem,State Preferred,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Cigna,Cigna,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Connecticare,Commerical,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Connecticare,Exchange,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,Multiplan,Multiplan,,,95.29,,95.29,82.95,95.29,percent of total billed charges,,
CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,J3490,HCPCS,0065-0359-02,NDC,both,2,mL,112.11,67.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,82.95,95.29,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Aetna,Commerical,,,1542.3,,1542.3,1.35,1699.01,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Aetna,Middlesex Employees,,,1478.94,,1478.94,1.35,1699.01,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Anthem,Commerical,,,,,,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Anthem,Indemnity,,,1497.33,,1497.33,1.35,1699.01,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Anthem,Individual Exchange,,,,,,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Anthem,State Preferred,,,,,,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Cigna,Cigna,,1.57,,,1.57,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Connecticare,Commerical,,1.54,,,1.54,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Connecticare,Exchange,,1.54,,,1.54,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,Multiplan,Multiplan,,,1699.01,,1699.01,1.35,1699.01,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-01,NDC,both,0.1,ea,1998.84,1199.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,1699.01,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Aetna,Commerical,,,492.4,,492.4,1.35,542.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Aetna,Middlesex Employees,,,472.17,,472.17,1.35,542.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Anthem,Commerical,,,,,,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Anthem,Indemnity,,,478.05,,478.05,1.35,542.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Anthem,Individual Exchange,,,,,,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Anthem,State Preferred,,,,,,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Cigna,Cigna,,1.57,,,1.57,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Connecticare,Commerical,,1.54,,,1.54,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Connecticare,Exchange,,1.54,,,1.54,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,Multiplan,Multiplan,,,542.44,,542.44,1.35,542.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-956-16,NDC,both,0.1,ea,638.16,382.9,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,542.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Aetna,Commerical,,,2139.59,,2139.59,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Aetna,Middlesex Employees,,,2051.68,,2051.68,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Anthem,Commerical,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Anthem,Indemnity,,,2077.19,,2077.19,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Anthem,Individual Exchange,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Anthem,State Preferred,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Cigna,Cigna,,1.57,,,1.57,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Connecticare,Commerical,,1.54,,,1.54,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Connecticare,Exchange,,1.54,,,1.54,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,Multiplan,Multiplan,,,2356.98,,2356.98,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,0000-0000-11,NDC,both,10,mL,2772.92,1663.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Aetna,Commerical,,,2139.59,,2139.59,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Aetna,Middlesex Employees,,,2051.68,,2051.68,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Anthem,Commerical,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Anthem,Indemnity,,,2077.19,,2077.19,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Anthem,Individual Exchange,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Anthem,State Preferred,,,,,,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Cigna,Cigna,,1.57,,,1.57,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Connecticare,Commerical,,1.54,,,1.54,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Connecticare,Exchange,,1.54,,,1.54,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,Multiplan,Multiplan,,,2356.98,,2356.98,1.35,2356.98,percent of total billed charges,,
CYCLOPHOSPHAMIDE 10 MG/ML ORAL ELIXIR CHEMO,J9075,HCPCS,40810-0004-18,NDC,both,10,mL,2772.92,1663.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,2356.98,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Aetna,Commerical,,,3079.5,,3079.5,1.35,3392.4,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Aetna,Middlesex Employees,,,2952.99,,2952.99,1.35,3392.4,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Anthem,Commerical,,,,,,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Anthem,Indemnity,,,2989.7,,2989.7,1.35,3392.4,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Anthem,Individual Exchange,,,,,,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Anthem,State Preferred,,,,,,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Cigna,Cigna,,1.57,,,1.57,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Connecticare,Commerical,,1.54,,,1.54,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Connecticare,Exchange,,1.54,,,1.54,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,Multiplan,Multiplan,,,3392.4,,3392.4,1.35,3392.4,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-01,NDC,both,0.05,ea,3991.06,2394.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,3392.4,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Aetna,Commerical,,,984.8,,984.8,1.35,1084.86,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Aetna,Middlesex Employees,,,944.34,,944.34,1.35,1084.86,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Anthem,Commerical,,,,,,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Anthem,Indemnity,,,956.08,,956.08,1.35,1084.86,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Anthem,Individual Exchange,,,,,,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Anthem,State Preferred,,,,,,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Cigna,Cigna,,1.57,,,1.57,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Connecticare,Commerical,,1.54,,,1.54,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Connecticare,Exchange,,1.54,,,1.54,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,Multiplan,Multiplan,,,1084.86,,1084.86,1.35,1084.86,percent of total billed charges,,
CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-957-11,NDC,both,0.05,ea,1276.31,765.79,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,1084.86,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Aetna,Commerical,,,728.53,,728.53,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Aetna,Middlesex Employees,,,698.6,,698.6,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Anthem,Commerical,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Anthem,Indemnity,,,707.29,,707.29,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Anthem,Individual Exchange,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Anthem,State Preferred,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Cigna,Cigna,,1.76,,,1.76,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Connecticare,Commerical,,1.77,,,1.77,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Connecticare,Exchange,,1.77,,,1.77,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,Multiplan,Multiplan,,,802.55,,802.55,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-01,NDC,both,0.025,mL,944.18,566.51,United Healthcare/Oxford,United Healthcare/Oxford,,1.53,,,1.53,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Aetna,Commerical,,,728.53,,728.53,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Aetna,Middlesex Employees,,,698.6,,698.6,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Anthem,Commerical,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Anthem,Indemnity,,,707.29,,707.29,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Anthem,Individual Exchange,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Anthem,State Preferred,,,,,,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Cigna,Cigna,,1.76,,,1.76,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Connecticare,Commerical,,1.77,,,1.77,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Connecticare,Exchange,,1.77,,,1.77,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,Multiplan,Multiplan,,,802.55,,802.55,1.53,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9071,HCPCS,55150-271-99,NDC,both,0.025,mL,944.18,566.51,United Healthcare/Oxford,United Healthcare/Oxford,,1.53,,,1.53,1.53,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Aetna,Commerical,,,728.53,,728.53,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Aetna,Middlesex Employees,,,698.6,,698.6,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Commerical,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Indemnity,,,707.29,,707.29,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Individual Exchange,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Anthem,State Preferred,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Cigna,Cigna,,1.11,,,1.11,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Connecticare,Commerical,,1.41,,,1.41,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Connecticare,Exchange,,1.41,,,1.41,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,Multiplan,Multiplan,,,802.55,,802.55,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,50742-520-05,NDC,both,0.025,mL,944.18,566.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Aetna,Commerical,,,728.53,,728.53,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Aetna,Middlesex Employees,,,698.6,,698.6,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Anthem,Commerical,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Anthem,Indemnity,,,707.29,,707.29,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Anthem,Individual Exchange,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Anthem,State Preferred,,,,,,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Cigna,Cigna,,1.11,,,1.11,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Connecticare,Commerical,,1.41,,,1.41,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Connecticare,Exchange,,1.41,,,1.41,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,Multiplan,Multiplan,,,802.55,,802.55,0.96,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9073,HCPCS,75907-190-07,NDC,both,0.025,mL,944.18,566.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.96,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Aetna,Commerical,,,728.53,,728.53,1.35,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Aetna,Middlesex Employees,,,698.6,,698.6,1.35,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Commerical,,,,,,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Indemnity,,,707.29,,707.29,1.35,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Anthem,Individual Exchange,,,,,,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Anthem,State Preferred,,,,,,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Cigna,Cigna,,1.57,,,1.57,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Connecticare,Commerical,,1.54,,,1.54,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Connecticare,Exchange,,1.54,,,1.54,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,Multiplan,Multiplan,,,802.55,,802.55,1.35,802.55,percent of total billed charges,,
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,J9075,HCPCS,70860-218-05,NDC,both,0.025,mL,944.18,566.51,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,802.55,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Aetna,Commerical,,,15.41,,15.41,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Aetna,Middlesex Employees,,,14.78,,14.78,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Commerical,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Indemnity,,,14.96,,14.96,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Individual Exchange,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,State Preferred,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Cigna,Cigna,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Connecticare,Commerical,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Connecticare,Exchange,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Multiplan,Multiplan,,,16.97,,16.97,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,United Healthcare/Oxford,United Healthcare/Oxford,,1.17,,,1.17,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Aetna,Commerical,,,15.41,,15.41,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Aetna,Middlesex Employees,,,14.78,,14.78,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Commerical,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Indemnity,,,14.96,,14.96,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,Individual Exchange,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Anthem,State Preferred,,,,,,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Cigna,Cigna,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Connecticare,Commerical,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Connecticare,Exchange,,1.35,,,1.35,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,Multiplan,Multiplan,,,16.97,,16.97,1.17,16.97,percent of total billed charges,,
CYCLOPHOSPHAMIDE 25 MG CAPSULE CHEMO,J8530,HCPCS,0054-0382-25,NDC,both,1,ea,19.97,11.98,United Healthcare/Oxford,United Healthcare/Oxford,,1.17,,,1.17,1.17,16.97,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Aetna,Commerical,,,1041.61,,1041.61,1.35,1147.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Aetna,Middlesex Employees,,,998.81,,998.81,1.35,1147.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Anthem,Commerical,,,,,,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Anthem,Indemnity,,,1011.23,,1011.23,1.35,1147.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Anthem,Individual Exchange,,,,,,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Anthem,State Preferred,,,,,,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Cigna,Cigna,,1.57,,,1.57,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Connecticare,Commerical,,1.54,,,1.54,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Connecticare,Exchange,,1.54,,,1.54,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,Multiplan,Multiplan,,,1147.44,,1147.44,1.35,1147.44,percent of total billed charges,,
CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9075,HCPCS,10019-955-01,NDC,both,0.2,ea,1349.93,809.96,United Healthcare/Oxford,United Healthcare/Oxford,,1.35,,,1.35,1.35,1147.44,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Aetna,Commerical,,,12.31,,12.31,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Aetna,Middlesex Employees,,,11.81,,11.81,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Anthem,Commerical,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Anthem,Indemnity,,,11.96,,11.96,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Anthem,Individual Exchange,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Anthem,State Preferred,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Cigna,Cigna,,45.08,,,45.08,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Connecticare,Commerical,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Connecticare,Exchange,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,Multiplan,Multiplan,,,13.57,,13.57,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0078-0109-01,NDC,both,5,mL,15.96,9.58,United Healthcare/Oxford,United Healthcare/Oxford,,76.54,,,76.54,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Aetna,Commerical,,,12.31,,12.31,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Aetna,Middlesex Employees,,,11.81,,11.81,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Commerical,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Indemnity,,,11.96,,11.96,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Individual Exchange,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,State Preferred,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Cigna,Cigna,,45.08,,,45.08,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Connecticare,Commerical,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Connecticare,Exchange,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,Multiplan,Multiplan,,,13.57,,13.57,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0517-0866-10,NDC,both,5,mL,15.96,9.58,United Healthcare/Oxford,United Healthcare/Oxford,,76.54,,,76.54,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Aetna,Commerical,,,12.31,,12.31,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Aetna,Middlesex Employees,,,11.81,,11.81,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Commerical,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Indemnity,,,11.96,,11.96,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,Individual Exchange,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Anthem,State Preferred,,,,,,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Cigna,Cigna,,45.08,,,45.08,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Connecticare,Commerical,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Connecticare,Exchange,,76.52,,,76.52,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,Multiplan,Multiplan,,,13.57,,13.57,11.81,76.54,percent of total billed charges,,
CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,J7516,HCPCS,0574-0866-10,NDC,both,5,mL,15.96,9.58,United Healthcare/Oxford,United Healthcare/Oxford,,76.54,,,76.54,11.81,76.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Aetna,Commerical,,,4.12,,4.12,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Aetna,Middlesex Employees,,,3.95,,3.95,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Anthem,Commerical,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Anthem,Indemnity,,,4,,4,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Anthem,Individual Exchange,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Anthem,State Preferred,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Cigna,Cigna,,2.47,,,2.47,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Connecticare,Commerical,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Connecticare,Exchange,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,Multiplan,Multiplan,,,4.54,,4.54,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0074-3109-32,NDC,both,1,ea,5.34,3.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Aetna,Commerical,,,4.12,,4.12,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Aetna,Middlesex Employees,,,3.95,,3.95,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Anthem,Commerical,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Anthem,Indemnity,,,4,,4,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Anthem,Individual Exchange,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Anthem,State Preferred,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Cigna,Cigna,,2.47,,,2.47,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Connecticare,Commerical,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Connecticare,Exchange,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,Multiplan,Multiplan,,,4.54,,4.54,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0078-0248-15,NDC,both,1,ea,5.34,3.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Aetna,Commerical,,,4.12,,4.12,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Aetna,Middlesex Employees,,,3.95,,3.95,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Anthem,Commerical,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Anthem,Indemnity,,,4,,4,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Anthem,Individual Exchange,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Anthem,State Preferred,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Cigna,Cigna,,2.47,,,2.47,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Connecticare,Commerical,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Connecticare,Exchange,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,Multiplan,Multiplan,,,4.54,,4.54,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-19,NDC,both,1,ea,5.34,3.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Aetna,Commerical,,,4.12,,4.12,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Aetna,Middlesex Employees,,,3.95,,3.95,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Anthem,Commerical,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Anthem,Indemnity,,,4,,4,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Anthem,Individual Exchange,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Anthem,State Preferred,,,,,,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Cigna,Cigna,,2.47,,,2.47,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Connecticare,Commerical,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Connecticare,Exchange,,3.64,,,3.64,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,Multiplan,Multiplan,,,4.54,,4.54,2.47,4.54,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG CAPSULE,J7502,HCPCS,0093-9020-65,NDC,both,1,ea,5.34,3.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,4.54,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Aetna,Commerical,,,473.88,,473.88,2.47,522.03,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Aetna,Middlesex Employees,,,454.41,,454.41,2.47,522.03,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Anthem,Commerical,,,,,,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Anthem,Indemnity,,,460.06,,460.06,2.47,522.03,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Anthem,Individual Exchange,,,,,,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Anthem,State Preferred,,,,,,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Cigna,Cigna,,2.47,,,2.47,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Connecticare,Commerical,,3.64,,,3.64,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Connecticare,Exchange,,3.64,,,3.64,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,Multiplan,Multiplan,,,522.03,,522.03,2.47,522.03,percent of total billed charges,,
CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,J7502,HCPCS,0172-7313-20,NDC,both,1,mL,614.15,368.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,522.03,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Aetna,Commerical,,,10.17,,10.17,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Aetna,Middlesex Employees,,,9.75,,9.75,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Anthem,Commerical,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Anthem,Indemnity,,,9.87,,9.87,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Anthem,Individual Exchange,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Anthem,State Preferred,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Cigna,Cigna,,2.47,,,2.47,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Connecticare,Commerical,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Connecticare,Exchange,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,Multiplan,Multiplan,,,11.2,,11.2,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0074-3108-32,NDC,both,4,ea,13.18,7.91,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Aetna,Commerical,,,10.17,,10.17,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Aetna,Middlesex Employees,,,9.75,,9.75,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Anthem,Commerical,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Anthem,Indemnity,,,9.87,,9.87,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Anthem,Individual Exchange,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Anthem,State Preferred,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Cigna,Cigna,,2.47,,,2.47,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Connecticare,Commerical,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Connecticare,Exchange,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,Multiplan,Multiplan,,,11.2,,11.2,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,0078-0246-15,NDC,both,4,ea,13.18,7.91,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Aetna,Commerical,,,10.17,,10.17,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Aetna,Middlesex Employees,,,9.75,,9.75,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Anthem,Commerical,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Anthem,Indemnity,,,9.87,,9.87,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Anthem,Individual Exchange,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Anthem,State Preferred,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Cigna,Cigna,,2.47,,,2.47,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Connecticare,Commerical,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Connecticare,Exchange,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,Multiplan,Multiplan,,,11.2,,11.2,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-11,NDC,both,4,ea,13.18,7.91,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Aetna,Commerical,,,10.17,,10.17,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Aetna,Middlesex Employees,,,9.75,,9.75,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Anthem,Commerical,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Anthem,Indemnity,,,9.87,,9.87,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Anthem,Individual Exchange,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Anthem,State Preferred,,,,,,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Cigna,Cigna,,2.47,,,2.47,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Connecticare,Commerical,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Connecticare,Exchange,,3.64,,,3.64,2.47,11.2,Other,Could be inpatient or outpatient,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,Multiplan,Multiplan,,,11.2,,11.2,2.47,11.2,percent of total billed charges,,
CYCLOSPORINE MODIFIED 25 MG CAPSULE,J7502,HCPCS,23155-837-30,NDC,both,4,ea,13.18,7.91,United Healthcare/Oxford,United Healthcare/Oxford,,2.67,,,2.67,2.47,11.2,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 1 MG ORAL TAB,J3490,HCPCS,40810-0000-97,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
CYPROHEPTADINE 2 MG ORAL TAB,J3490,HCPCS,40810-0000-98,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Aetna,Commerical,,,150.97,,150.97,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Aetna,Middlesex Employees,,,144.77,,144.77,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Anthem,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Anthem,Indemnity,,,146.57,,146.57,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Anthem,Individual Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Anthem,State Preferred,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Cigna,Cigna,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Connecticare,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Connecticare,Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,Multiplan,Multiplan,,,166.31,,166.31,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,0527-1949-47,NDC,both,1,mL,195.66,117.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Aetna,Commerical,,,150.97,,150.97,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Aetna,Middlesex Employees,,,144.77,,144.77,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Anthem,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Anthem,Indemnity,,,146.57,,146.57,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Anthem,Individual Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Anthem,State Preferred,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Cigna,Cigna,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Connecticare,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Connecticare,Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,Multiplan,Multiplan,,,166.31,,166.31,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-044-16,NDC,both,1,mL,195.66,117.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Aetna,Commerical,,,150.97,,150.97,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Aetna,Middlesex Employees,,,144.77,,144.77,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Anthem,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Anthem,Indemnity,,,146.57,,146.57,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Anthem,Individual Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Anthem,State Preferred,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Cigna,Cigna,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Connecticare,Commerical,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Connecticare,Exchange,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,Multiplan,Multiplan,,,166.31,,166.31,144.77,166.31,percent of total billed charges,,
CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,J3490,HCPCS,64980-504-48,NDC,both,1,mL,195.66,117.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,144.77,166.31,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,52817-210-10,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
CYPROHEPTADINE 4 MG TABLET,J3490,HCPCS,70752-107-10,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Aetna,Commerical,,,260.06,,260.06,249.38,286.48,percent of total billed charges,,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Aetna,Middlesex Employees,,,249.38,,249.38,249.38,286.48,percent of total billed charges,,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Anthem,Commerical,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Anthem,Indemnity,,,252.48,,252.48,249.38,286.48,percent of total billed charges,,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Anthem,Individual Exchange,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Anthem,State Preferred,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Cigna,Cigna,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Connecticare,Commerical,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Connecticare,Exchange,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,Multiplan,Multiplan,,,286.48,,286.48,249.38,286.48,percent of total billed charges,,
CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-1007-3,NDC,both,1,mL,337.04,202.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,249.38,286.48,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Aetna,Commerical,,,13.2,,13.2,0.93,14.54,percent of total billed charges,,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Aetna,Middlesex Employees,,,12.66,,12.66,0.93,14.54,percent of total billed charges,,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Anthem,Commerical,,,,,,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Anthem,Indemnity,,,12.82,,12.82,0.93,14.54,percent of total billed charges,,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Anthem,Individual Exchange,,,,,,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Anthem,State Preferred,,,,,,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Cigna,Cigna,,1.07,,,1.07,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Connecticare,Commerical,,1.18,,,1.18,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Connecticare,Exchange,,1.18,,,1.18,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,Multiplan,Multiplan,,,14.54,,14.54,0.93,14.54,percent of total billed charges,,
CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-305-38,NDC,both,5,mL,17.11,10.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,14.54,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,25021-223-20,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,61703-319-22,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Aetna,Commerical,,,35.41,,35.41,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Aetna,Middlesex Employees,,,33.95,,33.95,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Commerical,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Indemnity,,,34.38,,34.38,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,Individual Exchange,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Anthem,State Preferred,,,,,,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Cigna,Cigna,,1.07,,,1.07,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Connecticare,Commerical,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Connecticare,Exchange,,1.18,,,1.18,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,Multiplan,Multiplan,,,39.01,,39.01,0.93,39.01,percent of total billed charges,,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,J9100,HCPCS,63323-120-20,NDC,both,1,mL,45.89,27.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,39.01,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Aetna,Commerical,,,53.05,,53.05,0.93,58.44,percent of total billed charges,,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Aetna,Middlesex Employees,,,50.87,,50.87,0.93,58.44,percent of total billed charges,,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Anthem,Commerical,,,,,,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Anthem,Indemnity,,,51.5,,51.5,0.93,58.44,percent of total billed charges,,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Anthem,Individual Exchange,,,,,,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Anthem,State Preferred,,,,,,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Cigna,Cigna,,1.07,,,1.07,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Connecticare,Commerical,,1.18,,,1.18,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Connecticare,Exchange,,1.18,,,1.18,0.93,58.44,Other,Could be inpatient or outpatient,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,Multiplan,Multiplan,,,58.44,,58.44,0.93,58.44,percent of total billed charges,,
CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,J9100,HCPCS,61703-303-46,NDC,both,5,mL,68.75,41.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.93,,,0.93,0.93,58.44,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Aetna,Commerical,,,5295.77,,5295.77,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Aetna,Middlesex Employees,,,5078.2,,5078.2,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Commerical,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Indemnity,,,5141.34,,5141.34,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Individual Exchange,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,State Preferred,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Cigna,Cigna,,2047.72,,,2047.72,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Connecticare,Commerical,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Connecticare,Exchange,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,Multiplan,Multiplan,,,5833.86,,5833.86,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-50,NDC,both,50,mL,6863.36,4118.02,United Healthcare/Oxford,United Healthcare/Oxford,,2210.81,,,2210.81,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Aetna,Commerical,,,5295.77,,5295.77,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Aetna,Middlesex Employees,,,5078.2,,5078.2,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Commerical,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Indemnity,,,5141.34,,5141.34,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Individual Exchange,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,State Preferred,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Cigna,Cigna,,2047.72,,,2047.72,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Connecticare,Commerical,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Connecticare,Exchange,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,Multiplan,Multiplan,,,5833.86,,5833.86,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,49591-532-51,NDC,both,50,mL,6863.36,4118.02,United Healthcare/Oxford,United Healthcare/Oxford,,2210.81,,,2210.81,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Aetna,Commerical,,,5295.77,,5295.77,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Aetna,Middlesex Employees,,,5078.2,,5078.2,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Commerical,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Indemnity,,,5141.34,,5141.34,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,Individual Exchange,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Anthem,State Preferred,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Cigna,Cigna,,2047.72,,,2047.72,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Connecticare,Commerical,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Connecticare,Exchange,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,Multiplan,Multiplan,,,5833.86,,5833.86,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-50,NDC,both,50,mL,6863.36,4118.02,United Healthcare/Oxford,United Healthcare/Oxford,,2210.81,,,2210.81,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Aetna,Commerical,,,5295.77,,5295.77,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Aetna,Middlesex Employees,,,5078.2,,5078.2,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Commerical,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Indemnity,,,5141.34,,5141.34,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,Individual Exchange,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Anthem,State Preferred,,,,,,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Cigna,Cigna,,2047.72,,,2047.72,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Connecticare,Commerical,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Connecticare,Exchange,,2771.38,,,2771.38,2047.72,5833.86,Other,Could be inpatient or outpatient,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,Multiplan,Multiplan,,,5833.86,,5833.86,2047.72,5833.86,percent of total billed charges,,
CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,J0850,HCPCS,70257-532-51,NDC,both,50,mL,6863.36,4118.02,United Healthcare/Oxford,United Healthcare/Oxford,,2210.81,,,2210.81,2047.72,5833.86,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Aetna,Commerical,,,257.75,,257.75,247.16,283.94,percent of total billed charges,,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Aetna,Middlesex Employees,,,247.16,,247.16,247.16,283.94,percent of total billed charges,,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Anthem,Commerical,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Anthem,Indemnity,,,250.24,,250.24,247.16,283.94,percent of total billed charges,,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Anthem,Individual Exchange,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Anthem,State Preferred,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Cigna,Cigna,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Connecticare,Commerical,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Connecticare,Exchange,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,Multiplan,Multiplan,,,283.94,,283.94,247.16,283.94,percent of total billed charges,,
DABRAFENIB 50 MG CAPSULE,J3490,HCPCS,0078-0682-66,NDC,both,1,ea,334.05,200.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,247.16,283.94,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Aetna,Commerical,,,332.17,,332.17,318.53,365.93,percent of total billed charges,,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Aetna,Middlesex Employees,,,318.53,,318.53,318.53,365.93,percent of total billed charges,,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Anthem,Commerical,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Anthem,Indemnity,,,322.49,,322.49,318.53,365.93,percent of total billed charges,,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Anthem,Individual Exchange,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Anthem,State Preferred,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Cigna,Cigna,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Connecticare,Commerical,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Connecticare,Exchange,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,Multiplan,Multiplan,,,365.93,,365.93,318.53,365.93,percent of total billed charges,,
DABRAFENIB 75 MG CAPSULE,J3490,HCPCS,0078-0681-66,NDC,both,1,ea,430.5,258.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,318.53,365.93,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Aetna,Commerical,,,33.57,,33.57,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Aetna,Middlesex Employees,,,32.19,,32.19,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Anthem,Commerical,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Anthem,Indemnity,,,32.59,,32.59,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Anthem,Individual Exchange,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Anthem,State Preferred,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Cigna,Cigna,,5.08,,,5.08,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Connecticare,Commerical,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Connecticare,Exchange,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,Multiplan,Multiplan,,,36.98,,36.98,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0143-9245-01,NDC,both,0.5,ea,43.51,26.11,United Healthcare/Oxford,United Healthcare/Oxford,,4.39,,,4.39,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Aetna,Commerical,,,33.57,,33.57,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Aetna,Middlesex Employees,,,32.19,,32.19,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Anthem,Commerical,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Anthem,Indemnity,,,32.59,,32.59,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Anthem,Individual Exchange,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Anthem,State Preferred,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Cigna,Cigna,,5.08,,,5.08,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Connecticare,Commerical,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Connecticare,Exchange,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,Multiplan,Multiplan,,,36.98,,36.98,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,0703-5075-03,NDC,both,0.5,ea,43.51,26.11,United Healthcare/Oxford,United Healthcare/Oxford,,4.39,,,4.39,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Aetna,Commerical,,,33.57,,33.57,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Aetna,Middlesex Employees,,,32.19,,32.19,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Anthem,Commerical,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Anthem,Indemnity,,,32.59,,32.59,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Anthem,Individual Exchange,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Anthem,State Preferred,,,,,,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Cigna,Cigna,,5.08,,,5.08,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Connecticare,Commerical,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Connecticare,Exchange,,6.52,,,6.52,4.39,36.98,Other,Could be inpatient or outpatient,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,Multiplan,Multiplan,,,36.98,,36.98,4.39,36.98,percent of total billed charges,,
DACARBAZINE 200 MG INTRAVENOUS SOLUTION,J9130,HCPCS,63323-128-20,NDC,both,0.5,ea,43.51,26.11,United Healthcare/Oxford,United Healthcare/Oxford,,4.39,,,4.39,4.39,36.98,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-1,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,39822-2100-2,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-431-01,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55150-928-02,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,55292-811-55,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Aetna,Commerical,,,1075.2,,1075.2,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Aetna,Middlesex Employees,,,1031.03,,1031.03,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Anthem,Commerical,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Anthem,Indemnity,,,1043.85,,1043.85,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Anthem,Individual Exchange,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Anthem,State Preferred,,,,,,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Cigna,Cigna,,560.49,,,560.49,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Connecticare,Commerical,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Connecticare,Exchange,,430.81,,,430.81,430.81,1184.45,Other,Could be inpatient or outpatient,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,Multiplan,Multiplan,,,1184.45,,1184.45,430.81,1184.45,percent of total billed charges,,
DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,J9120,HCPCS,67457-513-05,NDC,both,1,ea,1393.47,836.08,United Healthcare/Oxford,United Healthcare/Oxford,,484.96,,,484.96,430.81,1184.45,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Aetna,Commerical,,,4403.29,,4403.29,17.84,4850.7,percent of total billed charges,,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Aetna,Middlesex Employees,,,4222.39,,4222.39,17.84,4850.7,percent of total billed charges,,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Anthem,Commerical,,,,,,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Anthem,Indemnity,,,4274.89,,4274.89,17.84,4850.7,percent of total billed charges,,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Anthem,Individual Exchange,,,,,,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Anthem,State Preferred,,,,,,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Cigna,Cigna,,17.84,,,17.84,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Connecticare,Commerical,,23.84,,,23.84,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Connecticare,Exchange,,23.84,,,23.84,17.84,4850.7,Other,Could be inpatient or outpatient,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,Multiplan,Multiplan,,,4850.7,,4850.7,17.84,4850.7,percent of total billed charges,,
DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,J0875,HCPCS,57970-100-01,NDC,both,1,ea,5706.7,3424.02,United Healthcare/Oxford,United Healthcare/Oxford,,19.26,,,19.26,17.84,4850.7,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Aetna,Commerical,,,252.14,,252.14,241.78,277.75,percent of total billed charges,,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Aetna,Middlesex Employees,,,241.78,,241.78,241.78,277.75,percent of total billed charges,,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Anthem,Commerical,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Anthem,Indemnity,,,244.78,,244.78,241.78,277.75,percent of total billed charges,,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Anthem,Individual Exchange,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Anthem,State Preferred,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Cigna,Cigna,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Connecticare,Commerical,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Connecticare,Exchange,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,Multiplan,Multiplan,,,277.75,,277.75,241.78,277.75,percent of total billed charges,,
DANTROLENE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-123-06,NDC,both,1,ea,326.77,196.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,241.78,277.75,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Aetna,Commerical,,,3.93,,3.93,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Anthem,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Anthem,Indemnity,,,3.81,,3.81,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Anthem,Individual Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Anthem,State Preferred,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Cigna,Cigna,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Connecticare,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Connecticare,Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,Multiplan,Multiplan,,,4.33,,4.33,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,0904-7211-04,NDC,both,1,ea,5.09,3.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Aetna,Commerical,,,3.93,,3.93,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Anthem,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Anthem,Indemnity,,,3.81,,3.81,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Anthem,Individual Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Anthem,State Preferred,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Cigna,Cigna,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Connecticare,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Connecticare,Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,Multiplan,Multiplan,,,4.33,,4.33,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,40810-0005-21,NDC,both,1,ea,5.09,3.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Aetna,Commerical,,,3.93,,3.93,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Anthem,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Anthem,Indemnity,,,3.81,,3.81,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Anthem,Individual Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Anthem,State Preferred,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Cigna,Cigna,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Connecticare,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Connecticare,Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,Multiplan,Multiplan,,,4.33,,4.33,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,42023-124-01,NDC,both,1,ea,5.09,3.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Aetna,Commerical,,,3.93,,3.93,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Anthem,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Anthem,Indemnity,,,3.81,,3.81,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Anthem,Individual Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Anthem,State Preferred,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Cigna,Cigna,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Connecticare,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Connecticare,Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,Multiplan,Multiplan,,,4.33,,4.33,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-11,NDC,both,1,ea,5.09,3.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Aetna,Commerical,,,3.93,,3.93,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Aetna,Middlesex Employees,,,3.77,,3.77,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Anthem,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Anthem,Indemnity,,,3.81,,3.81,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Anthem,Individual Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Anthem,State Preferred,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Cigna,Cigna,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Connecticare,Commerical,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Connecticare,Exchange,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,Multiplan,Multiplan,,,4.33,,4.33,3.77,4.33,percent of total billed charges,,
DANTROLENE 25 MG CAPSULE,J3490,HCPCS,68084-300-21,NDC,both,1,ea,5.09,3.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.77,4.33,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Aetna,Commerical,,,6190.97,,6190.97,5936.62,6820.02,percent of total billed charges,,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Aetna,Middlesex Employees,,,5936.62,,5936.62,5936.62,6820.02,percent of total billed charges,,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Anthem,Commerical,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Anthem,Indemnity,,,6010.44,,6010.44,5936.62,6820.02,percent of total billed charges,,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Anthem,Individual Exchange,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Anthem,State Preferred,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Cigna,Cigna,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Connecticare,Commerical,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Connecticare,Exchange,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,Multiplan,Multiplan,,,6820.02,,6820.02,5936.62,6820.02,percent of total billed charges,,
DANTROLENE 250 MG INTRAVENOUS SUSPENSION,J3490,HCPCS,42367-540-32,NDC,both,1,ea,8023.55,4814.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5936.62,6820.02,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Aetna,Commerical,,,161.66,,161.66,155.02,178.08,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Aetna,Middlesex Employees,,,155.02,,155.02,155.02,178.08,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Anthem,Commerical,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Anthem,Indemnity,,,156.94,,156.94,155.02,178.08,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Anthem,Individual Exchange,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Anthem,State Preferred,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Cigna,Cigna,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Connecticare,Commerical,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Connecticare,Exchange,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,Multiplan,Multiplan,,,178.08,,178.08,155.02,178.08,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0000-99,NDC,both,1,mL,209.51,125.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,155.02,178.08,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Aetna,Commerical,,,80.83,,80.83,77.51,89.05,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Aetna,Middlesex Employees,,,77.51,,77.51,77.51,89.05,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Anthem,Commerical,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Anthem,Indemnity,,,78.48,,78.48,77.51,89.05,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Anthem,Individual Exchange,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Anthem,State Preferred,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Cigna,Cigna,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Connecticare,Commerical,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Connecticare,Exchange,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,Multiplan,Multiplan,,,89.05,,89.05,77.51,89.05,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-15,NDC,both,1,mL,104.76,62.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,77.51,89.05,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Aetna,Commerical,,,323.31,,323.31,310.03,356.16,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Aetna,Middlesex Employees,,,310.03,,310.03,310.03,356.16,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Anthem,Commerical,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Anthem,Indemnity,,,313.88,,313.88,310.03,356.16,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Anthem,Individual Exchange,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Anthem,State Preferred,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Cigna,Cigna,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Connecticare,Commerical,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Connecticare,Exchange,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,Multiplan,Multiplan,,,356.16,,356.16,310.03,356.16,percent of total billed charges,,
DANTROLENE 5 MG/ML ORAL SYRUP,J3490,HCPCS,40810-0012-16,NDC,both,1,mL,419.01,251.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,310.03,356.16,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,0115-4422-01,NDC,both,1,ea,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
DANTROLENE 50 MG CAPSULE,J3490,HCPCS,42023-125-01,NDC,both,1,ea,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Aetna,Commerical,,,43.95,,43.95,42.14,48.42,percent of total billed charges,,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Aetna,Middlesex Employees,,,42.14,,42.14,42.14,48.42,percent of total billed charges,,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Anthem,Commerical,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Anthem,Indemnity,,,42.67,,42.67,42.14,48.42,percent of total billed charges,,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Anthem,Individual Exchange,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Anthem,State Preferred,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Cigna,Cigna,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Connecticare,Commerical,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Connecticare,Exchange,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,Multiplan,Multiplan,,,48.42,,48.42,42.14,48.42,percent of total billed charges,,
DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,J3490,HCPCS,0310-6210-39,NDC,both,1,ea,56.96,34.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.14,48.42,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,49938-101-30,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
DAPSONE 100 MG TABLET,J3490,HCPCS,70954-136-10,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-11,NDC,both,1,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DAPSONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-15,NDC,both,1,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,49938-102-30,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DAPSONE 25 MG TABLET,J3490,HCPCS,70954-135-10,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Aetna,Commerical,,,3.1,,3.1,2.97,3.42,percent of total billed charges,,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Aetna,Middlesex Employees,,,2.97,,2.97,2.97,3.42,percent of total billed charges,,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Anthem,Commerical,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Anthem,Indemnity,,,3.01,,3.01,2.97,3.42,percent of total billed charges,,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Anthem,Individual Exchange,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Anthem,State Preferred,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Cigna,Cigna,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Connecticare,Commerical,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Connecticare,Exchange,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,Multiplan,Multiplan,,,3.42,,3.42,2.97,3.42,percent of total billed charges,,
DAPSONE 50 MG TABLET,J3490,HCPCS,40810-0013-53,NDC,both,1,UN,4.02,2.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.97,3.42,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Aetna,Commerical,,,45.52,,45.52,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Aetna,Middlesex Employees,,,43.65,,43.65,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Commerical,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Indemnity,,,44.19,,44.19,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Individual Exchange,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Anthem,State Preferred,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Cigna,Cigna,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Connecticare,Commerical,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Connecticare,Exchange,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,Multiplan,Multiplan,,,50.14,,50.14,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,25021-174-15,NDC,both,0.002,ea,58.99,35.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Aetna,Commerical,,,45.52,,45.52,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Aetna,Middlesex Employees,,,43.65,,43.65,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Anthem,Commerical,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Anthem,Indemnity,,,44.19,,44.19,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Anthem,Individual Exchange,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Anthem,State Preferred,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Cigna,Cigna,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Connecticare,Commerical,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Connecticare,Exchange,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,Multiplan,Multiplan,,,50.14,,50.14,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,43598-413-11,NDC,both,0.002,ea,58.99,35.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Aetna,Commerical,,,45.52,,45.52,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Aetna,Middlesex Employees,,,43.65,,43.65,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Anthem,Commerical,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Anthem,Indemnity,,,44.19,,44.19,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Anthem,Individual Exchange,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Anthem,State Preferred,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Cigna,Cigna,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Connecticare,Commerical,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Connecticare,Exchange,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,Multiplan,Multiplan,,,50.14,,50.14,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-371-19,NDC,both,0.002,ea,58.99,35.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Aetna,Commerical,,,544.12,,544.12,0.02,599.4,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Aetna,Middlesex Employees,,,521.76,,521.76,0.02,599.4,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Anthem,Commerical,,,,,,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Anthem,Indemnity,,,528.25,,528.25,0.02,599.4,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Anthem,Individual Exchange,,,,,,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Anthem,State Preferred,,,,,,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Cigna,Cigna,,0.02,,,0.02,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Connecticare,Commerical,,0.05,,,0.05,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Connecticare,Exchange,,0.05,,,0.05,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,Multiplan,Multiplan,,,599.4,,599.4,0.02,599.4,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,63323-871-15,NDC,both,0.002,ea,705.18,423.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,599.4,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Aetna,Commerical,,,1048.28,,1048.28,0.02,1154.79,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Aetna,Middlesex Employees,,,1005.21,,1005.21,0.02,1154.79,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Anthem,Commerical,,,,,,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Anthem,Indemnity,,,1017.71,,1017.71,0.02,1154.79,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Anthem,Individual Exchange,,,,,,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Anthem,State Preferred,,,,,,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Cigna,Cigna,,0.02,,,0.02,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Connecticare,Commerical,,0.05,,,0.05,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Connecticare,Exchange,,0.05,,,0.05,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,Multiplan,Multiplan,,,1154.79,,1154.79,0.02,1154.79,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,67919-011-01,NDC,both,0.002,ea,1358.58,815.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1154.79,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Aetna,Commerical,,,45.52,,45.52,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Aetna,Middlesex Employees,,,43.65,,43.65,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Commerical,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Indemnity,,,44.19,,44.19,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Anthem,Individual Exchange,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Anthem,State Preferred,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Cigna,Cigna,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Connecticare,Commerical,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Connecticare,Exchange,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,Multiplan,Multiplan,,,50.14,,50.14,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-15,NDC,both,0.002,ea,58.99,35.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Aetna,Commerical,,,45.52,,45.52,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Aetna,Middlesex Employees,,,43.65,,43.65,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Anthem,Commerical,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Anthem,Indemnity,,,44.19,,44.19,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Anthem,Individual Exchange,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Anthem,State Preferred,,,,,,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Cigna,Cigna,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Connecticare,Commerical,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Connecticare,Exchange,,0.05,,,0.05,0.02,50.14,Other,Could be inpatient or outpatient,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,Multiplan,Multiplan,,,50.14,,50.14,0.02,50.14,percent of total billed charges,,
DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,J0878,HCPCS,71288-016-95,NDC,both,0.002,ea,58.99,35.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,50.14,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Aetna,Commerical,,,1967.16,,1967.16,78.54,2167.04,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Aetna,Middlesex Employees,,,1886.35,,1886.35,78.54,2167.04,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Anthem,Commerical,,,,,,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Anthem,Indemnity,,,1909.8,,1909.8,78.54,2167.04,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Anthem,Individual Exchange,,,,,,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Anthem,State Preferred,,,,,,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Cigna,Cigna,,90.78,,,90.78,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Connecticare,Commerical,,99.43,,,99.43,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Connecticare,Exchange,,99.43,,,99.43,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,Multiplan,Multiplan,,,2167.04,,2167.04,78.54,2167.04,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-05,NDC,both,0.5,mL,2549.46,1529.68,United Healthcare/Oxford,United Healthcare/Oxford,,78.54,,,78.54,78.54,2167.04,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Aetna,Commerical,,,7868.65,,7868.65,78.54,8668.16,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Aetna,Middlesex Employees,,,7545.38,,7545.38,78.54,8668.16,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Anthem,Commerical,,,,,,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Anthem,Indemnity,,,7639.2,,7639.2,78.54,8668.16,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Anthem,Individual Exchange,,,,,,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Anthem,State Preferred,,,,,,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Cigna,Cigna,,90.78,,,90.78,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Connecticare,Commerical,,99.43,,,99.43,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Connecticare,Exchange,,99.43,,,99.43,78.54,8668.16,Other,Could be inpatient or outpatient,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,Multiplan,Multiplan,,,8668.16,,8668.16,78.54,8668.16,percent of total billed charges,,
DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,J9145,HCPCS,57894-502-20,NDC,both,0.5,mL,10197.84,6118.7,United Healthcare/Oxford,United Healthcare/Oxford,,78.54,,,78.54,78.54,8668.16,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Aetna,Commerical,,,578.94,,578.94,3.73,637.76,percent of total billed charges,,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Aetna,Middlesex Employees,,,555.15,,555.15,3.73,637.76,percent of total billed charges,,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Anthem,Commerical,,,,,,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Anthem,Indemnity,,,562.06,,562.06,3.73,637.76,percent of total billed charges,,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Anthem,Individual Exchange,,,,,,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Anthem,State Preferred,,,,,,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Cigna,Cigna,,4.2,,,4.2,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Connecticare,Commerical,,4.64,,,4.64,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Connecticare,Exchange,,4.64,,,4.64,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,Multiplan,Multiplan,,,637.76,,637.76,3.73,637.76,percent of total billed charges,,
DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-002-04,NDC,both,0.04,mL,750.31,450.19,United Healthcare/Oxford,United Healthcare/Oxford,,3.73,,,3.73,3.73,637.76,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Aetna,Commerical,,,908.84,,908.84,3.73,1001.19,percent of total billed charges,,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Aetna,Middlesex Employees,,,871.51,,871.51,3.73,1001.19,percent of total billed charges,,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Anthem,Commerical,,,,,,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Anthem,Indemnity,,,882.34,,882.34,3.73,1001.19,percent of total billed charges,,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Anthem,Individual Exchange,,,,,,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Anthem,State Preferred,,,,,,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Cigna,Cigna,,4.2,,,4.2,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Connecticare,Commerical,,4.64,,,4.64,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Connecticare,Exchange,,4.64,,,4.64,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,Multiplan,Multiplan,,,1001.19,,1001.19,3.73,1001.19,percent of total billed charges,,
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-003-04,NDC,both,0.025,mL,1177.87,706.72,United Healthcare/Oxford,United Healthcare/Oxford,,3.73,,,3.73,3.73,1001.19,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Aetna,Commerical,,,1201.06,,1201.06,3.73,1323.09,percent of total billed charges,,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Aetna,Middlesex Employees,,,1151.71,,1151.71,3.73,1323.09,percent of total billed charges,,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Anthem,Commerical,,,,,,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Anthem,Indemnity,,,1166.03,,1166.03,3.73,1323.09,percent of total billed charges,,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Anthem,Individual Exchange,,,,,,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Anthem,State Preferred,,,,,,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Cigna,Cigna,,4.2,,,4.2,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Connecticare,Commerical,,4.64,,,4.64,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Connecticare,Exchange,,4.64,,,4.64,3.73,1323.09,Other,Could be inpatient or outpatient,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,Multiplan,Multiplan,,,1323.09,,1323.09,3.73,1323.09,percent of total billed charges,,
DARBEPOETIN ALFA 60 MCG/ML IN POLYSORBATE INJECTION,J0881,HCPCS,55513-004-04,NDC,both,0.017,mL,1556.58,933.95,United Healthcare/Oxford,United Healthcare/Oxford,,3.73,,,3.73,3.73,1323.09,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Commerical,,,1632.08,,1632.08,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Middlesex Employees,,,1565.03,,1565.03,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Indemnity,,,1584.49,,1584.49,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Individual Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Anthem,State Preferred,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Cigna,Cigna,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,Multiplan,Multiplan,,,1797.91,,1797.91,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,0003-0852-22,NDC,both,1,ea,2115.19,1269.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Aetna,Commerical,,,1632.08,,1632.08,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Aetna,Middlesex Employees,,,1565.03,,1565.03,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Anthem,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Anthem,Indemnity,,,1584.49,,1584.49,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Anthem,Individual Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Anthem,State Preferred,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Cigna,Cigna,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Connecticare,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Connecticare,Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,Multiplan,Multiplan,,,1797.91,,1797.91,1565.03,1797.91,percent of total billed charges,,
DASATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-36,NDC,both,1,ea,2115.19,1269.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Commerical,,,1632.08,,1632.08,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Middlesex Employees,,,1565.03,,1565.03,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Indemnity,,,1584.49,,1584.49,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Individual Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Anthem,State Preferred,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Cigna,Cigna,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,Multiplan,Multiplan,,,1797.91,,1797.91,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,0003-0857-22,NDC,both,1,ea,2115.19,1269.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Aetna,Commerical,,,1632.08,,1632.08,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Aetna,Middlesex Employees,,,1565.03,,1565.03,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Anthem,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Anthem,Indemnity,,,1584.49,,1584.49,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Anthem,Individual Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Anthem,State Preferred,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Cigna,Cigna,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Connecticare,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Connecticare,Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,Multiplan,Multiplan,,,1797.91,,1797.91,1565.03,1797.91,percent of total billed charges,,
DASATINIB 140 MG TABLET,J8999,HCPCS,40810-0017-41,NDC,both,1,ea,2115.19,1269.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Aetna,Commerical,,,452.77,,452.77,434.17,498.78,percent of total billed charges,,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Aetna,Middlesex Employees,,,434.17,,434.17,434.17,498.78,percent of total billed charges,,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Anthem,Commerical,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Anthem,Indemnity,,,439.57,,439.57,434.17,498.78,percent of total billed charges,,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Anthem,Individual Exchange,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Anthem,State Preferred,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Cigna,Cigna,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Connecticare,Commerical,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Connecticare,Exchange,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,Multiplan,Multiplan,,,498.78,,498.78,434.17,498.78,percent of total billed charges,,
DASATINIB 20 MG TABLET,J8999,HCPCS,0003-0527-11,NDC,both,1,ea,586.8,352.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,434.17,498.78,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Aetna,Commerical,,,905.54,,905.54,868.34,997.55,percent of total billed charges,,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Aetna,Middlesex Employees,,,868.34,,868.34,868.34,997.55,percent of total billed charges,,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Anthem,Commerical,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Anthem,Indemnity,,,879.14,,879.14,868.34,997.55,percent of total billed charges,,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Anthem,Individual Exchange,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Anthem,State Preferred,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Cigna,Cigna,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Connecticare,Commerical,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Connecticare,Exchange,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,Multiplan,Multiplan,,,997.55,,997.55,868.34,997.55,percent of total billed charges,,
DASATINIB 50 MG TABLET,J8999,HCPCS,0003-0528-11,NDC,both,1,ea,1173.59,704.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Aetna,Commerical,,,905.54,,905.54,868.34,997.55,percent of total billed charges,,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Aetna,Middlesex Employees,,,868.34,,868.34,868.34,997.55,percent of total billed charges,,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Anthem,Commerical,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Anthem,Indemnity,,,879.14,,879.14,868.34,997.55,percent of total billed charges,,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Anthem,Individual Exchange,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Anthem,State Preferred,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Cigna,Cigna,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Connecticare,Commerical,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Connecticare,Exchange,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,Multiplan,Multiplan,,,997.55,,997.55,868.34,997.55,percent of total billed charges,,
DASATINIB 70 MG TABLET,J8999,HCPCS,0003-0524-11,NDC,both,1,ea,1173.59,704.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,868.34,997.55,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Commerical,,,1632.08,,1632.08,1565.03,1797.91,percent of total billed charges,,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Aetna,Middlesex Employees,,,1565.03,,1565.03,1565.03,1797.91,percent of total billed charges,,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Indemnity,,,1584.49,,1584.49,1565.03,1797.91,percent of total billed charges,,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Anthem,Individual Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Anthem,State Preferred,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Cigna,Cigna,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Commerical,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Connecticare,Exchange,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,Multiplan,Multiplan,,,1797.91,,1797.91,1565.03,1797.91,percent of total billed charges,,
DASATINIB 80 MG TABLET,J8999,HCPCS,0003-0855-22,NDC,both,1,ea,2115.19,1269.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1565.03,1797.91,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Aetna,Commerical,,,29338.68,,29338.68,294.76,32319.69,percent of total billed charges,,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Aetna,Middlesex Employees,,,28133.34,,28133.34,294.76,32319.69,percent of total billed charges,,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Anthem,Commerical,,,,,,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Anthem,Indemnity,,,28483.16,,28483.16,294.76,32319.69,percent of total billed charges,,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Anthem,Individual Exchange,,,,,,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Anthem,State Preferred,,,,,,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Cigna,Cigna,,340.67,,,340.67,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Connecticare,Commerical,,370.29,,,370.29,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Connecticare,Exchange,,370.29,,,370.29,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,Multiplan,Multiplan,,,32319.69,,32319.69,294.76,32319.69,percent of total billed charges,,
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,J9153,HCPCS,68727-745-02,NDC,both,0.023,ea,38023.17,22813.9,United Healthcare/Oxford,United Healthcare/Oxford,,294.76,,,294.76,294.76,32319.69,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0143-9551-10,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-13,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-91,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,0703-5233-93,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-01,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-02,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Aetna,Commerical,,,161.13,,161.13,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Aetna,Middlesex Employees,,,154.51,,154.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Anthem,Commerical,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Anthem,Indemnity,,,156.43,,156.43,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Anthem,Individual Exchange,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Anthem,State Preferred,,,,,,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Cigna,Cigna,,37.59,,,37.59,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Connecticare,Commerical,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Connecticare,Exchange,,37.31,,,37.31,32.53,177.51,Other,Could be inpatient or outpatient,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,Multiplan,Multiplan,,,177.51,,177.51,32.53,177.51,percent of total billed charges,,
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,J9150,HCPCS,42658-021-91,NDC,both,2,mL,208.83,125.3,United Healthcare/Oxford,United Healthcare/Oxford,,32.53,,,32.53,32.53,177.51,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Aetna,Commerical,,,1853.11,,1853.11,1.74,2041.39,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Aetna,Middlesex Employees,,,1776.97,,1776.97,1.74,2041.39,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Anthem,Commerical,,,,,,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Anthem,Indemnity,,,1799.07,,1799.07,1.74,2041.39,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Anthem,Individual Exchange,,,,,,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Anthem,State Preferred,,,,,,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Cigna,Cigna,,2.02,,,2.02,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Connecticare,Commerical,,2.49,,,2.49,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Connecticare,Exchange,,2.49,,,2.49,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,Multiplan,Multiplan,,,2041.39,,2041.39,1.74,2041.39,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55111-556-10,NDC,both,0.02,ea,2401.64,1440.98,United Healthcare/Oxford,United Healthcare/Oxford,,1.74,,,1.74,1.74,2041.39,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Aetna,Commerical,,,236.77,,236.77,1.74,260.83,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Aetna,Middlesex Employees,,,227.05,,227.05,1.74,260.83,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Anthem,Commerical,,,,,,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Anthem,Indemnity,,,229.87,,229.87,1.74,260.83,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Anthem,Individual Exchange,,,,,,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Anthem,State Preferred,,,,,,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Cigna,Cigna,,2.02,,,2.02,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Connecticare,Commerical,,2.49,,,2.49,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Connecticare,Exchange,,2.49,,,2.49,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,Multiplan,Multiplan,,,260.83,,260.83,1.74,260.83,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,55150-376-01,NDC,both,0.02,ea,306.86,184.12,United Healthcare/Oxford,United Healthcare/Oxford,,1.74,,,1.74,1.74,260.83,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Aetna,Commerical,,,3045.69,,3045.69,1.74,3355.15,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Aetna,Middlesex Employees,,,2920.56,,2920.56,1.74,3355.15,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Anthem,Commerical,,,,,,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Anthem,Indemnity,,,2956.88,,2956.88,1.74,3355.15,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Anthem,Individual Exchange,,,,,,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Anthem,State Preferred,,,,,,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Cigna,Cigna,,2.02,,,2.02,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Connecticare,Commerical,,2.49,,,2.49,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Connecticare,Exchange,,2.49,,,2.49,1.74,3355.15,Other,Could be inpatient or outpatient,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,Multiplan,Multiplan,,,3355.15,,3355.15,1.74,3355.15,percent of total billed charges,,
DECITABINE 50 MG INTRAVENOUS SOLUTION,J0894,HCPCS,62856-600-01,NDC,both,0.02,ea,3947.24,2368.34,United Healthcare/Oxford,United Healthcare/Oxford,,1.74,,,1.74,1.74,3355.15,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Aetna,Commerical,,,144.01,,144.01,138.09,158.64,percent of total billed charges,,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Aetna,Middlesex Employees,,,138.09,,138.09,138.09,158.64,percent of total billed charges,,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Anthem,Commerical,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Anthem,Indemnity,,,139.81,,139.81,138.09,158.64,percent of total billed charges,,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Anthem,Individual Exchange,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Anthem,State Preferred,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Cigna,Cigna,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Connecticare,Commerical,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Connecticare,Exchange,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,Multiplan,Multiplan,,,158.64,,158.64,138.09,158.64,percent of total billed charges,,
DEFERASIROX 125 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0468-15,NDC,both,1,ea,186.64,111.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.09,158.64,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Aetna,Commerical,,,277.21,,277.21,265.82,305.38,percent of total billed charges,,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Aetna,Middlesex Employees,,,265.82,,265.82,265.82,305.38,percent of total billed charges,,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Anthem,Commerical,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Anthem,Indemnity,,,269.13,,269.13,265.82,305.38,percent of total billed charges,,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Anthem,Individual Exchange,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Anthem,State Preferred,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Cigna,Cigna,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Connecticare,Commerical,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Connecticare,Exchange,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,Multiplan,Multiplan,,,305.38,,305.38,265.82,305.38,percent of total billed charges,,
DEFERASIROX 180 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0713-15,NDC,both,1,ea,359.27,215.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,265.82,305.38,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Aetna,Commerical,,,11.26,,11.26,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Aetna,Middlesex Employees,,,10.8,,10.8,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Anthem,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Anthem,Indemnity,,,10.93,,10.93,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Anthem,Individual Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Anthem,State Preferred,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Cigna,Cigna,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Connecticare,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Connecticare,Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,Multiplan,Multiplan,,,12.4,,12.4,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,0078-0469-15,NDC,both,1,ea,14.59,8.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Aetna,Commerical,,,11.26,,11.26,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Aetna,Middlesex Employees,,,10.8,,10.8,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Anthem,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Anthem,Indemnity,,,10.93,,10.93,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Anthem,Individual Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Anthem,State Preferred,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Cigna,Cigna,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Connecticare,Commerical,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Connecticare,Exchange,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,Multiplan,Multiplan,,,12.4,,12.4,10.8,12.4,percent of total billed charges,,
DEFERASIROX 250 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-569-83,NDC,both,1,ea,14.59,8.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.8,12.4,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Aetna,Commerical,,,554.41,,554.41,531.63,610.74,percent of total billed charges,,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Aetna,Middlesex Employees,,,531.63,,531.63,531.63,610.74,percent of total billed charges,,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Anthem,Commerical,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Anthem,Indemnity,,,538.24,,538.24,531.63,610.74,percent of total billed charges,,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Anthem,Individual Exchange,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Anthem,State Preferred,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Cigna,Cigna,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Connecticare,Commerical,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Connecticare,Exchange,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,Multiplan,Multiplan,,,610.74,,610.74,531.63,610.74,percent of total billed charges,,
DEFERASIROX 360 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0720-15,NDC,both,1,ea,718.52,431.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,531.63,610.74,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Anthem,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Anthem,Individual Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Anthem,State Preferred,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Cigna,Cigna,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Connecticare,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Connecticare,Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,0078-0656-15,NDC,both,1,ea,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Anthem,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Anthem,Individual Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Anthem,State Preferred,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Cigna,Cigna,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Connecticare,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Connecticare,Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,43598-851-30,NDC,both,1,ea,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Anthem,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Anthem,Individual Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Anthem,State Preferred,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Cigna,Cigna,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Connecticare,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Connecticare,Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,5.28,6.06,percent of total billed charges,,
DEFERASIROX 360 MG TABLET,J3490,HCPCS,70700-271-30,NDC,both,1,ea,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Aetna,Commerical,,,19.47,,19.47,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Aetna,Middlesex Employees,,,18.67,,18.67,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Anthem,Commerical,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Anthem,Indemnity,,,18.9,,18.9,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Anthem,Individual Exchange,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Anthem,State Preferred,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Cigna,Cigna,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Connecticare,Commerical,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Connecticare,Exchange,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,Multiplan,Multiplan,,,21.45,,21.45,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-92,NDC,both,1,ea,25.23,15.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Aetna,Commerical,,,19.47,,19.47,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Aetna,Middlesex Employees,,,18.67,,18.67,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Anthem,Commerical,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Anthem,Indemnity,,,18.9,,18.9,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Anthem,Individual Exchange,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Anthem,State Preferred,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Cigna,Cigna,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Connecticare,Commerical,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Connecticare,Exchange,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,Multiplan,Multiplan,,,21.45,,21.45,18.67,21.45,percent of total billed charges,,
DEFERASIROX 500 MG DISPERSIBLE TABLET,J3490,HCPCS,62756-570-83,NDC,both,1,ea,25.23,15.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.67,21.45,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Aetna,Commerical,,,28.45,,28.45,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Aetna,Middlesex Employees,,,27.28,,27.28,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Anthem,Commerical,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Anthem,Indemnity,,,27.62,,27.62,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Anthem,Individual Exchange,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Anthem,State Preferred,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Cigna,Cigna,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Connecticare,Commerical,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Connecticare,Exchange,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,Multiplan,Multiplan,,,31.34,,31.34,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,0078-0727-15,NDC,both,1,ea,36.87,22.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Aetna,Commerical,,,28.45,,28.45,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Aetna,Middlesex Employees,,,27.28,,27.28,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Anthem,Commerical,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Anthem,Indemnity,,,27.62,,27.62,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Anthem,Individual Exchange,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Anthem,State Preferred,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Cigna,Cigna,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Connecticare,Commerical,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Connecticare,Exchange,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,Multiplan,Multiplan,,,31.34,,31.34,27.28,31.34,percent of total billed charges,,
DEFERASIROX 90 MG ORAL GRANULES IN PACKET,J3490,HCPCS,42806-371-30,NDC,both,1,ea,36.87,22.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.28,31.34,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Aetna,Commerical,,,1.78,,1.78,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Aetna,Middlesex Employees,,,1.71,,1.71,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Anthem,Commerical,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Anthem,Indemnity,,,1.73,,1.73,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Anthem,Individual Exchange,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Anthem,State Preferred,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Cigna,Cigna,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Connecticare,Commerical,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Connecticare,Exchange,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,Multiplan,Multiplan,,,1.96,,1.96,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,0078-0654-15,NDC,both,1,ea,2.31,1.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Aetna,Commerical,,,1.78,,1.78,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Aetna,Middlesex Employees,,,1.71,,1.71,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Anthem,Commerical,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Anthem,Indemnity,,,1.73,,1.73,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Anthem,Individual Exchange,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Anthem,State Preferred,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Cigna,Cigna,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Connecticare,Commerical,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Connecticare,Exchange,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,Multiplan,Multiplan,,,1.96,,1.96,1.71,1.96,percent of total billed charges,,
DEFERASIROX 90 MG TABLET,J3490,HCPCS,43598-853-30,NDC,both,1,ea,2.31,1.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.71,1.96,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Aetna,Commerical,,,69.92,,69.92,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Aetna,Middlesex Employees,,,67.05,,67.05,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Anthem,Commerical,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Anthem,Indemnity,,,67.88,,67.88,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Anthem,Individual Exchange,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Anthem,State Preferred,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Cigna,Cigna,,7.8,,,7.8,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Connecticare,Commerical,,10.35,,,10.35,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Connecticare,Exchange,,10.35,,,10.35,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,Multiplan,Multiplan,,,77.03,,77.03,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,0409-2337-25,NDC,both,0.25,ea,90.62,54.37,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Aetna,Commerical,,,69.92,,69.92,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Aetna,Middlesex Employees,,,67.05,,67.05,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Anthem,Commerical,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Anthem,Indemnity,,,67.88,,67.88,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Anthem,Individual Exchange,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Anthem,State Preferred,,,,,,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Cigna,Cigna,,7.8,,,7.8,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Connecticare,Commerical,,10.35,,,10.35,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Connecticare,Exchange,,10.35,,,10.35,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,Multiplan,Multiplan,,,77.03,,77.03,7.8,77.03,percent of total billed charges,,
DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,J0895,HCPCS,63323-599-30,NDC,both,0.25,ea,90.62,54.37,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,77.03,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Aetna,Commerical,,,29.95,,29.95,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Aetna,Middlesex Employees,,,28.72,,28.72,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Anthem,Commerical,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Anthem,Indemnity,,,29.08,,29.08,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Anthem,Individual Exchange,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Anthem,State Preferred,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Cigna,Cigna,,7.8,,,7.8,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Connecticare,Commerical,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Connecticare,Exchange,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,Multiplan,Multiplan,,,33,,33,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,0409-2336-10,NDC,both,1,ea,38.82,23.29,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Aetna,Commerical,,,29.95,,29.95,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Aetna,Middlesex Employees,,,28.72,,28.72,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Anthem,Commerical,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Anthem,Indemnity,,,29.08,,29.08,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Anthem,Individual Exchange,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Anthem,State Preferred,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Cigna,Cigna,,7.8,,,7.8,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Connecticare,Commerical,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Connecticare,Exchange,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,Multiplan,Multiplan,,,33,,33,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,52609-4505-6,NDC,both,1,ea,38.82,23.29,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Aetna,Commerical,,,29.95,,29.95,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Aetna,Middlesex Employees,,,28.72,,28.72,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Anthem,Commerical,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Anthem,Indemnity,,,29.08,,29.08,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Anthem,Individual Exchange,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Anthem,State Preferred,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Cigna,Cigna,,7.8,,,7.8,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Connecticare,Commerical,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Connecticare,Exchange,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,Multiplan,Multiplan,,,33,,33,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6236-6,NDC,both,1,ea,38.82,23.29,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Aetna,Commerical,,,29.95,,29.95,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Aetna,Middlesex Employees,,,28.72,,28.72,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Anthem,Commerical,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Anthem,Indemnity,,,29.08,,29.08,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Anthem,Individual Exchange,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Anthem,State Preferred,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Cigna,Cigna,,7.8,,,7.8,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Connecticare,Commerical,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Connecticare,Exchange,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,Multiplan,Multiplan,,,33,,33,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-0,NDC,both,1,ea,38.82,23.29,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Aetna,Commerical,,,29.95,,29.95,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Aetna,Middlesex Employees,,,28.72,,28.72,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Anthem,Commerical,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Anthem,Indemnity,,,29.08,,29.08,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Anthem,Individual Exchange,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Anthem,State Preferred,,,,,,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Cigna,Cigna,,7.8,,,7.8,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Connecticare,Commerical,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Connecticare,Exchange,,10.35,,,10.35,7.8,33,Other,Could be inpatient or outpatient,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,Multiplan,Multiplan,,,33,,33,7.8,33,percent of total billed charges,,
DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,J0895,HCPCS,60505-6238-6,NDC,both,1,ea,38.82,23.29,United Healthcare/Oxford,United Healthcare/Oxford,,8.42,,,8.42,7.8,33,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Aetna,Commerical,,,3013.45,,3013.45,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Aetna,Middlesex Employees,,,2889.65,,2889.65,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Anthem,Commerical,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Anthem,Indemnity,,,2925.58,,2925.58,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Anthem,Individual Exchange,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Anthem,State Preferred,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Cigna,Cigna,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Connecticare,Commerical,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Connecticare,Exchange,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,Multiplan,Multiplan,,,3319.64,,3319.64,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-01,NDC,both,1,mL,3905.46,2343.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Aetna,Commerical,,,3013.45,,3013.45,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Aetna,Middlesex Employees,,,2889.65,,2889.65,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Anthem,Commerical,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Anthem,Indemnity,,,2925.58,,2925.58,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Anthem,Individual Exchange,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Anthem,State Preferred,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Cigna,Cigna,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Connecticare,Commerical,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Connecticare,Exchange,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,Multiplan,Multiplan,,,3319.64,,3319.64,2889.65,3319.64,percent of total billed charges,,
DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,68727-800-02,NDC,both,1,mL,3905.46,2343.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2889.65,3319.64,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-501-10,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-502-11,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-503-12,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-504-13,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-505-14,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-506-15,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-507-16,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-508-17,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-509-18,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-510-19,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-511-20,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-512-21,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-513-22,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-514-23,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-515-24,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-516-25,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-517-26,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-518-27,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-519-28,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-520-29,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-521-30,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-522-31,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-523-32,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-524-33,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-525-34,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-526-35,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-527-36,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-528-37,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-529-38,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-530-39,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-531-40,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-532-41,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-533-42,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-534-43,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-535-44,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-536-45,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-537-46,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-538-47,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-539-48,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-540-49,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-541-50,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-542-51,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-543-52,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-544-53,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-545-54,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-546-55,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-547-56,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-548-57,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-549-58,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-550-59,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-551-60,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-552-61,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-553-62,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-554-63,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3198872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-555-64,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-556-65,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-557-66,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-558-67,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-559-68,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-560-69,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-561-70,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Aetna,Commerical,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Aetna,Middlesex Employees,,3199872,,,3199872,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Anthem,Commerical,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Anthem,Indemnity,,,4794240,,4794240,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Anthem,Individual Exchange,,2106444,,,2106444,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Anthem,State Preferred,,2633056,,,2633056,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Cigna,Cigna,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Connecticare,Commerical,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Connecticare,Exchange,,,,,,2106444,5440000,Other,Could be inpatient or outpatient,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,Multiplan,Multiplan,,,5440000,,5440000,2106444,5440000,percent of total billed charges,,
DELANDISTROGENE MOXEPARVOVEC-ROKL 1.33X10EXP13 VG/ML INTRAVENOUS SUSP,J1413,HCPCS,60923-562-01,NDC,both,10,mL,6400000,3840000,United Healthcare/Oxford,United Healthcare/Oxford,,4059135.05,,,4059135.05,2106444,5440000,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Aetna,Commerical,,,8498.91,,8498.91,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Aetna,Commerical,,,8498.91,,8498.91,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Aetna,Middlesex Employees,,,8149.75,,8149.75,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Aetna,Middlesex Employees,,,8149.75,,8149.75,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Commerical,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Commerical,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Indemnity,,,8251.08,,8251.08,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Indemnity,,,8251.08,,8251.08,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Individual Exchange,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,Individual Exchange,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,State Preferred,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Anthem,State Preferred,,,,,,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Cigna,Cigna,,37.72,,,37.72,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Cigna,Cigna,,37.72,,,37.72,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Connecticare,Commerical,,41.17,,,41.17,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Connecticare,Commerical,,41.17,,,41.17,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Connecticare,Exchange,,41.17,,,41.17,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Connecticare,Exchange,,41.17,,,41.17,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Multiplan,Multiplan,,,9362.46,,9362.46,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,Multiplan,Multiplan,,,9362.46,,9362.46,32.64,9362.46,percent of total billed charges,,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,United Healthcare/Oxford,United Healthcare/Oxford,,32.64,,,32.64,32.64,9362.46,Other,Could be inpatient or outpatient,
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,J0897,HCPCS,55513-730-01,NDC,both,0.85,mL,11014.66,6608.8,United Healthcare/Oxford,United Healthcare/Oxford,,32.64,,,32.64,32.64,9362.46,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Aetna,Commerical,,,365.98,,365.98,350.94,403.16,percent of total billed charges,,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Aetna,Middlesex Employees,,,350.94,,350.94,350.94,403.16,percent of total billed charges,,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Anthem,Commerical,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Anthem,Indemnity,,,355.31,,355.31,350.94,403.16,percent of total billed charges,,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Anthem,Individual Exchange,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Anthem,State Preferred,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Cigna,Cigna,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Connecticare,Commerical,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Connecticare,Exchange,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,Multiplan,Multiplan,,,403.16,,403.16,350.94,403.16,percent of total billed charges,,
DESFLURANE 100 % INHALATION LIQUID,J3490,HCPCS,10019-644-34,NDC,both,1,mL,474.31,284.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,350.94,403.16,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Aetna,Commerical,,,18.39,,18.39,17.64,20.26,percent of total billed charges,,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Aetna,Middlesex Employees,,,17.64,,17.64,17.64,20.26,percent of total billed charges,,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Anthem,Commerical,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Anthem,Indemnity,,,17.86,,17.86,17.64,20.26,percent of total billed charges,,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Anthem,Individual Exchange,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Anthem,State Preferred,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Cigna,Cigna,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Connecticare,Commerical,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Connecticare,Exchange,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,Multiplan,Multiplan,,,20.26,,20.26,17.64,20.26,percent of total billed charges,,
DESMOPRESSIN 0.025 MG ORAL TAB,J3490,HCPCS,40810-0017-82,NDC,both,1,ea,23.84,14.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.64,20.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Aetna,Commerical,,,2.52,,2.52,2.42,2.78,percent of total billed charges,,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Aetna,Middlesex Employees,,,2.42,,2.42,2.42,2.78,percent of total billed charges,,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Anthem,Commerical,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Anthem,Indemnity,,,2.45,,2.45,2.42,2.78,percent of total billed charges,,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Anthem,Individual Exchange,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Anthem,State Preferred,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Cigna,Cigna,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Connecticare,Commerical,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Connecticare,Exchange,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,Multiplan,Multiplan,,,2.78,,2.78,2.42,2.78,percent of total billed charges,,
DESMOPRESSIN 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-01,NDC,both,1,ea,3.27,1.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.42,2.78,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,23155-489-01,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,40810-0001-02,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
DESMOPRESSIN 0.1 MG TABLET,J3490,HCPCS,68084-606-21,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Aetna,Commerical,,,9.27,,9.27,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Aetna,Middlesex Employees,,,8.89,,8.89,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Anthem,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Anthem,Indemnity,,,9,,9,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Anthem,Individual Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Anthem,State Preferred,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Cigna,Cigna,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Connecticare,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Connecticare,Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,Multiplan,Multiplan,,,10.21,,10.21,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,23155-490-01,NDC,both,1,ea,12.01,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Aetna,Commerical,,,9.27,,9.27,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Aetna,Middlesex Employees,,,8.89,,8.89,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Anthem,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Anthem,Indemnity,,,9,,9,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Anthem,Individual Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Anthem,State Preferred,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Cigna,Cigna,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Connecticare,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Connecticare,Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,Multiplan,Multiplan,,,10.21,,10.21,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-11,NDC,both,1,ea,12.01,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Aetna,Commerical,,,9.27,,9.27,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Aetna,Middlesex Employees,,,8.89,,8.89,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Anthem,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Anthem,Indemnity,,,9,,9,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Anthem,Individual Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Anthem,State Preferred,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Cigna,Cigna,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Connecticare,Commerical,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Connecticare,Exchange,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,Multiplan,Multiplan,,,10.21,,10.21,8.89,10.21,percent of total billed charges,,
DESMOPRESSIN 0.2 MG TABLET,J3490,HCPCS,60687-732-21,NDC,both,1,ea,12.01,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.89,10.21,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Aetna,Commerical,,,167.11,,167.11,6.28,184.08,percent of total billed charges,,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Aetna,Middlesex Employees,,,160.24,,160.24,6.28,184.08,percent of total billed charges,,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Anthem,Commerical,,,,,,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Anthem,Indemnity,,,162.23,,162.23,6.28,184.08,percent of total billed charges,,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Anthem,Individual Exchange,,,,,,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Anthem,State Preferred,,,,,,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Cigna,Cigna,,6.28,,,6.28,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Connecticare,Commerical,,8.28,,,8.28,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Connecticare,Exchange,,8.28,,,8.28,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,Multiplan,Multiplan,,,184.08,,184.08,6.28,184.08,percent of total billed charges,,
DESMOPRESSIN 0.4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,40810-0017-48,NDC,both,2.5,mL,216.57,129.94,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,184.08,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Aetna,Commerical,,,171.94,,171.94,164.87,189.41,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Aetna,Middlesex Employees,,,164.87,,164.87,164.87,189.41,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Anthem,Commerical,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Anthem,Indemnity,,,166.92,,166.92,164.87,189.41,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Anthem,Individual Exchange,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Anthem,State Preferred,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Cigna,Cigna,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Connecticare,Commerical,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Connecticare,Exchange,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,Multiplan,Multiplan,,,189.41,,189.41,164.87,189.41,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,47335-788-91,NDC,both,1,mL,222.83,133.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,164.87,189.41,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Aetna,Commerical,,,582.03,,582.03,558.12,641.17,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Aetna,Middlesex Employees,,,558.12,,558.12,558.12,641.17,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Anthem,Commerical,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Anthem,Indemnity,,,565.06,,565.06,558.12,641.17,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Anthem,Individual Exchange,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Anthem,State Preferred,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Cigna,Cigna,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Connecticare,Commerical,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Connecticare,Exchange,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,Multiplan,Multiplan,,,641.17,,641.17,558.12,641.17,percent of total billed charges,,
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),J3490,HCPCS,60505-0815-0,NDC,both,1,mL,754.32,452.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,558.12,641.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Aetna,Commerical,,,2302.25,,2302.25,2207.66,2536.17,percent of total billed charges,,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Aetna,Middlesex Employees,,,2207.66,,2207.66,2207.66,2536.17,percent of total billed charges,,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Anthem,Commerical,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Anthem,Indemnity,,,2235.11,,2235.11,2207.66,2536.17,percent of total billed charges,,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Anthem,Individual Exchange,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Anthem,State Preferred,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Cigna,Cigna,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Connecticare,Commerical,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Connecticare,Exchange,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,Multiplan,Multiplan,,,2536.17,,2536.17,2207.66,2536.17,percent of total billed charges,,
DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY,J3490,HCPCS,0053-6871-00,NDC,both,1,mL,2983.73,1790.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2207.66,2536.17,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,80.81,48.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Aetna,Commerical,,,46.53,,46.53,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Aetna,Middlesex Employees,,,44.62,,44.62,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Anthem,Commerical,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Anthem,Indemnity,,,45.17,,45.17,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Anthem,Individual Exchange,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Anthem,State Preferred,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Cigna,Cigna,,6.28,,,6.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Connecticare,Commerical,,8.28,,,8.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Connecticare,Exchange,,8.28,,,8.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,Multiplan,Multiplan,,,51.26,,51.26,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,22.6,13.56,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,808.1,484.86,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,808.1,484.86,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,80.81,48.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,80.81,48.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Aetna,Commerical,,,62.35,,62.35,6.28,68.69,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Aetna,Middlesex Employees,,,59.79,,59.79,6.28,68.69,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Anthem,Commerical,,,,,,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Anthem,Indemnity,,,60.53,,60.53,6.28,68.69,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Anthem,Individual Exchange,,,,,,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Anthem,State Preferred,,,,,,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Cigna,Cigna,,6.28,,,6.28,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Connecticare,Commerical,,8.28,,,8.28,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Connecticare,Exchange,,8.28,,,8.28,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,Multiplan,Multiplan,,,68.69,,68.69,6.28,68.69,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,55566-2200-0,NDC,both,0.25,mL,80.81,48.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,68.69,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,80.81,48.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,808.1,484.86,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Aetna,Commerical,,,623.53,,623.53,6.28,686.89,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Aetna,Middlesex Employees,,,597.91,,597.91,6.28,686.89,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Commerical,,,,,,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Indemnity,,,605.35,,605.35,6.28,686.89,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Anthem,Individual Exchange,,,,,,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Anthem,State Preferred,,,,,,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Cigna,Cigna,,6.28,,,6.28,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Connecticare,Commerical,,8.28,,,8.28,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Connecticare,Exchange,,8.28,,,8.28,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,Multiplan,Multiplan,,,686.89,,686.89,6.28,686.89,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,69918-901-11,NDC,both,0.25,mL,808.1,484.86,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,686.89,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML FOR ORAL USE,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,808.1,484.86,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0409-2265-01,NDC,both,0.25,mL,118.51,71.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Aetna,Commerical,,,46.53,,46.53,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Aetna,Middlesex Employees,,,44.62,,44.62,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Anthem,Commerical,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Anthem,Indemnity,,,45.17,,45.17,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Anthem,Individual Exchange,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Anthem,State Preferred,,,,,,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Cigna,Cigna,,6.28,,,6.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Connecticare,Commerical,,8.28,,,8.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Connecticare,Exchange,,8.28,,,8.28,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,Multiplan,Multiplan,,,51.26,,51.26,6.28,51.26,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,0703-5051-01,NDC,both,0.25,mL,60.3,36.18,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,51.26,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,25021-461-10,NDC,both,0.25,mL,845.8,507.48,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-053-11,NDC,both,0.25,mL,845.8,507.48,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-09,NDC,both,0.25,mL,118.51,71.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,43598-931-11,NDC,both,0.25,mL,118.51,71.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Aetna,Commerical,,,91.44,,91.44,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Aetna,Middlesex Employees,,,87.69,,87.69,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Anthem,Commerical,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Anthem,Indemnity,,,88.78,,88.78,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Anthem,Individual Exchange,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Anthem,State Preferred,,,,,,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Cigna,Cigna,,6.28,,,6.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Connecticare,Commerical,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Connecticare,Exchange,,8.28,,,8.28,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,Multiplan,Multiplan,,,100.73,,100.73,6.28,100.73,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-899-10,NDC,both,0.25,mL,118.51,71.11,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,100.73,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,69918-901-10,NDC,both,0.25,mL,845.8,507.48,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Commerical,,,652.62,,652.62,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Aetna,Middlesex Employees,,,625.81,,625.81,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Commerical,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Indemnity,,,633.59,,633.59,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Anthem,Individual Exchange,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Anthem,State Preferred,,,,,,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Cigna,Cigna,,6.28,,,6.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Commerical,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Connecticare,Exchange,,8.28,,,8.28,6.28,718.93,Other,Could be inpatient or outpatient,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,Multiplan,Multiplan,,,718.93,,718.93,6.28,718.93,percent of total billed charges,,
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,J2597,HCPCS,70860-454-10,NDC,both,0.25,mL,845.8,507.48,United Healthcare/Oxford,United Healthcare/Oxford,,6.78,,,6.78,6.28,718.93,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Aetna,Commerical,,,43.23,,43.23,41.45,47.62,percent of total billed charges,,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Aetna,Middlesex Employees,,,41.45,,41.45,41.45,47.62,percent of total billed charges,,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Anthem,Commerical,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Anthem,Indemnity,,,41.96,,41.96,41.45,47.62,percent of total billed charges,,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Anthem,Individual Exchange,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Anthem,State Preferred,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Cigna,Cigna,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Connecticare,Commerical,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Connecticare,Exchange,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,Multiplan,Multiplan,,,47.62,,47.62,41.45,47.62,percent of total billed charges,,
DESOXIMETASONE 0.25 % TOPICAL CREAM,J3490,HCPCS,45802-495-35,NDC,both,15,gm,56.02,33.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,41.45,47.62,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Aetna,Commerical,,,1.55,,1.55,1.49,1.71,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Aetna,Middlesex Employees,,,1.49,,1.49,1.49,1.71,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Anthem,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Anthem,Indemnity,,,1.51,,1.51,1.49,1.71,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Anthem,Individual Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Anthem,State Preferred,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Cigna,Cigna,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Connecticare,Commerical,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Connecticare,Exchange,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,Multiplan,Multiplan,,,1.71,,1.71,1.49,1.71,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-006-33,NDC,both,1,ea,2.01,1.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.49,1.71,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
"DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51991-311-90,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Aetna,Commerical,,,109.77,,109.77,0.13,120.92,percent of total billed charges,,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Aetna,Middlesex Employees,,,105.26,,105.26,0.13,120.92,percent of total billed charges,,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Anthem,Commerical,,,,,,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Anthem,Indemnity,,,106.57,,106.57,0.13,120.92,percent of total billed charges,,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Anthem,Individual Exchange,,,,,,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Anthem,State Preferred,,,,,,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Cigna,Cigna,,0.16,,,0.16,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Connecticare,Commerical,,0.17,,,0.17,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Connecticare,Exchange,,0.17,,,0.17,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,Multiplan,Multiplan,,,120.92,,120.92,0.13,120.92,percent of total billed charges,,
DEXAMETHASONE 0.2 MG/ML IN D10W NICU,J1100,HCPCS,40810-0004-49,NDC,both,5,mL,142.26,85.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,120.92,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,0.08,,,0.08,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,0.06,,,0.06,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,0.06,,,0.06,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,0.08,,,0.08,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,0.06,,,0.06,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,0.06,,,0.06,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.06,0.17,percent of total billed charges,,
DEXAMETHASONE 0.25 MG ORAL TAB CHEMO,J8540,HCPCS,40810-0001-03,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.17,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Commerical,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Cigna,Cigna,,0.08,,,0.08,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Connecticare,Commerical,,0.06,,,0.06,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Connecticare,Exchange,,0.06,,,0.06,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Commerical,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Cigna,Cigna,,0.08,,,0.08,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Connecticare,Commerical,,0.06,,,0.06,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Connecticare,Exchange,,0.06,,,0.06,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.06,0.54,percent of total billed charges,,
DEXAMETHASONE 0.5 MG TABLET CHEMO,J8540,HCPCS,0054-8179-25,NDC,both,0.5,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.54,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Aetna,Commerical,,,42.85,,42.85,0.06,47.21,percent of total billed charges,,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Aetna,Middlesex Employees,,,41.09,,41.09,0.06,47.21,percent of total billed charges,,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Anthem,Commerical,,,,,,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Anthem,Indemnity,,,41.61,,41.61,0.06,47.21,percent of total billed charges,,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Anthem,Individual Exchange,,,,,,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Anthem,State Preferred,,,,,,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Cigna,Cigna,,0.08,,,0.08,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Connecticare,Commerical,,0.06,,,0.06,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Connecticare,Exchange,,0.06,,,0.06,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,Multiplan,Multiplan,,,47.21,,47.21,0.06,47.21,percent of total billed charges,,
DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,J8540,HCPCS,0054-3177-63,NDC,both,2.5,mL,55.54,33.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,47.21,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.06,0.73,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.06,0.73,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Anthem,Commerical,,,,,,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.06,0.73,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Cigna,Cigna,,0.08,,,0.08,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Connecticare,Commerical,,0.06,,,0.06,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Connecticare,Exchange,,0.06,,,0.06,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.06,0.73,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-4181-25,NDC,both,0.25,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.73,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Aetna,Commerical,,,0.88,,0.88,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Commerical,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Indemnity,,,0.85,,0.85,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Individual Exchange,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,State Preferred,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Cigna,Cigna,,0.08,,,0.08,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Connecticare,Commerical,,0.06,,,0.06,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Connecticare,Exchange,,0.06,,,0.06,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Multiplan,Multiplan,,,0.97,,0.97,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Aetna,Commerical,,,0.88,,0.88,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Commerical,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Indemnity,,,0.85,,0.85,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,Individual Exchange,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Anthem,State Preferred,,,,,,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Cigna,Cigna,,0.08,,,0.08,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Connecticare,Commerical,,0.06,,,0.06,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Connecticare,Exchange,,0.06,,,0.06,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,Multiplan,Multiplan,,,0.97,,0.97,0.06,0.97,percent of total billed charges,,
DEXAMETHASONE 1 MG TABLET CHEMO,J8540,HCPCS,0054-8174-25,NDC,both,0.25,ea,1.14,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.97,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Aetna,Commerical,,,67.74,,67.74,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Aetna,Middlesex Employees,,,64.96,,64.96,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Commerical,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Indemnity,,,65.76,,65.76,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Individual Exchange,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,State Preferred,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Cigna,Cigna,,0.08,,,0.08,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Connecticare,Commerical,,0.06,,,0.06,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Connecticare,Exchange,,0.06,,,0.06,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Multiplan,Multiplan,,,74.62,,74.62,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Aetna,Commerical,,,67.74,,67.74,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Aetna,Middlesex Employees,,,64.96,,64.96,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Commerical,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Indemnity,,,65.76,,65.76,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,Individual Exchange,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Anthem,State Preferred,,,,,,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Cigna,Cigna,,0.08,,,0.08,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Connecticare,Commerical,,0.06,,,0.06,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Connecticare,Exchange,,0.06,,,0.06,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,Multiplan,Multiplan,,,74.62,,74.62,0.06,74.62,percent of total billed charges,,
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE) CHEMO,J8540,HCPCS,0054-3176-44,NDC,both,0.25,mL,87.79,52.67,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,74.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,0.39,,0.39,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,0.43,,0.43,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,4.18,,4.18,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,4.01,,4.01,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,4.06,,4.06,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,4.61,,4.61,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Aetna,Commerical,,,23.59,,23.59,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Aetna,Middlesex Employees,,,22.62,,22.62,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Anthem,Commerical,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Anthem,Indemnity,,,22.9,,22.9,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Anthem,Individual Exchange,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Anthem,State Preferred,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Cigna,Cigna,,0.16,,,0.16,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Connecticare,Commerical,,0.17,,,0.17,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Connecticare,Exchange,,0.17,,,0.17,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,Multiplan,Multiplan,,,25.98,,25.98,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-00,NDC,both,0.1,mL,30.57,18.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Aetna,Commerical,,,23.59,,23.59,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Aetna,Middlesex Employees,,,22.62,,22.62,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Anthem,Commerical,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Anthem,Indemnity,,,22.9,,22.9,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Anthem,Individual Exchange,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Anthem,State Preferred,,,,,,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Cigna,Cigna,,0.16,,,0.16,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Connecticare,Commerical,,0.17,,,0.17,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Connecticare,Exchange,,0.17,,,0.17,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,Multiplan,Multiplan,,,25.98,,25.98,0.13,25.98,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,67457-483-10,NDC,both,0.1,mL,30.57,18.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,25.98,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,2.36,,2.36,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,2.26,,2.26,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,2.29,,2.29,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,2.6,,2.6,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-01,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,4.18,,4.18,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,4.01,,4.01,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,4.06,,4.06,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,4.61,,4.61,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,2.36,,2.36,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,2.26,,2.26,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,2.29,,2.29,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,2.6,,2.6,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-1,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Aetna,Commerical,,,2.36,,2.36,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Aetna,Middlesex Employees,,,2.26,,2.26,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Anthem,Commerical,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Anthem,Indemnity,,,2.29,,2.29,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Anthem,Individual Exchange,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Anthem,State Preferred,,,,,,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Cigna,Cigna,,0.16,,,0.16,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Connecticare,Commerical,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Connecticare,Exchange,,0.17,,,0.17,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,Multiplan,Multiplan,,,2.6,,2.6,0.13,2.6,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML INJECTION CCMC,J1100,HCPCS,70121-1399-5,NDC,both,0.1,mL,3.06,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,2.6,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-21,NDC,both,0.1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Aetna,Commerical,,,0.39,,0.39,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Aetna,Middlesex Employees,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Commerical,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Indemnity,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Anthem,State Preferred,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Cigna,Cigna,,0.16,,,0.16,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Connecticare,Commerical,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Connecticare,Exchange,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,Multiplan,Multiplan,,,0.43,,0.43,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-01,NDC,both,0.1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Commerical,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Anthem,State Preferred,,,,,,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Cigna,Cigna,,0.16,,,0.16,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Connecticare,Commerical,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Connecticare,Exchange,,0.17,,,0.17,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,0.13,4.85,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,55150-304-25,NDC,both,0.1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.85,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Aetna,Commerical,,,4.18,,4.18,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.01,,4.01,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Commerical,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Indemnity,,,4.06,,4.06,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Anthem,State Preferred,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Cigna,Cigna,,0.16,,,0.16,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Connecticare,Commerical,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Connecticare,Exchange,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,Multiplan,Multiplan,,,4.61,,4.61,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Aetna,Commerical,,,44.04,,44.04,0.13,48.51,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Aetna,Middlesex Employees,,,42.23,,42.23,0.13,48.51,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Anthem,Commerical,,,,,,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Anthem,Indemnity,,,42.75,,42.75,0.13,48.51,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Anthem,Individual Exchange,,,,,,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Anthem,State Preferred,,,,,,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Cigna,Cigna,,0.16,,,0.16,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Connecticare,Commerical,,0.17,,,0.17,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Connecticare,Exchange,,0.17,,,0.17,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,Multiplan,Multiplan,,,48.51,,48.51,0.13,48.51,percent of total billed charges,,
DEXAMETHASONE 10 MG/ML ORAL SOLUTION,J1100,HCPCS,63323-516-10,NDC,both,0.1,mL,57.07,34.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,48.51,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Aetna,Commerical,,,1.76,,1.76,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Aetna,Middlesex Employees,,,1.69,,1.69,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Commerical,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Indemnity,,,1.71,,1.71,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Individual Exchange,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,State Preferred,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Cigna,Cigna,,0.08,,,0.08,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Connecticare,Commerical,,0.06,,,0.06,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Connecticare,Exchange,,0.06,,,0.06,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Multiplan,Multiplan,,,1.94,,1.94,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Aetna,Commerical,,,1.76,,1.76,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Aetna,Middlesex Employees,,,1.69,,1.69,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Commerical,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Indemnity,,,1.71,,1.71,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,Individual Exchange,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Anthem,State Preferred,,,,,,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Cigna,Cigna,,0.08,,,0.08,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Connecticare,Commerical,,0.06,,,0.06,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Connecticare,Exchange,,0.06,,,0.06,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,Multiplan,Multiplan,,,1.94,,1.94,0.06,1.94,percent of total billed charges,,
DEXAMETHASONE 2 MG TABLET CHEMO,J8540,HCPCS,0054-8176-25,NDC,both,0.125,ea,2.28,1.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,1.94,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-4184-25,NDC,both,0.063,ea,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,0904-7266-61,NDC,both,0.063,ea,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,0054-8175-25,NDC,both,0.063,ea,3.6,2.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-13,NDC,both,0.063,ea,3.6,2.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Aetna,Commerical,,,2.38,,2.38,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Aetna,Middlesex Employees,,,2.28,,2.28,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Anthem,Commerical,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Anthem,Indemnity,,,2.31,,2.31,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Anthem,Individual Exchange,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Anthem,State Preferred,,,,,,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Cigna,Cigna,,0.08,,,0.08,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Connecticare,Commerical,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Connecticare,Exchange,,0.06,,,0.06,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,Multiplan,Multiplan,,,2.62,,2.62,0.06,2.62,percent of total billed charges,,
DEXAMETHASONE 4 MG TABLET CHEMO,J8540,HCPCS,47781-914-51,NDC,both,0.063,ea,3.6,2.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,2.62,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.06,0.14,percent of total billed charges,,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.06,0.14,percent of total billed charges,,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Anthem,Commerical,,,,,,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.06,0.14,percent of total billed charges,,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Anthem,Individual Exchange,,,,,,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Anthem,State Preferred,,,,,,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Cigna,Cigna,,0.08,,,0.08,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Connecticare,Commerical,,0.06,,,0.06,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Connecticare,Exchange,,0.06,,,0.06,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.06,0.14,percent of total billed charges,,
DEXAMETHASONE 4 MG/ML ORAL SOLUTION,J8540,HCPCS,40810-0003-99,NDC,both,1,mL,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.06,0.14,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-01,NDC,both,1,mL,4.24,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,21.2,12.72,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Aetna,Commerical,,,41.94,,41.94,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Aetna,Middlesex Employees,,,40.21,,40.21,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Anthem,Commerical,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Anthem,Indemnity,,,40.71,,40.71,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Anthem,Individual Exchange,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Anthem,State Preferred,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Cigna,Cigna,,0.16,,,0.16,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Connecticare,Commerical,,0.17,,,0.17,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Connecticare,Exchange,,0.17,,,0.17,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,Multiplan,Multiplan,,,46.2,,46.2,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE FOR IONTOPHORESIS,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,127.2,76.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Aetna,Commerical,,,4.18,,4.18,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Aetna,Middlesex Employees,,,4.01,,4.01,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Anthem,Commerical,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Anthem,Indemnity,,,4.06,,4.06,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Anthem,Individual Exchange,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Anthem,State Preferred,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Cigna,Cigna,,0.16,,,0.16,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Connecticare,Commerical,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Connecticare,Exchange,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,Multiplan,Multiplan,,,4.61,,4.61,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-506-01,NDC,both,0.1,mL,5.42,3.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Aetna,Commerical,,,4.18,,4.18,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Aetna,Middlesex Employees,,,4.01,,4.01,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Anthem,Commerical,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Anthem,Indemnity,,,4.06,,4.06,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Anthem,Individual Exchange,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Anthem,State Preferred,,,,,,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Cigna,Cigna,,0.16,,,0.16,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Connecticare,Commerical,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Connecticare,Exchange,,0.17,,,0.17,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,Multiplan,Multiplan,,,4.61,,4.61,0.13,4.61,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,70069-021-25,NDC,both,0.1,mL,5.42,3.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.61,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Aetna,Commerical,,,121.26,,121.26,116.28,133.58,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Aetna,Middlesex Employees,,,116.28,,116.28,116.28,133.58,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Anthem,Commerical,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Anthem,Indemnity,,,117.72,,117.72,116.28,133.58,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Anthem,Individual Exchange,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Anthem,State Preferred,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Cigna,Cigna,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Connecticare,Commerical,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Connecticare,Exchange,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,Multiplan,Multiplan,,,133.58,,133.58,116.28,133.58,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,J3490,HCPCS,24208-720-02,NDC,both,5,mL,157.15,94.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,116.28,133.58,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Anthem,Commerical,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Anthem,Individual Exchange,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Anthem,State Preferred,,,,,,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Cigna,Cigna,,0.16,,,0.16,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Connecticare,Commerical,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Connecticare,Exchange,,0.17,,,0.17,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.13,0.43,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-0367-25,NDC,both,0.1,mL,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,0.43,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Anthem,Commerical,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Anthem,Individual Exchange,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Anthem,State Preferred,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Cigna,Cigna,,0.16,,,0.16,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Connecticare,Commerical,,0.17,,,0.17,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Connecticare,Exchange,,0.17,,,0.17,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-00,NDC,both,0.1,mL,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Anthem,Commerical,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Anthem,Individual Exchange,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Anthem,State Preferred,,,,,,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Cigna,Cigna,,0.16,,,0.16,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Connecticare,Commerical,,0.17,,,0.17,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Connecticare,Exchange,,0.17,,,0.17,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,0.13,4.34,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-420-10,NDC,both,0.1,mL,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,4.34,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-01,NDC,both,0.25,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6145-25,NDC,both,0.25,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-01,NDC,both,0.25,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,0641-6146-25,NDC,both,1,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-01,NDC,both,1,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-02,NDC,both,0.25,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-05,NDC,both,0.25,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Aetna,Commerical,,,41.94,,41.94,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Aetna,Middlesex Employees,,,40.21,,40.21,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Anthem,Commerical,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Anthem,Indemnity,,,40.71,,40.71,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Anthem,Individual Exchange,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Anthem,State Preferred,,,,,,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Cigna,Cigna,,0.16,,,0.16,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Connecticare,Commerical,,0.17,,,0.17,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Connecticare,Exchange,,0.17,,,0.17,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,Multiplan,Multiplan,,,46.2,,46.2,0.13,46.2,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,63323-165-30,NDC,both,0.25,mL,54.35,32.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,46.2,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-00,NDC,both,0.25,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Commerical,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Anthem,State Preferred,,,,,,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Cigna,Cigna,,0.16,,,0.16,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Connecticare,Commerical,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Connecticare,Exchange,,0.17,,,0.17,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,0.13,7.7,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-418-05,NDC,both,0.25,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.7,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-00,NDC,both,0.25,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-419-01,NDC,both,1,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-00,NDC,both,0.25,mL,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Aetna,Commerical,,,2.44,,2.44,0.13,2.69,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Aetna,Middlesex Employees,,,2.34,,2.34,0.13,2.69,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Anthem,Commerical,,,,,,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Anthem,Indemnity,,,2.37,,2.37,0.13,2.69,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Anthem,Individual Exchange,,,,,,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Anthem,State Preferred,,,,,,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Cigna,Cigna,,0.16,,,0.16,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Connecticare,Commerical,,0.17,,,0.17,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Connecticare,Exchange,,0.17,,,0.17,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,Multiplan,Multiplan,,,2.69,,2.69,0.13,2.69,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,J1100,HCPCS,67457-423-12,NDC,both,0.25,mL,3.16,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,2.69,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Aetna,Commerical,,,1.4,,1.4,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Aetna,Middlesex Employees,,,1.35,,1.35,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Anthem,Commerical,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Anthem,Indemnity,,,1.36,,1.36,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Anthem,Individual Exchange,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Anthem,State Preferred,,,,,,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Cigna,Cigna,,0.16,,,0.16,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Connecticare,Commerical,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Connecticare,Exchange,,0.17,,,0.17,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,Multiplan,Multiplan,,,1.55,,1.55,0.13,1.55,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1100,HCPCS,63323-165-01,NDC,both,1,mL,44.01,26.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,1.55,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Aetna,Commerical,,,6.89,,6.89,0.13,7.59,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,0.13,7.59,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Anthem,Commerical,,,,,,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Anthem,Indemnity,,,6.69,,6.69,0.13,7.59,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Anthem,Individual Exchange,,,,,,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Anthem,State Preferred,,,,,,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Cigna,Cigna,,0.16,,,0.16,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Connecticare,Commerical,,0.17,,,0.17,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Connecticare,Exchange,,0.17,,,0.17,0.13,7.59,Other,Could be inpatient or outpatient,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,Multiplan,Multiplan,,,7.59,,7.59,0.13,7.59,percent of total billed charges,,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE,J1100,HCPCS,76045-106-10,NDC,both,0.25,mL,8.93,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.13,7.59,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Aetna,Commerical,,,65.9,,65.9,63.19,72.6,percent of total billed charges,,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Aetna,Middlesex Employees,,,63.19,,63.19,63.19,72.6,percent of total billed charges,,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Anthem,Commerical,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Anthem,Indemnity,,,63.98,,63.98,63.19,72.6,percent of total billed charges,,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Anthem,Individual Exchange,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Anthem,State Preferred,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Cigna,Cigna,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Connecticare,Commerical,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Connecticare,Exchange,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,Multiplan,Multiplan,,,72.6,,72.6,63.19,72.6,percent of total billed charges,,
DEXMEDETOMIDINE 10 MCG/ML INTRANASAL DILUTION,J3490,HCPCS,40810-0202-70,NDC,both,1,mL,85.41,51.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.19,72.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,21.02,12.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,21.02,12.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRANASAL SOLN,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,21.02,12.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,16729-432-93,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-01,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-421-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,66794-233-42,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-605-03,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-505-03,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0409-1638-02,NDC,both,1,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,0781-3297-95,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,55150-209-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-02,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE 100 MCG/ML ORAL SOLUTION,J3490,HCPCS,66794-230-42,NDC,both,0.01,mL,9.18,5.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Aetna,Commerical,,,28.52,,28.52,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Aetna,Middlesex Employees,,,27.35,,27.35,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Anthem,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Anthem,Indemnity,,,27.69,,27.69,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Anthem,Individual Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Anthem,State Preferred,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Cigna,Cigna,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Connecticare,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Connecticare,Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,Multiplan,Multiplan,,,31.42,,31.42,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-50,NDC,both,0.25,mL,36.96,22.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Aetna,Commerical,,,28.52,,28.52,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Aetna,Middlesex Employees,,,27.35,,27.35,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Anthem,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Anthem,Indemnity,,,27.69,,27.69,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Anthem,Individual Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Anthem,State Preferred,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Cigna,Cigna,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Connecticare,Commerical,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Connecticare,Exchange,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,Multiplan,Multiplan,,,31.42,,31.42,27.35,31.42,percent of total billed charges,,
DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-55,NDC,both,0.25,mL,36.96,22.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.35,31.42,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Commerical,,,2.03,,2.03,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Indemnity,,,1.97,,1.97,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) DILUTED INTRANASAL SOLUTION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Commerical,,,2.03,,2.03,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Indemnity,,,1.97,,1.97,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Aetna,Commerical,,,710.74,,710.74,681.54,782.95,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Aetna,Middlesex Employees,,,681.54,,681.54,681.54,782.95,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Anthem,Commerical,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Anthem,Indemnity,,,690.01,,690.01,681.54,782.95,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Anthem,Individual Exchange,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Anthem,State Preferred,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Cigna,Cigna,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Connecticare,Commerical,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Connecticare,Exchange,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,Multiplan,Multiplan,,,782.95,,782.95,681.54,782.95,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,40810-0203-60,NDC,both,1,mL,921.12,552.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,681.54,782.95,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43066-557-12,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-11,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,43598-975-58,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,55150-297-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-00,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,67457-925-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,J3490,HCPCS,68094-247-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Commerical,,,2.03,,2.03,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Indemnity,,,1.97,,1.97,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1174-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE 4MCG/ML 100 ML BOTTLE SEDATION,J3490,HCPCS,0409-1660-35,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Commerical,,,2.03,,2.03,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Indemnity,,,1.97,,1.97,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0338-9557-12,NDC,both,1,mL,2.63,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,0409-1596-10,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Aetna,Commerical,,,142.15,,142.15,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Aetna,Middlesex Employees,,,136.31,,136.31,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Indemnity,,,138.01,,138.01,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,Individual Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Anthem,State Preferred,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Cigna,Cigna,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Connecticare,Commerical,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Connecticare,Exchange,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,Multiplan,Multiplan,,,156.6,,156.6,136.31,156.6,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS FROM BAG,J3490,HCPCS,55150-297-01,NDC,both,1,mL,184.23,110.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,136.31,156.6,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Aetna,Commerical,,,7.08,,7.08,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Aetna,Middlesex Employees,,,6.79,,6.79,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Anthem,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Anthem,Indemnity,,,6.88,,6.88,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Anthem,Individual Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Anthem,State Preferred,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Cigna,Cigna,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Connecticare,Commerical,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Connecticare,Exchange,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,Multiplan,Multiplan,,,7.8,,7.8,6.79,7.8,percent of total billed charges,,
DEXMEDETOMIDINE IV BOLUS SEDATION,J3490,HCPCS,16729-239-93,NDC,both,0.01,mL,10.06,6.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.79,7.8,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Aetna,Commerical,,,1.14,,1.14,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Aetna,Middlesex Employees,,,1.1,,1.1,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Anthem,Commerical,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Anthem,Indemnity,,,1.11,,1.11,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Anthem,Individual Exchange,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Anthem,State Preferred,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Cigna,Cigna,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Connecticare,Commerical,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Connecticare,Exchange,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,Multiplan,Multiplan,,,1.26,,1.26,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0078-0382-05,NDC,both,1,ea,1.48,0.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Aetna,Commerical,,,1.14,,1.14,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Aetna,Middlesex Employees,,,1.1,,1.1,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Anthem,Commerical,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Anthem,Indemnity,,,1.11,,1.11,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Anthem,Individual Exchange,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Anthem,State Preferred,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Cigna,Cigna,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Connecticare,Commerical,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Connecticare,Exchange,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,Multiplan,Multiplan,,,1.26,,1.26,1.1,1.26,percent of total billed charges,,
DEXMETHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,27808-093-01,NDC,both,1,ea,1.48,0.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.1,1.26,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Aetna,Commerical,,,2.67,,2.67,2.56,2.94,percent of total billed charges,,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Aetna,Middlesex Employees,,,2.56,,2.56,2.56,2.94,percent of total billed charges,,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Anthem,Commerical,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Anthem,Indemnity,,,2.59,,2.59,2.56,2.94,percent of total billed charges,,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Anthem,Individual Exchange,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Anthem,State Preferred,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Cigna,Cigna,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Connecticare,Commerical,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Connecticare,Exchange,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,Multiplan,Multiplan,,,2.94,,2.94,2.56,2.94,percent of total billed charges,,
DEXMETHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,0078-0381-05,NDC,both,1,ea,3.46,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.56,2.94,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Aetna,Commerical,,,35.35,,35.35,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Aetna,Middlesex Employees,,,33.9,,33.9,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Anthem,Commerical,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Anthem,Indemnity,,,34.32,,34.32,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Anthem,Individual Exchange,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Anthem,State Preferred,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Cigna,Cigna,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Connecticare,Commerical,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Connecticare,Exchange,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,Multiplan,Multiplan,,,38.95,,38.95,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0527-8107-37,NDC,both,1,ea,45.82,27.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Aetna,Commerical,,,35.35,,35.35,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Aetna,Middlesex Employees,,,33.9,,33.9,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Anthem,Commerical,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Anthem,Indemnity,,,34.32,,34.32,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Anthem,Individual Exchange,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Anthem,State Preferred,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Cigna,Cigna,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Connecticare,Commerical,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Connecticare,Exchange,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,Multiplan,Multiplan,,,38.95,,38.95,33.9,38.95,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-74,NDC,both,1,ea,45.82,27.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.9,38.95,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Aetna,Commerical,,,22.28,,22.28,21.37,24.55,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Aetna,Middlesex Employees,,,21.37,,21.37,21.37,24.55,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Anthem,Commerical,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Anthem,Indemnity,,,21.63,,21.63,21.37,24.55,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Anthem,Individual Exchange,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Anthem,State Preferred,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Cigna,Cigna,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Connecticare,Commerical,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Connecticare,Exchange,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,Multiplan,Multiplan,,,24.55,,24.55,21.37,24.55,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,0078-0493-05,NDC,both,1,ea,28.88,17.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.37,24.55,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Aetna,Commerical,,,113.22,,113.22,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Aetna,Middlesex Employees,,,108.57,,108.57,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Anthem,Commerical,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Anthem,Indemnity,,,109.92,,109.92,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Anthem,Individual Exchange,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Anthem,State Preferred,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Cigna,Cigna,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Connecticare,Commerical,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Connecticare,Exchange,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,Multiplan,Multiplan,,,124.72,,124.72,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,40810-0204-75,NDC,both,1,ea,146.73,88.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Aetna,Commerical,,,113.22,,113.22,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Aetna,Middlesex Employees,,,108.57,,108.57,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Anthem,Commerical,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Anthem,Indemnity,,,109.92,,109.92,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Anthem,Individual Exchange,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Anthem,State Preferred,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Cigna,Cigna,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Connecticare,Commerical,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Connecticare,Exchange,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,Multiplan,Multiplan,,,124.72,,124.72,108.57,124.72,percent of total billed charges,,
"DEXMETHYLPHENIDATE ER 15 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",J3490,HCPCS,49884-428-01,NDC,both,1,ea,146.73,88.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.57,124.72,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Aetna,Commerical,,,1122.84,,1122.84,122.82,1236.93,percent of total billed charges,,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Aetna,Middlesex Employees,,,1076.71,,1076.71,122.82,1236.93,percent of total billed charges,,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Anthem,Commerical,,,,,,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Anthem,Indemnity,,,1090.1,,1090.1,122.82,1236.93,percent of total billed charges,,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Anthem,Individual Exchange,,,,,,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Anthem,State Preferred,,,,,,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Cigna,Cigna,,141.94,,,141.94,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Connecticare,Commerical,,133.6,,,133.6,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Connecticare,Exchange,,133.6,,,133.6,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,Multiplan,Multiplan,,,1236.93,,1236.93,122.82,1236.93,percent of total billed charges,,
DEXRAZOXANE HCL (FOR EXTRAVASATION) 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,66220-110-01,NDC,both,1,ea,1455.21,873.13,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,1236.93,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8717-62,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-01,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-432-02,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-01,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-434-02,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Aetna,Commerical,,,220.73,,220.73,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Aetna,Middlesex Employees,,,211.66,,211.66,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Anthem,Commerical,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Anthem,Indemnity,,,214.3,,214.3,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Anthem,Individual Exchange,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Anthem,State Preferred,,,,,,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Cigna,Cigna,,141.94,,,141.94,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Connecticare,Commerical,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Connecticare,Exchange,,133.6,,,133.6,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,Multiplan,Multiplan,,,243.16,,243.16,122.82,243.16,percent of total billed charges,,
DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-207-25,NDC,both,1,ea,286.07,171.64,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,243.16,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Aetna,Commerical,,,273.15,,273.15,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Aetna,Middlesex Employees,,,261.93,,261.93,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Anthem,Commerical,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Anthem,Indemnity,,,265.19,,265.19,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Anthem,Individual Exchange,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Anthem,State Preferred,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Cigna,Cigna,,141.94,,,141.94,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Connecticare,Commerical,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Connecticare,Exchange,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,Multiplan,Multiplan,,,300.91,,300.91,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,0013-8727-89,NDC,both,0.5,ea,354.01,212.41,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Aetna,Commerical,,,273.15,,273.15,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Aetna,Middlesex Employees,,,261.93,,261.93,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Commerical,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Indemnity,,,265.19,,265.19,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Individual Exchange,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Anthem,State Preferred,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Cigna,Cigna,,141.94,,,141.94,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Connecticare,Commerical,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Connecticare,Exchange,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,Multiplan,Multiplan,,,300.91,,300.91,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-435-01,NDC,both,0.5,ea,354.01,212.41,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Aetna,Commerical,,,273.15,,273.15,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Aetna,Middlesex Employees,,,261.93,,261.93,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Commerical,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Indemnity,,,265.19,,265.19,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Anthem,Individual Exchange,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Anthem,State Preferred,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Cigna,Cigna,,141.94,,,141.94,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Connecticare,Commerical,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Connecticare,Exchange,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,Multiplan,Multiplan,,,300.91,,300.91,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,55150-437-01,NDC,both,0.5,ea,354.01,212.41,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Aetna,Commerical,,,273.15,,273.15,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Aetna,Middlesex Employees,,,261.93,,261.93,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Anthem,Commerical,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Anthem,Indemnity,,,265.19,,265.19,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Anthem,Individual Exchange,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Anthem,State Preferred,,,,,,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Cigna,Cigna,,141.94,,,141.94,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Connecticare,Commerical,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Connecticare,Exchange,,133.6,,,133.6,122.82,300.91,Other,Could be inpatient or outpatient,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,Multiplan,Multiplan,,,300.91,,300.91,122.82,300.91,percent of total billed charges,,
DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,J1190,HCPCS,67457-208-50,NDC,both,0.5,ea,354.01,212.41,United Healthcare/Oxford,United Healthcare/Oxford,,122.82,,,122.82,122.82,300.91,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Aetna,Commerical,,,101.96,,101.96,27.14,112.32,percent of total billed charges,,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Aetna,Middlesex Employees,,,97.77,,97.77,27.14,112.32,percent of total billed charges,,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Anthem,Commerical,,,,,,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Anthem,Indemnity,,,98.99,,98.99,27.14,112.32,percent of total billed charges,,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Anthem,Individual Exchange,,,,,,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Anthem,State Preferred,,,,,,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Cigna,Cigna,,45,,,45,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Connecticare,Commerical,,27.14,,,27.14,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Connecticare,Exchange,,27.14,,,27.14,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,Multiplan,Multiplan,,,112.32,,112.32,27.14,112.32,percent of total billed charges,,
DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7100,HCPCS,0409-7419-03,NDC,both,500,mL,132.14,79.28,United Healthcare/Oxford,United Healthcare/Oxford,,57.16,,,57.16,27.14,112.32,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Aetna,Commerical,,,85.7,,85.7,27.14,94.41,percent of total billed charges,,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Aetna,Middlesex Employees,,,82.18,,82.18,27.14,94.41,percent of total billed charges,,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Anthem,Commerical,,,,,,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Anthem,Indemnity,,,83.2,,83.2,27.14,94.41,percent of total billed charges,,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Anthem,Individual Exchange,,,,,,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Anthem,State Preferred,,,,,,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Cigna,Cigna,,45,,,45,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Connecticare,Commerical,,27.14,,,27.14,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Connecticare,Exchange,,27.14,,,27.14,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,Multiplan,Multiplan,,,94.41,,94.41,27.14,94.41,percent of total billed charges,,
DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,J7100,HCPCS,0409-7418-03,NDC,both,500,mL,111.07,66.64,United Healthcare/Oxford,United Healthcare/Oxford,,57.16,,,57.16,27.14,94.41,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Aetna,Commerical,,,1.37,,1.37,1.31,1.5,percent of total billed charges,,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Aetna,Middlesex Employees,,,1.31,,1.31,1.31,1.5,percent of total billed charges,,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Anthem,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Anthem,Indemnity,,,1.33,,1.33,1.31,1.5,percent of total billed charges,,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Anthem,Individual Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Anthem,State Preferred,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Cigna,Cigna,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Connecticare,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Connecticare,Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,Multiplan,Multiplan,,,1.5,,1.5,1.31,1.5,percent of total billed charges,,
DEXTROAMPHETAMINE SULFATE 5 MG TABLET,J3490,HCPCS,0555-0952-02,NDC,both,1,ea,1.77,1.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Aetna,Commerical,,,1.06,,1.06,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Aetna,Middlesex Employees,,,1.02,,1.02,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Anthem,Commerical,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Anthem,Indemnity,,,1.03,,1.03,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Anthem,Individual Exchange,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Anthem,State Preferred,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Cigna,Cigna,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Connecticare,Commerical,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Connecticare,Exchange,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,Multiplan,Multiplan,,,1.17,,1.17,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,0555-0972-02,NDC,both,1,ea,1.38,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Aetna,Commerical,,,1.06,,1.06,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Aetna,Middlesex Employees,,,1.02,,1.02,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Anthem,Commerical,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Anthem,Indemnity,,,1.03,,1.03,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Anthem,Individual Exchange,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Anthem,State Preferred,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Cigna,Cigna,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Connecticare,Commerical,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Connecticare,Exchange,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,Multiplan,Multiplan,,,1.17,,1.17,1.02,1.17,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,J3490,HCPCS,47781-176-01,NDC,both,1,ea,1.38,0.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.02,1.17,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Aetna,Commerical,,,0.92,,0.92,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Aetna,Middlesex Employees,,,0.88,,0.88,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Anthem,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Anthem,Indemnity,,,0.89,,0.89,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Anthem,Individual Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Anthem,State Preferred,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Cigna,Cigna,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Connecticare,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Connecticare,Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,Multiplan,Multiplan,,,1.01,,1.01,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,3.23,1.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Aetna,Commerical,,,0.92,,0.92,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Aetna,Middlesex Employees,,,0.88,,0.88,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Anthem,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Anthem,Indemnity,,,0.89,,0.89,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Anthem,Individual Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Anthem,State Preferred,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Cigna,Cigna,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Connecticare,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Connecticare,Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,Multiplan,Multiplan,,,1.01,,1.01,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,0555-0971-02,NDC,both,1,ea,1.19,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Aetna,Commerical,,,0.92,,0.92,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Aetna,Middlesex Employees,,,0.88,,0.88,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Anthem,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Anthem,Indemnity,,,0.89,,0.89,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Anthem,Individual Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Anthem,State Preferred,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Cigna,Cigna,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Connecticare,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Connecticare,Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,Multiplan,Multiplan,,,1.01,,1.01,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,40810-0000-35,NDC,both,1,ea,1.19,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Aetna,Commerical,,,0.92,,0.92,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Aetna,Middlesex Employees,,,0.88,,0.88,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Anthem,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Anthem,Indemnity,,,0.89,,0.89,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Anthem,Individual Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Anthem,State Preferred,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Cigna,Cigna,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Connecticare,Commerical,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Connecticare,Exchange,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,Multiplan,Multiplan,,,1.01,,1.01,0.88,1.01,percent of total billed charges,,
DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,J3490,HCPCS,47781-174-01,NDC,both,1,ea,1.19,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.88,1.01,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1487-01,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Aetna,Commerical,,,14.5,,14.5,13.9,15.97,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Aetna,Middlesex Employees,,,13.9,,13.9,13.9,15.97,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Anthem,Commerical,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Anthem,Indemnity,,,14.08,,14.08,13.9,15.97,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Anthem,Individual Exchange,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Anthem,State Preferred,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Cigna,Cigna,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Connecticare,Commerical,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Connecticare,Exchange,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,Multiplan,Multiplan,,,15.97,,15.97,13.9,15.97,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0228-3059-11,NDC,both,1,ea,18.79,11.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.9,15.97,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,40810-0006-15,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-383-01,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-337-88,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-338-88,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Aetna,Commerical,,,21.06,,21.06,20.19,23.2,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Aetna,Middlesex Employees,,,20.19,,20.19,20.19,23.2,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Anthem,Commerical,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Anthem,Indemnity,,,20.44,,20.44,20.19,23.2,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Anthem,Individual Exchange,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Anthem,State Preferred,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Cigna,Cigna,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Connecticare,Commerical,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Connecticare,Exchange,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,Multiplan,Multiplan,,,23.2,,23.2,20.19,23.2,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-387-01,NDC,both,1,ea,27.29,16.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.19,23.2,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Aetna,Commerical,,,20.26,,20.26,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Aetna,Middlesex Employees,,,19.43,,19.43,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Anthem,Commerical,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Anthem,Indemnity,,,19.67,,19.67,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Anthem,Individual Exchange,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Anthem,State Preferred,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Cigna,Cigna,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Connecticare,Commerical,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Connecticare,Exchange,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,Multiplan,Multiplan,,,22.32,,22.32,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-339-88,NDC,both,1,ea,26.26,15.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,0115-1490-01,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Aetna,Commerical,,,3.26,,3.26,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Aetna,Middlesex Employees,,,3.12,,3.12,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Anthem,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Anthem,Indemnity,,,3.16,,3.16,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Anthem,Individual Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Anthem,State Preferred,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Cigna,Cigna,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Connecticare,Commerical,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Connecticare,Exchange,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,Multiplan,Multiplan,,,3.59,,3.59,3.12,3.59,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,57664-340-88,NDC,both,1,ea,4.22,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.12,3.59,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Aetna,Commerical,,,20.26,,20.26,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Aetna,Middlesex Employees,,,19.43,,19.43,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Anthem,Commerical,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Anthem,Indemnity,,,19.67,,19.67,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Anthem,Individual Exchange,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Anthem,State Preferred,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Cigna,Cigna,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Connecticare,Commerical,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Connecticare,Exchange,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,Multiplan,Multiplan,,,22.32,,22.32,19.43,22.32,percent of total billed charges,,
"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",J3490,HCPCS,54092-381-01,NDC,both,1,ea,26.26,15.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.43,22.32,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,00318-0743-20,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,0536-1068-34,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
DEXTROMETHORPHAN HBR 15 MG CAPSULE,J3490,HCPCS,40810-0018-97,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Aetna,Commerical,,,16.05,,16.05,15.39,17.68,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Aetna,Middlesex Employees,,,15.39,,15.39,15.39,17.68,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Anthem,Commerical,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Anthem,Indemnity,,,15.58,,15.58,15.39,17.68,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Anthem,Individual Exchange,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Anthem,State Preferred,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Cigna,Cigna,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Connecticare,Commerical,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Connecticare,Exchange,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,Multiplan,Multiplan,,,17.68,,17.68,15.39,17.68,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,0904-6312-56,NDC,both,1,mL,20.8,12.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.39,17.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Aetna,Commerical,,,22.62,,22.62,21.69,24.92,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Aetna,Middlesex Employees,,,21.69,,21.69,21.69,24.92,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Anthem,Commerical,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Anthem,Indemnity,,,21.96,,21.96,21.69,24.92,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Anthem,Individual Exchange,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Anthem,State Preferred,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Cigna,Cigna,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Connecticare,Commerical,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Connecticare,Exchange,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,Multiplan,Multiplan,,,24.92,,24.92,21.69,24.92,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-63,NDC,both,1,mL,29.32,17.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.69,24.92,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Aetna,Commerical,,,25.37,,25.37,24.33,27.95,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Aetna,Middlesex Employees,,,24.33,,24.33,24.33,27.95,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Anthem,Commerical,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Anthem,Indemnity,,,24.63,,24.63,24.33,27.95,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Anthem,Individual Exchange,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Anthem,State Preferred,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Cigna,Cigna,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Connecticare,Commerical,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Connecticare,Exchange,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,Multiplan,Multiplan,,,27.95,,27.95,24.33,27.95,percent of total billed charges,,
DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,J3490,HCPCS,63824-175-65,NDC,both,1,mL,32.88,19.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.33,27.95,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Anthem,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Anthem,Individual Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Anthem,State Preferred,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Cigna,Cigna,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Connecticare,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Connecticare,Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-736-04,NDC,both,1,mL,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Anthem,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Anthem,Individual Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Anthem,State Preferred,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Cigna,Cigna,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Connecticare,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Connecticare,Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,6.69,7.68,percent of total billed charges,,
DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0026-4,NDC,both,1,mL,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Aetna,Commerical,,,82.75,,82.75,79.35,91.15,percent of total billed charges,,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Aetna,Middlesex Employees,,,79.35,,79.35,79.35,91.15,percent of total billed charges,,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Anthem,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Anthem,Indemnity,,,80.33,,80.33,79.35,91.15,percent of total billed charges,,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Anthem,Individual Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Anthem,State Preferred,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Cigna,Cigna,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Connecticare,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Connecticare,Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,Multiplan,Multiplan,,,91.15,,91.15,79.35,91.15,percent of total billed charges,,
DEXTROSE (BULK) GRANULES,J3490,HCPCS,51552-0458-6,NDC,both,1,gm,107.24,64.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Aetna,Commerical,,,1071.27,,1071.27,1027.26,1180.12,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Aetna,Middlesex Employees,,,1027.26,,1027.26,1027.26,1180.12,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Anthem,Commerical,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Anthem,Indemnity,,,1040.04,,1040.04,1027.26,1180.12,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Anthem,Individual Exchange,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Anthem,State Preferred,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Cigna,Cigna,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Connecticare,Commerical,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Connecticare,Exchange,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,Multiplan,Multiplan,,,1180.12,,1180.12,1027.26,1180.12,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,38779-0072-1,NDC,both,1,gm,1388.38,833.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1027.26,1180.12,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Aetna,Commerical,,,45.81,,45.81,43.93,50.46,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Aetna,Middlesex Employees,,,43.93,,43.93,43.93,50.46,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Anthem,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Anthem,Indemnity,,,44.47,,44.47,43.93,50.46,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Anthem,Individual Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Anthem,State Preferred,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Cigna,Cigna,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Connecticare,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Connecticare,Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,Multiplan,Multiplan,,,50.46,,50.46,43.93,50.46,percent of total billed charges,,
DEXTROSE (BULK) POWDER,J3490,HCPCS,51552-0123-6,NDC,both,1,gm,59.37,35.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,25.5,29.3,percent of total billed charges,,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,25.5,29.3,percent of total billed charges,,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Anthem,Commerical,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,25.5,29.3,percent of total billed charges,,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Anthem,State Preferred,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Cigna,Cigna,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Connecticare,Commerical,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Connecticare,Exchange,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,25.5,29.3,percent of total billed charges,,
DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-7622-00,NDC,both,1,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Aetna,Commerical,,,13.3,,13.3,12.76,14.65,percent of total billed charges,,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Aetna,Middlesex Employees,,,12.76,,12.76,12.76,14.65,percent of total billed charges,,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Anthem,Commerical,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Anthem,Indemnity,,,12.91,,12.91,12.76,14.65,percent of total billed charges,,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Anthem,Individual Exchange,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Anthem,State Preferred,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Cigna,Cigna,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Connecticare,Commerical,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Connecticare,Exchange,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,Multiplan,Multiplan,,,14.65,,14.65,12.76,14.65,percent of total billed charges,,
DEXTROSE 10 % ENTERAL,J3490,HCPCS,0264-7520-10,NDC,both,1,mL,17.24,10.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.76,14.65,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Aetna,Commerical,,,0.74,,0.74,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Aetna,Middlesex Employees,,,0.71,,0.71,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Anthem,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Anthem,Indemnity,,,0.72,,0.72,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Anthem,Individual Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Anthem,State Preferred,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Cigna,Cigna,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Connecticare,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Connecticare,Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7930-02,NDC,both,1,mL,0.96,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Aetna,Commerical,,,0.74,,0.74,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Aetna,Middlesex Employees,,,0.71,,0.71,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Anthem,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Anthem,Indemnity,,,0.72,,0.72,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Anthem,Individual Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Anthem,State Preferred,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Cigna,Cigna,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Connecticare,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Connecticare,Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.71,0.82,percent of total billed charges,,
DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,J3490,HCPCS,17271-721-05,NDC,both,1,mL,0.96,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR GRAM DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
DEXTROSE 10% IV BOLUS FOR VOLUME DOSING,J3490,HCPCS,0409-7930-09,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-03,NDC,both,1,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,0942-0641-04,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,J3490,HCPCS,23731-6051-3,NDC,both,1,mL,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7935-19,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Aetna,Commerical,,,37.56,,37.56,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Aetna,Middlesex Employees,,,36.02,,36.02,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Anthem,Commerical,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Anthem,Indemnity,,,36.47,,36.47,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Anthem,Individual Exchange,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Anthem,State Preferred,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Cigna,Cigna,,8.08,,,8.08,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Connecticare,Commerical,,9.88,,,9.88,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Connecticare,Exchange,,9.88,,,9.88,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,Multiplan,Multiplan,,,41.38,,41.38,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-10,NDC,both,10,mL,48.68,29.21,United Healthcare/Oxford,United Healthcare/Oxford,,6.99,,,6.99,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Aetna,Commerical,,,37.56,,37.56,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Aetna,Middlesex Employees,,,36.02,,36.02,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Anthem,Commerical,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Anthem,Indemnity,,,36.47,,36.47,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Anthem,Individual Exchange,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Anthem,State Preferred,,,,,,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Cigna,Cigna,,8.08,,,8.08,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Connecticare,Commerical,,9.88,,,9.88,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Connecticare,Exchange,,9.88,,,9.88,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,Multiplan,Multiplan,,,41.38,,41.38,6.99,41.38,percent of total billed charges,,
DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,J3489,HCPCS,0409-1775-40,NDC,both,1,mL,48.68,29.21,United Healthcare/Oxford,United Healthcare/Oxford,,6.99,,,6.99,6.99,41.38,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Aetna,Commerical,,,9.1,,9.1,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Aetna,Middlesex Employees,,,8.72,,8.72,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Anthem,Commerical,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Anthem,Indemnity,,,8.83,,8.83,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Anthem,Individual Exchange,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Anthem,State Preferred,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Cigna,Cigna,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Connecticare,Commerical,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Connecticare,Exchange,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,Multiplan,Multiplan,,,10.02,,10.02,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006915,NDC,both,1,gm,11.79,7.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Aetna,Commerical,,,9.1,,9.1,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Aetna,Middlesex Employees,,,8.72,,8.72,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Anthem,Commerical,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Anthem,Indemnity,,,8.83,,8.83,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Anthem,Individual Exchange,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Anthem,State Preferred,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Cigna,Cigna,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Connecticare,Commerical,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Connecticare,Exchange,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,Multiplan,Multiplan,,,10.02,,10.02,8.72,10.02,percent of total billed charges,,
DEXTROSE 40 % ORAL GEL,J3490,HCPCS,574006930,NDC,both,1,gm,11.79,7.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.72,10.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0077-04,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7924-09,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,63323-873-10,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7926-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,1.31,,,1.31,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,1.74,,,1.74,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,1.74,,,1.74,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0409-7941-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,1.31,,,1.31,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,1.74,,,1.74,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,1.74,,,1.74,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.31,1.74,percent of total billed charges,,
DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J7042,HCPCS,0990-7941-03,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,1.74,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,2.77,13.02,percent of total billed charges,,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,2.77,13.02,percent of total billed charges,,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Anthem,Commerical,,,,,,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,2.77,13.02,percent of total billed charges,,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Anthem,State Preferred,,,,,,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Cigna,Cigna,,2.77,,,2.77,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Connecticare,Commerical,,3.7,,,3.7,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Connecticare,Exchange,,3.7,,,3.7,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,2.77,13.02,percent of total billed charges,,
DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0990-7929-09,NDC,both,1000,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,1.9,13.02,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,1.9,13.02,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Anthem,Commerical,,,,,,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,1.9,13.02,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Anthem,State Preferred,,,,,,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Cigna,Cigna,,1.9,,,1.9,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Connecticare,Commerical,,2.79,,,2.79,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Connecticare,Exchange,,2.79,,,2.79,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,1.9,13.02,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7060,HCPCS,0264-7510-10,NDC,both,500,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,13.02,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Commerical,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,State Preferred,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Cigna,Cigna,,3.8,,,3.8,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Commerical,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Exchange,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % ENTERAL,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,1.9,7.17,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,1.9,7.17,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Anthem,Commerical,,,,,,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,1.9,7.17,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Anthem,State Preferred,,,,,,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Cigna,Cigna,,1.9,,,1.9,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Connecticare,Commerical,,2.79,,,2.79,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Connecticare,Exchange,,2.79,,,2.79,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,1.9,7.17,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0264-1510-31,NDC,both,50,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,7.17,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Aetna,Commerical,,,65.02,,65.02,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Aetna,Middlesex Employees,,,62.34,,62.34,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Anthem,Commerical,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Anthem,Indemnity,,,63.12,,63.12,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Anthem,Individual Exchange,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Anthem,State Preferred,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Cigna,Cigna,,1.9,,,1.9,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Connecticare,Commerical,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Connecticare,Exchange,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,Multiplan,Multiplan,,,71.62,,71.62,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-03,NDC,both,500,mL,84.26,50.56,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Aetna,Commerical,,,31.03,,31.03,1.9,34.19,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Aetna,Middlesex Employees,,,29.76,,29.76,1.9,34.19,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Anthem,Commerical,,,,,,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Anthem,Indemnity,,,30.13,,30.13,1.9,34.19,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Anthem,Individual Exchange,,,,,,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Anthem,State Preferred,,,,,,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Cigna,Cigna,,1.9,,,1.9,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Connecticare,Commerical,,2.79,,,2.79,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Connecticare,Exchange,,2.79,,,2.79,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,Multiplan,Multiplan,,,34.19,,34.19,1.9,34.19,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0409-7922-53,NDC,both,500,mL,40.22,24.13,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,34.19,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Aetna,Commerical,,,65.02,,65.02,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Aetna,Middlesex Employees,,,62.34,,62.34,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Anthem,Commerical,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Anthem,Indemnity,,,63.12,,63.12,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Anthem,Individual Exchange,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Anthem,State Preferred,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Cigna,Cigna,,1.9,,,1.9,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Connecticare,Commerical,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Connecticare,Exchange,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,Multiplan,Multiplan,,,71.62,,71.62,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-02,NDC,both,500,mL,84.26,50.56,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Aetna,Commerical,,,65.02,,65.02,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Aetna,Middlesex Employees,,,62.34,,62.34,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Anthem,Commerical,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Anthem,Indemnity,,,63.12,,63.12,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Anthem,Individual Exchange,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Anthem,State Preferred,,,,,,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Cigna,Cigna,,1.9,,,1.9,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Connecticare,Commerical,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Connecticare,Exchange,,2.79,,,2.79,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,Multiplan,Multiplan,,,71.62,,71.62,1.9,71.62,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7060,HCPCS,0990-7922-61,NDC,both,500,mL,84.26,50.56,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.9,71.62,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Aetna,Commerical,,,130.03,,130.03,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Aetna,Middlesex Employees,,,124.69,,124.69,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Anthem,Commerical,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Anthem,Indemnity,,,126.24,,126.24,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Anthem,Individual Exchange,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Anthem,State Preferred,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Cigna,Cigna,,3.8,,,3.8,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Connecticare,Commerical,,5.57,,,5.57,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Connecticare,Exchange,,5.57,,,5.57,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,Multiplan,Multiplan,,,143.24,,143.24,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,168.52,101.11,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Commerical,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,State Preferred,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Cigna,Cigna,,3.8,,,3.8,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Commerical,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Exchange,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,1.9,,,1.9,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,2.79,,,2.79,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,2.79,,,2.79,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0264-7510-20,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Anthem,Commerical,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Anthem,State Preferred,,,,,,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Cigna,Cigna,,1.9,,,1.9,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Connecticare,Commerical,,2.79,,,2.79,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Connecticare,Exchange,,2.79,,,2.79,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,2.79,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7060,HCPCS,0338-0017-02,NDC,both,500,mL,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.42,2.79,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,130.03,,130.03,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,124.69,,124.69,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,126.24,,126.24,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,3.8,,,3.8,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,5.57,,,5.57,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,5.57,,,5.57,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,143.24,,143.24,3.8,143.24,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0264-7510-00,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,3.8,143.24,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,5.57,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,5.57,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,5.57,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,3.8,,,3.8,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,5.57,,,5.57,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,5.57,,,5.57,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,5.57,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-04,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,2.83,5.57,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Commerical,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Anthem,State Preferred,,,,,,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Cigna,Cigna,,3.8,,,3.8,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Commerical,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Connecticare,Exchange,,5.57,,,5.57,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,3.8,45.58,percent of total billed charges,,
DEXTROSE 5 % IV BOLUS,J7070,HCPCS,0338-0017-18,NDC,both,1000,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,4.1,,,4.1,3.8,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,State Preferred,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Cigna,Cigna,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,J7799,HCPCS,0409-7936-19,NDC,both,50,mL,137.88,82.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,State Preferred,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Cigna,Cigna,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,10.2,11.72,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Aetna,Commerical,,,36.8,,36.8,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Aetna,Middlesex Employees,,,35.29,,35.29,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Anthem,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Anthem,Indemnity,,,35.72,,35.72,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Anthem,Individual Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Anthem,State Preferred,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Cigna,Cigna,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Connecticare,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Connecticare,Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,Multiplan,Multiplan,,,40.54,,40.54,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-4902-34,NDC,both,50,mL,47.69,28.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Aetna,Commerical,,,36.8,,36.8,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Aetna,Middlesex Employees,,,35.29,,35.29,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Anthem,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Anthem,Indemnity,,,35.72,,35.72,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Anthem,Individual Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Anthem,State Preferred,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Cigna,Cigna,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Connecticare,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Connecticare,Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,Multiplan,Multiplan,,,40.54,,40.54,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-16,NDC,both,50,mL,47.69,28.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Aetna,Commerical,,,36.8,,36.8,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Aetna,Middlesex Employees,,,35.29,,35.29,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Anthem,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Anthem,Indemnity,,,35.72,,35.72,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Anthem,Individual Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Anthem,State Preferred,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Cigna,Cigna,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Connecticare,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Connecticare,Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,Multiplan,Multiplan,,,40.54,,40.54,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,0409-7517-66,NDC,both,50,mL,47.69,28.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Aetna,Commerical,,,36.8,,36.8,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Aetna,Middlesex Employees,,,35.29,,35.29,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Anthem,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Anthem,Indemnity,,,35.72,,35.72,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Anthem,Individual Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Anthem,State Preferred,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Cigna,Cigna,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Connecticare,Commerical,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Connecticare,Exchange,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,Multiplan,Multiplan,,,40.54,,40.54,35.29,40.54,percent of total billed charges,,
DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,J7799,HCPCS,76329-3301-1,NDC,both,50,mL,47.69,28.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.29,40.54,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,10.2,11.72,percent of total billed charges,,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,10.2,11.72,percent of total billed charges,,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,10.2,11.72,percent of total billed charges,,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Anthem,State Preferred,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Cigna,Cigna,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Connecticare,Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,10.2,11.72,percent of total billed charges,,
DEXTROSE 50% IV BOLUS FOR VOLUME DOSING,J7799,HCPCS,0409-6648-02,NDC,both,50,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.58,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.58,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Anthem,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,39.67,45.58,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Anthem,Individual Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Anthem,State Preferred,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Cigna,Cigna,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Connecticare,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Connecticare,Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,39.67,45.58,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0719-06,NDC,both,1,mL,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,14.17,16.28,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,14.17,16.28,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Anthem,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,14.17,16.28,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Anthem,State Preferred,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Cigna,Cigna,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Connecticare,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Connecticare,Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,14.17,16.28,percent of total billed charges,,
DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7918-19,NDC,both,1,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Aetna,Commerical,,,13.47,,13.47,12.92,14.84,percent of total billed charges,,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Aetna,Middlesex Employees,,,12.92,,12.92,12.92,14.84,percent of total billed charges,,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Anthem,Commerical,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Anthem,Indemnity,,,13.08,,13.08,12.92,14.84,percent of total billed charges,,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Anthem,Individual Exchange,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Anthem,State Preferred,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Cigna,Cigna,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Connecticare,Commerical,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Connecticare,Exchange,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,Multiplan,Multiplan,,,14.84,,14.84,12.92,14.84,percent of total billed charges,,
DEXTROSE-DEXTRIN-MALTOSE 24 GRAM/31 GRAM ORAL GEL,J3490,HCPCS,187074633,NDC,both,31,gm,17.46,10.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.92,14.84,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Aetna,Commerical,,,63.83,,63.83,0.08,70.32,percent of total billed charges,,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Aetna,Middlesex Employees,,,61.21,,61.21,0.08,70.32,percent of total billed charges,,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Anthem,Commerical,,,,,,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Anthem,Indemnity,,,61.97,,61.97,0.08,70.32,percent of total billed charges,,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Anthem,Individual Exchange,,,,,,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Anthem,State Preferred,,,,,,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Cigna,Cigna,,0.08,,,0.08,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Connecticare,Commerical,,0.11,,,0.11,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Connecticare,Exchange,,0.11,,,0.11,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,Multiplan,Multiplan,,,70.32,,70.32,0.08,70.32,percent of total billed charges,,
DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,Q9958,HCPCS,0270-1410-30,NDC,both,1,mL,82.73,49.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,70.32,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Aetna,Commerical,,,1.63,,1.63,0.25,1.79,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Aetna,Middlesex Employees,,,1.56,,1.56,0.25,1.79,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Anthem,Commerical,,,,,,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Anthem,Indemnity,,,1.58,,1.58,0.25,1.79,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Anthem,Individual Exchange,,,,,,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Anthem,State Preferred,,,,,,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Cigna,Cigna,,0.25,,,0.25,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Connecticare,Commerical,,0.33,,,0.33,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Connecticare,Exchange,,0.33,,,0.33,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,Multiplan,Multiplan,,,1.79,,1.79,0.25,1.79,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-04,NDC,both,1,mL,2.11,1.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.27,,,0.27,0.25,1.79,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Aetna,Commerical,,,59.23,,59.23,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Aetna,Middlesex Employees,,,56.79,,56.79,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Anthem,Commerical,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Anthem,Indemnity,,,57.5,,57.5,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Anthem,Individual Exchange,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Anthem,State Preferred,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Cigna,Cigna,,0.25,,,0.25,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Connecticare,Commerical,,0.33,,,0.33,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Connecticare,Exchange,,0.33,,,0.33,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,Multiplan,Multiplan,,,65.25,,65.25,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-05,NDC,both,1,mL,76.76,46.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.27,,,0.27,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Aetna,Commerical,,,118.45,,118.45,0.25,130.48,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Aetna,Middlesex Employees,,,113.58,,113.58,0.25,130.48,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Anthem,Commerical,,,,,,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Anthem,Indemnity,,,114.99,,114.99,0.25,130.48,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Anthem,Individual Exchange,,,,,,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Anthem,State Preferred,,,,,,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Cigna,Cigna,,0.25,,,0.25,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Connecticare,Commerical,,0.33,,,0.33,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Connecticare,Exchange,,0.33,,,0.33,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,Multiplan,Multiplan,,,130.48,,130.48,0.25,130.48,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0019-4816-06,NDC,both,1,mL,153.51,92.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.27,,,0.27,0.25,130.48,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,0.25,2.51,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,0.25,2.51,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Anthem,Commerical,,,,,,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,0.25,2.51,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Anthem,Individual Exchange,,,,,,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Anthem,State Preferred,,,,,,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Cigna,Cigna,,0.25,,,0.25,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Connecticare,Commerical,,0.33,,,0.33,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Connecticare,Exchange,,0.33,,,0.33,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,0.25,2.51,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-35,NDC,both,1,mL,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.27,,,0.27,0.25,2.51,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Aetna,Commerical,,,59.23,,59.23,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Aetna,Middlesex Employees,,,56.79,,56.79,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Anthem,Commerical,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Anthem,Indemnity,,,57.5,,57.5,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Anthem,Individual Exchange,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Anthem,State Preferred,,,,,,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Cigna,Cigna,,0.25,,,0.25,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Connecticare,Commerical,,0.33,,,0.33,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Connecticare,Exchange,,0.33,,,0.33,0.25,65.25,Other,Could be inpatient or outpatient,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,Multiplan,Multiplan,,,65.25,,65.25,0.25,65.25,percent of total billed charges,,
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,Q9963,HCPCS,0270-0445-40,NDC,both,1,mL,76.76,46.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.27,,,0.27,0.25,65.25,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
DIAZEPAM 1 MG ORAL TAB,J8499,HCPCS,40810-0001-07,NDC,both,2,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Aetna,Commerical,,,663.75,,663.75,636.48,731.19,percent of total billed charges,,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Aetna,Middlesex Employees,,,636.48,,636.48,636.48,731.19,percent of total billed charges,,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Anthem,Commerical,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Anthem,Indemnity,,,644.39,,644.39,636.48,731.19,percent of total billed charges,,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Anthem,Individual Exchange,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Anthem,State Preferred,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Cigna,Cigna,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Connecticare,Commerical,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Connecticare,Exchange,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,Multiplan,Multiplan,,,731.19,,731.19,636.48,731.19,percent of total billed charges,,
DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,J3490,HCPCS,68682-655-20,NDC,both,1,ea,860.22,516.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,636.48,731.19,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-01,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
DIAZEPAM 2 MG TABLET,J8499,HCPCS,51079-284-20,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Aetna,Commerical,,,558.07,,558.07,535.14,614.77,percent of total billed charges,,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Aetna,Middlesex Employees,,,535.14,,535.14,535.14,614.77,percent of total billed charges,,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Anthem,Commerical,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Anthem,Indemnity,,,541.79,,541.79,535.14,614.77,percent of total billed charges,,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Anthem,Individual Exchange,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Anthem,State Preferred,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Cigna,Cigna,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Connecticare,Commerical,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Connecticare,Exchange,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,Multiplan,Multiplan,,,614.77,,614.77,535.14,614.77,percent of total billed charges,,
DIAZEPAM 2.5 MG RECTAL KIT,J3490,HCPCS,66490-650-20,NDC,both,1,ea,723.26,433.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,535.14,614.77,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,0904-5880-61,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,51079-285-20,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
DIAZEPAM 5 MG TABLET,J8499,HCPCS,63739-073-10,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Aetna,Commerical,,,164.02,,164.02,157.28,180.68,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Aetna,Middlesex Employees,,,157.28,,157.28,157.28,180.68,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Anthem,Commerical,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Anthem,Indemnity,,,159.24,,159.24,157.28,180.68,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Anthem,Individual Exchange,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Anthem,State Preferred,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Cigna,Cigna,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Connecticare,Commerical,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Connecticare,Exchange,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,Multiplan,Multiplan,,,180.68,,180.68,157.28,180.68,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-3188-63,NDC,both,1,mL,212.57,127.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,157.28,180.68,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Aetna,Commerical,,,9.59,,9.59,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Aetna,Middlesex Employees,,,9.2,,9.2,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Anthem,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Anthem,Indemnity,,,9.31,,9.31,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Anthem,Individual Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Anthem,State Preferred,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Cigna,Cigna,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Connecticare,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Connecticare,Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,Multiplan,Multiplan,,,10.57,,10.57,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-41,NDC,both,1,mL,12.43,7.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Aetna,Commerical,,,9.59,,9.59,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Aetna,Middlesex Employees,,,9.2,,9.2,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Anthem,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Anthem,Indemnity,,,9.31,,9.31,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Anthem,Individual Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Anthem,State Preferred,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Cigna,Cigna,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Connecticare,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Connecticare,Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,Multiplan,Multiplan,,,10.57,,10.57,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,0904-7117-93,NDC,both,1,mL,12.43,7.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Aetna,Commerical,,,9.59,,9.59,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Aetna,Middlesex Employees,,,9.2,,9.2,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Anthem,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Anthem,Indemnity,,,9.31,,9.31,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Anthem,Individual Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Anthem,State Preferred,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Cigna,Cigna,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Connecticare,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Connecticare,Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,Multiplan,Multiplan,,,10.57,,10.57,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-59,NDC,both,1,mL,12.43,7.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Aetna,Commerical,,,9.59,,9.59,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Aetna,Middlesex Employees,,,9.2,,9.2,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Anthem,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Anthem,Indemnity,,,9.31,,9.31,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Anthem,Individual Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Anthem,State Preferred,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Cigna,Cigna,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Connecticare,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Connecticare,Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,Multiplan,Multiplan,,,10.57,,10.57,9.2,10.57,percent of total billed charges,,
"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",J8499,HCPCS,68094-750-62,NDC,both,1,mL,12.43,7.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,40810-0005-08,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-40,NDC,both,1,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
DIAZEPAM 5 MG/5 ML ORAL SOLUTION SYRINGE,J8499,HCPCS,60687-755-86,NDC,both,1,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Aetna,Commerical,,,99.57,,99.57,6.16,109.68,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Aetna,Middlesex Employees,,,95.48,,95.48,6.16,109.68,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Anthem,Commerical,,,,,,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Anthem,Indemnity,,,96.66,,96.66,6.16,109.68,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Anthem,Individual Exchange,,,,,,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Anthem,State Preferred,,,,,,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Cigna,Cigna,,6.16,,,6.16,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Connecticare,Commerical,,8.9,,,8.9,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Connecticare,Exchange,,8.9,,,8.9,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,Multiplan,Multiplan,,,109.68,,109.68,6.16,109.68,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SOLUTION,J3360,HCPCS,69339-137-95,NDC,both,1,mL,129.04,77.42,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,109.68,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0409-1273-32,NDC,both,2,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-01,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,0641-6244-10,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,40810-0020-61,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69339-136-34,NDC,both,2,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-00,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,6.16,,,6.16,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,8.9,,,8.9,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,6.16,53.72,percent of total billed charges,,
DIAZEPAM 5 MG/ML INJECTION SYRINGE,J3360,HCPCS,76045-204-20,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,6.65,,,6.65,6.16,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Aetna,Commerical,,,713.63,,713.63,684.31,786.14,percent of total billed charges,,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Aetna,Middlesex Employees,,,684.31,,684.31,684.31,786.14,percent of total billed charges,,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Anthem,Commerical,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Anthem,Indemnity,,,692.82,,692.82,684.31,786.14,percent of total billed charges,,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Anthem,Individual Exchange,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Anthem,State Preferred,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Cigna,Cigna,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Connecticare,Commerical,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Connecticare,Exchange,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,Multiplan,Multiplan,,,786.14,,786.14,684.31,786.14,percent of total billed charges,,
DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT,J3490,HCPCS,68682-652-20,NDC,both,1,ea,924.87,554.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,684.31,786.14,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 10 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 2.5 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Commerical,,,48.77,,48.77,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Aetna,Middlesex Employees,,,46.76,,46.76,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Indemnity,,,47.34,,47.34,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,Individual Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Anthem,State Preferred,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Cigna,Cigna,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Commerical,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Connecticare,Exchange,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,Multiplan,Multiplan,,,53.72,,53.72,46.76,53.72,percent of total billed charges,,
DIAZEPAM RECTAL 20 MG,J3490,HCPCS,69374-965-02,NDC,both,1,mL,63.2,37.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.76,53.72,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Aetna,Commerical,,,447.46,,447.46,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Aetna,Middlesex Employees,,,429.08,,429.08,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Anthem,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Anthem,Indemnity,,,434.41,,434.41,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Anthem,Individual Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Anthem,State Preferred,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Cigna,Cigna,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Connecticare,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Connecticare,Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,Multiplan,Multiplan,,,492.92,,492.92,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0254-1010-19,NDC,both,1,mL,579.91,347.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Aetna,Commerical,,,447.46,,447.46,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Aetna,Middlesex Employees,,,429.08,,429.08,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Anthem,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Anthem,Indemnity,,,434.41,,434.41,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Anthem,Individual Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Anthem,State Preferred,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Cigna,Cigna,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Connecticare,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Connecticare,Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,Multiplan,Multiplan,,,492.92,,492.92,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,0575-6200-30,NDC,both,1,mL,579.91,347.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Aetna,Commerical,,,447.46,,447.46,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Aetna,Middlesex Employees,,,429.08,,429.08,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Anthem,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Anthem,Indemnity,,,434.41,,434.41,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Anthem,Individual Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Anthem,State Preferred,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Cigna,Cigna,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Connecticare,Commerical,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Connecticare,Exchange,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,Multiplan,Multiplan,,,492.92,,492.92,429.08,492.92,percent of total billed charges,,
DIAZOXIDE 50 MG/ML ORAL SUSPENSION,J8499,HCPCS,13517-100-30,NDC,both,1,mL,579.91,347.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,429.08,492.92,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Aetna,Commerical,,,8.53,,8.53,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Aetna,Middlesex Employees,,,8.18,,8.18,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Anthem,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Anthem,Indemnity,,,8.28,,8.28,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Anthem,Individual Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Anthem,State Preferred,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Cigna,Cigna,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Connecticare,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Connecticare,Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,Multiplan,Multiplan,,,9.39,,9.39,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,0536-1211-95,NDC,both,1,gm,11.05,6.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Aetna,Commerical,,,8.53,,8.53,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Aetna,Middlesex Employees,,,8.18,,8.18,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Anthem,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Anthem,Indemnity,,,8.28,,8.28,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Anthem,Individual Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Anthem,State Preferred,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Cigna,Cigna,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Connecticare,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Connecticare,Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,Multiplan,Multiplan,,,9.39,,9.39,8.18,9.39,percent of total billed charges,,
DIBUCAINE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-050-03,NDC,both,28,gm,11.05,6.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Aetna,Commerical,,,106.98,,106.98,102.59,117.85,percent of total billed charges,,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Aetna,Middlesex Employees,,,102.59,,102.59,102.59,117.85,percent of total billed charges,,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Anthem,Commerical,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Anthem,Indemnity,,,103.86,,103.86,102.59,117.85,percent of total billed charges,,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Anthem,Individual Exchange,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Anthem,State Preferred,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Cigna,Cigna,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Connecticare,Commerical,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Connecticare,Exchange,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,Multiplan,Multiplan,,,117.85,,117.85,102.59,117.85,percent of total billed charges,,
DICLOFENAC 1 % TOPICAL GEL,J3490,HCPCS,63481-684-47,NDC,both,100,gm,138.65,83.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.59,117.85,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Aetna,Commerical,,,2.65,,2.65,2.55,2.92,percent of total billed charges,,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.92,percent of total billed charges,,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Anthem,Commerical,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Anthem,Indemnity,,,2.58,,2.58,2.55,2.92,percent of total billed charges,,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Anthem,Individual Exchange,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Anthem,State Preferred,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Cigna,Cigna,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Connecticare,Commerical,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Connecticare,Exchange,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,Multiplan,Multiplan,,,2.92,,2.92,2.55,2.92,percent of total billed charges,,
DICLOXACILLIN 500 MG CAPSULE,J3490,HCPCS,0093-3125-01,NDC,both,1,ea,3.44,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,51079-118-20,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
DICYCLOMINE 10 MG CAPSULE,J3490,HCPCS,60687-369-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 10 MG ORAL TAB,J3490,HCPCS,40810-0001-09,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Aetna,Commerical,,,322.9,,322.9,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Aetna,Middlesex Employees,,,309.63,,309.63,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Anthem,Commerical,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Anthem,Indemnity,,,313.48,,313.48,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Anthem,Individual Exchange,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Anthem,State Preferred,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Cigna,Cigna,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Connecticare,Commerical,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Connecticare,Exchange,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,Multiplan,Multiplan,,,355.71,,355.71,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0603-1161-58,NDC,both,1,mL,418.48,251.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Aetna,Commerical,,,322.9,,322.9,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Aetna,Middlesex Employees,,,309.63,,309.63,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Anthem,Commerical,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Anthem,Indemnity,,,313.48,,313.48,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Anthem,Individual Exchange,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Anthem,State Preferred,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Cigna,Cigna,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Connecticare,Commerical,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Connecticare,Exchange,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,Multiplan,Multiplan,,,355.71,,355.71,309.63,355.71,percent of total billed charges,,
DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,70954-261-10,NDC,both,1,mL,418.48,251.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,309.63,355.71,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-01,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Aetna,Commerical,,,1.03,,1.03,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Aetna,Middlesex Employees,,,0.99,,0.99,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Anthem,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Anthem,Indemnity,,,1,,1,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Anthem,Individual Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Anthem,State Preferred,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Cigna,Cigna,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Connecticare,Commerical,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Connecticare,Exchange,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,Multiplan,Multiplan,,,1.14,,1.14,0.99,1.14,percent of total billed charges,,
DICYCLOMINE 20 MG TABLET,J3490,HCPCS,51079-119-20,NDC,both,1,ea,1.34,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.99,1.14,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
DICYCLOMINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-10,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Aetna,Commerical,,,383.8,,383.8,368.03,422.8,percent of total billed charges,,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Aetna,Middlesex Employees,,,368.03,,368.03,368.03,422.8,percent of total billed charges,,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Anthem,Commerical,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Anthem,Indemnity,,,372.61,,372.61,368.03,422.8,percent of total billed charges,,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Anthem,Individual Exchange,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Anthem,State Preferred,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Cigna,Cigna,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Connecticare,Commerical,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Connecticare,Exchange,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,Multiplan,Multiplan,,,422.8,,422.8,368.03,422.8,percent of total billed charges,,
DIFLUPREDNATE 0.05 % EYE DROPS,J3490,HCPCS,69238-1380-3,NDC,both,1,mL,497.41,298.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,368.03,422.8,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.75,0.87,percent of total billed charges,,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.87,percent of total billed charges,,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Anthem,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.87,percent of total billed charges,,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Cigna,Cigna,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Connecticare,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Connecticare,Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.75,0.87,percent of total billed charges,,
DIGOXIN 125 MCG (0.125 MG) TABLET,J3490,HCPCS,40810-0006-92,NDC,both,1,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,0143-1240-01,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
DIGOXIN 125 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,70954-201-10,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Aetna,Commerical,,,42.68,,42.68,8.1,47.02,percent of total billed charges,,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Aetna,Middlesex Employees,,,40.93,,40.93,8.1,47.02,percent of total billed charges,,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Anthem,Commerical,,,,,,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Anthem,Indemnity,,,41.44,,41.44,8.1,47.02,percent of total billed charges,,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Anthem,Individual Exchange,,,,,,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Anthem,State Preferred,,,,,,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Cigna,Cigna,,8.1,,,8.1,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Connecticare,Commerical,,24,,,24,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Connecticare,Exchange,,24,,,24,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,Multiplan,Multiplan,,,47.02,,47.02,8.1,47.02,percent of total billed charges,,
DIGOXIN 2.5 MCG/ML IN D5W NICU,J1160,HCPCS,40810-0205-94,NDC,both,200,mL,55.32,33.19,United Healthcare/Oxford,United Healthcare/Oxford,,8.75,,,8.75,8.1,47.02,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Commerical,,,3.99,,3.99,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Middlesex Employees,,,3.83,,3.83,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Indemnity,,,3.87,,3.87,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Individual Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,State Preferred,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Cigna,Cigna,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Multiplan,Multiplan,,,4.39,,4.39,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG (0.25 MG) TABLET,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Commerical,,,3.99,,3.99,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Middlesex Employees,,,3.83,,3.83,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Indemnity,,,3.87,,3.87,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Individual Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,State Preferred,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Cigna,Cigna,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Multiplan,Multiplan,,,4.39,,4.39,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB DIGITALIZING,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Commerical,,,3.99,,3.99,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Aetna,Middlesex Employees,,,3.83,,3.83,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Indemnity,,,3.87,,3.87,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,Individual Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Anthem,State Preferred,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Cigna,Cigna,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Commerical,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Connecticare,Exchange,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,Multiplan,Multiplan,,,4.39,,4.39,3.83,4.39,percent of total billed charges,,
DIGOXIN 250 MCG ORAL TAB MAINTENANCE,J3490,HCPCS,42292-002-01,NDC,both,1,ea,5.17,3.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.83,4.39,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Aetna,Commerical,,,15.84,,15.84,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Aetna,Middlesex Employees,,,15.19,,15.19,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Anthem,Commerical,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Anthem,Indemnity,,,15.38,,15.38,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Anthem,Individual Exchange,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Anthem,State Preferred,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Cigna,Cigna,,8.1,,,8.1,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Connecticare,Commerical,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Connecticare,Exchange,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,Multiplan,Multiplan,,,17.45,,17.45,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-31,NDC,both,2,mL,20.53,12.32,United Healthcare/Oxford,United Healthcare/Oxford,,8.75,,,8.75,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Aetna,Commerical,,,15.84,,15.84,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Aetna,Middlesex Employees,,,15.19,,15.19,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Anthem,Commerical,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Anthem,Indemnity,,,15.38,,15.38,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Anthem,Individual Exchange,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Anthem,State Preferred,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Cigna,Cigna,,8.1,,,8.1,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Connecticare,Commerical,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Connecticare,Exchange,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,Multiplan,Multiplan,,,17.45,,17.45,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0641-1410-35,NDC,both,2,mL,20.53,12.32,United Healthcare/Oxford,United Healthcare/Oxford,,8.75,,,8.75,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Aetna,Commerical,,,15.84,,15.84,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Aetna,Middlesex Employees,,,15.19,,15.19,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Anthem,Commerical,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Anthem,Indemnity,,,15.38,,15.38,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Anthem,Individual Exchange,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Anthem,State Preferred,,,,,,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Cigna,Cigna,,8.1,,,8.1,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Connecticare,Commerical,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Connecticare,Exchange,,24,,,24,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,Multiplan,Multiplan,,,17.45,,17.45,8.1,24,percent of total billed charges,,
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,J1160,HCPCS,0781-3059-95,NDC,both,2,mL,20.53,12.32,United Healthcare/Oxford,United Healthcare/Oxford,,8.75,,,8.75,8.1,24,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Aetna,Commerical,,,37.59,,37.59,8.1,41.41,percent of total billed charges,,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Aetna,Middlesex Employees,,,36.05,,36.05,8.1,41.41,percent of total billed charges,,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Anthem,Commerical,,,,,,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Anthem,Indemnity,,,36.5,,36.5,8.1,41.41,percent of total billed charges,,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Anthem,Individual Exchange,,,,,,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Anthem,State Preferred,,,,,,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Cigna,Cigna,,8.1,,,8.1,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Connecticare,Commerical,,24,,,24,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Connecticare,Exchange,,24,,,24,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,Multiplan,Multiplan,,,41.41,,41.41,8.1,41.41,percent of total billed charges,,
DIGOXIN 4 MCG/ML IN D10W NICU,J1160,HCPCS,40810-0004-50,NDC,both,125,mL,48.72,29.23,United Healthcare/Oxford,United Healthcare/Oxford,,8.75,,,8.75,8.1,41.41,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Aetna,Commerical,,,342.22,,342.22,328.16,376.99,percent of total billed charges,,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Aetna,Middlesex Employees,,,328.16,,328.16,328.16,376.99,percent of total billed charges,,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Anthem,Commerical,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Anthem,Indemnity,,,332.24,,332.24,328.16,376.99,percent of total billed charges,,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Anthem,Individual Exchange,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Anthem,State Preferred,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Cigna,Cigna,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Connecticare,Commerical,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Connecticare,Exchange,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,Multiplan,Multiplan,,,376.99,,376.99,328.16,376.99,percent of total billed charges,,
DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,J8499,HCPCS,0054-0057-46,NDC,both,1,mL,443.52,266.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,328.16,376.99,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Aetna,Commerical,,,60.29,,60.29,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Aetna,Middlesex Employees,,,57.82,,57.82,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Anthem,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Anthem,Indemnity,,,58.53,,58.53,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Anthem,Individual Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Anthem,State Preferred,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Cigna,Cigna,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Connecticare,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Connecticare,Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,Multiplan,Multiplan,,,66.42,,66.42,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN DIGITALIZING,J8499,HCPCS,40810-0004-80,NDC,both,1,mL,78.14,46.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Aetna,Commerical,,,60.29,,60.29,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Aetna,Middlesex Employees,,,57.82,,57.82,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Anthem,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Anthem,Indemnity,,,58.53,,58.53,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Anthem,Individual Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Anthem,State Preferred,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Cigna,Cigna,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Connecticare,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Connecticare,Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,Multiplan,Multiplan,,,66.42,,66.42,57.82,66.42,percent of total billed charges,,
DIGOXIN 50 MCG/ML ORAL SOLN MAINTENANCE,J8499,HCPCS,40810-0004-81,NDC,both,1,mL,78.14,46.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Aetna,Commerical,,,13081.44,,13081.44,5398.51,14410.6,percent of total billed charges,,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Aetna,Middlesex Employees,,,12544.01,,12544.01,5398.51,14410.6,percent of total billed charges,,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Anthem,Commerical,,,,,,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Anthem,Indemnity,,,12699.98,,12699.98,5398.51,14410.6,percent of total billed charges,,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Anthem,Individual Exchange,,,,,,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Anthem,State Preferred,,,,,,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Cigna,Cigna,,5398.51,,,5398.51,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Connecticare,Commerical,,7464.04,,,7464.04,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Connecticare,Exchange,,7464.04,,,7464.04,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,Multiplan,Multiplan,,,14410.6,,14410.6,5398.51,14410.6,percent of total billed charges,,
DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,J1162,HCPCS,50633-120-11,NDC,both,1,ea,16953.65,10172.19,United Healthcare/Oxford,United Healthcare/Oxford,,5828.48,,,5828.48,5398.51,14410.6,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Aetna,Commerical,,,137.96,,137.96,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Aetna,Middlesex Employees,,,132.29,,132.29,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Anthem,Commerical,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Anthem,Indemnity,,,133.94,,133.94,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Anthem,Individual Exchange,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Anthem,State Preferred,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Cigna,Cigna,,53.23,,,53.23,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Connecticare,Commerical,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Connecticare,Exchange,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,Multiplan,Multiplan,,,151.98,,151.98,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,0574-0850-05,NDC,both,1,mL,178.8,107.28,United Healthcare/Oxford,United Healthcare/Oxford,,57.47,,,57.47,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Aetna,Commerical,,,137.96,,137.96,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Aetna,Middlesex Employees,,,132.29,,132.29,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Anthem,Commerical,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Anthem,Indemnity,,,133.94,,133.94,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Anthem,Individual Exchange,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Anthem,State Preferred,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Cigna,Cigna,,53.23,,,53.23,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Connecticare,Commerical,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Connecticare,Exchange,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,Multiplan,Multiplan,,,151.98,,151.98,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,61990-0411-2,NDC,both,1,mL,178.8,107.28,United Healthcare/Oxford,United Healthcare/Oxford,,57.47,,,57.47,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Aetna,Commerical,,,137.96,,137.96,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Aetna,Middlesex Employees,,,132.29,,132.29,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Anthem,Commerical,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Anthem,Indemnity,,,133.94,,133.94,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Anthem,Individual Exchange,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Anthem,State Preferred,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Cigna,Cigna,,53.23,,,53.23,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Connecticare,Commerical,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Connecticare,Exchange,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,Multiplan,Multiplan,,,151.98,,151.98,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-00,NDC,both,1,mL,178.8,107.28,United Healthcare/Oxford,United Healthcare/Oxford,,57.47,,,57.47,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Aetna,Commerical,,,137.96,,137.96,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Aetna,Middlesex Employees,,,132.29,,132.29,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Anthem,Commerical,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Anthem,Indemnity,,,133.94,,133.94,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Anthem,Individual Exchange,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Anthem,State Preferred,,,,,,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Cigna,Cigna,,53.23,,,53.23,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Connecticare,Commerical,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Connecticare,Exchange,,73.41,,,73.41,53.23,151.98,Other,Could be inpatient or outpatient,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,Multiplan,Multiplan,,,151.98,,151.98,53.23,151.98,percent of total billed charges,,
DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,J1110,HCPCS,81284-411-10,NDC,both,1,mL,178.8,107.28,United Healthcare/Oxford,United Healthcare/Oxford,,57.47,,,57.47,53.23,151.98,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Aetna,Commerical,,,128.38,,128.38,123.1,141.42,percent of total billed charges,,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Aetna,Middlesex Employees,,,123.1,,123.1,123.1,141.42,percent of total billed charges,,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Anthem,Commerical,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Anthem,Indemnity,,,124.64,,124.64,123.1,141.42,percent of total billed charges,,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Anthem,Individual Exchange,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Anthem,State Preferred,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Cigna,Cigna,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Connecticare,Commerical,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Connecticare,Exchange,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,Multiplan,Multiplan,,,141.42,,141.42,123.1,141.42,percent of total billed charges,,
DILTIAZEM 12 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0018-01,NDC,both,1,mL,166.38,99.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,123.1,141.42,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Aetna,Commerical,,,2.65,,2.65,2.55,2.92,percent of total billed charges,,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.92,percent of total billed charges,,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Anthem,Commerical,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Anthem,Indemnity,,,2.58,,2.58,2.55,2.92,percent of total billed charges,,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Anthem,Individual Exchange,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Anthem,State Preferred,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Cigna,Cigna,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Connecticare,Commerical,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Connecticare,Exchange,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,Multiplan,Multiplan,,,2.92,,2.92,2.55,2.92,percent of total billed charges,,
DILTIAZEM 15 MG TABLET,J3490,HCPCS,40810-0017-99,NDC,both,2,ea,3.44,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.92,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,0093-0318-01,NDC,both,1,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,50228-481-01,NDC,both,1,ea,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-01,NDC,both,1,ea,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,51079-745-20,NDC,both,1,ea,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,60687-717-01,NDC,both,1,ea,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
DILTIAZEM 30 MG TABLET,J3490,HCPCS,63739-079-10,NDC,both,1,ea,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1171-02,NDC,both,1,mL,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6014-01,NDC,both,1,mL,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,17478-937-10,NDC,both,1,mL,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,0093-0319-01,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Aetna,Commerical,,,0.46,,0.46,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Anthem,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Anthem,Indemnity,,,0.45,,0.45,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Anthem,Individual Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Anthem,State Preferred,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Cigna,Cigna,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Connecticare,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Connecticare,Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,Multiplan,Multiplan,,,0.51,,0.51,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-01,NDC,both,1,ea,0.6,0.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Aetna,Commerical,,,0.46,,0.46,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Anthem,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Anthem,Indemnity,,,0.45,,0.45,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Anthem,Individual Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Anthem,State Preferred,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Cigna,Cigna,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Connecticare,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Connecticare,Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,Multiplan,Multiplan,,,0.51,,0.51,0.44,0.51,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,51079-746-20,NDC,both,1,ea,0.6,0.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Aetna,Commerical,,,1.5,,1.5,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Aetna,Middlesex Employees,,,1.44,,1.44,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Anthem,Commerical,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Anthem,Indemnity,,,1.46,,1.46,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Anthem,Individual Exchange,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Anthem,State Preferred,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Cigna,Cigna,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Connecticare,Commerical,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Connecticare,Exchange,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,Multiplan,Multiplan,,,1.66,,1.66,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,60687-728-01,NDC,both,1,ea,1.95,1.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Aetna,Commerical,,,1.5,,1.5,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Aetna,Middlesex Employees,,,1.44,,1.44,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Anthem,Commerical,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Anthem,Indemnity,,,1.46,,1.46,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Anthem,Individual Exchange,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Anthem,State Preferred,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Cigna,Cigna,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Connecticare,Commerical,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Connecticare,Exchange,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,Multiplan,Multiplan,,,1.66,,1.66,1.44,1.66,percent of total billed charges,,
DILTIAZEM 60 MG TABLET,J3490,HCPCS,63739-080-10,NDC,both,1,ea,1.95,1.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.44,1.66,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Aetna,Commerical,,,9.42,,9.42,9.03,10.38,percent of total billed charges,,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Aetna,Middlesex Employees,,,9.03,,9.03,9.03,10.38,percent of total billed charges,,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Anthem,Commerical,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Anthem,Indemnity,,,9.15,,9.15,9.03,10.38,percent of total billed charges,,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Anthem,Individual Exchange,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Anthem,State Preferred,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Cigna,Cigna,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Connecticare,Commerical,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Connecticare,Exchange,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,Multiplan,Multiplan,,,10.38,,10.38,9.03,10.38,percent of total billed charges,,
"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",J3490,HCPCS,51079-924-20,NDC,both,1,ea,12.21,7.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.03,10.38,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Aetna,Commerical,,,34.73,,34.73,33.3,38.26,percent of total billed charges,,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Aetna,Middlesex Employees,,,33.3,,33.3,33.3,38.26,percent of total billed charges,,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Anthem,Commerical,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Anthem,Indemnity,,,33.72,,33.72,33.3,38.26,percent of total billed charges,,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Anthem,Individual Exchange,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Anthem,State Preferred,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Cigna,Cigna,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Connecticare,Commerical,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Connecticare,Exchange,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,Multiplan,Multiplan,,,38.26,,38.26,33.3,38.26,percent of total billed charges,,
DILUENT FOR EPOPROSTENOL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9258-09,NDC,both,1,mL,45.01,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.3,38.26,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,J3490,HCPCS,0781-6021-94,NDC,both,1,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-12,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
DIMENHYDRINATE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-13,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-2051-59,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
DIMENHYDRINATE 50 MG TABLET,J3490,HCPCS,0904-6772-12,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Aetna,Commerical,,,248.32,,248.32,61.64,273.56,percent of total billed charges,,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Aetna,Middlesex Employees,,,238.12,,238.12,61.64,273.56,percent of total billed charges,,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Anthem,Commerical,,,,,,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Anthem,Indemnity,,,241.08,,241.08,61.64,273.56,percent of total billed charges,,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Anthem,Individual Exchange,,,,,,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Anthem,State Preferred,,,,,,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Cigna,Cigna,,61.64,,,61.64,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Connecticare,Commerical,,91.32,,,91.32,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Connecticare,Exchange,,91.32,,,91.32,61.64,273.56,Other,Could be inpatient or outpatient,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,Multiplan,Multiplan,,,273.56,,273.56,61.64,273.56,percent of total billed charges,,
DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION,J0470,HCPCS,17478-526-03,NDC,both,1,mL,321.83,193.1,United Healthcare/Oxford,United Healthcare/Oxford,,72.97,,,72.97,61.64,273.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Aetna,Commerical,,,7.77,,7.77,7.45,8.56,percent of total billed charges,,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Aetna,Middlesex Employees,,,7.45,,7.45,7.45,8.56,percent of total billed charges,,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Anthem,Commerical,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Anthem,Indemnity,,,7.54,,7.54,7.45,8.56,percent of total billed charges,,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Anthem,Individual Exchange,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Anthem,State Preferred,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Cigna,Cigna,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Connecticare,Commerical,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Connecticare,Exchange,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,Multiplan,Multiplan,,,8.56,,8.56,7.45,8.56,percent of total billed charges,,
DIMETHICONE 1.2 %-COLLOIDAL OATMEAL LOTION,J3490,HCPCS,8137003602,NDC,both,1,gm,10.07,6.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Aetna,Commerical,,,7.45,,7.45,7.15,8.21,percent of total billed charges,,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Aetna,Middlesex Employees,,,7.15,,7.15,7.15,8.21,percent of total billed charges,,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Anthem,Commerical,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Anthem,Indemnity,,,7.24,,7.24,7.15,8.21,percent of total billed charges,,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Anthem,Individual Exchange,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Anthem,State Preferred,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Cigna,Cigna,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Connecticare,Commerical,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Connecticare,Exchange,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,Multiplan,Multiplan,,,8.21,,8.21,7.15,8.21,percent of total billed charges,,
DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION,J3490,HCPCS,8137-003602,NDC,both,2.5,UN,9.66,5.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.15,8.21,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Aetna,Commerical,,,1882.63,,1882.63,797.97,2073.92,percent of total billed charges,,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Aetna,Middlesex Employees,,,1805.29,,1805.29,797.97,2073.92,percent of total billed charges,,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Anthem,Commerical,,,,,,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Anthem,Indemnity,,,1827.74,,1827.74,797.97,2073.92,percent of total billed charges,,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Anthem,Individual Exchange,,,,,,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Anthem,State Preferred,,,,,,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Cigna,Cigna,,797.97,,,797.97,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Connecticare,Commerical,,1093.17,,,1093.17,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Connecticare,Exchange,,1093.17,,,1093.17,797.97,2073.92,Other,Could be inpatient or outpatient,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,Multiplan,Multiplan,,,2073.92,,2073.92,797.97,2073.92,percent of total billed charges,,
DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,J1212,HCPCS,67457-177-50,NDC,both,50,mL,2439.91,1463.95,United Healthcare/Oxford,United Healthcare/Oxford,,861.53,,,861.53,797.97,2073.92,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Aetna,Commerical,,,22164.21,,22164.21,21253.63,24416.25,percent of total billed charges,,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Aetna,Middlesex Employees,,,21253.63,,21253.63,21253.63,24416.25,percent of total billed charges,,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Anthem,Commerical,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Anthem,Indemnity,,,21517.9,,21517.9,21253.63,24416.25,percent of total billed charges,,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Anthem,Individual Exchange,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Anthem,State Preferred,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Cigna,Cigna,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Connecticare,Commerical,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Connecticare,Exchange,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,Multiplan,Multiplan,,,24416.25,,24416.25,21253.63,24416.25,percent of total billed charges,,
DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,J1246,HCPCS,66302-014-01,NDC,both,1,mL,28725,17235,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21253.63,24416.25,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Aetna,Commerical,,,383.15,,383.15,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Aetna,Middlesex Employees,,,367.4,,367.4,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Anthem,Commerical,,230.29,,,230.29,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Anthem,Indemnity,,,371.97,,371.97,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Anthem,Individual Exchange,,184.23,,,184.23,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Anthem,State Preferred,,230.29,,,230.29,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Cigna,Cigna,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Connecticare,Commerical,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Connecticare,Exchange,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,Multiplan,Multiplan,,,422.08,,422.08,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-10,NDC,both,0.5,mL,496.56,297.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Aetna,Commerical,,,383.15,,383.15,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Aetna,Middlesex Employees,,,367.4,,367.4,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Anthem,Commerical,,230.29,,,230.29,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Anthem,Indemnity,,,371.97,,371.97,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Anthem,Individual Exchange,,184.23,,,184.23,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Anthem,State Preferred,,230.29,,,230.29,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Cigna,Cigna,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Connecticare,Commerical,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Connecticare,Exchange,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,Multiplan,Multiplan,,,422.08,,422.08,184.23,422.08,percent of total billed charges,,
"DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SUSP",90697,HCPCS,63361-243-58,NDC,both,0.5,mL,496.56,297.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,184.23,422.08,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Aetna,Commerical,,,56.71,,56.71,35.17,62.48,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Aetna,Middlesex Employees,,,54.38,,54.38,35.17,62.48,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Anthem,Commerical,,43.97,,,43.97,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Anthem,Indemnity,,,55.06,,55.06,35.17,62.48,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Anthem,Individual Exchange,,35.17,,,35.17,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Anthem,State Preferred,,43.97,,,43.97,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Cigna,Cigna,,,,,,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Connecticare,Commerical,,,,,,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Connecticare,Exchange,,,,,,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,Multiplan,Multiplan,,,62.48,,62.48,35.17,62.48,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-43,NDC,both,0.5,mL,73.5,44.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.17,62.48,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Aetna,Commerical,,,5.94,,5.94,5.7,43.97,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Aetna,Middlesex Employees,,,5.7,,5.7,5.7,43.97,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Anthem,Commerical,,43.97,,,43.97,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Anthem,Indemnity,,,5.77,,5.77,5.7,43.97,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Anthem,Individual Exchange,,35.17,,,35.17,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Anthem,State Preferred,,43.97,,,43.97,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Cigna,Cigna,,,,,,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Connecticare,Commerical,,,,,,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Connecticare,Exchange,,,,,,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,Multiplan,Multiplan,,,6.55,,6.55,5.7,43.97,percent of total billed charges,,
"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",90700,HCPCS,58160-810-52,NDC,both,0.5,mL,7.7,4.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.7,43.97,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Aetna,Commerical,,,95.61,,95.61,91.68,105.32,percent of total billed charges,,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Aetna,Middlesex Employees,,,91.68,,91.68,91.68,105.32,percent of total billed charges,,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Anthem,Commerical,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Anthem,Indemnity,,,92.82,,92.82,91.68,105.32,percent of total billed charges,,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Anthem,Individual Exchange,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Anthem,State Preferred,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Cigna,Cigna,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Connecticare,Commerical,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Connecticare,Exchange,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,Multiplan,Multiplan,,,105.32,,105.32,91.68,105.32,percent of total billed charges,,
"DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH",J3490,HCPCS,65628-050-01,NDC,both,1,mL,123.91,74.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.68,105.32,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Aetna,Commerical,,,10.79,,10.79,10.34,11.88,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Aetna,Middlesex Employees,,,10.34,,10.34,10.34,11.88,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Anthem,Commerical,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Anthem,Indemnity,,,10.47,,10.47,10.34,11.88,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Anthem,Individual Exchange,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Anthem,State Preferred,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Cigna,Cigna,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Connecticare,Commerical,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Connecticare,Exchange,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,Multiplan,Multiplan,,,11.88,,11.88,10.34,11.88,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,A9150,HCPCS,0121-0489-05,NDC,both,5,mL,13.98,8.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-00,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0121-0865-05,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-41,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,0904-7323-70,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-05,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,57237-317-51,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-40,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,60687-829-86,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,68094-022-59,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,A9150,HCPCS,69339-151-05,NDC,both,20,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0536-1010-01,NDC,both,2,ea,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-60,NDC,both,2,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-5306-61,NDC,both,2,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,0904-7237-61,NDC,both,2,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
DIPHENHYDRAMINE 25 MG CAPSULE,A9150,HCPCS,70000-0207-1,NDC,both,2,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-00,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,63323-664-01,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-01,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,J1200,HCPCS,72485-101-25,NDC,both,1,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J1200,HCPCS,63323-664-00,NDC,both,1,mL,40.2,24.12,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-21,NDC,both,1,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,0641-0376-25,NDC,both,1,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Aetna,Commerical,,,1.51,,1.51,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Aetna,Middlesex Employees,,,1.45,,1.45,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Anthem,Commerical,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Anthem,Indemnity,,,1.47,,1.47,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Cigna,Cigna,,1.03,,,1.03,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Connecticare,Commerical,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Connecticare,Exchange,,1.14,,,1.14,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,Multiplan,Multiplan,,,1.67,,1.67,1.03,1.67,percent of total billed charges,,
DIPHENHYDRAMINE IV PRN,J1200,HCPCS,63323-664-01,NDC,both,1,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.11,,,1.11,1.03,1.67,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Aetna,Commerical,,,4.98,,4.98,4.77,5.48,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Aetna,Middlesex Employees,,,4.77,,4.77,4.77,5.48,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Anthem,Commerical,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Anthem,Indemnity,,,4.83,,4.83,4.77,5.48,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Anthem,Individual Exchange,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Anthem,State Preferred,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Cigna,Cigna,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Connecticare,Commerical,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Connecticare,Exchange,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,Multiplan,Multiplan,,,5.48,,5.48,4.77,5.48,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,1254717167,NDC,both,1,gm,6.45,3.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.77,5.48,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Aetna,Commerical,,,4.8,,4.8,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Aetna,Middlesex Employees,,,4.6,,4.6,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Anthem,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Anthem,Indemnity,,,4.66,,4.66,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Anthem,Individual Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Anthem,State Preferred,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Cigna,Cigna,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Connecticare,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Connecticare,Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,Multiplan,Multiplan,,,5.29,,5.29,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,0904-5354-31,NDC,both,1,gm,6.22,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Aetna,Commerical,,,4.8,,4.8,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Aetna,Middlesex Employees,,,4.6,,4.6,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Anthem,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Anthem,Indemnity,,,4.66,,4.66,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Anthem,Individual Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Anthem,State Preferred,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Cigna,Cigna,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Connecticare,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Connecticare,Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,Multiplan,Multiplan,,,5.29,,5.29,4.6,5.29,percent of total billed charges,,
DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,J3490,HCPCS,45802-358-03,NDC,both,28,gm,6.22,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Aetna,Commerical,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Anthem,Indemnity,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0025-0061-31,NDC,both,1,ea,0.36,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Aetna,Commerical,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Anthem,Indemnity,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,J3490,HCPCS,0378-0415-01,NDC,both,1,ea,0.36,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Aetna,Commerical,,,23.23,,23.23,22.28,25.59,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Aetna,Middlesex Employees,,,22.28,,22.28,22.28,25.59,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Anthem,Commerical,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Anthem,Indemnity,,,22.56,,22.56,22.28,25.59,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Anthem,Individual Exchange,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Anthem,State Preferred,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Cigna,Cigna,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Connecticare,Commerical,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Connecticare,Exchange,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,Multiplan,Multiplan,,,25.59,,25.59,22.28,25.59,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,0054-3194-46,NDC,both,1,mL,30.11,18.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,1.86,2.13,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,1.86,2.13,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Anthem,Commerical,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,1.86,2.13,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Anthem,State Preferred,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Cigna,Cigna,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Connecticare,Commerical,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Connecticare,Exchange,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,1.86,2.13,percent of total billed charges,,
DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,J3490,HCPCS,40810-0205-57,NDC,both,1,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Aetna,Commerical,,,131.15,,131.15,47.04,144.47,percent of total billed charges,,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Aetna,Middlesex Employees,,,125.76,,125.76,47.04,144.47,percent of total billed charges,,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Anthem,Commerical,,58.8,,,58.8,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Anthem,Indemnity,,,127.32,,127.32,47.04,144.47,percent of total billed charges,,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Anthem,Individual Exchange,,47.04,,,47.04,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Anthem,State Preferred,,58.8,,,58.8,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Cigna,Cigna,,,,,,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Connecticare,Commerical,,,,,,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Connecticare,Exchange,,,,,,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,Multiplan,Multiplan,,,144.47,,144.47,47.04,144.47,percent of total billed charges,,
"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",90715,HCPCS,49281-400-10,NDC,both,0.5,mL,169.97,101.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.04,144.47,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Aetna,Commerical,,,104.32,,104.32,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Aetna,Middlesex Employees,,,100.03,,100.03,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Anthem,Commerical,,58.8,,,58.8,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Anthem,Indemnity,,,101.28,,101.28,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Anthem,Individual Exchange,,47.04,,,47.04,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Anthem,State Preferred,,58.8,,,58.8,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Cigna,Cigna,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Connecticare,Commerical,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Connecticare,Exchange,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,Multiplan,Multiplan,,,114.92,,114.92,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-43,NDC,both,0.5,mL,135.2,81.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Aetna,Commerical,,,108.54,,108.54,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Aetna,Middlesex Employees,,,104.08,,104.08,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Anthem,Commerical,,58.8,,,58.8,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Anthem,Indemnity,,,105.38,,105.38,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Anthem,Individual Exchange,,47.04,,,47.04,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Anthem,State Preferred,,58.8,,,58.8,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Cigna,Cigna,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Connecticare,Commerical,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Connecticare,Exchange,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,Multiplan,Multiplan,,,119.57,,119.57,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",90715,HCPCS,58160-842-52,NDC,both,0.5,mL,140.67,84.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Aetna,Commerical,,,104.32,,104.32,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Aetna,Middlesex Employees,,,100.03,,100.03,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Anthem,Commerical,,58.8,,,58.8,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Anthem,Indemnity,,,101.28,,101.28,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Anthem,Individual Exchange,,47.04,,,47.04,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Anthem,State Preferred,,58.8,,,58.8,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Cigna,Cigna,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Connecticare,Commerical,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Connecticare,Exchange,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,Multiplan,Multiplan,,,114.92,,114.92,47.04,114.92,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-01,NDC,both,0.5,mL,135.2,81.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.04,114.92,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Aetna,Commerical,,,108.54,,108.54,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Aetna,Middlesex Employees,,,104.08,,104.08,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Anthem,Commerical,,58.8,,,58.8,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Anthem,Indemnity,,,105.38,,105.38,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Anthem,Individual Exchange,,47.04,,,47.04,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Anthem,State Preferred,,58.8,,,58.8,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Cigna,Cigna,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Connecticare,Commerical,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Connecticare,Exchange,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,Multiplan,Multiplan,,,119.57,,119.57,47.04,119.57,percent of total billed charges,,
"DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP",90715,HCPCS,58160-842-11,NDC,both,0.5,mL,140.67,84.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.04,119.57,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Aetna,Commerical,,,16.32,,16.32,15.65,17.98,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Aetna,Middlesex Employees,,,15.65,,15.65,15.65,17.98,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Anthem,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Anthem,Indemnity,,,15.84,,15.84,15.65,17.98,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Anthem,Individual Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Anthem,State Preferred,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Cigna,Cigna,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Connecticare,Commerical,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Connecticare,Exchange,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,Multiplan,Multiplan,,,17.98,,17.98,15.65,17.98,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-14,NDC,both,1,mL,21.15,12.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.65,17.98,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Aetna,Commerical,,,32.63,,32.63,31.29,35.95,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Aetna,Middlesex Employees,,,31.29,,31.29,31.29,35.95,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Anthem,Commerical,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Anthem,Indemnity,,,31.68,,31.68,31.29,35.95,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Anthem,Individual Exchange,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Anthem,State Preferred,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Cigna,Cigna,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Connecticare,Commerical,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Connecticare,Exchange,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,Multiplan,Multiplan,,,35.95,,35.95,31.29,35.95,percent of total billed charges,,
DIPYRIDAMOLE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-55,NDC,both,1,mL,42.29,25.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.29,35.95,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Aetna,Commerical,,,3.37,,3.37,3.23,3.71,percent of total billed charges,,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Aetna,Middlesex Employees,,,3.23,,3.23,3.23,3.71,percent of total billed charges,,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Anthem,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Anthem,Indemnity,,,3.27,,3.27,3.23,3.71,percent of total billed charges,,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Anthem,Individual Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Anthem,State Preferred,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Cigna,Cigna,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Connecticare,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Connecticare,Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,Multiplan,Multiplan,,,3.71,,3.71,3.23,3.71,percent of total billed charges,,
DIPYRIDAMOLE 25 MG TABLET,J3490,HCPCS,64980-133-01,NDC,both,1,ea,4.37,2.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Aetna,Commerical,,,284.3,,284.3,272.62,313.18,percent of total billed charges,,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Aetna,Middlesex Employees,,,272.62,,272.62,272.62,313.18,percent of total billed charges,,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Anthem,Commerical,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Anthem,Indemnity,,,276.01,,276.01,272.62,313.18,percent of total billed charges,,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Anthem,Individual Exchange,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Anthem,State Preferred,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Cigna,Cigna,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Connecticare,Commerical,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Connecticare,Exchange,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,Multiplan,Multiplan,,,313.18,,313.18,272.62,313.18,percent of total billed charges,,
DISOPYRAMIDE 10MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0207-59,NDC,both,1,mL,368.45,221.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,272.62,313.18,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Aetna,Commerical,,,3.43,,3.43,3.29,3.77,percent of total billed charges,,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Aetna,Middlesex Employees,,,3.29,,3.29,3.29,3.77,percent of total billed charges,,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Anthem,Commerical,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Anthem,Indemnity,,,3.33,,3.33,3.29,3.77,percent of total billed charges,,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Anthem,Individual Exchange,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Anthem,State Preferred,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Cigna,Cigna,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Connecticare,Commerical,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Connecticare,Exchange,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,Multiplan,Multiplan,,,3.77,,3.77,3.29,3.77,percent of total billed charges,,
DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,J3490,HCPCS,51862-095-01,NDC,both,1,ea,4.44,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.29,3.77,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Aetna,Commerical,,,4.77,,4.77,4.57,5.25,percent of total billed charges,,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Aetna,Middlesex Employees,,,4.57,,4.57,4.57,5.25,percent of total billed charges,,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Anthem,Commerical,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Anthem,Indemnity,,,4.63,,4.63,4.57,5.25,percent of total billed charges,,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Anthem,Individual Exchange,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Anthem,State Preferred,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Cigna,Cigna,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Connecticare,Commerical,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Connecticare,Exchange,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,Multiplan,Multiplan,,,5.25,,5.25,4.57,5.25,percent of total billed charges,,
DISULFIRAM 125 MG TABLET CHEMO,J3490,HCPCS,40810-0202-04,NDC,both,1,ea,6.18,3.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.57,5.25,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Aetna,Commerical,,,8.36,,8.36,8.02,9.21,percent of total billed charges,,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Aetna,Middlesex Employees,,,8.02,,8.02,8.02,9.21,percent of total billed charges,,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Anthem,Commerical,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Anthem,Indemnity,,,8.12,,8.12,8.02,9.21,percent of total billed charges,,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Anthem,Individual Exchange,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Anthem,State Preferred,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Cigna,Cigna,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Connecticare,Commerical,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Connecticare,Exchange,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,Multiplan,Multiplan,,,9.21,,9.21,8.02,9.21,percent of total billed charges,,
DISULFIRAM 250 MG TABLET CHEMO,J3490,HCPCS,40810-0202-05,NDC,both,1,ea,10.84,6.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.02,9.21,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Aetna,Commerical,,,2.04,,2.04,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Anthem,Indemnity,,,1.98,,1.98,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,0904-6615-61,NDC,both,1,ea,2.64,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Aetna,Commerical,,,2.04,,2.04,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Aetna,Middlesex Employees,,,1.95,,1.95,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Anthem,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Anthem,Indemnity,,,1.98,,1.98,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Anthem,Individual Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Anthem,State Preferred,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Cigna,Cigna,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Connecticare,Commerical,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Connecticare,Exchange,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,Multiplan,Multiplan,,,2.24,,2.24,1.95,2.24,percent of total billed charges,,
"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",J3490,HCPCS,68084-313-01,NDC,both,1,ea,2.64,1.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.95,2.24,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-796-88,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6860-61,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-797-88,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0074-6215-13,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0832-7124-01,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0904-6861-61,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,57237-048-01,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",J3490,HCPCS,62756-798-88,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Aetna,Commerical,,,2.58,,2.58,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Aetna,Middlesex Employees,,,2.47,,2.47,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Anthem,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Anthem,Indemnity,,,2.5,,2.5,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Anthem,Individual Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Anthem,State Preferred,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Cigna,Cigna,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Connecticare,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Connecticare,Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,Multiplan,Multiplan,,,2.84,,2.84,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6363-61,NDC,both,1,ea,3.34,2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Aetna,Commerical,,,2.58,,2.58,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Aetna,Middlesex Employees,,,2.47,,2.47,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Anthem,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Anthem,Indemnity,,,2.5,,2.5,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Anthem,Individual Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Anthem,State Preferred,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Cigna,Cigna,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Connecticare,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Connecticare,Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,Multiplan,Multiplan,,,2.84,,2.84,2.47,2.84,percent of total billed charges,,
"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-310-01,NDC,both,1,ea,3.34,2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6364-45,NDC,both,1,ea,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-11,NDC,both,1,ea,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-260-13,NDC,both,1,ea,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Aetna,Commerical,,,13.77,,13.77,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Aetna,Middlesex Employees,,,13.21,,13.21,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Anthem,Commerical,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Anthem,Indemnity,,,13.37,,13.37,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Anthem,Individual Exchange,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Anthem,State Preferred,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Cigna,Cigna,,8.57,,,8.57,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Connecticare,Commerical,,12.11,,,12.11,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Connecticare,Exchange,,12.11,,,12.11,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,Multiplan,Multiplan,,,15.17,,15.17,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-01,NDC,both,1,mL,17.85,10.71,United Healthcare/Oxford,United Healthcare/Oxford,,9.25,,,9.25,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Aetna,Commerical,,,13.77,,13.77,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Aetna,Middlesex Employees,,,13.21,,13.21,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Anthem,Commerical,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Anthem,Indemnity,,,13.37,,13.37,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Anthem,Individual Exchange,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Anthem,State Preferred,,,,,,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Cigna,Cigna,,8.57,,,8.57,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Connecticare,Commerical,,12.11,,,12.11,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Connecticare,Exchange,,12.11,,,12.11,8.57,15.17,Other,Could be inpatient or outpatient,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,Multiplan,Multiplan,,,15.17,,15.17,8.57,15.17,percent of total billed charges,,
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,J1250,HCPCS,0409-2344-02,NDC,both,1,mL,17.85,10.71,United Healthcare/Oxford,United Healthcare/Oxford,,9.25,,,9.25,8.57,15.17,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Aetna,Commerical,,,104.17,,104.17,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Aetna,Middlesex Employees,,,99.89,,99.89,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Anthem,Commerical,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Anthem,Indemnity,,,101.14,,101.14,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Anthem,Individual Exchange,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Anthem,State Preferred,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Cigna,Cigna,,8.57,,,8.57,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Connecticare,Commerical,,12.11,,,12.11,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Connecticare,Exchange,,12.11,,,12.11,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,Multiplan,Multiplan,,,114.76,,114.76,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0338-1075-02,NDC,both,250,mL,135.01,81.01,United Healthcare/Oxford,United Healthcare/Oxford,,9.25,,,9.25,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Aetna,Commerical,,,104.17,,104.17,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Aetna,Middlesex Employees,,,99.89,,99.89,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Anthem,Commerical,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Anthem,Indemnity,,,101.14,,101.14,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Anthem,Individual Exchange,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Anthem,State Preferred,,,,,,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Cigna,Cigna,,8.57,,,8.57,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Connecticare,Commerical,,12.11,,,12.11,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Connecticare,Exchange,,12.11,,,12.11,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,Multiplan,Multiplan,,,114.76,,114.76,8.57,114.76,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-31,NDC,both,125,mL,135.01,81.01,United Healthcare/Oxford,United Healthcare/Oxford,,9.25,,,9.25,8.57,114.76,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,8.57,42.32,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,8.57,42.32,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Anthem,Commerical,,,,,,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,8.57,42.32,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Anthem,State Preferred,,,,,,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Cigna,Cigna,,8.57,,,8.57,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Connecticare,Commerical,,12.11,,,12.11,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Connecticare,Exchange,,12.11,,,12.11,8.57,42.32,Other,Could be inpatient or outpatient,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,8.57,42.32,percent of total billed charges,,
"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",J1250,HCPCS,0409-2347-32,NDC,both,125,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,9.25,,,9.25,8.57,42.32,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Aetna,Commerical,,,35.32,,35.32,1.05,38.9,percent of total billed charges,,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Aetna,Middlesex Employees,,,33.87,,33.87,1.05,38.9,percent of total billed charges,,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Anthem,Commerical,,,,,,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Anthem,Indemnity,,,34.29,,34.29,1.05,38.9,percent of total billed charges,,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Anthem,Individual Exchange,,,,,,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Anthem,State Preferred,,,,,,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Cigna,Cigna,,1.17,,,1.17,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Connecticare,Commerical,,1.21,,,1.21,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Connecticare,Exchange,,1.21,,,1.21,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,Multiplan,Multiplan,,,38.9,,38.9,1.05,38.9,percent of total billed charges,,
DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-02,NDC,both,0.1,mL,45.77,27.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.05,,,1.05,1.05,38.9,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Aetna,Commerical,,,142.56,,142.56,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Aetna,Middlesex Employees,,,136.7,,136.7,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Anthem,Commerical,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Anthem,Indemnity,,,138.4,,138.4,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Anthem,Individual Exchange,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Anthem,State Preferred,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Cigna,Cigna,,1.17,,,1.17,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Connecticare,Commerical,,1.21,,,1.21,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Connecticare,Exchange,,1.21,,,1.21,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,Multiplan,Multiplan,,,157.05,,157.05,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,0409-0201-10,NDC,both,0.1,mL,184.76,110.86,United Healthcare/Oxford,United Healthcare/Oxford,,1.05,,,1.05,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Aetna,Commerical,,,3738.8,,3738.8,1.05,4118.68,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Aetna,Middlesex Employees,,,3585.19,,3585.19,1.05,4118.68,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Anthem,Commerical,,,,,,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Anthem,Indemnity,,,3629.77,,3629.77,1.05,4118.68,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Anthem,Individual Exchange,,,,,,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Anthem,State Preferred,,,,,,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Cigna,Cigna,,1.17,,,1.17,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Connecticare,Commerical,,1.21,,,1.21,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Connecticare,Exchange,,1.21,,,1.21,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,Multiplan,Multiplan,,,4118.68,,4118.68,1.05,4118.68,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,66758-050-02,NDC,both,0.1,mL,4845.51,2907.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.05,,,1.05,1.05,4118.68,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Aetna,Commerical,,,142.56,,142.56,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Aetna,Middlesex Employees,,,136.7,,136.7,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Anthem,Commerical,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Anthem,Indemnity,,,138.4,,138.4,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Anthem,Individual Exchange,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Anthem,State Preferred,,,,,,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Cigna,Cigna,,1.17,,,1.17,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Connecticare,Commerical,,1.21,,,1.21,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Connecticare,Exchange,,1.21,,,1.21,1.05,157.05,Other,Could be inpatient or outpatient,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,Multiplan,Multiplan,,,157.05,,157.05,1.05,157.05,percent of total billed charges,,
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,J9171,HCPCS,67457-532-08,NDC,both,0.1,mL,184.76,110.86,United Healthcare/Oxford,United Healthcare/Oxford,,1.05,,,1.05,1.05,157.05,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,0904-6997-60,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
DOCUSATE CALCIUM 240 MG CAPSULE,J3490,HCPCS,40810-0209-44,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Aetna,Commerical,,,26.57,,26.57,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Aetna,Middlesex Employees,,,25.47,,25.47,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Indemnity,,,25.79,,25.79,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Individual Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,State Preferred,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Cigna,Cigna,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Connecticare,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Connecticare,Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Multiplan,Multiplan,,,29.27,,29.27,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,State Preferred,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Cigna,Cigna,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Aetna,Commerical,,,143.98,,143.98,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Aetna,Middlesex Employees,,,138.07,,138.07,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Indemnity,,,139.78,,139.78,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Individual Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,State Preferred,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Cigna,Cigna,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Connecticare,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Connecticare,Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Multiplan,Multiplan,,,158.61,,158.61,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 10 MG/ML OTIC,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6455-61,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-6998-60,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7115-61,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7183-61,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,0904-7280-60,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,45802-486-78,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-01,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
DOCUSATE SODIUM 100 MG CAPSULE,J3490,HCPCS,60687-129-11,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,6761811128,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
DOCUSATE SODIUM 50 MG CAPSULE,J3490,HCPCS,40810-0011-29,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Aetna,Commerical,,,143.98,,143.98,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Aetna,Middlesex Employees,,,138.07,,138.07,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Anthem,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Anthem,Indemnity,,,139.78,,139.78,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Anthem,Individual Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Anthem,State Preferred,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Cigna,Cigna,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Connecticare,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Connecticare,Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,Multiplan,Multiplan,,,158.61,,158.61,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-0935-16,NDC,both,1,mL,186.6,111.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-00,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0121-1870-10,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-66,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-7279-72,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-10,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Aetna,Commerical,,,3.05,,3.05,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Anthem,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Anthem,Indemnity,,,2.96,,2.96,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Anthem,Individual Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Anthem,State Preferred,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Cigna,Cigna,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Connecticare,Commerical,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Connecticare,Exchange,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,Multiplan,Multiplan,,,3.36,,3.36,2.92,3.36,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-349-11,NDC,both,1,mL,3.95,2.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.36,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,State Preferred,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Cigna,Cigna,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Aetna,Commerical,,,143.98,,143.98,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Aetna,Middlesex Employees,,,138.07,,138.07,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Anthem,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Anthem,Indemnity,,,139.78,,139.78,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Anthem,Individual Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Anthem,State Preferred,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Cigna,Cigna,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Connecticare,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Connecticare,Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,Multiplan,Multiplan,,,158.61,,158.61,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,186.6,111.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Aetna,Commerical,,,143.98,,143.98,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Aetna,Middlesex Employees,,,138.07,,138.07,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Anthem,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Anthem,Indemnity,,,139.78,,139.78,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Anthem,Individual Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Anthem,State Preferred,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Cigna,Cigna,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Connecticare,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Connecticare,Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,Multiplan,Multiplan,,,158.61,,158.61,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0039-6,NDC,both,1,mL,186.6,111.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Aetna,Commerical,,,26.57,,26.57,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Aetna,Middlesex Employees,,,25.47,,25.47,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Indemnity,,,25.79,,25.79,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,Individual Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Anthem,State Preferred,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Cigna,Cigna,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Connecticare,Commerical,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Connecticare,Exchange,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,Multiplan,Multiplan,,,29.27,,29.27,25.47,29.27,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,0536-1304-85,NDC,both,1,mL,34.43,20.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.47,29.27,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Aetna,Commerical,,,1.22,,1.22,1.17,1.34,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Aetna,Middlesex Employees,,,1.17,,1.17,1.17,1.34,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Anthem,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Anthem,Indemnity,,,1.18,,1.18,1.17,1.34,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Anthem,Individual Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Anthem,State Preferred,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Cigna,Cigna,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Connecticare,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Connecticare,Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,Multiplan,Multiplan,,,1.34,,1.34,1.17,1.34,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-11,NDC,both,1,mL,1.58,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Commerical,,,6.99,,6.99,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Aetna,Middlesex Employees,,,6.7,,6.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Indemnity,,,6.79,,6.79,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,Individual Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Anthem,State Preferred,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Cigna,Cigna,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Commerical,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Connecticare,Exchange,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,Multiplan,Multiplan,,,7.7,,7.7,6.7,7.7,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,50383-771-16,NDC,both,1,mL,9.06,5.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.7,7.7,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Aetna,Commerical,,,143.98,,143.98,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Aetna,Middlesex Employees,,,138.07,,138.07,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Indemnity,,,139.78,,139.78,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,Individual Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Anthem,State Preferred,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Cigna,Cigna,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Connecticare,Commerical,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Connecticare,Exchange,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,Multiplan,Multiplan,,,158.61,,158.61,138.07,158.61,percent of total billed charges,,
DOCUSATE SODIUM 50 MG/5 ML RECTAL LIQUID,J3490,HCPCS,57896-403-16,NDC,both,1,mL,34.43,20.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.07,158.61,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,0069-5800-60,NDC,both,1,ea,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
DOFETILIDE 125 MCG CAPSULE,J3490,HCPCS,72205-039-60,NDC,both,1,ea,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Aetna,Commerical,,,193.19,,193.19,185.25,212.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Aetna,Middlesex Employees,,,185.25,,185.25,185.25,212.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Anthem,Commerical,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Anthem,Indemnity,,,187.55,,187.55,185.25,212.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Anthem,Individual Exchange,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Anthem,State Preferred,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Cigna,Cigna,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Connecticare,Commerical,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Connecticare,Exchange,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,Multiplan,Multiplan,,,212.81,,212.81,185.25,212.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,40810-0207-71,NDC,both,1,ea,250.37,150.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,185.25,212.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Aetna,Commerical,,,121.47,,121.47,116.48,133.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Aetna,Middlesex Employees,,,116.48,,116.48,116.48,133.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Anthem,Commerical,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Anthem,Indemnity,,,117.92,,117.92,116.48,133.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Anthem,Individual Exchange,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Anthem,State Preferred,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Cigna,Cigna,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Connecticare,Commerical,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Connecticare,Exchange,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,Multiplan,Multiplan,,,133.81,,133.81,116.48,133.81,percent of total billed charges,,
DOLUTEGRAVIR 50 MG TABLET,J3490,HCPCS,49702-228-13,NDC,both,1,ea,157.42,94.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,116.48,133.81,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Aetna,Commerical,,,31.77,,31.77,0.89,35,percent of total billed charges,,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Aetna,Middlesex Employees,,,30.47,,30.47,0.89,35,percent of total billed charges,,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Anthem,Commerical,,,,,,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Anthem,Indemnity,,,30.85,,30.85,0.89,35,percent of total billed charges,,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Anthem,Individual Exchange,,,,,,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Anthem,State Preferred,,,,,,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Cigna,Cigna,,0.89,,,0.89,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Connecticare,Commerical,,1.1,,,1.1,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Connecticare,Exchange,,1.1,,,1.1,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,Multiplan,Multiplan,,,35,,35,0.89,35,percent of total billed charges,,
DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,J1265,HCPCS,0338-1005-02,NDC,both,50,mL,41.18,24.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,35,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Aetna,Commerical,,,7.78,,7.78,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Aetna,Middlesex Employees,,,7.46,,7.46,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Anthem,Commerical,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Anthem,Indemnity,,,7.55,,7.55,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Anthem,Individual Exchange,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Anthem,State Preferred,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Cigna,Cigna,,0.89,,,0.89,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Connecticare,Commerical,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Connecticare,Exchange,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,Multiplan,Multiplan,,,8.57,,8.57,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-01,NDC,both,1,mL,10.08,6.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Aetna,Commerical,,,7.78,,7.78,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Aetna,Middlesex Employees,,,7.46,,7.46,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Anthem,Commerical,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Anthem,Indemnity,,,7.55,,7.55,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Anthem,Individual Exchange,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Anthem,State Preferred,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Cigna,Cigna,,0.89,,,0.89,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Connecticare,Commerical,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Connecticare,Exchange,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,Multiplan,Multiplan,,,8.57,,8.57,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0143-9252-25,NDC,both,1,mL,10.08,6.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Aetna,Commerical,,,7.78,,7.78,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Aetna,Middlesex Employees,,,7.46,,7.46,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Anthem,Commerical,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Anthem,Indemnity,,,7.55,,7.55,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Anthem,Individual Exchange,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Anthem,State Preferred,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Cigna,Cigna,,0.89,,,0.89,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Connecticare,Commerical,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Connecticare,Exchange,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,Multiplan,Multiplan,,,8.57,,8.57,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-01,NDC,both,1,mL,10.08,6.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Aetna,Commerical,,,7.78,,7.78,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Aetna,Middlesex Employees,,,7.46,,7.46,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Anthem,Commerical,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Anthem,Indemnity,,,7.55,,7.55,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Anthem,Individual Exchange,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Anthem,State Preferred,,,,,,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Cigna,Cigna,,0.89,,,0.89,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Connecticare,Commerical,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Connecticare,Exchange,,1.1,,,1.1,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,Multiplan,Multiplan,,,8.57,,8.57,0.89,8.57,percent of total billed charges,,
DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-5820-11,NDC,both,1,mL,10.08,6.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,8.57,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Aetna,Commerical,,,5.76,,5.76,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Aetna,Middlesex Employees,,,5.53,,5.53,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Anthem,Commerical,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Anthem,Indemnity,,,5.6,,5.6,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Anthem,Individual Exchange,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Anthem,State Preferred,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Cigna,Cigna,,0.89,,,0.89,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Connecticare,Commerical,,1.1,,,1.1,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Connecticare,Exchange,,1.1,,,1.1,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,Multiplan,Multiplan,,,6.35,,6.35,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-20,NDC,both,1,mL,7.47,4.48,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Aetna,Commerical,,,5.76,,5.76,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Aetna,Middlesex Employees,,,5.53,,5.53,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Anthem,Commerical,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Anthem,Indemnity,,,5.6,,5.6,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Anthem,Individual Exchange,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Anthem,State Preferred,,,,,,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Cigna,Cigna,,0.89,,,0.89,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Connecticare,Commerical,,1.1,,,1.1,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Connecticare,Exchange,,1.1,,,1.1,0.89,6.35,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,Multiplan,Multiplan,,,6.35,,6.35,0.89,6.35,percent of total billed charges,,
DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0409-9104-21,NDC,both,1,mL,7.47,4.48,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,6.35,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Aetna,Commerical,,,19.95,,19.95,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Aetna,Middlesex Employees,,,19.13,,19.13,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Anthem,Commerical,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Anthem,Indemnity,,,19.37,,19.37,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Anthem,Individual Exchange,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Anthem,State Preferred,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Cigna,Cigna,,0.89,,,0.89,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Connecticare,Commerical,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Connecticare,Exchange,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,Multiplan,Multiplan,,,21.98,,21.98,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1007-02,NDC,both,25,mL,25.86,15.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Aetna,Commerical,,,19.95,,19.95,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Aetna,Middlesex Employees,,,19.13,,19.13,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Anthem,Commerical,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Anthem,Indemnity,,,19.37,,19.37,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Anthem,Individual Exchange,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Anthem,State Preferred,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Cigna,Cigna,,0.89,,,0.89,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Connecticare,Commerical,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Connecticare,Exchange,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,Multiplan,Multiplan,,,21.98,,21.98,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-11,NDC,both,25,mL,25.86,15.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Aetna,Commerical,,,19.95,,19.95,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Aetna,Middlesex Employees,,,19.13,,19.13,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Commerical,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Indemnity,,,19.37,,19.37,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Individual Exchange,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,State Preferred,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Cigna,Cigna,,0.89,,,0.89,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Connecticare,Commerical,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Connecticare,Exchange,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Multiplan,Multiplan,,,21.98,,21.98,0.89,21.98,percent of total billed charges,,
"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Aetna,Commerical,,,19.95,,19.95,0.89,21.98,percent of total billed charges,,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Aetna,Middlesex Employees,,,19.13,,19.13,0.89,21.98,percent of total billed charges,,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Commerical,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Indemnity,,,19.37,,19.37,0.89,21.98,percent of total billed charges,,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,Individual Exchange,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Anthem,State Preferred,,,,,,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Cigna,Cigna,,0.89,,,0.89,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Connecticare,Commerical,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Connecticare,Exchange,,1.1,,,1.1,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,Multiplan,Multiplan,,,21.98,,21.98,0.89,21.98,percent of total billed charges,,
DOPAMINE 400 MG/250 ML IN 5% DEXTROSE IV PREMIX BAG NICU,J1265,HCPCS,0409-7809-22,NDC,both,25,mL,25.86,15.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,21.98,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,1.1,percent of total billed charges,,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,1.1,percent of total billed charges,,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Anthem,Commerical,,,,,,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,1.1,percent of total billed charges,,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Anthem,State Preferred,,,,,,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Cigna,Cigna,,0.89,,,0.89,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Connecticare,Commerical,,1.1,,,1.1,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Connecticare,Exchange,,1.1,,,1.1,0.21,1.1,Other,Could be inpatient or outpatient,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,1.1,percent of total billed charges,,
DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1905-25,NDC,both,1,mL,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.21,1.1,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Aetna,Commerical,,,53.19,,53.19,0.89,58.6,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Aetna,Middlesex Employees,,,51.01,,51.01,0.89,58.6,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Anthem,Commerical,,,,,,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Anthem,Indemnity,,,51.64,,51.64,0.89,58.6,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Anthem,Individual Exchange,,,,,,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Anthem,State Preferred,,,,,,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Cigna,Cigna,,0.89,,,0.89,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Connecticare,Commerical,,1.1,,,1.1,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Connecticare,Exchange,,1.1,,,1.1,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,Multiplan,Multiplan,,,58.6,,58.6,0.89,58.6,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,0338-1009-02,NDC,both,12.5,mL,68.94,41.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,58.6,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,0.89,11.72,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,0.89,11.72,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Anthem,Commerical,,,,,,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,0.89,11.72,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Anthem,State Preferred,,,,,,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Cigna,Cigna,,0.89,,,0.89,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Connecticare,Commerical,,1.1,,,1.1,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Connecticare,Exchange,,1.1,,,1.1,0.89,11.72,Other,Could be inpatient or outpatient,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,0.89,11.72,percent of total billed charges,,
"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",J1265,HCPCS,40810-0203-22,NDC,both,12.5,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,11.72,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Aetna,Commerical,,,7.15,,7.15,0.89,7.88,percent of total billed charges,,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Aetna,Middlesex Employees,,,6.86,,6.86,0.89,7.88,percent of total billed charges,,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Anthem,Commerical,,,,,,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Anthem,Indemnity,,,6.94,,6.94,0.89,7.88,percent of total billed charges,,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Anthem,Individual Exchange,,,,,,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Anthem,State Preferred,,,,,,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Cigna,Cigna,,0.89,,,0.89,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Connecticare,Commerical,,1.1,,,1.1,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Connecticare,Exchange,,1.1,,,1.1,0.89,7.88,Other,Could be inpatient or outpatient,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,Multiplan,Multiplan,,,7.88,,7.88,0.89,7.88,percent of total billed charges,,
DOPAMINE 800 MG/5 ML (160 MG/ML) INTRAVENOUS SOLUTION,J1265,HCPCS,0517-1305-25,NDC,both,0.25,mL,9.27,5.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.96,,,0.96,0.89,7.88,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Aetna,Commerical,,,391.6,,391.6,60.39,431.39,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Aetna,Middlesex Employees,,,375.51,,375.51,60.39,431.39,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Anthem,Commerical,,,,,,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Anthem,Indemnity,,,380.18,,380.18,60.39,431.39,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Anthem,Individual Exchange,,,,,,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Anthem,State Preferred,,,,,,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Cigna,Cigna,,60.39,,,60.39,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Connecticare,Commerical,,81.66,,,81.66,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Connecticare,Exchange,,81.66,,,81.66,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,Multiplan,Multiplan,,,431.39,,431.39,60.39,431.39,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-39,NDC,both,1,mL,507.52,304.51,United Healthcare/Oxford,United Healthcare/Oxford,,65.2,,,65.2,60.39,431.39,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Aetna,Commerical,,,326.33,,326.33,60.39,359.49,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Aetna,Middlesex Employees,,,312.93,,312.93,60.39,359.49,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Anthem,Commerical,,,,,,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Anthem,Indemnity,,,316.82,,316.82,60.39,359.49,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Anthem,Individual Exchange,,,,,,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Anthem,State Preferred,,,,,,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Cigna,Cigna,,60.39,,,60.39,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Connecticare,Commerical,,81.66,,,81.66,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Connecticare,Exchange,,81.66,,,81.66,60.39,359.49,Other,Could be inpatient or outpatient,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,Multiplan,Multiplan,,,359.49,,359.49,60.39,359.49,percent of total billed charges,,
DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,J7639,HCPCS,50242-100-40,NDC,both,2.5,mL,422.93,253.76,United Healthcare/Oxford,United Healthcare/Oxford,,65.2,,,65.2,60.39,359.49,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Aetna,Commerical,,,9.27,,9.27,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Aetna,Middlesex Employees,,,8.89,,8.89,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Anthem,Commerical,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Anthem,Indemnity,,,9,,9,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Anthem,Individual Exchange,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Anthem,State Preferred,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Cigna,Cigna,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Connecticare,Commerical,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Connecticare,Exchange,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,Multiplan,Multiplan,,,10.22,,10.22,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-01,NDC,both,1,ea,12.02,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Aetna,Commerical,,,9.27,,9.27,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Aetna,Middlesex Employees,,,8.89,,8.89,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Anthem,Commerical,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Anthem,Indemnity,,,9,,9,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Anthem,Individual Exchange,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Anthem,State Preferred,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Cigna,Cigna,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Connecticare,Commerical,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Connecticare,Exchange,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,Multiplan,Multiplan,,,10.22,,10.22,8.89,10.22,percent of total billed charges,,
DOXAZOSIN 1 MG TABLET,J3490,HCPCS,51079-957-20,NDC,both,1,ea,12.02,7.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.89,10.22,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Aetna,Commerical,,,2.73,,2.73,2.62,3.01,percent of total billed charges,,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Aetna,Middlesex Employees,,,2.62,,2.62,2.62,3.01,percent of total billed charges,,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Anthem,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Anthem,Indemnity,,,2.65,,2.65,2.62,3.01,percent of total billed charges,,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Anthem,Individual Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Anthem,State Preferred,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Cigna,Cigna,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Connecticare,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Connecticare,Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,Multiplan,Multiplan,,,3.01,,3.01,2.62,3.01,percent of total billed charges,,
DOXAZOSIN 2 MG TABLET,J3490,HCPCS,51079-958-01,NDC,both,1,ea,3.54,2.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Aetna,Commerical,,,164.61,,164.61,3.98,181.34,percent of total billed charges,,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Aetna,Middlesex Employees,,,157.85,,157.85,3.98,181.34,percent of total billed charges,,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Anthem,Commerical,,,,,,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Anthem,Indemnity,,,159.81,,159.81,3.98,181.34,percent of total billed charges,,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Anthem,Individual Exchange,,,,,,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Anthem,State Preferred,,,,,,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Cigna,Cigna,,4.6,,,4.6,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Connecticare,Commerical,,5.04,,,5.04,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Connecticare,Exchange,,5.04,,,5.04,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,Multiplan,Multiplan,,,181.34,,181.34,3.98,181.34,percent of total billed charges,,
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3034-20,NDC,both,5,mL,213.34,128,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,181.34,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0069-3032-20,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9090-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9371-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Aetna,Commerical,,,34.51,,34.51,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Aetna,Middlesex Employees,,,33.09,,33.09,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Commerical,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Indemnity,,,33.5,,33.5,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,Individual Exchange,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Anthem,State Preferred,,,,,,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Cigna,Cigna,,4.6,,,4.6,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Connecticare,Commerical,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Connecticare,Exchange,,5.04,,,5.04,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,Multiplan,Multiplan,,,38.01,,38.01,3.98,38.01,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,0143-9547-01,NDC,both,5,mL,44.72,26.83,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,38.01,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Aetna,Commerical,,,103.43,,103.43,3.98,113.94,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Aetna,Middlesex Employees,,,99.18,,99.18,3.98,113.94,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Anthem,Commerical,,,,,,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Anthem,Indemnity,,,100.42,,100.42,3.98,113.94,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Anthem,Individual Exchange,,,,,,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Anthem,State Preferred,,,,,,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Cigna,Cigna,,4.6,,,4.6,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Connecticare,Commerical,,5.04,,,5.04,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Connecticare,Exchange,,5.04,,,5.04,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,Multiplan,Multiplan,,,113.94,,113.94,3.98,113.94,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,25021-207-25,NDC,both,5,mL,134.05,80.43,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,113.94,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Aetna,Commerical,,,99,,99,3.98,109.06,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Aetna,Middlesex Employees,,,94.94,,94.94,3.98,109.06,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Anthem,Commerical,,,,,,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Anthem,Indemnity,,,96.12,,96.12,3.98,109.06,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Anthem,Individual Exchange,,,,,,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Anthem,State Preferred,,,,,,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Cigna,Cigna,,4.6,,,4.6,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Connecticare,Commerical,,5.04,,,5.04,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Connecticare,Exchange,,5.04,,,5.04,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,Multiplan,Multiplan,,,109.06,,109.06,3.98,109.06,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,62756-826-40,NDC,both,5,mL,128.31,76.99,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,109.06,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Aetna,Commerical,,,98.49,,98.49,3.98,108.49,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Aetna,Middlesex Employees,,,94.44,,94.44,3.98,108.49,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Anthem,Commerical,,,,,,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Anthem,Indemnity,,,95.62,,95.62,3.98,108.49,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Anthem,Individual Exchange,,,,,,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Anthem,State Preferred,,,,,,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Cigna,Cigna,,4.6,,,4.6,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Connecticare,Commerical,,5.04,,,5.04,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Connecticare,Exchange,,5.04,,,5.04,3.98,108.49,Other,Could be inpatient or outpatient,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,Multiplan,Multiplan,,,108.49,,108.49,3.98,108.49,percent of total billed charges,,
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,J9000,HCPCS,63323-883-30,NDC,both,5,mL,127.64,76.58,United Healthcare/Oxford,United Healthcare/Oxford,,3.98,,,3.98,3.98,108.49,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Aetna,Commerical,,,881.78,,881.78,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Aetna,Middlesex Employees,,,845.56,,845.56,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Anthem,Commerical,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Anthem,Indemnity,,,856.07,,856.07,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Anthem,Individual Exchange,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Anthem,State Preferred,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Cigna,Cigna,,192.08,,,192.08,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Connecticare,Commerical,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Connecticare,Exchange,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,Multiplan,Multiplan,,,971.38,,971.38,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,0338-0063-01,NDC,both,5,mL,1142.8,685.68,United Healthcare/Oxford,United Healthcare/Oxford,,166.2,,,166.2,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Aetna,Commerical,,,881.78,,881.78,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Aetna,Middlesex Employees,,,845.56,,845.56,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Anthem,Commerical,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Anthem,Indemnity,,,856.07,,856.07,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Anthem,Individual Exchange,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Anthem,State Preferred,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Cigna,Cigna,,192.08,,,192.08,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Connecticare,Commerical,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Connecticare,Exchange,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,Multiplan,Multiplan,,,971.38,,971.38,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-283-35,NDC,both,5,mL,1142.8,685.68,United Healthcare/Oxford,United Healthcare/Oxford,,166.2,,,166.2,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Aetna,Commerical,,,2204.45,,2204.45,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Aetna,Middlesex Employees,,,2113.89,,2113.89,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Anthem,Commerical,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Anthem,Indemnity,,,2140.17,,2140.17,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Anthem,Individual Exchange,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Anthem,State Preferred,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Cigna,Cigna,,192.08,,,192.08,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Connecticare,Commerical,,203.21,,,203.21,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Connecticare,Exchange,,203.21,,,203.21,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,Multiplan,Multiplan,,,2428.44,,2428.44,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-541-25,NDC,both,5,mL,2856.99,1714.19,United Healthcare/Oxford,United Healthcare/Oxford,,166.2,,,166.2,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Aetna,Commerical,,,881.78,,881.78,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Aetna,Middlesex Employees,,,845.56,,845.56,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Anthem,Commerical,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Anthem,Indemnity,,,856.07,,856.07,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Anthem,Individual Exchange,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Anthem,State Preferred,,,,,,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Cigna,Cigna,,192.08,,,192.08,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Connecticare,Commerical,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Connecticare,Exchange,,203.21,,,203.21,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,Multiplan,Multiplan,,,971.38,,971.38,166.2,971.38,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,43598-682-35,NDC,both,5,mL,1142.8,685.68,United Healthcare/Oxford,United Healthcare/Oxford,,166.2,,,166.2,166.2,971.38,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Aetna,Commerical,,,2204.45,,2204.45,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Aetna,Middlesex Employees,,,2113.89,,2113.89,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Anthem,Commerical,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Anthem,Indemnity,,,2140.17,,2140.17,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Anthem,Individual Exchange,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Anthem,State Preferred,,,,,,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Cigna,Cigna,,192.08,,,192.08,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Connecticare,Commerical,,203.21,,,203.21,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Connecticare,Exchange,,203.21,,,203.21,166.2,2428.44,Other,Could be inpatient or outpatient,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,Multiplan,Multiplan,,,2428.44,,2428.44,166.2,2428.44,percent of total billed charges,,
"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",Q2050,HCPCS,47335-050-40,NDC,both,5,mL,2856.99,1714.19,United Healthcare/Oxford,United Healthcare/Oxford,,166.2,,,166.2,166.2,2428.44,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Aetna,Commerical,,,900.2,,900.2,863.22,991.67,percent of total billed charges,,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Aetna,Middlesex Employees,,,863.22,,863.22,863.22,991.67,percent of total billed charges,,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Anthem,Commerical,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Anthem,Indemnity,,,873.95,,873.95,863.22,991.67,percent of total billed charges,,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Anthem,Individual Exchange,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Anthem,State Preferred,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Cigna,Cigna,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Connecticare,Commerical,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Connecticare,Exchange,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,Multiplan,Multiplan,,,991.67,,991.67,863.22,991.67,percent of total billed charges,,
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP,J3490,HCPCS,0069-0971-93,NDC,both,1,mL,1166.67,700,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,863.22,991.67,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,0143-9803-50,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,53489-119-02,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG CAPSULE,J3490,HCPCS,62135-985-50,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Aetna,Commerical,,,46.94,,46.94,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Aetna,Middlesex Employees,,,45.01,,45.01,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Anthem,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Anthem,Indemnity,,,45.57,,45.57,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Anthem,Individual Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Anthem,State Preferred,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Cigna,Cigna,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Connecticare,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Connecticare,Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-02,NDC,both,1,ea,60.83,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Aetna,Commerical,,,46.94,,46.94,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Aetna,Middlesex Employees,,,45.01,,45.01,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Anthem,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Anthem,Indemnity,,,45.57,,45.57,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Anthem,Individual Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Anthem,State Preferred,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Cigna,Cigna,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Connecticare,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Connecticare,Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-03,NDC,both,1,ea,60.83,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Aetna,Commerical,,,46.94,,46.94,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Aetna,Middlesex Employees,,,45.01,,45.01,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Anthem,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Anthem,Indemnity,,,45.57,,45.57,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Anthem,Individual Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Anthem,State Preferred,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Cigna,Cigna,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Connecticare,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Connecticare,Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-11,NDC,both,1,ea,60.83,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.58,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.58,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Anthem,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,39.67,45.58,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Anthem,Individual Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Anthem,State Preferred,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Cigna,Cigna,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Connecticare,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Connecticare,Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,39.67,45.58,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-130-13,NDC,both,1,ea,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Aetna,Commerical,,,46.94,,46.94,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Aetna,Middlesex Employees,,,45.01,,45.01,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Anthem,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Anthem,Indemnity,,,45.57,,45.57,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Anthem,Individual Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Anthem,State Preferred,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Cigna,Cigna,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Connecticare,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Connecticare,Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-01,NDC,both,1,ea,60.83,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Aetna,Commerical,,,46.94,,46.94,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Aetna,Middlesex Employees,,,45.01,,45.01,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Anthem,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Anthem,Indemnity,,,45.57,,45.57,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Anthem,Individual Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Anthem,State Preferred,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Cigna,Cigna,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Connecticare,Commerical,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Connecticare,Exchange,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.01,51.71,percent of total billed charges,,
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,72266-237-05,NDC,both,1,ea,60.83,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.01,51.71,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-3141-50,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
DOXYCYCLINE HYCLATE 50 MG CAPSULE,J3490,HCPCS,0143-9802-50,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Aetna,Commerical,,,3.16,,3.16,3.03,3.48,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Aetna,Middlesex Employees,,,3.03,,3.03,3.03,3.48,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Anthem,Commerical,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Anthem,Indemnity,,,3.06,,3.06,3.03,3.48,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Anthem,Individual Exchange,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Anthem,State Preferred,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Cigna,Cigna,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Connecticare,Commerical,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Connecticare,Exchange,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,Multiplan,Multiplan,,,3.48,,3.48,3.03,3.48,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,J3490,HCPCS,68084-743-21,NDC,both,1,ea,4.09,2.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.03,3.48,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Aetna,Commerical,,,34.41,,34.41,32.99,37.9,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Aetna,Middlesex Employees,,,32.99,,32.99,32.99,37.9,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Anthem,Commerical,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Anthem,Indemnity,,,33.4,,33.4,32.99,37.9,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Anthem,Individual Exchange,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Anthem,State Preferred,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Cigna,Cigna,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Connecticare,Commerical,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Connecticare,Exchange,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,Multiplan,Multiplan,,,37.9,,37.9,32.99,37.9,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-417-46,NDC,both,1,mL,44.59,26.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.99,37.9,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Aetna,Commerical,,,53.9,,53.9,51.69,59.38,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Aetna,Middlesex Employees,,,51.69,,51.69,51.69,59.38,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Anthem,Commerical,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Anthem,Indemnity,,,52.33,,52.33,51.69,59.38,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Anthem,Individual Exchange,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Anthem,State Preferred,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Cigna,Cigna,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Connecticare,Commerical,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Connecticare,Exchange,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,Multiplan,Multiplan,,,59.38,,59.38,51.69,59.38,percent of total billed charges,,
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68180-657-01,NDC,both,1,mL,69.86,41.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.69,59.38,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Aetna,Commerical,,,52.3,,52.3,50.15,174.83,percent of total billed charges,,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Aetna,Middlesex Employees,,,50.15,,50.15,50.15,174.83,percent of total billed charges,,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Anthem,Commerical,,174.83,,,174.83,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Anthem,Indemnity,,,50.77,,50.77,50.15,174.83,percent of total billed charges,,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Anthem,Individual Exchange,,139.86,,,139.86,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Anthem,State Preferred,,174.83,,,174.83,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Cigna,Cigna,,,,,,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Connecticare,Commerical,,,,,,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Connecticare,Exchange,,,,,,50.15,174.83,Other,Could be inpatient or outpatient,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,Multiplan,Multiplan,,,57.61,,57.61,50.15,174.83,percent of total billed charges,,
DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT,90698,HCPCS,49281-510-05,NDC,both,1,ea,67.78,40.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.15,174.83,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Aetna,Commerical,,,13.97,,13.97,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Aetna,Middlesex Employees,,,13.39,,13.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Anthem,Commerical,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Anthem,Indemnity,,,13.56,,13.56,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Anthem,Individual Exchange,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Anthem,State Preferred,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Cigna,Cigna,,3.04,,,3.04,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Connecticare,Commerical,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Connecticare,Exchange,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,Multiplan,Multiplan,,,15.39,,15.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,0904-6745-61,NDC,both,1,ea,18.1,10.86,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Aetna,Commerical,,,13.97,,13.97,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Aetna,Middlesex Employees,,,13.39,,13.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Anthem,Commerical,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Anthem,Indemnity,,,13.56,,13.56,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Anthem,Individual Exchange,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Anthem,State Preferred,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Cigna,Cigna,,3.04,,,3.04,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Connecticare,Commerical,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Connecticare,Exchange,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,Multiplan,Multiplan,,,15.39,,15.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,40810-0005-24,NDC,both,1,ea,18.1,10.86,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Aetna,Commerical,,,13.97,,13.97,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Aetna,Middlesex Employees,,,13.39,,13.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Anthem,Commerical,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Anthem,Indemnity,,,13.56,,13.56,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Anthem,Individual Exchange,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Anthem,State Preferred,,,,,,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Cigna,Cigna,,3.04,,,3.04,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Connecticare,Commerical,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Connecticare,Exchange,,3.69,,,3.69,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,Multiplan,Multiplan,,,15.39,,15.39,3.04,15.39,percent of total billed charges,,
DRONABINOL 2.5 MG CAPSULE,Q0167,HCPCS,67877-753-60,NDC,both,1,ea,18.1,10.86,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,15.39,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Aetna,Commerical,,,21.93,,21.93,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Aetna,Middlesex Employees,,,21.03,,21.03,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Anthem,Commerical,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Anthem,Indemnity,,,21.29,,21.29,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Anthem,Individual Exchange,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Anthem,State Preferred,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Cigna,Cigna,,3.04,,,3.04,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Connecticare,Commerical,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Connecticare,Exchange,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,Multiplan,Multiplan,,,24.16,,24.16,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0527-1451-06,NDC,both,0.5,ea,28.42,17.05,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Aetna,Commerical,,,21.93,,21.93,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Aetna,Middlesex Employees,,,21.03,,21.03,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Anthem,Commerical,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Anthem,Indemnity,,,21.29,,21.29,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Anthem,Individual Exchange,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Anthem,State Preferred,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Cigna,Cigna,,3.04,,,3.04,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Connecticare,Commerical,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Connecticare,Exchange,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,Multiplan,Multiplan,,,24.16,,24.16,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,0904-6746-04,NDC,both,0.5,ea,28.42,17.05,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Aetna,Commerical,,,21.93,,21.93,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Aetna,Middlesex Employees,,,21.03,,21.03,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Anthem,Commerical,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Anthem,Indemnity,,,21.29,,21.29,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Anthem,Individual Exchange,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Anthem,State Preferred,,,,,,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Cigna,Cigna,,3.04,,,3.04,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Connecticare,Commerical,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Connecticare,Exchange,,3.69,,,3.69,3.04,24.16,Other,Could be inpatient or outpatient,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,Multiplan,Multiplan,,,24.16,,24.16,3.04,24.16,percent of total billed charges,,
DRONABINOL 5 MG CAPSULE,Q0167,HCPCS,67877-754-60,NDC,both,0.5,ea,28.42,17.05,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,24.16,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,13.63,percent of total billed charges,,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,13.63,percent of total billed charges,,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Anthem,Commerical,,,,,,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,13.63,percent of total billed charges,,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Anthem,State Preferred,,,,,,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Cigna,Cigna,,10.72,,,10.72,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Connecticare,Commerical,,3.27,,,3.27,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Connecticare,Exchange,,3.27,,,3.27,0.4,13.63,Other,Could be inpatient or outpatient,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,13.63,percent of total billed charges,,
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,J1790,HCPCS,0409-1187-01,NDC,both,2,mL,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,13.63,,,13.63,0.4,13.63,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3235-60,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-05,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,15.87,18.23,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,15.87,18.23,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,15.87,18.23,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,15.87,18.23,percent of total billed charges,,
"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-017-60,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.87,18.23,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3240-30,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,47335-382-81,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-018-90,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Aetna,Commerical,,,3.87,,3.87,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Anthem,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Anthem,Indemnity,,,3.76,,3.76,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Anthem,Individual Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Anthem,State Preferred,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Cigna,Cigna,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Connecticare,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Connecticare,Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,Multiplan,Multiplan,,,4.27,,4.27,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0002-3270-30,NDC,both,1,ea,5.02,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Aetna,Commerical,,,3.87,,3.87,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Anthem,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Anthem,Indemnity,,,3.76,,3.76,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Anthem,Individual Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Anthem,State Preferred,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Cigna,Cigna,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Connecticare,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Connecticare,Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,Multiplan,Multiplan,,,4.27,,4.27,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0228-2892-03,NDC,both,1,ea,5.02,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Aetna,Commerical,,,3.87,,3.87,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Anthem,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Anthem,Indemnity,,,3.76,,3.76,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Anthem,Individual Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Anthem,State Preferred,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Cigna,Cigna,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Connecticare,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Connecticare,Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,Multiplan,Multiplan,,,4.27,,4.27,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-7045-61,NDC,both,1,ea,5.02,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Aetna,Commerical,,,3.87,,3.87,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Anthem,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Anthem,Indemnity,,,3.76,,3.76,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Anthem,Individual Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Anthem,State Preferred,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Cigna,Cigna,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Connecticare,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Connecticare,Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,Multiplan,Multiplan,,,4.27,,4.27,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-07,NDC,both,1,ea,5.02,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Aetna,Commerical,,,3.87,,3.87,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Anthem,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Anthem,Indemnity,,,3.76,,3.76,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Anthem,Individual Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Anthem,State Preferred,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Cigna,Cigna,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Connecticare,Commerical,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Connecticare,Exchange,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,Multiplan,Multiplan,,,4.27,,4.27,3.71,4.27,percent of total billed charges,,
"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,57237-019-30,NDC,both,1,ea,5.02,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.71,4.27,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Aetna,Commerical,,,5301.56,,5301.56,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Aetna,Middlesex Employees,,,5083.76,,5083.76,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Anthem,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Anthem,Indemnity,,,5146.97,,5146.97,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Anthem,Individual Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Anthem,State Preferred,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Cigna,Cigna,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Connecticare,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Connecticare,Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,Multiplan,Multiplan,,,5840.24,,5840.24,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-00,NDC,both,2,mL,6870.87,4122.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Aetna,Commerical,,,5301.56,,5301.56,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Aetna,Middlesex Employees,,,5083.76,,5083.76,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Anthem,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Anthem,Indemnity,,,5146.97,,5146.97,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Anthem,Individual Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Anthem,State Preferred,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Cigna,Cigna,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Connecticare,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Connecticare,Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,Multiplan,Multiplan,,,5840.24,,5840.24,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-01,NDC,both,2,mL,6870.87,4122.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Aetna,Commerical,,,5301.56,,5301.56,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Aetna,Middlesex Employees,,,5083.76,,5083.76,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Anthem,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Anthem,Indemnity,,,5146.97,,5146.97,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Anthem,Individual Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Anthem,State Preferred,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Cigna,Cigna,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Connecticare,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Connecticare,Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,Multiplan,Multiplan,,,5840.24,,5840.24,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-02,NDC,both,2,mL,6870.87,4122.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Aetna,Commerical,,,5301.56,,5301.56,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Aetna,Middlesex Employees,,,5083.76,,5083.76,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Anthem,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Anthem,Indemnity,,,5146.97,,5146.97,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Anthem,Individual Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Anthem,State Preferred,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Cigna,Cigna,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Connecticare,Commerical,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Connecticare,Exchange,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,Multiplan,Multiplan,,,5840.24,,5840.24,5083.76,5840.24,percent of total billed charges,,
DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,J3590,HCPCS,0024-5915-20,NDC,both,2,mL,6870.87,4122.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5083.76,5840.24,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Aetna,Commerical,,,143.33,,143.33,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Aetna,Middlesex Employees,,,137.44,,137.44,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Commerical,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Indemnity,,,139.15,,139.15,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Individual Exchange,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,State Preferred,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Cigna,Cigna,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Connecticare,Commerical,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Connecticare,Exchange,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,Multiplan,Multiplan,,,157.9,,157.9,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,71285-0422-1,NDC,both,250,mL,185.76,111.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Aetna,Commerical,,,143.33,,143.33,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Aetna,Middlesex Employees,,,137.44,,137.44,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Commerical,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Indemnity,,,139.15,,139.15,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,Individual Exchange,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Anthem,State Preferred,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Cigna,Cigna,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Connecticare,Commerical,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Connecticare,Exchange,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,Multiplan,Multiplan,,,157.9,,157.9,137.44,157.9,percent of total billed charges,,
EARLY PARENTERAL NUTRITION- AMINO ACID 4 % PEDI-D10W-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,J3490,HCPCS,72196-0422-1,NDC,both,250,mL,185.76,111.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,137.44,157.9,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Aetna,Commerical,,,43641.71,,43641.71,636.05,48076.02,percent of total billed charges,,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Aetna,Middlesex Employees,,,41848.76,,41848.76,636.05,48076.02,percent of total billed charges,,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Anthem,Commerical,,,,,,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Anthem,Indemnity,,,42369.11,,42369.11,636.05,48076.02,percent of total billed charges,,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Anthem,Individual Exchange,,,,,,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Anthem,State Preferred,,,,,,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Cigna,Cigna,,636.05,,,636.05,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Connecticare,Commerical,,864.01,,,864.01,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Connecticare,Exchange,,864.01,,,864.01,636.05,48076.02,Other,Could be inpatient or outpatient,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,Multiplan,Multiplan,,,48076.02,,48076.02,636.05,48076.02,percent of total billed charges,,
ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,J1290,HCPCS,47783-101-01,NDC,both,0.1,mL,56560.02,33936.01,United Healthcare/Oxford,United Healthcare/Oxford,,686.71,,,686.71,636.05,48076.02,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Aetna,Commerical,,,19276.93,,19276.93,254.78,21235.6,percent of total billed charges,,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Aetna,Middlesex Employees,,,18484.97,,18484.97,254.78,21235.6,percent of total billed charges,,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Anthem,Commerical,,,,,,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Anthem,Indemnity,,,18714.81,,18714.81,254.78,21235.6,percent of total billed charges,,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Anthem,Individual Exchange,,,,,,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Anthem,State Preferred,,,,,,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Cigna,Cigna,,254.78,,,254.78,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Connecticare,Commerical,,343.01,,,343.01,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Connecticare,Exchange,,343.01,,,343.01,254.78,21235.6,Other,Could be inpatient or outpatient,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,Multiplan,Multiplan,,,21235.6,,21235.6,254.78,21235.6,percent of total billed charges,,
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,J1300,HCPCS,25682-001-01,NDC,both,1,mL,24983.06,14989.84,United Healthcare/Oxford,United Healthcare/Oxford,,275.07,,,275.07,254.78,21235.6,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Aetna,Commerical,,,18470.18,,18470.18,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Aetna,Middlesex Employees,,,17711.36,,17711.36,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Commerical,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Indemnity,,,17931.58,,17931.58,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Individual Exchange,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Anthem,State Preferred,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Cigna,Cigna,,7485.71,,,7485.71,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Connecticare,Commerical,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Connecticare,Exchange,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,Multiplan,Multiplan,,,20346.88,,20346.88,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-05,NDC,both,5,mL,23937.5,14362.5,United Healthcare/Oxford,United Healthcare/Oxford,,7697.77,,,7697.77,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Aetna,Commerical,,,18470.18,,18470.18,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Aetna,Middlesex Employees,,,17711.36,,17711.36,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Anthem,Commerical,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Anthem,Indemnity,,,17931.58,,17931.58,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Anthem,Individual Exchange,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Anthem,State Preferred,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Cigna,Cigna,,7485.71,,,7485.71,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Connecticare,Commerical,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Connecticare,Exchange,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,Multiplan,Multiplan,,,20346.88,,20346.88,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,64980-588-51,NDC,both,5,mL,23937.5,14362.5,United Healthcare/Oxford,United Healthcare/Oxford,,7697.77,,,7697.77,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Aetna,Commerical,,,18470.18,,18470.18,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Aetna,Middlesex Employees,,,17711.36,,17711.36,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Commerical,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Indemnity,,,17931.58,,17931.58,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Anthem,Individual Exchange,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Anthem,State Preferred,,,,,,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Cigna,Cigna,,7485.71,,,7485.71,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Connecticare,Commerical,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Connecticare,Exchange,,8716.92,,,8716.92,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,Multiplan,Multiplan,,,20346.88,,20346.88,7485.71,20346.88,percent of total billed charges,,
EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,J0600,HCPCS,99207-240-05,NDC,both,5,mL,23937.5,14362.5,United Healthcare/Oxford,United Healthcare/Oxford,,7697.77,,,7697.77,7485.71,20346.88,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Aetna,Commerical,,,428.51,,428.51,410.9,472.05,percent of total billed charges,,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Aetna,Middlesex Employees,,,410.9,,410.9,410.9,472.05,percent of total billed charges,,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Anthem,Commerical,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Anthem,Indemnity,,,416.01,,416.01,410.9,472.05,percent of total billed charges,,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Anthem,Individual Exchange,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Anthem,State Preferred,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Cigna,Cigna,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Connecticare,Commerical,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Connecticare,Exchange,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,Multiplan,Multiplan,,,472.05,,472.05,410.9,472.05,percent of total billed charges,,
EDETATE DISODIUM 3 % OPHTHALMIC SOLUTION,J3490,HCPCS,40810-0208-44,NDC,both,1,mL,555.35,333.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,410.9,472.05,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Aetna,Commerical,,,21.77,,21.77,20.88,23.99,percent of total billed charges,,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Aetna,Middlesex Employees,,,20.88,,20.88,20.88,23.99,percent of total billed charges,,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Anthem,Commerical,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Anthem,Indemnity,,,21.14,,21.14,20.88,23.99,percent of total billed charges,,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Anthem,Individual Exchange,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Anthem,State Preferred,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Cigna,Cigna,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Connecticare,Commerical,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Connecticare,Exchange,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,Multiplan,Multiplan,,,23.99,,23.99,20.88,23.99,percent of total billed charges,,
EFAVIRENZ 200 MG CAPSULE,J3490,HCPCS,0056-0474-92,NDC,both,1,ea,28.22,16.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.88,23.99,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Aetna,Commerical,,,5.45,,5.45,5.22,6,percent of total billed charges,,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Aetna,Middlesex Employees,,,5.22,,5.22,5.22,6,percent of total billed charges,,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Anthem,Commerical,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Anthem,Indemnity,,,5.29,,5.29,5.22,6,percent of total billed charges,,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Anthem,Individual Exchange,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Anthem,State Preferred,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Cigna,Cigna,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Connecticare,Commerical,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Connecticare,Exchange,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,Multiplan,Multiplan,,,6,,6,5.22,6,percent of total billed charges,,
EFAVIRENZ 50 MG CAPSULE,J3490,HCPCS,0056-0470-30,NDC,both,1,ea,7.06,4.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.22,6,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Aetna,Commerical,,,65.32,,65.32,62.63,71.95,percent of total billed charges,,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Aetna,Middlesex Employees,,,62.63,,62.63,62.63,71.95,percent of total billed charges,,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Anthem,Commerical,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Anthem,Indemnity,,,63.41,,63.41,62.63,71.95,percent of total billed charges,,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Anthem,Individual Exchange,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Anthem,State Preferred,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Cigna,Cigna,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Connecticare,Commerical,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Connecticare,Exchange,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,Multiplan,Multiplan,,,71.95,,71.95,62.63,71.95,percent of total billed charges,,
EFAVIRENZ 600 MG TABLET,J3490,HCPCS,0056-0510-30,NDC,both,1,ea,84.65,50.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.63,71.95,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Aetna,Commerical,,,192.34,,192.34,184.44,211.89,percent of total billed charges,,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Aetna,Middlesex Employees,,,184.44,,184.44,184.44,211.89,percent of total billed charges,,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Anthem,Commerical,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Anthem,Indemnity,,,186.74,,186.74,184.44,211.89,percent of total billed charges,,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Anthem,Individual Exchange,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Anthem,State Preferred,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Cigna,Cigna,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Connecticare,Commerical,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Connecticare,Exchange,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,Multiplan,Multiplan,,,211.89,,211.89,184.44,211.89,percent of total billed charges,,
EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,J8499,HCPCS,15584-0101-1,NDC,both,1,ea,249.28,149.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,184.44,211.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Aetna,Commerical,,,44.33,,44.33,42.51,48.83,percent of total billed charges,,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Aetna,Middlesex Employees,,,42.51,,42.51,42.51,48.83,percent of total billed charges,,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Anthem,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Anthem,Indemnity,,,43.04,,43.04,42.51,48.83,percent of total billed charges,,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Anthem,Individual Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Anthem,State Preferred,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Cigna,Cigna,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Connecticare,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Connecticare,Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,Multiplan,Multiplan,,,48.83,,48.83,42.51,48.83,percent of total billed charges,,
ELECTROLYTE-A INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0221-04,NDC,both,1000,mL,57.45,34.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Aetna,Commerical,,,4.44,,4.44,4.25,4.89,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Aetna,Middlesex Employees,,,4.25,,4.25,4.25,4.89,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Anthem,Commerical,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Anthem,Indemnity,,,4.31,,4.31,4.25,4.89,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Anthem,Individual Exchange,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Anthem,State Preferred,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Cigna,Cigna,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Connecticare,Commerical,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Connecticare,Exchange,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,Multiplan,Multiplan,,,4.89,,4.89,4.25,4.89,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-03,NDC,both,1,mL,5.75,3.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.25,4.89,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7670-09,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Aetna,Commerical,,,4119.59,,4119.59,326.05,4538.17,percent of total billed charges,,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Aetna,Middlesex Employees,,,3950.34,,3950.34,326.05,4538.17,percent of total billed charges,,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Anthem,Commerical,,,,,,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Anthem,Indemnity,,,3999.46,,3999.46,326.05,4538.17,percent of total billed charges,,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Anthem,Individual Exchange,,,,,,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Anthem,State Preferred,,,,,,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Cigna,Cigna,,326.05,,,326.05,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Connecticare,Commerical,,448.8,,,448.8,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Connecticare,Exchange,,448.8,,,448.8,326.05,4538.17,Other,Could be inpatient or outpatient,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,Multiplan,Multiplan,,,4538.17,,4538.17,326.05,4538.17,percent of total billed charges,,
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION,J1322,HCPCS,68135-100-01,NDC,both,1,mL,5339.02,3203.41,United Healthcare/Oxford,United Healthcare/Oxford,,352.02,,,352.02,326.05,4538.17,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Aetna,Commerical,,,11975.8,,11975.8,400.71,13192.63,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Aetna,Middlesex Employees,,,11483.8,,11483.8,400.71,13192.63,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Anthem,Commerical,,,,,,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Anthem,Indemnity,,,11626.59,,11626.59,400.71,13192.63,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Anthem,Individual Exchange,,,,,,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Anthem,State Preferred,,,,,,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Cigna,Cigna,,414.34,,,414.34,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Connecticare,Commerical,,577.24,,,577.24,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Connecticare,Exchange,,577.24,,,577.24,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,Multiplan,Multiplan,,,13192.63,,13192.63,400.71,13192.63,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-501-01,NDC,both,1,mL,15520.74,9312.44,United Healthcare/Oxford,United Healthcare/Oxford,,400.71,,,400.71,400.71,13192.63,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Aetna,Commerical,,,59879.01,,59879.01,400.71,65963.14,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Aetna,Middlesex Employees,,,57418.97,,57418.97,400.71,65963.14,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Anthem,Commerical,,,,,,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Anthem,Indemnity,,,58132.92,,58132.92,400.71,65963.14,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Anthem,Individual Exchange,,,,,,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Anthem,State Preferred,,,,,,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Cigna,Cigna,,414.34,,,414.34,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Connecticare,Commerical,,577.24,,,577.24,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Connecticare,Exchange,,577.24,,,577.24,400.71,65963.14,Other,Could be inpatient or outpatient,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,Multiplan,Multiplan,,,65963.14,,65963.14,400.71,65963.14,percent of total billed charges,,
EMAPALUMAB-LZSG 5 MG/ML INTRAVENOUS SOLUTION,J9210,HCPCS,66658-505-01,NDC,both,1,mL,77603.69,46562.21,United Healthcare/Oxford,United Healthcare/Oxford,,400.71,,,400.71,400.71,65963.14,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Aetna,Commerical,,,56.26,,56.26,53.95,61.97,percent of total billed charges,,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Aetna,Middlesex Employees,,,53.95,,53.95,53.95,61.97,percent of total billed charges,,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Anthem,Commerical,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Anthem,Indemnity,,,54.62,,54.62,53.95,61.97,percent of total billed charges,,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Anthem,Individual Exchange,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Anthem,State Preferred,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Cigna,Cigna,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Connecticare,Commerical,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Connecticare,Exchange,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,Multiplan,Multiplan,,,61.97,,61.97,53.95,61.97,percent of total billed charges,,
EMPAGLIFLOZIN 10 MG TABLET,J3490,HCPCS,0597-0152-37,NDC,both,1,ea,72.91,43.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.95,61.97,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Aetna,Commerical,,,44.74,,44.74,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Aetna,Middlesex Employees,,,42.9,,42.9,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Anthem,Commerical,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Anthem,Indemnity,,,43.43,,43.43,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Anthem,Individual Exchange,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Anthem,State Preferred,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Cigna,Cigna,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Connecticare,Commerical,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Connecticare,Exchange,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,Multiplan,Multiplan,,,49.28,,49.28,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 2.5 MG TABLET,J3490,HCPCS,40810-0208-82,NDC,both,1,ea,57.98,34.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Aetna,Commerical,,,44.74,,44.74,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Aetna,Middlesex Employees,,,42.9,,42.9,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Anthem,Commerical,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Anthem,Indemnity,,,43.43,,43.43,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Anthem,Individual Exchange,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Anthem,State Preferred,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Cigna,Cigna,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Connecticare,Commerical,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Connecticare,Exchange,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,Multiplan,Multiplan,,,49.28,,49.28,42.9,49.28,percent of total billed charges,,
EMPAGLIFLOZIN 5 MG TABLET,J3490,HCPCS,40810-0208-83,NDC,both,1,ea,57.98,34.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.9,49.28,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Aetna,Commerical,,,360.21,,360.21,345.41,396.81,percent of total billed charges,,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Aetna,Middlesex Employees,,,345.41,,345.41,345.41,396.81,percent of total billed charges,,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Anthem,Commerical,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Anthem,Indemnity,,,349.71,,349.71,345.41,396.81,percent of total billed charges,,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Anthem,Individual Exchange,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Anthem,State Preferred,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Cigna,Cigna,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Connecticare,Commerical,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Connecticare,Exchange,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,Multiplan,Multiplan,,,396.81,,396.81,345.41,396.81,percent of total billed charges,,
EMTRICITABINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,61958-0602-1,NDC,both,1,mL,466.84,280.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,345.41,396.81,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Aetna,Commerical,,,50.87,,50.87,48.78,56.04,percent of total billed charges,,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Aetna,Middlesex Employees,,,48.78,,48.78,48.78,56.04,percent of total billed charges,,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Anthem,Commerical,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Anthem,Indemnity,,,49.39,,49.39,48.78,56.04,percent of total billed charges,,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Anthem,Individual Exchange,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Anthem,State Preferred,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Cigna,Cigna,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Connecticare,Commerical,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Connecticare,Exchange,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,Multiplan,Multiplan,,,56.04,,56.04,48.78,56.04,percent of total billed charges,,
EMTRICITABINE 200 MG CAPSULE,J3490,HCPCS,61958-0601-1,NDC,both,1,ea,65.93,39.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.78,56.04,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Aetna,Commerical,,,1.84,,1.84,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Aetna,Middlesex Employees,,,1.76,,1.76,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Anthem,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Anthem,Indemnity,,,1.78,,1.78,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Anthem,Individual Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Anthem,State Preferred,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Cigna,Cigna,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Connecticare,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Connecticare,Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,Multiplan,Multiplan,,,2.02,,2.02,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0015-50,NDC,both,1,ea,2.38,1.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Aetna,Commerical,,,1.84,,1.84,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Aetna,Middlesex Employees,,,1.76,,1.76,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Anthem,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Anthem,Indemnity,,,1.78,,1.78,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Anthem,Individual Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Anthem,State Preferred,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Cigna,Cigna,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Connecticare,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Connecticare,Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,Multiplan,Multiplan,,,2.02,,2.02,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-953-30,NDC,both,1,ea,2.38,1.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Aetna,Commerical,,,1.84,,1.84,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Aetna,Middlesex Employees,,,1.76,,1.76,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Anthem,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Anthem,Indemnity,,,1.78,,1.78,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Anthem,Individual Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Anthem,State Preferred,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Cigna,Cigna,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Connecticare,Commerical,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Connecticare,Exchange,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,Multiplan,Multiplan,,,2.02,,2.02,1.76,2.02,percent of total billed charges,,
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0701-1,NDC,both,1,ea,2.38,1.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.76,2.02,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,2.28,2.62,percent of total billed charges,,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,2.28,2.62,percent of total billed charges,,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Anthem,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,2.28,2.62,percent of total billed charges,,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Anthem,Individual Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Anthem,State Preferred,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Cigna,Cigna,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Connecticare,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Connecticare,Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,2.28,2.62,percent of total billed charges,,
ENALAPRIL 1.25 MG TABLET,J3490,HCPCS,40810-0013-54,NDC,both,1,UN,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Aetna,Commerical,,,766,,766,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Aetna,Middlesex Employees,,,734.53,,734.53,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Anthem,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Anthem,Indemnity,,,743.66,,743.66,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Anthem,Individual Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Anthem,State Preferred,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Cigna,Cigna,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Connecticare,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Connecticare,Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,Multiplan,Multiplan,,,843.83,,843.83,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-4001-1,NDC,both,1,mL,992.74,595.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Aetna,Commerical,,,766,,766,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Aetna,Middlesex Employees,,,734.53,,734.53,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Anthem,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Anthem,Indemnity,,,743.66,,743.66,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Anthem,Individual Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Anthem,State Preferred,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Cigna,Cigna,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Connecticare,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Connecticare,Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,Multiplan,Multiplan,,,843.83,,843.83,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69238-2141-7,NDC,both,1,mL,992.74,595.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Aetna,Commerical,,,766,,766,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Aetna,Middlesex Employees,,,734.53,,734.53,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Anthem,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Anthem,Indemnity,,,743.66,,743.66,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Anthem,Individual Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Anthem,State Preferred,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Cigna,Cigna,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Connecticare,Commerical,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Connecticare,Exchange,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,Multiplan,Multiplan,,,843.83,,843.83,734.53,843.83,percent of total billed charges,,
ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,69452-237-46,NDC,both,1,mL,992.74,595.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,734.53,843.83,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,0904-5610-61,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
ENALAPRIL MALEATE 10 MG TABLET,J3490,HCPCS,23155-772-01,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Aetna,Commerical,,,1.24,,1.24,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Aetna,Middlesex Employees,,,1.19,,1.19,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Anthem,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Anthem,Indemnity,,,1.21,,1.21,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Anthem,Individual Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Anthem,State Preferred,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Cigna,Cigna,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Connecticare,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Connecticare,Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,Multiplan,Multiplan,,,1.37,,1.37,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,0904-5609-61,NDC,both,1,ea,1.61,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Aetna,Commerical,,,1.24,,1.24,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Aetna,Middlesex Employees,,,1.19,,1.19,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Anthem,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Anthem,Indemnity,,,1.21,,1.21,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Anthem,Individual Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Anthem,State Preferred,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Cigna,Cigna,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Connecticare,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Connecticare,Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,Multiplan,Multiplan,,,1.37,,1.37,1.19,1.37,percent of total billed charges,,
ENALAPRIL MALEATE 2.5 MG TABLET,J3490,HCPCS,23155-704-01,NDC,both,1,ea,1.61,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Aetna,Commerical,,,2.11,,2.11,2.03,2.33,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.33,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Anthem,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Anthem,Indemnity,,,2.05,,2.05,2.03,2.33,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Anthem,Individual Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Anthem,State Preferred,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Cigna,Cigna,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Connecticare,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Connecticare,Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,Multiplan,Multiplan,,,2.33,,2.33,2.03,2.33,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,0904-5611-61,NDC,both,1,ea,2.74,1.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
ENALAPRIL MALEATE 20 MG TABLET,J3490,HCPCS,23155-773-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0093-0027-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,0904-5502-61,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,23155-705-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ENALAPRIL MALEATE 5 MG TABLET,J3490,HCPCS,64679-924-02,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Aetna,Commerical,,,82.75,,82.75,79.35,91.15,percent of total billed charges,,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Aetna,Middlesex Employees,,,79.35,,79.35,79.35,91.15,percent of total billed charges,,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Anthem,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Anthem,Indemnity,,,80.33,,80.33,79.35,91.15,percent of total billed charges,,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Anthem,Individual Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Anthem,State Preferred,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Cigna,Cigna,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Connecticare,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Connecticare,Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,Multiplan,Multiplan,,,91.15,,91.15,79.35,91.15,percent of total billed charges,,
ENALAPRILAT  25 MCG/ML IN D5W DILUTION,J3490,HCPCS,40810-0205-30,NDC,both,1,mL,107.24,64.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Anthem,Commerical,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Anthem,State Preferred,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Cigna,Cigna,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Connecticare,Commerical,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Connecticare,Exchange,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-01,NDC,both,1,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Anthem,Commerical,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Anthem,State Preferred,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Cigna,Cigna,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Connecticare,Commerical,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Connecticare,Exchange,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,13.04,14.98,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9787-10,NDC,both,1,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.04,14.98,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Aetna,Commerical,,,27.18,,27.18,26.07,29.95,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Aetna,Middlesex Employees,,,26.07,,26.07,26.07,29.95,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Anthem,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Anthem,Indemnity,,,26.39,,26.39,26.07,29.95,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Anthem,Individual Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Anthem,State Preferred,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Cigna,Cigna,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Connecticare,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Connecticare,Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,Multiplan,Multiplan,,,29.95,,29.95,26.07,29.95,percent of total billed charges,,
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2122-02,NDC,both,1,mL,35.23,21.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Aetna,Commerical,,,82.75,,82.75,79.35,91.15,percent of total billed charges,,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Aetna,Middlesex Employees,,,79.35,,79.35,79.35,91.15,percent of total billed charges,,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Anthem,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Anthem,Indemnity,,,80.33,,80.33,79.35,91.15,percent of total billed charges,,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Anthem,Individual Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Anthem,State Preferred,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Cigna,Cigna,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Connecticare,Commerical,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Connecticare,Exchange,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,Multiplan,Multiplan,,,91.15,,91.15,79.35,91.15,percent of total billed charges,,
ENALAPRILAT 25 MCG/ML IN NS DILUTION,J3490,HCPCS,40810-0018-33,NDC,both,1,mL,107.24,64.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.35,91.15,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Aetna,Commerical,,,102.91,,102.91,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Aetna,Middlesex Employees,,,98.68,,98.68,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Commerical,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Indemnity,,,99.91,,99.91,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Individual Exchange,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,State Preferred,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Cigna,Cigna,,0.66,,,0.66,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Connecticare,Commerical,,0.87,,,0.87,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Connecticare,Exchange,,0.87,,,0.87,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Multiplan,Multiplan,,,113.36,,113.36,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Aetna,Commerical,,,102.91,,102.91,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Aetna,Middlesex Employees,,,98.68,,98.68,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Commerical,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Indemnity,,,99.91,,99.91,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,Individual Exchange,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Anthem,State Preferred,,,,,,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Cigna,Cigna,,0.66,,,0.66,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Connecticare,Commerical,,0.87,,,0.87,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Connecticare,Exchange,,0.87,,,0.87,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,Multiplan,Multiplan,,,113.36,,113.36,0.66,113.36,percent of total billed charges,,
ENOXAPARIN (LOVENOX) 20 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS,J1650,HCPCS,40810-0203-53,NDC,both,0.5,mL,133.37,80.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,113.36,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Aetna,Commerical,,,51.46,,51.46,0.66,56.69,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Aetna,Middlesex Employees,,,49.34,,49.34,0.66,56.69,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Anthem,Commerical,,,,,,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Anthem,Indemnity,,,49.96,,49.96,0.66,56.69,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Anthem,Individual Exchange,,,,,,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Anthem,State Preferred,,,,,,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Cigna,Cigna,,0.66,,,0.66,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Connecticare,Commerical,,0.87,,,0.87,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Connecticare,Exchange,,0.87,,,0.87,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,Multiplan,Multiplan,,,56.69,,56.69,0.66,56.69,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS,J1650,HCPCS,40810-0013-06,NDC,both,1,mL,66.69,40.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,56.69,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Aetna,Commerical,,,5.01,,5.01,0.66,5.52,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Aetna,Middlesex Employees,,,4.8,,4.8,0.66,5.52,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Anthem,Commerical,,,,,,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Anthem,Indemnity,,,4.86,,4.86,0.66,5.52,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Anthem,Individual Exchange,,,,,,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Anthem,State Preferred,,,,,,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Cigna,Cigna,,0.66,,,0.66,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Connecticare,Commerical,,0.87,,,0.87,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Connecticare,Exchange,,0.87,,,0.87,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,Multiplan,Multiplan,,,5.52,,5.52,0.66,5.52,percent of total billed charges,,
ENOXAPARIN 10 MG/ML IN NS NICU,J1650,HCPCS,40810-0004-51,NDC,both,1,mL,6.49,3.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,5.52,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0623-00,NDC,both,1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-05,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3268-69,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-21,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-63,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-65,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-586-96,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Aetna,Commerical,,,23.27,,23.27,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Aetna,Middlesex Employees,,,22.32,,22.32,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Anthem,Commerical,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Anthem,Indemnity,,,22.59,,22.59,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Anthem,Individual Exchange,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Anthem,State Preferred,,,,,,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Cigna,Cigna,,0.66,,,0.66,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Connecticare,Commerical,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Connecticare,Exchange,,0.87,,,0.87,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,Multiplan,Multiplan,,,25.64,,25.64,0.66,25.64,percent of total billed charges,,
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-605-01,NDC,both,0.1,mL,30.16,18.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,25.64,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Aetna,Commerical,,,24.96,,24.96,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Aetna,Middlesex Employees,,,23.94,,23.94,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Commerical,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Indemnity,,,24.23,,24.23,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Individual Exchange,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Anthem,State Preferred,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Cigna,Cigna,,0.66,,,0.66,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Connecticare,Commerical,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Connecticare,Exchange,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,Multiplan,Multiplan,,,27.5,,27.5,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-2912-01,NDC,both,0.067,mL,32.35,19.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Aetna,Commerical,,,24.96,,24.96,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Aetna,Middlesex Employees,,,23.94,,23.94,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Commerical,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Indemnity,,,24.23,,24.23,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Anthem,Individual Exchange,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Anthem,State Preferred,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Cigna,Cigna,,0.66,,,0.66,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Connecticare,Commerical,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Connecticare,Exchange,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,Multiplan,Multiplan,,,27.5,,27.5,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-609-01,NDC,both,0.067,mL,32.35,19.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Aetna,Commerical,,,24.96,,24.96,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Aetna,Middlesex Employees,,,23.94,,23.94,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Anthem,Commerical,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Anthem,Indemnity,,,24.23,,24.23,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Anthem,Individual Exchange,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Anthem,State Preferred,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Cigna,Cigna,,0.66,,,0.66,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Connecticare,Commerical,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Connecticare,Exchange,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,Multiplan,Multiplan,,,27.5,,27.5,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-21,NDC,both,0.067,mL,32.35,19.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Aetna,Commerical,,,24.96,,24.96,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Aetna,Middlesex Employees,,,23.94,,23.94,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Anthem,Commerical,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Anthem,Indemnity,,,24.23,,24.23,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Anthem,Individual Exchange,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Anthem,State Preferred,,,,,,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Cigna,Cigna,,0.66,,,0.66,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Connecticare,Commerical,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Connecticare,Exchange,,0.87,,,0.87,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,Multiplan,Multiplan,,,27.5,,27.5,0.66,27.5,percent of total billed charges,,
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-655-99,NDC,both,0.067,mL,32.35,19.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,27.5,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Aetna,Commerical,,,66.83,,66.83,0.66,73.62,percent of total billed charges,,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Aetna,Middlesex Employees,,,64.08,,64.08,0.66,73.62,percent of total billed charges,,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Anthem,Commerical,,,,,,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Anthem,Indemnity,,,64.88,,64.88,0.66,73.62,percent of total billed charges,,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Anthem,Individual Exchange,,,,,,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Anthem,State Preferred,,,,,,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Cigna,Cigna,,0.66,,,0.66,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Connecticare,Commerical,,0.87,,,0.87,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Connecticare,Exchange,,0.87,,,0.87,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,Multiplan,Multiplan,,,73.62,,73.62,0.66,73.62,percent of total billed charges,,
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0798-4,NDC,both,0.067,mL,86.61,51.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,73.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0624-30,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-01,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3238-63,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-01,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-13,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-83,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-533-93,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-21,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-63,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-65,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Commerical,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Anthem,Individual Exchange,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Anthem,State Preferred,,,,,,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Cigna,Cigna,,0.66,,,0.66,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Connecticare,Commerical,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Connecticare,Exchange,,0.87,,,0.87,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.66,7.46,percent of total billed charges,,
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-559-93,NDC,both,0.1,mL,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,7.46,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Commerical,,,208.11,,208.11,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Middlesex Employees,,,199.56,,199.56,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Commerical,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Indemnity,,,202.04,,202.04,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Individual Exchange,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Anthem,State Preferred,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Cigna,Cigna,,0.66,,,0.66,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Commerical,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Exchange,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,Multiplan,Multiplan,,,229.25,,229.25,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,0075-0626-03,NDC,both,0.1,mL,269.71,161.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Commerical,,,208.11,,208.11,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Middlesex Employees,,,199.56,,199.56,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Commerical,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Indemnity,,,202.04,,202.04,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Individual Exchange,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Anthem,State Preferred,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Cigna,Cigna,,0.66,,,0.66,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Commerical,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Exchange,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,Multiplan,Multiplan,,,229.25,,229.25,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,63323-539-03,NDC,both,0.1,mL,269.71,161.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Commerical,,,208.11,,208.11,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Aetna,Middlesex Employees,,,199.56,,199.56,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Commerical,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Indemnity,,,202.04,,202.04,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Anthem,Individual Exchange,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Anthem,State Preferred,,,,,,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Cigna,Cigna,,0.66,,,0.66,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Commerical,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Connecticare,Exchange,,0.87,,,0.87,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,Multiplan,Multiplan,,,229.25,,229.25,0.66,229.25,percent of total billed charges,,
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,J1650,HCPCS,71288-426-03,NDC,both,0.1,mL,269.71,161.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,229.25,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0620-40,NDC,both,0.4,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Aetna,Commerical,,,65.02,,65.02,0.66,71.62,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Aetna,Middlesex Employees,,,62.34,,62.34,0.66,71.62,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Anthem,Commerical,,,,,,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Anthem,Indemnity,,,63.12,,63.12,0.66,71.62,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Anthem,Individual Exchange,,,,,,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Anthem,State Preferred,,,,,,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Cigna,Cigna,,0.66,,,0.66,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Connecticare,Commerical,,0.87,,,0.87,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Connecticare,Exchange,,0.87,,,0.87,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,Multiplan,Multiplan,,,71.62,,71.62,0.66,71.62,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0548-5602-00,NDC,both,0.1,mL,84.26,50.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,71.62,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-02,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3246-64,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-0,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,60505-0792-4,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-01,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-535-87,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-21,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-63,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-65,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Aetna,Commerical,,,8.19,,8.19,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Aetna,Middlesex Employees,,,7.86,,7.86,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Anthem,Commerical,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Anthem,Indemnity,,,7.96,,7.96,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Anthem,Individual Exchange,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Anthem,State Preferred,,,,,,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Cigna,Cigna,,0.66,,,0.66,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Connecticare,Commerical,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Connecticare,Exchange,,0.87,,,0.87,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,Multiplan,Multiplan,,,9.03,,9.03,0.66,9.03,percent of total billed charges,,
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-564-97,NDC,both,0.1,mL,10.62,6.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,9.03,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0075-0621-60,NDC,both,0.6,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-03,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,0781-3256-66,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-63,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-65,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-566-98,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-01,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-08,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-88,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Commerical,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Anthem,State Preferred,,,,,,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Cigna,Cigna,,0.66,,,0.66,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Connecticare,Commerical,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Connecticare,Exchange,,0.87,,,0.87,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,0.66,18.89,percent of total billed charges,,
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-607-98,NDC,both,0.1,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,18.89,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Aetna,Commerical,,,20.34,,20.34,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Aetna,Middlesex Employees,,,19.5,,19.5,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Anthem,Commerical,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Anthem,Indemnity,,,19.75,,19.75,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Anthem,Individual Exchange,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Anthem,State Preferred,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Cigna,Cigna,,0.66,,,0.66,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Connecticare,Commerical,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Connecticare,Exchange,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,Multiplan,Multiplan,,,22.41,,22.41,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-531-01,NDC,both,0.1,mL,26.36,15.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Aetna,Commerical,,,20.34,,20.34,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Aetna,Middlesex Employees,,,19.5,,19.5,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Anthem,Commerical,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Anthem,Indemnity,,,19.75,,19.75,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Anthem,Individual Exchange,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Anthem,State Preferred,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Cigna,Cigna,,0.66,,,0.66,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Connecticare,Commerical,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Connecticare,Exchange,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,Multiplan,Multiplan,,,22.41,,22.41,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-21,NDC,both,0.1,mL,26.36,15.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Aetna,Commerical,,,20.34,,20.34,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Aetna,Middlesex Employees,,,19.5,,19.5,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Anthem,Commerical,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Anthem,Indemnity,,,19.75,,19.75,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Anthem,Individual Exchange,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Anthem,State Preferred,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Cigna,Cigna,,0.66,,,0.66,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Connecticare,Commerical,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Connecticare,Exchange,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,Multiplan,Multiplan,,,22.41,,22.41,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-63,NDC,both,0.1,mL,26.36,15.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Aetna,Commerical,,,20.34,,20.34,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Aetna,Middlesex Employees,,,19.5,,19.5,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Anthem,Commerical,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Anthem,Indemnity,,,19.75,,19.75,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Anthem,Individual Exchange,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Anthem,State Preferred,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Cigna,Cigna,,0.66,,,0.66,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Connecticare,Commerical,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Connecticare,Exchange,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,Multiplan,Multiplan,,,22.41,,22.41,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-65,NDC,both,0.1,mL,26.36,15.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Aetna,Commerical,,,20.34,,20.34,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Aetna,Middlesex Employees,,,19.5,,19.5,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Anthem,Commerical,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Anthem,Indemnity,,,19.75,,19.75,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Anthem,Individual Exchange,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Anthem,State Preferred,,,,,,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Cigna,Cigna,,0.66,,,0.66,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Connecticare,Commerical,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Connecticare,Exchange,,0.87,,,0.87,0.66,22.41,Other,Could be inpatient or outpatient,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,Multiplan,Multiplan,,,22.41,,22.41,0.66,22.41,percent of total billed charges,,
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,J1650,HCPCS,63323-584-99,NDC,both,0.1,mL,26.36,15.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.71,,,0.71,0.66,22.41,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-01,NDC,both,1,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6238-25,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-71,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3269-95,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-11,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-725-25,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-1,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-4200-4,NDC,both,1,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-00,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-257-01,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-25,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70756-611-82,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Aetna,Commerical,,,11.87,,11.87,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Aetna,Middlesex Employees,,,11.38,,11.38,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Anthem,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Anthem,Indemnity,,,11.52,,11.52,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Anthem,Individual Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Anthem,State Preferred,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Cigna,Cigna,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Connecticare,Commerical,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Connecticare,Exchange,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,Multiplan,Multiplan,,,13.07,,13.07,11.38,13.07,percent of total billed charges,,
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,76014-005-30,NDC,both,0.002,mL,15.38,9.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.38,13.07,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Aetna,Commerical,,,540.71,,540.71,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Aetna,Middlesex Employees,,,518.49,,518.49,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Anthem,Commerical,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Anthem,Indemnity,,,524.94,,524.94,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Anthem,Individual Exchange,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Anthem,State Preferred,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Cigna,Cigna,,0.92,,,0.92,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Connecticare,Commerical,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Connecticare,Exchange,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,Multiplan,Multiplan,,,595.65,,595.65,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-19,NDC,both,0.667,ea,700.76,420.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Aetna,Commerical,,,540.71,,540.71,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Aetna,Middlesex Employees,,,518.49,,518.49,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Anthem,Commerical,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Anthem,Indemnity,,,524.94,,524.94,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Anthem,Individual Exchange,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Anthem,State Preferred,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Cigna,Cigna,,0.92,,,0.92,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Connecticare,Commerical,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Connecticare,Exchange,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,Multiplan,Multiplan,,,595.65,,595.65,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,0093-5985-27,NDC,both,0.667,ea,700.76,420.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Aetna,Commerical,,,540.71,,540.71,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Aetna,Middlesex Employees,,,518.49,,518.49,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Anthem,Commerical,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Anthem,Indemnity,,,524.94,,524.94,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Anthem,Individual Exchange,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Anthem,State Preferred,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Cigna,Cigna,,0.92,,,0.92,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Connecticare,Commerical,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Connecticare,Exchange,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,Multiplan,Multiplan,,,595.65,,595.65,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-01,NDC,both,0.667,ea,700.76,420.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Aetna,Commerical,,,540.71,,540.71,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Aetna,Middlesex Employees,,,518.49,,518.49,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Anthem,Commerical,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Anthem,Indemnity,,,524.94,,524.94,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Anthem,Individual Exchange,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Anthem,State Preferred,,,,,,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Cigna,Cigna,,0.92,,,0.92,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Connecticare,Commerical,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Connecticare,Exchange,,1.26,,,1.26,0.92,595.65,Other,Could be inpatient or outpatient,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,Multiplan,Multiplan,,,595.65,,595.65,0.92,595.65,percent of total billed charges,,
"EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR",J0171,HCPCS,49502-101-02,NDC,both,0.667,ea,700.76,420.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,595.65,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,35.01,21.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-01,NDC,both,0.1,mL,35.01,21.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,0409-4933-11,NDC,both,0.1,mL,35.01,21.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,69374-925-10,NDC,both,1,mL,35.01,21.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.92,,,0.92,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,1.26,,,1.26,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,1.26,,,1.26,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,J0171,HCPCS,76329-3318-1,NDC,both,1,mL,35.01,21.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.92,,,0.92,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,1.26,,,1.26,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,1.26,,,1.26,0.92,19.53,Other,Could be inpatient or outpatient,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.92,19.53,percent of total billed charges,,
EPINEPHRINE 0.1 MG/ML IV FOR CARDIOPULMONARY ARREST,J0171,HCPCS,76329-3316-1,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,19.53,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Aetna,Commerical,,,406.14,,406.14,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Aetna,Middlesex Employees,,,389.45,,389.45,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Anthem,Commerical,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Anthem,Indemnity,,,394.3,,394.3,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Anthem,Individual Exchange,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Anthem,State Preferred,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Cigna,Cigna,,0.92,,,0.92,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Connecticare,Commerical,,1.26,,,1.26,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Connecticare,Exchange,,1.26,,,1.26,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,Multiplan,Multiplan,,,447.41,,447.41,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-01,NDC,both,0.334,ea,526.36,315.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Aetna,Commerical,,,406.14,,406.14,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Aetna,Middlesex Employees,,,389.45,,389.45,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Anthem,Commerical,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Anthem,Indemnity,,,394.3,,394.3,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Anthem,Individual Exchange,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Anthem,State Preferred,,,,,,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Cigna,Cigna,,0.92,,,0.92,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Connecticare,Commerical,,1.26,,,1.26,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Connecticare,Exchange,,1.26,,,1.26,0.92,447.41,Other,Could be inpatient or outpatient,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,Multiplan,Multiplan,,,447.41,,447.41,0.92,447.41,percent of total billed charges,,
"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",J0171,HCPCS,49502-102-02,NDC,both,0.334,ea,526.36,315.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,447.41,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
"EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN FOR IFC HTFD",J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML ENDOTRACHEAL FOR CARDIAC ARREST,J0171,HCPCS,0409-7241-01,NDC,both,0.1,mL,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-01,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Aetna,Commerical,,,39.82,,39.82,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Aetna,Middlesex Employees,,,38.19,,38.19,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Commerical,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Indemnity,,,38.66,,38.66,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,Individual Exchange,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Anthem,State Preferred,,,,,,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Cigna,Cigna,,0.92,,,0.92,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Connecticare,Commerical,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Connecticare,Exchange,,1.26,,,1.26,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,Multiplan,Multiplan,,,43.87,,43.87,0.92,43.87,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJ FOR ANAPHYLAXIS,J0171,HCPCS,42023-159-25,NDC,both,0.1,mL,51.61,30.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,43.87,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Aetna,Commerical,,,483.54,,483.54,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Aetna,Middlesex Employees,,,463.67,,463.67,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Anthem,Commerical,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Anthem,Indemnity,,,469.44,,469.44,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Anthem,Individual Exchange,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Anthem,State Preferred,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Cigna,Cigna,,0.92,,,0.92,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Connecticare,Commerical,,1.26,,,1.26,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Connecticare,Exchange,,1.26,,,1.26,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,Multiplan,Multiplan,,,532.67,,532.67,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-01,NDC,both,0.1,mL,626.67,376,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Aetna,Commerical,,,483.54,,483.54,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Aetna,Middlesex Employees,,,463.67,,463.67,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Anthem,Commerical,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Anthem,Indemnity,,,469.44,,469.44,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Anthem,Individual Exchange,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Anthem,State Preferred,,,,,,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Cigna,Cigna,,0.92,,,0.92,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Connecticare,Commerical,,1.26,,,1.26,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Connecticare,Exchange,,1.26,,,1.26,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,Multiplan,Multiplan,,,532.67,,532.67,0.92,532.67,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,42023-168-99,NDC,both,0.1,mL,626.67,376,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,532.67,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Aetna,Commerical,,,161.18,,161.18,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Aetna,Middlesex Employees,,,154.56,,154.56,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Commerical,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Indemnity,,,156.48,,156.48,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Individual Exchange,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Anthem,State Preferred,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Cigna,Cigna,,0.92,,,0.92,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Connecticare,Commerical,,1.26,,,1.26,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Connecticare,Exchange,,1.26,,,1.26,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,Multiplan,Multiplan,,,177.56,,177.56,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-120-01,NDC,both,0.1,mL,208.89,125.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Aetna,Commerical,,,161.18,,161.18,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Aetna,Middlesex Employees,,,154.56,,154.56,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Commerical,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Indemnity,,,156.48,,156.48,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Anthem,Individual Exchange,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Anthem,State Preferred,,,,,,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Cigna,Cigna,,0.92,,,0.92,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Connecticare,Commerical,,1.26,,,1.26,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Connecticare,Exchange,,1.26,,,1.26,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,Multiplan,Multiplan,,,177.56,,177.56,0.92,177.56,percent of total billed charges,,
EPINEPHRINE 1 MG/ML INJECTION SOLUTION,J0171,HCPCS,54288-600-01,NDC,both,0.1,mL,208.89,125.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,177.56,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE 8 MG/250 ML (32 MCG/ML) CONTINUOUS FREQUENCY,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Aetna,Commerical,,,27.01,,27.01,0.92,29.76,percent of total billed charges,,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Aetna,Middlesex Employees,,,25.9,,25.9,0.92,29.76,percent of total billed charges,,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Commerical,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Indemnity,,,26.23,,26.23,0.92,29.76,percent of total billed charges,,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,Individual Exchange,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Anthem,State Preferred,,,,,,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Cigna,Cigna,,0.92,,,0.92,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Connecticare,Commerical,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Connecticare,Exchange,,1.26,,,1.26,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,Multiplan,Multiplan,,,29.76,,29.76,0.92,29.76,percent of total billed charges,,
EPINEPHRINE FOR PULM HEMORRHAGE,J0171,HCPCS,0409-4921-34,NDC,both,10,mL,16.01,9.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,29.76,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Aetna,Commerical,,,25.6,,25.6,0.92,28.2,percent of total billed charges,,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Aetna,Middlesex Employees,,,24.55,,24.55,0.92,28.2,percent of total billed charges,,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Anthem,Commerical,,,,,,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Anthem,Indemnity,,,24.86,,24.86,0.92,28.2,percent of total billed charges,,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Anthem,Individual Exchange,,,,,,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Anthem,State Preferred,,,,,,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Cigna,Cigna,,0.92,,,0.92,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Connecticare,Commerical,,1.26,,,1.26,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Connecticare,Exchange,,1.26,,,1.26,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,Multiplan,Multiplan,,,28.2,,28.2,0.92,28.2,percent of total billed charges,,
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,J0171,HCPCS,54288-103-10,NDC,both,0.1,mL,33.18,19.91,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.92,28.2,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Aetna,Commerical,,,21.46,,21.46,20.58,23.64,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Aetna,Middlesex Employees,,,20.58,,20.58,20.58,23.64,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Anthem,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Anthem,Indemnity,,,20.83,,20.83,20.58,23.64,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Anthem,Individual Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Anthem,State Preferred,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Cigna,Cigna,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Connecticare,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Connecticare,Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,Multiplan,Multiplan,,,23.64,,23.64,20.58,23.64,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,J3490,HCPCS,70092-1617-46,NDC,both,1,mL,27.81,16.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Aetna,Commerical,,,246.83,,246.83,236.69,271.91,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Aetna,Middlesex Employees,,,236.69,,236.69,236.69,271.91,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Anthem,Commerical,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Anthem,Indemnity,,,239.63,,239.63,236.69,271.91,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Anthem,Individual Exchange,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Anthem,State Preferred,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Cigna,Cigna,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Connecticare,Commerical,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Connecticare,Exchange,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,Multiplan,Multiplan,,,271.91,,271.91,236.69,271.91,percent of total billed charges,,
EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,J3490,HCPCS,40810-0208-89,NDC,both,1,mL,319.89,191.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,236.69,271.91,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70004-0607-40,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70092-1516-05,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,70324-077-01,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,71506-060-58,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Aetna,Commerical,,,174.36,,174.36,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Aetna,Middlesex Employees,,,167.2,,167.2,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Indemnity,,,169.27,,169.27,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,Individual Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Anthem,State Preferred,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Cigna,Cigna,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Connecticare,Commerical,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Connecticare,Exchange,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,Multiplan,Multiplan,,,192.07,,192.07,167.2,192.07,percent of total billed charges,,
EPINEPHRINE HCL 8 MG/250 ML (32 MCG/ML) IN 0.9 % SODIUM CHLOR IV SOLN,J3490,HCPCS,76154-814-15,NDC,both,1,mL,225.97,135.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.2,192.07,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Aetna,Commerical,,,495.98,,495.98,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Aetna,Middlesex Employees,,,475.61,,475.61,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Commerical,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Indemnity,,,481.52,,481.52,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Individual Exchange,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,State Preferred,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Cigna,Cigna,,11.46,,,11.46,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Connecticare,Commerical,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Connecticare,Exchange,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Multiplan,Multiplan,,,546.38,,546.38,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Aetna,Commerical,,,495.98,,495.98,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Aetna,Middlesex Employees,,,475.61,,475.61,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Commerical,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Indemnity,,,481.52,,481.52,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Individual Exchange,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,State Preferred,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Cigna,Cigna,,11.46,,,11.46,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Connecticare,Commerical,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Connecticare,Exchange,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Multiplan,Multiplan,,,546.38,,546.38,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Aetna,Commerical,,,657.67,,657.67,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Aetna,Middlesex Employees,,,630.65,,630.65,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Anthem,Commerical,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Anthem,Indemnity,,,638.5,,638.5,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Anthem,Individual Exchange,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Anthem,State Preferred,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Cigna,Cigna,,11.46,,,11.46,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Connecticare,Commerical,,11.5,,,11.5,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Connecticare,Exchange,,11.5,,,11.5,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,Multiplan,Multiplan,,,724.5,,724.5,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-00,NDC,both,0.01,mL,852.35,511.41,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Aetna,Commerical,,,657.67,,657.67,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Aetna,Middlesex Employees,,,630.65,,630.65,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Anthem,Commerical,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Anthem,Indemnity,,,638.5,,638.5,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Anthem,Individual Exchange,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Anthem,State Preferred,,,,,,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Cigna,Cigna,,11.46,,,11.46,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Connecticare,Commerical,,11.5,,,11.5,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Connecticare,Exchange,,11.5,,,11.5,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,Multiplan,Multiplan,,,724.5,,724.5,9.92,724.5,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-310-01,NDC,both,0.01,mL,852.35,511.41,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,724.5,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Aetna,Commerical,,,495.98,,495.98,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Aetna,Middlesex Employees,,,475.61,,475.61,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Commerical,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Indemnity,,,481.52,,481.52,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,Individual Exchange,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Anthem,State Preferred,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Cigna,Cigna,,11.46,,,11.46,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Connecticare,Commerical,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Connecticare,Exchange,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,Multiplan,Multiplan,,,546.38,,546.38,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-01,NDC,both,0.01,mL,642.8,385.68,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Aetna,Commerical,,,495.98,,495.98,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Aetna,Middlesex Employees,,,475.61,,475.61,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Commerical,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Indemnity,,,481.52,,481.52,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,Individual Exchange,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Anthem,State Preferred,,,,,,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Cigna,Cigna,,11.46,,,11.46,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Connecticare,Commerical,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Connecticare,Exchange,,11.5,,,11.5,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,Multiplan,Multiplan,,,546.38,,546.38,9.92,546.38,percent of total billed charges,,
"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-144-10,NDC,both,0.1,mL,642.8,385.68,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,546.38,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Aetna,Commerical,,,122.47,,122.47,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Aetna,Middlesex Employees,,,117.44,,117.44,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Commerical,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Indemnity,,,118.9,,118.9,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Individual Exchange,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,State Preferred,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Cigna,Cigna,,11.46,,,11.46,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Connecticare,Commerical,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Connecticare,Exchange,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Multiplan,Multiplan,,,134.91,,134.91,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Aetna,Commerical,,,122.47,,122.47,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Aetna,Middlesex Employees,,,117.44,,117.44,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Commerical,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Indemnity,,,118.9,,118.9,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Individual Exchange,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,State Preferred,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Cigna,Cigna,,11.46,,,11.46,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Connecticare,Commerical,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Connecticare,Exchange,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Multiplan,Multiplan,,,134.91,,134.91,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Aetna,Commerical,,,122.47,,122.47,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Aetna,Middlesex Employees,,,117.44,,117.44,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Anthem,Commerical,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Anthem,Indemnity,,,118.9,,118.9,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Anthem,Individual Exchange,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Anthem,State Preferred,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Cigna,Cigna,,11.46,,,11.46,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Connecticare,Commerical,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Connecticare,Exchange,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,Multiplan,Multiplan,,,134.91,,134.91,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-00,NDC,both,0.05,mL,158.72,95.23,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Aetna,Commerical,,,154.81,,154.81,9.92,170.54,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Aetna,Middlesex Employees,,,148.45,,148.45,9.92,170.54,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Anthem,Commerical,,,,,,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Anthem,Indemnity,,,150.29,,150.29,9.92,170.54,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Anthem,Individual Exchange,,,,,,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Anthem,State Preferred,,,,,,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Cigna,Cigna,,11.46,,,11.46,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Connecticare,Commerical,,11.5,,,11.5,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Connecticare,Exchange,,11.5,,,11.5,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,Multiplan,Multiplan,,,170.54,,170.54,9.92,170.54,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-302-01,NDC,both,0.05,mL,200.63,120.38,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,170.54,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Aetna,Commerical,,,122.47,,122.47,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Aetna,Middlesex Employees,,,117.44,,117.44,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Commerical,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Indemnity,,,118.9,,118.9,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,Individual Exchange,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Anthem,State Preferred,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Cigna,Cigna,,11.46,,,11.46,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Connecticare,Commerical,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Connecticare,Exchange,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,Multiplan,Multiplan,,,134.91,,134.91,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-01,NDC,both,0.05,mL,158.72,95.23,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Aetna,Commerical,,,122.47,,122.47,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Aetna,Middlesex Employees,,,117.44,,117.44,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Commerical,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Indemnity,,,118.9,,118.9,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,Individual Exchange,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Anthem,State Preferred,,,,,,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Cigna,Cigna,,11.46,,,11.46,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Connecticare,Commerical,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Connecticare,Exchange,,11.5,,,11.5,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,Multiplan,Multiplan,,,134.91,,134.91,9.92,134.91,percent of total billed charges,,
"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-126-10,NDC,both,0.5,mL,158.72,95.23,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,134.91,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Aetna,Commerical,,,962.86,,962.86,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Aetna,Middlesex Employees,,,923.31,,923.31,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Commerical,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Indemnity,,,934.79,,934.79,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Individual Exchange,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,State Preferred,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Cigna,Cigna,,11.46,,,11.46,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Commerical,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Exchange,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Multiplan,Multiplan,,,1060.7,,1060.7,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Aetna,Commerical,,,962.86,,962.86,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Aetna,Middlesex Employees,,,923.31,,923.31,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Commerical,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Indemnity,,,934.79,,934.79,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Individual Exchange,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,State Preferred,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Cigna,Cigna,,11.46,,,11.46,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Commerical,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Exchange,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Multiplan,Multiplan,,,1060.7,,1060.7,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Aetna,Commerical,,,962.86,,962.86,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Aetna,Middlesex Employees,,,923.31,,923.31,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Commerical,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Indemnity,,,934.79,,934.79,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,Individual Exchange,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Anthem,State Preferred,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Cigna,Cigna,,11.46,,,11.46,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Commerical,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Exchange,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,Multiplan,Multiplan,,,1060.7,,1060.7,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-01,NDC,both,0.005,mL,1247.88,748.73,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Aetna,Commerical,,,962.86,,962.86,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Aetna,Middlesex Employees,,,923.31,,923.31,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Commerical,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Indemnity,,,934.79,,934.79,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,Individual Exchange,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Anthem,State Preferred,,,,,,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Cigna,Cigna,,11.46,,,11.46,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Commerical,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Connecticare,Exchange,,11.5,,,11.5,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,Multiplan,Multiplan,,,1060.7,,1060.7,9.92,1060.7,percent of total billed charges,,
"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-478-10,NDC,both,0.005,mL,1247.88,748.73,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,1060.7,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Aetna,Commerical,,,213.98,,213.98,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Aetna,Middlesex Employees,,,205.19,,205.19,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Commerical,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Indemnity,,,207.74,,207.74,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Individual Exchange,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,State Preferred,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Cigna,Cigna,,11.46,,,11.46,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Connecticare,Commerical,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Connecticare,Exchange,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Multiplan,Multiplan,,,235.72,,235.72,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Aetna,Commerical,,,213.98,,213.98,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Aetna,Middlesex Employees,,,205.19,,205.19,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Anthem,Commerical,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Anthem,Indemnity,,,207.74,,207.74,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Anthem,Individual Exchange,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Anthem,State Preferred,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Cigna,Cigna,,11.46,,,11.46,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Connecticare,Commerical,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Connecticare,Exchange,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,Multiplan,Multiplan,,,235.72,,235.72,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-00,NDC,both,0.33,mL,277.32,166.39,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Aetna,Commerical,,,278.01,,278.01,9.92,306.26,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Aetna,Middlesex Employees,,,266.59,,266.59,9.92,306.26,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Anthem,Commerical,,,,,,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Anthem,Indemnity,,,269.9,,269.9,9.92,306.26,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Anthem,Individual Exchange,,,,,,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Anthem,State Preferred,,,,,,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Cigna,Cigna,,11.46,,,11.46,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Connecticare,Commerical,,11.5,,,11.5,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Connecticare,Exchange,,11.5,,,11.5,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,Multiplan,Multiplan,,,306.26,,306.26,9.92,306.26,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,59676-303-01,NDC,both,0.33,mL,360.3,216.18,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,306.26,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Aetna,Commerical,,,213.98,,213.98,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Aetna,Middlesex Employees,,,205.19,,205.19,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Commerical,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Indemnity,,,207.74,,207.74,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,Individual Exchange,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Anthem,State Preferred,,,,,,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Cigna,Cigna,,11.46,,,11.46,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Connecticare,Commerical,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Connecticare,Exchange,,11.5,,,11.5,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,Multiplan,Multiplan,,,235.72,,235.72,9.92,235.72,percent of total billed charges,,
"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-267-10,NDC,both,0.33,mL,277.32,166.39,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,235.72,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Aetna,Commerical,,,215.85,,215.85,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Aetna,Middlesex Employees,,,206.98,,206.98,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Commerical,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Indemnity,,,209.55,,209.55,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Individual Exchange,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,State Preferred,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Cigna,Cigna,,11.46,,,11.46,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Connecticare,Commerical,,11.5,,,11.5,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Connecticare,Exchange,,11.5,,,11.5,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Multiplan,Multiplan,,,237.78,,237.78,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Aetna,Commerical,,,215.85,,215.85,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Aetna,Middlesex Employees,,,206.98,,206.98,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Commerical,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Indemnity,,,209.55,,209.55,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,Individual Exchange,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Anthem,State Preferred,,,,,,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Cigna,Cigna,,11.46,,,11.46,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Connecticare,Commerical,,11.5,,,11.5,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Connecticare,Exchange,,11.5,,,11.5,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,Multiplan,Multiplan,,,237.78,,237.78,9.92,237.78,percent of total billed charges,,
"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION CCMC",J0885,HCPCS,55513-148-10,NDC,both,0.25,mL,279.74,167.84,United Healthcare/Oxford,United Healthcare/Oxford,,9.92,,,9.92,9.92,237.78,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Aetna,Commerical,,,296.4,,296.4,8.32,326.52,percent of total billed charges,,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Aetna,Middlesex Employees,,,284.23,,284.23,8.32,326.52,percent of total billed charges,,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Anthem,Commerical,,,,,,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Anthem,Indemnity,,,287.76,,287.76,8.32,326.52,percent of total billed charges,,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Anthem,Individual Exchange,,,,,,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Anthem,State Preferred,,,,,,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Cigna,Cigna,,9.62,,,9.62,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Connecticare,Commerical,,11.64,,,11.64,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Connecticare,Exchange,,11.64,,,11.64,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,Multiplan,Multiplan,,,326.52,,326.52,8.32,326.52,percent of total billed charges,,
"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1308-10,NDC,both,0.1,mL,384.14,230.48,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,8.32,326.52,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Aetna,Commerical,,,82.55,,82.55,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Aetna,Middlesex Employees,,,79.16,,79.16,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Anthem,Commerical,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Anthem,Indemnity,,,80.15,,80.15,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Anthem,Individual Exchange,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Anthem,State Preferred,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Cigna,Cigna,,9.62,,,9.62,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Connecticare,Commerical,,11.64,,,11.64,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Connecticare,Exchange,,11.64,,,11.64,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,Multiplan,Multiplan,,,90.94,,90.94,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-01,NDC,both,0.05,mL,106.99,64.19,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Aetna,Commerical,,,82.55,,82.55,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Aetna,Middlesex Employees,,,79.16,,79.16,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Anthem,Commerical,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Anthem,Indemnity,,,80.15,,80.15,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Anthem,Individual Exchange,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Anthem,State Preferred,,,,,,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Cigna,Cigna,,9.62,,,9.62,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Connecticare,Commerical,,11.64,,,11.64,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Connecticare,Exchange,,11.64,,,11.64,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,Multiplan,Multiplan,,,90.94,,90.94,8.32,90.94,percent of total billed charges,,
"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1305-10,NDC,both,0.5,mL,106.99,64.19,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,8.32,90.94,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Aetna,Commerical,,,110.89,,110.89,8.32,122.15,percent of total billed charges,,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Aetna,Middlesex Employees,,,106.33,,106.33,8.32,122.15,percent of total billed charges,,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Anthem,Commerical,,,,,,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Anthem,Indemnity,,,107.65,,107.65,8.32,122.15,percent of total billed charges,,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Anthem,Individual Exchange,,,,,,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Anthem,State Preferred,,,,,,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Cigna,Cigna,,9.62,,,9.62,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Connecticare,Commerical,,11.64,,,11.64,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Connecticare,Exchange,,11.64,,,11.64,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,Multiplan,Multiplan,,,122.15,,122.15,8.32,122.15,percent of total billed charges,,
"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1306-10,NDC,both,0.034,mL,143.71,86.23,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,8.32,122.15,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Aetna,Commerical,,,136.01,,136.01,8.32,149.83,percent of total billed charges,,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Aetna,Middlesex Employees,,,130.42,,130.42,8.32,149.83,percent of total billed charges,,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Anthem,Commerical,,,,,,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Anthem,Indemnity,,,132.04,,132.04,8.32,149.83,percent of total billed charges,,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Anthem,Individual Exchange,,,,,,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Anthem,State Preferred,,,,,,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Cigna,Cigna,,9.62,,,9.62,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Connecticare,Commerical,,11.64,,,11.64,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Connecticare,Exchange,,11.64,,,11.64,8.32,149.83,Other,Could be inpatient or outpatient,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,Multiplan,Multiplan,,,149.83,,149.83,8.32,149.83,percent of total billed charges,,
"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",Q5106,HCPCS,0069-1307-10,NDC,both,0.025,mL,176.27,105.76,United Healthcare/Oxford,United Healthcare/Oxford,,8.32,,,8.32,8.32,149.83,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Aetna,Commerical,,,34.2,,34.2,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Aetna,Middlesex Employees,,,32.79,,32.79,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Anthem,Commerical,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Anthem,Indemnity,,,33.2,,33.2,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Anthem,Individual Exchange,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Anthem,State Preferred,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Cigna,Cigna,,18.61,,,18.61,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Connecticare,Commerical,,24.22,,,24.22,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Connecticare,Exchange,,24.22,,,24.22,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,Multiplan,Multiplan,,,37.67,,37.67,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0173-0517-00,NDC,both,1,ea,44.32,26.59,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Aetna,Commerical,,,34.2,,34.2,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Aetna,Middlesex Employees,,,32.79,,32.79,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Anthem,Commerical,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Anthem,Indemnity,,,33.2,,33.2,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Anthem,Individual Exchange,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Anthem,State Preferred,,,,,,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Cigna,Cigna,,18.61,,,18.61,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Connecticare,Commerical,,24.22,,,24.22,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Connecticare,Exchange,,24.22,,,24.22,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,Multiplan,Multiplan,,,37.67,,37.67,18.61,37.67,percent of total billed charges,,
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,0703-1985-01,NDC,both,1,ea,44.32,26.59,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,37.67,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Aetna,Commerical,,,58.25,,58.25,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Aetna,Middlesex Employees,,,55.86,,55.86,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Anthem,Commerical,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Anthem,Indemnity,,,56.55,,56.55,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Anthem,Individual Exchange,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Anthem,State Preferred,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Cigna,Cigna,,18.61,,,18.61,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Connecticare,Commerical,,24.22,,,24.22,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Connecticare,Exchange,,24.22,,,24.22,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,Multiplan,Multiplan,,,64.17,,64.17,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-059-40,NDC,both,1,ea,75.49,45.29,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Aetna,Commerical,,,58.25,,58.25,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Aetna,Middlesex Employees,,,55.86,,55.86,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Anthem,Commerical,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Anthem,Indemnity,,,56.55,,56.55,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Anthem,Individual Exchange,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Anthem,State Preferred,,,,,,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Cigna,Cigna,,18.61,,,18.61,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Connecticare,Commerical,,24.22,,,24.22,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Connecticare,Exchange,,24.22,,,24.22,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,Multiplan,Multiplan,,,64.17,,64.17,18.61,64.17,percent of total billed charges,,
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-403-01,NDC,both,1,ea,75.49,45.29,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,64.17,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Aetna,Commerical,,,116.76,,116.76,18.61,128.62,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Aetna,Middlesex Employees,,,111.96,,111.96,18.61,128.62,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Anthem,Commerical,,,,,,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Anthem,Indemnity,,,113.35,,113.35,18.61,128.62,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Anthem,Individual Exchange,,,,,,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Anthem,State Preferred,,,,,,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Cigna,Cigna,,18.61,,,18.61,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Connecticare,Commerical,,24.22,,,24.22,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Connecticare,Exchange,,24.22,,,24.22,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,Multiplan,Multiplan,,,128.62,,128.62,18.61,128.62,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,62756-060-40,NDC,both,0.334,ea,151.32,90.79,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,128.62,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Aetna,Commerical,,,222.01,,222.01,18.61,244.57,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Aetna,Middlesex Employees,,,212.89,,212.89,18.61,244.57,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Anthem,Commerical,,,,,,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Anthem,Indemnity,,,215.54,,215.54,18.61,244.57,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Anthem,Individual Exchange,,,,,,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Anthem,State Preferred,,,,,,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Cigna,Cigna,,18.61,,,18.61,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Connecticare,Commerical,,24.22,,,24.22,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Connecticare,Exchange,,24.22,,,24.22,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,Multiplan,Multiplan,,,244.57,,244.57,18.61,244.57,percent of total billed charges,,
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,J1325,HCPCS,66215-402-01,NDC,both,0.333,ea,287.73,172.64,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,244.57,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Aetna,Commerical,,,138.9,,138.9,18.61,153.02,percent of total billed charges,,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Aetna,Middlesex Employees,,,133.2,,133.2,18.61,153.02,percent of total billed charges,,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Anthem,Commerical,,,,,,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Anthem,Indemnity,,,134.85,,134.85,18.61,153.02,percent of total billed charges,,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Anthem,Individual Exchange,,,,,,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Anthem,State Preferred,,,,,,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Cigna,Cigna,,18.61,,,18.61,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Connecticare,Commerical,,24.22,,,24.22,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Connecticare,Exchange,,24.22,,,24.22,18.61,153.02,Other,Could be inpatient or outpatient,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,Multiplan,Multiplan,,,153.02,,153.02,18.61,153.02,percent of total billed charges,,
EPOPROSTENOL 3 MCG/ML INHALATION,J1325,HCPCS,40810-0018-80,NDC,both,166.667,mL,180.02,108.01,United Healthcare/Oxford,United Healthcare/Oxford,,20.09,,,20.09,18.61,153.02,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Aetna,Commerical,,,1608.02,,1608.02,3.7,1771.41,percent of total billed charges,,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Aetna,Middlesex Employees,,,1541.96,,1541.96,3.7,1771.41,percent of total billed charges,,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Anthem,Commerical,,,,,,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Anthem,Indemnity,,,1561.13,,1561.13,3.7,1771.41,percent of total billed charges,,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Anthem,Individual Exchange,,,,,,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Anthem,State Preferred,,,,,,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Cigna,Cigna,,13.68,,,13.68,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Connecticare,Commerical,,,,,,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Connecticare,Exchange,,,,,,3.7,1771.41,Other,Could be inpatient or outpatient,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,Multiplan,Multiplan,,,1771.41,,1771.41,3.7,1771.41,percent of total billed charges,,
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,J1327,HCPCS,0085-1136-01,NDC,both,6.667,mL,2084.01,1250.41,United Healthcare/Oxford,United Healthcare/Oxford,,3.7,,,3.7,3.7,1771.41,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,40810-0018-61,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",J3490,HCPCS,64380-737-06,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Aetna,Commerical,,,83.87,,83.87,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Aetna,Middlesex Employees,,,80.43,,80.43,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Anthem,Commerical,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Anthem,Indemnity,,,81.43,,81.43,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Anthem,Individual Exchange,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Anthem,State Preferred,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Cigna,Cigna,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Connecticare,Commerical,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Connecticare,Exchange,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,Multiplan,Multiplan,,,92.4,,92.4,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,3932835760,NDC,both,1,mL,108.7,65.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Aetna,Commerical,,,83.87,,83.87,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Aetna,Middlesex Employees,,,80.43,,80.43,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Anthem,Commerical,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Anthem,Indemnity,,,81.43,,81.43,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Anthem,Individual Exchange,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Anthem,State Preferred,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Cigna,Cigna,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Connecticare,Commerical,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Connecticare,Exchange,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,Multiplan,Multiplan,,,92.4,,92.4,80.43,92.4,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,4778164726,NDC,both,1,mL,108.7,65.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.43,92.4,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Aetna,Commerical,,,178.73,,178.73,171.39,196.89,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Aetna,Middlesex Employees,,,171.39,,171.39,171.39,196.89,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Anthem,Commerical,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Anthem,Indemnity,,,173.52,,173.52,171.39,196.89,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Anthem,Individual Exchange,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Anthem,State Preferred,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Cigna,Cigna,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Connecticare,Commerical,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Connecticare,Exchange,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,Multiplan,Multiplan,,,196.89,,196.89,171.39,196.89,percent of total billed charges,,
"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",J3490,HCPCS,7583401060,NDC,both,1,mL,231.64,138.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,171.39,196.89,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Aetna,Commerical,,,4042.75,,4042.75,172.37,4453.52,percent of total billed charges,,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Aetna,Middlesex Employees,,,3876.66,,3876.66,172.37,4453.52,percent of total billed charges,,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Anthem,Commerical,,,,,,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Anthem,Indemnity,,,3924.86,,3924.86,172.37,4453.52,percent of total billed charges,,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Anthem,Individual Exchange,,,,,,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Anthem,State Preferred,,,,,,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Cigna,Cigna,,199.22,,,199.22,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Connecticare,Commerical,,207.34,,,207.34,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Connecticare,Exchange,,207.34,,,207.34,172.37,4453.52,Other,Could be inpatient or outpatient,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,Multiplan,Multiplan,,,4453.52,,4453.52,172.37,4453.52,percent of total billed charges,,
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,J9179,HCPCS,62856-389-01,NDC,both,0.2,mL,5239.44,3143.66,United Healthcare/Oxford,United Healthcare/Oxford,,172.37,,,172.37,172.37,4453.52,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Aetna,Commerical,,,224.13,,224.13,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Aetna,Middlesex Employees,,,214.92,,214.92,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Anthem,Commerical,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Anthem,Indemnity,,,217.59,,217.59,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Anthem,Individual Exchange,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Anthem,State Preferred,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Cigna,Cigna,,12.14,,,12.14,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Connecticare,Commerical,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Connecticare,Exchange,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,Multiplan,Multiplan,,,246.9,,246.9,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,0006-3843-71,NDC,both,0.5,ea,290.47,174.28,United Healthcare/Oxford,United Healthcare/Oxford,,13.1,,,13.1,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Aetna,Commerical,,,224.13,,224.13,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Aetna,Middlesex Employees,,,214.92,,214.92,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Anthem,Commerical,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Anthem,Indemnity,,,217.59,,217.59,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Anthem,Individual Exchange,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Anthem,State Preferred,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Cigna,Cigna,,12.14,,,12.14,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Connecticare,Commerical,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Connecticare,Exchange,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,Multiplan,Multiplan,,,246.9,,246.9,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-01,NDC,both,0.5,ea,290.47,174.28,United Healthcare/Oxford,United Healthcare/Oxford,,13.1,,,13.1,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Aetna,Commerical,,,224.13,,224.13,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Aetna,Middlesex Employees,,,214.92,,214.92,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Anthem,Commerical,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Anthem,Indemnity,,,217.59,,217.59,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Anthem,Individual Exchange,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Anthem,State Preferred,,,,,,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Cigna,Cigna,,12.14,,,12.14,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Connecticare,Commerical,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Connecticare,Exchange,,15.91,,,15.91,12.14,246.9,Other,Could be inpatient or outpatient,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,Multiplan,Multiplan,,,246.9,,246.9,12.14,246.9,percent of total billed charges,,
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,J1335,HCPCS,63323-823-20,NDC,both,0.5,ea,290.47,174.28,United Healthcare/Oxford,United Healthcare/Oxford,,13.1,,,13.1,12.14,246.9,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Aetna,Commerical,,,289.15,,289.15,78.86,318.53,percent of total billed charges,,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Aetna,Middlesex Employees,,,277.27,,277.27,78.86,318.53,percent of total billed charges,,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Anthem,Commerical,,,,,,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Anthem,Indemnity,,,280.72,,280.72,78.86,318.53,percent of total billed charges,,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Anthem,Individual Exchange,,,,,,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Anthem,State Preferred,,,,,,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Cigna,Cigna,,78.86,,,78.86,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Connecticare,Commerical,,99.83,,,99.83,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Connecticare,Exchange,,99.83,,,99.83,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,Multiplan,Multiplan,,,318.53,,318.53,78.86,318.53,percent of total billed charges,,
ERYTHROMYCIN 2.5 MG/ML IN NS NICU,J1364,HCPCS,40810-0004-52,NDC,both,200,mL,374.74,224.84,United Healthcare/Oxford,United Healthcare/Oxford,,85.14,,,85.14,78.86,318.53,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Aetna,Commerical,,,16.51,,16.51,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Aetna,Middlesex Employees,,,15.83,,15.83,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Anthem,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Anthem,Indemnity,,,16.03,,16.03,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Anthem,Individual Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Anthem,State Preferred,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Cigna,Cigna,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Connecticare,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Connecticare,Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,Multiplan,Multiplan,,,18.19,,18.19,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,24338-102-03,NDC,both,1,ea,21.4,12.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Aetna,Commerical,,,16.51,,16.51,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Aetna,Middlesex Employees,,,15.83,,15.83,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Anthem,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Anthem,Indemnity,,,16.03,,16.03,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Anthem,Individual Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Anthem,State Preferred,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Cigna,Cigna,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Connecticare,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Connecticare,Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,Multiplan,Multiplan,,,18.19,,18.19,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,21.4,12.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Aetna,Commerical,,,4.79,,4.79,4.59,5.28,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Aetna,Middlesex Employees,,,4.59,,4.59,4.59,5.28,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Anthem,Commerical,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Anthem,Indemnity,,,4.65,,4.65,4.59,5.28,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Anthem,Individual Exchange,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Anthem,State Preferred,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Cigna,Cigna,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Connecticare,Commerical,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Connecticare,Exchange,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,Multiplan,Multiplan,,,5.28,,5.28,4.59,5.28,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,24338-102-13,NDC,both,1,ea,6.21,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.59,5.28,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Aetna,Commerical,,,16.51,,16.51,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Aetna,Middlesex Employees,,,15.83,,15.83,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Anthem,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Anthem,Indemnity,,,16.03,,16.03,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Anthem,Individual Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Anthem,State Preferred,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Cigna,Cigna,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Connecticare,Commerical,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Connecticare,Exchange,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,Multiplan,Multiplan,,,18.19,,18.19,15.83,18.19,percent of total billed charges,,
ERYTHROMYCIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0007-00,NDC,both,1,ea,6.21,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.83,18.19,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Aetna,Commerical,,,21.42,,21.42,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Aetna,Middlesex Employees,,,20.54,,20.54,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Anthem,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Anthem,Indemnity,,,20.8,,20.8,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Anthem,Individual Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Anthem,State Preferred,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Cigna,Cigna,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Connecticare,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Connecticare,Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,Multiplan,Multiplan,,,23.6,,23.6,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,0574-4024-50,NDC,both,1,gm,27.76,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Aetna,Commerical,,,21.42,,21.42,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Aetna,Middlesex Employees,,,20.54,,20.54,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Anthem,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Anthem,Indemnity,,,20.8,,20.8,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Anthem,Individual Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Anthem,State Preferred,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Cigna,Cigna,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Connecticare,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Connecticare,Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,Multiplan,Multiplan,,,23.6,,23.6,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,17478-070-31,NDC,both,1,gm,27.76,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Aetna,Commerical,,,21.42,,21.42,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Aetna,Middlesex Employees,,,20.54,,20.54,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Anthem,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Anthem,Indemnity,,,20.8,,20.8,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Anthem,Individual Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Anthem,State Preferred,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Cigna,Cigna,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Connecticare,Commerical,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Connecticare,Exchange,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,Multiplan,Multiplan,,,23.6,,23.6,20.54,23.6,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-19,NDC,both,1,gm,27.76,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.54,23.6,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Aetna,Commerical,,,74.95,,74.95,71.87,82.57,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Aetna,Middlesex Employees,,,71.87,,71.87,71.87,82.57,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Anthem,Commerical,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Anthem,Indemnity,,,72.77,,72.77,71.87,82.57,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Anthem,Individual Exchange,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Anthem,State Preferred,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Cigna,Cigna,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Connecticare,Commerical,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Connecticare,Exchange,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,Multiplan,Multiplan,,,82.57,,82.57,71.87,82.57,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,24208-910-55,NDC,both,3.5,gm,97.14,58.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,71.87,82.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Aetna,Commerical,,,85.66,,85.66,82.14,94.36,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Aetna,Middlesex Employees,,,82.14,,82.14,82.14,94.36,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Anthem,Commerical,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Anthem,Indemnity,,,83.16,,83.16,82.14,94.36,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Anthem,Individual Exchange,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Anthem,State Preferred,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Cigna,Cigna,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Connecticare,Commerical,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Connecticare,Exchange,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,Multiplan,Multiplan,,,94.36,,94.36,82.14,94.36,percent of total billed charges,,
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,J3490,HCPCS,72485-670-35,NDC,both,1,gm,111.01,66.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,82.14,94.36,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,60219-1503-1,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,69238-1503-1,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-132-13,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,24338-134-02,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Aetna,Commerical,,,695.67,,695.67,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Aetna,Middlesex Employees,,,667.09,,667.09,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Indemnity,,,675.38,,675.38,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,Individual Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Anthem,State Preferred,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Cigna,Cigna,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Connecticare,Commerical,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Connecticare,Exchange,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,Multiplan,Multiplan,,,766.35,,766.35,667.09,766.35,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,75834-295-01,NDC,both,1,mL,901.59,540.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.09,766.35,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Aetna,Commerical,,,1223.17,,1223.17,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Aetna,Middlesex Employees,,,1172.92,,1172.92,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Anthem,Commerical,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Anthem,Indemnity,,,1187.5,,1187.5,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Anthem,Individual Exchange,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Anthem,State Preferred,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Cigna,Cigna,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Connecticare,Commerical,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Connecticare,Exchange,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,Multiplan,Multiplan,,,1347.45,,1347.45,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,24338-130-13,NDC,both,1,mL,1585.24,951.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Aetna,Commerical,,,1223.17,,1223.17,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Aetna,Middlesex Employees,,,1172.92,,1172.92,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Anthem,Commerical,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Anthem,Indemnity,,,1187.5,,1187.5,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Anthem,Individual Exchange,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Anthem,State Preferred,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Cigna,Cigna,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Connecticare,Commerical,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Connecticare,Exchange,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,Multiplan,Multiplan,,,1347.45,,1347.45,1172.92,1347.45,percent of total billed charges,,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,J3490,HCPCS,40810-0015-74,NDC,both,1,mL,1585.24,951.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1172.92,1347.45,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Aetna,Commerical,,,163.27,,163.27,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Aetna,Middlesex Employees,,,156.56,,156.56,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Anthem,Commerical,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Anthem,Indemnity,,,158.51,,158.51,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Anthem,Individual Exchange,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Anthem,State Preferred,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Cigna,Cigna,,78.86,,,78.86,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Connecticare,Commerical,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Connecticare,Exchange,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,Multiplan,Multiplan,,,179.86,,179.86,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-01,NDC,both,1,ea,211.6,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,85.14,,,85.14,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Aetna,Commerical,,,163.27,,163.27,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Aetna,Middlesex Employees,,,156.56,,156.56,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Anthem,Commerical,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Anthem,Indemnity,,,158.51,,158.51,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Anthem,Individual Exchange,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Anthem,State Preferred,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Cigna,Cigna,,78.86,,,78.86,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Connecticare,Commerical,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Connecticare,Exchange,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,Multiplan,Multiplan,,,179.86,,179.86,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,0409-6482-11,NDC,both,1,ea,211.6,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,85.14,,,85.14,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Aetna,Commerical,,,163.27,,163.27,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Aetna,Middlesex Employees,,,156.56,,156.56,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Anthem,Commerical,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Anthem,Indemnity,,,158.51,,158.51,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Anthem,Individual Exchange,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Anthem,State Preferred,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Cigna,Cigna,,78.86,,,78.86,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Connecticare,Commerical,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Connecticare,Exchange,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,Multiplan,Multiplan,,,179.86,,179.86,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-05,NDC,both,1,ea,211.6,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,85.14,,,85.14,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Aetna,Commerical,,,163.27,,163.27,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Aetna,Middlesex Employees,,,156.56,,156.56,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Anthem,Commerical,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Anthem,Indemnity,,,158.51,,158.51,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Anthem,Individual Exchange,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Anthem,State Preferred,,,,,,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Cigna,Cigna,,78.86,,,78.86,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Connecticare,Commerical,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Connecticare,Exchange,,99.83,,,99.83,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,Multiplan,Multiplan,,,179.86,,179.86,78.86,179.86,percent of total billed charges,,
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,J1364,HCPCS,14789-116-07,NDC,both,1,ea,211.6,126.96,United Healthcare/Oxford,United Healthcare/Oxford,,85.14,,,85.14,78.86,179.86,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Aetna,Commerical,,,73.94,,73.94,70.9,81.46,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Aetna,Middlesex Employees,,,70.9,,70.9,70.9,81.46,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Anthem,Commerical,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Anthem,Indemnity,,,71.79,,71.79,70.9,81.46,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Anthem,Individual Exchange,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Anthem,State Preferred,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Cigna,Cigna,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Connecticare,Commerical,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Connecticare,Exchange,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,Multiplan,Multiplan,,,81.46,,81.46,70.9,81.46,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL,J3490,HCPCS,45802-966-94,NDC,both,30,gm,95.83,57.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.9,81.46,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Aetna,Commerical,,,111.53,,111.53,106.95,122.87,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Aetna,Middlesex Employees,,,106.95,,106.95,106.95,122.87,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Anthem,Commerical,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Anthem,Indemnity,,,108.28,,108.28,106.95,122.87,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Anthem,Individual Exchange,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Anthem,State Preferred,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Cigna,Cigna,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Connecticare,Commerical,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Connecticare,Exchange,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,Multiplan,Multiplan,,,122.87,,122.87,106.95,122.87,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,45802-038-46,NDC,both,1,mL,144.55,86.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.95,122.87,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Aetna,Commerical,,,46.81,,46.81,44.89,51.57,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Aetna,Middlesex Employees,,,44.89,,44.89,44.89,51.57,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Anthem,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Anthem,Indemnity,,,45.45,,45.45,44.89,51.57,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Anthem,Individual Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Anthem,State Preferred,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Cigna,Cigna,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Connecticare,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Connecticare,Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,Multiplan,Multiplan,,,51.57,,51.57,44.89,51.57,percent of total billed charges,,
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION,J3490,HCPCS,52565-027-59,NDC,both,1,mL,60.67,36.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Aetna,Commerical,,,0.65,,0.65,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.62,,0.62,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Anthem,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Anthem,Indemnity,,,0.63,,0.63,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Cigna,Cigna,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Connecticare,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Connecticare,Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-01,NDC,both,1,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Aetna,Commerical,,,0.65,,0.65,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.62,,0.62,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Anthem,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Anthem,Indemnity,,,0.63,,0.63,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Cigna,Cigna,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Connecticare,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Connecticare,Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.62,0.71,percent of total billed charges,,
ESCITALOPRAM 10 MG TABLET,J8499,HCPCS,68084-617-11,NDC,both,1,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Aetna,Commerical,,,11.57,,11.57,11.09,12.74,percent of total billed charges,,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Aetna,Middlesex Employees,,,11.09,,11.09,11.09,12.74,percent of total billed charges,,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Anthem,Commerical,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Anthem,Indemnity,,,11.23,,11.23,11.09,12.74,percent of total billed charges,,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Anthem,Individual Exchange,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Anthem,State Preferred,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Cigna,Cigna,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Connecticare,Commerical,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Connecticare,Exchange,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,Multiplan,Multiplan,,,12.74,,12.74,11.09,12.74,percent of total billed charges,,
ESCITALOPRAM 2.5 MG TABLET,J3490,HCPCS,40810-0013-55,NDC,both,1,ea,14.99,8.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.09,12.74,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,0904-6427-61,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-01,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
ESCITALOPRAM 20 MG TABLET,J8499,HCPCS,68084-618-11,NDC,both,1,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,0456-2005-01,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0010-00,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,40810-0201-43,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,43547-280-10,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
ESCITALOPRAM 5 MG TABLET,J3490,HCPCS,65862-373-01,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Aetna,Commerical,,,194.34,,194.34,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Aetna,Middlesex Employees,,,186.36,,186.36,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Anthem,Commerical,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Anthem,Indemnity,,,188.68,,188.68,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Anthem,Individual Exchange,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Anthem,State Preferred,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Cigna,Cigna,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Connecticare,Commerical,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Connecticare,Exchange,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,Multiplan,Multiplan,,,214.09,,214.09,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,16571-769-24,NDC,both,1,mL,251.87,151.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Aetna,Commerical,,,449.67,,449.67,431.2,495.36,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Aetna,Middlesex Employees,,,431.2,,431.2,431.2,495.36,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Anthem,Commerical,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Anthem,Indemnity,,,436.56,,436.56,431.2,495.36,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Anthem,Individual Exchange,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Anthem,State Preferred,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Cigna,Cigna,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Connecticare,Commerical,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Connecticare,Exchange,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,Multiplan,Multiplan,,,495.36,,495.36,431.2,495.36,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,31722-569-24,NDC,both,1,mL,582.78,349.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,431.2,495.36,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Aetna,Commerical,,,448.96,,448.96,430.52,494.58,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Aetna,Middlesex Employees,,,430.52,,430.52,430.52,494.58,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Anthem,Commerical,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Anthem,Indemnity,,,435.87,,435.87,430.52,494.58,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Anthem,Individual Exchange,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Anthem,State Preferred,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Cigna,Cigna,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Connecticare,Commerical,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Connecticare,Exchange,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,Multiplan,Multiplan,,,494.58,,494.58,430.52,494.58,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-551-70,NDC,both,1,mL,581.86,349.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,430.52,494.58,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Aetna,Commerical,,,194.34,,194.34,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Aetna,Middlesex Employees,,,186.36,,186.36,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Anthem,Commerical,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Anthem,Indemnity,,,188.68,,188.68,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Anthem,Individual Exchange,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Anthem,State Preferred,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Cigna,Cigna,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Connecticare,Commerical,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Connecticare,Exchange,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,Multiplan,Multiplan,,,214.09,,214.09,186.36,214.09,percent of total billed charges,,
ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,65162-705-88,NDC,both,1,mL,251.87,151.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,186.36,214.09,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Aetna,Commerical,,,44.48,,44.48,0.29,49,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Aetna,Middlesex Employees,,,42.66,,42.66,0.29,49,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Anthem,Commerical,,,,,,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Anthem,Indemnity,,,43.19,,43.19,0.29,49,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Anthem,Individual Exchange,,,,,,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Anthem,State Preferred,,,,,,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Cigna,Cigna,,0.29,,,0.29,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Connecticare,Commerical,,0.3,,,0.3,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Connecticare,Exchange,,0.3,,,0.3,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,Multiplan,Multiplan,,,49,,49,0.29,49,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,40810-0011-46,NDC,both,50,mL,57.65,34.59,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,49,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Aetna,Commerical,,,44.78,,44.78,0.29,49.33,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Aetna,Middlesex Employees,,,42.94,,42.94,0.29,49.33,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Anthem,Commerical,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Anthem,Indemnity,,,43.47,,43.47,0.29,49.33,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Anthem,Individual Exchange,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Anthem,State Preferred,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Cigna,Cigna,,0.29,,,0.29,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Connecticare,Commerical,,0.3,,,0.3,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Connecticare,Exchange,,0.3,,,0.3,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,Multiplan,Multiplan,,,49.33,,49.33,0.29,49.33,percent of total billed charges,,
ESMOLOL 10 MG/ML IV INFUSION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,11.53,6.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Aetna,Commerical,,,44.78,,44.78,0.29,49.33,percent of total billed charges,,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Aetna,Middlesex Employees,,,42.94,,42.94,0.29,49.33,percent of total billed charges,,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Anthem,Commerical,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Anthem,Indemnity,,,43.47,,43.47,0.29,49.33,percent of total billed charges,,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Anthem,Individual Exchange,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Anthem,State Preferred,,,,,,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Cigna,Cigna,,0.29,,,0.29,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Connecticare,Commerical,,0.3,,,0.3,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Connecticare,Exchange,,0.3,,,0.3,0.29,49.33,Other,Could be inpatient or outpatient,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,Multiplan,Multiplan,,,49.33,,49.33,0.29,49.33,percent of total billed charges,,
ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,J1805,HCPCS,63323-652-10,NDC,both,1,mL,58.03,34.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,49.33,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Aetna,Commerical,,,1433.29,,1433.29,0.29,1578.92,percent of total billed charges,,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Aetna,Middlesex Employees,,,1374.4,,1374.4,0.29,1578.92,percent of total billed charges,,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Anthem,Commerical,,,,,,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Anthem,Indemnity,,,1391.49,,1391.49,0.29,1578.92,percent of total billed charges,,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Anthem,Individual Exchange,,,,,,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Anthem,State Preferred,,,,,,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Cigna,Cigna,,0.29,,,0.29,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Connecticare,Commerical,,0.3,,,0.3,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Connecticare,Exchange,,0.3,,,0.3,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,Multiplan,Multiplan,,,1578.92,,1578.92,0.29,1578.92,percent of total billed charges,,
"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-075-87,NDC,both,0.5,mL,1857.55,1114.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,1578.92,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Aetna,Commerical,,,1330.59,,1330.59,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Aetna,Middlesex Employees,,,1275.93,,1275.93,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Anthem,Commerical,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Anthem,Indemnity,,,1291.79,,1291.79,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Anthem,Individual Exchange,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Anthem,State Preferred,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Cigna,Cigna,,0.29,,,0.29,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Connecticare,Commerical,,0.3,,,0.3,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Connecticare,Exchange,,0.3,,,0.3,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,Multiplan,Multiplan,,,1465.79,,1465.79,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,10019-055-61,NDC,both,250,mL,1724.46,1034.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Aetna,Commerical,,,1330.59,,1330.59,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Aetna,Middlesex Employees,,,1275.93,,1275.93,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Anthem,Commerical,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Anthem,Indemnity,,,1291.79,,1291.79,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Anthem,Individual Exchange,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Anthem,State Preferred,,,,,,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Cigna,Cigna,,0.29,,,0.29,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Connecticare,Commerical,,0.3,,,0.3,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Connecticare,Exchange,,0.3,,,0.3,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,Multiplan,Multiplan,,,1465.79,,1465.79,0.29,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1805,HCPCS,44567-450-10,NDC,both,1,mL,1724.46,1034.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.32,,,0.32,0.29,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Aetna,Commerical,,,1330.59,,1330.59,0.45,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Aetna,Middlesex Employees,,,1275.93,,1275.93,0.45,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Anthem,Commerical,,,,,,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Anthem,Indemnity,,,1291.79,,1291.79,0.45,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Anthem,Individual Exchange,,,,,,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Anthem,State Preferred,,,,,,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Cigna,Cigna,,0.45,,,0.45,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Connecticare,Commerical,,0.55,,,0.55,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Connecticare,Exchange,,0.55,,,0.55,0.45,1465.79,Other,Could be inpatient or outpatient,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,Multiplan,Multiplan,,,1465.79,,1465.79,0.45,1465.79,percent of total billed charges,,
"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",J1806,HCPCS,44567-450-01,NDC,both,1,mL,1724.46,1034.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.49,,,0.49,0.45,1465.79,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Anthem,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Anthem,Individual Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Anthem,State Preferred,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Cigna,Cigna,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Connecticare,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Connecticare,Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,16729-252-69,NDC,both,1,ea,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Anthem,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Anthem,Individual Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Anthem,State Preferred,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Cigna,Cigna,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Connecticare,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Connecticare,Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,22.67,26.04,percent of total billed charges,,
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,J3490,HCPCS,17478-850-10,NDC,both,1,ea,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Aetna,Commerical,,,992.2,,992.2,951.44,1093.02,percent of total billed charges,,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Aetna,Middlesex Employees,,,951.44,,951.44,951.44,1093.02,percent of total billed charges,,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Anthem,Commerical,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Anthem,Indemnity,,,963.27,,963.27,951.44,1093.02,percent of total billed charges,,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Anthem,Individual Exchange,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Anthem,State Preferred,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Cigna,Cigna,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Connecticare,Commerical,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Connecticare,Exchange,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,Multiplan,Multiplan,,,1093.02,,1093.02,951.44,1093.02,percent of total billed charges,,
ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,J3490,HCPCS,0430-3754-14,NDC,both,1,gm,1285.9,771.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,951.44,1093.02,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Aetna,Commerical,,,0.7,,0.7,0.67,0.77,percent of total billed charges,,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Anthem,Indemnity,,,0.68,,0.68,0.67,0.77,percent of total billed charges,,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
ESZOPICLONE 1 MG TABLET,J8499,HCPCS,55111-629-30,NDC,both,1,ea,0.91,0.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Aetna,Commerical,,,1515.12,,1515.12,628.68,1669.07,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Aetna,Middlesex Employees,,,1452.88,,1452.88,628.68,1669.07,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Anthem,Commerical,,,,,,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Anthem,Indemnity,,,1470.94,,1470.94,628.68,1669.07,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Anthem,Individual Exchange,,,,,,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Anthem,State Preferred,,,,,,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Cigna,Cigna,,1015.64,,,1015.64,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Connecticare,Commerical,,628.68,,,628.68,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Connecticare,Exchange,,628.68,,,628.68,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,Multiplan,Multiplan,,,1669.07,,1669.07,628.68,1669.07,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-01,NDC,both,0.98,mL,1963.61,1178.17,United Healthcare/Oxford,United Healthcare/Oxford,,964.75,,,964.75,628.68,1669.07,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Aetna,Commerical,,,1546.04,,1546.04,628.68,1703.13,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Aetna,Middlesex Employees,,,1482.52,,1482.52,628.68,1703.13,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Anthem,Commerical,,,,,,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Anthem,Indemnity,,,1500.96,,1500.96,628.68,1703.13,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Anthem,Individual Exchange,,,,,,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Anthem,State Preferred,,,,,,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Cigna,Cigna,,1015.64,,,1015.64,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Connecticare,Commerical,,628.68,,,628.68,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Connecticare,Exchange,,628.68,,,628.68,628.68,1703.13,Other,Could be inpatient or outpatient,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,Multiplan,Multiplan,,,1703.13,,1703.13,628.68,1703.13,percent of total billed charges,,
ETANERCEPT 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,J1438,HCPCS,58406-435-04,NDC,both,0.5,mL,2003.68,1202.21,United Healthcare/Oxford,United Healthcare/Oxford,,964.75,,,964.75,628.68,1703.13,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Aetna,Commerical,,,23641.82,,23641.82,184.42,26044,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Aetna,Middlesex Employees,,,22670.54,,22670.54,184.42,26044,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Anthem,Commerical,,,,,,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Anthem,Indemnity,,,22952.42,,22952.42,184.42,26044,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Anthem,Individual Exchange,,,,,,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Anthem,State Preferred,,,,,,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Cigna,Cigna,,184.42,,,184.42,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Connecticare,Commerical,,,,,,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Connecticare,Exchange,,,,,,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,Multiplan,Multiplan,,,26044,,26044,184.42,26044,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-284-10,NDC,both,0.2,mL,30640,18384,United Healthcare/Oxford,United Healthcare/Oxford,,234.24,,,234.24,184.42,26044,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Aetna,Commerical,,,4728.36,,4728.36,184.42,5208.8,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Aetna,Middlesex Employees,,,4534.11,,4534.11,184.42,5208.8,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Anthem,Commerical,,,,,,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Anthem,Indemnity,,,4590.48,,4590.48,184.42,5208.8,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Anthem,Individual Exchange,,,,,,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Anthem,State Preferred,,,,,,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Cigna,Cigna,,184.42,,,184.42,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Connecticare,Commerical,,,,,,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Connecticare,Exchange,,,,,,184.42,5208.8,Other,Could be inpatient or outpatient,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,Multiplan,Multiplan,,,5208.8,,5208.8,184.42,5208.8,percent of total billed charges,,
ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLUTION,J1428,HCPCS,60923-363-02,NDC,both,0.2,mL,6128,3676.8,United Healthcare/Oxford,United Healthcare/Oxford,,234.24,,,234.24,184.42,5208.8,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Aetna,Commerical,,,11226.91,,11226.91,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Aetna,Middlesex Employees,,,10765.67,,10765.67,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Anthem,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Anthem,Indemnity,,,10899.53,,10899.53,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Anthem,Individual Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Anthem,State Preferred,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Cigna,Cigna,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Connecticare,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Connecticare,Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,Multiplan,Multiplan,,,12367.64,,12367.64,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,42023-157-01,NDC,both,1,ea,14550.17,8730.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Aetna,Commerical,,,11226.91,,11226.91,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Aetna,Middlesex Employees,,,10765.67,,10765.67,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Indemnity,,,10899.53,,10899.53,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Individual Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Anthem,State Preferred,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Cigna,Cigna,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Connecticare,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Connecticare,Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,Multiplan,Multiplan,,,12367.64,,12367.64,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-297-50,NDC,both,1,ea,14550.17,8730.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Aetna,Commerical,,,11226.91,,11226.91,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Aetna,Middlesex Employees,,,10765.67,,10765.67,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Indemnity,,,10899.53,,10899.53,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Anthem,Individual Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Anthem,State Preferred,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Cigna,Cigna,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Connecticare,Commerical,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Connecticare,Exchange,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,Multiplan,Multiplan,,,12367.64,,12367.64,10765.67,12367.64,percent of total billed charges,,
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,J3490,HCPCS,69315-701-50,NDC,both,1,ea,14550.17,8730.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10765.67,12367.64,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Aetna,Commerical,,,3.95,,3.95,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Aetna,Middlesex Employees,,,3.79,,3.79,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Anthem,Commerical,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Anthem,Indemnity,,,3.84,,3.84,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Anthem,Individual Exchange,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Anthem,State Preferred,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Cigna,Cigna,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Connecticare,Commerical,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Connecticare,Exchange,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,Multiplan,Multiplan,,,4.35,,4.35,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,25010-215-15,NDC,both,1,ea,5.12,3.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Aetna,Commerical,,,3.95,,3.95,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Aetna,Middlesex Employees,,,3.79,,3.79,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Anthem,Commerical,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Anthem,Indemnity,,,3.84,,3.84,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Anthem,Individual Exchange,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Anthem,State Preferred,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Cigna,Cigna,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Connecticare,Commerical,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Connecticare,Exchange,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,Multiplan,Multiplan,,,4.35,,4.35,3.79,4.35,percent of total billed charges,,
ETHACRYNIC ACID 25 MG TABLET,J3490,HCPCS,68180-159-01,NDC,both,1,ea,5.12,3.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.79,4.35,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,40810-0001-18,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
ETHAMBUTOL 100 MG TABLET,J3490,HCPCS,68180-280-01,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
ETHAMBUTOL 200 MG ORAL TAB,J3490,HCPCS,40810-0001-19,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Aetna,Commerical,,,2.22,,2.22,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Aetna,Middlesex Employees,,,2.13,,2.13,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Anthem,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Anthem,Indemnity,,,2.16,,2.16,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Anthem,Individual Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Anthem,State Preferred,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Cigna,Cigna,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Connecticare,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Connecticare,Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,Multiplan,Multiplan,,,2.45,,2.45,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-01,NDC,both,1,ea,2.88,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Aetna,Commerical,,,4.58,,4.58,4.39,5.04,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Aetna,Middlesex Employees,,,4.39,,4.39,4.39,5.04,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Anthem,Commerical,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Anthem,Indemnity,,,4.44,,4.44,4.39,5.04,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Anthem,Individual Exchange,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Anthem,State Preferred,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Cigna,Cigna,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Connecticare,Commerical,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Connecticare,Exchange,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,Multiplan,Multiplan,,,5.04,,5.04,4.39,5.04,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68084-280-11,NDC,both,1,ea,5.93,3.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.39,5.04,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Aetna,Commerical,,,2.22,,2.22,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Aetna,Middlesex Employees,,,2.13,,2.13,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Anthem,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Anthem,Indemnity,,,2.16,,2.16,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Anthem,Individual Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Anthem,State Preferred,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Cigna,Cigna,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Connecticare,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Connecticare,Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,Multiplan,Multiplan,,,2.45,,2.45,2.13,2.45,percent of total billed charges,,
ETHAMBUTOL 400 MG TABLET,J3490,HCPCS,68850-012-02,NDC,both,1,ea,2.88,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Aetna,Commerical,,,208.2,,208.2,199.65,229.36,percent of total billed charges,,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Aetna,Middlesex Employees,,,199.65,,199.65,199.65,229.36,percent of total billed charges,,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Anthem,Commerical,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Anthem,Indemnity,,,202.13,,202.13,199.65,229.36,percent of total billed charges,,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Anthem,Individual Exchange,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Anthem,State Preferred,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Cigna,Cigna,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Connecticare,Commerical,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Connecticare,Exchange,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,Multiplan,Multiplan,,,229.36,,229.36,199.65,229.36,percent of total billed charges,,
ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION,J3490,HCPCS,17478-503-05,NDC,both,1,mL,269.83,161.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,199.65,229.36,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Aetna,Commerical,,,32.44,,32.44,31.11,35.73,percent of total billed charges,,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Aetna,Middlesex Employees,,,31.11,,31.11,31.11,35.73,percent of total billed charges,,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Anthem,Commerical,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Anthem,Indemnity,,,31.49,,31.49,31.11,35.73,percent of total billed charges,,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Anthem,Individual Exchange,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Anthem,State Preferred,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Cigna,Cigna,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Connecticare,Commerical,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Connecticare,Exchange,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,Multiplan,Multiplan,,,35.73,,35.73,31.11,35.73,percent of total billed charges,,
ETHANOL 70% LOCK,J3490,HCPCS,40810-0201-09,NDC,both,1,mL,42.04,25.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.11,35.73,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Anthem,Commerical,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Anthem,State Preferred,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Cigna,Cigna,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Connecticare,Commerical,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Connecticare,Exchange,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,23155-532-01,NDC,both,1,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Anthem,Commerical,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Anthem,State Preferred,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Cigna,Cigna,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Connecticare,Commerical,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Connecticare,Exchange,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,3.28,3.77,percent of total billed charges,,
ETHOSUXIMIDE 250 MG CAPSULE,J3490,HCPCS,61748-025-01,NDC,both,1,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.28,3.77,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Aetna,Commerical,,,152.37,,152.37,146.11,167.85,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Aetna,Middlesex Employees,,,146.11,,146.11,146.11,167.85,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Anthem,Commerical,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Anthem,Indemnity,,,147.92,,147.92,146.11,167.85,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Anthem,Individual Exchange,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Anthem,State Preferred,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Cigna,Cigna,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Connecticare,Commerical,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Connecticare,Exchange,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,Multiplan,Multiplan,,,167.85,,167.85,146.11,167.85,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0670-16,NDC,both,1,mL,197.47,118.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.11,167.85,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Aetna,Commerical,,,152.69,,152.69,146.42,168.21,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Aetna,Middlesex Employees,,,146.42,,146.42,146.42,168.21,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Anthem,Commerical,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Anthem,Indemnity,,,148.24,,148.24,146.42,168.21,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Anthem,Individual Exchange,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Anthem,State Preferred,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Cigna,Cigna,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Connecticare,Commerical,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Connecticare,Exchange,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,Multiplan,Multiplan,,,168.21,,168.21,146.42,168.21,percent of total billed charges,,
ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,59762-2350-7,NDC,both,1,mL,197.89,118.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,146.42,168.21,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Aetna,Commerical,,,177.44,,177.44,170.15,195.47,percent of total billed charges,,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Aetna,Middlesex Employees,,,170.15,,170.15,170.15,195.47,percent of total billed charges,,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Anthem,Commerical,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Anthem,Indemnity,,,172.27,,172.27,170.15,195.47,percent of total billed charges,,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Anthem,Individual Exchange,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Anthem,State Preferred,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Cigna,Cigna,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Connecticare,Commerical,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Connecticare,Exchange,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,Multiplan,Multiplan,,,195.47,,195.47,170.15,195.47,percent of total billed charges,,
ETHYL ALCOHOL 25% IN SW,J3490,HCPCS,40810-0018-19,NDC,both,1,mL,229.97,137.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.15,195.47,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Aetna,Commerical,,,2389.31,,2389.31,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Aetna,Middlesex Employees,,,2291.14,,2291.14,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Anthem,Commerical,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Anthem,Indemnity,,,2319.63,,2319.63,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Anthem,Individual Exchange,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Anthem,State Preferred,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Cigna,Cigna,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Connecticare,Commerical,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Connecticare,Exchange,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,Multiplan,Multiplan,,,2632.08,,2632.08,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-02,NDC,both,1,mL,3096.56,1857.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Aetna,Commerical,,,2389.31,,2389.31,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Aetna,Middlesex Employees,,,2291.14,,2291.14,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Anthem,Commerical,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Anthem,Indemnity,,,2319.63,,2319.63,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Anthem,Individual Exchange,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Anthem,State Preferred,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Cigna,Cigna,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Connecticare,Commerical,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Connecticare,Exchange,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,Multiplan,Multiplan,,,2632.08,,2632.08,2291.14,2632.08,percent of total billed charges,,
ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,J3490,HCPCS,54288-105-15,NDC,both,1,mL,3096.56,1857.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2291.14,2632.08,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-01,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9310-10,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9506-10,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-01,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6695-11,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-01,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-445-10,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-01,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-146-10,NDC,both,1,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Aetna,Commerical,,,3417.08,,3417.08,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Aetna,Middlesex Employees,,,3276.69,,3276.69,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Commerical,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Indemnity,,,3317.43,,3317.43,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Individual Exchange,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Anthem,State Preferred,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Cigna,Cigna,,1332.73,,,1332.73,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Connecticare,Commerical,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Connecticare,Exchange,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,Multiplan,Multiplan,,,3764.28,,3764.28,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,0052-4330-01,NDC,both,1,ea,4428.56,2657.14,United Healthcare/Oxford,United Healthcare/Oxford,,1692.8,,,1692.8,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Aetna,Commerical,,,3417.08,,3417.08,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Aetna,Middlesex Employees,,,3276.69,,3276.69,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Commerical,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Indemnity,,,3317.43,,3317.43,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Anthem,Individual Exchange,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Anthem,State Preferred,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Cigna,Cigna,,1332.73,,,1332.73,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Connecticare,Commerical,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Connecticare,Exchange,,,,,,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,Multiplan,Multiplan,,,3764.28,,3764.28,1332.73,3764.28,percent of total billed charges,,
ETONOGESTREL 68 MG SUBDERMAL IMPLANT,J7307,HCPCS,78206-145-01,NDC,both,1,ea,4428.56,2657.14,United Healthcare/Oxford,United Healthcare/Oxford,,1692.8,,,1692.8,1332.73,3764.28,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Aetna,Commerical,,,65.74,,65.74,1.38,72.42,percent of total billed charges,,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Aetna,Middlesex Employees,,,63.04,,63.04,1.38,72.42,percent of total billed charges,,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Anthem,Commerical,,,,,,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Anthem,Indemnity,,,63.82,,63.82,1.38,72.42,percent of total billed charges,,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Anthem,Individual Exchange,,,,,,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Anthem,State Preferred,,,,,,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Cigna,Cigna,,1.59,,,1.59,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Connecticare,Commerical,,2.1,,,2.1,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Connecticare,Exchange,,2.1,,,2.1,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,Multiplan,Multiplan,,,72.42,,72.42,1.38,72.42,percent of total billed charges,,
ETOPOSIDE 0.1 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0017-94,NDC,both,100,mL,85.2,51.12,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,72.42,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Aetna,Commerical,,,47.41,,47.41,1.38,52.23,percent of total billed charges,,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Aetna,Middlesex Employees,,,45.47,,45.47,1.38,52.23,percent of total billed charges,,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Anthem,Commerical,,,,,,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Anthem,Indemnity,,,46.03,,46.03,1.38,52.23,percent of total billed charges,,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Anthem,Individual Exchange,,,,,,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Anthem,State Preferred,,,,,,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Cigna,Cigna,,1.59,,,1.59,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Connecticare,Commerical,,2.1,,,2.1,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Connecticare,Exchange,,2.1,,,2.1,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,Multiplan,Multiplan,,,52.23,,52.23,1.38,52.23,percent of total billed charges,,
ETOPOSIDE 0.2 MG/ML INTRATHECAL ONCOLOGY,J9181,HCPCS,40810-0019-12,NDC,both,50,mL,61.45,36.87,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,52.23,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Aetna,Commerical,,,36.06,,36.06,34.58,117.06,percent of total billed charges,,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Aetna,Middlesex Employees,,,34.58,,34.58,34.58,117.06,percent of total billed charges,,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Anthem,Commerical,,,,,,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Anthem,Indemnity,,,35.01,,35.01,34.58,117.06,percent of total billed charges,,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Anthem,Individual Exchange,,,,,,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Anthem,State Preferred,,,,,,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Cigna,Cigna,,106.82,,,106.82,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Connecticare,Commerical,,117.06,,,117.06,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Connecticare,Exchange,,117.06,,,117.06,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,Multiplan,Multiplan,,,39.72,,39.72,34.58,117.06,percent of total billed charges,,
ETOPOSIDE 10 MG/ML ORAL SOLUTION,J8560,HCPCS,40810-0012-17,NDC,both,5,mL,46.73,28.04,United Healthcare/Oxford,United Healthcare/Oxford,,92.43,,,92.43,34.58,117.06,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Commerical,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Anthem,State Preferred,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Cigna,Cigna,,1.59,,,1.59,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Commerical,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Exchange,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9376-01,NDC,both,0.5,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Commerical,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Anthem,State Preferred,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Cigna,Cigna,,1.59,,,1.59,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Commerical,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Exchange,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0143-9510-01,NDC,both,0.5,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Commerical,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Anthem,State Preferred,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Cigna,Cigna,,1.59,,,1.59,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Commerical,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Connecticare,Exchange,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5653-01,NDC,both,0.5,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Aetna,Commerical,,,133.29,,133.29,1.38,146.83,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Aetna,Middlesex Employees,,,127.81,,127.81,1.38,146.83,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Anthem,Commerical,,,,,,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Anthem,Indemnity,,,129.4,,129.4,1.38,146.83,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Anthem,Individual Exchange,,,,,,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Anthem,State Preferred,,,,,,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Cigna,Cigna,,1.59,,,1.59,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Connecticare,Commerical,,2.1,,,2.1,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Connecticare,Exchange,,2.1,,,2.1,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,Multiplan,Multiplan,,,146.83,,146.83,1.38,146.83,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,0703-5656-01,NDC,both,0.5,mL,172.74,103.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,146.83,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Anthem,Commerical,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Anthem,State Preferred,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Cigna,Cigna,,1.59,,,1.59,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Connecticare,Commerical,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Connecticare,Exchange,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,16729-114-31,NDC,both,0.5,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Anthem,Commerical,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Anthem,State Preferred,,,,,,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Cigna,Cigna,,1.59,,,1.59,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Connecticare,Commerical,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Connecticare,Exchange,,2.1,,,2.1,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,1.38,29.37,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-05,NDC,both,0.5,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,29.37,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Aetna,Commerical,,,183.82,,183.82,1.38,202.5,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Aetna,Middlesex Employees,,,176.27,,176.27,1.38,202.5,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Anthem,Commerical,,,,,,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Anthem,Indemnity,,,178.46,,178.46,1.38,202.5,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Anthem,Individual Exchange,,,,,,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Anthem,State Preferred,,,,,,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Cigna,Cigna,,1.59,,,1.59,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Connecticare,Commerical,,2.1,,,2.1,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Connecticare,Exchange,,2.1,,,2.1,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,Multiplan,Multiplan,,,202.5,,202.5,1.38,202.5,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-25,NDC,both,0.5,mL,238.23,142.94,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,202.5,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Aetna,Commerical,,,266.56,,266.56,1.38,293.65,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Aetna,Middlesex Employees,,,255.61,,255.61,1.38,293.65,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Anthem,Commerical,,,,,,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Anthem,Indemnity,,,258.79,,258.79,1.38,293.65,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Anthem,Individual Exchange,,,,,,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Anthem,State Preferred,,,,,,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Cigna,Cigna,,1.59,,,1.59,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Connecticare,Commerical,,2.1,,,2.1,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Connecticare,Exchange,,2.1,,,2.1,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,Multiplan,Multiplan,,,293.65,,293.65,1.38,293.65,percent of total billed charges,,
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,J9181,HCPCS,63323-104-50,NDC,both,0.5,mL,345.47,207.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,293.65,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Aetna,Commerical,,,214.27,,214.27,92.43,236.05,percent of total billed charges,,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Aetna,Middlesex Employees,,,205.47,,205.47,92.43,236.05,percent of total billed charges,,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Anthem,Commerical,,,,,,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Anthem,Indemnity,,,208.03,,208.03,92.43,236.05,percent of total billed charges,,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Anthem,Individual Exchange,,,,,,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Anthem,State Preferred,,,,,,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Cigna,Cigna,,106.82,,,106.82,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Connecticare,Commerical,,117.06,,,117.06,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Connecticare,Exchange,,117.06,,,117.06,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,Multiplan,Multiplan,,,236.05,,236.05,92.43,236.05,percent of total billed charges,,
ETOPOSIDE 50 MG CAPSULE,J8560,HCPCS,0378-3266-94,NDC,both,1,ea,277.7,166.62,United Healthcare/Oxford,United Healthcare/Oxford,,92.43,,,92.43,92.43,236.05,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Aetna,Commerical,,,484.54,,484.54,1.38,533.77,percent of total billed charges,,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Aetna,Middlesex Employees,,,464.64,,464.64,1.38,533.77,percent of total billed charges,,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Anthem,Commerical,,,,,,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Anthem,Indemnity,,,470.41,,470.41,1.38,533.77,percent of total billed charges,,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Anthem,Individual Exchange,,,,,,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Anthem,State Preferred,,,,,,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Cigna,Cigna,,1.59,,,1.59,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Connecticare,Commerical,,2.1,,,2.1,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Connecticare,Exchange,,2.1,,,2.1,1.38,533.77,Other,Could be inpatient or outpatient,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,Multiplan,Multiplan,,,533.77,,533.77,1.38,533.77,percent of total billed charges,,
ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,J9181,HCPCS,61269-410-20,NDC,both,0.1,ea,627.97,376.78,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.38,533.77,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Aetna,Commerical,,,23.43,,23.43,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Aetna,Middlesex Employees,,,22.46,,22.46,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Anthem,Commerical,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Anthem,Indemnity,,,22.74,,22.74,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Anthem,Individual Exchange,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Anthem,State Preferred,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Cigna,Cigna,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Connecticare,Commerical,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Connecticare,Exchange,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,Multiplan,Multiplan,,,25.81,,25.81,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,59676-570-01,NDC,both,1,ea,30.36,18.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Aetna,Commerical,,,23.43,,23.43,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Aetna,Middlesex Employees,,,22.46,,22.46,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Anthem,Commerical,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Anthem,Indemnity,,,22.74,,22.74,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Anthem,Individual Exchange,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Anthem,State Preferred,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Cigna,Cigna,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Connecticare,Commerical,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Connecticare,Exchange,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,Multiplan,Multiplan,,,25.81,,25.81,22.46,25.81,percent of total billed charges,,
ETRAVIRINE 100 MG TABLET,J3490,HCPCS,60219-1721-7,NDC,both,1,ea,30.36,18.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.46,25.81,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,3.37,,,3.37,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,3.37,,,3.37,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-20,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,0.32,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Aetna,Commerical,,,22.16,,22.16,2.68,24.41,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Aetna,Middlesex Employees,,,21.25,,21.25,2.68,24.41,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Anthem,Commerical,,,,,,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Anthem,Indemnity,,,21.51,,21.51,2.68,24.41,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Anthem,Individual Exchange,,,,,,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Anthem,State Preferred,,,,,,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Cigna,Cigna,,,,,,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Connecticare,Commerical,,3.37,,,3.37,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Connecticare,Exchange,,3.37,,,3.37,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,Multiplan,Multiplan,,,24.41,,24.41,2.68,24.41,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,J7527,HCPCS,0078-0417-61,NDC,both,1,ea,28.72,17.23,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,2.68,24.41,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Anthem,Commerical,,,,,,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Anthem,State Preferred,,,,,,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Cigna,Cigna,,,,,,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Connecticare,Commerical,,3.37,,,3.37,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Connecticare,Exchange,,3.37,,,3.37,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,3.37,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-20,NDC,both,0.5,ea,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,0.63,3.37,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Aetna,Commerical,,,57.63,,57.63,2.68,63.49,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Aetna,Middlesex Employees,,,55.26,,55.26,2.68,63.49,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Anthem,Commerical,,,,,,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Anthem,Indemnity,,,55.95,,55.95,2.68,63.49,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Anthem,Individual Exchange,,,,,,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Anthem,State Preferred,,,,,,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Cigna,Cigna,,,,,,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Connecticare,Commerical,,3.37,,,3.37,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Connecticare,Exchange,,3.37,,,3.37,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,Multiplan,Multiplan,,,63.49,,63.49,2.68,63.49,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,J7527,HCPCS,0078-0414-61,NDC,both,0.5,ea,74.69,44.81,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,2.68,63.49,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Aetna,Commerical,,,86.62,,86.62,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Aetna,Middlesex Employees,,,83.06,,83.06,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Anthem,Commerical,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Anthem,Indemnity,,,84.09,,84.09,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Anthem,Individual Exchange,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Anthem,State Preferred,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Cigna,Cigna,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Connecticare,Commerical,,3.37,,,3.37,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Connecticare,Exchange,,3.37,,,3.37,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,Multiplan,Multiplan,,,95.42,,95.42,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-20,NDC,both,0.334,ea,112.26,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Aetna,Commerical,,,86.62,,86.62,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Aetna,Middlesex Employees,,,83.06,,83.06,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Anthem,Commerical,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Anthem,Indemnity,,,84.09,,84.09,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Anthem,Individual Exchange,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Anthem,State Preferred,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Cigna,Cigna,,,,,,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Connecticare,Commerical,,3.37,,,3.37,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Connecticare,Exchange,,3.37,,,3.37,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,Multiplan,Multiplan,,,95.42,,95.42,2.68,95.42,percent of total billed charges,,
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,J7527,HCPCS,0078-0415-61,NDC,both,0.334,ea,112.26,67.36,United Healthcare/Oxford,United Healthcare/Oxford,,2.68,,,2.68,2.68,95.42,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Aetna,Commerical,,,1912.96,,1912.96,1834.37,2107.33,percent of total billed charges,,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Aetna,Middlesex Employees,,,1834.37,,1834.37,1834.37,2107.33,percent of total billed charges,,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Anthem,Commerical,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Anthem,Indemnity,,,1857.18,,1857.18,1834.37,2107.33,percent of total billed charges,,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Anthem,Individual Exchange,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Anthem,State Preferred,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Cigna,Cigna,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Connecticare,Commerical,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Connecticare,Exchange,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,Multiplan,Multiplan,,,2107.33,,2107.33,1834.37,2107.33,percent of total billed charges,,
EVEROLIMUS 10 MG TABLET CHEMO,J3490,HCPCS,0078-0567-51,NDC,both,1,ea,2479.21,1487.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1834.37,2107.33,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Aetna,Commerical,,,708.69,,708.69,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Aetna,Middlesex Employees,,,679.58,,679.58,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Anthem,Commerical,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Anthem,Indemnity,,,688.03,,688.03,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Anthem,Individual Exchange,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Anthem,State Preferred,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Cigna,Cigna,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Connecticare,Commerical,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Connecticare,Exchange,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,Multiplan,Multiplan,,,780.7,,780.7,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 5 MG TABLET CHEMO,J3490,HCPCS,0054-0481-14,NDC,both,1,ea,918.47,551.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Aetna,Commerical,,,708.69,,708.69,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Aetna,Middlesex Employees,,,679.58,,679.58,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Anthem,Commerical,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Anthem,Indemnity,,,688.03,,688.03,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Anthem,Individual Exchange,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Anthem,State Preferred,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Cigna,Cigna,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Connecticare,Commerical,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Connecticare,Exchange,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,Multiplan,Multiplan,,,780.7,,780.7,679.58,780.7,percent of total billed charges,,
EVEROLIMUS 7.5 MG TABLET CHEMO,J3490,HCPCS,0054-0497-14,NDC,both,1,ea,918.47,551.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,679.58,780.7,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,1.86,3.29,percent of total billed charges,,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,1.86,3.29,percent of total billed charges,,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Anthem,Commerical,,,,,,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,1.86,3.29,percent of total billed charges,,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Anthem,Individual Exchange,,,,,,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Anthem,State Preferred,,,,,,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Cigna,Cigna,,1.86,,,1.86,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Connecticare,Commerical,,2.52,,,2.52,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Connecticare,Exchange,,2.52,,,2.52,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,1.86,3.29,percent of total billed charges,,
"FACTOR IX CPLX(PCC) NO.4, 3-FACTOR 500 (+/-) UNIT INTRAVENOUS SOLUTION",J7194,HCPCS,68516-3204-1,NDC,both,0.002,ea,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,2.01,,,2.01,1.86,3.29,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Aetna,Commerical,,,16194.65,,16194.65,11.47,17840.14,percent of total billed charges,,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Aetna,Middlesex Employees,,,15529.32,,15529.32,11.47,17840.14,percent of total billed charges,,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Anthem,Commerical,,,,,,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Anthem,Indemnity,,,15722.41,,15722.41,11.47,17840.14,percent of total billed charges,,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Anthem,Individual Exchange,,,,,,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Anthem,State Preferred,,,,,,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Cigna,Cigna,,11.47,,,11.47,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Connecticare,Commerical,,15.51,,,15.51,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Connecticare,Exchange,,15.51,,,15.51,11.47,17840.14,Other,Could be inpatient or outpatient,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,Multiplan,Multiplan,,,17840.14,,17840.14,11.47,17840.14,percent of total billed charges,,
"FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS SOLUTION",J7180,HCPCS,63833-518-02,NDC,both,0.001,ea,20988.4,12593.04,United Healthcare/Oxford,United Healthcare/Oxford,,12.38,,,12.38,11.47,17840.14,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6022-25,NDC,both,1,mL,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-16,NDC,both,1,mL,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-739-41,NDC,both,1,mL,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Aetna,Commerical,,,2.63,,2.63,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Aetna,Middlesex Employees,,,2.52,,2.52,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Anthem,Commerical,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Anthem,Indemnity,,,2.55,,2.55,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Anthem,Individual Exchange,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Anthem,State Preferred,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Cigna,Cigna,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Connecticare,Commerical,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Connecticare,Exchange,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,Multiplan,Multiplan,,,2.9,,2.9,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-00,NDC,both,1,mL,3.41,2.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Aetna,Commerical,,,2.63,,2.63,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Aetna,Middlesex Employees,,,2.52,,2.52,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Anthem,Commerical,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Anthem,Indemnity,,,2.55,,2.55,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Anthem,Individual Exchange,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Anthem,State Preferred,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Cigna,Cigna,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Connecticare,Commerical,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Connecticare,Exchange,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,Multiplan,Multiplan,,,2.9,,2.9,2.52,2.9,percent of total billed charges,,
FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-433-22,NDC,both,1,mL,3.41,2.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.52,2.9,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Aetna,Commerical,,,206.4,,206.4,197.92,227.38,percent of total billed charges,,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Aetna,Middlesex Employees,,,197.92,,197.92,197.92,227.38,percent of total billed charges,,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Anthem,Commerical,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Anthem,Indemnity,,,200.38,,200.38,197.92,227.38,percent of total billed charges,,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Anthem,Individual Exchange,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Anthem,State Preferred,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Cigna,Cigna,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Connecticare,Commerical,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Connecticare,Exchange,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,Multiplan,Multiplan,,,227.38,,227.38,197.92,227.38,percent of total billed charges,,
FAMOTIDINE 1 MG/ML,J3490,HCPCS,40810-0013-19,NDC,both,1,mL,267.5,160.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,197.92,227.38,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Aetna,Commerical,,,46.06,,46.06,44.16,50.74,percent of total billed charges,,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Aetna,Middlesex Employees,,,44.16,,44.16,44.16,50.74,percent of total billed charges,,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Anthem,Commerical,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Anthem,Indemnity,,,44.71,,44.71,44.16,50.74,percent of total billed charges,,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Anthem,Individual Exchange,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Anthem,State Preferred,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Cigna,Cigna,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Connecticare,Commerical,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Connecticare,Exchange,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,Multiplan,Multiplan,,,50.74,,50.74,44.16,50.74,percent of total billed charges,,
FAMOTIDINE 1 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-53,NDC,both,1,mL,59.69,35.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.16,50.74,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
FAMOTIDINE 10 MG TABLET,J3490,HCPCS,0904-5529-52,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Aetna,Commerical,,,11.12,,11.12,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Aetna,Middlesex Employees,,,10.66,,10.66,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Anthem,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Anthem,Indemnity,,,10.79,,10.79,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Anthem,Individual Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Anthem,State Preferred,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Cigna,Cigna,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Connecticare,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Connecticare,Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,Multiplan,Multiplan,,,12.25,,12.25,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0641-6021-10,NDC,both,1,mL,14.41,8.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,55390-028-10,NDC,both,1,mL,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-03,NDC,both,1,mL,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Aetna,Commerical,,,11.12,,11.12,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Aetna,Middlesex Employees,,,10.66,,10.66,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Anthem,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Anthem,Indemnity,,,10.79,,10.79,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Anthem,Individual Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Anthem,State Preferred,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Cigna,Cigna,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Connecticare,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Connecticare,Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,Multiplan,Multiplan,,,12.25,,12.25,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-06,NDC,both,1,mL,14.41,8.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Aetna,Commerical,,,11.12,,11.12,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Aetna,Middlesex Employees,,,10.66,,10.66,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Anthem,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Anthem,Indemnity,,,10.79,,10.79,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Anthem,Individual Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Anthem,State Preferred,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Cigna,Cigna,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Connecticare,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Connecticare,Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,Multiplan,Multiplan,,,12.25,,12.25,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-738-20,NDC,both,1,mL,14.41,8.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Aetna,Commerical,,,11.12,,11.12,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Aetna,Middlesex Employees,,,10.66,,10.66,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Anthem,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Anthem,Indemnity,,,10.79,,10.79,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Anthem,Individual Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Anthem,State Preferred,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Cigna,Cigna,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Connecticare,Commerical,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Connecticare,Exchange,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,Multiplan,Multiplan,,,12.25,,12.25,10.66,12.25,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-753-20,NDC,both,1,mL,14.41,8.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.66,12.25,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J3490,HCPCS,63323-738-03,NDC,both,1,mL,43.28,25.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0172-5728-70,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0536-1298-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Aetna,Commerical,,,0.51,,0.51,0.49,0.56,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Aetna,Middlesex Employees,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Anthem,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Anthem,Indemnity,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Anthem,Individual Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Anthem,State Preferred,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Cigna,Cigna,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Connecticare,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Connecticare,Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,Multiplan,Multiplan,,,0.56,,0.56,0.49,0.56,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-5780-17,NDC,both,1,ea,0.66,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-06,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,0904-7193-61,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,40810-0008-43,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-11,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-299-15,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-11,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,50268-303-15,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,51079-966-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FAMOTIDINE 20 MG TABLET,J3490,HCPCS,63739-645-10,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Aetna,Commerical,,,70.93,,70.93,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Aetna,Middlesex Employees,,,68.01,,68.01,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Anthem,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Anthem,Indemnity,,,68.86,,68.86,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Anthem,Individual Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Anthem,State Preferred,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Cigna,Cigna,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Connecticare,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Connecticare,Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,Multiplan,Multiplan,,,78.13,,78.13,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,68180-150-01,NDC,both,1,mL,91.92,55.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Aetna,Commerical,,,70.93,,70.93,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Aetna,Middlesex Employees,,,68.01,,68.01,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Anthem,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Anthem,Indemnity,,,68.86,,68.86,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Anthem,Individual Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Anthem,State Preferred,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Cigna,Cigna,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Connecticare,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Connecticare,Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,Multiplan,Multiplan,,,78.13,,78.13,68.01,78.13,percent of total billed charges,,
FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,J3490,HCPCS,70954-316-10,NDC,both,1,mL,91.92,55.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FAMOTIDINE 5 MG SPLIT TABLET,J3490,HCPCS,40810-0202-03,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % CCB IV,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,206.82,124.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,103.41,62.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,103.41,62.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,206.82,124.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % INTRAVENOUS,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,413.64,248.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,105.33,63.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0264-4460-30,NDC,both,250,mL,52.67,31.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,52.67,31.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 250 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,210.65,126.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0264-4460-10,NDC,both,500,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-13,NDC,both,500,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,15.71,9.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-01,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-531-10,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-01,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-533-25,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-01,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Aetna,Commerical,,,319.16,,319.16,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Aetna,Middlesex Employees,,,306.05,,306.05,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Anthem,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Anthem,Indemnity,,,309.86,,309.86,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Anthem,Individual Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Anthem,State Preferred,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Cigna,Cigna,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Connecticare,Commerical,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Connecticare,Exchange,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,Multiplan,Multiplan,,,351.59,,351.59,306.05,351.59,percent of total billed charges,,
FAT EMULSION 20 % IV 500 ML,J3490,HCPCS,65219-535-50,NDC,both,1000,mL,157.03,94.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,306.05,351.59,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
FAT EMULSION BOLUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
FAT EMULSION CONTINUOUS FOR ANESTHESIA OD,J3490,HCPCS,0338-0519-09,NDC,both,250,mL,72.77,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
FAT EMULSIONS 20% IV NICU NON-TPN,J3490,HCPCS,0338-0519-58,NDC,both,100,mL,58.22,34.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Aetna,Commerical,,,96.05,,96.05,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Aetna,Middlesex Employees,,,92.1,,92.1,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Anthem,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Anthem,Indemnity,,,93.25,,93.25,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Anthem,Individual Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Anthem,State Preferred,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Cigna,Cigna,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Connecticare,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Connecticare,Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,Multiplan,Multiplan,,,105.81,,105.81,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-03,NDC,both,500,mL,124.48,74.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Aetna,Commerical,,,96.05,,96.05,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Aetna,Middlesex Employees,,,92.1,,92.1,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Anthem,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Anthem,Indemnity,,,93.25,,93.25,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Anthem,Individual Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Anthem,State Preferred,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Cigna,Cigna,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Connecticare,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Connecticare,Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,Multiplan,Multiplan,,,105.81,,105.81,92.1,105.81,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % 500 ML,J3490,HCPCS,63323-820-50,NDC,both,500,mL,124.48,74.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Anthem,Commerical,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Anthem,State Preferred,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Cigna,Cigna,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Connecticare,Commerical,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Connecticare,Exchange,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-00,NDC,both,100,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Aetna,Commerical,,,17.14,,17.14,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Aetna,Middlesex Employees,,,16.44,,16.44,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Anthem,Commerical,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Anthem,Indemnity,,,16.65,,16.65,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Anthem,Individual Exchange,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Anthem,State Preferred,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Cigna,Cigna,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Connecticare,Commerical,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Connecticare,Exchange,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,Multiplan,Multiplan,,,18.89,,18.89,16.44,18.89,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,J3490,HCPCS,63323-820-01,NDC,both,100,mL,22.22,13.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.44,18.89,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Aetna,Commerical,,,68.71,,68.71,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Aetna,Middlesex Employees,,,65.89,,65.89,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Anthem,Commerical,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Anthem,Indemnity,,,66.71,,66.71,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Anthem,Individual Exchange,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Anthem,State Preferred,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Cigna,Cigna,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Connecticare,Commerical,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Connecticare,Exchange,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,Multiplan,Multiplan,,,75.69,,75.69,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-04,NDC,both,250,mL,89.05,53.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Aetna,Commerical,,,68.71,,68.71,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Aetna,Middlesex Employees,,,65.89,,65.89,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Anthem,Commerical,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Anthem,Indemnity,,,66.71,,66.71,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Anthem,Individual Exchange,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Anthem,State Preferred,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Cigna,Cigna,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Connecticare,Commerical,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Connecticare,Exchange,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,Multiplan,Multiplan,,,75.69,,75.69,65.89,75.69,percent of total billed charges,,
FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20% 250 ML,J3490,HCPCS,63323-820-74,NDC,both,250,mL,89.05,53.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.89,75.69,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Aetna,Commerical,,,223.72,,223.72,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Aetna,Middlesex Employees,,,214.53,,214.53,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Anthem,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Anthem,Indemnity,,,217.19,,217.19,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Anthem,Individual Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Anthem,State Preferred,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Cigna,Cigna,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Connecticare,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Connecticare,Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,Multiplan,Multiplan,,,246.45,,246.45,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-00,NDC,both,100,mL,289.94,173.964,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Aetna,Commerical,,,111.86,,111.86,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Aetna,Middlesex Employees,,,107.26,,107.26,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Anthem,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Anthem,Indemnity,,,108.6,,108.6,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Anthem,Individual Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Anthem,State Preferred,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Cigna,Cigna,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Connecticare,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Connecticare,Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,Multiplan,Multiplan,,,123.22,,123.22,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-21,NDC,both,50,mL,144.97,86.982,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Aetna,Commerical,,,223.72,,223.72,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Aetna,Middlesex Employees,,,214.53,,214.53,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Indemnity,,,217.19,,217.19,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Individual Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,State Preferred,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Cigna,Cigna,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Connecticare,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Connecticare,Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Multiplan,Multiplan,,,246.45,,246.45,214.53,246.45,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Aetna,Commerical,,,111.86,,111.86,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Aetna,Middlesex Employees,,,107.26,,107.26,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Anthem,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Anthem,Indemnity,,,108.6,,108.6,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Anthem,Individual Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Anthem,State Preferred,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Cigna,Cigna,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Connecticare,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Connecticare,Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,Multiplan,Multiplan,,,123.22,,123.22,107.26,123.22,percent of total billed charges,,
"FATTY ACID NO.6-FISH OIL-GLYCERIN-PHOSPHOLIPIDS, EGG 10 % IV EMULSION",B4187,HCPCS,63323-205-50,NDC,both,50,mL,144.97,86.982,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,40810-0019-76,NDC,both,1,UN,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,43547-295-03,NDC,both,1,ea,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-11,NDC,both,1,ea,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
FEBUXOSTAT 40 MG TABLET,J3490,HCPCS,60687-538-21,NDC,both,1,ea,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,0037-0430-01,NDC,both,1,ea,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,53746-734-90,NDC,both,1,ea,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
FELBAMATE 400 MG TABLET,J3490,HCPCS,72578-056-16,NDC,both,1,ea,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Aetna,Commerical,,,296.97,,296.97,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Aetna,Middlesex Employees,,,284.77,,284.77,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Anthem,Commerical,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Anthem,Indemnity,,,288.31,,288.31,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Anthem,Individual Exchange,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Anthem,State Preferred,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Cigna,Cigna,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Connecticare,Commerical,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Connecticare,Exchange,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,Multiplan,Multiplan,,,327.14,,327.14,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0037-0442-67,NDC,both,1,mL,384.87,230.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Aetna,Commerical,,,296.97,,296.97,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Aetna,Middlesex Employees,,,284.77,,284.77,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Anthem,Commerical,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Anthem,Indemnity,,,288.31,,288.31,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Anthem,Individual Exchange,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Anthem,State Preferred,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Cigna,Cigna,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Connecticare,Commerical,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Connecticare,Exchange,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,Multiplan,Multiplan,,,327.14,,327.14,284.77,327.14,percent of total billed charges,,
FELBAMATE 600 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-051-10,NDC,both,1,mL,384.87,230.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,284.77,327.14,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Aetna,Commerical,,,19.08,,19.08,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Aetna,Middlesex Employees,,,18.3,,18.3,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Commerical,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Indemnity,,,18.53,,18.53,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Individual Exchange,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,State Preferred,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Cigna,Cigna,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Connecticare,Commerical,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Connecticare,Exchange,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Multiplan,Multiplan,,,21.02,,21.02,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Aetna,Commerical,,,19.08,,19.08,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Aetna,Middlesex Employees,,,18.3,,18.3,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Commerical,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Indemnity,,,18.53,,18.53,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,Individual Exchange,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Anthem,State Preferred,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Cigna,Cigna,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Connecticare,Commerical,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Connecticare,Exchange,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,Multiplan,Multiplan,,,21.02,,21.02,18.3,21.02,percent of total billed charges,,
FENOFIBRATE 40 MG TABLET CHEMO,J3490,HCPCS,0378-4390-77,NDC,both,1,ea,24.73,14.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.3,21.02,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
FENOFIBRATE 54 MG TABLET CHEMO,J3490,HCPCS,0115-5511-10,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Aetna,Commerical,,,16.38,,16.38,15.71,18.05,percent of total billed charges,,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Aetna,Middlesex Employees,,,15.71,,15.71,15.71,18.05,percent of total billed charges,,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Anthem,Commerical,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Anthem,Indemnity,,,15.9,,15.9,15.71,18.05,percent of total billed charges,,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Anthem,Individual Exchange,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Anthem,State Preferred,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Cigna,Cigna,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Connecticare,Commerical,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Connecticare,Exchange,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,Multiplan,Multiplan,,,18.05,,18.05,15.71,18.05,percent of total billed charges,,
FENOFIBRATE MICRONIZED 130 MG CAPSULE CHEMO,J3490,HCPCS,60505-3121-3,NDC,both,1,ea,21.23,12.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.71,18.05,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Aetna,Commerical,,,2.19,,2.19,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Aetna,Middlesex Employees,,,2.1,,2.1,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Indemnity,,,2.13,,2.13,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Individual Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,State Preferred,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Cigna,Cigna,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Connecticare,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Connecticare,Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Multiplan,Multiplan,,,2.41,,2.41,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Aetna,Commerical,,,2.19,,2.19,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Aetna,Middlesex Employees,,,2.1,,2.1,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Indemnity,,,2.13,,2.13,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,Individual Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Anthem,State Preferred,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Cigna,Cigna,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Connecticare,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Connecticare,Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,Multiplan,Multiplan,,,2.41,,2.41,2.1,2.41,percent of total billed charges,,
FENOFIBRATE MICRONIZED 67 MG CAPSULE CHEMO,J3490,HCPCS,0378-8628-77,NDC,both,1,ea,2.84,1.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Aetna,Commerical,,,2000.49,,2000.49,1918.3,2203.75,percent of total billed charges,,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Aetna,Middlesex Employees,,,1918.3,,1918.3,1918.3,2203.75,percent of total billed charges,,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Anthem,Commerical,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Anthem,Indemnity,,,1942.15,,1942.15,1918.3,2203.75,percent of total billed charges,,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Anthem,Individual Exchange,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Anthem,State Preferred,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Cigna,Cigna,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Connecticare,Commerical,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Connecticare,Exchange,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,Multiplan,Multiplan,,,2203.75,,2203.75,1918.3,2203.75,percent of total billed charges,,
FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2304-02,NDC,both,1,mL,2592.65,1555.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1918.3,2203.75,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-22,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Aetna,Commerical,,,9.14,,9.14,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Aetna,Middlesex Employees,,,8.76,,8.76,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Anthem,Commerical,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Anthem,Indemnity,,,8.87,,8.87,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Anthem,Individual Exchange,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Anthem,State Preferred,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Cigna,Cigna,,0.95,,,0.95,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Connecticare,Commerical,,1.38,,,1.38,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Connecticare,Exchange,,1.38,,,1.38,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,Multiplan,Multiplan,,,10.06,,10.06,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Aetna,Commerical,,,9.14,,9.14,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Aetna,Middlesex Employees,,,8.76,,8.76,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Anthem,Commerical,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Anthem,Indemnity,,,8.87,,8.87,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Anthem,Individual Exchange,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Anthem,State Preferred,,,,,,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Cigna,Cigna,,0.95,,,0.95,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Connecticare,Commerical,,1.38,,,1.38,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Connecticare,Exchange,,1.38,,,1.38,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,Multiplan,Multiplan,,,10.06,,10.06,0.95,10.06,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-28,NDC,both,2,mL,11.84,7.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,10.06,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Aetna,Commerical,,,18.26,,18.26,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Aetna,Middlesex Employees,,,17.51,,17.51,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Anthem,Commerical,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Anthem,Indemnity,,,17.73,,17.73,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Cigna,Cigna,,0.95,,,0.95,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Connecticare,Commerical,,1.38,,,1.38,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Connecticare,Exchange,,1.38,,,1.38,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,Multiplan,Multiplan,,,20.12,,20.12,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Aetna,Commerical,,,18.26,,18.26,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Aetna,Middlesex Employees,,,17.51,,17.51,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Anthem,Commerical,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Anthem,Indemnity,,,17.73,,17.73,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Anthem,Individual Exchange,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Anthem,State Preferred,,,,,,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Cigna,Cigna,,0.95,,,0.95,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Connecticare,Commerical,,1.38,,,1.38,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Connecticare,Exchange,,1.38,,,1.38,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,Multiplan,Multiplan,,,20.12,,20.12,0.95,20.12,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-31,NDC,both,2,mL,23.67,14.2,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,20.12,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Aetna,Commerical,,,45.66,,45.66,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Aetna,Middlesex Employees,,,43.79,,43.79,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Anthem,Commerical,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Anthem,Indemnity,,,44.33,,44.33,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Cigna,Cigna,,0.95,,,0.95,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Connecticare,Commerical,,1.38,,,1.38,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Connecticare,Exchange,,1.38,,,1.38,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,Multiplan,Multiplan,,,50.3,,50.3,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Aetna,Commerical,,,45.66,,45.66,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Aetna,Middlesex Employees,,,43.79,,43.79,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Anthem,Commerical,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Anthem,Indemnity,,,44.33,,44.33,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Anthem,Individual Exchange,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Anthem,State Preferred,,,,,,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Cigna,Cigna,,0.95,,,0.95,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Connecticare,Commerical,,1.38,,,1.38,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Connecticare,Exchange,,1.38,,,1.38,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,Multiplan,Multiplan,,,50.3,,50.3,0.95,50.3,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0409-9094-61,NDC,both,2,mL,59.18,35.51,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,50.3,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-01,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-02,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,J3010,HCPCS,63323-806-12,NDC,both,2,mL,2.37,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION (NICU),J3010,HCPCS,0641-6027-25,NDC,both,2,mL,7.44,4.46,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Aetna,Commerical,,,198.89,,198.89,0.95,219.1,percent of total billed charges,,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Aetna,Middlesex Employees,,,190.72,,190.72,0.95,219.1,percent of total billed charges,,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Anthem,Commerical,,,,,,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Anthem,Indemnity,,,193.09,,193.09,0.95,219.1,percent of total billed charges,,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Anthem,Individual Exchange,,,,,,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Anthem,State Preferred,,,,,,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Cigna,Cigna,,0.95,,,0.95,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Connecticare,Commerical,,1.38,,,1.38,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Connecticare,Exchange,,1.38,,,1.38,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,Multiplan,Multiplan,,,219.1,,219.1,0.95,219.1,percent of total billed charges,,
FENTANYL 10 MCG/ML INJECTION SYRINGE,J3010,HCPCS,71266-9180-1,NDC,both,10,mL,257.76,154.66,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,219.1,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Aetna,Commerical,,,81.27,,81.27,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Aetna,Middlesex Employees,,,77.93,,77.93,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Commerical,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Indemnity,,,78.9,,78.9,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Individual Exchange,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,State Preferred,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Cigna,Cigna,,0.95,,,0.95,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Connecticare,Commerical,,1.38,,,1.38,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Connecticare,Exchange,,1.38,,,1.38,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Multiplan,Multiplan,,,89.53,,89.53,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML IV INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Aetna,Commerical,,,81.27,,81.27,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Aetna,Middlesex Employees,,,77.93,,77.93,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Commerical,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Indemnity,,,78.9,,78.9,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,Individual Exchange,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Anthem,State Preferred,,,,,,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Cigna,Cigna,,0.95,,,0.95,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Connecticare,Commerical,,1.38,,,1.38,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Connecticare,Exchange,,1.38,,,1.38,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,Multiplan,Multiplan,,,89.53,,89.53,0.95,89.53,percent of total billed charges,,
FENTANYL 10 MCG/ML SC INFUSION,J3010,HCPCS,70004-202-22,NDC,both,10,mL,105.33,63.2,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,89.53,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Aetna,Commerical,,,33.33,,33.33,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Aetna,Middlesex Employees,,,31.96,,31.96,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Anthem,Commerical,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Anthem,Indemnity,,,32.36,,32.36,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Anthem,Individual Exchange,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Anthem,State Preferred,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Cigna,Cigna,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Connecticare,Commerical,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Connecticare,Exchange,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,Multiplan,Multiplan,,,36.72,,36.72,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9000-76,NDC,both,1,ea,43.2,25.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Aetna,Commerical,,,33.33,,33.33,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Aetna,Middlesex Employees,,,31.96,,31.96,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Anthem,Commerical,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Anthem,Indemnity,,,32.36,,32.36,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Anthem,Individual Exchange,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Anthem,State Preferred,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Cigna,Cigna,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Connecticare,Commerical,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Connecticare,Exchange,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,Multiplan,Multiplan,,,36.72,,36.72,31.96,36.72,percent of total billed charges,,
FENTANYL 100 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,60505-7014-0,NDC,both,1,ea,43.2,25.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.96,36.72,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Aetna,Commerical,,,28.41,,28.41,27.24,31.3,percent of total billed charges,,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Aetna,Middlesex Employees,,,27.24,,27.24,27.24,31.3,percent of total billed charges,,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Anthem,Commerical,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Anthem,Indemnity,,,27.58,,27.58,27.24,31.3,percent of total billed charges,,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Anthem,Individual Exchange,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Anthem,State Preferred,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Cigna,Cigna,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Connecticare,Commerical,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Connecticare,Exchange,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,Multiplan,Multiplan,,,31.3,,31.3,27.24,31.3,percent of total billed charges,,
FENTANYL 12 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9119-98,NDC,both,1,ea,36.82,22.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.24,31.3,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Aetna,Commerical,,,20.54,,20.54,19.7,22.63,percent of total billed charges,,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Aetna,Middlesex Employees,,,19.7,,19.7,19.7,22.63,percent of total billed charges,,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Anthem,Commerical,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Anthem,Indemnity,,,19.94,,19.94,19.7,22.63,percent of total billed charges,,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Anthem,Individual Exchange,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Anthem,State Preferred,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Cigna,Cigna,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Connecticare,Commerical,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Connecticare,Exchange,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,Multiplan,Multiplan,,,22.63,,22.63,19.7,22.63,percent of total billed charges,,
FENTANYL 200 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7865-65,NDC,both,1,ea,26.62,15.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.7,22.63,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Aetna,Commerical,,,20.02,,20.02,19.2,22.06,percent of total billed charges,,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Aetna,Middlesex Employees,,,19.2,,19.2,19.2,22.06,percent of total billed charges,,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Anthem,Commerical,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Anthem,Indemnity,,,19.44,,19.44,19.2,22.06,percent of total billed charges,,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Anthem,Individual Exchange,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Anthem,State Preferred,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Cigna,Cigna,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Connecticare,Commerical,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Connecticare,Exchange,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,Multiplan,Multiplan,,,22.06,,22.06,19.2,22.06,percent of total billed charges,,
FENTANYL 25 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0378-9121-98,NDC,both,1,ea,25.95,15.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.2,22.06,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Aetna,Commerical,,,20.18,,20.18,19.35,22.23,percent of total billed charges,,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Aetna,Middlesex Employees,,,19.35,,19.35,19.35,22.23,percent of total billed charges,,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Anthem,Commerical,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Anthem,Indemnity,,,19.59,,19.59,19.35,22.23,percent of total billed charges,,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Anthem,Individual Exchange,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Anthem,State Preferred,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Cigna,Cigna,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Connecticare,Commerical,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Connecticare,Exchange,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,Multiplan,Multiplan,,,22.23,,22.23,19.35,22.23,percent of total billed charges,,
FENTANYL 400 MCG LOZENGE ON A HANDLE,J3490,HCPCS,0093-7866-65,NDC,both,1,ea,26.15,15.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.35,22.23,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Aetna,Commerical,,,15.39,,15.39,14.75,16.95,percent of total billed charges,,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Aetna,Middlesex Employees,,,14.75,,14.75,14.75,16.95,percent of total billed charges,,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Anthem,Commerical,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Anthem,Indemnity,,,14.94,,14.94,14.75,16.95,percent of total billed charges,,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Anthem,Individual Exchange,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Anthem,State Preferred,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Cigna,Cigna,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Connecticare,Commerical,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Connecticare,Exchange,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,Multiplan,Multiplan,,,16.95,,16.95,14.75,16.95,percent of total billed charges,,
FENTANYL 50 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9050-76,NDC,both,1,ea,19.94,11.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.75,16.95,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Aetna,Commerical,,,20.54,,20.54,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Aetna,Middlesex Employees,,,19.7,,19.7,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Anthem,Commerical,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Anthem,Indemnity,,,19.94,,19.94,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Anthem,Individual Exchange,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Anthem,State Preferred,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Cigna,Cigna,,0.95,,,0.95,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Connecticare,Commerical,,1.38,,,1.38,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Connecticare,Exchange,,1.38,,,1.38,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,Multiplan,Multiplan,,,22.63,,22.63,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-49,NDC,both,50,mL,26.62,15.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Aetna,Commerical,,,41.08,,41.08,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Aetna,Middlesex Employees,,,39.39,,39.39,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Anthem,Commerical,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Anthem,Indemnity,,,39.88,,39.88,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Anthem,Individual Exchange,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Anthem,State Preferred,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Cigna,Cigna,,0.95,,,0.95,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Connecticare,Commerical,,1.38,,,1.38,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Connecticare,Exchange,,1.38,,,1.38,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,Multiplan,Multiplan,,,45.25,,45.25,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0011-50,NDC,both,2,mL,53.24,31.94,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Aetna,Commerical,,,61.62,,61.62,0.95,67.88,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Aetna,Middlesex Employees,,,59.09,,59.09,0.95,67.88,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Anthem,Commerical,,,,,,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Anthem,Indemnity,,,59.82,,59.82,0.95,67.88,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Anthem,Individual Exchange,,,,,,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Anthem,State Preferred,,,,,,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Cigna,Cigna,,0.95,,,0.95,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Connecticare,Commerical,,1.38,,,1.38,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Connecticare,Exchange,,1.38,,,1.38,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,Multiplan,Multiplan,,,67.88,,67.88,0.95,67.88,percent of total billed charges,,
FENTANYL 50 MCG/ML IV INFUSION,J3010,HCPCS,40810-0018-99,NDC,both,2,mL,79.86,47.92,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,67.88,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Aetna,Commerical,,,20.54,,20.54,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Aetna,Middlesex Employees,,,19.7,,19.7,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Anthem,Commerical,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Anthem,Indemnity,,,19.94,,19.94,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Anthem,Individual Exchange,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Anthem,State Preferred,,,,,,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Cigna,Cigna,,0.95,,,0.95,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Connecticare,Commerical,,1.38,,,1.38,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Connecticare,Exchange,,1.38,,,1.38,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,Multiplan,Multiplan,,,22.63,,22.63,0.95,22.63,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-51,NDC,both,50,mL,26.62,15.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,22.63,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Aetna,Commerical,,,41.08,,41.08,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Aetna,Middlesex Employees,,,39.39,,39.39,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Anthem,Commerical,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Anthem,Indemnity,,,39.88,,39.88,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Anthem,Individual Exchange,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Anthem,State Preferred,,,,,,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Cigna,Cigna,,0.95,,,0.95,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Connecticare,Commerical,,1.38,,,1.38,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Connecticare,Exchange,,1.38,,,1.38,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,Multiplan,Multiplan,,,45.25,,45.25,0.95,45.25,percent of total billed charges,,
FENTANYL 50 MCG/ML SC INFUSION,J3010,HCPCS,40810-0011-52,NDC,both,2,mL,53.24,31.94,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,45.25,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Aetna,Commerical,,,24.45,,24.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Aetna,Middlesex Employees,,,23.45,,23.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Anthem,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Anthem,Indemnity,,,23.74,,23.74,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Anthem,Individual Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Anthem,State Preferred,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Cigna,Cigna,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Connecticare,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Connecticare,Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,Multiplan,Multiplan,,,26.94,,26.94,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,0406-9075-76,NDC,both,1,ea,31.69,19.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Aetna,Commerical,,,24.45,,24.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Aetna,Middlesex Employees,,,23.45,,23.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Anthem,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Anthem,Indemnity,,,23.74,,23.74,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Anthem,Individual Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Anthem,State Preferred,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Cigna,Cigna,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Connecticare,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Connecticare,Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,Multiplan,Multiplan,,,26.94,,26.94,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-11,NDC,both,1,ea,31.69,19.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Aetna,Commerical,,,24.45,,24.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Aetna,Middlesex Employees,,,23.45,,23.45,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Anthem,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Anthem,Indemnity,,,23.74,,23.74,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Anthem,Individual Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Anthem,State Preferred,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Cigna,Cigna,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Connecticare,Commerical,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Connecticare,Exchange,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,Multiplan,Multiplan,,,26.94,,26.94,23.45,26.94,percent of total billed charges,,
FENTANYL 75 MCG/HR TRANSDERMAL PATCH,J3490,HCPCS,47781-427-47,NDC,both,1,ea,31.69,19.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.45,26.94,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Aetna,Commerical,,,1.63,,1.63,1.56,1.79,percent of total billed charges,,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Aetna,Middlesex Employees,,,1.56,,1.56,1.56,1.79,percent of total billed charges,,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Indemnity,,,1.58,,1.58,1.56,1.79,percent of total billed charges,,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Individual Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,State Preferred,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Cigna,Cigna,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Connecticare,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Connecticare,Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Multiplan,Multiplan,,,1.79,,1.79,1.56,1.79,percent of total billed charges,,
FENTANYL CITRATE FOR INHALATION,J7699,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Aetna,Commerical,,,1.83,,1.83,0.95,2.01,percent of total billed charges,,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Aetna,Middlesex Employees,,,1.75,,1.75,0.95,2.01,percent of total billed charges,,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Commerical,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Indemnity,,,1.78,,1.78,0.95,2.01,percent of total billed charges,,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,Individual Exchange,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Anthem,State Preferred,,,,,,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Cigna,Cigna,,0.95,,,0.95,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Connecticare,Commerical,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Connecticare,Exchange,,1.38,,,1.38,0.95,2.01,Other,Could be inpatient or outpatient,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,Multiplan,Multiplan,,,2.01,,2.01,0.95,2.01,percent of total billed charges,,
FENTANYL CITRATE INTRANASAL 50 MCG/ML,J3010,HCPCS,0409-9093-32,NDC,both,2,mL,2.11,1.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.02,,,1.02,0.95,2.01,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Aetna,Commerical,,,3833.22,,3833.22,1.28,4222.7,percent of total billed charges,,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Aetna,Middlesex Employees,,,3675.73,,3675.73,1.28,4222.7,percent of total billed charges,,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Anthem,Commerical,,,,,,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Anthem,Indemnity,,,3721.44,,3721.44,1.28,4222.7,percent of total billed charges,,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Anthem,Individual Exchange,,,,,,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Anthem,State Preferred,,,,,,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Cigna,Cigna,,1.28,,,1.28,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Connecticare,Commerical,,1.68,,,1.68,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Connecticare,Exchange,,1.68,,,1.68,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,Multiplan,Multiplan,,,4222.7,,4222.7,1.28,4222.7,percent of total billed charges,,
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,J1439,HCPCS,0517-0650-01,NDC,both,0.02,mL,4967.88,2980.73,United Healthcare/Oxford,United Healthcare/Oxford,,1.38,,,1.38,1.28,4222.7,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Aetna,Commerical,,,7370.72,,7370.72,23.33,8119.64,percent of total billed charges,,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Aetna,Middlesex Employees,,,7067.91,,7067.91,23.33,8119.64,percent of total billed charges,,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Anthem,Commerical,,,,,,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Anthem,Indemnity,,,7155.79,,7155.79,23.33,8119.64,percent of total billed charges,,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Anthem,Individual Exchange,,,,,,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Anthem,State Preferred,,,,,,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Cigna,Cigna,,23.33,,,23.33,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Connecticare,Commerical,,32.15,,,32.15,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Connecticare,Exchange,,32.15,,,32.15,23.33,8119.64,Other,Could be inpatient or outpatient,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,Multiplan,Multiplan,,,8119.64,,8119.64,23.33,8119.64,percent of total billed charges,,
FERRIC DERISOMALTOSE 100 MG IRON/ML INTRAVENOUS SOLUTION,J1437,HCPCS,73594-9310-1,NDC,both,0.01,mL,9552.52,5731.51,United Healthcare/Oxford,United Healthcare/Oxford,,25.19,,,25.19,23.33,8119.64,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,3932855750,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/1 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-88,NDC,both,1,mL,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,536134480,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,3932805750,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,5038362750,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Commerical,,,9.61,,9.61,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Aetna,Middlesex Employees,,,9.21,,9.21,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Indemnity,,,9.33,,9.33,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,Individual Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Anthem,State Preferred,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Cigna,Cigna,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Commerical,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Connecticare,Exchange,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,Multiplan,Multiplan,,,10.58,,10.58,9.21,10.58,percent of total billed charges,,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,J3490,HCPCS,7139974805,NDC,both,1,mL,12.45,7.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.21,10.58,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 162.5 MG TABLET,J3490,HCPCS,40810-0013-56,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Aetna,Commerical,,,13.98,,13.98,13.41,15.4,percent of total billed charges,,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Aetna,Middlesex Employees,,,13.41,,13.41,13.41,15.4,percent of total billed charges,,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Anthem,Commerical,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Anthem,Indemnity,,,13.57,,13.57,13.41,15.4,percent of total billed charges,,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Anthem,Individual Exchange,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Anthem,State Preferred,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Cigna,Cigna,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Connecticare,Commerical,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Connecticare,Exchange,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,Multiplan,Multiplan,,,15.4,,15.4,13.41,15.4,percent of total billed charges,,
FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,J3490,HCPCS,5485981016,NDC,both,1,mL,18.12,10.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.41,15.4,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,904759161,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
FERROUS SULFATE 325 MG (65 MG IRON) TABLET,J3490,HCPCS,3786476099,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
FERROUS SULFATE 7.5 MG IRON (37.5 MG)/0.5 ML ORAL DROPS SYRINGE,J3490,HCPCS,40810-0004-87,NDC,both,0.5,mL,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Aetna,Commerical,,,652.9,,652.9,0.37,719.24,percent of total billed charges,,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Aetna,Middlesex Employees,,,626.08,,626.08,0.37,719.24,percent of total billed charges,,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Anthem,Commerical,,,,,,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Anthem,Indemnity,,,633.87,,633.87,0.37,719.24,percent of total billed charges,,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Anthem,Individual Exchange,,,,,,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Anthem,State Preferred,,,,,,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Cigna,Cigna,,0.37,,,0.37,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Connecticare,Commerical,,0.52,,,0.52,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Connecticare,Exchange,,0.52,,,0.52,0.37,719.24,Other,Could be inpatient or outpatient,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,Multiplan,Multiplan,,,719.24,,719.24,0.37,719.24,percent of total billed charges,,
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,Q0138,HCPCS,59338-775-01,NDC,both,1,mL,846.17,507.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.4,,,0.4,0.37,719.24,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Aetna,Commerical,,,3413790.27,,3413790.27,1.63,3760655.43,percent of total billed charges,,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Aetna,Middlesex Employees,,,3273539.94,,3273539.94,1.63,3760655.43,percent of total billed charges,,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Anthem,Commerical,,,,,,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Anthem,Indemnity,,,3314243.5,,3314243.5,1.63,3760655.43,percent of total billed charges,,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Anthem,Individual Exchange,,,,,,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Anthem,State Preferred,,,,,,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Cigna,Cigna,,1.63,,,1.63,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Connecticare,Commerical,,2.21,,,2.21,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Connecticare,Exchange,,2.21,,,2.21,1.63,3760655.43,Other,Could be inpatient or outpatient,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,Multiplan,Multiplan,,,3760655.43,,3760655.43,1.63,3760655.43,percent of total billed charges,,
"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",J7178,HCPCS,63833-891-51,NDC,both,1,ME,4424300.5,2654580.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.76,,,1.76,1.63,3760655.43,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Aetna,Commerical,,,400.29,,400.29,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Aetna,Middlesex Employees,,,383.85,,383.85,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Indemnity,,,388.62,,388.62,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Individual Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,State Preferred,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Cigna,Cigna,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Connecticare,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Connecticare,Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Multiplan,Multiplan,,,440.96,,440.96,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Aetna,Commerical,,,400.29,,400.29,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Aetna,Middlesex Employees,,,383.85,,383.85,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Indemnity,,,388.62,,388.62,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Individual Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,State Preferred,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Cigna,Cigna,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Connecticare,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Connecticare,Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Multiplan,Multiplan,,,440.96,,440.96,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET,J8499,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Aetna,Commerical,,,400.29,,400.29,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Aetna,Middlesex Employees,,,383.85,,383.85,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Indemnity,,,388.62,,388.62,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,Individual Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Anthem,State Preferred,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Cigna,Cigna,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Connecticare,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Connecticare,Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,Multiplan,Multiplan,,,440.96,,440.96,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,40810-0017-86,NDC,both,1,ea,518.78,311.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Aetna,Commerical,,,400.29,,400.29,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Aetna,Middlesex Employees,,,383.85,,383.85,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Indemnity,,,388.62,,388.62,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,Individual Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Anthem,State Preferred,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Cigna,Cigna,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Connecticare,Commerical,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Connecticare,Exchange,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,Multiplan,Multiplan,,,440.96,,440.96,383.85,440.96,percent of total billed charges,,
FIDAXOMICIN 200 MG TABLET FIRST ORDER,J3490,HCPCS,52015-080-01,NDC,both,1,ea,518.78,311.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,383.85,440.96,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Aetna,Commerical,,,1601.15,,1601.15,1535.37,1763.84,percent of total billed charges,,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Aetna,Middlesex Employees,,,1535.37,,1535.37,1535.37,1763.84,percent of total billed charges,,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Anthem,Commerical,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Anthem,Indemnity,,,1554.46,,1554.46,1535.37,1763.84,percent of total billed charges,,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Anthem,Individual Exchange,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Anthem,State Preferred,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Cigna,Cigna,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Connecticare,Commerical,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Connecticare,Exchange,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,Multiplan,Multiplan,,,1763.84,,1763.84,1535.37,1763.84,percent of total billed charges,,
FIDAXOMICIN 50 MG TABLET,J8499,HCPCS,40810-0205-29,NDC,both,4,ea,2075.1,1245.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1535.37,1763.84,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Aetna,Commerical,,,925.5,,925.5,1.22,1019.54,percent of total billed charges,,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Aetna,Middlesex Employees,,,887.48,,887.48,1.22,1019.54,percent of total billed charges,,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Anthem,Commerical,,,,,,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Anthem,Indemnity,,,898.52,,898.52,1.22,1019.54,percent of total billed charges,,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Anthem,Individual Exchange,,,,,,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Anthem,State Preferred,,,,,,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Cigna,Cigna,,1.41,,,1.41,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Connecticare,Commerical,,1.52,,,1.52,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Connecticare,Exchange,,1.52,,,1.52,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,Multiplan,Multiplan,,,1019.54,,1019.54,1.22,1019.54,percent of total billed charges,,
FILGRASTIM 300 MCG/ML INJECTION SOLUTION,J1442,HCPCS,55513-530-01,NDC,both,0.003,mL,1199.46,719.68,United Healthcare/Oxford,United Healthcare/Oxford,,1.22,,,1.22,1.22,1019.54,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Commerical,,,1455.43,,1455.43,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Middlesex Employees,,,1395.64,,1395.64,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Commerical,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Indemnity,,,1412.99,,1412.99,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Individual Exchange,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Anthem,State Preferred,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Cigna,Cigna,,1.41,,,1.41,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Commerical,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Exchange,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,Multiplan,Multiplan,,,1603.31,,1603.31,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-01,NDC,both,0.003,mL,1886.25,1131.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.22,,,1.22,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Commerical,,,1455.43,,1455.43,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Middlesex Employees,,,1395.64,,1395.64,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Commerical,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Indemnity,,,1412.99,,1412.99,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Individual Exchange,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,State Preferred,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Cigna,Cigna,,1.41,,,1.41,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Commerical,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Exchange,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Multiplan,Multiplan,,,1603.31,,1603.31,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.22,,,1.22,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Commerical,,,1455.43,,1455.43,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Aetna,Middlesex Employees,,,1395.64,,1395.64,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Commerical,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Indemnity,,,1412.99,,1412.99,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,Individual Exchange,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Anthem,State Preferred,,,,,,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Cigna,Cigna,,1.41,,,1.41,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Commerical,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Connecticare,Exchange,,1.52,,,1.52,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,Multiplan,Multiplan,,,1603.31,,1603.31,1.22,1603.31,percent of total billed charges,,
FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION CCMC,J1442,HCPCS,55513-546-10,NDC,both,0.003,mL,1886.25,1131.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.22,,,1.22,1.22,1603.31,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Aetna,Commerical,,,733.54,,733.54,0.31,808.07,percent of total billed charges,,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Aetna,Middlesex Employees,,,703.4,,703.4,0.31,808.07,percent of total billed charges,,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Anthem,Commerical,,,,,,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Anthem,Indemnity,,,712.15,,712.15,0.31,808.07,percent of total billed charges,,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Anthem,Individual Exchange,,,,,,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Anthem,State Preferred,,,,,,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Cigna,Cigna,,0.35,,,0.35,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Connecticare,Commerical,,0.49,,,0.49,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Connecticare,Exchange,,0.49,,,0.49,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,Multiplan,Multiplan,,,808.07,,808.07,0.31,808.07,percent of total billed charges,,
FILGRASTIM-SNDZ 30 MCG/ML IN DEXTOSE 5% DILUTION BEACON,Q5101,HCPCS,40810-208-49,NDC,both,0.034,mL,950.67,570.4,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,808.07,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-01,NDC,both,0.002,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-05,NDC,both,0.002,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Commerical,,,380.28,,380.28,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Aetna,Middlesex Employees,,,364.65,,364.65,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Commerical,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Indemnity,,,369.19,,369.19,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,Individual Exchange,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Anthem,State Preferred,,,,,,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Cigna,Cigna,,0.35,,,0.35,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Commerical,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Connecticare,Exchange,,0.49,,,0.49,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,Multiplan,Multiplan,,,418.91,,418.91,0.31,418.91,percent of total billed charges,,
FILGRASTIM-SNDZ 300/0.5 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-318-10,NDC,both,0.01,mL,492.84,295.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,418.91,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Commerical,,,561.89,,561.89,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Middlesex Employees,,,538.8,,538.8,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Commerical,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Indemnity,,,545.5,,545.5,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Individual Exchange,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,State Preferred,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Cigna,Cigna,,0.35,,,0.35,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Commerical,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Exchange,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Multiplan,Multiplan,,,618.98,,618.98,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Commerical,,,561.89,,561.89,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Middlesex Employees,,,538.8,,538.8,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Commerical,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Indemnity,,,545.5,,545.5,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Individual Exchange,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,State Preferred,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Cigna,Cigna,,0.35,,,0.35,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Commerical,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Exchange,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Multiplan,Multiplan,,,618.98,,618.98,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION DOSEEDGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Aetna,Commerical,,,561.89,,561.89,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Aetna,Middlesex Employees,,,538.8,,538.8,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Anthem,Commerical,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Anthem,Indemnity,,,545.5,,545.5,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Anthem,Individual Exchange,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Anthem,State Preferred,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Cigna,Cigna,,0.35,,,0.35,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Connecticare,Commerical,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Connecticare,Exchange,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,Multiplan,Multiplan,,,618.98,,618.98,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-01,NDC,both,0.002,mL,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Commerical,,,561.89,,561.89,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Middlesex Employees,,,538.8,,538.8,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Commerical,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Indemnity,,,545.5,,545.5,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Individual Exchange,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,State Preferred,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Cigna,Cigna,,0.35,,,0.35,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Commerical,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Exchange,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Multiplan,Multiplan,,,618.98,,618.98,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Commerical,,,561.89,,561.89,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Aetna,Middlesex Employees,,,538.8,,538.8,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Commerical,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Indemnity,,,545.5,,545.5,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,Individual Exchange,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Anthem,State Preferred,,,,,,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Cigna,Cigna,,0.35,,,0.35,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Commerical,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Connecticare,Exchange,,0.49,,,0.49,0.31,618.98,Other,Could be inpatient or outpatient,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,Multiplan,Multiplan,,,618.98,,618.98,0.31,618.98,percent of total billed charges,,
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE BEACON,Q5101,HCPCS,61314-326-10,NDC,both,0.002,mL,728.21,436.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.31,,,0.31,0.31,618.98,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Aetna,Commerical,,,111.86,,111.86,107.26,123.22,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Aetna,Middlesex Employees,,,107.26,,107.26,107.26,123.22,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Anthem,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Anthem,Indemnity,,,108.6,,108.6,107.26,123.22,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Anthem,Individual Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Anthem,State Preferred,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Cigna,Cigna,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Connecticare,Commerical,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Connecticare,Exchange,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,Multiplan,Multiplan,,,123.22,,123.22,107.26,123.22,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR < 30 ML,B4187,HCPCS,63323-205-21,NDC,both,50,mL,202.99,121.794,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.26,123.22,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Aetna,Commerical,,,223.72,,223.72,214.53,246.45,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Aetna,Middlesex Employees,,,214.53,,214.53,214.53,246.45,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Indemnity,,,217.19,,217.19,214.53,246.45,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,Individual Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Anthem,State Preferred,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Cigna,Cigna,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Connecticare,Commerical,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Connecticare,Exchange,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,Multiplan,Multiplan,,,246.45,,246.45,214.53,246.45,percent of total billed charges,,
FISH OIL BASED FAT EMULSION (OMEGAVEN) FOR >80 ML,B4187,HCPCS,63323-205-31,NDC,both,100,mL,289.94,173.964,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.53,246.45,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,0054-0011-21,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
FLECAINIDE 100 MG TABLET,J3490,HCPCS,53746-642-01,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Aetna,Commerical,,,48.23,,48.23,46.25,53.13,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Aetna,Middlesex Employees,,,46.25,,46.25,46.25,53.13,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Anthem,Commerical,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Anthem,Indemnity,,,46.83,,46.83,46.25,53.13,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Anthem,Individual Exchange,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Anthem,State Preferred,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Cigna,Cigna,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Connecticare,Commerical,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Connecticare,Exchange,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,Multiplan,Multiplan,,,53.13,,53.13,46.25,53.13,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-23,NDC,both,1,mL,62.51,37.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.25,53.13,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Aetna,Commerical,,,96.47,,96.47,92.5,106.27,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Aetna,Middlesex Employees,,,92.5,,92.5,92.5,106.27,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Anthem,Commerical,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Anthem,Indemnity,,,93.65,,93.65,92.5,106.27,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Anthem,Individual Exchange,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Anthem,State Preferred,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Cigna,Cigna,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Connecticare,Commerical,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Connecticare,Exchange,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,Multiplan,Multiplan,,,106.27,,106.27,92.5,106.27,percent of total billed charges,,
FLECAINIDE 20 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-57,NDC,both,1,mL,125.02,75.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,92.5,106.27,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.39,0.45,percent of total billed charges,,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.39,0.45,percent of total billed charges,,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Anthem,Commerical,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.39,0.45,percent of total billed charges,,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Cigna,Cigna,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Connecticare,Commerical,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Connecticare,Exchange,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.39,0.45,percent of total billed charges,,
FLECAINIDE 25 MG ORAL TAB,J3490,HCPCS,40810-0001-22,NDC,both,1,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,0054-0010-21,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
FLECAINIDE 50 MG TABLET,J3490,HCPCS,53746-641-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Aetna,Commerical,,,27.19,,27.19,26.07,29.95,percent of total billed charges,,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Aetna,Middlesex Employees,,,26.07,,26.07,26.07,29.95,percent of total billed charges,,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Anthem,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Anthem,Indemnity,,,26.4,,26.4,26.07,29.95,percent of total billed charges,,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Anthem,Individual Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Anthem,State Preferred,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Cigna,Cigna,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Connecticare,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Connecticare,Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,Multiplan,Multiplan,,,29.95,,29.95,26.07,29.95,percent of total billed charges,,
FLEXIBLE COLLODION (BULK) LIQUID,J3490,HCPCS,5155201174,NDC,both,1,mL,35.24,21.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
FLINSTONES COMPLETE (IRON) CHEWABLE 1/2 TABLET,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Aetna,Commerical,,,55.65,,55.65,27.3,61.3,percent of total billed charges,,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Aetna,Middlesex Employees,,,53.36,,53.36,27.3,61.3,percent of total billed charges,,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Anthem,Commerical,,34.12,,,34.12,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Anthem,Indemnity,,,54.03,,54.03,27.3,61.3,percent of total billed charges,,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Anthem,Individual Exchange,,27.3,,,27.3,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Anthem,State Preferred,,34.12,,,34.12,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Cigna,Cigna,,,,,,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Connecticare,Commerical,,,,,,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Connecticare,Exchange,,,,,,27.3,61.3,Other,Could be inpatient or outpatient,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,Multiplan,Multiplan,,,61.3,,61.3,27.3,61.3,percent of total billed charges,,
FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,90656,HCPCS,19515-810-52,NDC,both,0.5,mL,72.12,43.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.3,61.3,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Aetna,Commerical,,,3.45,,3.45,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Aetna,Middlesex Employees,,,3.31,,3.31,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Anthem,Commerical,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Anthem,Indemnity,,,3.35,,3.35,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Anthem,Individual Exchange,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Anthem,State Preferred,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Cigna,Cigna,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Connecticare,Commerical,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Connecticare,Exchange,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,Multiplan,Multiplan,,,3.8,,3.8,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0172-5411-46,NDC,both,1,ea,4.47,2.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Aetna,Commerical,,,3.45,,3.45,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Aetna,Middlesex Employees,,,3.31,,3.31,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Anthem,Commerical,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Anthem,Indemnity,,,3.35,,3.35,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Anthem,Individual Exchange,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Anthem,State Preferred,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Cigna,Cigna,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Connecticare,Commerical,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Connecticare,Exchange,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,Multiplan,Multiplan,,,3.8,,3.8,3.31,3.8,percent of total billed charges,,
FLUCONAZOLE 100 MG TABLET,J3490,HCPCS,0904-6500-61,NDC,both,1,ea,4.47,2.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.31,3.8,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Aetna,Commerical,,,71.94,,71.94,2.77,79.25,percent of total billed charges,,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Aetna,Middlesex Employees,,,68.99,,68.99,2.77,79.25,percent of total billed charges,,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Anthem,Commerical,,,,,,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Anthem,Indemnity,,,69.85,,69.85,2.77,79.25,percent of total billed charges,,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Anthem,Individual Exchange,,,,,,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Anthem,State Preferred,,,,,,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Cigna,Cigna,,2.77,,,2.77,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Connecticare,Commerical,,3.99,,,3.99,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Connecticare,Exchange,,3.99,,,3.99,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,Multiplan,Multiplan,,,79.25,,79.25,2.77,79.25,percent of total billed charges,,
FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,55390-194-01,NDC,both,100,mL,93.24,55.94,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,79.25,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Aetna,Commerical,,,8.28,,8.28,7.94,9.12,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Aetna,Middlesex Employees,,,7.94,,7.94,7.94,9.12,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Anthem,Commerical,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Anthem,Indemnity,,,8.04,,8.04,7.94,9.12,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Anthem,Individual Exchange,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Anthem,State Preferred,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Cigna,Cigna,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Connecticare,Commerical,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Connecticare,Exchange,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,Multiplan,Multiplan,,,9.12,,9.12,7.94,9.12,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,57237-005-11,NDC,both,1,ea,10.73,6.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.94,9.12,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Aetna,Commerical,,,3.2,,3.2,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Aetna,Middlesex Employees,,,3.07,,3.07,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Anthem,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Anthem,Indemnity,,,3.11,,3.11,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Anthem,Individual Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Anthem,State Preferred,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Cigna,Cigna,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Connecticare,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Connecticare,Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,Multiplan,Multiplan,,,3.53,,3.53,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62135-132-77,NDC,both,1,ea,4.15,2.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Aetna,Commerical,,,3.2,,3.2,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Aetna,Middlesex Employees,,,3.07,,3.07,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Anthem,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Anthem,Indemnity,,,3.11,,3.11,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Anthem,Individual Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Anthem,State Preferred,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Cigna,Cigna,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Connecticare,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Connecticare,Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,Multiplan,Multiplan,,,3.53,,3.53,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,62559-992-12,NDC,both,1,ea,4.15,2.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Aetna,Commerical,,,3.2,,3.2,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Aetna,Middlesex Employees,,,3.07,,3.07,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Anthem,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Anthem,Indemnity,,,3.11,,3.11,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Anthem,Individual Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Anthem,State Preferred,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Cigna,Cigna,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Connecticare,Commerical,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Connecticare,Exchange,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,Multiplan,Multiplan,,,3.53,,3.53,3.07,3.53,percent of total billed charges,,
FLUCONAZOLE 150 MG TABLET,J3490,HCPCS,68462-103-40,NDC,both,1,ea,4.15,2.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.07,3.53,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Aetna,Commerical,,,46.23,,46.23,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Aetna,Middlesex Employees,,,44.33,,44.33,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Anthem,Commerical,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Anthem,Indemnity,,,44.89,,44.89,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Anthem,Individual Exchange,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Anthem,State Preferred,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Cigna,Cigna,,2.77,,,2.77,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Connecticare,Commerical,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Connecticare,Exchange,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,Multiplan,Multiplan,,,50.93,,50.93,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,59.92,35.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Aetna,Commerical,,,46.23,,46.23,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Aetna,Middlesex Employees,,,44.33,,44.33,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Anthem,Commerical,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Anthem,Indemnity,,,44.89,,44.89,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Anthem,Individual Exchange,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Anthem,State Preferred,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Cigna,Cigna,,2.77,,,2.77,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Connecticare,Commerical,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Connecticare,Exchange,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,Multiplan,Multiplan,,,50.93,,50.93,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,25021-184-66,NDC,both,100,mL,59.92,35.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Aetna,Commerical,,,46.23,,46.23,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Aetna,Middlesex Employees,,,44.33,,44.33,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Anthem,Commerical,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Anthem,Indemnity,,,44.89,,44.89,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Anthem,Individual Exchange,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Anthem,State Preferred,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Cigna,Cigna,,2.77,,,2.77,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Connecticare,Commerical,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Connecticare,Exchange,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,Multiplan,Multiplan,,,50.93,,50.93,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-002-06,NDC,both,100,mL,59.92,35.95,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Aetna,Commerical,,,46.23,,46.23,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Aetna,Middlesex Employees,,,44.33,,44.33,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Anthem,Commerical,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Anthem,Indemnity,,,44.89,,44.89,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Anthem,State Preferred,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Cigna,Cigna,,2.77,,,2.77,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Connecticare,Commerical,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Connecticare,Exchange,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,Multiplan,Multiplan,,,50.93,,50.93,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,0409-4688-18,NDC,both,100,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Aetna,Commerical,,,46.23,,46.23,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Aetna,Middlesex Employees,,,44.33,,44.33,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Anthem,Commerical,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Anthem,Indemnity,,,44.89,,44.89,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Anthem,State Preferred,,,,,,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Cigna,Cigna,,2.77,,,2.77,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Connecticare,Commerical,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Connecticare,Exchange,,3.99,,,3.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,Multiplan,Multiplan,,,50.93,,50.93,2.77,50.93,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-66,NDC,both,100,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.93,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Aetna,Commerical,,,40.62,,40.62,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Aetna,Middlesex Employees,,,38.95,,38.95,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Anthem,Commerical,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Anthem,Indemnity,,,39.43,,39.43,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Anthem,State Preferred,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Cigna,Cigna,,2.77,,,2.77,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Connecticare,Commerical,,3.99,,,3.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Connecticare,Exchange,,3.99,,,3.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,Multiplan,Multiplan,,,44.74,,44.74,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,25021-184-82,NDC,both,100,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Aetna,Commerical,,,40.62,,40.62,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Aetna,Middlesex Employees,,,38.95,,38.95,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Anthem,Commerical,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Anthem,Indemnity,,,39.43,,39.43,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Anthem,State Preferred,,,,,,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Cigna,Cigna,,2.77,,,2.77,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Connecticare,Commerical,,3.99,,,3.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Connecticare,Exchange,,3.99,,,3.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,Multiplan,Multiplan,,,44.74,,44.74,2.77,44.74,percent of total billed charges,,
FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-002-06,NDC,both,100,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,44.74,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Aetna,Commerical,,,45,,45,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Aetna,Middlesex Employees,,,43.15,,43.15,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Indemnity,,,43.69,,43.69,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Individual Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,State Preferred,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Cigna,Cigna,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Connecticare,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Connecticare,Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Multiplan,Multiplan,,,49.57,,49.57,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Aetna,Commerical,,,45,,45,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Aetna,Middlesex Employees,,,43.15,,43.15,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Indemnity,,,43.69,,43.69,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Individual Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,State Preferred,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Cigna,Cigna,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Connecticare,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Connecticare,Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Multiplan,Multiplan,,,49.57,,49.57,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Aetna,Commerical,,,45,,45,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Aetna,Middlesex Employees,,,43.15,,43.15,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Indemnity,,,43.69,,43.69,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,Individual Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Anthem,State Preferred,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Cigna,Cigna,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Connecticare,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Connecticare,Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,Multiplan,Multiplan,,,49.57,,49.57,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,57237-150-35,NDC,both,1,mL,58.32,34.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Aetna,Commerical,,,45,,45,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Aetna,Middlesex Employees,,,43.15,,43.15,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Indemnity,,,43.69,,43.69,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,Individual Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Anthem,State Preferred,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Cigna,Cigna,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Connecticare,Commerical,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Connecticare,Exchange,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,Multiplan,Multiplan,,,49.57,,49.57,43.15,49.57,percent of total billed charges,,
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,59762-5030-1,NDC,both,1,mL,58.32,34.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.15,49.57,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Aetna,Commerical,,,45.64,,45.64,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Aetna,Middlesex Employees,,,43.77,,43.77,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Commerical,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Indemnity,,,44.31,,44.31,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Individual Exchange,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,State Preferred,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Cigna,Cigna,,2.77,,,2.77,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Connecticare,Commerical,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Connecticare,Exchange,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Multiplan,Multiplan,,,50.28,,50.28,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Aetna,Commerical,,,45.64,,45.64,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Aetna,Middlesex Employees,,,43.77,,43.77,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Commerical,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Indemnity,,,44.31,,44.31,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Individual Exchange,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,State Preferred,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Cigna,Cigna,,2.77,,,2.77,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Connecticare,Commerical,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Connecticare,Exchange,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Multiplan,Multiplan,,,50.28,,50.28,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Aetna,Commerical,,,45.64,,45.64,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Aetna,Middlesex Employees,,,43.77,,43.77,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Commerical,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Indemnity,,,44.31,,44.31,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,Individual Exchange,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Anthem,State Preferred,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Cigna,Cigna,,2.77,,,2.77,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Connecticare,Commerical,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Connecticare,Exchange,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,Multiplan,Multiplan,,,50.28,,50.28,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,69784-003-06,NDC,both,100,mL,59.15,35.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Aetna,Commerical,,,45.64,,45.64,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Aetna,Middlesex Employees,,,43.77,,43.77,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Commerical,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Indemnity,,,44.31,,44.31,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,Individual Exchange,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Anthem,State Preferred,,,,,,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Cigna,Cigna,,2.77,,,2.77,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Connecticare,Commerical,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Connecticare,Exchange,,3.99,,,3.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,Multiplan,Multiplan,,,50.28,,50.28,2.77,50.28,percent of total billed charges,,
FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1450,HCPCS,70655-088-10,NDC,both,100,mL,59.15,35.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,50.28,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0172-5410-46,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,40810-0015-39,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
FLUCONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,68462-101-30,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Aetna,Commerical,,,181.94,,181.94,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Aetna,Middlesex Employees,,,174.47,,174.47,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Anthem,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Anthem,Indemnity,,,176.64,,176.64,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Anthem,Individual Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Anthem,State Preferred,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Cigna,Cigna,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Connecticare,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Connecticare,Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,Multiplan,Multiplan,,,200.43,,200.43,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,43386-771-01,NDC,both,1,ea,235.8,141.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Aetna,Commerical,,,181.94,,181.94,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Aetna,Middlesex Employees,,,174.47,,174.47,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Anthem,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Anthem,Indemnity,,,176.64,,176.64,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Anthem,Individual Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Anthem,State Preferred,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Cigna,Cigna,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Connecticare,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Connecticare,Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,Multiplan,Multiplan,,,200.43,,200.43,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J3490,HCPCS,50268-331-12,NDC,both,1,ea,235.8,141.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Aetna,Commerical,,,181.94,,181.94,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Aetna,Middlesex Employees,,,174.47,,174.47,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Anthem,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Anthem,Indemnity,,,176.64,,176.64,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Anthem,Individual Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Anthem,State Preferred,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Cigna,Cigna,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Connecticare,Commerical,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Connecticare,Exchange,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,Multiplan,Multiplan,,,200.43,,200.43,174.47,200.43,percent of total billed charges,,
FLUCYTOSINE 250 MG CAPSULE,J8499,HCPCS,64980-179-01,NDC,both,1,ea,235.8,141.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.47,200.43,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Aetna,Commerical,,,1932.72,,1932.72,1853.32,2129.1,percent of total billed charges,,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Aetna,Middlesex Employees,,,1853.32,,1853.32,1853.32,2129.1,percent of total billed charges,,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Anthem,Commerical,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Anthem,Indemnity,,,1876.36,,1876.36,1853.32,2129.1,percent of total billed charges,,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Anthem,Individual Exchange,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Anthem,State Preferred,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Cigna,Cigna,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Connecticare,Commerical,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Connecticare,Exchange,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,Multiplan,Multiplan,,,2129.1,,2129.1,1853.32,2129.1,percent of total billed charges,,
FLUCYTOSINE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0204-91,NDC,both,1,mL,2504.82,1502.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1853.32,2129.1,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Aetna,Commerical,,,161.19,,161.19,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Aetna,Middlesex Employees,,,154.57,,154.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Anthem,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Anthem,Indemnity,,,156.49,,156.49,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Anthem,Individual Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Anthem,State Preferred,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Cigna,Cigna,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Connecticare,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Connecticare,Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,Multiplan,Multiplan,,,177.57,,177.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,42794-010-08,NDC,both,1,ea,208.9,125.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Aetna,Commerical,,,161.19,,161.19,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Aetna,Middlesex Employees,,,154.57,,154.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Anthem,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Anthem,Indemnity,,,156.49,,156.49,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Anthem,Individual Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Anthem,State Preferred,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Cigna,Cigna,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Connecticare,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Connecticare,Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,Multiplan,Multiplan,,,177.57,,177.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,43386-770-01,NDC,both,1,ea,208.9,125.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Aetna,Commerical,,,161.19,,161.19,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Aetna,Middlesex Employees,,,154.57,,154.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Anthem,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Anthem,Indemnity,,,156.49,,156.49,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Anthem,Individual Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Anthem,State Preferred,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Cigna,Cigna,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Connecticare,Commerical,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Connecticare,Exchange,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,Multiplan,Multiplan,,,177.57,,177.57,154.57,177.57,percent of total billed charges,,
FLUCYTOSINE 500 MG CAPSULE,J3490,HCPCS,59651-332-01,NDC,both,1,ea,208.9,125.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,154.57,177.57,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Aetna,Commerical,,,117.56,,117.56,112.73,323.31,percent of total billed charges,,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Aetna,Middlesex Employees,,,112.73,,112.73,112.73,323.31,percent of total billed charges,,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Anthem,Commerical,,,,,,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Anthem,Indemnity,,,114.13,,114.13,112.73,323.31,percent of total billed charges,,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Anthem,Individual Exchange,,,,,,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Anthem,State Preferred,,,,,,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Cigna,Cigna,,323.31,,,323.31,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Connecticare,Commerical,,204.85,,,204.85,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Connecticare,Exchange,,204.85,,,204.85,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,Multiplan,Multiplan,,,129.51,,129.51,112.73,323.31,percent of total billed charges,,
FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,J9185,HCPCS,63323-192-02,NDC,both,1,mL,152.36,91.42,United Healthcare/Oxford,United Healthcare/Oxford,,279.75,,,279.75,112.73,323.31,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Aetna,Commerical,,,1.21,,1.21,1.16,1.33,percent of total billed charges,,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Aetna,Middlesex Employees,,,1.16,,1.16,1.16,1.33,percent of total billed charges,,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Anthem,Commerical,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Anthem,Indemnity,,,1.18,,1.18,1.16,1.33,percent of total billed charges,,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Anthem,Individual Exchange,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Anthem,State Preferred,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Cigna,Cigna,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Connecticare,Commerical,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Connecticare,Exchange,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,Multiplan,Multiplan,,,1.33,,1.33,1.16,1.33,percent of total billed charges,,
FLUDROCORTISONE 0.025 MG ORAL TAB,J3490,HCPCS,4081-00003-85,NDC,both,1,ea,1.57,0.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.16,1.33,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Aetna,Commerical,,,1.66,,1.66,1.59,1.83,percent of total billed charges,,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Aetna,Middlesex Employees,,,1.59,,1.59,1.59,1.83,percent of total billed charges,,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Anthem,Commerical,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Anthem,Indemnity,,,1.61,,1.61,1.59,1.83,percent of total billed charges,,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Anthem,Individual Exchange,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Anthem,State Preferred,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Cigna,Cigna,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Connecticare,Commerical,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Connecticare,Exchange,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,Multiplan,Multiplan,,,1.83,,1.83,1.59,1.83,percent of total billed charges,,
FLUDROCORTISONE 0.05 MG ORAL TAB,J3490,HCPCS,40810-0001-27,NDC,both,1,ea,2.15,1.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-01,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
FLUDROCORTISONE 0.1 MG TABLET,J3490,HCPCS,68084-288-11,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-01,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Aetna,Commerical,,,15.61,,15.61,14.97,17.2,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Aetna,Middlesex Employees,,,14.97,,14.97,14.97,17.2,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Indemnity,,,15.15,,15.15,14.97,17.2,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Individual Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,State Preferred,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Cigna,Cigna,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Connecticare,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Connecticare,Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Multiplan,Multiplan,,,17.2,,17.2,14.97,17.2,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-01,NDC,both,1,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9784-10,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,36000-148-10,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9684-10,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Aetna,Commerical,,,15.61,,15.61,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Aetna,Middlesex Employees,,,14.97,,14.97,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Indemnity,,,15.15,,15.15,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,Individual Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Anthem,State Preferred,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Cigna,Cigna,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Connecticare,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Connecticare,Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,Multiplan,Multiplan,,,17.2,,17.2,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,0143-9783-10,NDC,both,1,mL,20.23,12.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-092-10,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Aetna,Commerical,,,15.61,,15.61,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Aetna,Middlesex Employees,,,14.97,,14.97,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Anthem,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Anthem,Indemnity,,,15.15,,15.15,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Anthem,Individual Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Anthem,State Preferred,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Cigna,Cigna,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Connecticare,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Connecticare,Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,Multiplan,Multiplan,,,17.2,,17.2,14.97,17.2,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,55390-093-10,NDC,both,1,mL,20.23,12.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
FLUMAZENIL IV INFUSION 0.01 MG/ML,J3490,HCPCS,63323-424-05,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Aetna,Commerical,,,109.63,,109.63,105.12,120.77,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Aetna,Middlesex Employees,,,105.12,,105.12,105.12,120.77,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Anthem,Commerical,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Anthem,Indemnity,,,106.43,,106.43,105.12,120.77,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Anthem,Individual Exchange,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Anthem,State Preferred,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Cigna,Cigna,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Connecticare,Commerical,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Connecticare,Exchange,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,Multiplan,Multiplan,,,120.77,,120.77,105.12,120.77,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL CREAM,J3490,HCPCS,52565-031-15,NDC,both,1,gm,142.08,85.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,105.12,120.77,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Aetna,Commerical,,,56.92,,56.92,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Aetna,Middlesex Employees,,,54.58,,54.58,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Anthem,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Anthem,Indemnity,,,55.26,,55.26,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Anthem,Individual Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Anthem,State Preferred,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Cigna,Cigna,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Connecticare,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Connecticare,Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,Multiplan,Multiplan,,,62.7,,62.7,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,0168-0059-60,NDC,both,60,mL,73.77,44.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Aetna,Commerical,,,56.92,,56.92,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Aetna,Middlesex Employees,,,54.58,,54.58,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Anthem,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Anthem,Indemnity,,,55.26,,55.26,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Anthem,Individual Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Anthem,State Preferred,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Cigna,Cigna,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Connecticare,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Connecticare,Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,Multiplan,Multiplan,,,62.7,,62.7,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,21922-003-01,NDC,both,1,mL,73.77,44.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Aetna,Commerical,,,56.92,,56.92,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Aetna,Middlesex Employees,,,54.58,,54.58,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Anthem,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Anthem,Indemnity,,,55.26,,55.26,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Anthem,Individual Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Anthem,State Preferred,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Cigna,Cigna,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Connecticare,Commerical,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Connecticare,Exchange,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,Multiplan,Multiplan,,,62.7,,62.7,54.58,62.7,percent of total billed charges,,
FLUOCINOLONE 0.01 % TOPICAL SOLUTION,J3490,HCPCS,52565-012-59,NDC,both,1,mL,73.77,44.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.58,62.7,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Aetna,Commerical,,,69.78,,69.78,66.91,76.87,percent of total billed charges,,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Aetna,Middlesex Employees,,,66.91,,66.91,66.91,76.87,percent of total billed charges,,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Anthem,Commerical,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Anthem,Indemnity,,,67.74,,67.74,66.91,76.87,percent of total billed charges,,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Anthem,Individual Exchange,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Anthem,State Preferred,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Cigna,Cigna,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Connecticare,Commerical,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Connecticare,Exchange,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,Multiplan,Multiplan,,,76.87,,76.87,66.91,76.87,percent of total billed charges,,
FLUOCINOLONE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0224-15,NDC,both,15,gm,90.43,54.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,66.91,76.87,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Aetna,Commerical,,,40.08,,40.08,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Aetna,Middlesex Employees,,,38.43,,38.43,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Anthem,Commerical,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Anthem,Indemnity,,,38.91,,38.91,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Anthem,Individual Exchange,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Anthem,State Preferred,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Cigna,Cigna,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Connecticare,Commerical,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Connecticare,Exchange,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,Multiplan,Multiplan,,,44.15,,44.15,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,0093-0262-15,NDC,both,1,gm,51.94,31.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Aetna,Commerical,,,40.08,,40.08,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Aetna,Middlesex Employees,,,38.43,,38.43,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Anthem,Commerical,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Anthem,Indemnity,,,38.91,,38.91,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Anthem,Individual Exchange,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Anthem,State Preferred,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Cigna,Cigna,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Connecticare,Commerical,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Connecticare,Exchange,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,Multiplan,Multiplan,,,44.15,,44.15,38.43,44.15,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL CREAM,J3490,HCPCS,69238-1534-5,NDC,both,1,gm,51.94,31.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.43,44.15,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Aetna,Commerical,,,22.3,,22.3,21.38,24.57,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Aetna,Middlesex Employees,,,21.38,,21.38,21.38,24.57,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Anthem,Commerical,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Anthem,Indemnity,,,21.65,,21.65,21.38,24.57,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Anthem,Individual Exchange,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Anthem,State Preferred,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Cigna,Cigna,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Connecticare,Commerical,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Connecticare,Exchange,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,Multiplan,Multiplan,,,24.57,,24.57,21.38,24.57,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL OINTMENT,J3490,HCPCS,51672-1264-1,NDC,both,15,gm,28.9,17.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.38,24.57,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Aetna,Commerical,,,84.23,,84.23,80.77,92.79,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Aetna,Middlesex Employees,,,80.77,,80.77,80.77,92.79,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Anthem,Commerical,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Anthem,Indemnity,,,81.77,,81.77,80.77,92.79,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Anthem,Individual Exchange,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Anthem,State Preferred,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Cigna,Cigna,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Connecticare,Commerical,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Connecticare,Exchange,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,Multiplan,Multiplan,,,92.79,,92.79,80.77,92.79,percent of total billed charges,,
FLUOCINONIDE 0.05 % TOPICAL SOLUTION,J3490,HCPCS,51672-1273-4,NDC,both,60,mL,109.16,65.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.77,92.79,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Aetna,Commerical,,,51.46,,51.46,49.34,56.69,percent of total billed charges,,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Aetna,Middlesex Employees,,,49.34,,49.34,49.34,56.69,percent of total billed charges,,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Anthem,Commerical,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Anthem,Indemnity,,,49.96,,49.96,49.34,56.69,percent of total billed charges,,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Anthem,Individual Exchange,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Anthem,State Preferred,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Cigna,Cigna,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Connecticare,Commerical,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Connecticare,Exchange,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,Multiplan,Multiplan,,,56.69,,56.69,49.34,56.69,percent of total billed charges,,
FLUORESCEIN 0.25 %-BENOXINATE 0.4 % EYE DROPS,J3490,HCPCS,59390-218-05,NDC,both,1,mL,66.69,40.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.34,56.69,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Aetna,Commerical,,,0.42,,0.42,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Anthem,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Anthem,Indemnity,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Anthem,Individual Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Anthem,State Preferred,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Cigna,Cigna,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Connecticare,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Connecticare,Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,Multiplan,Multiplan,,,0.47,,0.47,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17238-900-11,NDC,both,1,ea,0.55,0.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Aetna,Commerical,,,0.42,,0.42,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Anthem,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Anthem,Indemnity,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Anthem,Individual Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Anthem,State Preferred,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Cigna,Cigna,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Connecticare,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Connecticare,Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,Multiplan,Multiplan,,,0.47,,0.47,0.41,0.47,percent of total billed charges,,
FLUORESCEIN 1 MG EYE STRIPS,J3490,HCPCS,17478-404-01,NDC,both,1,ea,0.55,0.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Aetna,Commerical,,,108.15,,108.15,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Aetna,Middlesex Employees,,,103.7,,103.7,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Anthem,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Anthem,Indemnity,,,104.99,,104.99,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Anthem,Individual Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Anthem,State Preferred,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Cigna,Cigna,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Connecticare,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Connecticare,Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,Multiplan,Multiplan,,,119.14,,119.14,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,15.15,9.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Aetna,Commerical,,,108.15,,108.15,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Aetna,Middlesex Employees,,,103.7,,103.7,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Anthem,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Anthem,Indemnity,,,104.99,,104.99,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Anthem,Individual Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Anthem,State Preferred,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Cigna,Cigna,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Connecticare,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Connecticare,Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,Multiplan,Multiplan,,,119.14,,119.14,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 10% INJECTION FOR INTRATHECAL USE,J3490,HCPCS,17478-253-10,NDC,both,1,mL,15.15,9.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Aetna,Commerical,,,108.15,,108.15,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Aetna,Middlesex Employees,,,103.7,,103.7,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Anthem,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Anthem,Indemnity,,,104.99,,104.99,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Anthem,Individual Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Anthem,State Preferred,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Cigna,Cigna,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Connecticare,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Connecticare,Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,Multiplan,Multiplan,,,119.14,,119.14,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0065-0092-65,NDC,both,1,mL,140.16,84.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Aetna,Commerical,,,108.15,,108.15,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Aetna,Middlesex Employees,,,103.7,,103.7,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Indemnity,,,104.99,,104.99,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Individual Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,State Preferred,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Cigna,Cigna,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Connecticare,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Connecticare,Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Multiplan,Multiplan,,,119.14,,119.14,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Aetna,Commerical,,,108.15,,108.15,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Aetna,Middlesex Employees,,,103.7,,103.7,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Indemnity,,,104.99,,104.99,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,Individual Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Anthem,State Preferred,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Cigna,Cigna,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Connecticare,Commerical,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Connecticare,Exchange,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,Multiplan,Multiplan,,,119.14,,119.14,103.7,119.14,percent of total billed charges,,
FLUORESCEIN 500 MG/5 ML (10%) IV SOLN FOR PO,J3490,HCPCS,17478-253-10,NDC,both,1,mL,140.16,84.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,103.7,119.14,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,21.26,24.42,percent of total billed charges,,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,21.26,24.42,percent of total billed charges,,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,21.26,24.42,percent of total billed charges,,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,21.26,24.42,percent of total billed charges,,
FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,J8499,HCPCS,6126916550,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,3.66,19.53,percent of total billed charges,,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,3.66,19.53,percent of total billed charges,,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Anthem,Commerical,,,,,,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,3.66,19.53,percent of total billed charges,,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Anthem,State Preferred,,,,,,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Cigna,Cigna,,4.54,,,4.54,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Connecticare,Commerical,,3.66,,,3.66,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Connecticare,Exchange,,3.66,,,3.66,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,3.66,19.53,percent of total billed charges,,
FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-20,NDC,both,10,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,19.53,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Aetna,Commerical,,,172.59,,172.59,165.5,190.13,percent of total billed charges,,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Aetna,Middlesex Employees,,,165.5,,165.5,165.5,190.13,percent of total billed charges,,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Anthem,Commerical,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Anthem,Indemnity,,,167.56,,167.56,165.5,190.13,percent of total billed charges,,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Anthem,Individual Exchange,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Anthem,State Preferred,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Cigna,Cigna,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Connecticare,Commerical,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Connecticare,Exchange,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,Multiplan,Multiplan,,,190.13,,190.13,165.5,190.13,percent of total billed charges,,
FLUOROURACIL 5 % TOPICAL CREAM,J3490,HCPCS,0187-3204-47,NDC,both,1,gm,223.68,134.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,165.5,190.13,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,4.54,,,4.54,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-00,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Anthem,Commerical,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Anthem,State Preferred,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Cigna,Cigna,,4.54,,,4.54,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Connecticare,Commerical,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Connecticare,Exchange,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-10,NDC,both,10,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Aetna,Commerical,,,7.39,,7.39,3.66,8.14,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Aetna,Middlesex Employees,,,7.09,,7.09,3.66,8.14,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Anthem,Commerical,,,,,,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Anthem,Indemnity,,,7.18,,7.18,3.66,8.14,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Anthem,Individual Exchange,,,,,,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Anthem,State Preferred,,,,,,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Cigna,Cigna,,4.54,,,4.54,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Connecticare,Commerical,,3.66,,,3.66,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Connecticare,Exchange,,3.66,,,3.66,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,Multiplan,Multiplan,,,8.14,,8.14,3.66,8.14,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-19,NDC,both,1,mL,9.58,5.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,8.14,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,4.54,,,4.54,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,63323-117-31,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,4.54,,,4.54,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-22,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Anthem,Commerical,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Anthem,Individual Exchange,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Anthem,State Preferred,,,,,,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Cigna,Cigna,,4.54,,,4.54,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Connecticare,Commerical,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Connecticare,Exchange,,3.66,,,3.66,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,3.66,6.06,percent of total billed charges,,
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,J9190,HCPCS,70700-186-23,NDC,both,1,mL,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,3.93,,,3.93,3.66,6.06,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
FLUOXETINE 10 MG CAPSULE,J8499,HCPCS,0904-5784-61,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0378-0734-93,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-11,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,0832-0402-30,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,40810-0009-59,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-01,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Aetna,Commerical,,,0.55,,0.55,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Anthem,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Anthem,Indemnity,,,0.53,,0.53,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Anthem,Individual Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Anthem,State Preferred,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Cigna,Cigna,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Connecticare,Commerical,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Connecticare,Exchange,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,Multiplan,Multiplan,,,0.6,,0.6,0.53,0.6,percent of total billed charges,,
FLUOXETINE 10 MG TABLET,J8499,HCPCS,59651-308-30,NDC,both,1,ea,0.71,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.6,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
FLUOXETINE 20 MG CAPSULE,J8499,HCPCS,0904-5785-61,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0378-0735-93,NDC,both,1,ea,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,0832-0403-30,NDC,both,1,ea,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,40810-0020-14,NDC,both,1,UN,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,43598-566-30,NDC,both,1,ea,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,49884-336-11,NDC,both,1,ea,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Aetna,Commerical,,,1.91,,1.91,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Aetna,Middlesex Employees,,,1.83,,1.83,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Anthem,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Anthem,Indemnity,,,1.86,,1.86,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Anthem,Individual Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Anthem,State Preferred,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Cigna,Cigna,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Connecticare,Commerical,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Connecticare,Exchange,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,Multiplan,Multiplan,,,2.11,,2.11,1.83,2.11,percent of total billed charges,,
FLUOXETINE 20 MG TABLET,J8499,HCPCS,59651-309-01,NDC,both,1,ea,2.48,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.83,2.11,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,0121-0721-04,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,54838-523-40,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J8499,HCPCS,70954-600-10,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
FLUOXETINE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-28,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Aetna,Commerical,,,6.6,,6.6,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Aetna,Middlesex Employees,,,6.33,,6.33,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Anthem,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Anthem,Indemnity,,,6.41,,6.41,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Anthem,Individual Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Anthem,State Preferred,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Cigna,Cigna,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Connecticare,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Connecticare,Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,Multiplan,Multiplan,,,7.28,,7.28,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0527-1789-01,NDC,both,1,ea,8.56,5.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Aetna,Commerical,,,6.6,,6.6,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Aetna,Middlesex Employees,,,6.33,,6.33,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Anthem,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Anthem,Indemnity,,,6.41,,6.41,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Anthem,Individual Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Anthem,State Preferred,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Cigna,Cigna,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Connecticare,Commerical,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Connecticare,Exchange,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,Multiplan,Multiplan,,,7.28,,7.28,6.33,7.28,percent of total billed charges,,
FLUPHENAZINE 2.5 MG TABLET,J3490,HCPCS,0904-7158-61,NDC,both,1,ea,8.56,5.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.33,7.28,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Aetna,Commerical,,,427.27,,427.27,409.71,470.68,percent of total billed charges,,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Aetna,Middlesex Employees,,,409.71,,409.71,409.71,470.68,percent of total billed charges,,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Anthem,Commerical,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Anthem,Indemnity,,,414.81,,414.81,409.71,470.68,percent of total billed charges,,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Anthem,Individual Exchange,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Anthem,State Preferred,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Cigna,Cigna,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Connecticare,Commerical,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Connecticare,Exchange,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,Multiplan,Multiplan,,,470.68,,470.68,409.71,470.68,percent of total billed charges,,
FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0695-04,NDC,both,14,ea,553.74,332.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Aetna,Commerical,,,1831.12,,1831.12,1755.89,2017.18,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Aetna,Middlesex Employees,,,1755.89,,1755.89,1755.89,2017.18,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Anthem,Commerical,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Anthem,Indemnity,,,1777.73,,1777.73,1755.89,2017.18,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Anthem,Individual Exchange,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Anthem,State Preferred,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Cigna,Cigna,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Connecticare,Commerical,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Connecticare,Exchange,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,Multiplan,Multiplan,,,2017.18,,2017.18,1755.89,2017.18,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0054-0327-56,NDC,both,1,ea,2373.15,1423.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1755.89,2017.18,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Aetna,Commerical,,,838.52,,838.52,804.07,923.72,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Aetna,Middlesex Employees,,,804.07,,804.07,804.07,923.72,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Anthem,Commerical,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Anthem,Indemnity,,,814.07,,814.07,804.07,923.72,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Anthem,Individual Exchange,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Anthem,State Preferred,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Cigna,Cigna,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Connecticare,Commerical,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Connecticare,Exchange,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,Multiplan,Multiplan,,,923.72,,923.72,804.07,923.72,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-00,NDC,both,1,ea,1086.73,652.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,804.07,923.72,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Aetna,Commerical,,,427.27,,427.27,409.71,470.68,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Aetna,Middlesex Employees,,,409.71,,409.71,409.71,470.68,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Anthem,Commerical,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Anthem,Indemnity,,,414.81,,414.81,409.71,470.68,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Anthem,Individual Exchange,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Anthem,State Preferred,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Cigna,Cigna,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Connecticare,Commerical,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Connecticare,Exchange,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,Multiplan,Multiplan,,,470.68,,470.68,409.71,470.68,percent of total billed charges,,
FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0696-04,NDC,both,14,ea,553.74,332.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,409.71,470.68,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Aetna,Commerical,,,696.4,,696.4,667.79,767.16,percent of total billed charges,,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Aetna,Middlesex Employees,,,667.79,,667.79,667.79,767.16,percent of total billed charges,,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Anthem,Commerical,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Anthem,Indemnity,,,676.09,,676.09,667.79,767.16,percent of total billed charges,,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Anthem,Individual Exchange,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Anthem,State Preferred,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Cigna,Cigna,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Connecticare,Commerical,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Connecticare,Exchange,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,Multiplan,Multiplan,,,767.16,,767.16,667.79,767.16,percent of total billed charges,,
FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,J3490,HCPCS,0173-0697-04,NDC,both,14,ea,902.54,541.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,667.79,767.16,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Aetna,Commerical,,,497.62,,497.62,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Aetna,Middlesex Employees,,,477.18,,477.18,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Anthem,Commerical,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Anthem,Indemnity,,,483.11,,483.11,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Anthem,Individual Exchange,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Anthem,State Preferred,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Cigna,Cigna,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Connecticare,Commerical,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Connecticare,Exchange,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,Multiplan,Multiplan,,,548.18,,548.18,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0719-20,NDC,both,12,gm,644.92,386.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Aetna,Commerical,,,497.62,,497.62,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Aetna,Middlesex Employees,,,477.18,,477.18,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Anthem,Commerical,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Anthem,Indemnity,,,483.11,,483.11,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Anthem,Individual Exchange,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Anthem,State Preferred,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Cigna,Cigna,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Connecticare,Commerical,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Connecticare,Exchange,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,Multiplan,Multiplan,,,548.18,,548.18,477.18,548.18,percent of total billed charges,,
FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-079-96,NDC,both,1,gm,644.92,386.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,477.18,548.18,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Aetna,Commerical,,,772.46,,772.46,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Aetna,Middlesex Employees,,,740.72,,740.72,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Anthem,Commerical,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Anthem,Indemnity,,,749.93,,749.93,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Anthem,Individual Exchange,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Anthem,State Preferred,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Cigna,Cigna,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Connecticare,Commerical,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Connecticare,Exchange,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,Multiplan,Multiplan,,,850.94,,850.94,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0720-20,NDC,both,12,gm,1001.11,600.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Aetna,Commerical,,,772.46,,772.46,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Aetna,Middlesex Employees,,,740.72,,740.72,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Anthem,Commerical,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Anthem,Indemnity,,,749.93,,749.93,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Anthem,Individual Exchange,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Anthem,State Preferred,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Cigna,Cigna,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Connecticare,Commerical,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Connecticare,Exchange,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,Multiplan,Multiplan,,,850.94,,850.94,740.72,850.94,percent of total billed charges,,
FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-080-96,NDC,both,1,gm,1001.11,600.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,740.72,850.94,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Aetna,Commerical,,,371.56,,371.56,356.29,409.31,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Aetna,Middlesex Employees,,,356.29,,356.29,356.29,409.31,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Anthem,Commerical,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Anthem,Indemnity,,,360.72,,360.72,356.29,409.31,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Anthem,Individual Exchange,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Anthem,State Preferred,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Cigna,Cigna,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Connecticare,Commerical,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Connecticare,Exchange,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,Multiplan,Multiplan,,,409.31,,409.31,356.29,409.31,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,0173-0718-20,NDC,both,10.6,gm,481.54,288.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,356.29,409.31,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Aetna,Commerical,,,385.58,,385.58,369.74,424.75,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Aetna,Middlesex Employees,,,369.74,,369.74,369.74,424.75,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Anthem,Commerical,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Anthem,Indemnity,,,374.33,,374.33,369.74,424.75,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Anthem,Individual Exchange,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Anthem,State Preferred,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Cigna,Cigna,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Connecticare,Commerical,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Connecticare,Exchange,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,Multiplan,Multiplan,,,424.75,,424.75,369.74,424.75,percent of total billed charges,,
FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,J3490,HCPCS,66993-078-96,NDC,both,1,gm,499.71,299.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,369.74,424.75,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Aetna,Commerical,,,13.43,,13.43,12.88,14.8,percent of total billed charges,,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Aetna,Middlesex Employees,,,12.88,,12.88,12.88,14.8,percent of total billed charges,,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Anthem,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Anthem,Indemnity,,,13.04,,13.04,12.88,14.8,percent of total billed charges,,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Anthem,Individual Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Anthem,State Preferred,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Cigna,Cigna,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Connecticare,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Connecticare,Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,Multiplan,Multiplan,,,14.8,,14.8,12.88,14.8,percent of total billed charges,,
FLUTICASONE PROPIONATE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0054-3270-99,NDC,both,16,gm,40.02,24.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Aetna,Commerical,,,13.43,,13.43,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Aetna,Middlesex Employees,,,12.88,,12.88,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Anthem,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Anthem,Indemnity,,,13.04,,13.04,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Anthem,Individual Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Anthem,State Preferred,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Cigna,Cigna,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Connecticare,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Connecticare,Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,Multiplan,Multiplan,,,14.8,,14.8,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,0054-3270-99,NDC,both,16,gm,17.41,10.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Aetna,Commerical,,,13.43,,13.43,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Aetna,Middlesex Employees,,,12.88,,12.88,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Anthem,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Anthem,Indemnity,,,13.04,,13.04,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Anthem,Individual Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Anthem,State Preferred,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Cigna,Cigna,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Connecticare,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Connecticare,Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,Multiplan,Multiplan,,,14.8,,14.8,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0829-1,NDC,both,16,gm,17.41,10.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Aetna,Commerical,,,13.43,,13.43,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Aetna,Middlesex Employees,,,12.88,,12.88,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Anthem,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Anthem,Indemnity,,,13.04,,13.04,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Anthem,Individual Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Anthem,State Preferred,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Cigna,Cigna,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Connecticare,Commerical,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Connecticare,Exchange,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,Multiplan,Multiplan,,,14.8,,14.8,12.88,14.8,percent of total billed charges,,
"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",J3490,HCPCS,60505-0847-3,NDC,both,16,gm,17.41,10.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.88,14.8,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,0185-0157-01,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
FLUVOXAMINE 100 MG TABLET,J8499,HCPCS,62559-160-01,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Aetna,Commerical,,,8.64,,8.64,8.29,9.52,percent of total billed charges,,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Aetna,Middlesex Employees,,,8.29,,8.29,8.29,9.52,percent of total billed charges,,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Anthem,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Anthem,Indemnity,,,8.39,,8.39,8.29,9.52,percent of total billed charges,,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Anthem,Individual Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Anthem,State Preferred,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Cigna,Cigna,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Connecticare,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Connecticare,Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,Multiplan,Multiplan,,,9.52,,9.52,8.29,9.52,percent of total billed charges,,
FLUVOXAMINE 12.5 MG TABLET,J8499,HCPCS,40810-0205-89,NDC,both,2,ea,11.2,6.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,40810-0205-74,NDC,both,1,UN,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Aetna,Commerical,,,1.63,,1.63,1.56,1.79,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Aetna,Middlesex Employees,,,1.56,,1.56,1.56,1.79,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Anthem,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Anthem,Indemnity,,,1.58,,1.58,1.56,1.79,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Anthem,Individual Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Anthem,State Preferred,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Cigna,Cigna,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Connecticare,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Connecticare,Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,Multiplan,Multiplan,,,1.79,,1.79,1.56,1.79,percent of total billed charges,,
FLUVOXAMINE 25 MG TABLET,J8499,HCPCS,62559-158-01,NDC,both,1,ea,2.11,1.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
FOLIC ACID 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-29,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,0904-7224-61,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-01,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,60687-681-11,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,62584-897-01,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,63739-537-10,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
FOLIC ACID 1 MG TABLET,J8499,HCPCS,69315-127-01,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Aetna,Commerical,,,521.89,,521.89,500.45,574.92,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Aetna,Middlesex Employees,,,500.45,,500.45,500.45,574.92,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Anthem,Commerical,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Anthem,Indemnity,,,506.68,,506.68,500.45,574.92,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Anthem,Individual Exchange,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Anthem,State Preferred,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Cigna,Cigna,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Connecticare,Commerical,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Connecticare,Exchange,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,Multiplan,Multiplan,,,574.92,,574.92,500.45,574.92,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0001-30,NDC,both,1,mL,676.38,405.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,500.45,574.92,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Aetna,Commerical,,,260.95,,260.95,250.23,287.46,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Aetna,Middlesex Employees,,,250.23,,250.23,250.23,287.46,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Anthem,Commerical,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Anthem,Indemnity,,,253.34,,253.34,250.23,287.46,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Anthem,Individual Exchange,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Anthem,State Preferred,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Cigna,Cigna,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Connecticare,Commerical,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Connecticare,Exchange,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,Multiplan,Multiplan,,,287.46,,287.46,250.23,287.46,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-18,NDC,both,1,mL,338.19,202.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,250.23,287.46,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Aetna,Commerical,,,1043.79,,1043.79,1000.91,1149.85,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Aetna,Middlesex Employees,,,1000.91,,1000.91,1000.91,1149.85,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Anthem,Commerical,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Anthem,Indemnity,,,1013.35,,1013.35,1000.91,1149.85,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Anthem,Individual Exchange,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Anthem,State Preferred,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Cigna,Cigna,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Connecticare,Commerical,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Connecticare,Exchange,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,Multiplan,Multiplan,,,1149.85,,1149.85,1000.91,1149.85,percent of total billed charges,,
FOLIC ACID 100 MCG/ML ORAL SOLN,J3490,HCPCS,40810-0012-19,NDC,both,1,mL,1352.76,811.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1000.91,1149.85,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Aetna,Commerical,,,139.91,,139.91,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Aetna,Middlesex Employees,,,134.16,,134.16,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Anthem,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Anthem,Indemnity,,,135.83,,135.83,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Anthem,Individual Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Anthem,State Preferred,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Cigna,Cigna,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Connecticare,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Connecticare,Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,Multiplan,Multiplan,,,154.12,,154.12,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,39822-1100-1,NDC,both,1,mL,181.32,108.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Aetna,Commerical,,,139.91,,139.91,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Aetna,Middlesex Employees,,,134.16,,134.16,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Anthem,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Anthem,Indemnity,,,135.83,,135.83,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Anthem,Individual Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Anthem,State Preferred,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Cigna,Cigna,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Connecticare,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Connecticare,Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,Multiplan,Multiplan,,,154.12,,154.12,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-10,NDC,both,1,mL,181.32,108.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Aetna,Commerical,,,139.91,,139.91,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Aetna,Middlesex Employees,,,134.16,,134.16,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Anthem,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Anthem,Indemnity,,,135.83,,135.83,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Anthem,Individual Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Anthem,State Preferred,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Cigna,Cigna,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Connecticare,Commerical,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Connecticare,Exchange,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,Multiplan,Multiplan,,,154.12,,154.12,134.16,154.12,percent of total billed charges,,
FOLIC ACID 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,63323-184-11,NDC,both,1,mL,181.32,108.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,134.16,154.12,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Commerical,,,3835.69,,3835.69,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Middlesex Employees,,,3678.1,,3678.1,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Indemnity,,,3723.84,,3723.84,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Individual Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Anthem,State Preferred,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Cigna,Cigna,,14.57,,,14.57,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,Multiplan,Multiplan,,,4225.42,,4225.42,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0517-0710-01,NDC,both,0.015,mL,4971.08,2982.65,United Healthcare/Oxford,United Healthcare/Oxford,,8.03,,,8.03,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Commerical,,,3835.69,,3835.69,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Middlesex Employees,,,3678.1,,3678.1,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Indemnity,,,3723.84,,3723.84,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Individual Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Anthem,State Preferred,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Cigna,Cigna,,14.57,,,14.57,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,Multiplan,Multiplan,,,4225.42,,4225.42,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-73,NDC,both,0.015,mL,4971.08,2982.65,United Healthcare/Oxford,United Healthcare/Oxford,,8.03,,,8.03,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Commerical,,,3835.69,,3835.69,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Middlesex Employees,,,3678.1,,3678.1,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Indemnity,,,3723.84,,3723.84,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Individual Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Anthem,State Preferred,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Cigna,Cigna,,14.57,,,14.57,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,Multiplan,Multiplan,,,4225.42,,4225.42,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,0781-3182-84,NDC,both,0.015,mL,4971.08,2982.65,United Healthcare/Oxford,United Healthcare/Oxford,,8.03,,,8.03,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Commerical,,,3835.69,,3835.69,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Aetna,Middlesex Employees,,,3678.1,,3678.1,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Indemnity,,,3723.84,,3723.84,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Anthem,Individual Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Anthem,State Preferred,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Cigna,Cigna,,14.57,,,14.57,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Commerical,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Connecticare,Exchange,,,,,,8.03,4225.42,Other,Could be inpatient or outpatient,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,Multiplan,Multiplan,,,4225.42,,4225.42,8.03,4225.42,percent of total billed charges,,
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,J1451,HCPCS,70710-1478-1,NDC,both,0.015,mL,4971.08,2982.65,United Healthcare/Oxford,United Healthcare/Oxford,,8.03,,,8.03,8.03,4225.42,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Aetna,Commerical,,,54.93,,54.93,52.67,60.51,percent of total billed charges,,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Aetna,Middlesex Employees,,,52.67,,52.67,52.67,60.51,percent of total billed charges,,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Anthem,Commerical,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Anthem,Indemnity,,,53.33,,53.33,52.67,60.51,percent of total billed charges,,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Anthem,Individual Exchange,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Anthem,State Preferred,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Cigna,Cigna,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Connecticare,Commerical,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Connecticare,Exchange,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,Multiplan,Multiplan,,,60.51,,60.51,52.67,60.51,percent of total billed charges,,
FOSAMPRENAVIR 700 MG TABLET,J3490,HCPCS,49702-207-18,NDC,both,1,ea,71.19,42.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.67,60.51,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Aetna,Commerical,,,943.74,,943.74,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Aetna,Middlesex Employees,,,904.97,,904.97,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Anthem,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Anthem,Indemnity,,,916.22,,916.22,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Anthem,Individual Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Anthem,State Preferred,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Cigna,Cigna,,69.16,,,69.16,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,Multiplan,Multiplan,,,1039.64,,1039.64,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,63323-875-50,NDC,both,41.667,mL,1223.1,733.86,United Healthcare/Oxford,United Healthcare/Oxford,,59.8,,,59.8,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Aetna,Commerical,,,943.74,,943.74,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Aetna,Middlesex Employees,,,904.97,,904.97,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Anthem,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Anthem,Indemnity,,,916.22,,916.22,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Anthem,Individual Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Anthem,State Preferred,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Cigna,Cigna,,69.16,,,69.16,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,Multiplan,Multiplan,,,1039.64,,1039.64,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-01,NDC,both,41.667,mL,1223.1,733.86,United Healthcare/Oxford,United Healthcare/Oxford,,59.8,,,59.8,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Aetna,Commerical,,,943.74,,943.74,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Aetna,Middlesex Employees,,,904.97,,904.97,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Anthem,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Anthem,Indemnity,,,916.22,,916.22,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Anthem,Individual Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Anthem,State Preferred,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Cigna,Cigna,,69.16,,,69.16,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,Multiplan,Multiplan,,,1039.64,,1039.64,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-15,NDC,both,41.667,mL,1223.1,733.86,United Healthcare/Oxford,United Healthcare/Oxford,,59.8,,,59.8,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Aetna,Commerical,,,943.74,,943.74,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Aetna,Middlesex Employees,,,904.97,,904.97,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Anthem,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Anthem,Indemnity,,,916.22,,916.22,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Anthem,Individual Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Anthem,State Preferred,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Cigna,Cigna,,69.16,,,69.16,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Commerical,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Connecticare,Exchange,,,,,,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,Multiplan,Multiplan,,,1039.64,,1039.64,59.8,1039.64,percent of total billed charges,,
FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,J1455,HCPCS,76310-024-25,NDC,both,41.667,mL,1223.1,733.86,United Healthcare/Oxford,United Healthcare/Oxford,,59.8,,,59.8,59.8,1039.64,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-11,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,50268-327-15,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
FOSINOPRIL 10 MG TABLET,J3490,HCPCS,69097-856-05,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Aetna,Commerical,,,6.42,,6.42,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Aetna,Middlesex Employees,,,6.16,,6.16,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Anthem,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Anthem,Indemnity,,,6.23,,6.23,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Anthem,Individual Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Anthem,State Preferred,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Cigna,Cigna,,2.88,,,2.88,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Connecticare,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Connecticare,Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,Multiplan,Multiplan,,,7.07,,7.07,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5471-01,NDC,both,1,mL,8.32,4.99,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Aetna,Commerical,,,6.42,,6.42,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Aetna,Middlesex Employees,,,6.16,,6.16,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Anthem,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Anthem,Indemnity,,,6.23,,6.23,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Anthem,Individual Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Anthem,State Preferred,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Cigna,Cigna,,2.88,,,2.88,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Connecticare,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Connecticare,Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,Multiplan,Multiplan,,,7.07,,7.07,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0069-6001-25,NDC,both,1,mL,8.32,4.99,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Aetna,Commerical,,,9.04,,9.04,2.88,9.96,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Aetna,Middlesex Employees,,,8.67,,8.67,2.88,9.96,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Anthem,Commerical,,,,,,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Anthem,Indemnity,,,8.78,,8.78,2.88,9.96,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Anthem,Individual Exchange,,,,,,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Anthem,State Preferred,,,,,,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Cigna,Cigna,,2.88,,,2.88,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Connecticare,Commerical,,,,,,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Connecticare,Exchange,,,,,,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,Multiplan,Multiplan,,,9.96,,9.96,2.88,9.96,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6136-01,NDC,both,1,mL,11.72,7.03,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,9.96,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Aetna,Commerical,,,6.42,,6.42,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Aetna,Middlesex Employees,,,6.16,,6.16,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Anthem,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Anthem,Indemnity,,,6.23,,6.23,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Anthem,Individual Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Anthem,State Preferred,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Cigna,Cigna,,2.88,,,2.88,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Connecticare,Commerical,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Connecticare,Exchange,,,,,,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,Multiplan,Multiplan,,,7.07,,7.07,2.88,7.07,percent of total billed charges,,
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-02,NDC,both,1,mL,8.32,4.99,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,7.07,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Aetna,Commerical,,,36.53,,36.53,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Aetna,Middlesex Employees,,,35.03,,35.03,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Anthem,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Anthem,Indemnity,,,35.46,,35.46,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Anthem,Individual Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Anthem,State Preferred,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Cigna,Cigna,,2.88,,,2.88,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Connecticare,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Connecticare,Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,Multiplan,Multiplan,,,40.24,,40.24,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-01,NDC,both,1,mL,47.34,28.4,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Aetna,Commerical,,,36.53,,36.53,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Aetna,Middlesex Employees,,,35.03,,35.03,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Anthem,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Anthem,Indemnity,,,35.46,,35.46,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Anthem,Individual Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Anthem,State Preferred,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Cigna,Cigna,,2.88,,,2.88,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Connecticare,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Connecticare,Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,Multiplan,Multiplan,,,40.24,,40.24,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0069-5474-02,NDC,both,1,mL,47.34,28.4,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Aetna,Commerical,,,36.83,,36.83,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Aetna,Middlesex Employees,,,35.32,,35.32,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Anthem,Commerical,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Anthem,Indemnity,,,35.75,,35.75,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Anthem,Individual Exchange,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Anthem,State Preferred,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Cigna,Cigna,,2.88,,,2.88,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Connecticare,Commerical,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Connecticare,Exchange,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,Multiplan,Multiplan,,,40.57,,40.57,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-01,NDC,both,1,mL,47.73,28.64,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Aetna,Commerical,,,36.83,,36.83,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Aetna,Middlesex Employees,,,35.32,,35.32,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Anthem,Commerical,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Anthem,Indemnity,,,35.75,,35.75,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Anthem,Individual Exchange,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Anthem,State Preferred,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Cigna,Cigna,,2.88,,,2.88,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Connecticare,Commerical,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Connecticare,Exchange,,,,,,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,Multiplan,Multiplan,,,40.57,,40.57,2.88,40.57,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,0641-6137-10,NDC,both,1,mL,47.73,28.64,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,40.57,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Aetna,Commerical,,,36.53,,36.53,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Aetna,Middlesex Employees,,,35.03,,35.03,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Anthem,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Anthem,Indemnity,,,35.46,,35.46,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Anthem,Individual Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Anthem,State Preferred,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Cigna,Cigna,,2.88,,,2.88,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Connecticare,Commerical,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Connecticare,Exchange,,,,,,2.88,40.24,Other,Could be inpatient or outpatient,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,Multiplan,Multiplan,,,40.24,,40.24,2.88,40.24,percent of total billed charges,,
FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,Q2009,HCPCS,63323-403-10,NDC,both,1,mL,47.34,28.4,United Healthcare/Oxford,United Healthcare/Oxford,,3.75,,,3.75,2.88,40.24,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Aetna,Commerical,,,328.03,,328.03,314.55,361.36,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Aetna,Middlesex Employees,,,314.55,,314.55,314.55,361.36,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Anthem,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Anthem,Indemnity,,,318.46,,318.46,314.55,361.36,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Anthem,Individual Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Anthem,State Preferred,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Cigna,Cigna,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Connecticare,Commerical,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Connecticare,Exchange,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,Multiplan,Multiplan,,,361.36,,361.36,314.55,361.36,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,5155203676,NDC,both,1,gm,425.13,255.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,314.55,361.36,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Aetna,Commerical,,,297.85,,297.85,285.62,328.12,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Aetna,Middlesex Employees,,,285.62,,285.62,285.62,328.12,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Anthem,Commerical,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Anthem,Indemnity,,,289.17,,289.17,285.62,328.12,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Anthem,Individual Exchange,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Anthem,State Preferred,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Cigna,Cigna,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Connecticare,Commerical,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Connecticare,Exchange,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,Multiplan,Multiplan,,,328.12,,328.12,285.62,328.12,percent of total billed charges,,
FRUCTOSE (BULK) GRANULES,J3490,HCPCS,17317-0177-1,NDC,both,1,gm,386.02,231.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,285.62,328.12,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 10 MG ORAL TAB,J3490,HCPCS,4081-00000-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
FUROSEMIDE 10 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-90,NDC,both,1,mL,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-02,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Aetna,Commerical,,,3.87,,3.87,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Anthem,Commerical,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Anthem,Indemnity,,,3.75,,3.75,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Anthem,Individual Exchange,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Anthem,State Preferred,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Cigna,Cigna,,0.5,,,0.5,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Connecticare,Commerical,,0.6,,,0.6,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Connecticare,Exchange,,0.6,,,0.6,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,Multiplan,Multiplan,,,4.26,,4.26,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-04,NDC,both,2,mL,5.01,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Aetna,Commerical,,,9.67,,9.67,0.5,10.65,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Aetna,Middlesex Employees,,,9.27,,9.27,0.5,10.65,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Anthem,Commerical,,,,,,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Anthem,Indemnity,,,9.39,,9.39,0.5,10.65,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Anthem,Individual Exchange,,,,,,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Anthem,State Preferred,,,,,,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Cigna,Cigna,,0.5,,,0.5,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Connecticare,Commerical,,0.6,,,0.6,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Connecticare,Exchange,,0.6,,,0.6,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,Multiplan,Multiplan,,,10.65,,10.65,0.5,10.65,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-10,NDC,both,2,mL,12.53,7.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,10.65,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,0409-6102-25,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,16729-500-30,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,25021-311-02,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Aetna,Commerical,,,3.87,,3.87,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Aetna,Middlesex Employees,,,3.71,,3.71,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Anthem,Commerical,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Anthem,Indemnity,,,3.75,,3.75,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Anthem,Individual Exchange,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Anthem,State Preferred,,,,,,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Cigna,Cigna,,0.5,,,0.5,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Connecticare,Commerical,,0.6,,,0.6,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Connecticare,Exchange,,0.6,,,0.6,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,Multiplan,Multiplan,,,4.26,,4.26,0.5,4.26,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,36000-283-25,NDC,both,2,mL,5.01,3.01,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,4.26,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-01,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,55150-322-25,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,63323-280-02,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-02,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Anthem,Commerical,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Anthem,State Preferred,,,,,,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Cigna,Cigna,,0.5,,,0.5,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Connecticare,Commerical,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Connecticare,Exchange,,0.6,,,0.6,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,0.5,2.13,percent of total billed charges,,
FUROSEMIDE 10 MG/ML INJECTION SOLUTION,J1940,HCPCS,70860-302-41,NDC,both,2,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,2.13,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Aetna,Commerical,,,2.44,,2.44,2.34,2.69,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Aetna,Middlesex Employees,,,2.34,,2.34,2.34,2.69,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Anthem,Commerical,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Anthem,Indemnity,,,2.37,,2.37,2.34,2.69,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Anthem,Individual Exchange,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Anthem,State Preferred,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Cigna,Cigna,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Connecticare,Commerical,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Connecticare,Exchange,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,Multiplan,Multiplan,,,2.69,,2.69,2.34,2.69,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLN FROM INJECTION,J3490,HCPCS,36000-283-25,NDC,both,2,mL,3.16,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
FUROSEMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0054-3294-50,NDC,both,1,mL,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Aetna,Commerical,,,30.72,,30.72,0.5,33.84,percent of total billed charges,,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Aetna,Middlesex Employees,,,29.46,,29.46,0.5,33.84,percent of total billed charges,,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Anthem,Commerical,,,,,,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Anthem,Indemnity,,,29.82,,29.82,0.5,33.84,percent of total billed charges,,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Anthem,Individual Exchange,,,,,,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Anthem,State Preferred,,,,,,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Cigna,Cigna,,0.5,,,0.5,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Connecticare,Commerical,,0.6,,,0.6,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Connecticare,Exchange,,0.6,,,0.6,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,Multiplan,Multiplan,,,33.84,,33.84,0.5,33.84,percent of total billed charges,,
FUROSEMIDE 2 MG/ML IN D10W NICU,J1940,HCPCS,40810-0004-55,NDC,both,10,mL,39.81,23.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.54,,,0.54,0.5,33.84,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0054-8297-25,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,0904-7177-61,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,51079-072-20,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
FUROSEMIDE 20 MG TABLET,J3490,HCPCS,63304-624-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,0378-0216-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
FUROSEMIDE 40 MG TABLET,J3490,HCPCS,51079-073-20,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
FUROSEMIDE 5 MG ORAL TAB,J3490,HCPCS,40810-0001-32,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Aetna,Commerical,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Aetna,Middlesex Employees,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Anthem,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Anthem,Indemnity,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Anthem,Individual Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Anthem,State Preferred,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Cigna,Cigna,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Connecticare,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Connecticare,Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.12,0.14,percent of total billed charges,,
FUROSEMIDE 5 MG/0.5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0004-89,NDC,both,0.5,mL,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,0904-6665-61,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,49483-605-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,60687-580-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-591-10,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,63739-902-10,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Aetna,Commerical,,,1.59,,1.59,1.52,1.75,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Aetna,Middlesex Employees,,,1.52,,1.52,1.52,1.75,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Anthem,Commerical,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Anthem,Indemnity,,,1.54,,1.54,1.52,1.75,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Anthem,Individual Exchange,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Anthem,State Preferred,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Cigna,Cigna,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Connecticare,Commerical,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Connecticare,Exchange,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,Multiplan,Multiplan,,,1.75,,1.75,1.52,1.75,percent of total billed charges,,
GABAPENTIN 100 MG CAPSULE,J3490,HCPCS,67877-222-01,NDC,both,1,ea,2.06,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.52,1.75,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Aetna,Commerical,,,7.81,,7.81,7.49,8.6,percent of total billed charges,,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Aetna,Middlesex Employees,,,7.49,,7.49,7.49,8.6,percent of total billed charges,,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Anthem,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Anthem,Indemnity,,,7.58,,7.58,7.49,8.6,percent of total billed charges,,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Anthem,Individual Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Anthem,State Preferred,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Cigna,Cigna,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Connecticare,Commerical,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Connecticare,Exchange,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,Multiplan,Multiplan,,,8.6,,8.6,7.49,8.6,percent of total billed charges,,
GABAPENTIN 100 MG/ML ORAL SUSPENSION FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-09,NDC,both,1,mL,10.12,6.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.49,8.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Aetna,Commerical,,,258.35,,258.35,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Aetna,Middlesex Employees,,,247.73,,247.73,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Anthem,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Anthem,Indemnity,,,250.81,,250.81,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Anthem,Individual Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Anthem,State Preferred,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Cigna,Cigna,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Connecticare,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Connecticare,Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,Multiplan,Multiplan,,,284.6,,284.6,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0071-2012-47,NDC,both,1,mL,334.82,200.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Aetna,Commerical,,,329.19,,329.19,315.66,362.64,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Aetna,Middlesex Employees,,,315.66,,315.66,315.66,362.64,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Anthem,Commerical,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Anthem,Indemnity,,,319.59,,319.59,315.66,362.64,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Anthem,Individual Exchange,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Anthem,State Preferred,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Cigna,Cigna,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Connecticare,Commerical,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Connecticare,Exchange,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,Multiplan,Multiplan,,,362.64,,362.64,315.66,362.64,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,42192-608-16,NDC,both,1,mL,426.63,255.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,315.66,362.64,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Aetna,Commerical,,,258.35,,258.35,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Aetna,Middlesex Employees,,,247.73,,247.73,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Anthem,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Anthem,Indemnity,,,250.81,,250.81,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Anthem,Individual Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Anthem,State Preferred,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Cigna,Cigna,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Connecticare,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Connecticare,Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,Multiplan,Multiplan,,,284.6,,284.6,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,334.82,200.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Aetna,Commerical,,,258.35,,258.35,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Aetna,Middlesex Employees,,,247.73,,247.73,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Anthem,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Anthem,Indemnity,,,250.81,,250.81,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Anthem,Individual Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Anthem,State Preferred,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Cigna,Cigna,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Connecticare,Commerical,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Connecticare,Exchange,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,Multiplan,Multiplan,,,284.6,,284.6,247.73,284.6,percent of total billed charges,,
GABAPENTIN 250 MG/5 ML RECTAL SOLUTION,J3490,HCPCS,50383-311-47,NDC,both,1,mL,374.43,224.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,247.73,284.6,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,0904-6666-61,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,60687-591-11,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,62756-138-02,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-236-10,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,63739-903-10,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,67877-223-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
GABAPENTIN 300 MG CAPSULE,J3490,HCPCS,68084-762-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,0904-6667-61,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,62756-139-02,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,63739-904-10,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GABAPENTIN 400 MG CAPSULE,J3490,HCPCS,68084-774-01,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,0904-6823-61,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Aetna,Commerical,,,2,,2,1.92,2.2,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.2,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Anthem,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,1.92,2.2,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Anthem,Individual Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Anthem,State Preferred,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Cigna,Cigna,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Connecticare,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Connecticare,Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,1.92,2.2,percent of total billed charges,,
GABAPENTIN 600 MG TABLET,J3490,HCPCS,68462-126-01,NDC,both,1,ea,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Aetna,Commerical,,,257.1,,257.1,0.35,283.23,percent of total billed charges,,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Aetna,Middlesex Employees,,,246.54,,246.54,0.35,283.23,percent of total billed charges,,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Anthem,Commerical,,,,,,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Anthem,Indemnity,,,249.61,,249.61,0.35,283.23,percent of total billed charges,,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Anthem,Individual Exchange,,,,,,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Anthem,State Preferred,,,,,,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Cigna,Cigna,,0.35,,,0.35,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Connecticare,Commerical,,0.42,,,0.42,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Connecticare,Exchange,,0.42,,,0.42,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,Multiplan,Multiplan,,,283.23,,283.23,0.35,283.23,percent of total billed charges,,
GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-18,NDC,both,0.1,mL,333.21,199.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,283.23,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Aetna,Commerical,,,85.7,,85.7,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Aetna,Middlesex Employees,,,82.18,,82.18,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Anthem,Commerical,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Anthem,Indemnity,,,83.2,,83.2,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Anthem,Individual Exchange,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Anthem,State Preferred,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Cigna,Cigna,,0.35,,,0.35,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Connecticare,Commerical,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Connecticare,Exchange,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,Multiplan,Multiplan,,,94.41,,94.41,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-12,NDC,both,0.1,mL,111.07,66.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Aetna,Commerical,,,85.7,,85.7,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Aetna,Middlesex Employees,,,82.18,,82.18,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Anthem,Commerical,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Anthem,Indemnity,,,83.2,,83.2,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Anthem,Individual Exchange,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Anthem,State Preferred,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Cigna,Cigna,,0.35,,,0.35,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Connecticare,Commerical,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Connecticare,Exchange,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,Multiplan,Multiplan,,,94.41,,94.41,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-08,NDC,both,0.1,mL,111.07,66.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Aetna,Commerical,,,85.7,,85.7,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Aetna,Middlesex Employees,,,82.18,,82.18,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Anthem,Commerical,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Anthem,Indemnity,,,83.2,,83.2,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Anthem,Individual Exchange,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Anthem,State Preferred,,,,,,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Cigna,Cigna,,0.35,,,0.35,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Connecticare,Commerical,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Connecticare,Exchange,,0.42,,,0.42,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,Multiplan,Multiplan,,,94.41,,94.41,0.35,94.41,percent of total billed charges,,
GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-10,NDC,both,0.1,mL,111.07,66.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,94.41,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Aetna,Commerical,,,30.62,,30.62,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Aetna,Middlesex Employees,,,29.36,,29.36,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Anthem,Commerical,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Anthem,Indemnity,,,29.72,,29.72,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Anthem,Individual Exchange,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Anthem,State Preferred,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Cigna,Cigna,,0.35,,,0.35,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Connecticare,Commerical,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Connecticare,Exchange,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,Multiplan,Multiplan,,,33.73,,33.73,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-37,NDC,both,0.1,mL,39.68,23.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Aetna,Commerical,,,30.62,,30.62,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Aetna,Middlesex Employees,,,29.36,,29.36,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Anthem,Commerical,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Anthem,Indemnity,,,29.72,,29.72,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Anthem,Individual Exchange,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Anthem,State Preferred,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Cigna,Cigna,,0.35,,,0.35,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Connecticare,Commerical,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Connecticare,Exchange,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,Multiplan,Multiplan,,,33.73,,33.73,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-00,NDC,both,0.1,mL,39.68,23.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Aetna,Commerical,,,30.62,,30.62,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Aetna,Middlesex Employees,,,29.36,,29.36,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Anthem,Commerical,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Anthem,Indemnity,,,29.72,,29.72,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Anthem,Individual Exchange,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Anthem,State Preferred,,,,,,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Cigna,Cigna,,0.35,,,0.35,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Connecticare,Commerical,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Connecticare,Exchange,,0.42,,,0.42,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,Multiplan,Multiplan,,,33.73,,33.73,0.35,33.73,percent of total billed charges,,
GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-02,NDC,both,0.1,mL,39.68,23.81,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,33.73,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Aetna,Commerical,,,64.28,,64.28,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Aetna,Middlesex Employees,,,61.64,,61.64,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Anthem,Commerical,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Anthem,Indemnity,,,62.41,,62.41,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Anthem,Individual Exchange,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Anthem,State Preferred,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Cigna,Cigna,,0.35,,,0.35,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Connecticare,Commerical,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Connecticare,Exchange,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,Multiplan,Multiplan,,,70.81,,70.81,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,50419-325-11,NDC,both,0.1,mL,83.31,49.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Aetna,Commerical,,,64.28,,64.28,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Aetna,Middlesex Employees,,,61.64,,61.64,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Anthem,Commerical,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Anthem,Indemnity,,,62.41,,62.41,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Anthem,Individual Exchange,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Anthem,State Preferred,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Cigna,Cigna,,0.35,,,0.35,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Connecticare,Commerical,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Connecticare,Exchange,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,Multiplan,Multiplan,,,70.81,,70.81,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-03,NDC,both,0.1,mL,83.31,49.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Aetna,Commerical,,,64.28,,64.28,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Aetna,Middlesex Employees,,,61.64,,61.64,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Anthem,Commerical,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Anthem,Indemnity,,,62.41,,62.41,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Anthem,Individual Exchange,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Anthem,State Preferred,,,,,,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Cigna,Cigna,,0.35,,,0.35,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Connecticare,Commerical,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Connecticare,Exchange,,0.42,,,0.42,0.35,70.81,Other,Could be inpatient or outpatient,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,Multiplan,Multiplan,,,70.81,,70.81,0.35,70.81,percent of total billed charges,,
GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,A9585,HCPCS,65219-281-07,NDC,both,0.1,mL,83.31,49.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.38,,,0.38,0.35,70.81,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Aetna,Commerical,,,490.57,,490.57,1.7,540.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Aetna,Middlesex Employees,,,470.41,,470.41,1.7,540.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Anthem,Commerical,,,,,,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Anthem,Indemnity,,,476.26,,476.26,1.7,540.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Anthem,Individual Exchange,,,,,,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Anthem,State Preferred,,,,,,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Cigna,Cigna,,1.7,,,1.7,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Connecticare,Commerical,,2.28,,,2.28,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Connecticare,Exchange,,2.28,,,2.28,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,Multiplan,Multiplan,,,540.41,,540.41,1.7,540.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-84,NDC,both,0.05,mL,635.78,381.47,United Healthcare/Oxford,United Healthcare/Oxford,,1.83,,,1.83,1.7,540.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Aetna,Commerical,,,136.53,,136.53,1.7,150.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Aetna,Middlesex Employees,,,130.93,,130.93,1.7,150.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Anthem,Commerical,,,,,,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Anthem,Indemnity,,,132.55,,132.55,1.7,150.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Anthem,Individual Exchange,,,,,,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Anthem,State Preferred,,,,,,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Cigna,Cigna,,1.7,,,1.7,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Connecticare,Commerical,,2.28,,,2.28,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Connecticare,Exchange,,2.28,,,2.28,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,Multiplan,Multiplan,,,150.41,,150.41,1.7,150.41,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML(469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-81,NDC,both,0.2,mL,176.95,106.17,United Healthcare/Oxford,United Healthcare/Oxford,,1.83,,,1.83,1.7,150.41,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Aetna,Commerical,,,254.15,,254.15,1.7,279.97,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Aetna,Middlesex Employees,,,243.71,,243.71,1.7,279.97,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Anthem,Commerical,,,,,,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Anthem,Indemnity,,,246.74,,246.74,1.7,279.97,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Anthem,Individual Exchange,,,,,,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Anthem,State Preferred,,,,,,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Cigna,Cigna,,1.7,,,1.7,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Connecticare,Commerical,,2.28,,,2.28,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Connecticare,Exchange,,2.28,,,2.28,1.7,279.97,Other,Could be inpatient or outpatient,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,Multiplan,Multiplan,,,279.97,,279.97,1.7,279.97,percent of total billed charges,,
GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN,A9579,HCPCS,50419-188-82,NDC,both,0.1,mL,329.38,197.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.83,,,1.83,1.7,279.97,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Aetna,Commerical,,,419.5,,419.5,16.64,462.12,percent of total billed charges,,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Aetna,Middlesex Employees,,,402.26,,402.26,16.64,462.12,percent of total billed charges,,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Anthem,Commerical,,,,,,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Anthem,Indemnity,,,407.26,,407.26,16.64,462.12,percent of total billed charges,,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Anthem,Individual Exchange,,,,,,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Anthem,State Preferred,,,,,,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Cigna,Cigna,,16.64,,,16.64,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Connecticare,Commerical,,22.5,,,22.5,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Connecticare,Exchange,,22.5,,,22.5,16.64,462.12,Other,Could be inpatient or outpatient,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,Multiplan,Multiplan,,,462.12,,462.12,16.64,462.12,percent of total billed charges,,
GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,A9581,HCPCS,50419-320-05,NDC,both,1,mL,543.67,326.2,United Healthcare/Oxford,United Healthcare/Oxford,,17.97,,,17.97,16.64,462.12,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Aetna,Commerical,,,6797.02,,6797.02,537.51,7487.65,percent of total billed charges,,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Aetna,Middlesex Employees,,,6517.78,,6517.78,537.51,7487.65,percent of total billed charges,,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Anthem,Commerical,,,,,,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Anthem,Indemnity,,,6598.82,,6598.82,537.51,7487.65,percent of total billed charges,,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Anthem,Individual Exchange,,,,,,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Anthem,State Preferred,,,,,,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Cigna,Cigna,,537.51,,,537.51,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Connecticare,Commerical,,740.21,,,740.21,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Connecticare,Exchange,,740.21,,,740.21,537.51,7487.65,Other,Could be inpatient or outpatient,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,Multiplan,Multiplan,,,7487.65,,7487.65,537.51,7487.65,percent of total billed charges,,
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION,J1458,HCPCS,68135-020-01,NDC,both,1,mL,8809,5285.4,United Healthcare/Oxford,United Healthcare/Oxford,,580.32,,,580.32,537.51,7487.65,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Aetna,Commerical,,,291.83,,291.83,39.05,321.49,percent of total billed charges,,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Aetna,Middlesex Employees,,,279.84,,279.84,39.05,321.49,percent of total billed charges,,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Anthem,Commerical,,,,,,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Anthem,Indemnity,,,283.32,,283.32,39.05,321.49,percent of total billed charges,,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Anthem,Individual Exchange,,,,,,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Anthem,State Preferred,,,,,,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Cigna,Cigna,,45.13,,,45.13,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Connecticare,Commerical,,55.59,,,55.59,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Connecticare,Exchange,,55.59,,,55.59,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,Multiplan,Multiplan,,,321.49,,321.49,39.05,321.49,percent of total billed charges,,
GANCICLOVIR 2 MG/0.1 ML INTRAVITREAL,J1570,HCPCS,40810-0204-36,NDC,both,25,mL,378.22,226.93,United Healthcare/Oxford,United Healthcare/Oxford,,39.05,,,39.05,39.05,321.49,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Aetna,Commerical,,,49.19,,49.19,39.05,55.59,percent of total billed charges,,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Aetna,Middlesex Employees,,,47.17,,47.17,39.05,55.59,percent of total billed charges,,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Anthem,Commerical,,,,,,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Anthem,Indemnity,,,47.76,,47.76,39.05,55.59,percent of total billed charges,,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Anthem,Individual Exchange,,,,,,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Anthem,State Preferred,,,,,,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Cigna,Cigna,,45.13,,,45.13,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Connecticare,Commerical,,55.59,,,55.59,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Connecticare,Exchange,,55.59,,,55.59,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,Multiplan,Multiplan,,,54.19,,54.19,39.05,55.59,percent of total billed charges,,
GANCICLOVIR 5 MG/ML IN D5W NICU,J1570,HCPCS,40810-0004-56,NDC,both,100,mL,63.75,38.25,United Healthcare/Oxford,United Healthcare/Oxford,,39.05,,,39.05,39.05,55.59,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Aetna,Commerical,,,102.28,,102.28,39.05,112.68,percent of total billed charges,,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Aetna,Middlesex Employees,,,98.08,,98.08,39.05,112.68,percent of total billed charges,,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Anthem,Commerical,,,,,,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Anthem,Indemnity,,,99.3,,99.3,39.05,112.68,percent of total billed charges,,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Anthem,Individual Exchange,,,,,,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Anthem,State Preferred,,,,,,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Cigna,Cigna,,45.13,,,45.13,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Connecticare,Commerical,,55.59,,,55.59,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Connecticare,Exchange,,55.59,,,55.59,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,Multiplan,Multiplan,,,112.68,,112.68,39.05,112.68,percent of total billed charges,,
GANCICLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1570,HCPCS,25021-185-10,NDC,both,10,mL,132.56,79.54,United Healthcare/Oxford,United Healthcare/Oxford,,39.05,,,39.05,39.05,112.68,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Aetna,Commerical,,,137.31,,137.31,39.05,151.26,percent of total billed charges,,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Aetna,Middlesex Employees,,,131.67,,131.67,39.05,151.26,percent of total billed charges,,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Anthem,Commerical,,,,,,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Anthem,Indemnity,,,133.3,,133.3,39.05,151.26,percent of total billed charges,,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Anthem,Individual Exchange,,,,,,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Anthem,State Preferred,,,,,,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Cigna,Cigna,,45.13,,,45.13,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Connecticare,Commerical,,55.59,,,55.59,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Connecticare,Exchange,,55.59,,,55.59,39.05,151.26,Other,Could be inpatient or outpatient,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,Multiplan,Multiplan,,,151.26,,151.26,39.05,151.26,percent of total billed charges,,
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,J1570,HCPCS,63323-315-10,NDC,both,1,ea,177.95,106.77,United Healthcare/Oxford,United Healthcare/Oxford,,39.05,,,39.05,39.05,151.26,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Aetna,Commerical,,,3837.51,,3837.51,3679.86,4227.43,percent of total billed charges,,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Aetna,Middlesex Employees,,,3679.86,,3679.86,3679.86,4227.43,percent of total billed charges,,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Anthem,Commerical,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Anthem,Indemnity,,,3725.61,,3725.61,3679.86,4227.43,percent of total billed charges,,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Anthem,Individual Exchange,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Anthem,State Preferred,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Cigna,Cigna,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Connecticare,Commerical,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Connecticare,Exchange,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,Multiplan,Multiplan,,,4227.43,,4227.43,3679.86,4227.43,percent of total billed charges,,
GELATIN ABSORBABLE EYE FILM,J3490,HCPCS,9029703,NDC,both,1,ea,4973.45,2984.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3679.86,4227.43,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Aetna,Commerical,,,161.5,,161.5,154.86,177.91,percent of total billed charges,,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Aetna,Middlesex Employees,,,154.86,,154.86,154.86,177.91,percent of total billed charges,,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Anthem,Commerical,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Anthem,Indemnity,,,156.79,,156.79,154.86,177.91,percent of total billed charges,,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Anthem,Individual Exchange,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Anthem,State Preferred,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Cigna,Cigna,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Connecticare,Commerical,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Connecticare,Exchange,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,Multiplan,Multiplan,,,177.91,,177.91,154.86,177.91,percent of total billed charges,,
GELATIN ABSORBABLE MUCOSAL POWDER,J3490,HCPCS,0009-0433-04,NDC,both,1,gm,209.3,125.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,154.86,177.91,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Aetna,Commerical,,,583.4,,583.4,559.43,642.68,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Aetna,Middlesex Employees,,,559.43,,559.43,559.43,642.68,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Anthem,Commerical,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Anthem,Indemnity,,,566.39,,566.39,559.43,642.68,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Anthem,Individual Exchange,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Anthem,State Preferred,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Cigna,Cigna,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Connecticare,Commerical,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Connecticare,Exchange,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,Multiplan,Multiplan,,,642.68,,642.68,559.43,642.68,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,6371301975,NDC,both,1,ea,756.09,453.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,559.43,642.68,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Aetna,Commerical,,,180.83,,180.83,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Aetna,Middlesex Employees,,,173.4,,173.4,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Anthem,Commerical,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Anthem,Indemnity,,,175.56,,175.56,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Anthem,Individual Exchange,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Anthem,State Preferred,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Cigna,Cigna,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Connecticare,Commerical,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Connecticare,Exchange,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,Multiplan,Multiplan,,,199.21,,199.21,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 CM TOPICAL SPONGE",J3490,HCPCS,0009-0353-01,NDC,both,1,ea,234.36,140.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Aetna,Commerical,,,97.24,,97.24,93.24,107.12,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Aetna,Middlesex Employees,,,93.24,,93.24,93.24,107.12,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Anthem,Commerical,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Anthem,Indemnity,,,94.4,,94.4,93.24,107.12,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Anthem,Individual Exchange,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Anthem,State Preferred,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Cigna,Cigna,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Connecticare,Commerical,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Connecticare,Exchange,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,Multiplan,Multiplan,,,107.12,,107.12,93.24,107.12,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,6371301974,NDC,both,1,ea,126.02,75.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,93.24,107.12,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Aetna,Commerical,,,180.83,,180.83,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Aetna,Middlesex Employees,,,173.4,,173.4,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Anthem,Commerical,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Anthem,Indemnity,,,175.56,,175.56,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Anthem,Individual Exchange,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Anthem,State Preferred,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Cigna,Cigna,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Connecticare,Commerical,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Connecticare,Exchange,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,Multiplan,Multiplan,,,199.21,,199.21,173.4,199.21,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE",J3490,HCPCS,0009-0342-01,NDC,both,1,ea,234.36,140.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,173.4,199.21,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Aetna,Commerical,,,238.99,,238.99,229.17,263.27,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Aetna,Middlesex Employees,,,229.17,,229.17,229.17,263.27,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Anthem,Commerical,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Anthem,Indemnity,,,232.02,,232.02,229.17,263.27,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Anthem,Individual Exchange,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Anthem,State Preferred,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Cigna,Cigna,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Connecticare,Commerical,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Connecticare,Exchange,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,Multiplan,Multiplan,,,263.27,,263.27,229.17,263.27,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,6371301972,NDC,both,1,ea,309.73,185.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.17,263.27,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Aetna,Commerical,,,444.5,,444.5,426.23,489.66,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Aetna,Middlesex Employees,,,426.23,,426.23,426.23,489.66,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Anthem,Commerical,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Anthem,Indemnity,,,431.53,,431.53,426.23,489.66,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Anthem,Individual Exchange,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Anthem,State Preferred,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Cigna,Cigna,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Connecticare,Commerical,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Connecticare,Exchange,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,Multiplan,Multiplan,,,489.66,,489.66,426.23,489.66,percent of total billed charges,,
"GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE",J3490,HCPCS,0009-0315-08,NDC,both,1,ea,576.07,345.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,426.23,489.66,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Aetna,Commerical,,,35.29,,35.29,4.03,38.88,percent of total billed charges,,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Aetna,Middlesex Employees,,,33.84,,33.84,4.03,38.88,percent of total billed charges,,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Anthem,Commerical,,,,,,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Anthem,Indemnity,,,34.26,,34.26,4.03,38.88,percent of total billed charges,,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Anthem,Individual Exchange,,,,,,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Anthem,State Preferred,,,,,,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Cigna,Cigna,,4.65,,,4.65,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Connecticare,Commerical,,4.27,,,4.27,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Connecticare,Exchange,,4.27,,,4.27,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,Multiplan,Multiplan,,,38.88,,38.88,4.03,38.88,percent of total billed charges,,
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0181-01,NDC,both,5.26,mL,45.74,27.44,United Healthcare/Oxford,United Healthcare/Oxford,,4.03,,,4.03,4.03,38.88,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Aetna,Commerical,,,12.5,,12.5,4.03,13.77,percent of total billed charges,,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Aetna,Middlesex Employees,,,11.99,,11.99,4.03,13.77,percent of total billed charges,,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Anthem,Commerical,,,,,,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Anthem,Indemnity,,,12.14,,12.14,4.03,13.77,percent of total billed charges,,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Anthem,Individual Exchange,,,,,,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Anthem,State Preferred,,,,,,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Cigna,Cigna,,4.65,,,4.65,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Connecticare,Commerical,,4.27,,,4.27,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Connecticare,Exchange,,4.27,,,4.27,4.03,13.77,Other,Could be inpatient or outpatient,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,Multiplan,Multiplan,,,13.77,,13.77,4.03,13.77,percent of total billed charges,,
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,J9201,HCPCS,0409-0183-01,NDC,both,5.26,mL,16.2,9.72,United Healthcare/Oxford,United Healthcare/Oxford,,4.03,,,4.03,4.03,13.77,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0019-75,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,40810-0020-10,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
GEMFIBROZIL 600 MG TABLET,J3490,HCPCS,69097-821-03,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Aetna,Commerical,,,26.56,,26.56,25.47,29.26,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Aetna,Middlesex Employees,,,25.47,,25.47,25.47,29.26,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Anthem,Commerical,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Anthem,Indemnity,,,25.78,,25.78,25.47,29.26,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Anthem,Individual Exchange,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Anthem,State Preferred,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Cigna,Cigna,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Connecticare,Commerical,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Connecticare,Exchange,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,Multiplan,Multiplan,,,29.26,,29.26,25.47,29.26,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0683-15,NDC,both,1,gm,34.42,20.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.47,29.26,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Aetna,Commerical,,,153.73,,153.73,147.42,169.35,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Aetna,Middlesex Employees,,,147.42,,147.42,147.42,169.35,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Anthem,Commerical,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Anthem,Indemnity,,,149.25,,149.25,147.42,169.35,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Anthem,Individual Exchange,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Anthem,State Preferred,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Cigna,Cigna,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Connecticare,Commerical,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Connecticare,Exchange,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,Multiplan,Multiplan,,,169.35,,169.35,147.42,169.35,percent of total billed charges,,
GENTAMICIN 0.1 % TOPICAL OINTMENT,J3490,HCPCS,52565-090-30,NDC,both,1,gm,199.24,119.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,147.42,169.35,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Aetna,Commerical,,,21.61,,21.61,20.72,23.81,percent of total billed charges,,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Aetna,Middlesex Employees,,,20.72,,20.72,20.72,23.81,percent of total billed charges,,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Anthem,Commerical,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Anthem,Indemnity,,,20.98,,20.98,20.72,23.81,percent of total billed charges,,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Anthem,Individual Exchange,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Anthem,State Preferred,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Cigna,Cigna,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Connecticare,Commerical,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Connecticare,Exchange,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,Multiplan,Multiplan,,,23.81,,23.81,20.72,23.81,percent of total billed charges,,
GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT,J3490,HCPCS,17478-284-35,NDC,both,3.5,gm,28.01,16.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.72,23.81,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % EYE DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,24208-580-60,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,60758-188-05,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Aetna,Commerical,,,11.17,,11.17,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Aetna,Middlesex Employees,,,10.71,,10.71,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Indemnity,,,10.85,,10.85,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,Individual Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Anthem,State Preferred,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Cigna,Cigna,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Connecticare,Commerical,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Connecticare,Exchange,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,Multiplan,Multiplan,,,12.31,,12.31,10.71,12.31,percent of total billed charges,,
GENTAMICIN 0.3 % NASAL DROPS,J3490,HCPCS,61314-633-05,NDC,both,5,mL,14.48,8.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.71,12.31,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Aetna,Commerical,,,39.14,,39.14,2.34,43.12,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Aetna,Middlesex Employees,,,37.54,,37.54,2.34,43.12,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Anthem,Commerical,,,,,,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Anthem,Indemnity,,,38,,38,2.34,43.12,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Anthem,Individual Exchange,,,,,,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Anthem,State Preferred,,,,,,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Cigna,Cigna,,2.34,,,2.34,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Connecticare,Commerical,,4.18,,,4.18,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Connecticare,Exchange,,4.18,,,4.18,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,Multiplan,Multiplan,,,43.12,,43.12,2.34,43.12,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN 0.9% SODIUM CHLORIDE NICU,J1580,HCPCS,0338-0511-41,NDC,both,1,mL,50.73,30.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,43.12,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Aetna,Commerical,,,32.64,,32.64,2.34,35.96,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Aetna,Middlesex Employees,,,31.3,,31.3,2.34,35.96,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Anthem,Commerical,,,,,,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Anthem,Indemnity,,,31.69,,31.69,2.34,35.96,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Anthem,Individual Exchange,,,,,,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Anthem,State Preferred,,,,,,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Cigna,Cigna,,2.34,,,2.34,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Connecticare,Commerical,,4.18,,,4.18,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Connecticare,Exchange,,4.18,,,4.18,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,Multiplan,Multiplan,,,35.96,,35.96,2.34,35.96,percent of total billed charges,,
GENTAMICIN 2 MG/ML IN D10W NICU,J1580,HCPCS,40810-0004-57,NDC,both,40,mL,42.3,25.38,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,35.96,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Aetna,Commerical,,,8.87,,8.87,2.34,9.78,percent of total billed charges,,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Aetna,Middlesex Employees,,,8.51,,8.51,2.34,9.78,percent of total billed charges,,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Anthem,Commerical,,,,,,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Anthem,Indemnity,,,8.61,,8.61,2.34,9.78,percent of total billed charges,,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Anthem,Individual Exchange,,,,,,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Anthem,State Preferred,,,,,,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Cigna,Cigna,,2.34,,,2.34,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Connecticare,Commerical,,4.18,,,4.18,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Connecticare,Exchange,,4.18,,,4.18,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,Multiplan,Multiplan,,,9.78,,9.78,2.34,9.78,percent of total billed charges,,
GENTAMICIN 240 MG IN 500 ML NS FOR BLADDER IRRIGATION,J1580,HCPCS,40810-0020-36,NDC,both,166.667,mL,11.5,6.9,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,9.78,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Aetna,Commerical,,,265.51,,265.51,2.34,292.49,percent of total billed charges,,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Aetna,Middlesex Employees,,,254.6,,254.6,2.34,292.49,percent of total billed charges,,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Anthem,Commerical,,,,,,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Anthem,Indemnity,,,257.77,,257.77,2.34,292.49,percent of total billed charges,,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Anthem,Individual Exchange,,,,,,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Anthem,State Preferred,,,,,,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Cigna,Cigna,,2.34,,,2.34,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Connecticare,Commerical,,4.18,,,4.18,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Connecticare,Exchange,,4.18,,,4.18,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,Multiplan,Multiplan,,,292.49,,292.49,2.34,292.49,percent of total billed charges,,
GENTAMICIN 4 MG/ML,J1580,HCPCS,40810-0013-21,NDC,both,20,mL,344.1,206.46,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,292.49,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Anthem,Commerical,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Anthem,State Preferred,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Cigna,Cigna,,2.34,,,2.34,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Connecticare,Commerical,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Connecticare,Exchange,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,0409-1207-03,NDC,both,2,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Anthem,Commerical,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Anthem,State Preferred,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Cigna,Cigna,,2.34,,,2.34,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Connecticare,Commerical,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Connecticare,Exchange,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-01,NDC,both,2,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Anthem,Commerical,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Anthem,State Preferred,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Cigna,Cigna,,2.34,,,2.34,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Connecticare,Commerical,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Connecticare,Exchange,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,55150-402-25,NDC,both,2,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Commerical,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,State Preferred,,,,,,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Cigna,Cigna,,2.34,,,2.34,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Connecticare,Commerical,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Connecticare,Exchange,,4.18,,,4.18,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,2.34,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Aetna,Commerical,,,115.49,,115.49,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Aetna,Middlesex Employees,,,110.75,,110.75,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Anthem,Commerical,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Anthem,Indemnity,,,112.13,,112.13,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Anthem,Individual Exchange,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Anthem,State Preferred,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Cigna,Cigna,,2.34,,,2.34,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Connecticare,Commerical,,4.18,,,4.18,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Connecticare,Exchange,,4.18,,,4.18,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,Multiplan,Multiplan,,,127.23,,127.23,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-20,NDC,both,2,mL,149.68,89.81,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Aetna,Commerical,,,115.49,,115.49,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Aetna,Middlesex Employees,,,110.75,,110.75,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Anthem,Commerical,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Anthem,Indemnity,,,112.13,,112.13,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Anthem,Individual Exchange,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Anthem,State Preferred,,,,,,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Cigna,Cigna,,2.34,,,2.34,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Connecticare,Commerical,,4.18,,,4.18,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Connecticare,Exchange,,4.18,,,4.18,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,Multiplan,Multiplan,,,127.23,,127.23,2.34,127.23,percent of total billed charges,,
GENTAMICIN 40 MG/ML INJECTION SOLUTION,J1580,HCPCS,63323-010-96,NDC,both,2,mL,149.68,89.81,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,127.23,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Aetna,Commerical,,,28.61,,28.61,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Aetna,Middlesex Employees,,,27.44,,27.44,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Anthem,Commerical,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Anthem,Indemnity,,,27.78,,27.78,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Anthem,Individual Exchange,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Anthem,State Preferred,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Cigna,Cigna,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Connecticare,Commerical,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Connecticare,Exchange,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,Multiplan,Multiplan,,,31.52,,31.52,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,40810-0201-00,NDC,both,1,mL,37.08,22.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Aetna,Commerical,,,28.61,,28.61,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Aetna,Middlesex Employees,,,27.44,,27.44,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Anthem,Commerical,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Anthem,Indemnity,,,27.78,,27.78,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Anthem,Individual Exchange,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Anthem,State Preferred,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Cigna,Cigna,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Connecticare,Commerical,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Connecticare,Exchange,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,Multiplan,Multiplan,,,31.52,,31.52,27.44,31.52,percent of total billed charges,,
GENTAMICIN 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-010-20,NDC,both,1,mL,37.08,22.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.44,31.52,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,11.08,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,11.08,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Anthem,Commerical,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,11.08,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Anthem,State Preferred,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Cigna,Cigna,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Connecticare,Commerical,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Connecticare,Exchange,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,11.08,12.72,percent of total billed charges,,
GENTAMICIN 40 MG/ML RECTAL SOLN,J3490,HCPCS,63323-010-02,NDC,both,1,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Aetna,Commerical,,,11.55,,11.55,11.08,12.72,percent of total billed charges,,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Aetna,Middlesex Employees,,,11.08,,11.08,11.08,12.72,percent of total billed charges,,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Commerical,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Indemnity,,,11.21,,11.21,11.08,12.72,percent of total billed charges,,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,Individual Exchange,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Anthem,State Preferred,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Cigna,Cigna,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Connecticare,Commerical,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Connecticare,Exchange,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,Multiplan,Multiplan,,,12.72,,12.72,11.08,12.72,percent of total billed charges,,
GENTAMICIN FOR INHALATION,J7699,HCPCS,63323-010-02,NDC,both,2,mL,14.97,8.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.08,12.72,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Aetna,Commerical,,,11.84,,11.84,2.34,13.04,percent of total billed charges,,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Aetna,Middlesex Employees,,,11.35,,11.35,2.34,13.04,percent of total billed charges,,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Anthem,Commerical,,,,,,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Anthem,Indemnity,,,11.49,,11.49,2.34,13.04,percent of total billed charges,,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Anthem,Individual Exchange,,,,,,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Anthem,State Preferred,,,,,,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Cigna,Cigna,,2.34,,,2.34,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Connecticare,Commerical,,4.18,,,4.18,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Connecticare,Exchange,,4.18,,,4.18,2.34,13.04,Other,Could be inpatient or outpatient,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,Multiplan,Multiplan,,,13.04,,13.04,2.34,13.04,percent of total billed charges,,
GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,J1580,HCPCS,63323-173-02,NDC,both,4,mL,15.34,9.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.53,,,2.53,2.34,13.04,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Aetna,Commerical,,,18.09,,18.09,17.34,19.92,percent of total billed charges,,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Aetna,Middlesex Employees,,,17.34,,17.34,17.34,19.92,percent of total billed charges,,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Anthem,Commerical,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Anthem,Indemnity,,,17.56,,17.56,17.34,19.92,percent of total billed charges,,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Anthem,Individual Exchange,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Anthem,State Preferred,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Cigna,Cigna,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Connecticare,Commerical,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Connecticare,Exchange,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,Multiplan,Multiplan,,,19.92,,19.92,17.34,19.92,percent of total billed charges,,
GENTIAN VIOLET 0.5 % TOP SOLN,J3490,HCPCS,40810-0015-77,NDC,both,60,mL,23.44,14.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.34,19.92,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Aetna,Commerical,,,17.79,,17.79,17.05,19.59,percent of total billed charges,,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Aetna,Middlesex Employees,,,17.05,,17.05,17.05,19.59,percent of total billed charges,,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Anthem,Commerical,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Anthem,Indemnity,,,17.27,,17.27,17.05,19.59,percent of total billed charges,,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Anthem,Individual Exchange,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Anthem,State Preferred,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Cigna,Cigna,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Connecticare,Commerical,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Connecticare,Exchange,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,Multiplan,Multiplan,,,19.59,,19.59,17.05,19.59,percent of total billed charges,,
GENTIAN VIOLET 1 % TOPICAL SOLUTION,J3490,HCPCS,0395-1003-92,NDC,both,59,mL,23.05,13.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.05,19.59,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Aetna,Commerical,,,34,,34,32.61,37.46,percent of total billed charges,,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Aetna,Middlesex Employees,,,32.61,,32.61,32.61,37.46,percent of total billed charges,,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Anthem,Commerical,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Anthem,Indemnity,,,33.01,,33.01,32.61,37.46,percent of total billed charges,,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Anthem,Individual Exchange,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Anthem,State Preferred,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Cigna,Cigna,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Connecticare,Commerical,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Connecticare,Exchange,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,Multiplan,Multiplan,,,37.46,,37.46,32.61,37.46,percent of total billed charges,,
GENTIAN VIOLET 2 % TOPICAL SOLUTION,J3490,HCPCS,0395-1005-92,NDC,both,1,mL,44.07,26.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.61,37.46,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
GLIPIZIDE 2.5 MG TABLET,J3490,HCPCS,40810-0205-56,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,0904-6637-61,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-01,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
GLIPIZIDE 5 MG TABLET,J3490,HCPCS,51079-810-20,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,214.09,,,214.09,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0053-45,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,231.14,,,231.14,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,214.09,,,214.09,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,0597-0260-10,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,231.14,,,231.14,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,214.09,,,214.09,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,231.14,,,231.14,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,214.09,,,214.09,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,231.14,,,231.14,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,214.09,,,214.09,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,293.64,,,293.64,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,214.09,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML INTRAMUSCULAR FOR ENDOCRINE,J1610,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,231.14,,,231.14,214.09,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,146.53,,,146.53,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-593-03,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,158.2,,,158.2,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,146.53,,,146.53,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-594-03,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,158.2,,,158.2,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Aetna,Commerical,,,350.91,,350.91,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Aetna,Middlesex Employees,,,336.49,,336.49,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Commerical,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Indemnity,,,340.68,,340.68,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,Individual Exchange,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Anthem,State Preferred,,,,,,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Cigna,Cigna,,146.53,,,146.53,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Connecticare,Commerical,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Connecticare,Exchange,,166.33,,,166.33,146.53,386.56,Other,Could be inpatient or outpatient,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,Multiplan,Multiplan,,,386.56,,386.56,146.53,386.56,percent of total billed charges,,
GLUCAGON 1 MG/ML SOLUTION FOR INJECTION,J1611,HCPCS,63323-596-16,NDC,both,1,ea,454.78,272.87,United Healthcare/Oxford,United Healthcare/Oxford,,158.2,,,158.2,146.53,386.56,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Aetna,Commerical,,,59382.34,,59382.34,553.43,65416,percent of total billed charges,,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Aetna,Middlesex Employees,,,56942.7,,56942.7,553.43,65416,percent of total billed charges,,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Anthem,Commerical,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Anthem,Indemnity,,,57650.74,,57650.74,553.43,65416,percent of total billed charges,,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Anthem,Individual Exchange,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Anthem,State Preferred,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Cigna,Cigna,,553.43,,,553.43,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Connecticare,Commerical,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Connecticare,Exchange,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,Multiplan,Multiplan,,,65416,,65416,553.43,65416,percent of total billed charges,,
"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",C9293,HCPCS,50633-210-11,NDC,both,0.01,ea,76960,46176,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,553.43,65416,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Aetna,Commerical,,,3.5,,3.5,3.36,3.86,percent of total billed charges,,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Aetna,Middlesex Employees,,,3.36,,3.36,3.36,3.86,percent of total billed charges,,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Anthem,Commerical,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Anthem,Indemnity,,,3.4,,3.4,3.36,3.86,percent of total billed charges,,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Anthem,Individual Exchange,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Anthem,State Preferred,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Cigna,Cigna,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Connecticare,Commerical,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Connecticare,Exchange,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,Multiplan,Multiplan,,,3.86,,3.86,3.36,3.86,percent of total billed charges,,
GLUCOSE (TOLERANCE TEST) 100 GRAM ORAL LIQUID,J3490,HCPCS,85152-2000-08,NDC,both,296,mL,4.54,2.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.36,3.86,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Aetna,Commerical,,,5.5,,5.5,5.28,6.06,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,5.28,6.06,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Anthem,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Anthem,Indemnity,,,5.34,,5.34,5.28,6.06,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Anthem,Individual Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Anthem,State Preferred,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Cigna,Cigna,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Connecticare,Commerical,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Connecticare,Exchange,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,Multiplan,Multiplan,,,6.06,,6.06,5.28,6.06,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,3839650308,NDC,both,10,ea,7.13,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.28,6.06,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Aetna,Commerical,,,0.56,,0.56,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Anthem,Commerical,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Anthem,Indemnity,,,0.54,,0.54,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Anthem,Individual Exchange,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Anthem,State Preferred,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Cigna,Cigna,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Connecticare,Commerical,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Connecticare,Exchange,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,Multiplan,Multiplan,,,0.61,,0.61,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8068110000,NDC,both,1,ea,0.72,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Aetna,Commerical,,,0.56,,0.56,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Anthem,Commerical,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Anthem,Indemnity,,,0.54,,0.54,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Anthem,Individual Exchange,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Anthem,State Preferred,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Cigna,Cigna,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Connecticare,Commerical,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Connecticare,Exchange,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,Multiplan,Multiplan,,,0.61,,0.61,0.53,0.61,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,8770142601,NDC,both,1,ea,0.72,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.53,0.61,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
GLUCOSE 4 GRAM CHEWABLE TABLET,J3490,HCPCS,56151-1610-11,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
GLUCOSE 50G/250ML SOLUTION,J3490,HCPCS,40810-0017-62,NDC,both,250,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Aetna,Commerical,,,199.48,,199.48,191.29,219.75,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Aetna,Middlesex Employees,,,191.29,,191.29,191.29,219.75,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Anthem,Commerical,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Anthem,Indemnity,,,193.66,,193.66,191.29,219.75,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Anthem,Individual Exchange,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Anthem,State Preferred,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Cigna,Cigna,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Connecticare,Commerical,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Connecticare,Exchange,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,Multiplan,Multiplan,,,219.75,,219.75,191.29,219.75,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,3877924718,NDC,both,1,gm,258.53,155.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,191.29,219.75,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Aetna,Commerical,,,398.96,,398.96,382.57,439.49,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Aetna,Middlesex Employees,,,382.57,,382.57,382.57,439.49,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Anthem,Commerical,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Anthem,Indemnity,,,387.32,,387.32,382.57,439.49,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Anthem,Individual Exchange,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Anthem,State Preferred,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Cigna,Cigna,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Connecticare,Commerical,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Connecticare,Exchange,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,Multiplan,Multiplan,,,439.49,,439.49,382.57,439.49,percent of total billed charges,,
GLUTAMINE (BULK) POWDER,J3490,HCPCS,5155202857,NDC,both,1,gm,517.05,310.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,382.57,439.49,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Aetna,Commerical,,,36.53,,36.53,35.03,40.24,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Aetna,Middlesex Employees,,,35.03,,35.03,35.03,40.24,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Anthem,Commerical,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Anthem,Indemnity,,,35.46,,35.46,35.03,40.24,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Anthem,Individual Exchange,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Anthem,State Preferred,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Cigna,Cigna,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Connecticare,Commerical,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Connecticare,Exchange,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,Multiplan,Multiplan,,,40.24,,40.24,35.03,40.24,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0001-36,NDC,both,1,mL,47.34,28.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.03,40.24,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Aetna,Commerical,,,18.26,,18.26,17.51,20.12,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Aetna,Middlesex Employees,,,17.51,,17.51,17.51,20.12,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Anthem,Commerical,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Anthem,Indemnity,,,17.73,,17.73,17.51,20.12,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Anthem,Individual Exchange,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Anthem,State Preferred,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Cigna,Cigna,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Connecticare,Commerical,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Connecticare,Exchange,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,Multiplan,Multiplan,,,20.12,,20.12,17.51,20.12,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-34,NDC,both,1,mL,23.67,14.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.51,20.12,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Aetna,Commerical,,,73.06,,73.06,70.05,80.48,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Aetna,Middlesex Employees,,,70.05,,70.05,70.05,80.48,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Anthem,Commerical,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Anthem,Indemnity,,,70.92,,70.92,70.05,80.48,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Anthem,Individual Exchange,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Anthem,State Preferred,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Cigna,Cigna,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Connecticare,Commerical,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Connecticare,Exchange,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,Multiplan,Multiplan,,,80.48,,80.48,70.05,80.48,percent of total billed charges,,
GLUTAMINE 500 MG/ML SUSP,J3490,HCPCS,40810-0201-35,NDC,both,1,mL,94.68,56.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.05,80.48,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Aetna,Commerical,,,208.05,,208.05,199.51,229.19,percent of total billed charges,,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Aetna,Middlesex Employees,,,199.51,,199.51,199.51,229.19,percent of total billed charges,,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Anthem,Commerical,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Anthem,Indemnity,,,201.99,,201.99,199.51,229.19,percent of total billed charges,,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Anthem,Individual Exchange,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Anthem,State Preferred,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Cigna,Cigna,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Connecticare,Commerical,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Connecticare,Exchange,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,Multiplan,Multiplan,,,229.19,,229.19,199.51,229.19,percent of total billed charges,,
GLYBURIDE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0205-05,NDC,both,1,mL,269.64,161.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,199.51,229.19,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GLYBURIDE 1.25 MG TABLET,J3490,HCPCS,0093-8342-01,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,23155-057-01,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
GLYBURIDE 2.5 MG TABLET,J3490,HCPCS,51079-872-20,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Aetna,Commerical,,,0.95,,0.95,0.91,1.05,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Aetna,Middlesex Employees,,,0.91,,0.91,0.91,1.05,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Anthem,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Anthem,Indemnity,,,0.92,,0.92,0.91,1.05,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Anthem,Individual Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Anthem,State Preferred,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Cigna,Cigna,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Connecticare,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Connecticare,Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.91,1.05,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,23155-058-01,NDC,both,1,ea,1.23,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,51079-873-01,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
GLYBURIDE 5 MG TABLET,J3490,HCPCS,63739-119-10,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,0132-0079-12,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
GLYCERIN (ADULT) RECTAL SUPPOSITORY,J3490,HCPCS,57237-325-21,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0006-36,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-57,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,40810-0205-23,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,57237-326-52,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-12,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,58980-409-25,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
GLYCERIN (CHILD) RECTAL SUPPOSITORY,J3490,HCPCS,70000-0429-1,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,J3490,HCPCS,0132-0190-12,NDC,both,4,mL,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 0.5 ML,J3490,HCPCS,40810-0205-28,NDC,both,1,mL,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLN 1 ML,J3490,HCPCS,40810-0205-27,NDC,both,1,mL,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Aetna,Commerical,,,55.92,,55.92,53.62,61.6,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Aetna,Middlesex Employees,,,53.62,,53.62,53.62,61.6,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Anthem,Commerical,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Anthem,Indemnity,,,54.29,,54.29,53.62,61.6,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Anthem,Individual Exchange,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Anthem,State Preferred,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Cigna,Cigna,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Connecticare,Commerical,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Connecticare,Exchange,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,Multiplan,Multiplan,,,61.6,,61.6,53.62,61.6,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,0395-1031-16,NDC,both,1,mL,72.47,43.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.62,61.6,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,6.81,7.82,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,6.81,7.82,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Anthem,Commerical,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,6.81,7.82,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Anthem,State Preferred,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Cigna,Cigna,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Connecticare,Commerical,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Connecticare,Exchange,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,6.81,7.82,percent of total billed charges,,
GLYCERIN 99.5 % TOPICAL SOLUTION,J3490,HCPCS,40810-0015-20,NDC,both,1,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.81,7.82,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Aetna,Commerical,,,30.21,,30.21,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Aetna,Middlesex Employees,,,28.97,,28.97,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Anthem,Commerical,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Anthem,Indemnity,,,29.33,,29.33,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Anthem,Individual Exchange,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Anthem,State Preferred,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Cigna,Cigna,,0.52,,,0.52,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Connecticare,Commerical,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Connecticare,Exchange,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,Multiplan,Multiplan,,,33.28,,33.28,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9587-01,NDC,both,0.5,mL,39.15,23.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Aetna,Commerical,,,22.73,,22.73,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Aetna,Middlesex Employees,,,21.8,,21.8,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Commerical,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Indemnity,,,22.07,,22.07,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Individual Exchange,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,State Preferred,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Cigna,Cigna,,0.52,,,0.52,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Connecticare,Commerical,,0.78,,,0.78,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Connecticare,Exchange,,0.78,,,0.78,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Multiplan,Multiplan,,,25.04,,25.04,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Aetna,Commerical,,,30.21,,30.21,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Aetna,Middlesex Employees,,,28.97,,28.97,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Commerical,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Indemnity,,,29.33,,29.33,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Individual Exchange,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,State Preferred,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Cigna,Cigna,,0.52,,,0.52,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Connecticare,Commerical,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Connecticare,Exchange,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Multiplan,Multiplan,,,33.28,,33.28,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Aetna,Commerical,,,23.9,,23.9,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Aetna,Middlesex Employees,,,22.91,,22.91,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Commerical,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Indemnity,,,23.2,,23.2,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Individual Exchange,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,State Preferred,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Cigna,Cigna,,0.52,,,0.52,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Connecticare,Commerical,,0.78,,,0.78,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Connecticare,Exchange,,0.78,,,0.78,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Multiplan,Multiplan,,,26.32,,26.32,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Aetna,Commerical,,,7.45,,7.45,0.52,8.21,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Aetna,Middlesex Employees,,,7.15,,7.15,0.52,8.21,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Anthem,Commerical,,,,,,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Anthem,Indemnity,,,7.24,,7.24,0.52,8.21,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Anthem,Individual Exchange,,,,,,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Anthem,State Preferred,,,,,,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Cigna,Cigna,,0.52,,,0.52,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Connecticare,Commerical,,0.78,,,0.78,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Connecticare,Exchange,,0.78,,,0.78,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,Multiplan,Multiplan,,,8.21,,8.21,0.52,8.21,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-543-25,NDC,both,0.5,mL,9.66,5.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,8.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Aetna,Commerical,,,1.82,,1.82,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Anthem,Commerical,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Anthem,Indemnity,,,1.77,,1.77,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Anthem,Individual Exchange,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Anthem,State Preferred,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Cigna,Cigna,,0.52,,,0.52,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Connecticare,Commerical,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Connecticare,Exchange,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-01,NDC,both,0.5,mL,2.36,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Aetna,Commerical,,,1.82,,1.82,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Commerical,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Indemnity,,,1.77,,1.77,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Individual Exchange,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Anthem,State Preferred,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Cigna,Cigna,,0.52,,,0.52,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Connecticare,Commerical,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Connecticare,Exchange,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,43547-639-25,NDC,both,0.5,mL,2.36,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Aetna,Commerical,,,1.82,,1.82,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Anthem,Commerical,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Anthem,Indemnity,,,1.77,,1.77,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Anthem,Individual Exchange,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Anthem,State Preferred,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Cigna,Cigna,,0.52,,,0.52,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Connecticare,Commerical,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Connecticare,Exchange,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-22,NDC,both,0.5,mL,2.36,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Aetna,Commerical,,,1.82,,1.82,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Commerical,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Indemnity,,,1.77,,1.77,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Anthem,Individual Exchange,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Anthem,State Preferred,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Cigna,Cigna,,0.52,,,0.52,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Connecticare,Commerical,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Connecticare,Exchange,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,70700-165-25,NDC,both,0.5,mL,2.36,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Aetna,Commerical,,,3.64,,3.64,0.52,4.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.49,,3.49,0.52,4.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Anthem,Commerical,,,,,,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Anthem,Indemnity,,,3.54,,3.54,0.52,4.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Anthem,State Preferred,,,,,,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Cigna,Cigna,,0.52,,,0.52,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Connecticare,Commerical,,0.78,,,0.78,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Connecticare,Exchange,,0.78,,,0.78,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,Multiplan,Multiplan,,,4.01,,4.01,0.52,4.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-02,NDC,both,0.5,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,4.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Aetna,Commerical,,,1.82,,1.82,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Aetna,Middlesex Employees,,,1.75,,1.75,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Anthem,Commerical,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Anthem,Indemnity,,,1.77,,1.77,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Anthem,Individual Exchange,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Anthem,State Preferred,,,,,,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Cigna,Cigna,,0.52,,,0.52,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Connecticare,Commerical,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Connecticare,Exchange,,0.78,,,0.78,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,Multiplan,Multiplan,,,2.01,,2.01,0.52,2.01,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,J1596,HCPCS,71288-407-03,NDC,both,0.5,mL,2.36,1.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,2.01,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Aetna,Commerical,,,22.73,,22.73,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Aetna,Middlesex Employees,,,21.8,,21.8,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Commerical,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Indemnity,,,22.07,,22.07,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,Individual Exchange,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Anthem,State Preferred,,,,,,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Cigna,Cigna,,0.52,,,0.52,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Connecticare,Commerical,,0.78,,,0.78,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Connecticare,Exchange,,0.78,,,0.78,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,Multiplan,Multiplan,,,25.04,,25.04,0.52,25.04,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-01,NDC,both,1,mL,29.46,17.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,25.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Aetna,Commerical,,,30.21,,30.21,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Aetna,Middlesex Employees,,,28.97,,28.97,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Commerical,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Indemnity,,,29.33,,29.33,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,Individual Exchange,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Anthem,State Preferred,,,,,,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Cigna,Cigna,,0.52,,,0.52,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Connecticare,Commerical,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Connecticare,Exchange,,0.78,,,0.78,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,Multiplan,Multiplan,,,33.28,,33.28,0.52,33.28,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0143-9682-25,NDC,both,0.5,mL,39.15,23.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,33.28,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Aetna,Commerical,,,23.9,,23.9,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Aetna,Middlesex Employees,,,22.91,,22.91,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Commerical,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Indemnity,,,23.2,,23.2,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,Individual Exchange,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Anthem,State Preferred,,,,,,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Cigna,Cigna,,0.52,,,0.52,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Connecticare,Commerical,,0.78,,,0.78,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Connecticare,Exchange,,0.78,,,0.78,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,Multiplan,Multiplan,,,26.32,,26.32,0.52,26.32,percent of total billed charges,,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION FOR SEDATION,J1596,HCPCS,0517-4601-25,NDC,both,1,mL,30.97,18.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.56,,,0.56,0.52,26.32,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.25 MG ORAL TABLET,J3490,HCPCS,40810-0204-11,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG ORAL TAB,J3490,HCPCS,4081-00003-86,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Aetna,Commerical,,,112.6,,112.6,107.97,124.04,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Aetna,Middlesex Employees,,,107.97,,107.97,107.97,124.04,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Anthem,Commerical,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Anthem,Indemnity,,,109.32,,109.32,107.97,124.04,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Anthem,Individual Exchange,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Anthem,State Preferred,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Cigna,Cigna,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Connecticare,Commerical,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Connecticare,Exchange,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,Multiplan,Multiplan,,,124.04,,124.04,107.97,124.04,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-38,NDC,both,1,mL,145.93,87.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.97,124.04,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Aetna,Commerical,,,225.19,,225.19,215.94,248.07,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Aetna,Middlesex Employees,,,215.94,,215.94,215.94,248.07,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Anthem,Commerical,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Anthem,Indemnity,,,218.62,,218.62,215.94,248.07,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Anthem,Individual Exchange,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Anthem,State Preferred,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Cigna,Cigna,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Connecticare,Commerical,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Connecticare,Exchange,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,Multiplan,Multiplan,,,248.07,,248.07,215.94,248.07,percent of total billed charges,,
GLYCOPYRROLATE 0.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-60,NDC,both,1,mL,291.85,175.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,215.94,248.07,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,23155-606-01,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,55111-648-01,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
GLYCOPYRROLATE 1 MG TABLET,J3490,HCPCS,60687-270-01,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Aetna,Commerical,,,774.4,,774.4,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Aetna,Middlesex Employees,,,742.59,,742.59,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Anthem,Commerical,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Anthem,Indemnity,,,751.82,,751.82,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Anthem,Individual Exchange,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Anthem,State Preferred,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Cigna,Cigna,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Connecticare,Commerical,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Connecticare,Exchange,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,Multiplan,Multiplan,,,853.09,,853.09,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,0259-0501-16,NDC,both,1,mL,1003.63,602.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Aetna,Commerical,,,774.4,,774.4,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Aetna,Middlesex Employees,,,742.59,,742.59,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Anthem,Commerical,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Anthem,Indemnity,,,751.82,,751.82,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Anthem,Individual Exchange,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Anthem,State Preferred,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Cigna,Cigna,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Connecticare,Commerical,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Connecticare,Exchange,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,Multiplan,Multiplan,,,853.09,,853.09,742.59,853.09,percent of total billed charges,,
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,J3490,HCPCS,51672-5316-9,NDC,both,1,mL,1003.63,602.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,742.59,853.09,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Aetna,Commerical,,,0.54,,0.54,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Aetna,Middlesex Employees,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Anthem,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Anthem,Indemnity,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Anthem,Individual Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Anthem,State Preferred,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Cigna,Cigna,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Connecticare,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Connecticare,Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,Multiplan,Multiplan,,,0.6,,0.6,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,23155-607-01,NDC,both,1,ea,0.7,0.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Aetna,Commerical,,,0.54,,0.54,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Aetna,Middlesex Employees,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Anthem,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Anthem,Indemnity,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Anthem,Individual Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Anthem,State Preferred,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Cigna,Cigna,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Connecticare,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Connecticare,Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,Multiplan,Multiplan,,,0.6,,0.6,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,55111-649-01,NDC,both,1,ea,0.7,0.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Aetna,Commerical,,,0.54,,0.54,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Aetna,Middlesex Employees,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Anthem,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Anthem,Indemnity,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Anthem,Individual Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Anthem,State Preferred,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Cigna,Cigna,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Connecticare,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Connecticare,Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,Multiplan,Multiplan,,,0.6,,0.6,0.52,0.6,percent of total billed charges,,
GLYCOPYRROLATE 2 MG TABLET,J3490,HCPCS,69076-476-01,NDC,both,1,ea,0.7,0.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Aetna,Commerical,,,32.12,,32.12,30.8,35.39,percent of total billed charges,,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Aetna,Middlesex Employees,,,30.8,,30.8,30.8,35.39,percent of total billed charges,,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Anthem,Commerical,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Anthem,Indemnity,,,31.19,,31.19,30.8,35.39,percent of total billed charges,,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Anthem,Individual Exchange,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Anthem,State Preferred,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Cigna,Cigna,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Connecticare,Commerical,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Connecticare,Exchange,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,Multiplan,Multiplan,,,35.39,,35.39,30.8,35.39,percent of total billed charges,,
GLYCOPYRROLATE 4 MCG/ML IN D10W NICU,J3490,HCPCS,40810-0004-58,NDC,both,1,mL,41.63,24.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.8,35.39,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Aetna,Commerical,,,5683.68,,5683.68,12.85,6261.18,percent of total billed charges,,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Aetna,Middlesex Employees,,,5450.17,,5450.17,12.85,6261.18,percent of total billed charges,,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Anthem,Commerical,,,,,,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Anthem,Indemnity,,,5517.94,,5517.94,12.85,6261.18,percent of total billed charges,,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Anthem,Individual Exchange,,,,,,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Anthem,State Preferred,,,,,,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Cigna,Cigna,,12.85,,,12.85,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Connecticare,Commerical,,16.95,,,16.95,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Connecticare,Exchange,,16.95,,,16.95,12.85,6261.18,Other,Could be inpatient or outpatient,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,Multiplan,Multiplan,,,6261.18,,6261.18,12.85,6261.18,percent of total billed charges,,
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,J1602,HCPCS,57894-350-01,NDC,both,0.08,mL,7366.09,4419.65,United Healthcare/Oxford,United Healthcare/Oxford,,13.87,,,13.87,12.85,6261.18,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Aetna,Commerical,,,5.83,,5.83,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Aetna,Middlesex Employees,,,5.59,,5.59,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Commerical,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Indemnity,,,5.66,,5.66,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Anthem,State Preferred,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Cigna,Cigna,,0.42,,,0.42,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Connecticare,Commerical,,0.43,,,0.43,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Connecticare,Exchange,,0.43,,,0.43,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,Multiplan,Multiplan,,,6.42,,6.42,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-318-01,NDC,both,0.1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Aetna,Commerical,,,5.83,,5.83,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Aetna,Middlesex Employees,,,5.59,,5.59,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Commerical,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Indemnity,,,5.66,,5.66,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Anthem,State Preferred,,,,,,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Cigna,Cigna,,0.42,,,0.42,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Connecticare,Commerical,,0.43,,,0.43,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Connecticare,Exchange,,0.43,,,0.43,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,Multiplan,Multiplan,,,6.42,,6.42,0.37,6.42,percent of total billed charges,,
GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,67457-863-01,NDC,both,0.1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,6.42,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Aetna,Commerical,,,25.59,,25.59,0.37,28.19,percent of total billed charges,,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Aetna,Middlesex Employees,,,24.54,,24.54,0.37,28.19,percent of total billed charges,,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Anthem,Commerical,,,,,,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Anthem,Indemnity,,,24.85,,24.85,0.37,28.19,percent of total billed charges,,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Anthem,Individual Exchange,,,,,,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Anthem,State Preferred,,,,,,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Cigna,Cigna,,0.42,,,0.42,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Connecticare,Commerical,,0.43,,,0.43,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Connecticare,Exchange,,0.43,,,0.43,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,Multiplan,Multiplan,,,28.19,,28.19,0.37,28.19,percent of total billed charges,,
GRANISETRON (PF) 100 MCG/ML (0.1 MG/ML) INTRAVENOUS SOLUTION,J1626,HCPCS,63323-317-01,NDC,both,1,mL,33.17,19.9,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,28.19,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Aetna,Commerical,,,6.85,,6.85,2.23,62.95,percent of total billed charges,,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Aetna,Middlesex Employees,,,6.57,,6.57,2.23,62.95,percent of total billed charges,,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Anthem,Commerical,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Anthem,Indemnity,,,6.65,,6.65,2.23,62.95,percent of total billed charges,,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Anthem,Individual Exchange,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Anthem,State Preferred,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Cigna,Cigna,,3.46,,,3.46,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Connecticare,Commerical,,2.23,,,2.23,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Connecticare,Exchange,,2.23,,,2.23,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,Multiplan,Multiplan,,,7.55,,7.55,2.23,62.95,percent of total billed charges,,
GRANISETRON 0.5 MG ORAL TAB,Q0166,HCPCS,40810-0003-87,NDC,both,2,ea,8.88,5.33,United Healthcare/Oxford,United Healthcare/Oxford,,62.95,,,62.95,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Aetna,Commerical,,,4.04,,4.04,2.23,62.95,percent of total billed charges,,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Aetna,Middlesex Employees,,,3.87,,3.87,2.23,62.95,percent of total billed charges,,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Anthem,Commerical,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Anthem,Indemnity,,,3.92,,3.92,2.23,62.95,percent of total billed charges,,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Anthem,Individual Exchange,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Anthem,State Preferred,,,,,,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Cigna,Cigna,,3.46,,,3.46,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Connecticare,Commerical,,2.23,,,2.23,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Connecticare,Exchange,,2.23,,,2.23,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,Multiplan,Multiplan,,,4.45,,4.45,2.23,62.95,percent of total billed charges,,
GRANISETRON HCL 1 MG TABLET,Q0166,HCPCS,51991-735-20,NDC,both,1,ea,5.23,3.14,United Healthcare/Oxford,United Healthcare/Oxford,,62.95,,,62.95,2.23,62.95,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Aetna,Commerical,,,2532.75,,2532.75,2.23,2790.1,percent of total billed charges,,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Aetna,Middlesex Employees,,,2428.7,,2428.7,2.23,2790.1,percent of total billed charges,,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Anthem,Commerical,,,,,,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Anthem,Indemnity,,,2458.9,,2458.9,2.23,2790.1,percent of total billed charges,,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Anthem,Individual Exchange,,,,,,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Anthem,State Preferred,,,,,,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Cigna,Cigna,,3.46,,,3.46,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Connecticare,Commerical,,2.23,,,2.23,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Connecticare,Exchange,,2.23,,,2.23,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,Multiplan,Multiplan,,,2790.1,,2790.1,2.23,2790.1,percent of total billed charges,,
GRANISETRON HCL 1 MG/5 ML ORAL SOLUTION,Q0166,HCPCS,40810-0018-06,NDC,both,5,mL,3282.47,1969.48,United Healthcare/Oxford,United Healthcare/Oxford,,62.95,,,62.95,2.23,2790.1,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Aetna,Commerical,,,7.41,,7.41,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Aetna,Middlesex Employees,,,7.1,,7.1,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Anthem,Commerical,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Anthem,Indemnity,,,7.19,,7.19,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Anthem,Individual Exchange,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Anthem,State Preferred,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Cigna,Cigna,,0.42,,,0.42,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Connecticare,Commerical,,0.43,,,0.43,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Connecticare,Exchange,,0.43,,,0.43,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,Multiplan,Multiplan,,,8.16,,8.16,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-01,NDC,both,0.01,mL,9.6,5.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Aetna,Commerical,,,56.15,,56.15,0.37,61.85,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,0.37,61.85,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Anthem,Commerical,,,,,,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Anthem,Indemnity,,,54.51,,54.51,0.37,61.85,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Anthem,Individual Exchange,,,,,,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Anthem,State Preferred,,,,,,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Cigna,Cigna,,0.42,,,0.42,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Connecticare,Commerical,,0.43,,,0.43,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Connecticare,Exchange,,0.43,,,0.43,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,Multiplan,Multiplan,,,61.85,,61.85,0.37,61.85,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9744-10,NDC,both,0.01,mL,72.77,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,61.85,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Aetna,Commerical,,,7.41,,7.41,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Aetna,Middlesex Employees,,,7.1,,7.1,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Anthem,Commerical,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Anthem,Indemnity,,,7.19,,7.19,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Anthem,Individual Exchange,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Anthem,State Preferred,,,,,,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Cigna,Cigna,,0.42,,,0.42,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Connecticare,Commerical,,0.43,,,0.43,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Connecticare,Exchange,,0.43,,,0.43,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,Multiplan,Multiplan,,,8.16,,8.16,0.37,8.16,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-02,NDC,both,0.01,mL,9.6,5.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,8.16,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Aetna,Commerical,,,22.95,,22.95,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Aetna,Middlesex Employees,,,22,,22,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Anthem,Commerical,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Anthem,Indemnity,,,22.28,,22.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Anthem,Individual Exchange,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Anthem,State Preferred,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Cigna,Cigna,,0.42,,,0.42,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Connecticare,Commerical,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Connecticare,Exchange,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,Multiplan,Multiplan,,,25.28,,25.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-01,NDC,both,0.1,mL,29.74,17.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Aetna,Commerical,,,177.31,,177.31,0.37,195.33,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Aetna,Middlesex Employees,,,170.03,,170.03,0.37,195.33,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Anthem,Commerical,,,,,,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Anthem,Indemnity,,,172.14,,172.14,0.37,195.33,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Anthem,Individual Exchange,,,,,,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Anthem,State Preferred,,,,,,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Cigna,Cigna,,0.42,,,0.42,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Connecticare,Commerical,,0.43,,,0.43,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Connecticare,Exchange,,0.43,,,0.43,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,Multiplan,Multiplan,,,195.33,,195.33,0.37,195.33,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,0143-9745-05,NDC,both,0.1,mL,229.8,137.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,195.33,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Aetna,Commerical,,,22.95,,22.95,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Aetna,Middlesex Employees,,,22,,22,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Anthem,Commerical,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Anthem,Indemnity,,,22.28,,22.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Anthem,Individual Exchange,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Anthem,State Preferred,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Cigna,Cigna,,0.42,,,0.42,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Connecticare,Commerical,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Connecticare,Exchange,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,Multiplan,Multiplan,,,25.28,,25.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,17478-546-05,NDC,both,0.1,mL,29.74,17.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Aetna,Commerical,,,188.73,,188.73,0.37,207.9,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Aetna,Middlesex Employees,,,180.97,,180.97,0.37,207.9,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Anthem,Commerical,,,,,,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Anthem,Indemnity,,,183.22,,183.22,0.37,207.9,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Anthem,Individual Exchange,,,,,,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Anthem,State Preferred,,,,,,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Cigna,Cigna,,0.42,,,0.42,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Connecticare,Commerical,,0.43,,,0.43,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Connecticare,Exchange,,0.43,,,0.43,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,Multiplan,Multiplan,,,207.9,,207.9,0.37,207.9,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,63323-319-04,NDC,both,0.1,mL,244.59,146.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,207.9,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Aetna,Commerical,,,22.95,,22.95,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Aetna,Middlesex Employees,,,22,,22,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Anthem,Commerical,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Anthem,Indemnity,,,22.28,,22.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Anthem,Individual Exchange,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Anthem,State Preferred,,,,,,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Cigna,Cigna,,0.42,,,0.42,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Connecticare,Commerical,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Connecticare,Exchange,,0.43,,,0.43,0.37,25.28,Other,Could be inpatient or outpatient,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,Multiplan,Multiplan,,,25.28,,25.28,0.37,25.28,percent of total billed charges,,
GRANISETRON HCL 1 MG/ML INTRAVENOUS SOLUTION,J1626,HCPCS,67457-864-04,NDC,both,0.1,mL,29.74,17.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.37,25.28,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Aetna,Commerical,,,143.27,,143.27,137.38,157.83,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Aetna,Middlesex Employees,,,137.38,,137.38,137.38,157.83,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Anthem,Commerical,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Anthem,Indemnity,,,139.09,,139.09,137.38,157.83,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Anthem,Individual Exchange,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Anthem,State Preferred,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Cigna,Cigna,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Connecticare,Commerical,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Connecticare,Exchange,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,Multiplan,Multiplan,,,157.83,,157.83,137.38,157.83,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0472-0013-04,NDC,both,1,mL,185.68,111.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,137.38,157.83,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Aetna,Commerical,,,137.6,,137.6,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Aetna,Middlesex Employees,,,131.95,,131.95,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Anthem,Commerical,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Anthem,Indemnity,,,133.59,,133.59,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Anthem,Individual Exchange,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Anthem,State Preferred,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Cigna,Cigna,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Connecticare,Commerical,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Connecticare,Exchange,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,Multiplan,Multiplan,,,151.58,,151.58,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,62135-968-41,NDC,both,1,mL,178.33,107,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Aetna,Commerical,,,137.6,,137.6,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Aetna,Middlesex Employees,,,131.95,,131.95,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Anthem,Commerical,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Anthem,Indemnity,,,133.59,,133.59,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Anthem,Individual Exchange,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Anthem,State Preferred,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Cigna,Cigna,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Connecticare,Commerical,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Connecticare,Exchange,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,Multiplan,Multiplan,,,151.58,,151.58,131.95,151.58,percent of total billed charges,,
GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69097-361-08,NDC,both,1,mL,178.33,107,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,131.95,151.58,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Aetna,Commerical,,,11.86,,11.86,11.37,13.06,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Aetna,Middlesex Employees,,,11.37,,11.37,11.37,13.06,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Anthem,Commerical,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Anthem,Indemnity,,,11.51,,11.51,11.37,13.06,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Anthem,Individual Exchange,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Anthem,State Preferred,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Cigna,Cigna,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Connecticare,Commerical,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Connecticare,Exchange,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,Multiplan,Multiplan,,,13.06,,13.06,11.37,13.06,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,6056906304,NDC,both,1,mL,15.37,9.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.37,13.06,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Aetna,Commerical,,,3.14,,3.14,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Aetna,Middlesex Employees,,,3.01,,3.01,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Anthem,Commerical,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Anthem,Indemnity,,,3.05,,3.05,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Anthem,Individual Exchange,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Anthem,State Preferred,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Cigna,Cigna,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Connecticare,Commerical,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Connecticare,Exchange,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,Multiplan,Multiplan,,,3.46,,3.46,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1182-97,NDC,both,1,mL,4.07,2.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Aetna,Commerical,,,12.58,,12.58,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Aetna,Middlesex Employees,,,12.07,,12.07,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Anthem,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Anthem,Indemnity,,,12.22,,12.22,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Anthem,Individual Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Anthem,State Preferred,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Cigna,Cigna,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Connecticare,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Connecticare,Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,Multiplan,Multiplan,,,13.86,,13.86,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0536-1314-85,NDC,both,1,mL,16.31,9.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Aetna,Commerical,,,12.58,,12.58,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Aetna,Middlesex Employees,,,12.07,,12.07,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Anthem,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Anthem,Indemnity,,,12.22,,12.22,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Anthem,Individual Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Anthem,State Preferred,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Cigna,Cigna,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Connecticare,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Connecticare,Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,Multiplan,Multiplan,,,13.86,,13.86,12.07,13.86,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-16,NDC,both,1,mL,16.31,9.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Aetna,Commerical,,,3.14,,3.14,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Aetna,Middlesex Employees,,,3.01,,3.01,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Anthem,Commerical,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Anthem,Indemnity,,,3.05,,3.05,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Anthem,Individual Exchange,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Anthem,State Preferred,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Cigna,Cigna,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Connecticare,Commerical,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Connecticare,Exchange,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,Multiplan,Multiplan,,,3.46,,3.46,3.01,3.46,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,0904-6763-20,NDC,both,1,mL,4.07,2.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.01,3.46,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Aetna,Commerical,,,6.28,,6.28,6.02,6.92,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Aetna,Middlesex Employees,,,6.02,,6.02,6.02,6.92,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Anthem,Commerical,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Anthem,Indemnity,,,6.1,,6.1,6.02,6.92,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Anthem,Individual Exchange,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Anthem,State Preferred,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Cigna,Cigna,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Connecticare,Commerical,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Connecticare,Exchange,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,Multiplan,Multiplan,,,6.92,,6.92,6.02,6.92,percent of total billed charges,,
GUAIFENESIN 100 MG/5 ML ORAL LIQUID,J3490,HCPCS,71399-0024-8,NDC,both,1,mL,8.14,4.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.02,6.92,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,40810-0010-41,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-32,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",J3490,HCPCS,63824-008-34,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Aetna,Commerical,,,138.31,,138.31,132.63,152.36,percent of total billed charges,,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Aetna,Middlesex Employees,,,132.63,,132.63,132.63,152.36,percent of total billed charges,,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Anthem,Commerical,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Anthem,Indemnity,,,134.28,,134.28,132.63,152.36,percent of total billed charges,,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Anthem,Individual Exchange,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Anthem,State Preferred,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Cigna,Cigna,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Connecticare,Commerical,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Connecticare,Exchange,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,Multiplan,Multiplan,,,152.36,,152.36,132.63,152.36,percent of total billed charges,,
GUANFACINE 0.2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0202-47,NDC,both,1,mL,179.25,107.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
GUANFACINE 0.25 MG TABLET,J3490,HCPCS,40810-0013-58,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
GUANFACINE 0.5 MG ORAL TAB,J3490,HCPCS,40810-0001-40,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,0378-1160-01,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
GUANFACINE 1 MG TABLET,J3490,HCPCS,29300-458-01,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Anthem,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Cigna,Cigna,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Connecticare,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Connecticare,Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,0591-0453-01,NDC,both,1,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Anthem,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Cigna,Cigna,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Connecticare,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Connecticare,Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,50268-374-15,NDC,both,1,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Anthem,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Cigna,Cigna,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Connecticare,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Connecticare,Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.78,0.9,percent of total billed charges,,
GUANFACINE 2 MG TABLET,J3490,HCPCS,65162-713-10,NDC,both,1,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,24979-533-01,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0010-57,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,54092-513-02,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,60505-3927-1,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,70436-039-01,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Aetna,Commerical,,,226.12,,226.12,216.83,249.09,percent of total billed charges,,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Aetna,Middlesex Employees,,,216.83,,216.83,216.83,249.09,percent of total billed charges,,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Anthem,Commerical,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Anthem,Indemnity,,,219.52,,219.52,216.83,249.09,percent of total billed charges,,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Anthem,Individual Exchange,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Anthem,State Preferred,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Cigna,Cigna,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Connecticare,Commerical,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Connecticare,Exchange,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,Multiplan,Multiplan,,,249.09,,249.09,216.83,249.09,percent of total billed charges,,
"GUM MASTIC-STORAX-METHYLSALICYLATE-ALCOHOL DROPS,DROPPERETTE",J3490,HCPCS,496052348,NDC,both,48,ea,293.05,175.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,216.83,249.09,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Aetna,Commerical,,,295.32,,295.32,139.86,325.33,percent of total billed charges,,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Aetna,Middlesex Employees,,,283.19,,283.19,139.86,325.33,percent of total billed charges,,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Anthem,Commerical,,174.83,,,174.83,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Anthem,Indemnity,,,286.71,,286.71,139.86,325.33,percent of total billed charges,,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Anthem,Individual Exchange,,139.86,,,139.86,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Anthem,State Preferred,,174.83,,,174.83,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Cigna,Cigna,,,,,,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Connecticare,Commerical,,,,,,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Connecticare,Exchange,,,,,,139.86,325.33,Other,Could be inpatient or outpatient,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,Multiplan,Multiplan,,,325.33,,325.33,139.86,325.33,percent of total billed charges,,
"HAEMOPHILUS B CONJ-TET,COMPONENT 2 OF 2 (PF) 10 MCG/0.5 ML IM SOLUTION",90698,HCPCS,49281-545-15,NDC,both,1,ea,382.74,229.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,139.86,325.33,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
HALOPERIDOL 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-41,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Aetna,Commerical,,,0.86,,0.86,0.82,0.94,percent of total billed charges,,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Aetna,Middlesex Employees,,,0.82,,0.82,0.82,0.94,percent of total billed charges,,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Anthem,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Anthem,Indemnity,,,0.83,,0.83,0.82,0.94,percent of total billed charges,,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Anthem,Individual Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Anthem,State Preferred,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Cigna,Cigna,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Connecticare,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Connecticare,Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,Multiplan,Multiplan,,,0.94,,0.94,0.82,0.94,percent of total billed charges,,
HALOPERIDOL 0.5 MG TABLET,J3490,HCPCS,51079-733-20,NDC,both,1,ea,1.11,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-01,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
HALOPERIDOL 1 MG TABLET,J3490,HCPCS,51079-734-20,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Aetna,Commerical,,,4.65,,4.65,4.46,5.13,percent of total billed charges,,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Aetna,Middlesex Employees,,,4.46,,4.46,4.46,5.13,percent of total billed charges,,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Anthem,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Anthem,Indemnity,,,4.52,,4.52,4.46,5.13,percent of total billed charges,,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Anthem,Individual Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Anthem,State Preferred,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Cigna,Cigna,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Connecticare,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Connecticare,Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,Multiplan,Multiplan,,,5.13,,5.13,4.46,5.13,percent of total billed charges,,
HALOPERIDOL 10 MG TABLET,J3490,HCPCS,51079-431-20,NDC,both,1,ea,6.03,3.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Aetna,Commerical,,,1.44,,1.44,1.38,1.59,percent of total billed charges,,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Aetna,Middlesex Employees,,,1.38,,1.38,1.38,1.59,percent of total billed charges,,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Anthem,Commerical,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Anthem,Indemnity,,,1.4,,1.4,1.38,1.59,percent of total billed charges,,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Anthem,Individual Exchange,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Anthem,State Preferred,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Cigna,Cigna,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Connecticare,Commerical,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Connecticare,Exchange,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,Multiplan,Multiplan,,,1.59,,1.59,1.38,1.59,percent of total billed charges,,
HALOPERIDOL 2 MG TABLET,J3490,HCPCS,0378-0214-01,NDC,both,1,ea,1.87,1.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.38,1.59,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
HALOPERIDOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-43,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Aetna,Commerical,,,1.32,,1.32,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Anthem,Commerical,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Anthem,Indemnity,,,1.28,,1.28,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Anthem,Individual Exchange,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Anthem,State Preferred,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Cigna,Cigna,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Connecticare,Commerical,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Connecticare,Exchange,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,Multiplan,Multiplan,,,1.45,,1.45,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,0904-6782-61,NDC,both,1,ea,1.71,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Aetna,Commerical,,,1.32,,1.32,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Anthem,Commerical,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Anthem,Indemnity,,,1.28,,1.28,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Anthem,Individual Exchange,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Anthem,State Preferred,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Cigna,Cigna,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Connecticare,Commerical,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Connecticare,Exchange,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,Multiplan,Multiplan,,,1.45,,1.45,1.27,1.45,percent of total billed charges,,
HALOPERIDOL 5 MG TABLET,J3490,HCPCS,60687-161-01,NDC,both,1,ea,1.71,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.45,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Aetna,Commerical,,,29.64,,29.64,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Aetna,Middlesex Employees,,,28.43,,28.43,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Commerical,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Indemnity,,,28.78,,28.78,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Individual Exchange,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Anthem,State Preferred,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Cigna,Cigna,,7.38,,,7.38,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Connecticare,Commerical,,10.35,,,10.35,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Connecticare,Exchange,,10.35,,,10.35,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,Multiplan,Multiplan,,,32.66,,32.66,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-471-01,NDC,both,0.5,mL,38.42,23.05,United Healthcare/Oxford,United Healthcare/Oxford,,7.97,,,7.97,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Aetna,Commerical,,,29.64,,29.64,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Aetna,Middlesex Employees,,,28.43,,28.43,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Commerical,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Indemnity,,,28.78,,28.78,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Anthem,Individual Exchange,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Anthem,State Preferred,,,,,,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Cigna,Cigna,,7.38,,,7.38,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Connecticare,Commerical,,10.35,,,10.35,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Connecticare,Exchange,,10.35,,,10.35,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,Multiplan,Multiplan,,,32.66,,32.66,7.38,32.66,percent of total billed charges,,
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-383-01,NDC,both,0.5,mL,38.42,23.05,United Healthcare/Oxford,United Healthcare/Oxford,,7.97,,,7.97,7.38,32.66,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Aetna,Commerical,,,25.45,,25.45,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Aetna,Middlesex Employees,,,24.4,,24.4,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Anthem,Commerical,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Anthem,Indemnity,,,24.71,,24.71,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Anthem,Individual Exchange,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Anthem,State Preferred,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Cigna,Cigna,,7.38,,,7.38,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Connecticare,Commerical,,10.35,,,10.35,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Connecticare,Exchange,,10.35,,,10.35,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,Multiplan,Multiplan,,,28.03,,28.03,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,63323-469-01,NDC,both,1,mL,32.98,19.79,United Healthcare/Oxford,United Healthcare/Oxford,,7.97,,,7.97,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Aetna,Commerical,,,25.45,,25.45,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Aetna,Middlesex Employees,,,24.4,,24.4,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Anthem,Commerical,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Anthem,Indemnity,,,24.71,,24.71,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Anthem,Individual Exchange,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Anthem,State Preferred,,,,,,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Cigna,Cigna,,7.38,,,7.38,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Connecticare,Commerical,,10.35,,,10.35,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Connecticare,Exchange,,10.35,,,10.35,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,Multiplan,Multiplan,,,28.03,,28.03,7.38,28.03,percent of total billed charges,,
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,J1631,HCPCS,70069-381-01,NDC,both,1,mL,32.98,19.79,United Healthcare/Oxford,United Healthcare/Oxford,,7.97,,,7.97,7.38,28.03,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Aetna,Commerical,,,55.32,,55.32,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Aetna,Middlesex Employees,,,53.05,,53.05,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Anthem,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Anthem,Indemnity,,,53.71,,53.71,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Anthem,Individual Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Anthem,State Preferred,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Cigna,Cigna,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Connecticare,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Connecticare,Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,Multiplan,Multiplan,,,60.95,,60.95,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,0121-0581-04,NDC,both,1,mL,71.7,43.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Aetna,Commerical,,,6.92,,6.92,6.64,7.62,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Aetna,Middlesex Employees,,,6.64,,6.64,6.64,7.62,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Anthem,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Anthem,Indemnity,,,6.72,,6.72,6.64,7.62,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Anthem,Individual Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Anthem,State Preferred,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Cigna,Cigna,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Connecticare,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Connecticare,Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,Multiplan,Multiplan,,,7.62,,7.62,6.64,7.62,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-15,NDC,both,1,mL,8.97,5.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Aetna,Commerical,,,55.32,,55.32,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Aetna,Middlesex Employees,,,53.05,,53.05,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Anthem,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Anthem,Indemnity,,,53.71,,53.71,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Anthem,Individual Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Anthem,State Preferred,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Cigna,Cigna,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Connecticare,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Connecticare,Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,Multiplan,Multiplan,,,60.95,,60.95,53.05,60.95,percent of total billed charges,,
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,J3490,HCPCS,54838-501-40,NDC,both,1,mL,71.7,43.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Anthem,Commerical,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Anthem,Individual Exchange,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Anthem,State Preferred,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Cigna,Cigna,,1.31,,,1.31,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Connecticare,Commerical,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Connecticare,Exchange,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-00,NDC,both,1,mL,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Anthem,Commerical,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Anthem,Individual Exchange,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Anthem,State Preferred,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Cigna,Cigna,,1.31,,,1.31,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Connecticare,Commerical,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Connecticare,Exchange,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,63323-474-01,NDC,both,1,mL,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Aetna,Commerical,,,1.58,,1.58,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Aetna,Middlesex Employees,,,1.52,,1.52,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Anthem,Commerical,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Anthem,Indemnity,,,1.54,,1.54,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Anthem,Individual Exchange,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Anthem,State Preferred,,,,,,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Cigna,Cigna,,1.31,,,1.31,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Connecticare,Commerical,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Connecticare,Exchange,,1.57,,,1.57,1.31,1.74,Other,Could be inpatient or outpatient,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,Multiplan,Multiplan,,,1.74,,1.74,1.31,1.74,percent of total billed charges,,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,J1630,HCPCS,67457-426-12,NDC,both,1,mL,2.05,1.23,United Healthcare/Oxford,United Healthcare/Oxford,,1.42,,,1.42,1.31,1.74,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Aetna,Commerical,,,18.92,,18.92,3.86,20.84,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Aetna,Middlesex Employees,,,18.14,,18.14,3.86,20.84,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Anthem,Commerical,,,,,,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Anthem,Indemnity,,,18.37,,18.37,3.86,20.84,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Anthem,Individual Exchange,,,,,,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Anthem,State Preferred,,,,,,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Cigna,Cigna,,3.86,,,3.86,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Connecticare,Commerical,,5.7,,,5.7,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Connecticare,Exchange,,5.7,,,5.7,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,Multiplan,Multiplan,,,20.84,,20.84,3.86,20.84,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0069-0058-01,NDC,both,1,mL,24.52,14.71,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,20.84,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Commerical,,,4.82,,4.82,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Middlesex Employees,,,4.62,,4.62,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Commerical,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Indemnity,,,4.68,,4.68,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Individual Exchange,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,State Preferred,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Cigna,Cigna,,0.26,,,0.26,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Commerical,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Exchange,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Multiplan,Multiplan,,,5.31,,5.31,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-10,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML DURING DIALYSIS",J1644,HCPCS,71288-402-11,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Commerical,,,4.82,,4.82,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Middlesex Employees,,,4.62,,4.62,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Commerical,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Indemnity,,,4.68,,4.68,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Individual Exchange,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,State Preferred,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Cigna,Cigna,,0.26,,,0.26,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Commerical,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Exchange,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Multiplan,Multiplan,,,5.31,,5.31,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML FOR DIALYSIS CATHETER",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Commerical,,,4.82,,4.82,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Middlesex Employees,,,4.62,,4.62,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Commerical,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Indemnity,,,4.68,,4.68,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Individual Exchange,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,State Preferred,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Cigna,Cigna,,0.26,,,0.26,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Commerical,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Exchange,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Multiplan,Multiplan,,,5.31,,5.31,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION CRRT",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1643,HCPCS,0409-2720-31,NDC,both,1,mL,60.86,36.52,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Aetna,Commerical,,,0.56,,0.56,0.26,0.61,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Aetna,Middlesex Employees,,,0.53,,0.53,0.26,0.61,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Anthem,Commerical,,,,,,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Anthem,Indemnity,,,0.54,,0.54,0.26,0.61,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Anthem,Individual Exchange,,,,,,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Anthem,State Preferred,,,,,,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Cigna,Cigna,,0.26,,,0.26,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Connecticare,Commerical,,0.33,,,0.33,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Connecticare,Exchange,,0.33,,,0.33,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,Multiplan,Multiplan,,,0.61,,0.61,0.26,0.61,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-01,NDC,both,1,mL,0.72,0.43,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,0.61,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-07,NDC,both,1,mL,60.86,36.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Commerical,,,4.82,,4.82,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Aetna,Middlesex Employees,,,4.62,,4.62,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Commerical,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Indemnity,,,4.68,,4.68,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,Individual Exchange,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Anthem,State Preferred,,,,,,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Cigna,Cigna,,0.26,,,0.26,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Commerical,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Connecticare,Exchange,,0.33,,,0.33,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,Multiplan,Multiplan,,,5.31,,5.31,0.26,5.31,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-11,NDC,both,1,mL,6.25,3.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.31,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-540-15,NDC,both,1,mL,60.86,36.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Aetna,Commerical,,,4.7,,4.7,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Aetna,Middlesex Employees,,,4.51,,4.51,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Anthem,Commerical,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Anthem,Indemnity,,,4.56,,4.56,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Anthem,Individual Exchange,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Anthem,State Preferred,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Cigna,Cigna,,0.26,,,0.26,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Connecticare,Commerical,,0.33,,,0.33,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Connecticare,Exchange,,0.33,,,0.33,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,Multiplan,Multiplan,,,5.18,,5.18,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-01,NDC,both,1,mL,6.09,3.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Aetna,Commerical,,,4.7,,4.7,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Aetna,Middlesex Employees,,,4.51,,4.51,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Anthem,Commerical,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Anthem,Indemnity,,,4.56,,4.56,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Anthem,Individual Exchange,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Anthem,State Preferred,,,,,,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Cigna,Cigna,,0.26,,,0.26,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Connecticare,Commerical,,0.33,,,0.33,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Connecticare,Exchange,,0.33,,,0.33,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,Multiplan,Multiplan,,,5.18,,5.18,0.26,5.18,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-02,NDC,both,1,mL,6.09,3.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,5.18,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-10,NDC,both,1,mL,60.86,36.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Aetna,Commerical,,,46.96,,46.96,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Aetna,Middlesex Employees,,,45.03,,45.03,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Anthem,Commerical,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Anthem,Indemnity,,,45.59,,45.59,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Anthem,Individual Exchange,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Anthem,State Preferred,,,,,,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Cigna,Cigna,,0.26,,,0.26,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Connecticare,Commerical,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Connecticare,Exchange,,0.33,,,0.33,0.26,51.73,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,Multiplan,Multiplan,,,51.73,,51.73,0.26,51.73,percent of total billed charges,,
"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,71288-402-11,NDC,both,1,mL,60.86,36.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,13.07,7.84,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Aetna,Commerical,,,46.4,,46.4,0.26,51.12,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Aetna,Middlesex Employees,,,44.5,,44.5,0.26,51.12,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Anthem,Commerical,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Anthem,Indemnity,,,45.05,,45.05,0.26,51.12,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Anthem,Individual Exchange,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Anthem,State Preferred,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Cigna,Cigna,,0.26,,,0.26,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Connecticare,Commerical,,0.33,,,0.33,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Connecticare,Exchange,,0.33,,,0.33,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,Multiplan,Multiplan,,,51.12,,51.12,0.26,51.12,percent of total billed charges,,
HEPARIN (PORCINE) 1000 UNIT/ML DIALYSIS PRN ORDER,J1644,HCPCS,25021-400-10,NDC,both,1,mL,60.14,36.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.12,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Anthem,Commerical,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Anthem,State Preferred,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Cigna,Cigna,,0.26,,,0.26,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Connecticare,Commerical,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Connecticare,Exchange,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-05,NDC,both,10,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Anthem,Commerical,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Anthem,State Preferred,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Cigna,Cigna,,0.26,,,0.26,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Connecticare,Commerical,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Connecticare,Exchange,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-30,NDC,both,10,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Anthem,Commerical,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Anthem,State Preferred,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Cigna,Cigna,,0.26,,,0.26,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Connecticare,Commerical,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Connecticare,Exchange,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7650-62,NDC,both,10,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Anthem,Commerical,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Anthem,State Preferred,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Cigna,Cigna,,0.26,,,0.26,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Connecticare,Commerical,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Connecticare,Exchange,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-01,NDC,both,10,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Anthem,Commerical,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Anthem,State Preferred,,,,,,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Cigna,Cigna,,0.26,,,0.26,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Connecticare,Commerical,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Connecticare,Exchange,,0.33,,,0.33,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,0.26,26.04,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-517-74,NDC,both,10,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,26.04,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Anthem,Commerical,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Anthem,State Preferred,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Cigna,Cigna,,0.26,,,0.26,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Connecticare,Commerical,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Connecticare,Exchange,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,0264-9577-10,NDC,both,500,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Anthem,Commerical,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Anthem,State Preferred,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Cigna,Cigna,,0.26,,,0.26,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Connecticare,Commerical,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Connecticare,Exchange,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML (50 UNIT/ML) IN DEXTROSE 5 % IV",J1644,HCPCS,63323-522-77,NDC,both,500,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Anthem,Commerical,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Anthem,State Preferred,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Cigna,Cigna,,0.26,,,0.26,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Connecticare,Commerical,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Connecticare,Exchange,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-3150-05,NDC,both,500,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Anthem,Commerical,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Anthem,State Preferred,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Cigna,Cigna,,0.26,,,0.26,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Connecticare,Commerical,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Connecticare,Exchange,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,0409-7651-13,NDC,both,500,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Anthem,Commerical,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Anthem,State Preferred,,,,,,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Cigna,Cigna,,0.26,,,0.26,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Connecticare,Commerical,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Connecticare,Exchange,,0.33,,,0.33,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,0.26,29.3,percent of total billed charges,,
"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",J1644,HCPCS,63323-518-01,NDC,both,20,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.3,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Aetna,Commerical,,,2.68,,2.68,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Aetna,Middlesex Employees,,,2.57,,2.57,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Anthem,Commerical,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Anthem,Indemnity,,,2.6,,2.6,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Anthem,Individual Exchange,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Anthem,State Preferred,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Cigna,Cigna,,0.26,,,0.26,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Connecticare,Commerical,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Connecticare,Exchange,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,Multiplan,Multiplan,,,2.95,,2.95,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-01,NDC,both,0.2,mL,3.47,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Commerical,,,26.75,,26.75,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Middlesex Employees,,,25.65,,25.65,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Commerical,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Indemnity,,,25.97,,25.97,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Individual Exchange,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Anthem,State Preferred,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Cigna,Cigna,,0.26,,,0.26,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Commerical,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Exchange,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,Multiplan,Multiplan,,,29.47,,29.47,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,25021-402-10,NDC,both,0.2,mL,34.67,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Commerical,,,26.75,,26.75,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Middlesex Employees,,,25.65,,25.65,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Commerical,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Indemnity,,,25.97,,25.97,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Individual Exchange,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Anthem,State Preferred,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Cigna,Cigna,,0.26,,,0.26,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Commerical,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Exchange,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,Multiplan,Multiplan,,,29.47,,29.47,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-047-10,NDC,both,0.2,mL,34.67,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Aetna,Commerical,,,2.68,,2.68,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Aetna,Middlesex Employees,,,2.57,,2.57,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Anthem,Commerical,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Anthem,Indemnity,,,2.6,,2.6,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Anthem,Individual Exchange,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Anthem,State Preferred,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Cigna,Cigna,,0.26,,,0.26,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Connecticare,Commerical,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Connecticare,Exchange,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,Multiplan,Multiplan,,,2.95,,2.95,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-03,NDC,both,0.2,mL,3.47,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Aetna,Commerical,,,2.68,,2.68,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Aetna,Middlesex Employees,,,2.57,,2.57,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Anthem,Commerical,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Anthem,Indemnity,,,2.6,,2.6,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Anthem,Individual Exchange,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Anthem,State Preferred,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Cigna,Cigna,,0.26,,,0.26,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Connecticare,Commerical,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Connecticare,Exchange,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,Multiplan,Multiplan,,,2.95,,2.95,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-09,NDC,both,0.2,mL,3.47,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Aetna,Commerical,,,2.68,,2.68,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Aetna,Middlesex Employees,,,2.57,,2.57,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Anthem,Commerical,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Anthem,Indemnity,,,2.6,,2.6,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Anthem,Individual Exchange,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Anthem,State Preferred,,,,,,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Cigna,Cigna,,0.26,,,0.26,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Connecticare,Commerical,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Connecticare,Exchange,,0.33,,,0.33,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,Multiplan,Multiplan,,,2.95,,2.95,0.26,2.95,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63323-262-26,NDC,both,0.2,mL,3.47,2.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,2.95,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Aetna,Commerical,,,26.75,,26.75,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Aetna,Middlesex Employees,,,25.65,,25.65,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Anthem,Commerical,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Anthem,Indemnity,,,25.97,,25.97,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Anthem,Individual Exchange,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Anthem,State Preferred,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Cigna,Cigna,,0.26,,,0.26,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Connecticare,Commerical,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Connecticare,Exchange,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,Multiplan,Multiplan,,,29.47,,29.47,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,63739-901-28,NDC,both,0.2,mL,34.67,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Commerical,,,26.75,,26.75,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Aetna,Middlesex Employees,,,25.65,,25.65,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Commerical,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Indemnity,,,25.97,,25.97,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Anthem,Individual Exchange,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Anthem,State Preferred,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Cigna,Cigna,,0.26,,,0.26,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Commerical,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Connecticare,Exchange,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,Multiplan,Multiplan,,,29.47,,29.47,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-10,NDC,both,0.2,mL,34.67,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Aetna,Commerical,,,26.75,,26.75,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Aetna,Middlesex Employees,,,25.65,,25.65,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Anthem,Commerical,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Anthem,Indemnity,,,25.97,,25.97,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Anthem,Individual Exchange,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Anthem,State Preferred,,,,,,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Cigna,Cigna,,0.26,,,0.26,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Connecticare,Commerical,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Connecticare,Exchange,,0.33,,,0.33,0.26,29.47,Other,Could be inpatient or outpatient,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,Multiplan,Multiplan,,,29.47,,29.47,0.26,29.47,percent of total billed charges,,
"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",J1644,HCPCS,67457-383-99,NDC,both,0.2,mL,34.67,20.8,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,29.47,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Aetna,Commerical,,,50.98,,50.98,0.02,56.16,percent of total billed charges,,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Aetna,Middlesex Employees,,,48.89,,48.89,0.02,56.16,percent of total billed charges,,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Anthem,Commerical,,,,,,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Anthem,Indemnity,,,49.49,,49.49,0.02,56.16,percent of total billed charges,,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Anthem,Individual Exchange,,,,,,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Anthem,State Preferred,,,,,,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Cigna,Cigna,,0.02,,,0.02,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Connecticare,Commerical,,0.03,,,0.03,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Connecticare,Exchange,,0.03,,,0.03,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,Multiplan,Multiplan,,,56.16,,56.16,0.02,56.16,percent of total billed charges,,
HEPARIN 1 UNIT/ML SYRINGE,J1642,HCPCS,70092-1216-50,NDC,both,10,mL,66.07,39.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,56.16,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Commerical,,,46.96,,46.96,3.86,51.73,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Aetna,Middlesex Employees,,,45.03,,45.03,3.86,51.73,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Commerical,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Indemnity,,,45.59,,45.59,3.86,51.73,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,Individual Exchange,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Anthem,State Preferred,,,,,,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Cigna,Cigna,,3.86,,,3.86,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Commerical,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Connecticare,Exchange,,5.7,,,5.7,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,Multiplan,Multiplan,,,51.73,,51.73,3.86,51.73,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1643,HCPCS,0409-2720-31,NDC,both,1,mL,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.17,,,4.17,3.86,51.73,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Aetna,Commerical,,,3.5,,3.5,0.26,3.85,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Aetna,Middlesex Employees,,,3.35,,3.35,0.26,3.85,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Anthem,Commerical,,,,,,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Anthem,Indemnity,,,3.39,,3.39,0.26,3.85,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Anthem,Individual Exchange,,,,,,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Anthem,State Preferred,,,,,,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Cigna,Cigna,,0.26,,,0.26,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Connecticare,Commerical,,0.33,,,0.33,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Connecticare,Exchange,,0.33,,,0.33,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,Multiplan,Multiplan,,,3.85,,3.85,0.26,3.85,percent of total billed charges,,
HEPARIN 1000 UNIT/ML DIALYSIS CONTINOUS ORDER,J1644,HCPCS,40810-0204-37,NDC,both,6,mL,4.53,2.72,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,3.85,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Aetna,Commerical,,,46.4,,46.4,0.26,51.12,percent of total billed charges,,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Aetna,Middlesex Employees,,,44.5,,44.5,0.26,51.12,percent of total billed charges,,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Anthem,Commerical,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Anthem,Indemnity,,,45.05,,45.05,0.26,51.12,percent of total billed charges,,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Anthem,Individual Exchange,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Anthem,State Preferred,,,,,,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Cigna,Cigna,,0.26,,,0.26,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Connecticare,Commerical,,0.33,,,0.33,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Connecticare,Exchange,,0.33,,,0.33,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,Multiplan,Multiplan,,,51.12,,51.12,0.26,51.12,percent of total billed charges,,
HEPARIN 40 UNITS/ML IV DILUTION,J1644,HCPCS,40810-0200-93,NDC,both,25,mL,60.14,36.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,51.12,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Aetna,Commerical,,,1.6,,1.6,0.02,1.76,percent of total billed charges,,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Aetna,Middlesex Employees,,,1.53,,1.53,0.02,1.76,percent of total billed charges,,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Commerical,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Indemnity,,,1.55,,1.55,0.02,1.76,percent of total billed charges,,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Individual Exchange,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,State Preferred,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Cigna,Cigna,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Connecticare,Commerical,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Connecticare,Exchange,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Multiplan,Multiplan,,,1.76,,1.76,0.02,1.76,percent of total billed charges,,
HEPARIN BOLUS 100 UNIT/ML INTRAVENOUS,J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Aetna,Commerical,,,4.58,,4.58,0.02,5.05,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Aetna,Middlesex Employees,,,4.4,,4.4,0.02,5.05,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Anthem,Commerical,,,,,,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Anthem,Indemnity,,,4.45,,4.45,0.02,5.05,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Anthem,Individual Exchange,,,,,,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Anthem,State Preferred,,,,,,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Cigna,Cigna,,0.02,,,0.02,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Connecticare,Commerical,,0.03,,,0.03,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Connecticare,Exchange,,0.03,,,0.03,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,Multiplan,Multiplan,,,5.05,,5.05,0.02,5.05,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-01,NDC,both,0.1,mL,5.94,3.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,5.05,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Aetna,Commerical,,,5.89,,5.89,0.02,6.49,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Aetna,Middlesex Employees,,,5.65,,5.65,0.02,6.49,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Anthem,Commerical,,,,,,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Anthem,Indemnity,,,5.72,,5.72,0.02,6.49,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Anthem,Individual Exchange,,,,,,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Anthem,State Preferred,,,,,,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Cigna,Cigna,,0.02,,,0.02,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Connecticare,Commerical,,0.03,,,0.03,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Connecticare,Exchange,,0.03,,,0.03,0.02,6.49,Other,Could be inpatient or outpatient,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,Multiplan,Multiplan,,,6.49,,6.49,0.02,6.49,percent of total billed charges,,
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,J1642,HCPCS,63323-545-05,NDC,both,0.1,mL,7.63,4.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,6.49,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,0.02,1.73,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,0.02,1.73,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Anthem,Commerical,,,,,,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,0.02,1.73,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Anthem,Individual Exchange,,,,,,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Anthem,State Preferred,,,,,,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Cigna,Cigna,,0.02,,,0.02,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Connecticare,Commerical,,0.03,,,0.03,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Connecticare,Exchange,,0.03,,,0.03,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,0.02,1.73,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425322233,NDC,both,1,mL,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.73,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Aetna,Commerical,,,1.36,,1.36,0.02,1.5,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Aetna,Middlesex Employees,,,1.3,,1.3,0.02,1.5,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Anthem,Commerical,,,,,,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Anthem,Indemnity,,,1.32,,1.32,0.02,1.5,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Anthem,Individual Exchange,,,,,,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Anthem,State Preferred,,,,,,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Cigna,Cigna,,0.02,,,0.02,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Connecticare,Commerical,,0.03,,,0.03,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Connecticare,Exchange,,0.03,,,0.03,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,Multiplan,Multiplan,,,1.5,,1.5,0.02,1.5,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306413,NDC,both,1,mL,1.76,1.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.5,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Anthem,Commerical,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Anthem,Individual Exchange,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Anthem,State Preferred,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Cigna,Cigna,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Connecticare,Commerical,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Connecticare,Exchange,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333323,NDC,both,1,mL,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Anthem,Commerical,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Anthem,Individual Exchange,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Anthem,State Preferred,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Cigna,Cigna,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Connecticare,Commerical,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Connecticare,Exchange,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333333,NDC,both,1,mL,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Aetna,Commerical,,,1.6,,1.6,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Aetna,Middlesex Employees,,,1.53,,1.53,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Commerical,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Indemnity,,,1.55,,1.55,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,Individual Exchange,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Anthem,State Preferred,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Cigna,Cigna,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Connecticare,Commerical,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Connecticare,Exchange,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,Multiplan,Multiplan,,,1.76,,1.76,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,6425333335,NDC,both,1,mL,2.07,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Anthem,Commerical,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Anthem,Individual Exchange,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Anthem,State Preferred,,,,,,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Cigna,Cigna,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Connecticare,Commerical,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Connecticare,Exchange,,0.03,,,0.03,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.02,1.06,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306423,NDC,both,1,mL,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.06,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Aetna,Commerical,,,1.6,,1.6,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Aetna,Middlesex Employees,,,1.53,,1.53,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Anthem,Commerical,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Anthem,Indemnity,,,1.55,,1.55,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Anthem,Individual Exchange,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Anthem,State Preferred,,,,,,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Cigna,Cigna,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Connecticare,Commerical,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Connecticare,Exchange,,0.03,,,0.03,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,Multiplan,Multiplan,,,1.76,,1.76,0.02,1.76,percent of total billed charges,,
"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",J1642,HCPCS,8290306513,NDC,both,1,mL,2.07,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.02,,,0.02,0.02,1.76,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Aetna,Commerical,,,198.89,,198.89,86.08,219.1,percent of total billed charges,,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Aetna,Middlesex Employees,,,190.72,,190.72,86.08,219.1,percent of total billed charges,,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Anthem,Commerical,,107.59,,,107.59,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Anthem,Indemnity,,,193.09,,193.09,86.08,219.1,percent of total billed charges,,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Anthem,Individual Exchange,,86.08,,,86.08,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Anthem,State Preferred,,107.59,,,107.59,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Cigna,Cigna,,,,,,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Connecticare,Commerical,,,,,,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Connecticare,Exchange,,,,,,86.08,219.1,Other,Could be inpatient or outpatient,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,Multiplan,Multiplan,,,219.1,,219.1,86.08,219.1,percent of total billed charges,,
"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",90632,HCPCS,58160-826-52,NDC,both,1,mL,257.76,154.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.08,219.1,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Aetna,Commerical,,,81.69,,81.69,46.42,89.99,percent of total billed charges,,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Aetna,Middlesex Employees,,,78.33,,78.33,46.42,89.99,percent of total billed charges,,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Anthem,Commerical,,58.03,,,58.03,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Anthem,Indemnity,,,79.31,,79.31,46.42,89.99,percent of total billed charges,,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Anthem,Individual Exchange,,46.42,,,46.42,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Anthem,State Preferred,,58.03,,,58.03,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Cigna,Cigna,,,,,,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Connecticare,Commerical,,,,,,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Connecticare,Exchange,,,,,,46.42,89.99,Other,Could be inpatient or outpatient,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,Multiplan,Multiplan,,,89.99,,89.99,46.42,89.99,percent of total billed charges,,
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE,90633,HCPCS,58160-825-52,NDC,both,0.5,mL,105.87,63.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.42,89.99,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Aetna,Commerical,,,1984.18,,1984.18,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Aetna,Middlesex Employees,,,1902.66,,1902.66,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Anthem,Commerical,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Anthem,Indemnity,,,1926.32,,1926.32,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Anthem,Individual Exchange,,170.89,,,170.89,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Anthem,State Preferred,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Cigna,Cigna,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Connecticare,Commerical,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Connecticare,Exchange,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,Multiplan,Multiplan,,,2185.78,,2185.78,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,59730-4203-1,NDC,both,5,mL,2571.51,1542.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Aetna,Commerical,,,1984.18,,1984.18,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Aetna,Middlesex Employees,,,1902.66,,1902.66,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Anthem,Commerical,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Anthem,Indemnity,,,1926.32,,1926.32,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Anthem,Individual Exchange,,170.89,,,170.89,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Anthem,State Preferred,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Cigna,Cigna,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Connecticare,Commerical,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Connecticare,Exchange,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,Multiplan,Multiplan,,,2185.78,,2185.78,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-1,NDC,both,1,mL,2571.51,1542.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Aetna,Commerical,,,1984.18,,1984.18,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Aetna,Middlesex Employees,,,1902.66,,1902.66,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Anthem,Commerical,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Anthem,Indemnity,,,1926.32,,1926.32,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Anthem,Individual Exchange,,170.89,,,170.89,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Anthem,State Preferred,,213.62,,,213.62,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Cigna,Cigna,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Connecticare,Commerical,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Connecticare,Exchange,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,Multiplan,Multiplan,,,2185.78,,2185.78,170.89,2185.78,percent of total billed charges,,
"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",90371,HCPCS,69800-4203-2,NDC,both,1,mL,2571.51,1542.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.89,2185.78,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Aetna,Commerical,,,507.98,,507.98,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Aetna,Middlesex Employees,,,487.11,,487.11,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Anthem,Commerical,,213.62,,,213.62,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Anthem,Indemnity,,,493.16,,493.16,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Anthem,Individual Exchange,,170.89,,,170.89,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Anthem,State Preferred,,213.62,,,213.62,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Cigna,Cigna,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Connecticare,Commerical,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Connecticare,Exchange,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,Multiplan,Multiplan,,,559.59,,559.59,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,59730-4202-1,NDC,both,1,mL,658.34,395,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Aetna,Commerical,,,507.98,,507.98,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Aetna,Middlesex Employees,,,487.11,,487.11,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Anthem,Commerical,,213.62,,,213.62,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Anthem,Indemnity,,,493.16,,493.16,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Anthem,Individual Exchange,,170.89,,,170.89,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Anthem,State Preferred,,213.62,,,213.62,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Cigna,Cigna,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Connecticare,Commerical,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Connecticare,Exchange,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,Multiplan,Multiplan,,,559.59,,559.59,170.89,559.59,percent of total billed charges,,
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSCULAR SOLN,90371,HCPCS,69800-4202-1,NDC,both,1,mL,658.34,395,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.89,559.59,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Aetna,Commerical,,,139,,139,91.78,153.12,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Aetna,Middlesex Employees,,,133.29,,133.29,91.78,153.12,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Anthem,Commerical,,114.72,,,114.72,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Anthem,Indemnity,,,134.94,,134.94,91.78,153.12,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Anthem,Individual Exchange,,91.78,,,91.78,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Anthem,State Preferred,,114.72,,,114.72,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Cigna,Cigna,,,,,,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Connecticare,Commerical,,,,,,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Connecticare,Exchange,,,,,,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,Multiplan,Multiplan,,,153.12,,153.12,91.78,153.12,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP,90743,HCPCS,58160-821-11,NDC,both,0.5,mL,180.14,108.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.78,153.12,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Aetna,Commerical,,,313.05,,313.05,300.19,344.86,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Aetna,Middlesex Employees,,,300.19,,300.19,300.19,344.86,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Anthem,Commerical,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Anthem,Indemnity,,,303.92,,303.92,300.19,344.86,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Anthem,Individual Exchange,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Anthem,State Preferred,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Cigna,Cigna,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Connecticare,Commerical,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Connecticare,Exchange,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,Multiplan,Multiplan,,,344.86,,344.86,300.19,344.86,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,J3490,HCPCS,0006-4992-00,NDC,both,1,mL,405.72,243.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,300.19,344.86,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Aetna,Commerical,,,60.72,,60.72,37.58,66.89,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Aetna,Middlesex Employees,,,58.22,,58.22,37.58,66.89,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Anthem,Commerical,,46.97,,,46.97,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Anthem,Indemnity,,,58.95,,58.95,37.58,66.89,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Anthem,Individual Exchange,,37.58,,,37.58,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Anthem,State Preferred,,46.97,,,46.97,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Cigna,Cigna,,,,,,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Connecticare,Commerical,,,,,,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Connecticare,Exchange,,,,,,37.58,66.89,Other,Could be inpatient or outpatient,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,Multiplan,Multiplan,,,66.89,,66.89,37.58,66.89,percent of total billed charges,,
HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,90744,HCPCS,0006-4981-00,NDC,both,0.5,mL,78.69,47.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.58,66.89,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Anthem,Commerical,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Anthem,State Preferred,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Cigna,Cigna,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Connecticare,Commerical,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Connecticare,Exchange,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0264-1965-10,NDC,both,500,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Anthem,Commerical,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Anthem,State Preferred,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Cigna,Cigna,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Connecticare,Commerical,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Connecticare,Exchange,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,36.84,42.32,percent of total billed charges,,
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7248-03,NDC,both,1,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.84,42.32,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Aetna,Commerical,,,57633.21,,57633.21,49898.82,69248.92,percent of total billed charges,,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Aetna,Middlesex Employees,,,55265.44,,55265.44,49898.82,69248.92,percent of total billed charges,,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Anthem,Commerical,,,,,,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Anthem,Indemnity,,,55952.62,,55952.62,49898.82,69248.92,percent of total billed charges,,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Anthem,Individual Exchange,,,,,,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Anthem,State Preferred,,,,,,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Cigna,Cigna,,49898.82,,,49898.82,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Connecticare,Commerical,,69248.92,,,69248.92,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Connecticare,Exchange,,69248.92,,,69248.92,49898.82,69248.92,Other,Could be inpatient or outpatient,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,Multiplan,Multiplan,,,63489.15,,63489.15,49898.82,69248.92,percent of total billed charges,,
HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,J9226,HCPCS,67979-002-01,NDC,both,1,ea,74693.12,44815.87,United Healthcare/Oxford,United Healthcare/Oxford,,53873.07,,,53873.07,49898.82,69248.92,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Aetna,Commerical,,,4.73,,4.73,4.54,5.21,percent of total billed charges,,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Aetna,Middlesex Employees,,,4.54,,4.54,4.54,5.21,percent of total billed charges,,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Anthem,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Anthem,Indemnity,,,4.59,,4.59,4.54,5.21,percent of total billed charges,,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Anthem,Individual Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Anthem,State Preferred,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Cigna,Cigna,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Connecticare,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Connecticare,Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,Multiplan,Multiplan,,,5.21,,5.21,4.54,5.21,percent of total billed charges,,
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,C9132,HCPCS,63833-386-02,NDC,both,1,ea,6.13,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Aetna,Commerical,,,4.73,,4.73,4.54,5.21,percent of total billed charges,,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Aetna,Middlesex Employees,,,4.54,,4.54,4.54,5.21,percent of total billed charges,,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Anthem,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Anthem,Indemnity,,,4.59,,4.59,4.54,5.21,percent of total billed charges,,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Anthem,Individual Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Anthem,State Preferred,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Cigna,Cigna,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Connecticare,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Connecticare,Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,Multiplan,Multiplan,,,5.21,,5.21,4.54,5.21,percent of total billed charges,,
"HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",C9132,HCPCS,63833-387-02,NDC,both,1,ea,6.13,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Aetna,Commerical,,,616.61,,616.61,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Aetna,Middlesex Employees,,,591.28,,591.28,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Anthem,Commerical,,469.6,,,469.6,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Anthem,Indemnity,,,598.63,,598.63,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Anthem,Individual Exchange,,375.68,,,375.68,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Anthem,State Preferred,,469.6,,,469.6,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Cigna,Cigna,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Connecticare,Commerical,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Connecticare,Exchange,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,Multiplan,Multiplan,,,679.26,,679.26,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-01,NDC,both,0.5,mL,799.13,479.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Aetna,Commerical,,,616.61,,616.61,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Aetna,Middlesex Employees,,,591.28,,591.28,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Anthem,Commerical,,469.6,,,469.6,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Anthem,Indemnity,,,598.63,,598.63,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Anthem,Individual Exchange,,375.68,,,375.68,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Anthem,State Preferred,,469.6,,,469.6,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Cigna,Cigna,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Connecticare,Commerical,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Connecticare,Exchange,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,Multiplan,Multiplan,,,679.26,,679.26,375.68,679.26,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION",90651,HCPCS,0006-4119-03,NDC,both,0.5,mL,799.13,479.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,375.68,679.26,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Aetna,Commerical,,,793.48,,793.48,375.68,874.11,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Aetna,Middlesex Employees,,,760.88,,760.88,375.68,874.11,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Anthem,Commerical,,469.6,,,469.6,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Anthem,Indemnity,,,770.34,,770.34,375.68,874.11,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Anthem,Individual Exchange,,375.68,,,375.68,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Anthem,State Preferred,,469.6,,,469.6,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Cigna,Cigna,,,,,,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Connecticare,Commerical,,,,,,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Connecticare,Exchange,,,,,,375.68,874.11,Other,Could be inpatient or outpatient,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,Multiplan,Multiplan,,,874.11,,874.11,375.68,874.11,percent of total billed charges,,
"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",90651,HCPCS,0006-4121-02,NDC,both,0.5,mL,1028.36,617.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,375.68,874.11,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Aetna,Commerical,,,357.07,,357.07,0.45,393.35,percent of total billed charges,,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Aetna,Middlesex Employees,,,342.4,,342.4,0.45,393.35,percent of total billed charges,,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Anthem,Commerical,,,,,,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Anthem,Indemnity,,,346.66,,346.66,0.45,393.35,percent of total billed charges,,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Anthem,Individual Exchange,,,,,,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Anthem,State Preferred,,,,,,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Cigna,Cigna,,0.58,,,0.58,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Connecticare,Commerical,,0.76,,,0.76,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Connecticare,Exchange,,0.76,,,0.76,0.45,393.35,Other,Could be inpatient or outpatient,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,Multiplan,Multiplan,,,393.35,,393.35,0.45,393.35,percent of total billed charges,,
HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,J3471,HCPCS,24208-002-02,NDC,both,0.005,mL,462.77,277.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.45,,,0.45,0.45,393.35,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Aetna,Commerical,,,146.16,,146.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Aetna,Middlesex Employees,,,140.16,,140.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Anthem,Commerical,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Anthem,Indemnity,,,141.9,,141.9,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Anthem,Individual Exchange,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Anthem,State Preferred,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Cigna,Cigna,,0.41,,,0.41,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Connecticare,Commerical,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Connecticare,Exchange,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,Multiplan,Multiplan,,,161.02,,161.02,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 15 UNIT/ML INJECTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,190.19,114.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.44,,,0.44,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Aetna,Commerical,,,146.16,,146.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Aetna,Middlesex Employees,,,140.16,,140.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Anthem,Commerical,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Anthem,Indemnity,,,141.9,,141.9,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Anthem,Individual Exchange,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Anthem,State Preferred,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Cigna,Cigna,,0.41,,,0.41,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Connecticare,Commerical,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Connecticare,Exchange,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,Multiplan,Multiplan,,,161.02,,161.02,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-01,NDC,both,0.007,mL,189.43,113.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.44,,,0.44,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Aetna,Commerical,,,146.16,,146.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Aetna,Middlesex Employees,,,140.16,,140.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Anthem,Commerical,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Anthem,Indemnity,,,141.9,,141.9,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Anthem,Individual Exchange,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Anthem,State Preferred,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Cigna,Cigna,,0.41,,,0.41,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Connecticare,Commerical,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Connecticare,Exchange,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,Multiplan,Multiplan,,,161.02,,161.02,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-02,NDC,both,0.007,mL,189.43,113.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.44,,,0.44,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Aetna,Commerical,,,146.16,,146.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Aetna,Middlesex Employees,,,140.16,,140.16,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Anthem,Commerical,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Anthem,Indemnity,,,141.9,,141.9,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Anthem,Individual Exchange,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Anthem,State Preferred,,,,,,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Cigna,Cigna,,0.41,,,0.41,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Connecticare,Commerical,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Connecticare,Exchange,,0.56,,,0.56,0.41,161.02,Other,Could be inpatient or outpatient,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,Multiplan,Multiplan,,,161.02,,161.02,0.41,161.02,percent of total billed charges,,
"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",J3473,HCPCS,18657-117-04,NDC,both,0.007,mL,189.43,113.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.44,,,0.44,0.41,161.02,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Aetna,Commerical,,,472.08,,472.08,4.64,520.05,percent of total billed charges,,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Aetna,Middlesex Employees,,,452.69,,452.69,4.64,520.05,percent of total billed charges,,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Anthem,Commerical,,,,,,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Anthem,Indemnity,,,458.31,,458.31,4.64,520.05,percent of total billed charges,,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Anthem,Individual Exchange,,,,,,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Anthem,State Preferred,,,,,,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Cigna,Cigna,,4.64,,,4.64,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Connecticare,Commerical,,6.17,,,6.17,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Connecticare,Exchange,,6.17,,,6.17,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,Multiplan,Multiplan,,,520.05,,520.05,4.64,520.05,percent of total billed charges,,
HYDRALAZINE 0.2 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-59,NDC,both,100,mL,611.82,367.09,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,4.64,520.05,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Aetna,Commerical,,,46.12,,46.12,4.64,50.8,percent of total billed charges,,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Aetna,Middlesex Employees,,,44.22,,44.22,4.64,50.8,percent of total billed charges,,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Anthem,Commerical,,,,,,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Anthem,Indemnity,,,44.77,,44.77,4.64,50.8,percent of total billed charges,,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Anthem,Individual Exchange,,,,,,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Anthem,State Preferred,,,,,,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Cigna,Cigna,,4.64,,,4.64,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Connecticare,Commerical,,6.17,,,6.17,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Connecticare,Exchange,,6.17,,,6.17,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,Multiplan,Multiplan,,,50.8,,50.8,4.64,50.8,percent of total billed charges,,
HYDRALAZINE 1 MG/ML IN NS NICU,J0360,HCPCS,40810-0004-79,NDC,both,20,mL,59.77,35.86,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,4.64,50.8,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,0904-6440-61,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Aetna,Commerical,,,0.51,,0.51,0.49,0.56,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Aetna,Middlesex Employees,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Anthem,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Anthem,Indemnity,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Anthem,Individual Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Anthem,State Preferred,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Cigna,Cigna,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Connecticare,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Connecticare,Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,Multiplan,Multiplan,,,0.56,,0.56,0.49,0.56,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,23155-001-01,NDC,both,1,ea,0.66,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-01,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Aetna,Commerical,,,0.68,,0.68,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Aetna,Middlesex Employees,,,0.65,,0.65,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Anthem,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Anthem,Indemnity,,,0.66,,0.66,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Anthem,Individual Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Anthem,State Preferred,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Cigna,Cigna,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Connecticare,Commerical,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Connecticare,Exchange,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,Multiplan,Multiplan,,,0.75,,0.75,0.65,0.75,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,51079-074-20,NDC,both,1,ea,0.88,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.65,0.75,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-01,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
HYDRALAZINE 10 MG TABLET,J3490,HCPCS,68084-447-11,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Aetna,Commerical,,,9.65,,9.65,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Aetna,Middlesex Employees,,,9.25,,9.25,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Anthem,Commerical,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Anthem,Indemnity,,,9.36,,9.36,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Anthem,Individual Exchange,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Anthem,State Preferred,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Cigna,Cigna,,4.64,,,4.64,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Connecticare,Commerical,,6.17,,,6.17,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Connecticare,Exchange,,6.17,,,6.17,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,Multiplan,Multiplan,,,10.63,,10.63,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-01,NDC,both,1,mL,12.5,7.5,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,6.17,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,6.17,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Anthem,Commerical,,,,,,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,6.17,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Anthem,State Preferred,,,,,,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Cigna,Cigna,,4.64,,,4.64,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Connecticare,Commerical,,6.17,,,6.17,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Connecticare,Exchange,,6.17,,,6.17,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,6.17,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,0517-0901-25,NDC,both,1,mL,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,0.33,6.17,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Aetna,Commerical,,,9.65,,9.65,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Aetna,Middlesex Employees,,,9.25,,9.25,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Anthem,Commerical,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Anthem,Indemnity,,,9.36,,9.36,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Anthem,Individual Exchange,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Anthem,State Preferred,,,,,,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Cigna,Cigna,,4.64,,,4.64,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Connecticare,Commerical,,6.17,,,6.17,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Connecticare,Exchange,,6.17,,,6.17,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,Multiplan,Multiplan,,,10.63,,10.63,4.64,10.63,percent of total billed charges,,
HYDRALAZINE 20 MG/ML INJECTION SOLUTION,J0360,HCPCS,63323-614-01,NDC,both,1,mL,12.5,7.5,United Healthcare/Oxford,United Healthcare/Oxford,,5.01,,,5.01,4.64,10.63,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Aetna,Commerical,,,14.34,,14.34,13.75,15.79,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Aetna,Middlesex Employees,,,13.75,,13.75,13.75,15.79,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Anthem,Commerical,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Anthem,Indemnity,,,13.92,,13.92,13.75,15.79,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Anthem,Individual Exchange,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Anthem,State Preferred,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Cigna,Cigna,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Connecticare,Commerical,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Connecticare,Exchange,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,Multiplan,Multiplan,,,15.79,,15.79,13.75,15.79,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-45,NDC,both,1,mL,18.58,11.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.75,15.79,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Aetna,Commerical,,,7.17,,7.17,6.87,7.9,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Aetna,Middlesex Employees,,,6.87,,6.87,6.87,7.9,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Anthem,Commerical,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Anthem,Indemnity,,,6.96,,6.96,6.87,7.9,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Anthem,Individual Exchange,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Anthem,State Preferred,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Cigna,Cigna,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Connecticare,Commerical,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Connecticare,Exchange,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,Multiplan,Multiplan,,,7.9,,7.9,6.87,7.9,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-20,NDC,both,1,mL,9.29,5.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.87,7.9,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Aetna,Commerical,,,28.67,,28.67,27.49,31.59,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Aetna,Middlesex Employees,,,27.49,,27.49,27.49,31.59,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Anthem,Commerical,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Anthem,Indemnity,,,27.84,,27.84,27.49,31.59,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Anthem,Individual Exchange,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Anthem,State Preferred,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Cigna,Cigna,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Connecticare,Commerical,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Connecticare,Exchange,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,Multiplan,Multiplan,,,31.59,,31.59,27.49,31.59,percent of total billed charges,,
HYDRALAZINE 4 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-21,NDC,both,1,mL,37.16,22.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.49,31.59,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
HYDRALAZINE 5 MG ORAL TAB,J3490,HCPCS,40810-0003-88,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,40810-0209-21,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
HYDRALAZINE 50 MG TABLET,J3490,HCPCS,51079-076-20,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Aetna,Commerical,,,2.44,,2.44,2.34,2.69,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Aetna,Middlesex Employees,,,2.34,,2.34,2.34,2.69,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Anthem,Commerical,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Anthem,Indemnity,,,2.37,,2.37,2.34,2.69,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Anthem,Individual Exchange,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Anthem,State Preferred,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Cigna,Cigna,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Connecticare,Commerical,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Connecticare,Exchange,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,Multiplan,Multiplan,,,2.69,,2.69,2.34,2.69,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,0228-2820-11,NDC,both,1,ea,3.16,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.34,2.69,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 12.5 MG TABLET,J3490,HCPCS,40810-0001-47,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,16729-183-01,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,23155-008-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 25 MG TABLET,J3490,HCPCS,63739-128-10,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Aetna,Commerical,,,60.29,,60.29,57.82,66.42,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Aetna,Middlesex Employees,,,57.82,,57.82,57.82,66.42,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Anthem,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Anthem,Indemnity,,,58.53,,58.53,57.82,66.42,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Anthem,Individual Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Anthem,State Preferred,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Cigna,Cigna,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Connecticare,Commerical,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Connecticare,Exchange,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,Multiplan,Multiplan,,,66.42,,66.42,57.82,66.42,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0018-00,NDC,both,1,mL,78.14,46.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.82,66.42,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0001-48,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-01,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROCHLOROTHIAZIDE 6.25 MG ORAL TAB,J3490,HCPCS,60687-593-11,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Aetna,Commerical,,,2.3,,2.3,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Aetna,Middlesex Employees,,,2.2,,2.2,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Anthem,Commerical,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Anthem,Indemnity,,,2.23,,2.23,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Anthem,Individual Exchange,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Anthem,State Preferred,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Cigna,Cigna,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Connecticare,Commerical,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Connecticare,Exchange,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,Multiplan,Multiplan,,,2.53,,2.53,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-23,NDC,both,1,ea,2.98,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Aetna,Commerical,,,2.3,,2.3,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Aetna,Middlesex Employees,,,2.2,,2.2,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Anthem,Commerical,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Anthem,Indemnity,,,2.23,,2.23,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Anthem,Individual Exchange,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Anthem,State Preferred,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Cigna,Cigna,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Connecticare,Commerical,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Connecticare,Exchange,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,Multiplan,Multiplan,,,2.53,,2.53,2.2,2.53,percent of total billed charges,,
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0406-0125-62,NDC,both,1,ea,2.98,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.2,2.53,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
HYDROCODONE 2.5 MG-ACETAMINOPHEN 162.5 MG TABLET,J8499,HCPCS,40810-0017-38,NDC,both,2,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Aetna,Commerical,,,0.69,,0.69,0.66,0.76,percent of total billed charges,,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Aetna,Middlesex Employees,,,0.66,,0.66,0.66,0.76,percent of total billed charges,,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Anthem,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Anthem,Indemnity,,,0.67,,0.67,0.66,0.76,percent of total billed charges,,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Anthem,Individual Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Anthem,State Preferred,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Cigna,Cigna,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Connecticare,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Connecticare,Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,Multiplan,Multiplan,,,0.76,,0.76,0.66,0.76,percent of total billed charges,,
HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,J8499,HCPCS,0904-6824-61,NDC,both,1,ea,0.89,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Aetna,Commerical,,,10.49,,10.49,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Aetna,Middlesex Employees,,,10.06,,10.06,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Anthem,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Anthem,Indemnity,,,10.19,,10.19,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Anthem,Individual Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Anthem,State Preferred,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Cigna,Cigna,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Connecticare,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Connecticare,Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,Multiplan,Multiplan,,,11.56,,11.56,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,0121-4772-05,NDC,both,5,mL,13.6,8.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Aetna,Commerical,,,10.49,,10.49,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Aetna,Middlesex Employees,,,10.06,,10.06,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Anthem,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Anthem,Indemnity,,,10.19,,10.19,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Anthem,Individual Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Anthem,State Preferred,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Cigna,Cigna,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Connecticare,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Connecticare,Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,Multiplan,Multiplan,,,11.56,,11.56,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-01,NDC,both,5,mL,13.6,8.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Aetna,Commerical,,,10.49,,10.49,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Aetna,Middlesex Employees,,,10.06,,10.06,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Anthem,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Anthem,Indemnity,,,10.19,,10.19,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Anthem,Individual Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Anthem,State Preferred,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Cigna,Cigna,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Connecticare,Commerical,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Connecticare,Exchange,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,Multiplan,Multiplan,,,11.56,,11.56,10.06,11.56,percent of total billed charges,,
HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,J3490,HCPCS,66689-004-50,NDC,both,5,mL,13.6,8.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.06,11.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Aetna,Commerical,,,111.84,,111.84,22.43,123.2,percent of total billed charges,,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Aetna,Middlesex Employees,,,107.24,,107.24,22.43,123.2,percent of total billed charges,,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Anthem,Commerical,,,,,,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Anthem,Indemnity,,,108.57,,108.57,22.43,123.2,percent of total billed charges,,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Anthem,Individual Exchange,,,,,,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Anthem,State Preferred,,,,,,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Cigna,Cigna,,22.43,,,22.43,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Connecticare,Commerical,,29.62,,,29.62,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Connecticare,Exchange,,29.62,,,29.62,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,Multiplan,Multiplan,,,123.2,,123.2,22.43,123.2,percent of total billed charges,,
HYDROCORTISONE 0.2 MG/ML IN NS NICU,J1720,HCPCS,40810-0004-60,NDC,both,500,mL,144.94,86.96,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,123.2,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Aetna,Commerical,,,14.49,,14.49,13.9,15.96,percent of total billed charges,,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Aetna,Middlesex Employees,,,13.9,,13.9,13.9,15.96,percent of total billed charges,,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Anthem,Commerical,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Anthem,Indemnity,,,14.07,,14.07,13.9,15.96,percent of total billed charges,,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Anthem,Individual Exchange,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Anthem,State Preferred,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Cigna,Cigna,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Connecticare,Commerical,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Connecticare,Exchange,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,Multiplan,Multiplan,,,15.96,,15.96,13.9,15.96,percent of total billed charges,,
HYDROCORTISONE 0.5 % TOPICAL CREAM,J3490,HCPCS,51672-2010-2,NDC,both,1,gm,18.78,11.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.9,15.96,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Aetna,Commerical,,,4.06,,4.06,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Aetna,Middlesex Employees,,,3.89,,3.89,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Anthem,Commerical,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Anthem,Indemnity,,,3.94,,3.94,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Anthem,Individual Exchange,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Anthem,State Preferred,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Cigna,Cigna,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Connecticare,Commerical,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Connecticare,Exchange,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,Multiplan,Multiplan,,,4.47,,4.47,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,4116700220,NDC,both,1,gm,5.26,3.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Aetna,Commerical,,,4.21,,4.21,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Aetna,Middlesex Employees,,,4.03,,4.03,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Anthem,Commerical,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Anthem,Indemnity,,,4.08,,4.08,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Anthem,Individual Exchange,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Anthem,State Preferred,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Cigna,Cigna,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Connecticare,Commerical,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Connecticare,Exchange,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,Multiplan,Multiplan,,,4.63,,4.63,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0168-0015-31,NDC,both,1,gm,5.45,3.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Aetna,Commerical,,,4.06,,4.06,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Aetna,Middlesex Employees,,,3.89,,3.89,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Anthem,Commerical,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Anthem,Indemnity,,,3.94,,3.94,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Anthem,Individual Exchange,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Anthem,State Preferred,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Cigna,Cigna,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Connecticare,Commerical,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Connecticare,Exchange,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,Multiplan,Multiplan,,,4.47,,4.47,3.89,4.47,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,0536-1277-80,NDC,both,1,gm,5.26,3.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.89,4.47,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,45802-438-03,NDC,both,1,gm,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Aetna,Commerical,,,12.95,,12.95,12.42,14.26,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Aetna,Middlesex Employees,,,12.42,,12.42,12.42,14.26,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Anthem,Commerical,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Anthem,Indemnity,,,12.57,,12.57,12.42,14.26,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Anthem,Individual Exchange,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Anthem,State Preferred,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Cigna,Cigna,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Connecticare,Commerical,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Connecticare,Exchange,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,Multiplan,Multiplan,,,14.26,,14.26,12.42,14.26,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,51672-2063-2,NDC,both,1,gm,16.78,10.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.42,14.26,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Aetna,Commerical,,,4.21,,4.21,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Aetna,Middlesex Employees,,,4.03,,4.03,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Anthem,Commerical,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Anthem,Indemnity,,,4.08,,4.08,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Anthem,Individual Exchange,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Anthem,State Preferred,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Cigna,Cigna,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Connecticare,Commerical,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Connecticare,Exchange,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,Multiplan,Multiplan,,,4.63,,4.63,4.03,4.63,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL CREAM,J3490,HCPCS,70000-0485-1,NDC,both,1,gm,5.45,3.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.03,4.63,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Aetna,Commerical,,,5.63,,5.63,5.4,6.21,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Aetna,Middlesex Employees,,,5.4,,5.4,5.4,6.21,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Anthem,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Anthem,Indemnity,,,5.47,,5.47,5.4,6.21,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Anthem,Individual Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Anthem,State Preferred,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Cigna,Cigna,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Connecticare,Commerical,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Connecticare,Exchange,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,Multiplan,Multiplan,,,6.21,,6.21,5.4,6.21,percent of total billed charges,,
HYDROCORTISONE 1 % TOPICAL OINTMENT,J3490,HCPCS,45802-276-03,NDC,both,1,gm,7.3,4.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.4,6.21,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-49,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Aetna,Commerical,,,4.08,,4.08,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Aetna,Middlesex Employees,,,3.91,,3.91,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Anthem,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Anthem,Indemnity,,,3.96,,3.96,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Anthem,Individual Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Anthem,State Preferred,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Cigna,Cigna,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Connecticare,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Connecticare,Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,Multiplan,Multiplan,,,4.5,,4.5,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0115-1697-01,NDC,both,1,ea,5.29,3.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Aetna,Commerical,,,4.08,,4.08,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Aetna,Middlesex Employees,,,3.91,,3.91,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Anthem,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Anthem,Indemnity,,,3.96,,3.96,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Anthem,Individual Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Anthem,State Preferred,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Cigna,Cigna,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Connecticare,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Connecticare,Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,Multiplan,Multiplan,,,4.5,,4.5,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,0904-7188-61,NDC,both,1,ea,5.29,3.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,59762-0074-1,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Aetna,Commerical,,,4.08,,4.08,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Aetna,Middlesex Employees,,,3.91,,3.91,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Anthem,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Anthem,Indemnity,,,3.96,,3.96,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Anthem,Individual Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Anthem,State Preferred,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Cigna,Cigna,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Connecticare,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Connecticare,Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,Multiplan,Multiplan,,,4.5,,4.5,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-01,NDC,both,1,ea,5.29,3.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Aetna,Commerical,,,4.08,,4.08,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Aetna,Middlesex Employees,,,3.91,,3.91,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Anthem,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Anthem,Indemnity,,,3.96,,3.96,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Anthem,Individual Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Anthem,State Preferred,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Cigna,Cigna,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Connecticare,Commerical,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Connecticare,Exchange,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,Multiplan,Multiplan,,,4.5,,4.5,3.91,4.5,percent of total billed charges,,
HYDROCORTISONE 10 MG TABLET,J3490,HCPCS,60687-511-11,NDC,both,1,ea,5.29,3.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.91,4.5,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Aetna,Commerical,,,74.47,,74.47,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Aetna,Middlesex Employees,,,71.42,,71.42,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Anthem,Commerical,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Anthem,Indemnity,,,72.3,,72.3,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Anthem,Individual Exchange,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Anthem,State Preferred,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Cigna,Cigna,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Connecticare,Commerical,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Connecticare,Exchange,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,Multiplan,Multiplan,,,82.04,,82.04,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,0574-2020-01,NDC,both,60,mL,96.52,57.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Aetna,Commerical,,,74.47,,74.47,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Aetna,Middlesex Employees,,,71.42,,71.42,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Anthem,Commerical,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Anthem,Indemnity,,,72.3,,72.3,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Anthem,Individual Exchange,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Anthem,State Preferred,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Cigna,Cigna,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Connecticare,Commerical,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Connecticare,Exchange,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,Multiplan,Multiplan,,,82.04,,82.04,71.42,82.04,percent of total billed charges,,
HYDROCORTISONE 100 MG/60 ML ENEMA,J3490,HCPCS,62559-111-11,NDC,both,60,mL,96.52,57.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,71.42,82.04,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Aetna,Commerical,,,56.28,,56.28,22.43,62,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Aetna,Middlesex Employees,,,53.97,,53.97,22.43,62,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Anthem,Commerical,,,,,,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Anthem,Indemnity,,,54.64,,54.64,22.43,62,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Anthem,Individual Exchange,,,,,,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Anthem,State Preferred,,,,,,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Cigna,Cigna,,22.43,,,22.43,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Connecticare,Commerical,,29.62,,,29.62,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Connecticare,Exchange,,29.62,,,29.62,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,Multiplan,Multiplan,,,62,,62,22.43,62,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML IN NS,J1720,HCPCS,40810-0004-61,NDC,both,50,mL,72.94,43.76,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,62,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Aetna,Commerical,,,184.77,,184.77,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Aetna,Middlesex Employees,,,177.18,,177.18,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Commerical,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Indemnity,,,179.38,,179.38,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Individual Exchange,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,State Preferred,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Cigna,Cigna,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Connecticare,Commerical,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Connecticare,Exchange,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Multiplan,Multiplan,,,203.54,,203.54,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Aetna,Commerical,,,369.53,,369.53,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Aetna,Middlesex Employees,,,354.35,,354.35,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Commerical,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Indemnity,,,358.75,,358.75,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Individual Exchange,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,State Preferred,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Cigna,Cigna,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Connecticare,Commerical,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Connecticare,Exchange,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Multiplan,Multiplan,,,407.07,,407.07,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Aetna,Commerical,,,184.77,,184.77,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Aetna,Middlesex Employees,,,177.18,,177.18,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Commerical,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Indemnity,,,179.38,,179.38,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,Individual Exchange,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Anthem,State Preferred,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Cigna,Cigna,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Connecticare,Commerical,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Connecticare,Exchange,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,Multiplan,Multiplan,,,203.54,,203.54,177.18,203.54,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0001-50,NDC,both,1,mL,239.46,143.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,177.18,203.54,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Aetna,Commerical,,,369.53,,369.53,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Aetna,Middlesex Employees,,,354.35,,354.35,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Commerical,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Indemnity,,,358.75,,358.75,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,Individual Exchange,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Anthem,State Preferred,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Cigna,Cigna,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Connecticare,Commerical,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Connecticare,Exchange,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,Multiplan,Multiplan,,,407.07,,407.07,354.35,407.07,percent of total billed charges,,
HYDROCORTISONE 2 MG/ML ORAL SUSP NICU,J3490,HCPCS,40810-0003-62,NDC,both,1,mL,478.91,287.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.35,407.07,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0080-31,NDC,both,1,gm,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Aetna,Commerical,,,6.86,,6.86,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Aetna,Middlesex Employees,,,6.58,,6.58,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Anthem,Commerical,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Anthem,Indemnity,,,6.66,,6.66,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Anthem,Individual Exchange,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Anthem,State Preferred,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Cigna,Cigna,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Connecticare,Commerical,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Connecticare,Exchange,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,Multiplan,Multiplan,,,7.56,,7.56,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0316-0193-20,NDC,both,1,gm,8.89,5.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Aetna,Commerical,,,14.54,,14.54,13.95,16.02,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Aetna,Middlesex Employees,,,13.95,,13.95,13.95,16.02,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Anthem,Commerical,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Anthem,Indemnity,,,14.12,,14.12,13.95,16.02,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Anthem,Individual Exchange,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Anthem,State Preferred,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Cigna,Cigna,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Connecticare,Commerical,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Connecticare,Exchange,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,Multiplan,Multiplan,,,16.02,,16.02,13.95,16.02,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,0472-0337-20,NDC,both,1,gm,18.85,11.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.95,16.02,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Aetna,Commerical,,,6.86,,6.86,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Aetna,Middlesex Employees,,,6.58,,6.58,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Anthem,Commerical,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Anthem,Indemnity,,,6.66,,6.66,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Anthem,Individual Exchange,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Anthem,State Preferred,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Cigna,Cigna,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Connecticare,Commerical,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Connecticare,Exchange,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,Multiplan,Multiplan,,,7.56,,7.56,6.58,7.56,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL CREAM,J3490,HCPCS,45802-004-02,NDC,both,1,gm,8.89,5.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.58,7.56,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Aetna,Commerical,,,9.6,,9.6,9.2,10.57,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Aetna,Middlesex Employees,,,9.2,,9.2,9.2,10.57,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Anthem,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Anthem,Indemnity,,,9.32,,9.32,9.2,10.57,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Anthem,Individual Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Anthem,State Preferred,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Cigna,Cigna,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Connecticare,Commerical,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Connecticare,Exchange,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,Multiplan,Multiplan,,,10.57,,10.57,9.2,10.57,percent of total billed charges,,
HYDROCORTISONE 2.5 % TOPICAL OINTMENT,J3490,HCPCS,0168-0146-30,NDC,both,1,gm,12.44,7.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.2,10.57,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.78,0.89,percent of total billed charges,,
HYDROCORTISONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-52,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Aetna,Commerical,,,1.08,,1.08,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Aetna,Middlesex Employees,,,1.04,,1.04,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Anthem,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Anthem,Indemnity,,,1.05,,1.05,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Anthem,Individual Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Anthem,State Preferred,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Cigna,Cigna,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Connecticare,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Connecticare,Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,Multiplan,Multiplan,,,1.19,,1.19,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,0115-1700-01,NDC,both,1,ea,1.4,0.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Aetna,Commerical,,,1.08,,1.08,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Aetna,Middlesex Employees,,,1.04,,1.04,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Anthem,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Anthem,Indemnity,,,1.05,,1.05,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Anthem,Individual Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Anthem,State Preferred,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Cigna,Cigna,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Connecticare,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Connecticare,Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,Multiplan,Multiplan,,,1.19,,1.19,1.04,1.19,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,40810-0007-11,NDC,both,1,ea,1.4,0.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Aetna,Commerical,,,2.53,,2.53,2.43,2.79,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Aetna,Middlesex Employees,,,2.43,,2.43,2.43,2.79,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Anthem,Commerical,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Anthem,Indemnity,,,2.46,,2.46,2.43,2.79,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Anthem,Individual Exchange,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Anthem,State Preferred,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Cigna,Cigna,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Connecticare,Commerical,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Connecticare,Exchange,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,Multiplan,Multiplan,,,2.79,,2.79,2.43,2.79,percent of total billed charges,,
HYDROCORTISONE 20 MG TABLET,J3490,HCPCS,59762-0075-1,NDC,both,1,ea,3.28,1.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0009-0012-01,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,0115-1696-06,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,40810-0008-57,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
HYDROCORTISONE 5 MG TABLET,J3490,HCPCS,59762-0073-1,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,71.62,42.97,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE 50 MG/ML IV BOLUS,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,71.62,42.97,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Aetna,Commerical,,,41.87,,41.87,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Aetna,Middlesex Employees,,,40.15,,40.15,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Anthem,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Anthem,Indemnity,,,40.65,,40.65,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Anthem,Individual Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Anthem,State Preferred,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Cigna,Cigna,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Connecticare,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Connecticare,Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,Multiplan,Multiplan,,,46.12,,46.12,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-06,NDC,both,1,ea,54.26,32.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Aetna,Commerical,,,41.87,,41.87,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Aetna,Middlesex Employees,,,40.15,,40.15,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Anthem,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Anthem,Indemnity,,,40.65,,40.65,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Anthem,Individual Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Anthem,State Preferred,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Cigna,Cigna,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Connecticare,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Connecticare,Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,Multiplan,Multiplan,,,46.12,,46.12,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,0713-0503-12,NDC,both,1,ea,54.26,32.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Aetna,Commerical,,,41.87,,41.87,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Aetna,Middlesex Employees,,,40.15,,40.15,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Indemnity,,,40.65,,40.65,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Individual Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Anthem,State Preferred,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Cigna,Cigna,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Connecticare,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Connecticare,Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,Multiplan,Multiplan,,,46.12,,46.12,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,42494-301-12,NDC,both,1,ea,54.26,32.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Aetna,Commerical,,,41.87,,41.87,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Aetna,Middlesex Employees,,,40.15,,40.15,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Indemnity,,,40.65,,40.65,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Anthem,Individual Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Anthem,State Preferred,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Cigna,Cigna,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Connecticare,Commerical,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Connecticare,Exchange,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,Multiplan,Multiplan,,,46.12,,46.12,40.15,46.12,percent of total billed charges,,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,J3490,HCPCS,59741-301-12,NDC,both,1,ea,54.26,32.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.15,46.12,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCC (PF) 50 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,108.41,65.05,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,25.21,15.13,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/ ML SOLN FOR IFC,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,25.21,15.13,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-03,NDC,both,1,ea,70.71,42.43,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Aetna,Commerical,,,54.56,,54.56,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Aetna,Middlesex Employees,,,52.32,,52.32,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Anthem,Commerical,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Anthem,Indemnity,,,52.97,,52.97,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Anthem,Individual Exchange,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Anthem,State Preferred,,,,,,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Cigna,Cigna,,22.43,,,22.43,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Connecticare,Commerical,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Connecticare,Exchange,,29.62,,,29.62,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,Multiplan,Multiplan,,,60.1,,60.1,22.43,60.1,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0011-04,NDC,both,1,ea,70.71,42.43,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,60.1,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Aetna,Commerical,,,102.23,,102.23,22.43,112.62,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Aetna,Middlesex Employees,,,98.03,,98.03,22.43,112.62,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Anthem,Commerical,,,,,,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Anthem,Indemnity,,,99.25,,99.25,22.43,112.62,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Anthem,Individual Exchange,,,,,,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Anthem,State Preferred,,,,,,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Cigna,Cigna,,22.43,,,22.43,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Connecticare,Commerical,,29.62,,,29.62,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Connecticare,Exchange,,29.62,,,29.62,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,Multiplan,Multiplan,,,112.62,,112.62,22.43,112.62,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-05,NDC,both,1,ea,132.49,79.49,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,112.62,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Aetna,Commerical,,,122.68,,122.68,22.43,135.14,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Aetna,Middlesex Employees,,,117.64,,117.64,22.43,135.14,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Anthem,Commerical,,,,,,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Anthem,Indemnity,,,119.1,,119.1,22.43,135.14,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Anthem,Individual Exchange,,,,,,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Anthem,State Preferred,,,,,,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Cigna,Cigna,,22.43,,,22.43,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Connecticare,Commerical,,29.62,,,29.62,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Connecticare,Exchange,,29.62,,,29.62,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,Multiplan,Multiplan,,,135.14,,135.14,22.43,135.14,percent of total billed charges,,
HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,J1720,HCPCS,0009-0013-06,NDC,both,0.4,ea,158.99,95.39,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,135.14,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Aetna,Commerical,,,40.19,,40.19,22.43,44.28,percent of total billed charges,,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Aetna,Middlesex Employees,,,38.54,,38.54,22.43,44.28,percent of total billed charges,,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Anthem,Commerical,,,,,,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Anthem,Indemnity,,,39.02,,39.02,22.43,44.28,percent of total billed charges,,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Anthem,Individual Exchange,,,,,,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Anthem,State Preferred,,,,,,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Cigna,Cigna,,22.43,,,22.43,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Connecticare,Commerical,,29.62,,,29.62,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Connecticare,Exchange,,29.62,,,29.62,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,Multiplan,Multiplan,,,44.28,,44.28,22.43,44.28,percent of total billed charges,,
HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,J1720,HCPCS,0009-0825-01,NDC,both,1,ea,52.09,31.25,United Healthcare/Oxford,United Healthcare/Oxford,,24.22,,,24.22,22.43,44.28,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Aetna,Commerical,,,46.94,,46.94,45.02,51.71,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Aetna,Middlesex Employees,,,45.02,,45.02,45.02,51.71,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Anthem,Commerical,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Anthem,Indemnity,,,45.58,,45.58,45.02,51.71,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Anthem,Individual Exchange,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Anthem,State Preferred,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Cigna,Cigna,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Connecticare,Commerical,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Connecticare,Exchange,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,Multiplan,Multiplan,,,51.71,,51.71,45.02,51.71,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,J3490,HCPCS,51672-1290-1,NDC,both,1,gm,60.84,36.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.02,51.71,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Aetna,Commerical,,,223.9,,223.9,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Aetna,Middlesex Employees,,,214.7,,214.7,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Anthem,Commerical,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Anthem,Indemnity,,,217.37,,217.37,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Anthem,Individual Exchange,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Anthem,State Preferred,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Cigna,Cigna,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Connecticare,Commerical,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Connecticare,Exchange,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,Multiplan,Multiplan,,,246.65,,246.65,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,0713-0560-15,NDC,both,1,gm,290.18,174.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Aetna,Commerical,,,223.9,,223.9,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Aetna,Middlesex Employees,,,214.7,,214.7,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Anthem,Commerical,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Anthem,Indemnity,,,217.37,,217.37,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Anthem,Individual Exchange,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Anthem,State Preferred,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Cigna,Cigna,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Connecticare,Commerical,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Connecticare,Exchange,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,Multiplan,Multiplan,,,246.65,,246.65,214.7,246.65,percent of total billed charges,,
HYDROCORTISONE VALERATE 0.2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1292-1,NDC,both,1,gm,290.18,174.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,214.7,246.65,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Aetna,Commerical,,,16.77,,16.77,16.09,18.48,percent of total billed charges,,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Aetna,Middlesex Employees,,,16.09,,16.09,16.09,18.48,percent of total billed charges,,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Anthem,Commerical,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Anthem,Indemnity,,,16.29,,16.29,16.09,18.48,percent of total billed charges,,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Anthem,Individual Exchange,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Anthem,State Preferred,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Cigna,Cigna,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Connecticare,Commerical,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Connecticare,Exchange,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,Multiplan,Multiplan,,,18.48,,18.48,16.09,18.48,percent of total billed charges,,
HYDROGEN PEROXIDE 3 % SOLUTION,J3490,HCPCS,49580-0268-3,NDC,both,1,mL,21.74,13.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.09,18.48,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Aetna,Commerical,,,253.27,,253.27,0.13,279,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Aetna,Middlesex Employees,,,242.86,,242.86,0.13,279,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Anthem,Commerical,,,,,,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Anthem,Indemnity,,,245.88,,245.88,0.13,279,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Anthem,Individual Exchange,,,,,,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Anthem,State Preferred,,,,,,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Cigna,Cigna,,,,,,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Connecticare,Commerical,,0.13,,,0.13,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Connecticare,Exchange,,0.13,,,0.13,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,Multiplan,Multiplan,,,279,,279,0.13,279,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-2634-50,NDC,both,0.01,mL,328.24,196.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,279,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Commerical,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Cigna,Cigna,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Commerical,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Exchange,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Aetna,Commerical,,,4.76,,4.76,0.13,5.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Aetna,Middlesex Employees,,,4.57,,4.57,0.13,5.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Anthem,Commerical,,,,,,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Anthem,Indemnity,,,4.62,,4.62,0.13,5.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Anthem,Individual Exchange,,,,,,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Anthem,State Preferred,,,,,,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Cigna,Cigna,,,,,,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Connecticare,Commerical,,0.13,,,0.13,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Connecticare,Exchange,,0.13,,,0.13,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,Multiplan,Multiplan,,,5.24,,5.24,0.13,5.24,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-10,NDC,both,0.01,mL,6.17,3.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,5.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Anthem,Commerical,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Anthem,Individual Exchange,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Anthem,State Preferred,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Cigna,Cigna,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Connecticare,Commerical,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Connecticare,Exchange,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3459-07,NDC,both,1,mL,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Anthem,Commerical,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Anthem,Individual Exchange,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Anthem,State Preferred,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Cigna,Cigna,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Connecticare,Commerical,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Connecticare,Exchange,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-01,NDC,both,0.05,mL,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Anthem,Commerical,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Anthem,Individual Exchange,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Anthem,State Preferred,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Cigna,Cigna,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Connecticare,Commerical,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Connecticare,Exchange,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-6151-25,NDC,both,1,mL,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Anthem,Commerical,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Anthem,Individual Exchange,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Anthem,State Preferred,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Cigna,Cigna,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Connecticare,Commerical,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Connecticare,Exchange,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-03,NDC,both,0.05,mL,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Anthem,Commerical,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Anthem,Individual Exchange,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Anthem,State Preferred,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Cigna,Cigna,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Connecticare,Commerical,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Connecticare,Exchange,,0.13,,,0.13,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,0.13,2.15,percent of total billed charges,,
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,63323-853-25,NDC,both,1,mL,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,2.15,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Aetna,Commerical,,,35.76,,35.76,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Aetna,Middlesex Employees,,,34.29,,34.29,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Indemnity,,,34.72,,34.72,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Individual Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,State Preferred,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Cigna,Cigna,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Connecticare,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Connecticare,Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Multiplan,Multiplan,,,39.4,,39.4,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML (50 ML) PCA OPIOID TOLERANT MG DOSING,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,50.54,,50.54,48.46,55.68,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,48.46,,48.46,48.46,55.68,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,49.07,,49.07,48.46,55.68,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,55.68,,55.68,48.46,55.68,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,69374-529-50,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.46,55.68,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,73177-104-05,NDC,both,1,mL,65.5,39.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Aetna,Commerical,,,35.76,,35.76,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Aetna,Middlesex Employees,,,34.29,,34.29,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Indemnity,,,34.72,,34.72,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,Individual Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Anthem,State Preferred,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Cigna,Cigna,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Connecticare,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Connecticare,Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,Multiplan,Multiplan,,,39.4,,39.4,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA ADULT,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,72.05,43.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,40810-0017-30,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,70092-9114-50,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,71266-9110-3,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,73177-104-05,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Aetna,Commerical,,,35.76,,35.76,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Aetna,Middlesex Employees,,,34.29,,34.29,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Anthem,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Anthem,Indemnity,,,34.72,,34.72,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Anthem,Individual Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Anthem,State Preferred,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Cigna,Cigna,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Connecticare,Commerical,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Connecticare,Exchange,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,Multiplan,Multiplan,,,39.4,,39.4,34.29,39.4,percent of total billed charges,,
HYDROMORPHONE 0.2 MG/ML PCA OPIOID NAIVE,J3490,HCPCS,88888-0005-88,NDC,both,55,mL,46.35,27.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.29,39.4,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
HYDROMORPHONE 1 MG ORAL TAB,J3490,HCPCS,40810-0001-53,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Aetna,Commerical,,,339.67,,339.67,325.72,374.19,percent of total billed charges,,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Aetna,Middlesex Employees,,,325.72,,325.72,325.72,374.19,percent of total billed charges,,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Anthem,Commerical,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Anthem,Indemnity,,,329.77,,329.77,325.72,374.19,percent of total billed charges,,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Anthem,Individual Exchange,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Anthem,State Preferred,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Cigna,Cigna,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Connecticare,Commerical,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Connecticare,Exchange,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,Multiplan,Multiplan,,,374.19,,374.19,325.72,374.19,percent of total billed charges,,
HYDROMORPHONE 1 MG/ML ORAL LIQUID,J3490,HCPCS,42858-304-16,NDC,both,1,mL,440.22,264.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,325.72,374.19,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Commerical,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Cigna,Cigna,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Commerical,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Exchange,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE ADULT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Commerical,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Cigna,Cigna,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Commerical,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Exchange,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE NAIVE,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-01,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Commerical,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Cigna,Cigna,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Commerical,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Connecticare,Exchange,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,32.05,19.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INJECTION SOLUTION OPIATE TOLERANT,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,30.82,18.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,0703-0113-03,NDC,both,0.4,mL,40.85,24.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Aetna,Commerical,,,5.71,,5.71,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Aetna,Middlesex Employees,,,5.48,,5.48,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Anthem,Commerical,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Anthem,Indemnity,,,5.54,,5.54,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Anthem,Individual Exchange,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Anthem,State Preferred,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Cigna,Cigna,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Connecticare,Commerical,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Connecticare,Exchange,,0.13,,,0.13,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,Multiplan,Multiplan,,,6.29,,6.29,0.13,6.29,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-01,NDC,both,0.4,mL,9.43,5.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,6.29,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Aetna,Commerical,,,24.73,,24.73,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Aetna,Middlesex Employees,,,23.71,,23.71,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Anthem,Commerical,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Anthem,Indemnity,,,24.01,,24.01,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Anthem,Individual Exchange,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Anthem,State Preferred,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Cigna,Cigna,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Connecticare,Commerical,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Connecticare,Exchange,,0.13,,,0.13,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,Multiplan,Multiplan,,,27.24,,27.24,0.13,27.24,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,17478-540-05,NDC,both,0.4,mL,40.85,24.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,27.24,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-07,NDC,both,0.01,mL,39.28,23.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Aetna,Commerical,,,23.78,,23.78,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Aetna,Middlesex Employees,,,22.8,,22.8,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Anthem,Commerical,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Anthem,Indemnity,,,23.09,,23.09,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Anthem,Individual Exchange,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Anthem,State Preferred,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Cigna,Cigna,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Connecticare,Commerical,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Connecticare,Exchange,,0.13,,,0.13,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,Multiplan,Multiplan,,,26.2,,26.2,0.13,26.2,percent of total billed charges,,
HYDROMORPHONE 10 MG/ML INTRANASAL SOLUTION,J1171,HCPCS,63323-851-15,NDC,both,0.01,mL,39.28,23.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,26.2,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.46,0.53,percent of total billed charges,,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Anthem,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Cigna,Cigna,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Connecticare,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Connecticare,Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.46,0.53,percent of total billed charges,,
HYDROMORPHONE 2 MG TABLET,J3490,HCPCS,42858-301-25,NDC,both,1,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Aetna,Commerical,,,1.9,,1.9,1.82,2.09,percent of total billed charges,,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Aetna,Middlesex Employees,,,1.82,,1.82,1.82,2.09,percent of total billed charges,,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Anthem,Commerical,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Anthem,Indemnity,,,1.84,,1.84,1.82,2.09,percent of total billed charges,,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Anthem,Individual Exchange,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Anthem,State Preferred,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Cigna,Cigna,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Connecticare,Commerical,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Connecticare,Exchange,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,Multiplan,Multiplan,,,2.09,,2.09,1.82,2.09,percent of total billed charges,,
HYDROMORPHONE 2 MG/2 ML LIQUID SYRINGE,J3490,HCPCS,40810-0014-24,NDC,both,2,mL,2.46,1.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Aetna,Commerical,,,8.01,,8.01,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Aetna,Middlesex Employees,,,7.68,,7.68,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Anthem,Commerical,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Anthem,Indemnity,,,7.78,,7.78,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Anthem,Individual Exchange,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Anthem,State Preferred,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Cigna,Cigna,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Connecticare,Commerical,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Connecticare,Exchange,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,Multiplan,Multiplan,,,8.82,,8.82,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0409-3365-01,NDC,both,1,mL,10.38,6.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Aetna,Commerical,,,8.01,,8.01,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Aetna,Middlesex Employees,,,7.68,,7.68,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Anthem,Commerical,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Anthem,Indemnity,,,7.78,,7.78,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Anthem,Individual Exchange,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Anthem,State Preferred,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Cigna,Cigna,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Connecticare,Commerical,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Connecticare,Exchange,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,Multiplan,Multiplan,,,8.82,,8.82,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-21,NDC,both,1,mL,10.38,6.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Aetna,Commerical,,,8.01,,8.01,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Aetna,Middlesex Employees,,,7.68,,7.68,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Anthem,Commerical,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Anthem,Indemnity,,,7.78,,7.78,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Anthem,Individual Exchange,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Anthem,State Preferred,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Cigna,Cigna,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Connecticare,Commerical,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Connecticare,Exchange,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,Multiplan,Multiplan,,,8.82,,8.82,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-0121-25,NDC,both,1,mL,10.38,6.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Aetna,Commerical,,,160.11,,160.11,0.13,176.38,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Aetna,Middlesex Employees,,,153.54,,153.54,0.13,176.38,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Anthem,Commerical,,,,,,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Anthem,Indemnity,,,155.45,,155.45,0.13,176.38,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Anthem,Individual Exchange,,,,,,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Anthem,State Preferred,,,,,,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Cigna,Cigna,,,,,,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Connecticare,Commerical,,0.13,,,0.13,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Connecticare,Exchange,,0.13,,,0.13,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,Multiplan,Multiplan,,,176.38,,176.38,0.13,176.38,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,0641-2341-41,NDC,both,0.05,mL,207.51,124.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,176.38,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Aetna,Commerical,,,8.01,,8.01,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Aetna,Middlesex Employees,,,7.68,,7.68,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Anthem,Commerical,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Anthem,Indemnity,,,7.78,,7.78,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Anthem,Individual Exchange,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Anthem,State Preferred,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Cigna,Cigna,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Connecticare,Commerical,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Connecticare,Exchange,,0.13,,,0.13,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,Multiplan,Multiplan,,,8.82,,8.82,0.13,8.82,percent of total billed charges,,
HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,J1171,HCPCS,76045-010-10,NDC,both,1,mL,10.38,6.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,8.82,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,0054-0264-24,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,42858-302-25,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-01,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
HYDROMORPHONE 4 MG TABLET,J3490,HCPCS,60687-590-11,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Aetna,Commerical,,,3.6,,3.6,3.45,3.96,percent of total billed charges,,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Aetna,Middlesex Employees,,,3.45,,3.45,3.45,3.96,percent of total billed charges,,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Anthem,Commerical,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Anthem,Indemnity,,,3.49,,3.49,3.45,3.96,percent of total billed charges,,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Anthem,Individual Exchange,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Anthem,State Preferred,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Cigna,Cigna,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Connecticare,Commerical,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Connecticare,Exchange,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,Multiplan,Multiplan,,,3.96,,3.96,3.45,3.96,percent of total billed charges,,
HYDROMORPHONE FOR INHALATION,J7699,HCPCS,0641-0121-21,NDC,both,1,mL,4.66,2.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.45,3.96,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Aetna,Commerical,,,118.51,,118.51,113.64,130.55,percent of total billed charges,,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Aetna,Middlesex Employees,,,113.64,,113.64,113.64,130.55,percent of total billed charges,,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Anthem,Commerical,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Anthem,Indemnity,,,115.05,,115.05,113.64,130.55,percent of total billed charges,,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Anthem,Individual Exchange,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Anthem,State Preferred,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Cigna,Cigna,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Connecticare,Commerical,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Connecticare,Exchange,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,Multiplan,Multiplan,,,130.55,,130.55,113.64,130.55,percent of total billed charges,,
HYDROQUINONE (BULK) 98% POWDER,J3490,HCPCS,51552-0066-4,NDC,both,1,gm,153.59,92.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.64,130.55,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Aetna,Commerical,,,68.98,,68.98,0.01,75.99,percent of total billed charges,,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Aetna,Middlesex Employees,,,66.15,,66.15,0.01,75.99,percent of total billed charges,,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Anthem,Commerical,,,,,,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Anthem,Indemnity,,,66.97,,66.97,0.01,75.99,percent of total billed charges,,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Anthem,Individual Exchange,,,,,,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Anthem,State Preferred,,,,,,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Cigna,Cigna,,0.01,,,0.01,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Connecticare,Commerical,,0.01,,,0.01,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Connecticare,Exchange,,0.01,,,0.01,0.01,75.99,Other,Could be inpatient or outpatient,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,Multiplan,Multiplan,,,75.99,,75.99,0.01,75.99,percent of total billed charges,,
"HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION",J3425,HCPCS,0591-2888-30,NDC,both,0.001,mL,89.4,53.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,75.99,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Aetna,Commerical,,,2756.22,,2756.22,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Aetna,Middlesex Employees,,,2642.99,,2642.99,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Commerical,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Indemnity,,,2675.85,,2675.85,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Individual Exchange,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Anthem,State Preferred,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Cigna,Cigna,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Connecticare,Commerical,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Connecticare,Exchange,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,Multiplan,Multiplan,,,3036.28,,3036.28,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,11704-370-01,NDC,both,0.001,ea,3572.09,2143.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Aetna,Commerical,,,2756.22,,2756.22,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Aetna,Middlesex Employees,,,2642.99,,2642.99,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Commerical,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Indemnity,,,2675.85,,2675.85,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Anthem,Individual Exchange,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Anthem,State Preferred,,,,,,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Cigna,Cigna,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Connecticare,Commerical,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Connecticare,Exchange,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,Multiplan,Multiplan,,,3036.28,,3036.28,0.01,3036.28,percent of total billed charges,,
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,J3425,HCPCS,50633-310-11,NDC,both,0.001,ea,3572.09,2143.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3036.28,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
HYDROXYCHLOROQUINE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-55,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Aetna,Commerical,,,3.04,,3.04,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Anthem,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Anthem,Indemnity,,,2.95,,2.95,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Anthem,Individual Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Anthem,State Preferred,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Cigna,Cigna,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Connecticare,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Connecticare,Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,Multiplan,Multiplan,,,3.35,,3.35,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-06,NDC,both,1,ea,3.94,2.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Aetna,Commerical,,,3.04,,3.04,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Anthem,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Anthem,Indemnity,,,2.95,,2.95,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Anthem,Individual Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Anthem,State Preferred,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Cigna,Cigna,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Connecticare,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Connecticare,Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,Multiplan,Multiplan,,,3.35,,3.35,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,0904-7046-61,NDC,both,1,ea,3.94,2.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Aetna,Commerical,,,3.04,,3.04,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Anthem,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Anthem,Indemnity,,,2.95,,2.95,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Anthem,Individual Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Anthem,State Preferred,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Cigna,Cigna,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Connecticare,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Connecticare,Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,Multiplan,Multiplan,,,3.35,,3.35,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,63304-296-01,NDC,both,1,ea,3.94,2.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Aetna,Commerical,,,3.04,,3.04,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Aetna,Middlesex Employees,,,2.92,,2.92,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Anthem,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Anthem,Indemnity,,,2.95,,2.95,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Anthem,Individual Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Anthem,State Preferred,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Cigna,Cigna,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Connecticare,Commerical,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Connecticare,Exchange,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,Multiplan,Multiplan,,,3.35,,3.35,2.92,3.35,percent of total billed charges,,
HYDROXYCHLOROQUINE 200 MG TABLET,J3490,HCPCS,68084-269-01,NDC,both,1,ea,3.94,2.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.92,3.35,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Aetna,Commerical,,,101.78,,101.78,97.6,112.12,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Aetna,Middlesex Employees,,,97.6,,97.6,97.6,112.12,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Anthem,Commerical,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Anthem,Indemnity,,,98.81,,98.81,97.6,112.12,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Anthem,Individual Exchange,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Anthem,State Preferred,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Cigna,Cigna,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Connecticare,Commerical,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Connecticare,Exchange,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,Multiplan,Multiplan,,,112.12,,112.12,97.6,112.12,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0001-56,NDC,both,1,mL,131.91,79.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.6,112.12,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Aetna,Commerical,,,50.89,,50.89,48.8,56.07,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Aetna,Middlesex Employees,,,48.8,,48.8,48.8,56.07,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Anthem,Commerical,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Anthem,Indemnity,,,49.41,,49.41,48.8,56.07,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Anthem,Individual Exchange,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Anthem,State Preferred,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Cigna,Cigna,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Connecticare,Commerical,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Connecticare,Exchange,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,Multiplan,Multiplan,,,56.07,,56.07,48.8,56.07,percent of total billed charges,,
HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-63,NDC,both,1,mL,65.96,39.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.8,56.07,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Aetna,Commerical,,,155.45,,155.45,149.06,171.24,percent of total billed charges,,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Aetna,Middlesex Employees,,,149.06,,149.06,149.06,171.24,percent of total billed charges,,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Anthem,Commerical,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Anthem,Indemnity,,,150.91,,150.91,149.06,171.24,percent of total billed charges,,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Anthem,Individual Exchange,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Anthem,State Preferred,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Cigna,Cigna,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Connecticare,Commerical,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Connecticare,Exchange,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,Multiplan,Multiplan,,,171.24,,171.24,149.06,171.24,percent of total billed charges,,
HYDROXYUREA (BULK) 100 % POWDER,J8999,HCPCS,51552-0851-9,NDC,both,1,gm,201.46,120.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,149.06,171.24,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 200 MG CAPSULE,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 300 MG CAPSULE,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
HYDROXYUREA (SICKLE CELL) 400 MG CAPSULE,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Aetna,Commerical,,,45.04,,45.04,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Aetna,Middlesex Employees,,,43.19,,43.19,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Commerical,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Indemnity,,,43.72,,43.72,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Individual Exchange,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,State Preferred,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Cigna,Cigna,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Connecticare,Commerical,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Connecticare,Exchange,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Multiplan,Multiplan,,,49.61,,49.61,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Aetna,Commerical,,,45.04,,45.04,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Aetna,Middlesex Employees,,,43.19,,43.19,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Commerical,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Indemnity,,,43.72,,43.72,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,Individual Exchange,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Anthem,State Preferred,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Cigna,Cigna,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Connecticare,Commerical,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Connecticare,Exchange,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,Multiplan,Multiplan,,,49.61,,49.61,43.19,49.61,percent of total billed charges,,
HYDROXYUREA 100 MG/ML ORAL SUSP CHEMO,J8999,HCPCS,40810-0004-12,NDC,both,1,mL,58.37,35.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.19,49.61,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 200 MG CAPSULE CHEMO,J8999,HCPCS,0003-6335-17,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,0003-6336-17,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
HYDROXYUREA 300 MG CAPSULE CHEMO,J8999,HCPCS,61269-403-60,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,0003-6337-17,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,40810-0005-62,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
HYDROXYUREA 400 MG CAPSULE CHEMO,J8999,HCPCS,61269-404-60,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Aetna,Commerical,,,2.28,,2.28,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Aetna,Middlesex Employees,,,2.19,,2.19,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Indemnity,,,2.22,,2.22,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Individual Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,State Preferred,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Cigna,Cigna,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Connecticare,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Connecticare,Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Aetna,Commerical,,,2.28,,2.28,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Aetna,Middlesex Employees,,,2.19,,2.19,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Indemnity,,,2.22,,2.22,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Individual Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,State Preferred,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Cigna,Cigna,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Connecticare,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Connecticare,Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Aetna,Commerical,,,2.28,,2.28,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Aetna,Middlesex Employees,,,2.19,,2.19,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Anthem,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Anthem,Indemnity,,,2.22,,2.22,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Anthem,Individual Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Anthem,State Preferred,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Cigna,Cigna,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Connecticare,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Connecticare,Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE,J8999,HCPCS,68084-284-11,NDC,both,1,ea,2.96,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Aetna,Commerical,,,2.28,,2.28,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Aetna,Middlesex Employees,,,2.19,,2.19,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Indemnity,,,2.22,,2.22,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,Individual Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Anthem,State Preferred,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Cigna,Cigna,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Connecticare,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Connecticare,Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,0904-6939-61,NDC,both,1,ea,2.96,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Aetna,Commerical,,,2.28,,2.28,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Aetna,Middlesex Employees,,,2.19,,2.19,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Indemnity,,,2.22,,2.22,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,Individual Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Anthem,State Preferred,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Cigna,Cigna,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Connecticare,Commerical,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Connecticare,Exchange,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.19,2.52,percent of total billed charges,,
HYDROXYUREA 500 MG CAPSULE CHEMO,J8999,HCPCS,68084-284-01,NDC,both,1,ea,2.96,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.19,2.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,23155-500-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,60687-664-11,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,63739-483-10,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
HYDROXYZINE HCL 10 MG TABLET,J3490,HCPCS,68084-253-11,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Aetna,Commerical,,,90.86,,90.86,87.13,100.1,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Aetna,Middlesex Employees,,,87.13,,87.13,87.13,100.1,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Anthem,Commerical,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Anthem,Indemnity,,,88.21,,88.21,87.13,100.1,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Anthem,Individual Exchange,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Anthem,State Preferred,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Cigna,Cigna,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Connecticare,Commerical,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Connecticare,Exchange,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,Multiplan,Multiplan,,,100.1,,100.1,87.13,100.1,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,54838-502-80,NDC,both,1,mL,117.76,70.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Aetna,Commerical,,,34.53,,34.53,33.11,38.04,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Aetna,Middlesex Employees,,,33.11,,33.11,33.11,38.04,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Anthem,Commerical,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Anthem,Indemnity,,,33.52,,33.52,33.11,38.04,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Anthem,Individual Exchange,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Anthem,State Preferred,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Cigna,Cigna,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Connecticare,Commerical,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Connecticare,Exchange,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,Multiplan,Multiplan,,,38.04,,38.04,33.11,38.04,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-04,NDC,both,1,mL,44.75,26.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.11,38.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Aetna,Commerical,,,95.05,,95.05,91.15,104.71,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Aetna,Middlesex Employees,,,91.15,,91.15,91.15,104.71,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Anthem,Commerical,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Anthem,Indemnity,,,92.28,,92.28,91.15,104.71,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Anthem,Individual Exchange,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Anthem,State Preferred,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Cigna,Cigna,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Connecticare,Commerical,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Connecticare,Exchange,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,Multiplan,Multiplan,,,104.71,,104.71,91.15,104.71,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-150-16,NDC,both,1,mL,123.19,73.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,91.15,104.71,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Aetna,Commerical,,,138.39,,138.39,132.7,152.45,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Aetna,Middlesex Employees,,,132.7,,132.7,132.7,152.45,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Anthem,Commerical,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Anthem,Indemnity,,,134.35,,134.35,132.7,152.45,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Anthem,Individual Exchange,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Anthem,State Preferred,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Cigna,Cigna,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Connecticare,Commerical,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Connecticare,Exchange,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,Multiplan,Multiplan,,,152.45,,152.45,132.7,152.45,percent of total billed charges,,
HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62135-750-47,NDC,both,1,mL,179.35,107.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,132.7,152.45,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
HYDROXYZINE HCL 12.5 MG TABLET,J3490,HCPCS,40810-0013-59,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,0904-6617-61,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,23155-501-01,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
HYDROXYZINE HCL 25 MG TABLET,J3490,HCPCS,68084-254-01,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Aetna,Commerical,,,56.36,,56.36,16.39,62.08,percent of total billed charges,,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Aetna,Middlesex Employees,,,54.04,,54.04,16.39,62.08,percent of total billed charges,,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Anthem,Commerical,,,,,,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Anthem,Indemnity,,,54.71,,54.71,16.39,62.08,percent of total billed charges,,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Anthem,Individual Exchange,,,,,,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Anthem,State Preferred,,,,,,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Cigna,Cigna,,16.39,,,16.39,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Connecticare,Commerical,,18.94,,,18.94,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Connecticare,Exchange,,18.94,,,18.94,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,Multiplan,Multiplan,,,62.08,,62.08,16.39,62.08,percent of total billed charges,,
HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,J3410,HCPCS,0517-5601-25,NDC,both,0.5,mL,73.04,43.82,United Healthcare/Oxford,United Healthcare/Oxford,,17.69,,,17.69,16.39,62.08,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Aetna,Commerical,,,0.36,,0.36,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Aetna,Middlesex Employees,,,0.35,,0.35,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Anthem,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Anthem,Indemnity,,,0.35,,0.35,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Anthem,Individual Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Anthem,State Preferred,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Cigna,Cigna,,0.11,,,0.11,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Connecticare,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Connecticare,Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,Multiplan,Multiplan,,,0.4,,0.4,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 25 MG CAPSULE,Q0177,HCPCS,51079-077-20,NDC,both,1,ea,0.47,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,0.11,,,0.11,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,0185-0615-01,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,0.11,,,0.11,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.11,2.44,Other,Could be inpatient or outpatient,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.11,2.44,percent of total billed charges,,
HYDROXYZINE PAMOATE 50 MG CAPSULE,Q0177,HCPCS,40810-0015-30,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,0.11,2.44,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Aetna,Commerical,,,1947.88,,1947.88,9.97,2145.8,percent of total billed charges,,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Aetna,Middlesex Employees,,,1867.86,,1867.86,9.97,2145.8,percent of total billed charges,,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Anthem,Commerical,,,,,,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Anthem,Indemnity,,,1891.08,,1891.08,9.97,2145.8,percent of total billed charges,,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Anthem,Individual Exchange,,,,,,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Anthem,State Preferred,,,,,,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Cigna,Cigna,,9.97,,,9.97,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Connecticare,Commerical,,13.98,,,13.98,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Connecticare,Exchange,,13.98,,,13.98,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,Multiplan,Multiplan,,,2145.8,,2145.8,9.97,2145.8,percent of total billed charges,,
HYLAN G-F 20  48 MG/6 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800903,NDC,both,0.125,mL,2524.47,1514.68,United Healthcare/Oxford,United Healthcare/Oxford,,10.76,,,10.76,9.97,2145.8,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Aetna,Commerical,,,649.29,,649.29,9.97,715.27,percent of total billed charges,,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Aetna,Middlesex Employees,,,622.62,,622.62,9.97,715.27,percent of total billed charges,,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Anthem,Commerical,,,,,,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Anthem,Indemnity,,,630.36,,630.36,9.97,715.27,percent of total billed charges,,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Anthem,Individual Exchange,,,,,,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Anthem,State Preferred,,,,,,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Cigna,Cigna,,9.97,,,9.97,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Connecticare,Commerical,,13.98,,,13.98,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Connecticare,Exchange,,13.98,,,13.98,9.97,715.27,Other,Could be inpatient or outpatient,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,Multiplan,Multiplan,,,715.27,,715.27,9.97,715.27,percent of total billed charges,,
HYLAN G-F 20 16 MG/2 ML INTRA-ARTICULAR SYRINGE,J7325,HCPCS,5846800901,NDC,both,2,mL,841.49,504.89,United Healthcare/Oxford,United Healthcare/Oxford,,10.76,,,10.76,9.97,715.27,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,40810-0011-06,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,J3490,HCPCS,47781-011-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Aetna,Commerical,,,33.47,,33.47,32.1,36.87,percent of total billed charges,,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Aetna,Middlesex Employees,,,32.1,,32.1,32.1,36.87,percent of total billed charges,,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Anthem,Commerical,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Anthem,Indemnity,,,32.5,,32.5,32.1,36.87,percent of total billed charges,,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Anthem,Individual Exchange,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Anthem,State Preferred,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Cigna,Cigna,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Connecticare,Commerical,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Connecticare,Exchange,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,Multiplan,Multiplan,,,36.87,,36.87,32.1,36.87,percent of total billed charges,,
HYOSCYAMINE 0.125 MG/ML ORAL DROPS,J3490,HCPCS,54838-506-15,NDC,both,1,mL,43.38,26.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.1,36.87,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Aetna,Commerical,,,145.07,,145.07,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Aetna,Middlesex Employees,,,139.11,,139.11,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Commerical,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Indemnity,,,140.84,,140.84,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Individual Exchange,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Anthem,State Preferred,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Cigna,Cigna,,62.24,,,62.24,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Connecticare,Commerical,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Connecticare,Exchange,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,Multiplan,Multiplan,,,159.81,,159.81,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,0037-9001-05,NDC,both,0.5,mL,188.01,112.81,United Healthcare/Oxford,United Healthcare/Oxford,,11.37,,,11.37,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Aetna,Commerical,,,145.07,,145.07,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Aetna,Middlesex Employees,,,139.11,,139.11,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Anthem,Commerical,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Anthem,Indemnity,,,140.84,,140.84,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Anthem,Individual Exchange,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Anthem,State Preferred,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Cigna,Cigna,,62.24,,,62.24,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Connecticare,Commerical,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Connecticare,Exchange,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,Multiplan,Multiplan,,,159.81,,159.81,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-01,NDC,both,1,mL,188.01,112.81,United Healthcare/Oxford,United Healthcare/Oxford,,11.37,,,11.37,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Aetna,Commerical,,,145.07,,145.07,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Aetna,Middlesex Employees,,,139.11,,139.11,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Commerical,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Indemnity,,,140.84,,140.84,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Anthem,Individual Exchange,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Anthem,State Preferred,,,,,,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Cigna,Cigna,,62.24,,,62.24,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Connecticare,Commerical,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Connecticare,Exchange,,54.15,,,54.15,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,Multiplan,Multiplan,,,159.81,,159.81,11.37,159.81,percent of total billed charges,,
HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,J1980,HCPCS,54288-111-05,NDC,both,0.5,mL,188.01,112.81,United Healthcare/Oxford,United Healthcare/Oxford,,11.37,,,11.37,11.37,159.81,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Aetna,Commerical,,,1.98,,1.98,1.9,2.18,percent of total billed charges,,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Aetna,Middlesex Employees,,,1.9,,1.9,1.9,2.18,percent of total billed charges,,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Anthem,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Anthem,Indemnity,,,1.93,,1.93,1.9,2.18,percent of total billed charges,,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Anthem,Individual Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Anthem,State Preferred,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Cigna,Cigna,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Connecticare,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Connecticare,Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.9,2.18,percent of total billed charges,,
HYOSCYAMINE SULFATE 0.125 MG TABLET,J3490,HCPCS,43199-013-01,NDC,both,1,ea,2.57,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
IBUPROFEN 100 MG (SPLIT TABLET),A9150,HCPCS,40810-0013-82,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,40810-0010-72,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,46122-632-62,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,70000-0240-1,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
IBUPROFEN 100 MG CHEWABLE TABLET,A9150,HCPCS,96295-13114,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-00,NDC,both,1,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-0917-05,NDC,both,1,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Aetna,Commerical,,,3.61,,3.61,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Aetna,Middlesex Employees,,,3.46,,3.46,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Anthem,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Anthem,Indemnity,,,3.51,,3.51,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Anthem,Individual Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Anthem,State Preferred,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Cigna,Cigna,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Connecticare,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Connecticare,Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,Multiplan,Multiplan,,,3.98,,3.98,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-00,NDC,both,1,mL,4.68,2.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Aetna,Commerical,,,3.61,,3.61,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Aetna,Middlesex Employees,,,3.46,,3.46,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Anthem,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Anthem,Indemnity,,,3.51,,3.51,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Anthem,Individual Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Anthem,State Preferred,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Cigna,Cigna,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Connecticare,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Connecticare,Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,Multiplan,Multiplan,,,3.98,,3.98,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-1828-10,NDC,both,1,mL,4.68,2.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-05,NDC,both,5,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Aetna,Commerical,,,12.06,,12.06,11.56,13.29,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Aetna,Middlesex Employees,,,11.56,,11.56,11.56,13.29,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Anthem,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Anthem,Indemnity,,,11.71,,11.71,11.56,13.29,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Anthem,Individual Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Anthem,State Preferred,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Cigna,Cigna,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Connecticare,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Connecticare,Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,Multiplan,Multiplan,,,13.29,,13.29,11.56,13.29,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,0904-5309-20,NDC,both,1,mL,15.63,9.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-59,NDC,both,5,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Aetna,Commerical,,,3.61,,3.61,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Aetna,Middlesex Employees,,,3.46,,3.46,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Anthem,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Anthem,Indemnity,,,3.51,,3.51,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Anthem,Individual Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Anthem,State Preferred,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Cigna,Cigna,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Connecticare,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Connecticare,Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,Multiplan,Multiplan,,,3.98,,3.98,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-59,NDC,both,10,mL,4.68,2.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Aetna,Commerical,,,3.61,,3.61,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Aetna,Middlesex Employees,,,3.46,,3.46,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Anthem,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Anthem,Indemnity,,,3.51,,3.51,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Anthem,Individual Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Anthem,State Preferred,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Cigna,Cigna,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Connecticare,Commerical,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Connecticare,Exchange,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,Multiplan,Multiplan,,,3.98,,3.98,3.46,3.98,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-503-61,NDC,both,10,mL,4.68,2.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.46,3.98,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-59,NDC,both,1,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,A9150,HCPCS,68094-600-61,NDC,both,1,mL,2.34,1.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,0121-4774-40,NDC,both,1,mL,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Aetna,Commerical,,,1.81,,1.81,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Aetna,Middlesex Employees,,,1.73,,1.73,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Anthem,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Anthem,Indemnity,,,1.75,,1.75,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Anthem,Individual Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Anthem,State Preferred,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Cigna,Cigna,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Connecticare,Commerical,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Connecticare,Exchange,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,Multiplan,Multiplan,,,1.99,,1.99,1.73,1.99,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION (FOR CYSTIC FIBROSIS),A9150,HCPCS,68094-494-61,NDC,both,5,mL,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.73,1.99,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Aetna,Commerical,,,16.67,,16.67,15.99,18.37,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Aetna,Middlesex Employees,,,15.99,,15.99,15.99,18.37,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Anthem,Commerical,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Anthem,Indemnity,,,16.19,,16.19,15.99,18.37,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Anthem,Individual Exchange,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Anthem,State Preferred,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Cigna,Cigna,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Connecticare,Commerical,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Connecticare,Exchange,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,Multiplan,Multiplan,,,18.37,,18.37,15.99,18.37,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,45018404,NDC,both,1,mL,21.61,12.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.99,18.37,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Aetna,Commerical,,,9.22,,9.22,8.84,10.16,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Aetna,Middlesex Employees,,,8.84,,8.84,8.84,10.16,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Anthem,Commerical,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Anthem,Indemnity,,,8.95,,8.95,8.84,10.16,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Anthem,Individual Exchange,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Anthem,State Preferred,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Cigna,Cigna,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Connecticare,Commerical,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Connecticare,Exchange,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,Multiplan,Multiplan,,,10.16,,10.16,8.84,10.16,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,9629513164,NDC,both,1,mL,11.95,7.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.84,10.16,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Aetna,Commerical,,,14.9,,14.9,14.29,16.41,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Aetna,Middlesex Employees,,,14.29,,14.29,14.29,16.41,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Anthem,Commerical,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Anthem,Indemnity,,,14.47,,14.47,14.29,16.41,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Anthem,Individual Exchange,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Anthem,State Preferred,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Cigna,Cigna,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Connecticare,Commerical,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Connecticare,Exchange,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,Multiplan,Multiplan,,,16.41,,16.41,14.29,16.41,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,50580-184-50,NDC,both,1,mL,19.31,11.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Aetna,Commerical,,,9.07,,9.07,8.7,10,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Aetna,Middlesex Employees,,,8.7,,8.7,8.7,10,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Anthem,Commerical,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Anthem,Indemnity,,,8.81,,8.81,8.7,10,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Anthem,Individual Exchange,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Anthem,State Preferred,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Cigna,Cigna,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Connecticare,Commerical,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Connecticare,Exchange,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,Multiplan,Multiplan,,,10,,10,8.7,10,percent of total billed charges,,
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION DYE FREE,A9150,HCPCS,51672-1385-8,NDC,both,1,mL,11.76,7.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.7,10,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Aetna,Commerical,,,0.46,,0.46,0.44,0.51,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.51,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Anthem,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Anthem,Indemnity,,,0.45,,0.45,0.44,0.51,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Anthem,Individual Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Anthem,State Preferred,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Cigna,Cigna,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Connecticare,Commerical,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Connecticare,Exchange,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,Multiplan,Multiplan,,,0.51,,0.51,0.44,0.51,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0573-0151-10,NDC,both,1,ea,0.6,0.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.51,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET,A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,0904-7914-61,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
IBUPROFEN 200 MG TABLET (FOR CYSTIC FIBROSIS),A9150,HCPCS,57896-941-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,49483-602-50,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-01,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,60687-446-11,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,63739-672-10,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET,J3490,HCPCS,67877-319-01,NDC,both,0.046,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
IBUPROFEN 400 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5853-61,NDC,both,1,ea,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
IBUPROFEN 50 MG ORAL CHEW,A9150,HCPCS,40810-0001-59,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,40810-0007-19,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,60687-457-11,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,63739-684-10,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET,J3490,HCPCS,67877-320-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5854-61,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
IBUPROFEN 600 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-684-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-60,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET,J3490,HCPCS,67877-321-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,0904-5855-61,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
IBUPROFEN 800 MG TABLET (FOR CYSTIC FIBROSIS),J3490,HCPCS,63739-691-10,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Aetna,Commerical,,,3182.87,,3182.87,3.41,3506.28,percent of total billed charges,,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Aetna,Middlesex Employees,,,3052.11,,3052.11,3.41,3506.28,percent of total billed charges,,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Anthem,Commerical,,,,,,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Anthem,Indemnity,,,3090.06,,3090.06,3.41,3506.28,percent of total billed charges,,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Anthem,Individual Exchange,,,,,,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Anthem,State Preferred,,,,,,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Cigna,Cigna,,3.41,,,3.41,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Connecticare,Commerical,,,,,,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Connecticare,Exchange,,,,,,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,Multiplan,Multiplan,,,3506.28,,3506.28,3.41,3506.28,percent of total billed charges,,
IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,J1741,HCPCS,55292-122-52,NDC,both,2,mL,4125.03,2475.02,United Healthcare/Oxford,United Healthcare/Oxford,,4.49,,,4.49,3.41,3506.28,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Aetna,Commerical,,,231.93,,231.93,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Aetna,Middlesex Employees,,,222.4,,222.4,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Anthem,Commerical,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Anthem,Indemnity,,,225.16,,225.16,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Anthem,Individual Exchange,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Anthem,State Preferred,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Cigna,Cigna,,350.99,,,350.99,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Connecticare,Commerical,,313.12,,,313.12,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Connecticare,Exchange,,313.12,,,313.12,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,Multiplan,Multiplan,,,255.49,,255.49,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-01,NDC,both,10,mL,300.58,180.35,United Healthcare/Oxford,United Healthcare/Oxford,,281.55,,,281.55,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Aetna,Commerical,,,231.93,,231.93,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Aetna,Middlesex Employees,,,222.4,,222.4,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Anthem,Commerical,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Anthem,Indemnity,,,225.16,,225.16,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Anthem,Individual Exchange,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Anthem,State Preferred,,,,,,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Cigna,Cigna,,350.99,,,350.99,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Connecticare,Commerical,,313.12,,,313.12,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Connecticare,Exchange,,313.12,,,313.12,222.4,350.99,Other,Could be inpatient or outpatient,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,Multiplan,Multiplan,,,255.49,,255.49,222.4,350.99,percent of total billed charges,,
IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,J1742,HCPCS,0009-3794-22,NDC,both,10,mL,300.58,180.35,United Healthcare/Oxford,United Healthcare/Oxford,,281.55,,,281.55,222.4,350.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Aetna,Commerical,,,81.24,,81.24,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Aetna,Middlesex Employees,,,77.9,,77.9,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Anthem,Commerical,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Anthem,Indemnity,,,78.87,,78.87,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Anthem,Individual Exchange,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Anthem,State Preferred,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Cigna,Cigna,,63.9,,,63.9,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Connecticare,Commerical,,71.33,,,71.33,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Connecticare,Exchange,,71.33,,,71.33,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,Multiplan,Multiplan,,,89.5,,89.5,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2576-91,NDC,both,5,mL,105.29,63.17,United Healthcare/Oxford,United Healthcare/Oxford,,55.29,,,55.29,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Aetna,Commerical,,,162.48,,162.48,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Aetna,Middlesex Employees,,,155.81,,155.81,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Anthem,Commerical,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Anthem,Indemnity,,,157.75,,157.75,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Anthem,Individual Exchange,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Anthem,State Preferred,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Cigna,Cigna,,63.9,,,63.9,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Connecticare,Commerical,,71.33,,,71.33,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Connecticare,Exchange,,71.33,,,71.33,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,Multiplan,Multiplan,,,178.99,,178.99,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-10,NDC,both,5,mL,210.58,126.35,United Healthcare/Oxford,United Healthcare/Oxford,,55.29,,,55.29,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Aetna,Commerical,,,162.48,,162.48,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Aetna,Middlesex Employees,,,155.81,,155.81,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Anthem,Commerical,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Anthem,Indemnity,,,157.75,,157.75,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Anthem,Individual Exchange,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Anthem,State Preferred,,,,,,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Cigna,Cigna,,63.9,,,63.9,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Connecticare,Commerical,,71.33,,,71.33,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Connecticare,Exchange,,71.33,,,71.33,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,Multiplan,Multiplan,,,178.99,,178.99,55.29,178.99,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0013-2586-91,NDC,both,5,mL,210.58,126.35,United Healthcare/Oxford,United Healthcare/Oxford,,55.29,,,55.29,55.29,178.99,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Aetna,Commerical,,,81.24,,81.24,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Aetna,Middlesex Employees,,,77.9,,77.9,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Anthem,Commerical,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Anthem,Indemnity,,,78.87,,78.87,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Anthem,Individual Exchange,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Anthem,State Preferred,,,,,,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Cigna,Cigna,,63.9,,,63.9,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Connecticare,Commerical,,71.33,,,71.33,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Connecticare,Exchange,,71.33,,,71.33,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,Multiplan,Multiplan,,,89.5,,89.5,55.29,89.5,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0143-9217-01,NDC,both,5,mL,105.29,63.17,United Healthcare/Oxford,United Healthcare/Oxford,,55.29,,,55.29,55.29,89.5,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Aetna,Commerical,,,243.37,,243.37,55.29,268.1,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Aetna,Middlesex Employees,,,233.37,,233.37,55.29,268.1,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Anthem,Commerical,,,,,,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Anthem,Indemnity,,,236.27,,236.27,55.29,268.1,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Anthem,Individual Exchange,,,,,,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Anthem,State Preferred,,,,,,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Cigna,Cigna,,63.9,,,63.9,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Connecticare,Commerical,,71.33,,,71.33,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Connecticare,Exchange,,71.33,,,71.33,55.29,268.1,Other,Could be inpatient or outpatient,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,Multiplan,Multiplan,,,268.1,,268.1,55.29,268.1,percent of total billed charges,,
IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,J9211,HCPCS,0703-4154-11,NDC,both,5,mL,315.41,189.25,United Healthcare/Oxford,United Healthcare/Oxford,,55.29,,,55.29,55.29,268.1,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Aetna,Commerical,,,9267.1,,9267.1,615.76,10208.7,percent of total billed charges,,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Aetna,Middlesex Employees,,,8886.38,,8886.38,615.76,10208.7,percent of total billed charges,,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Anthem,Commerical,,,,,,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Anthem,Indemnity,,,8996.87,,8996.87,615.76,10208.7,percent of total billed charges,,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Anthem,Individual Exchange,,,,,,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Anthem,State Preferred,,,,,,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Cigna,Cigna,,615.76,,,615.76,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Connecticare,Commerical,,821.4,,,821.4,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Connecticare,Exchange,,821.4,,,821.4,615.76,10208.7,Other,Could be inpatient or outpatient,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,Multiplan,Multiplan,,,10208.7,,10208.7,615.76,10208.7,percent of total billed charges,,
IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION,J1743,HCPCS,54092-700-01,NDC,both,0.5,mL,12010.24,7206.14,United Healthcare/Oxford,United Healthcare/Oxford,,664.8,,,664.8,615.76,10208.7,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Aetna,Commerical,,,108.55,,108.55,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Aetna,Middlesex Employees,,,104.09,,104.09,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Anthem,Commerical,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Anthem,Indemnity,,,105.38,,105.38,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Anthem,Individual Exchange,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Anthem,State Preferred,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Cigna,Cigna,,36.27,,,36.27,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Connecticare,Commerical,,38.06,,,38.06,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Connecticare,Exchange,,38.06,,,38.06,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,Multiplan,Multiplan,,,119.58,,119.58,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-925-01,NDC,both,1,ea,140.68,84.41,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Aetna,Commerical,,,108.55,,108.55,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Aetna,Middlesex Employees,,,104.09,,104.09,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Anthem,Commerical,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Anthem,Indemnity,,,105.38,,105.38,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Anthem,Individual Exchange,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Anthem,State Preferred,,,,,,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Cigna,Cigna,,36.27,,,36.27,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Connecticare,Commerical,,38.06,,,38.06,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Connecticare,Exchange,,38.06,,,38.06,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,Multiplan,Multiplan,,,119.58,,119.58,31.38,119.58,percent of total billed charges,,
IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,63323-142-12,NDC,both,1,ea,140.68,84.41,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,119.58,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Aetna,Commerical,,,94.1,,94.1,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Aetna,Middlesex Employees,,,90.23,,90.23,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Anthem,Commerical,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Anthem,Indemnity,,,91.35,,91.35,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Anthem,Individual Exchange,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Anthem,State Preferred,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Cigna,Cigna,,36.27,,,36.27,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Connecticare,Commerical,,38.06,,,38.06,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Connecticare,Exchange,,38.06,,,38.06,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,Multiplan,Multiplan,,,103.66,,103.66,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0143-9531-01,NDC,both,20,mL,121.95,73.17,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Aetna,Commerical,,,94.1,,94.1,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Aetna,Middlesex Employees,,,90.23,,90.23,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Anthem,Commerical,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Anthem,Indemnity,,,91.35,,91.35,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Anthem,Individual Exchange,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Anthem,State Preferred,,,,,,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Cigna,Cigna,,36.27,,,36.27,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Connecticare,Commerical,,38.06,,,38.06,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Connecticare,Exchange,,38.06,,,38.06,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,Multiplan,Multiplan,,,103.66,,103.66,31.38,103.66,percent of total billed charges,,
IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3427-11,NDC,both,20,mL,121.95,73.17,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,103.66,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Aetna,Commerical,,,423.28,,423.28,31.38,466.29,percent of total billed charges,,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Aetna,Middlesex Employees,,,405.89,,405.89,31.38,466.29,percent of total billed charges,,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Anthem,Commerical,,,,,,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Anthem,Indemnity,,,410.94,,410.94,31.38,466.29,percent of total billed charges,,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Anthem,Individual Exchange,,,,,,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Anthem,State Preferred,,,,,,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Cigna,Cigna,,36.27,,,36.27,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Connecticare,Commerical,,38.06,,,38.06,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Connecticare,Exchange,,38.06,,,38.06,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,Multiplan,Multiplan,,,466.29,,466.29,31.38,466.29,percent of total billed charges,,
IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,J9208,HCPCS,10019-926-02,NDC,both,0.333,ea,548.58,329.15,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,466.29,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Aetna,Commerical,,,307.26,,307.26,31.38,338.48,percent of total billed charges,,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Aetna,Middlesex Employees,,,294.64,,294.64,31.38,338.48,percent of total billed charges,,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Anthem,Commerical,,,,,,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Anthem,Indemnity,,,298.3,,298.3,31.38,338.48,percent of total billed charges,,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Anthem,Individual Exchange,,,,,,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Anthem,State Preferred,,,,,,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Cigna,Cigna,,36.27,,,36.27,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Connecticare,Commerical,,38.06,,,38.06,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Connecticare,Exchange,,38.06,,,38.06,31.38,338.48,Other,Could be inpatient or outpatient,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,Multiplan,Multiplan,,,338.48,,338.48,31.38,338.48,percent of total billed charges,,
IFOSFAMIDE 3 GRAM/60 ML INTRAVENOUS SOLUTION,J9208,HCPCS,0703-3429-11,NDC,both,0.333,mL,398.21,238.93,United Healthcare/Oxford,United Healthcare/Oxford,,31.38,,,31.38,31.38,338.48,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Aetna,Commerical,,,3.46,,3.46,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Aetna,Middlesex Employees,,,3.31,,3.31,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Anthem,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Anthem,Indemnity,,,3.36,,3.36,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Anthem,Individual Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Anthem,State Preferred,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Cigna,Cigna,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Connecticare,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Connecticare,Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,Multiplan,Multiplan,,,3.81,,3.81,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0078-0401-34,NDC,both,1,ea,4.48,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Aetna,Commerical,,,3.46,,3.46,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Aetna,Middlesex Employees,,,3.31,,3.31,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Anthem,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Anthem,Indemnity,,,3.36,,3.36,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Anthem,Individual Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Anthem,State Preferred,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Cigna,Cigna,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Connecticare,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Connecticare,Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,Multiplan,Multiplan,,,3.81,,3.81,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,0093-7629-98,NDC,both,1,ea,4.48,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Aetna,Commerical,,,3.46,,3.46,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Aetna,Middlesex Employees,,,3.31,,3.31,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Anthem,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Anthem,Indemnity,,,3.36,,3.36,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Anthem,Individual Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Anthem,State Preferred,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Cigna,Cigna,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Connecticare,Commerical,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Connecticare,Exchange,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,Multiplan,Multiplan,,,3.81,,3.81,3.31,3.81,percent of total billed charges,,
IMATINIB 100 MG TABLET,J8999,HCPCS,40810-0017-35,NDC,both,1,ea,4.48,2.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.31,3.81,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Aetna,Commerical,,,12.44,,12.44,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Aetna,Middlesex Employees,,,11.93,,11.93,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Anthem,Commerical,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Anthem,Indemnity,,,12.08,,12.08,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Anthem,Individual Exchange,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Anthem,State Preferred,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Cigna,Cigna,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Connecticare,Commerical,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Connecticare,Exchange,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,Multiplan,Multiplan,,,13.7,,13.7,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,0093-7630-56,NDC,both,1,ea,16.12,9.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Aetna,Commerical,,,12.44,,12.44,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Aetna,Middlesex Employees,,,11.93,,11.93,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Anthem,Commerical,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Anthem,Indemnity,,,12.08,,12.08,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Anthem,Individual Exchange,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Anthem,State Preferred,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Cigna,Cigna,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Connecticare,Commerical,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Connecticare,Exchange,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,Multiplan,Multiplan,,,13.7,,13.7,11.93,13.7,percent of total billed charges,,
IMATINIB 400 MG TABLET,J8999,HCPCS,43598-345-79,NDC,both,1,ea,16.12,9.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.93,13.7,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Aetna,Commerical,,,17.7,,17.7,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Aetna,Middlesex Employees,,,16.97,,16.97,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Anthem,Commerical,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Anthem,Indemnity,,,17.18,,17.18,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Anthem,Individual Exchange,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Anthem,State Preferred,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Cigna,Cigna,,7.81,,,7.81,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Connecticare,Commerical,,10.62,,,10.62,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Connecticare,Exchange,,10.62,,,10.62,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,Multiplan,Multiplan,,,19.5,,19.5,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-25,NDC,both,1,ea,22.94,13.76,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Aetna,Commerical,,,17.7,,17.7,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Aetna,Middlesex Employees,,,16.97,,16.97,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Anthem,Commerical,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Anthem,Indemnity,,,17.18,,17.18,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Anthem,Individual Exchange,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Anthem,State Preferred,,,,,,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Cigna,Cigna,,7.81,,,7.81,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Connecticare,Commerical,,10.62,,,10.62,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Connecticare,Exchange,,10.62,,,10.62,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,Multiplan,Multiplan,,,19.5,,19.5,7.81,19.5,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-93,NDC,both,1,ea,22.94,13.76,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,19.5,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Aetna,Commerical,,,13.3,,13.3,7.81,14.65,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Aetna,Middlesex Employees,,,12.76,,12.76,7.81,14.65,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Anthem,Commerical,,,,,,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Anthem,Indemnity,,,12.91,,12.91,7.81,14.65,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Anthem,Individual Exchange,,,,,,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Anthem,State Preferred,,,,,,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Cigna,Cigna,,7.81,,,7.81,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Connecticare,Commerical,,10.62,,,10.62,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Connecticare,Exchange,,10.62,,,10.62,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,Multiplan,Multiplan,,,14.65,,14.65,7.81,14.65,percent of total billed charges,,
IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-349-94,NDC,both,1,ea,17.24,10.34,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,14.65,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Aetna,Commerical,,,30.39,,30.39,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Aetna,Middlesex Employees,,,29.14,,29.14,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Anthem,Commerical,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Anthem,Indemnity,,,29.5,,29.5,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Anthem,Individual Exchange,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Anthem,State Preferred,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Cigna,Cigna,,7.81,,,7.81,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Connecticare,Commerical,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Connecticare,Exchange,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,Multiplan,Multiplan,,,33.47,,33.47,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-21,NDC,both,0.5,ea,39.38,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Aetna,Commerical,,,30.39,,30.39,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Aetna,Middlesex Employees,,,29.14,,29.14,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Anthem,Commerical,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Anthem,Indemnity,,,29.5,,29.5,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Anthem,Individual Exchange,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Anthem,State Preferred,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Cigna,Cigna,,7.81,,,7.81,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Connecticare,Commerical,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Connecticare,Exchange,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,Multiplan,Multiplan,,,33.47,,33.47,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-25,NDC,both,0.5,ea,39.38,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Aetna,Commerical,,,30.39,,30.39,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Aetna,Middlesex Employees,,,29.14,,29.14,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Anthem,Commerical,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Anthem,Indemnity,,,29.5,,29.5,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Anthem,Individual Exchange,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Anthem,State Preferred,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Cigna,Cigna,,7.81,,,7.81,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Connecticare,Commerical,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Connecticare,Exchange,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,Multiplan,Multiplan,,,33.47,,33.47,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-41,NDC,both,0.5,ea,39.38,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Aetna,Commerical,,,30.39,,30.39,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Aetna,Middlesex Employees,,,29.14,,29.14,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Anthem,Commerical,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Anthem,Indemnity,,,29.5,,29.5,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Anthem,Individual Exchange,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Anthem,State Preferred,,,,,,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Cigna,Cigna,,7.81,,,7.81,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Connecticare,Commerical,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Connecticare,Exchange,,10.62,,,10.62,7.81,33.47,Other,Could be inpatient or outpatient,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,Multiplan,Multiplan,,,33.47,,33.47,7.81,33.47,percent of total billed charges,,
IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,J0743,HCPCS,63323-322-93,NDC,both,0.5,ea,39.38,23.63,United Healthcare/Oxford,United Healthcare/Oxford,,8.43,,,8.43,7.81,33.47,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Aetna,Commerical,,,4.09,,4.09,3.92,4.51,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Aetna,Middlesex Employees,,,3.92,,3.92,3.92,4.51,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Anthem,Commerical,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Anthem,Indemnity,,,3.97,,3.97,3.92,4.51,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Anthem,Individual Exchange,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Anthem,State Preferred,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Cigna,Cigna,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Connecticare,Commerical,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Connecticare,Exchange,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,Multiplan,Multiplan,,,4.51,,4.51,3.92,4.51,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,0168-0432-24,NDC,both,1,ea,5.3,3.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.92,4.51,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Aetna,Commerical,,,49.01,,49.01,47,53.99,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Aetna,Middlesex Employees,,,47,,47,47,53.99,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Anthem,Commerical,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Anthem,Indemnity,,,47.58,,47.58,47,53.99,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Anthem,Individual Exchange,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Anthem,State Preferred,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Cigna,Cigna,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Connecticare,Commerical,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Connecticare,Exchange,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,Multiplan,Multiplan,,,53.99,,53.99,47,53.99,percent of total billed charges,,
IMIQUIMOD 5 % TOPICAL CREAM PACKET,J3490,HCPCS,45802-368-53,NDC,both,4,ea,63.52,38.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47,53.99,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Aetna,Commerical,,,777.09,,777.09,14.9,856.05,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Aetna,Middlesex Employees,,,745.17,,745.17,14.9,856.05,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Anthem,Commerical,,,,,,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Anthem,Indemnity,,,754.43,,754.43,14.9,856.05,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Anthem,Individual Exchange,,,,,,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Anthem,State Preferred,,,,,,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Cigna,Cigna,,14.9,,,14.9,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Connecticare,Commerical,,20.2,,,20.2,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Connecticare,Exchange,,20.2,,,20.2,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,Multiplan,Multiplan,,,856.05,,856.05,14.9,856.05,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-452-02,NDC,both,0.5,mL,1007.12,604.27,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,856.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Aetna,Commerical,,,826.95,,826.95,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Aetna,Middlesex Employees,,,792.97,,792.97,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Anthem,Commerical,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Anthem,Indemnity,,,802.83,,802.83,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Anthem,Individual Exchange,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Anthem,State Preferred,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Cigna,Cigna,,14.9,,,14.9,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Connecticare,Commerical,,20.2,,,20.2,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Connecticare,Exchange,,20.2,,,20.2,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,Multiplan,Multiplan,,,910.97,,910.97,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-22,NDC,both,0.5,mL,1071.73,643.04,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Aetna,Commerical,,,826.95,,826.95,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Aetna,Middlesex Employees,,,792.97,,792.97,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Anthem,Commerical,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Anthem,Indemnity,,,802.83,,802.83,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Anthem,Individual Exchange,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Anthem,State Preferred,,,,,,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Cigna,Cigna,,14.9,,,14.9,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Connecticare,Commerical,,20.2,,,20.2,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Connecticare,Exchange,,20.2,,,20.2,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,Multiplan,Multiplan,,,910.97,,910.97,14.9,910.97,percent of total billed charges,,
IMMUN GLOB G 2 GRAM/10ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYRINGE,J1559,HCPCS,44206-457-95,NDC,both,0.5,mL,1071.73,643.04,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,910.97,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Aetna,Commerical,,,1624.8,,1624.8,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Aetna,Middlesex Employees,,,1558.04,,1558.04,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Commerical,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Indemnity,,,1577.42,,1577.42,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Individual Exchange,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Anthem,State Preferred,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Cigna,Cigna,,14.9,,,14.9,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Connecticare,Commerical,,20.2,,,20.2,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Connecticare,Exchange,,20.2,,,20.2,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,Multiplan,Multiplan,,,1789.89,,1789.89,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-24,NDC,both,0.5,mL,2105.75,1263.45,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Aetna,Commerical,,,1624.8,,1624.8,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Aetna,Middlesex Employees,,,1558.04,,1558.04,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Commerical,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Indemnity,,,1577.42,,1577.42,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Anthem,Individual Exchange,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Anthem,State Preferred,,,,,,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Cigna,Cigna,,14.9,,,14.9,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Connecticare,Commerical,,20.2,,,20.2,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Connecticare,Exchange,,20.2,,,20.2,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,Multiplan,Multiplan,,,1789.89,,1789.89,14.9,1789.89,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML (20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SYR,J1559,HCPCS,44206-458-96,NDC,both,0.5,mL,2105.75,1263.45,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,1789.89,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Aetna,Commerical,,,1525.09,,1525.09,14.9,1680.05,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Aetna,Middlesex Employees,,,1462.43,,1462.43,14.9,1680.05,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Anthem,Commerical,,,,,,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Anthem,Indemnity,,,1480.62,,1480.62,14.9,1680.05,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Anthem,Individual Exchange,,,,,,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Anthem,State Preferred,,,,,,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Cigna,Cigna,,14.9,,,14.9,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Connecticare,Commerical,,20.2,,,20.2,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Connecticare,Exchange,,20.2,,,20.2,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,Multiplan,Multiplan,,,1680.05,,1680.05,14.9,1680.05,percent of total billed charges,,
IMMUN GLOB G 4 GRAM/20 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-454-04,NDC,both,0.5,mL,1976.53,1185.92,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,1680.05,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Aetna,Commerical,,,403.08,,403.08,14.9,444.03,percent of total billed charges,,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Aetna,Middlesex Employees,,,386.52,,386.52,14.9,444.03,percent of total billed charges,,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Anthem,Commerical,,,,,,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Anthem,Indemnity,,,391.32,,391.32,14.9,444.03,percent of total billed charges,,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Anthem,Individual Exchange,,,,,,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Anthem,State Preferred,,,,,,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Cigna,Cigna,,14.9,,,14.9,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Connecticare,Commerical,,20.2,,,20.2,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Connecticare,Exchange,,20.2,,,20.2,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,Multiplan,Multiplan,,,444.03,,444.03,14.9,444.03,percent of total billed charges,,
IMMUNE GLOB G 1 GRAM/5 ML(20 %)-PROL-IGA 0-50 MCG/ML SUBCUTANEOUS SOLN,J1559,HCPCS,44206-451-01,NDC,both,0.5,mL,522.39,313.43,United Healthcare/Oxford,United Healthcare/Oxford,,16.09,,,16.09,14.9,444.03,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Commerical,,,3203.31,,3203.31,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Middlesex Employees,,,3071.7,,3071.7,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Commerical,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Indemnity,,,3109.9,,3109.9,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Individual Exchange,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,State Preferred,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Cigna,Cigna,,56.03,,,56.03,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Commerical,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Exchange,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Multiplan,Multiplan,,,3528.78,,3528.78,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,United Healthcare/Oxford,United Healthcare/Oxford,,60.49,,,60.49,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Aetna,Commerical,,,6377.51,,6377.51,56.03,7025.51,percent of total billed charges,,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Aetna,Middlesex Employees,,,6115.5,,6115.5,56.03,7025.51,percent of total billed charges,,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Anthem,Commerical,,,,,,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Anthem,Indemnity,,,6191.54,,6191.54,56.03,7025.51,percent of total billed charges,,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Anthem,Individual Exchange,,,,,,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Anthem,State Preferred,,,,,,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Cigna,Cigna,,56.03,,,56.03,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Connecticare,Commerical,,74.52,,,74.52,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Connecticare,Exchange,,74.52,,,74.52,56.03,7025.51,Other,Could be inpatient or outpatient,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,Multiplan,Multiplan,,,7025.51,,7025.51,56.03,7025.51,percent of total billed charges,,
IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-24,NDC,both,5,mL,8265.31,4959.19,United Healthcare/Oxford,United Healthcare/Oxford,,60.49,,,60.49,56.03,7025.51,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-11,NDC,both,5,mL,2680.4,1608.24,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",J1569,HCPCS,0944-2700-12,NDC,both,5,mL,5323.1,3193.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Aetna,Commerical,,,4316.69,,4316.69,90.29,4755.29,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Aetna,Middlesex Employees,,,4139.34,,4139.34,90.29,4755.29,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Anthem,Commerical,,,,,,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Anthem,Indemnity,,,4190.81,,4190.81,90.29,4755.29,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Anthem,Individual Exchange,,,,,,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Anthem,State Preferred,,,,,,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Cigna,Cigna,,90.29,,,90.29,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Connecticare,Commerical,,125.51,,,125.51,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Connecticare,Exchange,,125.51,,,125.51,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,Multiplan,Multiplan,,,4755.29,,4755.29,90.29,4755.29,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2658-04,NDC,both,0.05,ea,5594.46,3356.68,United Healthcare/Oxford,United Healthcare/Oxford,,97.48,,,97.48,90.29,4755.29,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Aetna,Commerical,,,2172.9,,2172.9,90.29,2393.69,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Aetna,Middlesex Employees,,,2083.63,,2083.63,90.29,2393.69,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Anthem,Commerical,,,,,,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Anthem,Indemnity,,,2109.54,,2109.54,90.29,2393.69,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Anthem,Individual Exchange,,,,,,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Anthem,State Preferred,,,,,,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Cigna,Cigna,,90.29,,,90.29,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Connecticare,Commerical,,125.51,,,125.51,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Connecticare,Exchange,,125.51,,,125.51,90.29,2393.69,Other,Could be inpatient or outpatient,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,Multiplan,Multiplan,,,2393.69,,2393.69,90.29,2393.69,percent of total billed charges,,
"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",J1566,HCPCS,0944-2656-03,NDC,both,0.1,ea,2816.1,1689.66,United Healthcare/Oxford,United Healthcare/Oxford,,97.48,,,97.48,90.29,2393.69,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Aetna,Commerical,,,1616.2,,1616.2,56.03,1780.42,percent of total billed charges,,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Aetna,Middlesex Employees,,,1549.8,,1549.8,56.03,1780.42,percent of total billed charges,,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Anthem,Commerical,,,,,,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Anthem,Indemnity,,,1569.07,,1569.07,56.03,1780.42,percent of total billed charges,,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Anthem,Individual Exchange,,,,,,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Anthem,State Preferred,,,,,,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Cigna,Cigna,,56.03,,,56.03,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Connecticare,Commerical,,74.52,,,74.52,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Connecticare,Exchange,,74.52,,,74.52,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,Multiplan,Multiplan,,,1780.42,,1780.42,56.03,1780.42,percent of total billed charges,,
IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,J1561,HCPCS,13533-800-20,NDC,both,5,mL,2094.61,1256.77,United Healthcare/Oxford,United Healthcare/Oxford,,60.49,,,60.49,56.03,1780.42,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) 10% IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMAGARD) INFUSION NICU,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2796.84,1678.1,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Commerical,,,3203.31,,3203.31,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Middlesex Employees,,,3071.7,,3071.7,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Commerical,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Indemnity,,,3109.9,,3109.9,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Individual Exchange,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,State Preferred,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Cigna,Cigna,,56.03,,,56.03,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Commerical,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Exchange,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Multiplan,Multiplan,,,3528.78,,3528.78,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMENEX-C) ML/HR RATE,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,United Healthcare/Oxford,United Healthcare/Oxford,,60.49,,,60.49,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Commerical,,,3203.31,,3203.31,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Aetna,Middlesex Employees,,,3071.7,,3071.7,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Commerical,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Indemnity,,,3109.9,,3109.9,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,Individual Exchange,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Anthem,State Preferred,,,,,,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Cigna,Cigna,,56.03,,,56.03,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Commerical,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Connecticare,Exchange,,74.52,,,74.52,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,Multiplan,Multiplan,,,3528.78,,3528.78,56.03,3528.78,percent of total billed charges,,
IMMUNE GLOBULIN (GAMMUNEX-C) FOR IFC,J1561,HCPCS,13533-800-71,NDC,both,5,mL,4151.51,2490.91,United Healthcare/Oxford,United Healthcare/Oxford,,60.49,,,60.49,56.03,3528.78,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Commerical,,,1324.96,,1324.96,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Middlesex Employees,,,1270.53,,1270.53,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Commerical,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Indemnity,,,1286.32,,1286.32,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Individual Exchange,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,State Preferred,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Cigna,Cigna,,55,,,55,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Commerical,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Exchange,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Multiplan,Multiplan,,,1459.59,,1459.59,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Commerical,,,2620.82,,2620.82,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Middlesex Employees,,,2513.15,,2513.15,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Commerical,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Indemnity,,,2544.4,,2544.4,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Individual Exchange,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,State Preferred,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Cigna,Cigna,,55,,,55,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Commerical,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Exchange,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Multiplan,Multiplan,,,2887.12,,2887.12,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Commerical,,,5212.56,,5212.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Middlesex Employees,,,4998.41,,4998.41,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Commerical,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Indemnity,,,5060.56,,5060.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Individual Exchange,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,State Preferred,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Cigna,Cigna,,55,,,55,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Commerical,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Exchange,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Multiplan,Multiplan,,,5742.19,,5742.19,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (HUMAN) (IGG) 10% PRIVIGEN IV,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Commerical,,,1324.96,,1324.96,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Middlesex Employees,,,1270.53,,1270.53,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Commerical,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Indemnity,,,1286.32,,1286.32,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Individual Exchange,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,State Preferred,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Cigna,Cigna,,55,,,55,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Commerical,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Exchange,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Multiplan,Multiplan,,,1459.59,,1459.59,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Commerical,,,2620.82,,2620.82,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Middlesex Employees,,,2513.15,,2513.15,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Commerical,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Indemnity,,,2544.4,,2544.4,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Individual Exchange,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,State Preferred,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Cigna,Cigna,,55,,,55,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Commerical,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Exchange,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Multiplan,Multiplan,,,2887.12,,2887.12,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Commerical,,,5212.56,,5212.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Middlesex Employees,,,4998.41,,4998.41,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Commerical,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Indemnity,,,5060.56,,5060.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Individual Exchange,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,State Preferred,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Cigna,Cigna,,55,,,55,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Commerical,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Exchange,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Multiplan,Multiplan,,,5742.19,,5742.19,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV FOR IFC,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Commerical,,,1324.96,,1324.96,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Aetna,Middlesex Employees,,,1270.53,,1270.53,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Commerical,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Indemnity,,,1286.32,,1286.32,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,Individual Exchange,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Anthem,State Preferred,,,,,,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Cigna,Cigna,,55,,,55,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Commerical,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Connecticare,Exchange,,74.18,,,74.18,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,Multiplan,Multiplan,,,1459.59,,1459.59,55,1459.59,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-436-05,NDC,both,5,mL,1717.16,1030.3,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,1459.59,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Commerical,,,2620.82,,2620.82,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Aetna,Middlesex Employees,,,2513.15,,2513.15,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Commerical,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Indemnity,,,2544.4,,2544.4,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,Individual Exchange,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Anthem,State Preferred,,,,,,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Cigna,Cigna,,55,,,55,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Commerical,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Connecticare,Exchange,,74.18,,,74.18,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,Multiplan,Multiplan,,,2887.12,,2887.12,55,2887.12,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-437-10,NDC,both,5,mL,3396.61,2037.97,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,2887.12,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Commerical,,,5212.56,,5212.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Aetna,Middlesex Employees,,,4998.41,,4998.41,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Commerical,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Indemnity,,,5060.56,,5060.56,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,Individual Exchange,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Anthem,State Preferred,,,,,,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Cigna,Cigna,,55,,,55,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Commerical,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Connecticare,Exchange,,74.18,,,74.18,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,Multiplan,Multiplan,,,5742.19,,5742.19,55,5742.19,percent of total billed charges,,
IMMUNE GLOBULIN (PRIVIGEN) IV ML/HR,J1459,HCPCS,44206-438-20,NDC,both,5,mL,6755.52,4053.31,United Healthcare/Oxford,United Healthcare/Oxford,,59.38,,,59.38,55,5742.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR IFC,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR ORDER SET,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,3129.47,1877.68,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,6221.24,3732.74,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) FOR RENAL INSUFFICIENCY,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,12404.77,7442.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Commerical,,,1048.64,,1048.64,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Aetna,Middlesex Employees,,,1005.56,,1005.56,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Commerical,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Indemnity,,,1018.06,,1018.06,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,Individual Exchange,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Anthem,State Preferred,,,,,,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Cigna,Cigna,,50.93,,,50.93,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Commerical,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Connecticare,Exchange,,75.88,,,75.88,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,Multiplan,Multiplan,,,1155.19,,1155.19,50.93,1155.19,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-04,NDC,both,5,mL,1359.05,815.43,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,1155.19,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Commerical,,,2068.2,,2068.2,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Aetna,Middlesex Employees,,,1983.23,,1983.23,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Commerical,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Indemnity,,,2007.89,,2007.89,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,Individual Exchange,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Anthem,State Preferred,,,,,,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Cigna,Cigna,,50.93,,,50.93,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Commerical,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Connecticare,Exchange,,75.88,,,75.88,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,Multiplan,Multiplan,,,2278.34,,2278.34,50.93,2278.34,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-05,NDC,both,5,mL,2680.4,1608.24,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,2278.34,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Commerical,,,4107.3,,4107.3,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Aetna,Middlesex Employees,,,3938.56,,3938.56,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Commerical,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Indemnity,,,3987.53,,3987.53,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,Individual Exchange,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Anthem,State Preferred,,,,,,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Cigna,Cigna,,50.93,,,50.93,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Commerical,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Connecticare,Exchange,,75.88,,,75.88,50.93,4524.64,Other,Could be inpatient or outpatient,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,Multiplan,Multiplan,,,4524.64,,4524.64,50.93,4524.64,percent of total billed charges,,
IMMUNE GLOBULIN 10% (GAMMAGARD) ML/HR RATE,J1569,HCPCS,0944-2700-06,NDC,both,5,mL,5323.1,3193.86,United Healthcare/Oxford,United Healthcare/Oxford,,54.99,,,54.99,50.93,4524.64,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Aetna,Commerical,,,4235.58,,4235.58,16.27,4665.95,percent of total billed charges,,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Aetna,Middlesex Employees,,,4061.57,,4061.57,16.27,4665.95,percent of total billed charges,,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Anthem,Commerical,,,,,,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Anthem,Indemnity,,,4112.07,,4112.07,16.27,4665.95,percent of total billed charges,,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Anthem,Individual Exchange,,,,,,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Anthem,State Preferred,,,,,,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Cigna,Cigna,,16.27,,,16.27,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Connecticare,Commerical,,21.83,,,21.83,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Connecticare,Exchange,,21.83,,,21.83,16.27,4665.95,Other,Could be inpatient or outpatient,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,Multiplan,Multiplan,,,4665.95,,4665.95,16.27,4665.95,percent of total billed charges,,
"IMMUNE GLOBULIN,GAMMA(IGG)KLHW HUMAN 10 GRAM/50 ML(20%)SUBCUT SOLUTION",J1558,HCPCS,13533-810-50,NDC,both,0.5,mL,5489.35,3293.61,United Healthcare/Oxford,United Healthcare/Oxford,,17.57,,,17.57,16.27,4665.95,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Aetna,Commerical,,,1137.76,,1137.76,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Aetna,Middlesex Employees,,,1091.02,,1091.02,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Anthem,Commerical,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Anthem,Indemnity,,,1104.59,,1104.59,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Anthem,Individual Exchange,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Anthem,State Preferred,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Cigna,Cigna,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Connecticare,Commerical,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Connecticare,Exchange,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,Multiplan,Multiplan,,,1253.37,,1253.37,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-01,NDC,both,1,mL,1474.55,884.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Aetna,Commerical,,,1137.76,,1137.76,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Aetna,Middlesex Employees,,,1091.02,,1091.02,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Anthem,Commerical,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Anthem,Indemnity,,,1104.59,,1104.59,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Anthem,Individual Exchange,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Anthem,State Preferred,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Cigna,Cigna,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Connecticare,Commerical,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Connecticare,Exchange,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,Multiplan,Multiplan,,,1253.37,,1253.37,1091.02,1253.37,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-05,NDC,both,1,mL,1474.55,884.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1091.02,1253.37,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1474.55,884.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Aetna,Commerical,,,1135.52,,1135.52,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Aetna,Middlesex Employees,,,1088.87,,1088.87,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Anthem,Commerical,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Anthem,Indemnity,,,1102.41,,1102.41,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Anthem,Individual Exchange,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Anthem,State Preferred,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Cigna,Cigna,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Connecticare,Commerical,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Connecticare,Exchange,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,Multiplan,Multiplan,,,1250.89,,1250.89,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-00,NDC,both,1,mL,1471.64,882.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Aetna,Commerical,,,1135.52,,1135.52,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Aetna,Middlesex Employees,,,1088.87,,1088.87,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Anthem,Commerical,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Anthem,Indemnity,,,1102.41,,1102.41,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Anthem,Individual Exchange,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Anthem,State Preferred,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Cigna,Cigna,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Connecticare,Commerical,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Connecticare,Exchange,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,Multiplan,Multiplan,,,1250.89,,1250.89,1088.87,1250.89,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLUTION,J3490,HCPCS,81284-315-05,NDC,both,1,mL,1471.64,882.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1088.87,1250.89,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8%) INJ FOR INTRA-AMNIOTIC,J3490,HCPCS,0517-0375-10,NDC,both,5,mL,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Aetna,Commerical,,,359.65,,359.65,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Aetna,Middlesex Employees,,,344.87,,344.87,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Anthem,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Anthem,Indemnity,,,349.16,,349.16,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Anthem,Individual Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Anthem,State Preferred,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Cigna,Cigna,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Connecticare,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Connecticare,Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,Multiplan,Multiplan,,,396.19,,396.19,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-06,NDC,both,1,ea,466.11,279.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Aetna,Commerical,,,359.65,,359.65,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Aetna,Middlesex Employees,,,344.87,,344.87,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Anthem,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Anthem,Indemnity,,,349.16,,349.16,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Anthem,Individual Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Anthem,State Preferred,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Cigna,Cigna,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Connecticare,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Connecticare,Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,Multiplan,Multiplan,,,396.19,,396.19,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,17238-424-25,NDC,both,1,ea,466.11,279.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Aetna,Commerical,,,359.65,,359.65,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Aetna,Middlesex Employees,,,344.87,,344.87,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Anthem,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Anthem,Indemnity,,,349.16,,349.16,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Anthem,Individual Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Anthem,State Preferred,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Cigna,Cigna,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Connecticare,Commerical,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Connecticare,Exchange,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,Multiplan,Multiplan,,,396.19,,396.19,344.87,396.19,percent of total billed charges,,
INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,J3490,HCPCS,70100-424-02,NDC,both,1,ea,466.11,279.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,344.87,396.19,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Aetna,Commerical,,,853.98,,853.98,818.9,940.75,percent of total billed charges,,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Aetna,Middlesex Employees,,,818.9,,818.9,818.9,940.75,percent of total billed charges,,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Anthem,Commerical,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Anthem,Indemnity,,,829.08,,829.08,818.9,940.75,percent of total billed charges,,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Anthem,Individual Exchange,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Anthem,State Preferred,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Cigna,Cigna,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Connecticare,Commerical,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Connecticare,Exchange,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,Multiplan,Multiplan,,,940.75,,940.75,818.9,940.75,percent of total billed charges,,
INDOMETHACIN 0.1 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-62,NDC,both,1,mL,1106.77,664.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,818.9,940.75,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Aetna,Commerical,,,824.89,,824.89,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Aetna,Middlesex Employees,,,791,,791,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Anthem,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Anthem,Indemnity,,,800.84,,800.84,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Anthem,Individual Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Anthem,State Preferred,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Cigna,Cigna,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Connecticare,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Connecticare,Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,Multiplan,Multiplan,,,908.71,,908.71,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1113-01,NDC,both,1,ea,1069.07,641.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Aetna,Commerical,,,824.89,,824.89,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Aetna,Middlesex Employees,,,791,,791,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Anthem,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Anthem,Indemnity,,,800.84,,800.84,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Anthem,Individual Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Anthem,State Preferred,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Cigna,Cigna,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Connecticare,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Connecticare,Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,Multiplan,Multiplan,,,908.71,,908.71,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-659-03,NDC,both,1,ea,1069.07,641.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Aetna,Commerical,,,824.89,,824.89,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Aetna,Middlesex Employees,,,791,,791,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Anthem,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Anthem,Indemnity,,,800.84,,800.84,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Anthem,Individual Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Anthem,State Preferred,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Cigna,Cigna,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Connecticare,Commerical,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Connecticare,Exchange,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,Multiplan,Multiplan,,,908.71,,908.71,791,908.71,percent of total billed charges,,
INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,68382-470-01,NDC,both,1,ea,1069.07,641.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,791,908.71,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,50268-430-15,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Aetna,Commerical,,,1.9,,1.9,1.82,2.09,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Aetna,Middlesex Employees,,,1.82,,1.82,1.82,2.09,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Anthem,Commerical,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Anthem,Indemnity,,,1.84,,1.84,1.82,2.09,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Anthem,Individual Exchange,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Anthem,State Preferred,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Cigna,Cigna,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Connecticare,Commerical,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Connecticare,Exchange,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,Multiplan,Multiplan,,,2.09,,2.09,1.82,2.09,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,66267-119-30,NDC,both,1,ea,2.46,1.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.82,2.09,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
INDOMETHACIN 25 MG CAPSULE CHEMO,J3490,HCPCS,68462-406-01,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Aetna,Commerical,,,6735.64,,6735.64,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Aetna,Middlesex Employees,,,6458.92,,6458.92,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Indemnity,,,6539.23,,6539.23,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Individual Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,State Preferred,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Cigna,Cigna,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Connecticare,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Connecticare,Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Multiplan,Multiplan,,,7420.03,,7420.03,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Aetna,Commerical,,,6735.64,,6735.64,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Aetna,Middlesex Employees,,,6458.92,,6458.92,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Anthem,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Anthem,Indemnity,,,6539.23,,6539.23,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Anthem,Individual Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Anthem,State Preferred,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Cigna,Cigna,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Connecticare,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Connecticare,Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,Multiplan,Multiplan,,,7420.03,,7420.03,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-637-10,NDC,both,1,mL,8729.45,5237.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Aetna,Commerical,,,6735.64,,6735.64,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Aetna,Middlesex Employees,,,6458.92,,6458.92,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Indemnity,,,6539.23,,6539.23,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,Individual Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Anthem,State Preferred,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Cigna,Cigna,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Connecticare,Commerical,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Connecticare,Exchange,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,Multiplan,Multiplan,,,7420.03,,7420.03,6458.92,7420.03,percent of total billed charges,,
INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION CHEMO,J3490,HCPCS,69344-101-01,NDC,both,1,mL,8729.45,5237.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6458.92,7420.03,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
INDOMETHACIN 50 MG CAPSULE CHEMO,J3490,HCPCS,68462-302-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Aetna,Commerical,,,1029.41,,1029.41,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Aetna,Middlesex Employees,,,987.12,,987.12,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Anthem,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Anthem,Indemnity,,,999.39,,999.39,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Anthem,Individual Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Anthem,State Preferred,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Cigna,Cigna,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Connecticare,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Connecticare,Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,Multiplan,Multiplan,,,1134,,1134,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,69344-102-33,NDC,both,1,ea,1334.12,800.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Aetna,Commerical,,,1029.41,,1029.41,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Aetna,Middlesex Employees,,,987.12,,987.12,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Anthem,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Anthem,Indemnity,,,999.39,,999.39,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Anthem,Individual Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Anthem,State Preferred,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Cigna,Cigna,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Connecticare,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Connecticare,Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,Multiplan,Multiplan,,,1134,,1134,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-6,NDC,both,1,ea,1334.12,800.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Aetna,Commerical,,,1029.41,,1029.41,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Aetna,Middlesex Employees,,,987.12,,987.12,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Anthem,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Anthem,Indemnity,,,999.39,,999.39,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Anthem,Individual Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Anthem,State Preferred,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Cigna,Cigna,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Connecticare,Commerical,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Connecticare,Exchange,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,Multiplan,Multiplan,,,1134,,1134,987.12,1134,percent of total billed charges,,
INDOMETHACIN 50 MG RECTAL SUPPOSITORY,J3490,HCPCS,70710-1852-7,NDC,both,1,ea,1334.12,800.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,987.12,1134,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Aetna,Commerical,,,1675.4,,1675.4,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Aetna,Middlesex Employees,,,1606.57,,1606.57,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Commerical,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Indemnity,,,1626.54,,1626.54,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Individual Exchange,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,State Preferred,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Cigna,Cigna,,35.83,,,35.83,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Connecticare,Commerical,,49.2,,,49.2,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Connecticare,Exchange,,49.2,,,49.2,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,Multiplan,Multiplan,,,1845.63,,1845.63,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-030-01,NDC,both,0.1,ea,2171.33,1302.8,United Healthcare/Oxford,United Healthcare/Oxford,,38.69,,,38.69,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Aetna,Commerical,,,1675.4,,1675.4,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Aetna,Middlesex Employees,,,1606.57,,1606.57,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Commerical,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Indemnity,,,1626.54,,1626.54,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,Individual Exchange,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Anthem,State Preferred,,,,,,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Cigna,Cigna,,35.83,,,35.83,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Connecticare,Commerical,,49.2,,,49.2,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Connecticare,Exchange,,49.2,,,49.2,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,Multiplan,Multiplan,,,1845.63,,1845.63,35.83,1845.63,percent of total billed charges,,
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,J1745,HCPCS,57894-160-01,NDC,both,0.1,ea,2171.33,1302.8,United Healthcare/Oxford,United Healthcare/Oxford,,38.69,,,38.69,35.83,1845.63,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Aetna,Commerical,,,1677.69,,1677.69,33.8,1848.16,percent of total billed charges,,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Aetna,Middlesex Employees,,,1608.76,,1608.76,33.8,1848.16,percent of total billed charges,,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Anthem,Commerical,,,,,,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Anthem,Indemnity,,,1628.77,,1628.77,33.8,1848.16,percent of total billed charges,,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Anthem,Individual Exchange,,,,,,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Anthem,State Preferred,,,,,,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Cigna,Cigna,,33.8,,,33.8,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Connecticare,Commerical,,40.06,,,40.06,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Connecticare,Exchange,,40.06,,,40.06,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,Multiplan,Multiplan,,,1848.16,,1848.16,33.8,1848.16,percent of total billed charges,,
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,Q5104,HCPCS,0006-4305-02,NDC,both,0.1,ea,2174.3,1304.58,United Healthcare/Oxford,United Healthcare/Oxford,,36.49,,,36.49,33.8,1848.16,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Aetna,Commerical,,,1507.55,,1507.55,12.05,1660.73,percent of total billed charges,,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Aetna,Middlesex Employees,,,1445.62,,1445.62,12.05,1660.73,percent of total billed charges,,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Anthem,Commerical,,,,,,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Anthem,Indemnity,,,1463.59,,1463.59,12.05,1660.73,percent of total billed charges,,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Anthem,Individual Exchange,,,,,,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Anthem,State Preferred,,,,,,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Cigna,Cigna,,12.05,,,12.05,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Connecticare,Commerical,,18.11,,,18.11,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Connecticare,Exchange,,18.11,,,18.11,12.05,1660.73,Other,Could be inpatient or outpatient,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,Multiplan,Multiplan,,,1660.73,,1660.73,12.05,1660.73,percent of total billed charges,,
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,Q5103,HCPCS,0069-0809-01,NDC,both,0.1,ea,1953.8,1172.28,United Healthcare/Oxford,United Healthcare/Oxford,,13.01,,,13.01,12.05,1660.73,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Aetna,Commerical,,,64739.86,,64739.86,3195,71317.88,percent of total billed charges,,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Aetna,Middlesex Employees,,,62080.12,,62080.12,3195,71317.88,percent of total billed charges,,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Anthem,Commerical,,,,,,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Anthem,Indemnity,,,62852.03,,62852.03,3195,71317.88,percent of total billed charges,,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Anthem,Individual Exchange,,,,,,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Anthem,State Preferred,,,,,,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Cigna,Cigna,,3692.58,,,3692.58,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Connecticare,Commerical,,3998.93,,,3998.93,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Connecticare,Exchange,,3998.93,,,3998.93,3195,71317.88,Other,Could be inpatient or outpatient,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,Multiplan,Multiplan,,,71317.88,,71317.88,3195,71317.88,percent of total billed charges,,
INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,J9229,HCPCS,0008-0100-01,NDC,both,0.1,ea,83903.39,50342.03,United Healthcare/Oxford,United Healthcare/Oxford,,3195,,,3195,3195,71317.88,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Aetna,Commerical,,,192.21,,192.21,0.26,211.74,percent of total billed charges,,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Aetna,Middlesex Employees,,,184.32,,184.32,0.26,211.74,percent of total billed charges,,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Anthem,Commerical,,,,,,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Anthem,Indemnity,,,186.61,,186.61,0.26,211.74,percent of total billed charges,,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Anthem,Individual Exchange,,,,,,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Anthem,State Preferred,,,,,,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Cigna,Cigna,,0.26,,,0.26,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Connecticare,Commerical,,1.37,,,1.37,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Connecticare,Exchange,,1.37,,,1.37,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,Multiplan,Multiplan,,,211.74,,211.74,0.26,211.74,percent of total billed charges,,
INSULIN 10 UNIT/ML IV SOLUTION (REGULAR DILUTION),J1815,HCPCS,40810-0003-92,NDC,both,0.5,mL,249.11,149.47,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,211.74,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Aetna,Commerical,,,314.2,,314.2,0.26,346.13,percent of total billed charges,,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Aetna,Middlesex Employees,,,301.29,,301.29,0.26,346.13,percent of total billed charges,,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Anthem,Commerical,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Anthem,Indemnity,,,305.04,,305.04,0.26,346.13,percent of total billed charges,,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Anthem,Individual Exchange,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Anthem,State Preferred,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Cigna,Cigna,,0.26,,,0.26,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Connecticare,Commerical,,1.37,,,1.37,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Connecticare,Exchange,,1.37,,,1.37,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,Multiplan,Multiplan,,,346.13,,346.13,0.26,346.13,percent of total billed charges,,
INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,J1815,HCPCS,0169-3685-12,NDC,both,0.05,mL,407.21,244.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Aetna,Commerical,,,314.2,,314.2,0.26,346.13,percent of total billed charges,,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Aetna,Middlesex Employees,,,301.29,,301.29,0.26,346.13,percent of total billed charges,,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Anthem,Commerical,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Anthem,Indemnity,,,305.04,,305.04,0.26,346.13,percent of total billed charges,,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Anthem,Individual Exchange,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Anthem,State Preferred,,,,,,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Cigna,Cigna,,0.26,,,0.26,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Connecticare,Commerical,,1.37,,,1.37,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Connecticare,Exchange,,1.37,,,1.37,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,Multiplan,Multiplan,,,346.13,,346.13,0.26,346.13,percent of total billed charges,,
INSULIN ASPART U-100  100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-7501-11,NDC,both,0.05,mL,407.21,244.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,346.13,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Aetna,Commerical,,,685.32,,685.32,0.26,754.95,percent of total billed charges,,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Aetna,Middlesex Employees,,,657.16,,657.16,0.26,754.95,percent of total billed charges,,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Anthem,Commerical,,,,,,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Anthem,Indemnity,,,665.34,,665.34,0.26,754.95,percent of total billed charges,,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Anthem,Individual Exchange,,,,,,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Anthem,State Preferred,,,,,,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Cigna,Cigna,,0.26,,,0.26,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Connecticare,Commerical,,1.37,,,1.37,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Connecticare,Exchange,,1.37,,,1.37,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,Multiplan,Multiplan,,,754.95,,754.95,0.26,754.95,percent of total billed charges,,
INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0169-3687-12,NDC,both,0.05,mL,888.18,532.91,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,754.95,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Aetna,Commerical,,,199.13,,199.13,0.26,219.36,percent of total billed charges,,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Aetna,Middlesex Employees,,,190.95,,190.95,0.26,219.36,percent of total billed charges,,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Anthem,Commerical,,,,,,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Anthem,Indemnity,,,193.32,,193.32,0.26,219.36,percent of total billed charges,,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Anthem,Individual Exchange,,,,,,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Anthem,State Preferred,,,,,,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Cigna,Cigna,,0.26,,,0.26,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Connecticare,Commerical,,1.37,,,1.37,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Connecticare,Exchange,,1.37,,,1.37,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,Multiplan,Multiplan,,,219.36,,219.36,0.26,219.36,percent of total billed charges,,
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0088-2220-33,NDC,both,0.05,mL,258.07,154.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,219.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Aetna,Commerical,,,301.7,,301.7,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Aetna,Middlesex Employees,,,289.31,,289.31,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Anthem,Commerical,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Anthem,Indemnity,,,292.91,,292.91,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Anthem,Individual Exchange,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Anthem,State Preferred,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Cigna,Cigna,,0.26,,,0.26,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Connecticare,Commerical,,1.37,,,1.37,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Connecticare,Exchange,,1.37,,,1.37,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,Multiplan,Multiplan,,,332.36,,332.36,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-01,NDC,both,3,mL,391.01,234.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Aetna,Commerical,,,301.7,,301.7,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Aetna,Middlesex Employees,,,289.31,,289.31,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Anthem,Commerical,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Anthem,Indemnity,,,292.91,,292.91,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Anthem,Individual Exchange,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Anthem,State Preferred,,,,,,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Cigna,Cigna,,0.26,,,0.26,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Connecticare,Commerical,,1.37,,,1.37,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Connecticare,Exchange,,1.37,,,1.37,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,Multiplan,Multiplan,,,332.36,,332.36,0.26,332.36,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,J1815,HCPCS,0002-7516-59,NDC,both,0.05,mL,391.01,234.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,332.36,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Aetna,Commerical,,,115.25,,115.25,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Aetna,Middlesex Employees,,,110.52,,110.52,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Anthem,Commerical,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Anthem,Indemnity,,,111.89,,111.89,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Anthem,State Preferred,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Cigna,Cigna,,0.26,,,0.26,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Connecticare,Commerical,,1.37,,,1.37,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Connecticare,Exchange,,1.37,,,1.37,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,Multiplan,Multiplan,,,126.96,,126.96,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0002-7737-01,NDC,both,0.05,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Aetna,Commerical,,,115.25,,115.25,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Aetna,Middlesex Employees,,,110.52,,110.52,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Anthem,Commerical,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Anthem,Indemnity,,,111.89,,111.89,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Anthem,Individual Exchange,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Anthem,State Preferred,,,,,,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Cigna,Cigna,,0.26,,,0.26,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Connecticare,Commerical,,1.37,,,1.37,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Connecticare,Exchange,,1.37,,,1.37,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,Multiplan,Multiplan,,,126.96,,126.96,0.26,126.96,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5924-10,NDC,both,0.05,mL,149.37,89.62,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,126.96,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Commerical,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,State Preferred,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Cigna,Cigna,,0.26,,,0.26,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Commerical,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Exchange,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Commerical,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,State Preferred,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Cigna,Cigna,,0.26,,,0.26,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Commerical,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Exchange,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SLIDING SCALE,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Commerical,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,State Preferred,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Cigna,Cigna,,0.26,,,0.26,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Commerical,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Exchange,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Commerical,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Anthem,State Preferred,,,,,,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Cigna,Cigna,,0.26,,,0.26,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Commerical,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Connecticare,Exchange,,1.37,,,1.37,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,0.26,2.92,percent of total billed charges,,
INSULIN LISPRO 10 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,40810-0014-98,NDC,both,2,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,2.92,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CARBOHYDRATE COVERAGE SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML CORRECTION (BLOOD SUGAR) FACTOR BEDTIME,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML FIXED MEAL SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNIT/ML SLIDING SCALE,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR PRN SNACKS,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7510-17,NDC,both,3,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0002-7533-01,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Commerical,,,34.58,,34.58,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Aetna,Middlesex Employees,,,33.16,,33.16,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Commerical,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Indemnity,,,33.57,,33.57,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,Individual Exchange,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Anthem,State Preferred,,,,,,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Cigna,Cigna,,0.26,,,0.26,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Commerical,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Connecticare,Exchange,,1.37,,,1.37,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,Multiplan,Multiplan,,,38.1,,38.1,0.26,38.1,percent of total billed charges,,
INSULIN LISPRO 100 UNITS/ML SUB-Q DOSE CALCULATOR SCHEDULED,J1815,HCPCS,0024-5926-05,NDC,both,0.05,mL,44.82,26.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,38.1,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Aetna,Commerical,,,13.29,,13.29,0.26,14.64,percent of total billed charges,,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Aetna,Middlesex Employees,,,12.74,,12.74,0.26,14.64,percent of total billed charges,,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Anthem,Commerical,,,,,,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Anthem,Indemnity,,,12.9,,12.9,0.26,14.64,percent of total billed charges,,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Anthem,Individual Exchange,,,,,,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Anthem,State Preferred,,,,,,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Cigna,Cigna,,0.26,,,0.26,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Connecticare,Commerical,,1.37,,,1.37,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Connecticare,Exchange,,1.37,,,1.37,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,Multiplan,Multiplan,,,14.64,,14.64,0.26,14.64,percent of total billed charges,,
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,J1815,HCPCS,0002-7511-01,NDC,both,10,mL,17.22,10.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,14.64,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Aetna,Commerical,,,19.23,,19.23,0.26,21.18,percent of total billed charges,,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Aetna,Middlesex Employees,,,18.44,,18.44,0.26,21.18,percent of total billed charges,,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Anthem,Commerical,,,,,,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Anthem,Indemnity,,,18.67,,18.67,0.26,21.18,percent of total billed charges,,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Anthem,Individual Exchange,,,,,,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Anthem,State Preferred,,,,,,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Cigna,Cigna,,0.26,,,0.26,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Connecticare,Commerical,,1.37,,,1.37,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Connecticare,Exchange,,1.37,,,1.37,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,Multiplan,Multiplan,,,21.18,,21.18,0.26,21.18,percent of total billed charges,,
INSULIN REGULAR 0.1 UNIT/ML INFUSION NICU,J1815,HCPCS,40810-0205-07,NDC,both,3,mL,24.92,14.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,21.18,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Aetna,Commerical,,,57.04,,57.04,0.26,62.83,percent of total billed charges,,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Aetna,Middlesex Employees,,,54.69,,54.69,0.26,62.83,percent of total billed charges,,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Anthem,Commerical,,,,,,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Anthem,Indemnity,,,55.37,,55.37,0.26,62.83,percent of total billed charges,,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Anthem,Individual Exchange,,,,,,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Anthem,State Preferred,,,,,,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Cigna,Cigna,,0.26,,,0.26,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Connecticare,Commerical,,1.37,,,1.37,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Connecticare,Exchange,,1.37,,,1.37,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,Multiplan,Multiplan,,,62.83,,62.83,0.26,62.83,percent of total billed charges,,
INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,J1815,HCPCS,0338-0126-12,NDC,both,5,mL,73.92,44.35,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,62.83,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR 100 UNITS/ML IV BOLUS,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN REGULAR HUMAN 100 UNIT/ML HYPERKALEMIA,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-0213-01,NDC,both,0.05,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Commerical,,,15.55,,15.55,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Aetna,Middlesex Employees,,,14.91,,14.91,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Commerical,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Indemnity,,,15.09,,15.09,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,Individual Exchange,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Anthem,State Preferred,,,,,,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Cigna,Cigna,,0.26,,,0.26,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Commerical,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Connecticare,Exchange,,1.37,,,1.37,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,Multiplan,Multiplan,,,17.13,,17.13,0.26,17.13,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0002-8215-17,NDC,both,0.1,mL,20.15,12.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,17.13,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Aetna,Commerical,,,51.81,,51.81,0.26,57.07,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Aetna,Middlesex Employees,,,49.68,,49.68,0.26,57.07,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Anthem,Commerical,,,,,,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Anthem,Indemnity,,,50.29,,50.29,0.26,57.07,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Anthem,Individual Exchange,,,,,,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Anthem,State Preferred,,,,,,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Cigna,Cigna,,0.26,,,0.26,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Connecticare,Commerical,,1.37,,,1.37,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Connecticare,Exchange,,1.37,,,1.37,0.26,57.07,Other,Could be inpatient or outpatient,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,Multiplan,Multiplan,,,57.07,,57.07,0.26,57.07,percent of total billed charges,,
INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,J1815,HCPCS,0169-1833-11,NDC,both,0.05,mL,67.14,40.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.68,,,0.68,0.26,57.07,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Aetna,Commerical,,,4.57,,4.57,4.38,5.03,percent of total billed charges,,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Aetna,Middlesex Employees,,,4.38,,4.38,4.38,5.03,percent of total billed charges,,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Anthem,Commerical,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Anthem,Indemnity,,,4.43,,4.43,4.38,5.03,percent of total billed charges,,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Anthem,Individual Exchange,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Anthem,State Preferred,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Cigna,Cigna,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Connecticare,Commerical,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Connecticare,Exchange,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,Multiplan,Multiplan,,,5.03,,5.03,4.38,5.03,percent of total billed charges,,
INTRASITE TOPICAL GEL,J3490,HCPCS,8026731100,NDC,both,15,gm,5.92,3.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Aetna,Commerical,,,91.73,,91.73,87.96,101.05,percent of total billed charges,,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Aetna,Middlesex Employees,,,87.96,,87.96,87.96,101.05,percent of total billed charges,,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Anthem,Commerical,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Anthem,Indemnity,,,89.05,,89.05,87.96,101.05,percent of total billed charges,,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Anthem,Individual Exchange,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Anthem,State Preferred,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Cigna,Cigna,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Connecticare,Commerical,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Connecticare,Exchange,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,Multiplan,Multiplan,,,101.05,,101.05,87.96,101.05,percent of total billed charges,,
IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,J3490,HCPCS,48433-230-15,NDC,both,1,mL,118.88,71.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.96,101.05,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Aetna,Commerical,,,2.4,,2.4,2.3,2.64,percent of total billed charges,,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Aetna,Middlesex Employees,,,2.3,,2.3,2.3,2.64,percent of total billed charges,,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Anthem,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Anthem,Indemnity,,,2.33,,2.33,2.3,2.64,percent of total billed charges,,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Anthem,Individual Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Anthem,State Preferred,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Cigna,Cigna,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Connecticare,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Connecticare,Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,Multiplan,Multiplan,,,2.64,,2.64,2.3,2.64,percent of total billed charges,,
IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE,J3490,HCPCS,0869-0088-10,NDC,both,30,mL,3.11,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Aetna,Commerical,,,51.87,,51.87,0.4,57.14,percent of total billed charges,,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Aetna,Middlesex Employees,,,49.74,,49.74,0.4,57.14,percent of total billed charges,,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Anthem,Commerical,,,,,,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Anthem,Indemnity,,,50.35,,50.35,0.4,57.14,percent of total billed charges,,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Anthem,Individual Exchange,,,,,,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Anthem,State Preferred,,,,,,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Cigna,Cigna,,0.4,,,0.4,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Connecticare,Commerical,,0.58,,,0.58,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Connecticare,Exchange,,0.58,,,0.58,0.4,57.14,Other,Could be inpatient or outpatient,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,Multiplan,Multiplan,,,57.14,,57.14,0.4,57.14,percent of total billed charges,,
IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,Q9966,HCPCS,0407-2222-16,NDC,both,50,mL,67.22,40.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.43,,,0.43,0.4,57.14,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Aetna,Commerical,,,113.63,,113.63,2.14,125.18,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Aetna,Middlesex Employees,,,108.97,,108.97,2.14,125.18,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Anthem,Commerical,,,,,,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Anthem,Indemnity,,,110.32,,110.32,2.14,125.18,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Anthem,Individual Exchange,,,,,,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Anthem,State Preferred,,,,,,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Cigna,Cigna,,2.14,,,2.14,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Connecticare,Commerical,,2.37,,,2.37,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Connecticare,Exchange,,2.37,,,2.37,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,Multiplan,Multiplan,,,125.18,,125.18,2.14,125.18,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-10,NDC,both,1,mL,147.27,88.36,United Healthcare/Oxford,United Healthcare/Oxford,,2.31,,,2.31,2.14,125.18,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Aetna,Commerical,,,136.71,,136.71,2.14,150.6,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Aetna,Middlesex Employees,,,131.1,,131.1,2.14,150.6,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Anthem,Commerical,,,,,,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Anthem,Indemnity,,,132.73,,132.73,2.14,150.6,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Anthem,Individual Exchange,,,,,,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Anthem,State Preferred,,,,,,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Cigna,Cigna,,2.14,,,2.14,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Connecticare,Commerical,,2.37,,,2.37,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Connecticare,Exchange,,2.37,,,2.37,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,Multiplan,Multiplan,,,150.6,,150.6,2.14,150.6,percent of total billed charges,,
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,Q9965,HCPCS,0407-1411-20,NDC,both,1,mL,177.18,106.31,United Healthcare/Oxford,United Healthcare/Oxford,,2.31,,,2.31,2.14,150.6,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Aetna,Commerical,,,131.51,,131.51,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Aetna,Middlesex Employees,,,126.11,,126.11,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Commerical,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Indemnity,,,127.68,,127.68,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Individual Exchange,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,State Preferred,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Cigna,Cigna,,0.16,,,0.16,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Connecticare,Commerical,,0.22,,,0.22,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Connecticare,Exchange,,0.22,,,0.22,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Multiplan,Multiplan,,,144.87,,144.87,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Aetna,Commerical,,,131.51,,131.51,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Aetna,Middlesex Employees,,,126.11,,126.11,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Commerical,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Indemnity,,,127.68,,127.68,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,Individual Exchange,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Anthem,State Preferred,,,,,,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Cigna,Cigna,,0.16,,,0.16,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Connecticare,Commerical,,0.22,,,0.22,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Connecticare,Exchange,,0.22,,,0.22,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,Multiplan,Multiplan,,,144.87,,144.87,0.16,144.87,percent of total billed charges,,
IOHEXOL 300 MG IODINE/ML ORAL,Q9967,HCPCS,0407-1413-61,NDC,both,1,mL,170.44,102.26,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,144.87,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Aetna,Commerical,,,28.08,,28.08,26.92,30.93,percent of total billed charges,,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Aetna,Middlesex Employees,,,26.92,,26.92,26.92,30.93,percent of total billed charges,,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Anthem,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Anthem,Indemnity,,,27.26,,27.26,26.92,30.93,percent of total billed charges,,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Anthem,Individual Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Anthem,State Preferred,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Cigna,Cigna,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Connecticare,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Connecticare,Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,Multiplan,Multiplan,,,30.93,,30.93,26.92,30.93,percent of total billed charges,,
IOHEXOL 9 MG IODINE/ML ORAL SOLUTION,J3490,HCPCS,0407-1415-09,NDC,both,1,mL,36.39,21.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.16,18.23,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.16,18.23,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Anthem,Commerical,,,,,,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.16,18.23,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Anthem,Individual Exchange,,,,,,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Anthem,State Preferred,,,,,,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Cigna,Cigna,,0.16,,,0.16,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Connecticare,Commerical,,0.22,,,0.22,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Connecticare,Exchange,,0.22,,,0.22,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.16,18.23,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-05,NDC,both,1,mL,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,18.23,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Aetna,Commerical,,,33.1,,33.1,0.16,36.47,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Aetna,Middlesex Employees,,,31.74,,31.74,0.16,36.47,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Anthem,Commerical,,,,,,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Anthem,Indemnity,,,32.14,,32.14,0.16,36.47,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Anthem,Individual Exchange,,,,,,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Anthem,State Preferred,,,,,,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Cigna,Cigna,,0.16,,,0.16,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Connecticare,Commerical,,0.22,,,0.22,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Connecticare,Exchange,,0.22,,,0.22,0.16,36.47,Other,Could be inpatient or outpatient,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,Multiplan,Multiplan,,,36.47,,36.47,0.16,36.47,percent of total billed charges,,
IOPROMIDE 300 MG IODINE/ML INJECTION SOLUTION,Q9967,HCPCS,50419-344-10,NDC,both,1,mL,42.9,25.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,36.47,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Aetna,Commerical,,,49.51,,49.51,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Aetna,Middlesex Employees,,,47.47,,47.47,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Anthem,Commerical,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Anthem,Indemnity,,,48.06,,48.06,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Anthem,Individual Exchange,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Anthem,State Preferred,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Cigna,Cigna,,0.08,,,0.08,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Connecticare,Commerical,,0.11,,,0.11,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Connecticare,Exchange,,0.11,,,0.11,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,Multiplan,Multiplan,,,54.54,,54.54,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-07,NDC,both,1,mL,64.16,38.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Aetna,Commerical,,,49.51,,49.51,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Aetna,Middlesex Employees,,,47.47,,47.47,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Anthem,Commerical,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Anthem,Indemnity,,,48.06,,48.06,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Anthem,Individual Exchange,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Anthem,State Preferred,,,,,,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Cigna,Cigna,,0.08,,,0.08,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Connecticare,Commerical,,0.11,,,0.11,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Connecticare,Exchange,,0.11,,,0.11,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,Multiplan,Multiplan,,,54.54,,54.54,0.08,54.54,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTION,Q9958,HCPCS,0019-0862-50,NDC,both,1,mL,64.16,38.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,54.54,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Aetna,Commerical,,,113.78,,113.78,0.32,125.34,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Aetna,Middlesex Employees,,,109.11,,109.11,0.32,125.34,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Anthem,Commerical,,,,,,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Anthem,Indemnity,,,110.46,,110.46,0.32,125.34,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Anthem,Individual Exchange,,,,,,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Anthem,State Preferred,,,,,,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Cigna,Cigna,,0.32,,,0.32,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Connecticare,Commerical,,0.42,,,0.42,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Connecticare,Exchange,,0.42,,,0.42,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,Multiplan,Multiplan,,,125.34,,125.34,0.32,125.34,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 43 % INTRAVENOUS SOLUTION,Q9960,HCPCS,0019-3183-09,NDC,both,1,mL,147.46,88.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,125.34,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Aetna,Commerical,,,73.88,,73.88,0.29,81.39,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Aetna,Middlesex Employees,,,70.85,,70.85,0.29,81.39,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Anthem,Commerical,,,,,,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Anthem,Indemnity,,,71.73,,71.73,0.29,81.39,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Anthem,Individual Exchange,,,,,,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Anthem,State Preferred,,,,,,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Cigna,Cigna,,0.29,,,0.29,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Connecticare,Commerical,,0.42,,,0.42,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Connecticare,Exchange,,0.42,,,0.42,0.29,81.39,Other,Could be inpatient or outpatient,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,Multiplan,Multiplan,,,81.39,,81.39,0.29,81.39,percent of total billed charges,,
IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,Q9961,HCPCS,0019-0953-09,NDC,both,1,mL,95.75,57.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,81.39,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Aetna,Commerical,,,37.24,,37.24,0.16,41.02,percent of total billed charges,,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Aetna,Middlesex Employees,,,35.71,,35.71,0.16,41.02,percent of total billed charges,,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Anthem,Commerical,,,,,,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Anthem,Indemnity,,,36.15,,36.15,0.16,41.02,percent of total billed charges,,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Anthem,Individual Exchange,,,,,,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Anthem,State Preferred,,,,,,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Cigna,Cigna,,0.16,,,0.16,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Connecticare,Commerical,,0.22,,,0.22,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Connecticare,Exchange,,0.22,,,0.22,0.16,41.02,Other,Could be inpatient or outpatient,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,Multiplan,Multiplan,,,41.02,,41.02,0.16,41.02,percent of total billed charges,,
IOVERSOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,Q9967,HCPCS,0019-1323-11,NDC,both,1,mL,48.26,28.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,41.02,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Aetna,Commerical,,,24721.05,,24721.05,215.67,27232.88,percent of total billed charges,,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Aetna,Middlesex Employees,,,23705.42,,23705.42,215.67,27232.88,percent of total billed charges,,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Anthem,Commerical,,,,,,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Anthem,Indemnity,,,24000.18,,24000.18,215.67,27232.88,percent of total billed charges,,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Anthem,Individual Exchange,,,,,,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Anthem,State Preferred,,,,,,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Cigna,Cigna,,249.26,,,249.26,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Connecticare,Commerical,,270.1,,,270.1,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Connecticare,Exchange,,270.1,,,270.1,215.67,27232.88,Other,Could be inpatient or outpatient,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,Multiplan,Multiplan,,,27232.88,,27232.88,215.67,27232.88,percent of total billed charges,,
IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J9228,HCPCS,0003-2327-11,NDC,both,0.2,mL,32038.68,19223.21,United Healthcare/Oxford,United Healthcare/Oxford,,215.67,,,215.67,215.67,27232.88,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Anthem,Commerical,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Anthem,Individual Exchange,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Anthem,State Preferred,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Cigna,Cigna,,0.43,,,0.43,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Connecticare,Commerical,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Connecticare,Exchange,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-01,NDC,both,2.5,mL,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.46,,,0.46,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Anthem,Commerical,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Anthem,Individual Exchange,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Anthem,State Preferred,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Cigna,Cigna,,0.43,,,0.43,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Connecticare,Commerical,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Connecticare,Exchange,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,0487-9801-25,NDC,both,2.5,mL,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.46,,,0.46,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Anthem,Commerical,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Anthem,Individual Exchange,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Anthem,State Preferred,,,,,,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Cigna,Cigna,,0.43,,,0.43,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Connecticare,Commerical,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Connecticare,Exchange,,0.55,,,0.55,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.43,0.59,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,60687-394-79,NDC,both,2.5,mL,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.46,,,0.46,0.43,0.59,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.43,0.69,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.43,0.69,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Anthem,Commerical,,,,,,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.43,0.69,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Anthem,Individual Exchange,,,,,,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Anthem,State Preferred,,,,,,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Cigna,Cigna,,0.43,,,0.43,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Connecticare,Commerical,,0.55,,,0.55,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Connecticare,Exchange,,0.55,,,0.55,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.43,0.69,percent of total billed charges,,
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,J7644,HCPCS,76204-100-01,NDC,both,2.5,mL,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.46,,,0.46,0.43,0.69,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Aetna,Commerical,,,1303.6,,1303.6,1250.05,1436.06,percent of total billed charges,,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Aetna,Middlesex Employees,,,1250.05,,1250.05,1250.05,1436.06,percent of total billed charges,,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Anthem,Commerical,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Anthem,Indemnity,,,1265.59,,1265.59,1250.05,1436.06,percent of total billed charges,,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Anthem,Individual Exchange,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Anthem,State Preferred,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Cigna,Cigna,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Connecticare,Commerical,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Connecticare,Exchange,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,Multiplan,Multiplan,,,1436.06,,1436.06,1250.05,1436.06,percent of total billed charges,,
IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0597-0087-17,NDC,both,12.9,gm,1689.48,1013.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1250.05,1436.06,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Aetna,Commerical,,,53.19,,53.19,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Aetna,Middlesex Employees,,,51.01,,51.01,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Anthem,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Anthem,Indemnity,,,51.64,,51.64,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Anthem,Individual Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Anthem,State Preferred,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Cigna,Cigna,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Connecticare,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Connecticare,Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,Multiplan,Multiplan,,,58.6,,58.6,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,24208-398-30,NDC,both,1,mL,68.94,41.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Aetna,Commerical,,,15.69,,15.69,15.05,17.29,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Aetna,Middlesex Employees,,,15.05,,15.05,15.05,17.29,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Anthem,Commerical,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Anthem,Indemnity,,,15.24,,15.24,15.05,17.29,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Anthem,Individual Exchange,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Anthem,State Preferred,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Cigna,Cigna,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Connecticare,Commerical,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Connecticare,Exchange,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,Multiplan,Multiplan,,,17.29,,17.29,15.05,17.29,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,60505-0826-1,NDC,both,1,mL,20.34,12.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.05,17.29,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Aetna,Commerical,,,53.19,,53.19,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Aetna,Middlesex Employees,,,51.01,,51.01,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Anthem,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Anthem,Indemnity,,,51.64,,51.64,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Anthem,Individual Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Anthem,State Preferred,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Cigna,Cigna,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Connecticare,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Connecticare,Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,Multiplan,Multiplan,,,58.6,,58.6,51.01,58.6,percent of total billed charges,,
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,J3490,HCPCS,69238-2016-3,NDC,both,1,mL,68.94,41.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Aetna,Commerical,,,98.94,,98.94,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Aetna,Middlesex Employees,,,94.88,,94.88,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Anthem,Commerical,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Anthem,Indemnity,,,96.06,,96.06,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Anthem,Individual Exchange,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Anthem,State Preferred,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Cigna,Cigna,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Connecticare,Commerical,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Connecticare,Exchange,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,Multiplan,Multiplan,,,109,,109,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,0054-0046-41,NDC,both,15,mL,128.23,76.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Aetna,Commerical,,,98.94,,98.94,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Aetna,Middlesex Employees,,,94.88,,94.88,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Anthem,Commerical,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Anthem,Indemnity,,,96.06,,96.06,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Anthem,Individual Exchange,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Anthem,State Preferred,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Cigna,Cigna,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Connecticare,Commerical,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Connecticare,Exchange,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,Multiplan,Multiplan,,,109,,109,94.88,109,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,24208-399-15,NDC,both,1,mL,128.23,76.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,94.88,109,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Aetna,Commerical,,,31.61,,31.61,30.31,34.82,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Aetna,Middlesex Employees,,,30.31,,30.31,30.31,34.82,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Anthem,Commerical,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Anthem,Indemnity,,,30.69,,30.69,30.31,34.82,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Anthem,Individual Exchange,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Anthem,State Preferred,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Cigna,Cigna,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Connecticare,Commerical,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Connecticare,Exchange,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,Multiplan,Multiplan,,,34.82,,34.82,30.31,34.82,percent of total billed charges,,
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,J3490,HCPCS,60505-0827-1,NDC,both,1,mL,40.97,24.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.31,34.82,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Aetna,Commerical,,,48.59,,48.59,46.59,53.52,percent of total billed charges,,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Aetna,Middlesex Employees,,,46.59,,46.59,46.59,53.52,percent of total billed charges,,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Anthem,Commerical,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Anthem,Indemnity,,,47.17,,47.17,46.59,53.52,percent of total billed charges,,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Anthem,Individual Exchange,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Anthem,State Preferred,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Cigna,Cigna,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Connecticare,Commerical,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Connecticare,Exchange,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,Multiplan,Multiplan,,,53.52,,53.52,46.59,53.52,percent of total billed charges,,
IRBESARTAN 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0204-81,NDC,both,1,mL,62.97,37.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Aetna,Commerical,,,21.46,,21.46,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Aetna,Middlesex Employees,,,20.58,,20.58,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Anthem,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Anthem,Indemnity,,,20.83,,20.83,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Anthem,Individual Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Anthem,State Preferred,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Cigna,Cigna,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Connecticare,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Connecticare,Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,Multiplan,Multiplan,,,23.64,,23.64,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,0024-5852-30,NDC,both,1,ea,27.81,16.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Aetna,Commerical,,,21.46,,21.46,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Aetna,Middlesex Employees,,,20.58,,20.58,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Anthem,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Anthem,Indemnity,,,20.83,,20.83,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Anthem,Individual Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Anthem,State Preferred,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Cigna,Cigna,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Connecticare,Commerical,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Connecticare,Exchange,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,Multiplan,Multiplan,,,23.64,,23.64,20.58,23.64,percent of total billed charges,,
IRBESARTAN 300 MG TABLET,J3490,HCPCS,40810-0204-02,NDC,both,1,ea,27.81,16.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.58,23.64,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Aetna,Commerical,,,5.69,,5.69,5.45,6.26,percent of total billed charges,,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Aetna,Middlesex Employees,,,5.45,,5.45,5.45,6.26,percent of total billed charges,,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Anthem,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Anthem,Indemnity,,,5.52,,5.52,5.45,6.26,percent of total billed charges,,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Anthem,Individual Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Anthem,State Preferred,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Cigna,Cigna,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Connecticare,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Connecticare,Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,Multiplan,Multiplan,,,6.26,,6.26,5.45,6.26,percent of total billed charges,,
IRBESARTAN 37.5 MG TABLET,J3490,HCPCS,40810-0204-03,NDC,both,1,ea,7.37,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9583-01,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0143-9701-01,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-353-01,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,60505-6128-1,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-09,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Aetna,Commerical,,,39.84,,39.84,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Aetna,Middlesex Employees,,,38.2,,38.2,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Anthem,Commerical,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Anthem,Indemnity,,,38.68,,38.68,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Anthem,Individual Exchange,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Anthem,State Preferred,,,,,,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Cigna,Cigna,,3.82,,,3.82,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Connecticare,Commerical,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Connecticare,Exchange,,3.81,,,3.81,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,Multiplan,Multiplan,,,43.89,,43.89,3.31,43.89,percent of total billed charges,,
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-05,NDC,both,1,mL,51.63,30.98,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,43.89,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Aetna,Commerical,,,88.66,,88.66,3.31,97.67,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Aetna,Middlesex Employees,,,85.01,,85.01,3.31,97.67,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Anthem,Commerical,,,,,,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Anthem,Indemnity,,,86.07,,86.07,3.31,97.67,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Anthem,Individual Exchange,,,,,,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Anthem,State Preferred,,,,,,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Cigna,Cigna,,3.82,,,3.82,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Connecticare,Commerical,,3.81,,,3.81,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Connecticare,Exchange,,3.81,,,3.81,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,Multiplan,Multiplan,,,97.67,,97.67,3.31,97.67,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,25021-230-02,NDC,both,1,mL,114.9,68.94,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,97.67,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,0009-7529-04,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,55150-352-01,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,61703-349-16,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Commerical,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,Individual Exchange,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Anthem,State Preferred,,,,,,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Cigna,Cigna,,3.82,,,3.82,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Connecticare,Commerical,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Connecticare,Exchange,,3.81,,,3.81,3.31,15.21,Other,Could be inpatient or outpatient,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,3.31,15.21,percent of total billed charges,,
IRINOTECAN 40 MG/2 ML ORAL SOLUTION,J9206,HCPCS,63323-193-02,NDC,both,1,mL,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,3.31,,,3.31,3.31,15.21,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Aetna,Commerical,,,96.15,,96.15,20.33,105.92,percent of total billed charges,,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Aetna,Middlesex Employees,,,92.2,,92.2,20.33,105.92,percent of total billed charges,,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Anthem,Commerical,,,,,,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Anthem,Indemnity,,,93.35,,93.35,20.33,105.92,percent of total billed charges,,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Anthem,Individual Exchange,,,,,,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Anthem,State Preferred,,,,,,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Cigna,Cigna,,20.33,,,20.33,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Connecticare,Commerical,,26.98,,,26.98,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Connecticare,Exchange,,26.98,,,26.98,20.33,105.92,Other,Could be inpatient or outpatient,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,Multiplan,Multiplan,,,105.92,,105.92,20.33,105.92,percent of total billed charges,,
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,J1750,HCPCS,0023-6082-10,NDC,both,1,mL,124.61,74.77,United Healthcare/Oxford,United Healthcare/Oxford,,21.95,,,21.95,20.33,105.92,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Aetna,Commerical,,,180.92,,180.92,0.26,199.31,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Aetna,Middlesex Employees,,,173.49,,173.49,0.26,199.31,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Anthem,Commerical,,,,,,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Anthem,Indemnity,,,175.65,,175.65,0.26,199.31,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Anthem,Individual Exchange,,,,,,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Anthem,State Preferred,,,,,,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Cigna,Cigna,,0.26,,,0.26,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Connecticare,Commerical,,0.36,,,0.36,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Connecticare,Exchange,,0.36,,,0.36,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,Multiplan,Multiplan,,,199.31,,199.31,0.26,199.31,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-10,NDC,both,0.01,mL,234.48,140.69,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,199.31,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Aetna,Commerical,,,141.85,,141.85,0.26,156.26,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Aetna,Middlesex Employees,,,136.02,,136.02,0.26,156.26,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Anthem,Commerical,,,,,,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Anthem,Indemnity,,,137.71,,137.71,0.26,156.26,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Anthem,Individual Exchange,,,,,,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Anthem,State Preferred,,,,,,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Cigna,Cigna,,0.26,,,0.26,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Connecticare,Commerical,,0.36,,,0.36,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Connecticare,Exchange,,0.36,,,0.36,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,Multiplan,Multiplan,,,156.26,,156.26,0.26,156.26,percent of total billed charges,,
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2340-25,NDC,both,0.05,mL,183.84,110.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,156.26,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Aetna,Commerical,,,54.27,,54.27,0.26,59.79,percent of total billed charges,,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Aetna,Middlesex Employees,,,52.04,,52.04,0.26,59.79,percent of total billed charges,,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Anthem,Commerical,,,,,,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Anthem,Indemnity,,,52.69,,52.69,0.26,59.79,percent of total billed charges,,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Anthem,Individual Exchange,,,,,,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Anthem,State Preferred,,,,,,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Cigna,Cigna,,0.26,,,0.26,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Connecticare,Commerical,,0.36,,,0.36,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Connecticare,Exchange,,0.36,,,0.36,0.26,59.79,Other,Could be inpatient or outpatient,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,Multiplan,Multiplan,,,59.79,,59.79,0.26,59.79,percent of total billed charges,,
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,J1756,HCPCS,0517-2325-10,NDC,both,0.05,mL,70.34,42.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.26,59.79,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Aetna,Commerical,,,263.19,,263.19,252.38,289.94,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Aetna,Middlesex Employees,,,252.38,,252.38,252.38,289.94,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Anthem,Commerical,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Anthem,Indemnity,,,255.52,,255.52,252.38,289.94,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Anthem,Individual Exchange,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Anthem,State Preferred,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Cigna,Cigna,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Connecticare,Commerical,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Connecticare,Exchange,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,Multiplan,Multiplan,,,289.94,,289.94,252.38,289.94,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,J3490,HCPCS,0469-0520-14,NDC,both,1,ea,341.1,204.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,252.38,289.94,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Aetna,Commerical,,,1037.88,,1037.88,1.19,1143.34,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Aetna,Middlesex Employees,,,995.24,,995.24,1.19,1143.34,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Anthem,Commerical,,,,,,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Anthem,Indemnity,,,1007.61,,1007.61,1.19,1143.34,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Anthem,Individual Exchange,,,,,,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Anthem,State Preferred,,,,,,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Cigna,Cigna,,1.19,,,1.19,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Connecticare,Commerical,,,,,,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Connecticare,Exchange,,,,,,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,Multiplan,Multiplan,,,1143.34,,1143.34,1.19,1143.34,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-01,NDC,both,0.003,ea,1345.1,807.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.19,1143.34,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Aetna,Commerical,,,1035.81,,1035.81,1.19,1141.06,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Aetna,Middlesex Employees,,,993.26,,993.26,1.19,1141.06,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Anthem,Commerical,,,,,,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Anthem,Indemnity,,,1005.61,,1005.61,1.19,1141.06,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Anthem,Individual Exchange,,,,,,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Anthem,State Preferred,,,,,,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Cigna,Cigna,,1.19,,,1.19,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Connecticare,Commerical,,,,,,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Connecticare,Exchange,,,,,,1.19,1141.06,Other,Could be inpatient or outpatient,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,Multiplan,Multiplan,,,1141.06,,1141.06,1.19,1141.06,percent of total billed charges,,
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,J1833,HCPCS,0469-0420-99,NDC,both,0.002,ea,1342.42,805.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.19,1141.06,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
ISONIAZID 100 MG TABLET,J3490,HCPCS,0555-0066-02,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Aetna,Commerical,,,830.31,,830.31,796.2,914.68,percent of total billed charges,,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Aetna,Middlesex Employees,,,796.2,,796.2,796.2,914.68,percent of total billed charges,,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Anthem,Commerical,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Anthem,Indemnity,,,806.1,,806.1,796.2,914.68,percent of total billed charges,,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Anthem,Individual Exchange,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Anthem,State Preferred,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Cigna,Cigna,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Connecticare,Commerical,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Connecticare,Exchange,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,Multiplan,Multiplan,,,914.68,,914.68,796.2,914.68,percent of total billed charges,,
ISONIAZID 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,46287-009-01,NDC,both,1,mL,1076.09,645.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,796.2,914.68,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0187-4330-05,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Aetna,Commerical,,,341.33,,341.33,327.31,376.01,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Aetna,Middlesex Employees,,,327.31,,327.31,327.31,376.01,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Anthem,Commerical,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Anthem,Indemnity,,,331.38,,331.38,327.31,376.01,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Anthem,Individual Exchange,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Anthem,State Preferred,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Cigna,Cigna,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Connecticare,Commerical,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Connecticare,Exchange,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,Multiplan,Multiplan,,,376.01,,376.01,327.31,376.01,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,0548-9501-00,NDC,both,1,mL,442.37,265.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,327.31,376.01,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Aetna,Commerical,,,2804.36,,2804.36,2689.15,3089.31,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Aetna,Middlesex Employees,,,2689.15,,2689.15,2689.15,3089.31,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Anthem,Commerical,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Anthem,Indemnity,,,2722.59,,2722.59,2689.15,3089.31,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Anthem,Individual Exchange,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Anthem,State Preferred,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Cigna,Cigna,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Connecticare,Commerical,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Connecticare,Exchange,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,Multiplan,Multiplan,,,3089.31,,3089.31,2689.15,3089.31,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-05,NDC,both,1,mL,3634.48,2180.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2689.15,3089.31,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,14789-015-07,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-31,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,23155-661-42,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-01,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,69918-735-10,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-01,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Aetna,Commerical,,,1706.65,,1706.65,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Aetna,Middlesex Employees,,,1636.53,,1636.53,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Indemnity,,,1656.88,,1656.88,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Anthem,Individual Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Anthem,State Preferred,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Cigna,Cigna,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Connecticare,Commerical,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Connecticare,Exchange,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,Multiplan,Multiplan,,,1880.06,,1880.06,1636.53,1880.06,percent of total billed charges,,
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,J3490,HCPCS,72485-113-10,NDC,both,1,mL,2211.83,1327.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.53,1880.06,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0781-1556-13,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Aetna,Commerical,,,1.34,,1.34,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Anthem,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Anthem,Indemnity,,,1.3,,1.3,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Anthem,Individual Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Anthem,State Preferred,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Cigna,Cigna,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Connecticare,Commerical,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Connecticare,Exchange,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,Multiplan,Multiplan,,,1.48,,1.48,1.29,1.48,percent of total billed charges,,
ISOSORBIDE DINITRATE 10 MG TABLET,J3490,HCPCS,0904-6619-61,NDC,both,1,ea,1.74,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.48,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Aetna,Commerical,,,15.73,,15.73,15.09,17.33,percent of total billed charges,,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Aetna,Middlesex Employees,,,15.09,,15.09,15.09,17.33,percent of total billed charges,,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Anthem,Commerical,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Anthem,Indemnity,,,15.27,,15.27,15.09,17.33,percent of total billed charges,,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Anthem,Individual Exchange,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Anthem,State Preferred,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Cigna,Cigna,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Connecticare,Commerical,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Connecticare,Exchange,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,Multiplan,Multiplan,,,17.33,,17.33,15.09,17.33,percent of total billed charges,,
ISOTRETINOIN 10 MG CAPSULE CHEMO,J3490,HCPCS,0555-1054-56,NDC,both,1,ea,20.39,12.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.09,17.33,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Aetna,Commerical,,,18.66,,18.66,17.89,20.55,percent of total billed charges,,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Aetna,Middlesex Employees,,,17.89,,17.89,17.89,20.55,percent of total billed charges,,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Anthem,Commerical,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Anthem,Indemnity,,,18.11,,18.11,17.89,20.55,percent of total billed charges,,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Anthem,Individual Exchange,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Anthem,State Preferred,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Cigna,Cigna,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Connecticare,Commerical,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Connecticare,Exchange,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,Multiplan,Multiplan,,,20.55,,20.55,17.89,20.55,percent of total billed charges,,
ISOTRETINOIN 20 MG CAPSULE CHEMO,J3490,HCPCS,0555-1055-56,NDC,both,1,ea,24.18,14.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.89,20.55,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Aetna,Commerical,,,118.32,,118.32,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Aetna,Middlesex Employees,,,113.46,,113.46,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Anthem,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Anthem,Indemnity,,,114.87,,114.87,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Anthem,Individual Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Anthem,State Preferred,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Cigna,Cigna,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Connecticare,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Connecticare,Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,Multiplan,Multiplan,,,130.35,,130.35,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 25 MG CAPSULE CHEMO,J3490,HCPCS,10631-133-31,NDC,both,1,ea,153.35,92.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Aetna,Commerical,,,92.01,,92.01,88.23,101.36,percent of total billed charges,,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Aetna,Middlesex Employees,,,88.23,,88.23,88.23,101.36,percent of total billed charges,,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Anthem,Commerical,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Anthem,Indemnity,,,89.33,,89.33,88.23,101.36,percent of total billed charges,,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Anthem,Individual Exchange,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Anthem,State Preferred,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Cigna,Cigna,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Connecticare,Commerical,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Connecticare,Exchange,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,Multiplan,Multiplan,,,101.36,,101.36,88.23,101.36,percent of total billed charges,,
ISOTRETINOIN 30 MG CAPSULE CHEMO,J3490,HCPCS,10631-117-69,NDC,both,1,ea,119.25,71.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,88.23,101.36,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Aetna,Commerical,,,118.32,,118.32,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Aetna,Middlesex Employees,,,113.46,,113.46,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Anthem,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Anthem,Indemnity,,,114.87,,114.87,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Anthem,Individual Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Anthem,State Preferred,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Cigna,Cigna,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Connecticare,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Connecticare,Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,Multiplan,Multiplan,,,130.35,,130.35,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 35 MG CAPSULE CHEMO,J3490,HCPCS,10631-134-31,NDC,both,1,ea,153.35,92.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Aetna,Commerical,,,118.32,,118.32,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Aetna,Middlesex Employees,,,113.46,,113.46,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Anthem,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Anthem,Indemnity,,,114.87,,114.87,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Anthem,Individual Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Anthem,State Preferred,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Cigna,Cigna,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Connecticare,Commerical,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Connecticare,Exchange,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,Multiplan,Multiplan,,,130.35,,130.35,113.46,130.35,percent of total billed charges,,
ISOTRETINOIN 40 MG CAPSULE CHEMO,J3490,HCPCS,10631-118-31,NDC,both,1,ea,153.35,92.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.46,130.35,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Aetna,Commerical,,,71.64,,71.64,68.69,78.91,percent of total billed charges,,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Aetna,Middlesex Employees,,,68.69,,68.69,68.69,78.91,percent of total billed charges,,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Anthem,Commerical,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Anthem,Indemnity,,,69.55,,69.55,68.69,78.91,percent of total billed charges,,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Anthem,Individual Exchange,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Anthem,State Preferred,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Cigna,Cigna,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Connecticare,Commerical,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Connecticare,Exchange,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,Multiplan,Multiplan,,,78.91,,78.91,68.69,78.91,percent of total billed charges,,
ISRADIPINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0012-23,NDC,both,1,mL,92.84,55.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.69,78.91,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Aetna,Commerical,,,3.77,,3.77,3.62,4.16,percent of total billed charges,,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Aetna,Middlesex Employees,,,3.62,,3.62,3.62,4.16,percent of total billed charges,,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Anthem,Commerical,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Anthem,Indemnity,,,3.66,,3.66,3.62,4.16,percent of total billed charges,,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Anthem,Individual Exchange,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Anthem,State Preferred,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Cigna,Cigna,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Connecticare,Commerical,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Connecticare,Exchange,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,Multiplan,Multiplan,,,4.16,,4.16,3.62,4.16,percent of total billed charges,,
ISRADIPINE 2.5 MG CAPSULE,J8499,HCPCS,16252-539-01,NDC,both,1,ea,4.89,2.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,16252-540-01,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,40810-0018-94,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
ISRADIPINE 5 MG CAPSULE,J8499,HCPCS,50268-455-15,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Aetna,Commerical,,,794.81,,794.81,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Aetna,Middlesex Employees,,,762.16,,762.16,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Anthem,Commerical,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Anthem,Indemnity,,,771.63,,771.63,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Anthem,Individual Exchange,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Anthem,State Preferred,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Cigna,Cigna,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Connecticare,Commerical,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Connecticare,Exchange,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,Multiplan,Multiplan,,,875.57,,875.57,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,10147-0150-1,NDC,both,1,mL,1030.08,618.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Aetna,Commerical,,,794.81,,794.81,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Aetna,Middlesex Employees,,,762.16,,762.16,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Anthem,Commerical,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Anthem,Indemnity,,,771.63,,771.63,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Anthem,Individual Exchange,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Anthem,State Preferred,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Cigna,Cigna,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Connecticare,Commerical,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Connecticare,Exchange,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,Multiplan,Multiplan,,,875.57,,875.57,762.16,875.57,percent of total billed charges,,
ITRACONAZOLE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,50458-295-15,NDC,both,1,mL,1030.08,618.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,762.16,875.57,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Anthem,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Anthem,Individual Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Anthem,State Preferred,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Cigna,Cigna,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Connecticare,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Connecticare,Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-3,NDC,both,1,ea,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Anthem,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Anthem,Individual Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Anthem,State Preferred,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Cigna,Cigna,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Connecticare,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Connecticare,Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,10147-1700-7,NDC,both,1,ea,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Anthem,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Anthem,Individual Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Anthem,State Preferred,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Cigna,Cigna,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Connecticare,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Connecticare,Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,40810-0005-33,NDC,both,1,ea,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Aetna,Commerical,,,2.99,,2.99,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Aetna,Middlesex Employees,,,2.86,,2.86,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Anthem,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Anthem,Indemnity,,,2.9,,2.9,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Anthem,Individual Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Anthem,State Preferred,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Cigna,Cigna,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Connecticare,Commerical,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Connecticare,Exchange,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,Multiplan,Multiplan,,,3.29,,3.29,2.86,3.29,percent of total billed charges,,
ITRACONAZOLE 100 MG CAPSULE,J3490,HCPCS,67877-454-30,NDC,both,1,ea,3.87,2.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.86,3.29,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Aetna,Commerical,,,1163.03,,1163.03,1115.25,1281.21,percent of total billed charges,,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Aetna,Middlesex Employees,,,1115.25,,1115.25,1115.25,1281.21,percent of total billed charges,,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Anthem,Commerical,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Anthem,Indemnity,,,1129.12,,1129.12,1115.25,1281.21,percent of total billed charges,,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Anthem,Individual Exchange,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Anthem,State Preferred,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Cigna,Cigna,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Connecticare,Commerical,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Connecticare,Exchange,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,Multiplan,Multiplan,,,1281.21,,1281.21,1115.25,1281.21,percent of total billed charges,,
IVABRADINE 1 MG/ML ORAL SUSPENSION,J8499,HCPCS,40810-0207-91,NDC,both,1,mL,1507.3,904.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1115.25,1281.21,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Aetna,Commerical,,,23.26,,23.26,22.31,25.63,percent of total billed charges,,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Aetna,Middlesex Employees,,,22.31,,22.31,22.31,25.63,percent of total billed charges,,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Anthem,Commerical,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Anthem,Indemnity,,,22.59,,22.59,22.31,25.63,percent of total billed charges,,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Anthem,Individual Exchange,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Anthem,State Preferred,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Cigna,Cigna,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Connecticare,Commerical,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Connecticare,Exchange,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,Multiplan,Multiplan,,,25.63,,25.63,22.31,25.63,percent of total billed charges,,
IVABRADINE 2.5 MG TABLET,J8499,HCPCS,40810-9999-99,NDC,both,1,ea,30.15,18.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.31,25.63,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,25.56,29.37,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.37,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Anthem,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,25.56,29.37,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Anthem,Individual Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Anthem,State Preferred,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Cigna,Cigna,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Connecticare,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Connecticare,Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,25.56,29.37,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,40810-0208-05,NDC,both,1,ea,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Aetna,Commerical,,,26.65,,26.65,25.56,29.36,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.36,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Anthem,Commerical,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Anthem,Indemnity,,,25.87,,25.87,25.56,29.36,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Anthem,Individual Exchange,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Anthem,State Preferred,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Cigna,Cigna,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Connecticare,Commerical,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Connecticare,Exchange,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,Multiplan,Multiplan,,,29.36,,29.36,25.56,29.36,percent of total billed charges,,
IVABRADINE 5 MG TABLET,J8499,HCPCS,55513-800-60,NDC,both,1,ea,34.54,20.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.36,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Aetna,Commerical,,,29.38,,29.38,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Aetna,Middlesex Employees,,,28.18,,28.18,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Anthem,Commerical,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Anthem,Indemnity,,,28.53,,28.53,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Anthem,Individual Exchange,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Anthem,State Preferred,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Cigna,Cigna,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Connecticare,Commerical,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Connecticare,Exchange,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,Multiplan,Multiplan,,,32.37,,32.37,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-01,NDC,both,1,mL,38.08,22.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Aetna,Commerical,,,29.38,,29.38,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Aetna,Middlesex Employees,,,28.18,,28.18,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Anthem,Commerical,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Anthem,Indemnity,,,28.53,,28.53,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Anthem,Individual Exchange,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Anthem,State Preferred,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Cigna,Cigna,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Connecticare,Commerical,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Connecticare,Exchange,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,Multiplan,Multiplan,,,32.37,,32.37,28.18,32.37,percent of total billed charges,,
IVABRADINE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,55513-813-28,NDC,both,1,mL,38.08,22.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.18,32.37,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Aetna,Commerical,,,849.93,,849.93,351.24,936.28,percent of total billed charges,,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Aetna,Middlesex Employees,,,815.01,,815.01,351.24,936.28,percent of total billed charges,,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Anthem,Commerical,,439.05,,,439.05,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Anthem,Indemnity,,,825.14,,825.14,351.24,936.28,percent of total billed charges,,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Anthem,Individual Exchange,,351.24,,,351.24,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Anthem,State Preferred,,439.05,,,439.05,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Cigna,Cigna,,,,,,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Connecticare,Commerical,,,,,,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Connecticare,Exchange,,,,,,351.24,936.28,Other,Could be inpatient or outpatient,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,Multiplan,Multiplan,,,936.28,,936.28,351.24,936.28,percent of total billed charges,,
JAPANESE ENCEPHALITIS VACCINE (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90738,HCPCS,42515-002-01,NDC,both,0.5,mL,1101.51,660.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.24,936.28,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
KCL 20 MEQ/100 ML IN STERILE WATER,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Aetna,Commerical,,,78.14,,78.14,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Aetna,Middlesex Employees,,,74.93,,74.93,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Anthem,Commerical,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Anthem,Indemnity,,,75.86,,75.86,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Anthem,Individual Exchange,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Anthem,State Preferred,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Cigna,Cigna,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Connecticare,Commerical,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Connecticare,Exchange,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,Multiplan,Multiplan,,,86.08,,86.08,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-113-10,NDC,both,1,mL,101.27,60.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Aetna,Commerical,,,78.14,,78.14,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Aetna,Middlesex Employees,,,74.93,,74.93,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Anthem,Commerical,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Anthem,Indemnity,,,75.86,,75.86,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Anthem,Individual Exchange,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Anthem,State Preferred,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Cigna,Cigna,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Connecticare,Commerical,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Connecticare,Exchange,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,Multiplan,Multiplan,,,86.08,,86.08,74.93,86.08,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-181-20,NDC,both,1,mL,101.27,60.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,74.93,86.08,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Aetna,Commerical,,,19.54,,19.54,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Aetna,Middlesex Employees,,,18.73,,18.73,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Anthem,Commerical,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Anthem,Indemnity,,,18.97,,18.97,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Anthem,Individual Exchange,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Anthem,State Preferred,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Cigna,Cigna,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Connecticare,Commerical,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Connecticare,Exchange,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,Multiplan,Multiplan,,,21.52,,21.52,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-101-02,NDC,both,1,mL,25.32,15.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Aetna,Commerical,,,19.54,,19.54,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Aetna,Middlesex Employees,,,18.73,,18.73,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Anthem,Commerical,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Anthem,Indemnity,,,18.97,,18.97,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Anthem,Individual Exchange,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Anthem,State Preferred,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Cigna,Cigna,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Connecticare,Commerical,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Connecticare,Exchange,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,Multiplan,Multiplan,,,21.52,,21.52,18.73,21.52,percent of total billed charges,,
KETAMINE 10 MG/ML INJECTION SOLUTION,J3490,HCPCS,73177-156-02,NDC,both,1,mL,25.32,15.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.73,21.52,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Aetna,Commerical,,,19.92,,19.92,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Aetna,Middlesex Employees,,,19.1,,19.1,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Indemnity,,,19.34,,19.34,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Individual Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,State Preferred,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Cigna,Cigna,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Connecticare,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Connecticare,Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Multiplan,Multiplan,,,21.95,,21.95,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Aetna,Commerical,,,19.92,,19.92,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Aetna,Middlesex Employees,,,19.1,,19.1,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Indemnity,,,19.34,,19.34,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Individual Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,State Preferred,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Cigna,Cigna,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Connecticare,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Connecticare,Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Multiplan,Multiplan,,,21.95,,21.95,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML INJECTION SOLUTION,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Aetna,Commerical,,,19.92,,19.92,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Aetna,Middlesex Employees,,,19.1,,19.1,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Indemnity,,,19.34,,19.34,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,Individual Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Anthem,State Preferred,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Cigna,Cigna,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Connecticare,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Connecticare,Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,Multiplan,Multiplan,,,21.95,,21.95,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,0409-2051-05,NDC,both,1,mL,25.82,15.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Aetna,Commerical,,,19.92,,19.92,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Aetna,Middlesex Employees,,,19.1,,19.1,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Indemnity,,,19.34,,19.34,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,Individual Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Anthem,State Preferred,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Cigna,Cigna,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Connecticare,Commerical,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Connecticare,Exchange,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,Multiplan,Multiplan,,,21.95,,21.95,19.1,21.95,percent of total billed charges,,
KETAMINE 100 MG/ML ORAL SOLN,J3490,HCPCS,42023-115-10,NDC,both,1,mL,25.82,15.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.1,21.95,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Aetna,Commerical,,,127.38,,127.38,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Aetna,Middlesex Employees,,,122.14,,122.14,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Anthem,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Anthem,Indemnity,,,123.66,,123.66,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Anthem,Individual Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Anthem,State Preferred,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Cigna,Cigna,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Connecticare,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Connecticare,Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,Multiplan,Multiplan,,,140.32,,140.32,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,0143-9508-01,NDC,both,1,mL,165.08,99.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Aetna,Commerical,,,12.74,,12.74,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Aetna,Middlesex Employees,,,12.22,,12.22,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Anthem,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Anthem,Indemnity,,,12.37,,12.37,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Anthem,Individual Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Anthem,State Preferred,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Cigna,Cigna,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Connecticare,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Connecticare,Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,Multiplan,Multiplan,,,14.03,,14.03,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,40810-0206-36,NDC,both,1,mL,16.51,9.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Aetna,Commerical,,,127.38,,127.38,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Aetna,Middlesex Employees,,,122.14,,122.14,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Anthem,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Anthem,Indemnity,,,123.66,,123.66,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Anthem,Individual Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Anthem,State Preferred,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Cigna,Cigna,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Connecticare,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Connecticare,Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,Multiplan,Multiplan,,,140.32,,140.32,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,67457-001-10,NDC,both,1,mL,165.08,99.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Aetna,Commerical,,,12.74,,12.74,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Aetna,Middlesex Employees,,,12.22,,12.22,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Anthem,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Anthem,Indemnity,,,12.37,,12.37,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Anthem,Individual Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Anthem,State Preferred,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Cigna,Cigna,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Connecticare,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Connecticare,Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,Multiplan,Multiplan,,,14.03,,14.03,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,69374-511-01,NDC,both,1,mL,16.51,9.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Aetna,Commerical,,,12.74,,12.74,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Aetna,Middlesex Employees,,,12.22,,12.22,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Anthem,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Anthem,Indemnity,,,12.37,,12.37,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Anthem,Individual Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Anthem,State Preferred,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Cigna,Cigna,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Connecticare,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Connecticare,Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,Multiplan,Multiplan,,,14.03,,14.03,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,70092-9120-43,NDC,both,1,mL,16.51,9.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Aetna,Commerical,,,12.74,,12.74,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Aetna,Middlesex Employees,,,12.22,,12.22,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Anthem,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Anthem,Indemnity,,,12.37,,12.37,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Anthem,Individual Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Anthem,State Preferred,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Cigna,Cigna,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Connecticare,Commerical,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Connecticare,Exchange,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,Multiplan,Multiplan,,,14.03,,14.03,12.22,14.03,percent of total billed charges,,
KETAMINE 50 MG/ML INJECTION SOLUTION,J3490,HCPCS,71266-9070-2,NDC,both,1,mL,16.51,9.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.22,14.03,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Aetna,Commerical,,,127.38,,127.38,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Aetna,Middlesex Employees,,,122.14,,122.14,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Anthem,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Anthem,Indemnity,,,123.66,,123.66,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Anthem,Individual Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Anthem,State Preferred,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Cigna,Cigna,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Connecticare,Commerical,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Connecticare,Exchange,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,Multiplan,Multiplan,,,140.32,,140.32,122.14,140.32,percent of total billed charges,,
KETAMINE 50 MG/ML INTRANASAL SOLN,J3490,HCPCS,67457-001-10,NDC,both,1,mL,1.08,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.14,140.32,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Aetna,Commerical,,,39.1,,39.1,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Aetna,Middlesex Employees,,,37.5,,37.5,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Anthem,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Anthem,Indemnity,,,37.96,,37.96,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Anthem,Individual Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Anthem,State Preferred,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Cigna,Cigna,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Connecticare,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Connecticare,Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,Multiplan,Multiplan,,,43.08,,43.08,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,0168-0099-30,NDC,both,1,gm,50.68,30.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Aetna,Commerical,,,39.1,,39.1,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Aetna,Middlesex Employees,,,37.5,,37.5,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Anthem,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Anthem,Indemnity,,,37.96,,37.96,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Anthem,Individual Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Anthem,State Preferred,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Cigna,Cigna,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Connecticare,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Connecticare,Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,Multiplan,Multiplan,,,43.08,,43.08,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,21922-025-05,NDC,both,1,gm,50.68,30.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Aetna,Commerical,,,39.1,,39.1,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Aetna,Middlesex Employees,,,37.5,,37.5,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Anthem,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Anthem,Indemnity,,,37.96,,37.96,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Anthem,Individual Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Anthem,State Preferred,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Cigna,Cigna,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Connecticare,Commerical,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Connecticare,Exchange,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,Multiplan,Multiplan,,,43.08,,43.08,37.5,43.08,percent of total billed charges,,
KETOCONAZOLE 2 % TOPICAL CREAM,J3490,HCPCS,51672-1298-2,NDC,both,1,gm,50.68,30.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.5,43.08,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Aetna,Commerical,,,2.77,,2.77,2.66,3.05,percent of total billed charges,,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Aetna,Middlesex Employees,,,2.66,,2.66,2.66,3.05,percent of total billed charges,,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Anthem,Commerical,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Anthem,Indemnity,,,2.69,,2.69,2.66,3.05,percent of total billed charges,,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Anthem,Individual Exchange,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Anthem,State Preferred,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Cigna,Cigna,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Connecticare,Commerical,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Connecticare,Exchange,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,Multiplan,Multiplan,,,3.05,,3.05,2.66,3.05,percent of total billed charges,,
KETOCONAZOLE 200 MG TABLET,J3490,HCPCS,35573-433-30,NDC,both,1,ea,3.59,2.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.66,3.05,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,0338-0072-25,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-00,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-01,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-12,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,63323-162-23,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,68462-756-25,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-01,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70512-843-25,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-01,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,70860-701-03,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-01,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72266-118-25,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-01,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Commerical,,,1.97,,1.97,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Aetna,Middlesex Employees,,,1.89,,1.89,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Commerical,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Indemnity,,,1.91,,1.91,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Anthem,Individual Exchange,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Anthem,State Preferred,,,,,,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Cigna,Cigna,,0.94,,,0.94,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Commerical,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Connecticare,Exchange,,1.04,,,1.04,0.94,2.17,Other,Could be inpatient or outpatient,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,Multiplan,Multiplan,,,2.17,,2.17,0.94,2.17,percent of total billed charges,,
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,J1885,HCPCS,72611-722-25,NDC,both,0.5,mL,2.55,1.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.01,,,1.01,0.94,2.17,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
K-PHOS NEUTRAL 125 MG TABLET,J3490,HCPCS,40810-0013-60,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,0904-5928-61,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,40810-0008-60,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,60687-439-11,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,68382-798-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LABETALOL 100 MG TABLET,J3490,HCPCS,70377-060-12,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Aetna,Commerical,,,18.33,,18.33,0.19,20.19,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Aetna,Middlesex Employees,,,17.57,,17.57,0.19,20.19,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Anthem,Commerical,,,,,,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Anthem,Indemnity,,,17.79,,17.79,0.19,20.19,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Anthem,Individual Exchange,,,,,,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Anthem,State Preferred,,,,,,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Cigna,Cigna,,0.19,,,0.19,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Connecticare,Commerical,,0.41,,,0.41,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Connecticare,Exchange,,0.41,,,0.41,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,Multiplan,Multiplan,,,20.19,,20.19,0.19,20.19,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-24,NDC,both,0.2,mL,23.75,14.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,20.19,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,J1920,HCPCS,0409-2339-34,NDC,both,0.2,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-5929-61,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,0904-7110-61,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,60687-450-01,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,63739-366-10,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LABETALOL 200 MG TABLET,J3490,HCPCS,68382-799-05,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Aetna,Commerical,,,1.7,,1.7,1.63,1.87,percent of total billed charges,,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Aetna,Middlesex Employees,,,1.63,,1.63,1.63,1.87,percent of total billed charges,,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Anthem,Commerical,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Anthem,Indemnity,,,1.65,,1.65,1.63,1.87,percent of total billed charges,,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Anthem,Individual Exchange,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Anthem,State Preferred,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Cigna,Cigna,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Connecticare,Commerical,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Connecticare,Exchange,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,Multiplan,Multiplan,,,1.87,,1.87,1.63,1.87,percent of total billed charges,,
LABETALOL 25 MG ORAL TAB,J3490,HCPCS,40810-0001-62,NDC,both,1,ea,2.2,1.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.63,1.87,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Aetna,Commerical,,,203.21,,203.21,194.86,223.86,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Aetna,Middlesex Employees,,,194.86,,194.86,194.86,223.86,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Anthem,Commerical,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Anthem,Indemnity,,,197.28,,197.28,194.86,223.86,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Anthem,Individual Exchange,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Anthem,State Preferred,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Cigna,Cigna,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Connecticare,Commerical,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Connecticare,Exchange,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,Multiplan,Multiplan,,,223.86,,223.86,194.86,223.86,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-63,NDC,both,1,mL,263.36,158.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.86,223.86,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Aetna,Commerical,,,406.41,,406.41,389.71,447.7,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Aetna,Middlesex Employees,,,389.71,,389.71,389.71,447.7,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Anthem,Commerical,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Anthem,Indemnity,,,394.56,,394.56,389.71,447.7,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Anthem,Individual Exchange,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Anthem,State Preferred,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Cigna,Cigna,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Connecticare,Commerical,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Connecticare,Exchange,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,Multiplan,Multiplan,,,447.7,,447.7,389.71,447.7,percent of total billed charges,,
LABETALOL 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-64,NDC,both,1,mL,526.71,316.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,389.71,447.7,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0143-9622-01,NDC,both,1,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Aetna,Commerical,,,4.32,,4.32,0.19,4.76,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Aetna,Middlesex Employees,,,4.14,,4.14,0.19,4.76,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Anthem,Commerical,,,,,,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Anthem,Indemnity,,,4.19,,4.19,0.19,4.76,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Anthem,Individual Exchange,,,,,,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Anthem,State Preferred,,,,,,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Cigna,Cigna,,0.19,,,0.19,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Connecticare,Commerical,,0.41,,,0.41,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Connecticare,Exchange,,0.41,,,0.41,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,Multiplan,Multiplan,,,4.76,,4.76,0.19,4.76,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,0409-2267-20,NDC,both,1,mL,5.6,3.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,4.76,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,25021-317-20,NDC,both,1,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Aetna,Commerical,,,2.06,,2.06,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Aetna,Middlesex Employees,,,1.98,,1.98,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Anthem,Commerical,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Anthem,Indemnity,,,2,,2,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Anthem,Individual Exchange,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Anthem,State Preferred,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Cigna,Cigna,,0.19,,,0.19,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Connecticare,Commerical,,0.41,,,0.41,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Connecticare,Exchange,,0.41,,,0.41,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,Multiplan,Multiplan,,,2.27,,2.27,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-01,NDC,both,1,mL,2.67,1.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Aetna,Commerical,,,2.06,,2.06,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Aetna,Middlesex Employees,,,1.98,,1.98,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Anthem,Commerical,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Anthem,Indemnity,,,2,,2,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Anthem,Individual Exchange,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Anthem,State Preferred,,,,,,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Cigna,Cigna,,0.19,,,0.19,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Connecticare,Commerical,,0.41,,,0.41,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Connecticare,Exchange,,0.41,,,0.41,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,Multiplan,Multiplan,,,2.27,,2.27,0.19,2.27,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,36000-320-10,NDC,both,1,mL,2.67,1.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,2.27,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Anthem,Commerical,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Anthem,Individual Exchange,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Anthem,State Preferred,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Cigna,Cigna,,0.19,,,0.19,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Connecticare,Commerical,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Connecticare,Exchange,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,47781-586-56,NDC,both,1,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-934-98,NDC,both,1,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Anthem,Commerical,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Anthem,Individual Exchange,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Anthem,State Preferred,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Cigna,Cigna,,0.19,,,0.19,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Connecticare,Commerical,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Connecticare,Exchange,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,51991-935-98,NDC,both,1,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-102-01,NDC,both,1,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Anthem,Commerical,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Anthem,Individual Exchange,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Anthem,State Preferred,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Cigna,Cigna,,0.19,,,0.19,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Connecticare,Commerical,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Connecticare,Exchange,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-01,NDC,both,1,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Anthem,Commerical,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Anthem,Individual Exchange,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Anthem,State Preferred,,,,,,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Cigna,Cigna,,0.19,,,0.19,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Connecticare,Commerical,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Connecticare,Exchange,,0.41,,,0.41,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,0.19,22.66,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72266-103-41,NDC,both,1,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,22.66,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Aetna,Commerical,,,10.29,,10.29,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Anthem,Commerical,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Anthem,Indemnity,,,9.99,,9.99,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Anthem,Individual Exchange,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Anthem,State Preferred,,,,,,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Cigna,Cigna,,0.19,,,0.19,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Connecticare,Commerical,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Connecticare,Exchange,,0.41,,,0.41,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,0.19,11.33,percent of total billed charges,,
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,J1920,HCPCS,72611-734-01,NDC,both,1,mL,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,0.21,,,0.21,0.19,11.33,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Aetna,Commerical,,,0.69,,0.69,0.66,0.76,percent of total billed charges,,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Aetna,Middlesex Employees,,,0.66,,0.66,0.66,0.76,percent of total billed charges,,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Anthem,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Anthem,Indemnity,,,0.67,,0.67,0.66,0.76,percent of total billed charges,,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Anthem,Individual Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Anthem,State Preferred,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Cigna,Cigna,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Connecticare,Commerical,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Connecticare,Exchange,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,Multiplan,Multiplan,,,0.76,,0.76,0.66,0.76,percent of total billed charges,,
LABETALOL 50 MG ORAL TAB,J3490,HCPCS,4081-00003-89,NDC,both,1,ea,0.89,0.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.66,0.76,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Aetna,Commerical,,,204.76,,204.76,196.35,225.56,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Aetna,Middlesex Employees,,,196.35,,196.35,196.35,225.56,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Anthem,Commerical,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Anthem,Indemnity,,,198.79,,198.79,196.35,225.56,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Anthem,Individual Exchange,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Anthem,State Preferred,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Cigna,Cigna,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Connecticare,Commerical,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Connecticare,Exchange,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,Multiplan,Multiplan,,,225.56,,225.56,196.35,225.56,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-70,NDC,both,1,mL,265.37,159.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,196.35,225.56,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Aetna,Commerical,,,88.07,,88.07,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Aetna,Middlesex Employees,,,84.45,,84.45,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Anthem,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Anthem,Indemnity,,,85.5,,85.5,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Anthem,Individual Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Anthem,State Preferred,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Cigna,Cigna,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Connecticare,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Connecticare,Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,Multiplan,Multiplan,,,97.02,,97.02,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,0131-5410-72,NDC,both,1,mL,114.14,68.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-01,NDC,both,1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,66689-108-10,NDC,both,1,mL,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Aetna,Commerical,,,88.07,,88.07,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Aetna,Middlesex Employees,,,84.45,,84.45,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Anthem,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Anthem,Indemnity,,,85.5,,85.5,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Anthem,Individual Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Anthem,State Preferred,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Cigna,Cigna,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Connecticare,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Connecticare,Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,Multiplan,Multiplan,,,97.02,,97.02,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-732-95,NDC,both,1,mL,114.14,68.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Aetna,Commerical,,,88.07,,88.07,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Aetna,Middlesex Employees,,,84.45,,84.45,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Anthem,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Anthem,Indemnity,,,85.5,,85.5,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Anthem,Individual Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Anthem,State Preferred,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Cigna,Cigna,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Connecticare,Commerical,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Connecticare,Exchange,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,Multiplan,Multiplan,,,97.02,,97.02,84.45,97.02,percent of total billed charges,,
LACOSAMIDE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-488-10,NDC,both,1,mL,114.14,68.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,84.45,97.02,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,40810-0018-35,NDC,both,10,mL,32.71,19.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-01,NDC,both,1,mL,32.71,19.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 100MG/10ML SOLUTION SYRINGE,J3490,HCPCS,66689-108-10,NDC,both,1,mL,32.71,19.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Aetna,Commerical,,,4.41,,4.41,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Anthem,Indemnity,,,4.28,,4.28,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
LACOSAMIDE 12.5 MG TABLET,J3490,HCPCS,40810-0018-84,NDC,both,0.25,ea,5.71,3.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0131-1810-67,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-791-20,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-01,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-204-20,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-10,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,69543-455-20,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-1,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70710-1359-6,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-01,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Aetna,Commerical,,,64.85,,64.85,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Aetna,Middlesex Employees,,,62.18,,62.18,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Anthem,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Anthem,Indemnity,,,62.95,,62.95,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Anthem,Individual Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Anthem,State Preferred,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Cigna,Cigna,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Connecticare,Commerical,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Connecticare,Exchange,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,Multiplan,Multiplan,,,71.43,,71.43,62.18,71.43,percent of total billed charges,,
LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,J3490,HCPCS,72266-242-05,NDC,both,1,mL,84.04,50.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,62.18,71.43,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Aetna,Commerical,,,8.83,,8.83,8.47,9.73,percent of total billed charges,,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Aetna,Middlesex Employees,,,8.47,,8.47,8.47,9.73,percent of total billed charges,,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Anthem,Commerical,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Anthem,Indemnity,,,8.58,,8.58,8.47,9.73,percent of total billed charges,,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Anthem,Individual Exchange,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Anthem,State Preferred,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Cigna,Cigna,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Connecticare,Commerical,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Connecticare,Exchange,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,Multiplan,Multiplan,,,9.73,,9.73,8.47,9.73,percent of total billed charges,,
LACOSAMIDE 25 MG TABLET,J3490,HCPCS,40810-0018-83,NDC,both,0.5,ea,11.45,6.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.47,9.73,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Aetna,Commerical,,,35.27,,35.27,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Aetna,Middlesex Employees,,,33.82,,33.82,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Anthem,Commerical,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Anthem,Indemnity,,,34.24,,34.24,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Anthem,Individual Exchange,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Anthem,State Preferred,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Cigna,Cigna,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Connecticare,Commerical,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Connecticare,Exchange,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,Multiplan,Multiplan,,,38.85,,38.85,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-35,NDC,both,1,ea,45.71,27.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Aetna,Commerical,,,35.27,,35.27,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Aetna,Middlesex Employees,,,33.82,,33.82,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Anthem,Commerical,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Anthem,Indemnity,,,34.24,,34.24,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Anthem,Individual Exchange,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Anthem,State Preferred,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Cigna,Cigna,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Connecticare,Commerical,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Connecticare,Exchange,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,Multiplan,Multiplan,,,38.85,,38.85,33.82,38.85,percent of total billed charges,,
LACOSAMIDE 50 MG TABLET,J3490,HCPCS,0131-2477-60,NDC,both,1,ea,45.71,27.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.82,38.85,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,0.7,0.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,45008002,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,904522452,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343025,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,7733343050,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LACTASE 3,000 UNIT TABLET",J3490,HCPCS,40810-0009-50,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Commerical,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,State Preferred,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Cigna,Cigna,,2.77,,,2.77,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Commerical,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Exchange,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Commerical,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,State Preferred,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Cigna,Cigna,,2.77,,,2.77,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Connecticare,Commerical,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Connecticare,Exchange,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Commerical,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,State Preferred,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Cigna,Cigna,,2.77,,,2.77,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Connecticare,Commerical,,3.7,,,3.7,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Connecticare,Exchange,,3.7,,,3.7,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS BOLUS,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Commerical,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,State Preferred,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Cigna,Cigna,,2.77,,,2.77,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Commerical,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Exchange,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Commerical,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Anthem,State Preferred,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Cigna,Cigna,,2.77,,,2.77,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Connecticare,Commerical,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Connecticare,Exchange,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0338-0117-04,NDC,both,1000,mL,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Commerical,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Anthem,State Preferred,,,,,,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Cigna,Cigna,,2.77,,,2.77,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Connecticare,Commerical,,3.7,,,3.7,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Connecticare,Exchange,,3.7,,,3.7,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,2.77,9.77,percent of total billed charges,,
LACTATED RINGERS INTRAVENOUS SOLUTION,J7120,HCPCS,0409-7953-48,NDC,both,1000,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,2.77,9.77,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Commerical,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Anthem,State Preferred,,,,,,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Cigna,Cigna,,2.77,,,2.77,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Commerical,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Connecticare,Exchange,,3.7,,,3.7,0.01,3.7,Other,Could be inpatient or outpatient,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,3.7,percent of total billed charges,,
LACTATED RINGERS IV FOR INTRA-AMNIOTIC,J7120,HCPCS,0264-7750-00,NDC,both,1000,mL,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.99,,,2.99,0.01,3.7,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Aetna,Commerical,,,2.75,,2.75,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Aetna,Middlesex Employees,,,2.64,,2.64,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Anthem,Commerical,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Anthem,Indemnity,,,2.67,,2.67,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Anthem,Individual Exchange,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Anthem,State Preferred,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Cigna,Cigna,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Connecticare,Commerical,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Connecticare,Exchange,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,Multiplan,Multiplan,,,3.03,,3.03,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,6935541203,NDC,both,1,ea,3.57,2.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Aetna,Commerical,,,2.75,,2.75,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Aetna,Middlesex Employees,,,2.64,,2.64,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Anthem,Commerical,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Anthem,Indemnity,,,2.67,,2.67,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Anthem,Individual Exchange,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Anthem,State Preferred,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Cigna,Cigna,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Connecticare,Commerical,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Connecticare,Exchange,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,Multiplan,Multiplan,,,3.03,,3.03,2.64,3.03,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,J3490,HCPCS,40810-0019-80,NDC,both,1,ea,3.57,2.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.64,3.03,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMOPHILUS 450 BILLION CELL PACKET,J3490,HCPCS,4574901780,NDC,both,1,ea,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Aetna,Commerical,,,1.53,,1.53,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Aetna,Middlesex Employees,,,1.47,,1.47,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Anthem,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Anthem,Indemnity,,,1.48,,1.48,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Anthem,Individual Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Anthem,State Preferred,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Cigna,Cigna,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Connecticare,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Connecticare,Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,Multiplan,Multiplan,,,1.68,,1.68,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,4910036374,NDC,both,1,ea,1.98,1.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Aetna,Commerical,,,1.53,,1.53,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Aetna,Middlesex Employees,,,1.47,,1.47,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Anthem,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Anthem,Indemnity,,,1.48,,1.48,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Anthem,Individual Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Anthem,State Preferred,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Cigna,Cigna,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Connecticare,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Connecticare,Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,Multiplan,Multiplan,,,1.68,,1.68,1.47,1.68,percent of total billed charges,,
LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,J3490,HCPCS,40810-0015-24,NDC,both,1,ea,1.98,1.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Aetna,Commerical,,,32.21,,32.21,30.88,35.48,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Aetna,Middlesex Employees,,,30.88,,30.88,30.88,35.48,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Anthem,Commerical,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Anthem,Indemnity,,,31.27,,31.27,30.88,35.48,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Anthem,Individual Exchange,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Anthem,State Preferred,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Cigna,Cigna,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Connecticare,Commerical,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Connecticare,Exchange,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,Multiplan,Multiplan,,,35.48,,35.48,30.88,35.48,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,395150101,NDC,both,1,gm,41.74,25.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.88,35.48,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Aetna,Commerical,,,787.57,,787.57,755.22,867.6,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Aetna,Middlesex Employees,,,755.22,,755.22,755.22,867.6,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Anthem,Commerical,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Anthem,Indemnity,,,764.61,,764.61,755.22,867.6,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Anthem,Individual Exchange,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Anthem,State Preferred,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Cigna,Cigna,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Connecticare,Commerical,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Connecticare,Exchange,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,Multiplan,Multiplan,,,867.6,,867.6,755.22,867.6,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,3877903168,NDC,both,1,gm,1020.7,612.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,755.22,867.6,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Aetna,Commerical,,,206.87,,206.87,198.37,227.89,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Aetna,Middlesex Employees,,,198.37,,198.37,198.37,227.89,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Anthem,Commerical,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Anthem,Indemnity,,,200.83,,200.83,198.37,227.89,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Anthem,Individual Exchange,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Anthem,State Preferred,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Cigna,Cigna,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Connecticare,Commerical,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Connecticare,Exchange,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,Multiplan,Multiplan,,,227.89,,227.89,198.37,227.89,percent of total billed charges,,
LACTOSE (BULK) POWDER,J3490,HCPCS,6299113361,NDC,both,1,gm,268.1,160.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,198.37,227.89,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,50383-779-15,NDC,both,1,mL,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Aetna,Commerical,,,2.71,,2.71,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Anthem,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Anthem,Indemnity,,,2.63,,2.63,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Anthem,Individual Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Anthem,State Preferred,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Cigna,Cigna,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Connecticare,Commerical,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Connecticare,Exchange,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,Multiplan,Multiplan,,,2.98,,2.98,2.6,2.98,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLUTION,J3490,HCPCS,66689-039-01,NDC,both,15,mL,3.51,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.98,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Aetna,Commerical,,,22.37,,22.37,21.45,24.64,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Aetna,Middlesex Employees,,,21.45,,21.45,21.45,24.64,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Anthem,Commerical,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Anthem,Indemnity,,,21.72,,21.72,21.45,24.64,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Anthem,Individual Exchange,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Anthem,State Preferred,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Cigna,Cigna,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Connecticare,Commerical,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Connecticare,Exchange,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,Multiplan,Multiplan,,,24.64,,24.64,21.45,24.64,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0577-16,NDC,both,1,mL,28.99,17.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.45,24.64,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Aetna,Commerical,,,9.11,,9.11,8.74,10.04,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Aetna,Middlesex Employees,,,8.74,,8.74,8.74,10.04,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Anthem,Commerical,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Anthem,Indemnity,,,8.85,,8.85,8.74,10.04,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Anthem,Individual Exchange,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Anthem,State Preferred,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Cigna,Cigna,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Connecticare,Commerical,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Connecticare,Exchange,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,Multiplan,Multiplan,,,10.04,,10.04,8.74,10.04,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-08,NDC,both,1,mL,11.81,7.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.74,10.04,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,0121-0873-16,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Aetna,Commerical,,,11.91,,11.91,11.42,13.12,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Aetna,Middlesex Employees,,,11.42,,11.42,11.42,13.12,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Anthem,Commerical,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Anthem,Indemnity,,,11.57,,11.57,11.42,13.12,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Anthem,Individual Exchange,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Anthem,State Preferred,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Cigna,Cigna,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Connecticare,Commerical,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Connecticare,Exchange,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,Multiplan,Multiplan,,,13.12,,13.12,11.42,13.12,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,45963-439-63,NDC,both,1,mL,15.44,9.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,62135-003-47,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,J3490,HCPCS,64980-592-48,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Aetna,Commerical,,,148.95,,148.95,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Aetna,Middlesex Employees,,,142.83,,142.83,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Anthem,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Anthem,Indemnity,,,144.61,,144.61,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Anthem,Individual Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Anthem,State Preferred,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Cigna,Cigna,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Connecticare,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Connecticare,Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,Multiplan,Multiplan,,,164.08,,164.08,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,49702-205-48,NDC,both,1,mL,193.04,115.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Aetna,Commerical,,,148.95,,148.95,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Aetna,Middlesex Employees,,,142.83,,142.83,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Anthem,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Anthem,Indemnity,,,144.61,,144.61,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Anthem,Individual Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Anthem,State Preferred,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Cigna,Cigna,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Connecticare,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Connecticare,Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,Multiplan,Multiplan,,,164.08,,164.08,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-566-70,NDC,both,1,mL,193.04,115.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Aetna,Commerical,,,148.95,,148.95,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Aetna,Middlesex Employees,,,142.83,,142.83,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Anthem,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Anthem,Indemnity,,,144.61,,144.61,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Anthem,Individual Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Anthem,State Preferred,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Cigna,Cigna,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Connecticare,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Connecticare,Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,Multiplan,Multiplan,,,164.08,,164.08,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,57237-274-24,NDC,both,1,mL,193.04,115.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Aetna,Commerical,,,148.95,,148.95,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Aetna,Middlesex Employees,,,142.83,,142.83,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Anthem,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Anthem,Indemnity,,,144.61,,144.61,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Anthem,Individual Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Anthem,State Preferred,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Cigna,Cigna,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Connecticare,Commerical,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Connecticare,Exchange,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,Multiplan,Multiplan,,,164.08,,164.08,142.83,164.08,percent of total billed charges,,
LAMIVUDINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-055-24,NDC,both,1,mL,193.04,115.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,142.83,164.08,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Anthem,Indemnity,,,1.43,,1.43,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,33342-001-09,NDC,both,1,ea,1.91,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Anthem,Indemnity,,,1.43,,1.43,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,49702-203-18,NDC,both,1,ea,1.91,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Anthem,Indemnity,,,1.43,,1.43,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
LAMIVUDINE 150 MG TABLET,J3490,HCPCS,68180-602-07,NDC,both,1,ea,1.91,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Aetna,Commerical,,,2.55,,2.55,2.45,2.81,percent of total billed charges,,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Aetna,Middlesex Employees,,,2.45,,2.45,2.45,2.81,percent of total billed charges,,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Anthem,Commerical,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Anthem,Indemnity,,,2.48,,2.48,2.45,2.81,percent of total billed charges,,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Anthem,Individual Exchange,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Anthem,State Preferred,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Cigna,Cigna,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Connecticare,Commerical,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Connecticare,Exchange,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,Multiplan,Multiplan,,,2.81,,2.81,2.45,2.81,percent of total billed charges,,
LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,J3490,HCPCS,31722-506-60,NDC,both,1,ea,3.31,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.45,2.81,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Aetna,Commerical,,,13.08,,13.08,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Aetna,Middlesex Employees,,,12.54,,12.54,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Anthem,Commerical,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Anthem,Indemnity,,,12.7,,12.7,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Anthem,Individual Exchange,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Anthem,State Preferred,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Cigna,Cigna,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Connecticare,Commerical,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Connecticare,Exchange,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,Multiplan,Multiplan,,,14.41,,14.41,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 37.5 MG ORAL TAB,J3490,HCPCS,40810-0001-65,NDC,both,1,ea,16.95,10.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Aetna,Commerical,,,13.08,,13.08,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Aetna,Middlesex Employees,,,12.54,,12.54,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Anthem,Commerical,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Anthem,Indemnity,,,12.7,,12.7,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Anthem,Individual Exchange,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Anthem,State Preferred,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Cigna,Cigna,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Connecticare,Commerical,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Connecticare,Exchange,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,Multiplan,Multiplan,,,14.41,,14.41,12.54,14.41,percent of total billed charges,,
LAMIVUDINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-66,NDC,both,1,ea,16.95,10.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.54,14.41,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Aetna,Commerical,,,14.19,,14.19,13.61,15.63,percent of total billed charges,,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Aetna,Middlesex Employees,,,13.61,,13.61,13.61,15.63,percent of total billed charges,,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Anthem,Commerical,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Anthem,Indemnity,,,13.78,,13.78,13.61,15.63,percent of total billed charges,,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Anthem,Individual Exchange,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Anthem,State Preferred,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Cigna,Cigna,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Connecticare,Commerical,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Connecticare,Exchange,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,Multiplan,Multiplan,,,15.63,,15.63,13.61,15.63,percent of total billed charges,,
LAMOTRIGINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0003-53,NDC,both,1,mL,18.39,11.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.61,15.63,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0093-0463-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,0904-7008-61,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,51079-499-20,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Aetna,Commerical,,,0.7,,0.7,0.67,0.77,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Anthem,Indemnity,,,0.68,,0.68,0.67,0.77,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
LAMOTRIGINE 100 MG TABLET,J3490,HCPCS,65862-228-01,NDC,both,1,ea,0.91,0.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Aetna,Commerical,,,1.35,,1.35,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Anthem,Commerical,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Anthem,Indemnity,,,1.31,,1.31,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Anthem,Individual Exchange,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Anthem,State Preferred,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Cigna,Cigna,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Connecticare,Commerical,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Connecticare,Exchange,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,Multiplan,Multiplan,,,1.49,,1.49,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-80,NDC,both,1,ea,1.75,1.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Aetna,Commerical,,,1.35,,1.35,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Aetna,Middlesex Employees,,,1.29,,1.29,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Anthem,Commerical,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Anthem,Indemnity,,,1.31,,1.31,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Anthem,Individual Exchange,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Anthem,State Preferred,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Cigna,Cigna,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Connecticare,Commerical,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Connecticare,Exchange,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,Multiplan,Multiplan,,,1.49,,1.49,1.29,1.49,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-208-48,NDC,both,1,ea,1.75,1.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.29,1.49,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 12.5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
LAMOTRIGINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0001-67,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-01,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,51079-865-20,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-01,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Anthem,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Anthem,Indemnity,,,1.14,,1.14,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Anthem,Individual Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Anthem,State Preferred,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Cigna,Cigna,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Connecticare,Commerical,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Connecticare,Exchange,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,Multiplan,Multiplan,,,1.29,,1.29,1.12,1.29,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,60687-693-11,NDC,both,1,ea,1.52,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.29,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
LAMOTRIGINE 150 MG TABLET,J3490,HCPCS,65862-229-60,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51079-866-20,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
LAMOTRIGINE 200 MG TABLET,J3490,HCPCS,51672-4133-4,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Aetna,Commerical,,,0.93,,0.93,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,Individual Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Anthem,State Preferred,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Cigna,Cigna,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Connecticare,Commerical,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Connecticare,Exchange,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,Multiplan,Multiplan,,,1.03,,1.03,0.9,1.03,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,65862-362-01,NDC,both,1,ea,1.21,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.03,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-229-01,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,51672-4130-1,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,55111-220-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,63739-670-10,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,65862-227-01,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
LAMOTRIGINE 25 MG TABLET,J3490,HCPCS,68084-318-01,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,40810-0010-81,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET,J3490,HCPCS,68462-228-01,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
LAMOTRIGINE 6.25 MG SPLIT TABLET,J3490,HCPCS,40810-0203-71,NDC,both,1,UN,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Aetna,Commerical,,,0.42,,0.42,0.41,0.47,percent of total billed charges,,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Anthem,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Anthem,Indemnity,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Anthem,Individual Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Anthem,State Preferred,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Cigna,Cigna,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Connecticare,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Connecticare,Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,Multiplan,Multiplan,,,0.47,,0.47,0.41,0.47,percent of total billed charges,,
LAMOTRIGINE 75 MG ORAL TAB,J3490,HCPCS,40810-0001-68,NDC,both,1,ea,0.55,0.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-02,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-398-90,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Aetna,Commerical,,,39.36,,39.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Aetna,Middlesex Employees,,,37.74,,37.74,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Anthem,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Anthem,Indemnity,,,38.21,,38.21,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Anthem,Individual Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Anthem,State Preferred,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Cigna,Cigna,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Connecticare,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Connecticare,Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,Multiplan,Multiplan,,,43.36,,43.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-78,NDC,both,1,ea,51.01,30.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Aetna,Commerical,,,39.36,,39.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Aetna,Middlesex Employees,,,37.74,,37.74,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Anthem,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Anthem,Indemnity,,,38.21,,38.21,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Anthem,Individual Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Anthem,State Preferred,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Cigna,Cigna,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Connecticare,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Connecticare,Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,Multiplan,Multiplan,,,43.36,,43.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,43598-560-79,NDC,both,1,ea,51.01,30.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Aetna,Commerical,,,39.36,,39.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Aetna,Middlesex Employees,,,37.74,,37.74,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Anthem,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Anthem,Indemnity,,,38.21,,38.21,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Anthem,Individual Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Anthem,State Preferred,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Cigna,Cigna,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Connecticare,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Connecticare,Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,Multiplan,Multiplan,,,43.36,,43.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-543-11,NDC,both,1,ea,51.01,30.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Aetna,Commerical,,,39.36,,39.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Aetna,Middlesex Employees,,,37.74,,37.74,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Anthem,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Anthem,Indemnity,,,38.21,,38.21,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Anthem,Individual Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Anthem,State Preferred,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Cigna,Cigna,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Connecticare,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Connecticare,Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,Multiplan,Multiplan,,,43.36,,43.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-10,NDC,both,1,ea,51.01,30.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Aetna,Commerical,,,39.36,,39.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Aetna,Middlesex Employees,,,37.74,,37.74,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Anthem,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Anthem,Indemnity,,,38.21,,38.21,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Anthem,Individual Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Anthem,State Preferred,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Cigna,Cigna,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Connecticare,Commerical,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Connecticare,Exchange,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,Multiplan,Multiplan,,,43.36,,43.36,37.74,43.36,percent of total billed charges,,
"LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-895-78,NDC,both,1,ea,51.01,30.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.74,43.36,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Aetna,Commerical,,,497.37,,497.37,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Aetna,Middlesex Employees,,,476.93,,476.93,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Anthem,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Anthem,Indemnity,,,482.86,,482.86,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Anthem,Individual Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Anthem,State Preferred,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Cigna,Cigna,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Connecticare,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Connecticare,Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,Multiplan,Multiplan,,,547.9,,547.9,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0014-99,NDC,both,1,mL,644.59,386.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Aetna,Commerical,,,248.69,,248.69,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Aetna,Middlesex Employees,,,238.47,,238.47,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Anthem,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Anthem,Indemnity,,,241.43,,241.43,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Anthem,Individual Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Anthem,State Preferred,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Cigna,Cigna,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Connecticare,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Connecticare,Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,Multiplan,Multiplan,,,273.96,,273.96,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-01,NDC,both,1,mL,322.3,193.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Aetna,Commerical,,,58.78,,58.78,56.37,64.75,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Aetna,Middlesex Employees,,,56.37,,56.37,56.37,64.75,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Anthem,Commerical,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Anthem,Indemnity,,,57.07,,57.07,56.37,64.75,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Anthem,Individual Exchange,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Anthem,State Preferred,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Cigna,Cigna,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Connecticare,Commerical,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Connecticare,Exchange,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,Multiplan,Multiplan,,,64.75,,64.75,56.37,64.75,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-02,NDC,both,1,mL,76.18,45.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.37,64.75,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Aetna,Commerical,,,149.21,,149.21,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Aetna,Middlesex Employees,,,143.08,,143.08,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Commerical,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Indemnity,,,144.86,,144.86,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Individual Exchange,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,State Preferred,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Cigna,Cigna,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Connecticare,Commerical,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Connecticare,Exchange,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Multiplan,Multiplan,,,164.37,,164.37,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Aetna,Commerical,,,248.69,,248.69,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Aetna,Middlesex Employees,,,238.47,,238.47,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Indemnity,,,241.43,,241.43,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Individual Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,State Preferred,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Cigna,Cigna,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Connecticare,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Connecticare,Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Multiplan,Multiplan,,,273.96,,273.96,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Aetna,Commerical,,,497.37,,497.37,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Aetna,Middlesex Employees,,,476.93,,476.93,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Indemnity,,,482.86,,482.86,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Individual Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,State Preferred,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Cigna,Cigna,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Connecticare,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Connecticare,Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Multiplan,Multiplan,,,547.9,,547.9,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Aetna,Commerical,,,149.21,,149.21,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Aetna,Middlesex Employees,,,143.08,,143.08,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Commerical,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Indemnity,,,144.86,,144.86,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,Individual Exchange,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Anthem,State Preferred,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Cigna,Cigna,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Connecticare,Commerical,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Connecticare,Exchange,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,Multiplan,Multiplan,,,164.37,,164.37,143.08,164.37,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-03,NDC,both,1,mL,193.38,116.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.08,164.37,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Aetna,Commerical,,,248.69,,248.69,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Aetna,Middlesex Employees,,,238.47,,238.47,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Indemnity,,,241.43,,241.43,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,Individual Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Anthem,State Preferred,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Cigna,Cigna,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Connecticare,Commerical,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Connecticare,Exchange,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,Multiplan,Multiplan,,,273.96,,273.96,238.47,273.96,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-05,NDC,both,1,mL,322.3,193.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,238.47,273.96,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Aetna,Commerical,,,497.37,,497.37,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Aetna,Middlesex Employees,,,476.93,,476.93,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Indemnity,,,482.86,,482.86,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,Individual Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Anthem,State Preferred,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Cigna,Cigna,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Connecticare,Commerical,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Connecticare,Exchange,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,Multiplan,Multiplan,,,547.9,,547.9,476.93,547.9,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,J3490,HCPCS,65628-080-10,NDC,both,1,mL,644.59,386.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,476.93,547.9,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Aetna,Commerical,,,84.05,,84.05,80.6,92.59,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Aetna,Middlesex Employees,,,80.6,,80.6,80.6,92.59,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Anthem,Commerical,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Anthem,Indemnity,,,81.6,,81.6,80.6,92.59,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Anthem,Individual Exchange,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Anthem,State Preferred,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Cigna,Cigna,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Connecticare,Commerical,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Connecticare,Exchange,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,Multiplan,Multiplan,,,92.59,,92.59,80.6,92.59,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-24,NDC,both,10,mL,108.93,65.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Aetna,Commerical,,,42.03,,42.03,40.3,46.3,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Aetna,Middlesex Employees,,,40.3,,40.3,40.3,46.3,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Anthem,Commerical,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Anthem,Indemnity,,,40.8,,40.8,40.3,46.3,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Anthem,Individual Exchange,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Anthem,State Preferred,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Cigna,Cigna,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Connecticare,Commerical,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Connecticare,Exchange,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,Multiplan,Multiplan,,,46.3,,46.3,40.3,46.3,percent of total billed charges,,
LANSOPRAZOLE 3 MG/ML SUSP KETOGENIC DIET,J3490,HCPCS,40810-0012-88,NDC,both,10,mL,54.47,32.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.3,46.3,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,5.67,6.51,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,5.67,6.51,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Anthem,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,5.67,6.51,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Anthem,Individual Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Anthem,State Preferred,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Cigna,Cigna,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Connecticare,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Connecticare,Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,5.67,6.51,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0378-8030-77,NDC,both,1,ea,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,0904-6662-45,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,40810-0006-03,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-01,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,51079-121-08,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Aetna,Commerical,,,3.57,,3.57,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Anthem,Indemnity,,,3.47,,3.47,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",J3490,HCPCS,55111-399-90,NDC,both,1,ea,4.63,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Aetna,Commerical,,,17.36,,17.36,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Aetna,Middlesex Employees,,,16.65,,16.65,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Anthem,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Anthem,Indemnity,,,16.85,,16.85,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Anthem,Individual Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Anthem,State Preferred,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Cigna,Cigna,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Connecticare,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Connecticare,Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,Multiplan,Multiplan,,,19.13,,19.13,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,64764-544-11,NDC,both,1,ea,22.5,13.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Aetna,Commerical,,,17.36,,17.36,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Aetna,Middlesex Employees,,,16.65,,16.65,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Anthem,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Anthem,Indemnity,,,16.85,,16.85,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Anthem,Individual Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Anthem,State Preferred,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Cigna,Cigna,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Connecticare,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Connecticare,Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,Multiplan,Multiplan,,,19.13,,19.13,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-10,NDC,both,1,ea,22.5,13.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Aetna,Commerical,,,17.36,,17.36,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Aetna,Middlesex Employees,,,16.65,,16.65,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Anthem,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Anthem,Indemnity,,,16.85,,16.85,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Anthem,Individual Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Anthem,State Preferred,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Cigna,Cigna,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Connecticare,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Connecticare,Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,Multiplan,Multiplan,,,19.13,,19.13,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,65862-896-78,NDC,both,1,ea,22.5,13.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Aetna,Commerical,,,17.36,,17.36,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Aetna,Middlesex Employees,,,16.65,,16.65,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Anthem,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Anthem,Indemnity,,,16.85,,16.85,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Anthem,Individual Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Anthem,State Preferred,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Cigna,Cigna,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Connecticare,Commerical,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Connecticare,Exchange,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,Multiplan,Multiplan,,,19.13,,19.13,16.65,19.13,percent of total billed charges,,
"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",J3490,HCPCS,68382-772-77,NDC,both,1,ea,22.5,13.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.65,19.13,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Aetna,Commerical,,,3042.06,,3042.06,43.65,3351.15,percent of total billed charges,,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Aetna,Middlesex Employees,,,2917.08,,2917.08,43.65,3351.15,percent of total billed charges,,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Anthem,Commerical,,,,,,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Anthem,Indemnity,,,2953.35,,2953.35,43.65,3351.15,percent of total billed charges,,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Anthem,Individual Exchange,,,,,,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Anthem,State Preferred,,,,,,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Cigna,Cigna,,43.65,,,43.65,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Connecticare,Commerical,,59.09,,,59.09,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Connecticare,Exchange,,59.09,,,59.09,43.65,3351.15,Other,Could be inpatient or outpatient,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,Multiplan,Multiplan,,,3351.15,,3351.15,43.65,3351.15,percent of total billed charges,,
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION,J1931,HCPCS,58468-0070-1,NDC,both,0.1,mL,3942.53,2365.52,United Healthcare/Oxford,United Healthcare/Oxford,,47.13,,,47.13,43.65,3351.15,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Aetna,Commerical,,,35.01,,35.01,33.57,38.56,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Aetna,Middlesex Employees,,,33.57,,33.57,33.57,38.56,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Anthem,Commerical,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Anthem,Indemnity,,,33.99,,33.99,33.57,38.56,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Anthem,Individual Exchange,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Anthem,State Preferred,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Cigna,Cigna,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Connecticare,Commerical,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Connecticare,Exchange,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,Multiplan,Multiplan,,,38.56,,38.56,33.57,38.56,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,0517-0830-01,NDC,both,1,mL,45.37,27.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.57,38.56,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Aetna,Commerical,,,29.17,,29.17,27.98,32.14,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Aetna,Middlesex Employees,,,27.98,,27.98,27.98,32.14,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Anthem,Commerical,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Anthem,Indemnity,,,28.32,,28.32,27.98,32.14,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Anthem,Individual Exchange,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Anthem,State Preferred,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Cigna,Cigna,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Connecticare,Commerical,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Connecticare,Exchange,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,Multiplan,Multiplan,,,32.14,,32.14,27.98,32.14,percent of total billed charges,,
LATANOPROST 0.005 % EYE DROPS,J3490,HCPCS,59762-0333-2,NDC,both,2.5,mL,37.81,22.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.98,32.14,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Aetna,Commerical,,,45.81,,45.81,43.93,50.46,percent of total billed charges,,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Aetna,Middlesex Employees,,,43.93,,43.93,43.93,50.46,percent of total billed charges,,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Anthem,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Anthem,Indemnity,,,44.47,,44.47,43.93,50.46,percent of total billed charges,,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Anthem,Individual Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Anthem,State Preferred,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Cigna,Cigna,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Connecticare,Commerical,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Connecticare,Exchange,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,Multiplan,Multiplan,,,50.46,,50.46,43.93,50.46,percent of total billed charges,,
LEECHES,J3490,HCPCS,40810-0202-55,NDC,both,1,ea,59.37,35.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.93,50.46,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,22.67,26.04,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,22.67,26.04,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Anthem,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,22.67,26.04,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Anthem,State Preferred,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Cigna,Cigna,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Connecticare,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Connecticare,Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,22.67,26.04,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,40810-0013-07,NDC,both,3,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Aetna,Commerical,,,38.57,,38.57,36.99,42.49,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Aetna,Middlesex Employees,,,36.99,,36.99,36.99,42.49,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Anthem,Commerical,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Anthem,Indemnity,,,37.45,,37.45,36.99,42.49,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Anthem,Individual Exchange,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Anthem,State Preferred,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Cigna,Cigna,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Connecticare,Commerical,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Connecticare,Exchange,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,Multiplan,Multiplan,,,42.49,,42.49,36.99,42.49,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,70092-1135-44,NDC,both,1,mL,49.99,29.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.99,42.49,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Aetna,Commerical,,,25.27,,25.27,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Aetna,Middlesex Employees,,,24.23,,24.23,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Anthem,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Anthem,Indemnity,,,24.53,,24.53,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Anthem,Individual Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Anthem,State Preferred,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Cigna,Cigna,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Connecticare,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Connecticare,Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,Multiplan,Multiplan,,,27.84,,27.84,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,71266-6290-1,NDC,both,1,mL,32.75,19.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Aetna,Commerical,,,25.27,,25.27,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Aetna,Middlesex Employees,,,24.23,,24.23,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Anthem,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Anthem,Indemnity,,,24.53,,24.53,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Anthem,Individual Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Anthem,State Preferred,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Cigna,Cigna,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Connecticare,Commerical,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Connecticare,Exchange,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,Multiplan,Multiplan,,,27.84,,27.84,24.23,27.84,percent of total billed charges,,
LETS TOPICAL SOLUTION 3 ML,J3490,HCPCS,73177-121-19,NDC,both,1,mL,32.75,19.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.23,27.84,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Aetna,Commerical,,,15.76,,15.76,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Aetna,Middlesex Employees,,,15.11,,15.11,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Indemnity,,,15.3,,15.3,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Individual Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,State Preferred,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Cigna,Cigna,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Connecticare,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Connecticare,Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Multiplan,Multiplan,,,17.36,,17.36,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Aetna,Commerical,,,15.76,,15.76,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Aetna,Middlesex Employees,,,15.11,,15.11,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Anthem,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Anthem,Indemnity,,,15.3,,15.3,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Anthem,Individual Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Anthem,State Preferred,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Cigna,Cigna,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Connecticare,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Connecticare,Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,Multiplan,Multiplan,,,17.36,,17.36,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET,J3490,HCPCS,42806-133-24,NDC,both,1,ea,20.42,12.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Aetna,Commerical,,,15.76,,15.76,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Aetna,Middlesex Employees,,,15.11,,15.11,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Indemnity,,,15.3,,15.3,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,Individual Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Anthem,State Preferred,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Cigna,Cigna,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Connecticare,Commerical,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Connecticare,Exchange,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,Multiplan,Multiplan,,,17.36,,17.36,15.11,17.36,percent of total billed charges,,
LEUCOVORIN CALCIUM 10 MG TABLET CHEMO,J3490,HCPCS,0054-4497-10,NDC,both,1,ea,20.42,12.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.11,17.36,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Aetna,Commerical,,,19.6,,19.6,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Aetna,Middlesex Employees,,,18.79,,18.79,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Commerical,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Indemnity,,,19.03,,19.03,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Individual Exchange,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Anthem,State Preferred,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Cigna,Cigna,,6.25,,,6.25,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Connecticare,Commerical,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Connecticare,Exchange,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,Multiplan,Multiplan,,,21.59,,21.59,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9554-01,NDC,both,0.5,ea,25.4,15.24,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Aetna,Commerical,,,19.6,,19.6,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Aetna,Middlesex Employees,,,18.79,,18.79,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Commerical,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Indemnity,,,19.03,,19.03,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Anthem,Individual Exchange,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Anthem,State Preferred,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Cigna,Cigna,,6.25,,,6.25,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Connecticare,Commerical,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Connecticare,Exchange,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,Multiplan,Multiplan,,,21.59,,21.59,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5140-01,NDC,both,0.5,ea,25.4,15.24,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Aetna,Commerical,,,19.6,,19.6,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Aetna,Middlesex Employees,,,18.79,,18.79,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Anthem,Commerical,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Anthem,Indemnity,,,19.03,,19.03,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Anthem,Individual Exchange,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Anthem,State Preferred,,,,,,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Cigna,Cigna,,6.25,,,6.25,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Connecticare,Commerical,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Connecticare,Exchange,,6.21,,,6.21,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,Multiplan,Multiplan,,,21.59,,21.59,5.4,21.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,J0640,HCPCS,71288-161-20,NDC,both,0.5,ea,25.4,15.24,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,21.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Aetna,Commerical,,,15.06,,15.06,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Aetna,Middlesex Employees,,,14.44,,14.44,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Indemnity,,,14.62,,14.62,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Individual Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,State Preferred,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Cigna,Cigna,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Connecticare,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Connecticare,Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Multiplan,Multiplan,,,16.59,,16.59,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Aetna,Commerical,,,15.06,,15.06,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Aetna,Middlesex Employees,,,14.44,,14.44,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Anthem,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Anthem,Indemnity,,,14.62,,14.62,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Anthem,Individual Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Anthem,State Preferred,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Cigna,Cigna,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Connecticare,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Connecticare,Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,Multiplan,Multiplan,,,16.59,,16.59,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET,J3490,HCPCS,42806-134-24,NDC,both,1,ea,19.52,11.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Aetna,Commerical,,,15.06,,15.06,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Aetna,Middlesex Employees,,,14.44,,14.44,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Indemnity,,,14.62,,14.62,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,Individual Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Anthem,State Preferred,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Cigna,Cigna,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Connecticare,Commerical,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Connecticare,Exchange,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,Multiplan,Multiplan,,,16.59,,16.59,14.44,16.59,percent of total billed charges,,
LEUCOVORIN CALCIUM 15 MG TABLET CHEMO,J3490,HCPCS,0054-4498-10,NDC,both,1,ea,19.52,11.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.44,16.59,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Aetna,Commerical,,,14.27,,14.27,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Aetna,Middlesex Employees,,,13.69,,13.69,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Indemnity,,,13.86,,13.86,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Individual Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,State Preferred,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Cigna,Cigna,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Connecticare,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Connecticare,Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Multiplan,Multiplan,,,15.73,,15.73,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG ORAL TAB CHEMO,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Aetna,Commerical,,,14.27,,14.27,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Aetna,Middlesex Employees,,,13.69,,13.69,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Indemnity,,,13.86,,13.86,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,Individual Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Anthem,State Preferred,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Cigna,Cigna,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Connecticare,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Connecticare,Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,Multiplan,Multiplan,,,15.73,,15.73,13.69,15.73,percent of total billed charges,,
LEUCOVORIN CALCIUM 2.5 MG TABLET,J3490,HCPCS,40810-0001-69,NDC,both,1,ea,18.5,11.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Aetna,Commerical,,,79.64,,79.64,5.4,87.74,percent of total billed charges,,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Aetna,Middlesex Employees,,,76.37,,76.37,5.4,87.74,percent of total billed charges,,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Anthem,Commerical,,,,,,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Anthem,Indemnity,,,77.32,,77.32,5.4,87.74,percent of total billed charges,,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Anthem,Individual Exchange,,,,,,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Anthem,State Preferred,,,,,,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Cigna,Cigna,,6.25,,,6.25,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Connecticare,Commerical,,6.21,,,6.21,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Connecticare,Exchange,,6.21,,,6.21,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,Multiplan,Multiplan,,,87.74,,87.74,5.4,87.74,percent of total billed charges,,
LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-815-30,NDC,both,0.25,ea,103.22,61.93,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,87.74,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Aetna,Commerical,,,21.12,,21.12,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Aetna,Middlesex Employees,,,20.25,,20.25,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Anthem,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Anthem,Indemnity,,,20.5,,20.5,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Anthem,Individual Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Anthem,State Preferred,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Cigna,Cigna,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Connecticare,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Connecticare,Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,Multiplan,Multiplan,,,23.26,,23.26,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,0904-6703-10,NDC,both,1,ea,27.37,16.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Aetna,Commerical,,,21.12,,21.12,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Aetna,Middlesex Employees,,,20.25,,20.25,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Anthem,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Anthem,Indemnity,,,20.5,,20.5,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Anthem,Individual Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Anthem,State Preferred,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Cigna,Cigna,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Connecticare,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Connecticare,Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,Multiplan,Multiplan,,,23.26,,23.26,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-01,NDC,both,1,ea,27.37,16.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Aetna,Commerical,,,21.12,,21.12,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Aetna,Middlesex Employees,,,20.25,,20.25,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Anthem,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Anthem,Indemnity,,,20.5,,20.5,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Anthem,Individual Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Anthem,State Preferred,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Cigna,Cigna,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Connecticare,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Connecticare,Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,Multiplan,Multiplan,,,23.26,,23.26,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET,J3490,HCPCS,51079-582-05,NDC,both,1,ea,27.37,16.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Aetna,Commerical,,,21.12,,21.12,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Aetna,Middlesex Employees,,,20.25,,20.25,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Anthem,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Anthem,Indemnity,,,20.5,,20.5,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Anthem,Individual Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Anthem,State Preferred,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Cigna,Cigna,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Connecticare,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Connecticare,Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,Multiplan,Multiplan,,,23.26,,23.26,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-01,NDC,both,1,ea,52.43,31.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Aetna,Commerical,,,21.12,,21.12,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Aetna,Middlesex Employees,,,20.25,,20.25,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Anthem,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Anthem,Indemnity,,,20.5,,20.5,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Anthem,Individual Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Anthem,State Preferred,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Cigna,Cigna,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Connecticare,Commerical,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Connecticare,Exchange,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,Multiplan,Multiplan,,,23.26,,23.26,20.25,23.26,percent of total billed charges,,
LEUCOVORIN CALCIUM 25 MG TABLET CHEMO,J3490,HCPCS,51079-582-05,NDC,both,1,ea,52.43,31.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.25,23.26,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Aetna,Commerical,,,53.96,,53.96,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Aetna,Middlesex Employees,,,51.74,,51.74,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Commerical,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Indemnity,,,52.38,,52.38,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Individual Exchange,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Anthem,State Preferred,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Cigna,Cigna,,6.25,,,6.25,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Connecticare,Commerical,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Connecticare,Exchange,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,Multiplan,Multiplan,,,59.44,,59.44,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9552-01,NDC,both,0.143,ea,69.93,41.96,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Aetna,Commerical,,,53.96,,53.96,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Aetna,Middlesex Employees,,,51.74,,51.74,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Commerical,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Indemnity,,,52.38,,52.38,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Anthem,Individual Exchange,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Anthem,State Preferred,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Cigna,Cigna,,6.25,,,6.25,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Connecticare,Commerical,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Connecticare,Exchange,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,Multiplan,Multiplan,,,59.44,,59.44,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,0703-5145-01,NDC,both,0.143,ea,69.93,41.96,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Aetna,Commerical,,,53.96,,53.96,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Aetna,Middlesex Employees,,,51.74,,51.74,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Anthem,Commerical,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Anthem,Indemnity,,,52.38,,52.38,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Anthem,Individual Exchange,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Anthem,State Preferred,,,,,,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Cigna,Cigna,,6.25,,,6.25,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Connecticare,Commerical,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Connecticare,Exchange,,6.21,,,6.21,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,Multiplan,Multiplan,,,59.44,,59.44,5.4,59.44,percent of total billed charges,,
LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,J0640,HCPCS,67457-530-35,NDC,both,0.143,ea,69.93,41.96,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,59.44,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Aetna,Commerical,,,3.3,,3.3,3.17,3.64,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Aetna,Middlesex Employees,,,3.17,,3.17,3.17,3.64,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Anthem,Commerical,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Anthem,Indemnity,,,3.21,,3.21,3.17,3.64,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Anthem,Individual Exchange,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Anthem,State Preferred,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Cigna,Cigna,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Connecticare,Commerical,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Connecticare,Exchange,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,Multiplan,Multiplan,,,3.64,,3.64,3.17,3.64,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-13,NDC,both,1,ea,4.28,2.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.17,3.64,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Aetna,Commerical,,,3.23,,3.23,3.09,3.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Aetna,Middlesex Employees,,,3.09,,3.09,3.09,3.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Anthem,Commerical,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Anthem,Indemnity,,,3.13,,3.13,3.09,3.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Anthem,Individual Exchange,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Anthem,State Preferred,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Cigna,Cigna,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Connecticare,Commerical,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Connecticare,Exchange,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,Multiplan,Multiplan,,,3.55,,3.55,3.09,3.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-4496-25,NDC,both,1,ea,4.18,2.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.09,3.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Aetna,Commerical,,,7.75,,7.75,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Aetna,Middlesex Employees,,,7.43,,7.43,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Anthem,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Anthem,Indemnity,,,7.52,,7.52,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Anthem,Individual Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Anthem,State Preferred,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Cigna,Cigna,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Connecticare,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Connecticare,Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,Multiplan,Multiplan,,,8.53,,8.53,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,5.81,3.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Aetna,Commerical,,,4.48,,4.48,4.3,4.94,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Aetna,Middlesex Employees,,,4.3,,4.3,4.3,4.94,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Anthem,Commerical,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Anthem,Indemnity,,,4.35,,4.35,4.3,4.94,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Anthem,Individual Exchange,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Anthem,State Preferred,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Cigna,Cigna,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Connecticare,Commerical,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Connecticare,Exchange,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,Multiplan,Multiplan,,,4.94,,4.94,4.3,4.94,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET,J3490,HCPCS,42806-358-30,NDC,both,1,ea,5.81,3.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.3,4.94,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Aetna,Commerical,,,7.75,,7.75,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Aetna,Middlesex Employees,,,7.43,,7.43,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Anthem,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Anthem,Indemnity,,,7.52,,7.52,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Anthem,Individual Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Anthem,State Preferred,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Cigna,Cigna,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Connecticare,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Connecticare,Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,Multiplan,Multiplan,,,8.53,,8.53,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,0054-8496-19,NDC,both,1,ea,10.04,6.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Aetna,Commerical,,,7.75,,7.75,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Aetna,Middlesex Employees,,,7.43,,7.43,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Anthem,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Anthem,Indemnity,,,7.52,,7.52,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Anthem,Individual Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Anthem,State Preferred,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Cigna,Cigna,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Connecticare,Commerical,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Connecticare,Exchange,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,Multiplan,Multiplan,,,8.53,,8.53,7.43,8.53,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG TABLET CHEMO,J3490,HCPCS,51079-581-06,NDC,both,1,ea,10.04,6.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.43,8.53,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Aetna,Commerical,,,971.68,,971.68,931.76,1070.41,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Aetna,Middlesex Employees,,,931.76,,931.76,931.76,1070.41,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Anthem,Commerical,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Anthem,Indemnity,,,943.35,,943.35,931.76,1070.41,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Anthem,Individual Exchange,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Anthem,State Preferred,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Cigna,Cigna,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Connecticare,Commerical,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Connecticare,Exchange,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,Multiplan,Multiplan,,,1070.41,,1070.41,931.76,1070.41,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-29,NDC,both,5,mL,1259.31,755.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,931.76,1070.41,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Aetna,Commerical,,,485.85,,485.85,465.89,535.21,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Aetna,Middlesex Employees,,,465.89,,465.89,465.89,535.21,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Anthem,Commerical,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Anthem,Indemnity,,,471.68,,471.68,465.89,535.21,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Anthem,Individual Exchange,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Anthem,State Preferred,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Cigna,Cigna,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Connecticare,Commerical,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Connecticare,Exchange,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,Multiplan,Multiplan,,,535.21,,535.21,465.89,535.21,percent of total billed charges,,
LEUCOVORIN CALCIUM 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-30,NDC,both,5,mL,629.66,377.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,465.89,535.21,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Aetna,Commerical,,,13.66,,13.66,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Aetna,Middlesex Employees,,,13.1,,13.1,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Anthem,Commerical,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Anthem,Indemnity,,,13.26,,13.26,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Anthem,Individual Exchange,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Anthem,State Preferred,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Cigna,Cigna,,6.25,,,6.25,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Connecticare,Commerical,,6.21,,,6.21,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Connecticare,Exchange,,6.21,,,6.21,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,Multiplan,Multiplan,,,15.05,,15.05,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,0143-9555-01,NDC,both,1,ea,17.7,10.62,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Aetna,Commerical,,,13.66,,13.66,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Aetna,Middlesex Employees,,,13.1,,13.1,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Anthem,Commerical,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Anthem,Indemnity,,,13.26,,13.26,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Anthem,Individual Exchange,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Anthem,State Preferred,,,,,,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Cigna,Cigna,,6.25,,,6.25,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Connecticare,Commerical,,6.21,,,6.21,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Connecticare,Exchange,,6.21,,,6.21,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,Multiplan,Multiplan,,,15.05,,15.05,5.4,15.05,percent of total billed charges,,
LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-813-10,NDC,both,1,ea,17.7,10.62,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,15.05,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Aetna,Commerical,,,224.72,,224.72,5.4,247.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Aetna,Middlesex Employees,,,215.49,,215.49,5.4,247.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Anthem,Commerical,,,,,,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Anthem,Indemnity,,,218.17,,218.17,5.4,247.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Anthem,Individual Exchange,,,,,,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Anthem,State Preferred,,,,,,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Cigna,Cigna,,6.25,,,6.25,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Connecticare,Commerical,,6.21,,,6.21,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Connecticare,Exchange,,6.21,,,6.21,5.4,247.55,Other,Could be inpatient or outpatient,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,Multiplan,Multiplan,,,247.55,,247.55,5.4,247.55,percent of total billed charges,,
LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,J0640,HCPCS,25021-828-50,NDC,both,0.1,ea,291.24,174.74,United Healthcare/Oxford,United Healthcare/Oxford,,5.4,,,5.4,5.4,247.55,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Aetna,Commerical,,,1188.53,,1188.53,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Aetna,Middlesex Employees,,,1139.7,,1139.7,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Anthem,Commerical,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Anthem,Indemnity,,,1153.88,,1153.88,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Anthem,Individual Exchange,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Anthem,State Preferred,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Cigna,Cigna,,6.56,,,6.56,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Connecticare,Commerical,,14.05,,,14.05,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Connecticare,Exchange,,14.05,,,14.05,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,Multiplan,Multiplan,,,1309.3,,1309.3,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,0781-4003-32,NDC,both,1,ea,1540.35,924.21,United Healthcare/Oxford,United Healthcare/Oxford,,5.67,,,5.67,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Aetna,Commerical,,,1188.53,,1188.53,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Aetna,Middlesex Employees,,,1139.7,,1139.7,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Anthem,Commerical,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Anthem,Indemnity,,,1153.88,,1153.88,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Anthem,Individual Exchange,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Anthem,State Preferred,,,,,,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Cigna,Cigna,,6.56,,,6.56,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Connecticare,Commerical,,14.05,,,14.05,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Connecticare,Exchange,,14.05,,,14.05,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,Multiplan,Multiplan,,,1309.3,,1309.3,5.67,1309.3,percent of total billed charges,,
LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,J9218,HCPCS,55150-478-01,NDC,both,1,ea,1540.35,924.21,United Healthcare/Oxford,United Healthcare/Oxford,,5.67,,,5.67,5.67,1309.3,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Aetna,Commerical,,,30446.3,,30446.3,2042.19,33539.86,percent of total billed charges,,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Aetna,Middlesex Employees,,,29195.46,,29195.46,2042.19,33539.86,percent of total billed charges,,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Anthem,Commerical,,,,,,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Anthem,Indemnity,,,29558.48,,29558.48,2042.19,33539.86,percent of total billed charges,,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Anthem,Individual Exchange,,,,,,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Anthem,State Preferred,,,,,,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Cigna,Cigna,,2360.24,,,2360.24,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,Multiplan,Multiplan,,,33539.86,,33539.86,2042.19,33539.86,percent of total billed charges,,
LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3779-03,NDC,both,1,ea,39458.66,23675.2,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,33539.86,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Aetna,Commerical,,,10169.02,,10169.02,2042.19,11202.27,percent of total billed charges,,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Aetna,Middlesex Employees,,,9751.25,,9751.25,2042.19,11202.27,percent of total billed charges,,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Anthem,Commerical,,,,,,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Anthem,Indemnity,,,9872.49,,9872.49,2042.19,11202.27,percent of total billed charges,,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Anthem,Individual Exchange,,,,,,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Anthem,State Preferred,,,,,,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Cigna,Cigna,,2360.24,,,2360.24,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,Multiplan,Multiplan,,,11202.27,,11202.27,2042.19,11202.27,percent of total billed charges,,
LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2282-03,NDC,both,0.334,ea,13179.14,7907.48,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,11202.27,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Aetna,Commerical,,,11177.8,,11177.8,2042.19,12313.54,percent of total billed charges,,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Aetna,Middlesex Employees,,,10718.58,,10718.58,2042.19,12313.54,percent of total billed charges,,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Anthem,Commerical,,,,,,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Anthem,Indemnity,,,10851.85,,10851.85,2042.19,12313.54,percent of total billed charges,,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Anthem,Individual Exchange,,,,,,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Anthem,State Preferred,,,,,,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Cigna,Cigna,,2360.24,,,2360.24,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,Multiplan,Multiplan,,,12313.54,,12313.54,2042.19,12313.54,percent of total billed charges,,
LEUPROLIDE 15 MG INTRAMUSCULAR KIT,J1950,HCPCS,0074-2440-03,NDC,both,1,ea,14486.52,8691.91,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,12313.54,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Aetna,Commerical,,,16612.08,,16612.08,220.26,18299.98,percent of total billed charges,,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Aetna,Middlesex Employees,,,15929.6,,15929.6,220.26,18299.98,percent of total billed charges,,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Anthem,Commerical,,,,,,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Anthem,Indemnity,,,16127.67,,16127.67,220.26,18299.98,percent of total billed charges,,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Anthem,Individual Exchange,,,,,,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Anthem,State Preferred,,,,,,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Cigna,Cigna,,254.56,,,254.56,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Connecticare,Commerical,,269.53,,,269.53,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Connecticare,Exchange,,269.53,,,269.53,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,Multiplan,Multiplan,,,18299.98,,18299.98,220.26,18299.98,percent of total billed charges,,
LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3346-03,NDC,both,1,ea,21529.39,12917.63,United Healthcare/Oxford,United Healthcare/Oxford,,220.26,,,220.26,220.26,18299.98,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Aetna,Commerical,,,4646.81,,4646.81,2042.19,5118.96,percent of total billed charges,,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Aetna,Middlesex Employees,,,4455.9,,4455.9,2042.19,5118.96,percent of total billed charges,,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Anthem,Commerical,,,,,,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Anthem,Indemnity,,,4511.3,,4511.3,2042.19,5118.96,percent of total billed charges,,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Anthem,Individual Exchange,,,,,,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Anthem,State Preferred,,,,,,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Cigna,Cigna,,2360.24,,,2360.24,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,Multiplan,Multiplan,,,5118.96,,5118.96,2042.19,5118.96,percent of total billed charges,,
LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-3641-03,NDC,both,1,ea,6022.3,3613.38,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,5118.96,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Aetna,Commerical,,,33533.57,,33533.57,2042.19,36940.81,percent of total billed charges,,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Aetna,Middlesex Employees,,,32155.89,,32155.89,2042.19,36940.81,percent of total billed charges,,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Anthem,Commerical,,,,,,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Anthem,Indemnity,,,32555.72,,32555.72,2042.19,36940.81,percent of total billed charges,,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Anthem,Individual Exchange,,,,,,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Anthem,State Preferred,,,,,,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Cigna,Cigna,,2360.24,,,2360.24,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,Multiplan,Multiplan,,,36940.81,,36940.81,2042.19,36940.81,percent of total billed charges,,
LEUPROLIDE 30 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,J1950,HCPCS,0074-9694-03,NDC,both,0.125,ea,43459.78,26075.87,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,36940.81,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Aetna,Commerical,,,5590.11,,5590.11,2042.19,6158.11,percent of total billed charges,,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Aetna,Middlesex Employees,,,5360.45,,5360.45,2042.19,6158.11,percent of total billed charges,,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Anthem,Commerical,,,,,,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Anthem,Indemnity,,,5427.1,,5427.1,2042.19,6158.11,percent of total billed charges,,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Anthem,Individual Exchange,,,,,,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Anthem,State Preferred,,,,,,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Cigna,Cigna,,2360.24,,,2360.24,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Connecticare,Commerical,,2470.12,,,2470.12,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Connecticare,Exchange,,2470.12,,,2470.12,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,Multiplan,Multiplan,,,6158.11,,6158.11,2042.19,6158.11,percent of total billed charges,,
LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT,J1950,HCPCS,0074-2108-03,NDC,both,1,ea,7244.83,4346.9,United Healthcare/Oxford,United Healthcare/Oxford,,2042.19,,,2042.19,2042.19,6158.11,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Aetna,Commerical,,,5537.4,,5537.4,220.26,6100.03,percent of total billed charges,,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Aetna,Middlesex Employees,,,5309.9,,5309.9,220.26,6100.03,percent of total billed charges,,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Anthem,Commerical,,,,,,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Anthem,Indemnity,,,5375.92,,5375.92,220.26,6100.03,percent of total billed charges,,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Anthem,Individual Exchange,,,,,,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Anthem,State Preferred,,,,,,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Cigna,Cigna,,254.56,,,254.56,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Connecticare,Commerical,,269.53,,,269.53,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Connecticare,Exchange,,269.53,,,269.53,220.26,6100.03,Other,Could be inpatient or outpatient,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,Multiplan,Multiplan,,,6100.03,,6100.03,220.26,6100.03,percent of total billed charges,,
LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,J9217,HCPCS,0074-3642-03,NDC,both,1,ea,7176.51,4305.91,United Healthcare/Oxford,United Healthcare/Oxford,,220.26,,,220.26,220.26,6100.03,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Aetna,Commerical,,,4.4,,4.4,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Aetna,Middlesex Employees,,,4.22,,4.22,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Anthem,Commerical,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Anthem,Indemnity,,,4.27,,4.27,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Anthem,Individual Exchange,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Anthem,State Preferred,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Cigna,Cigna,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Connecticare,Commerical,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Connecticare,Exchange,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,Multiplan,Multiplan,,,4.85,,4.85,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-01,NDC,both,3,mL,5.7,3.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Aetna,Commerical,,,4.4,,4.4,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Aetna,Middlesex Employees,,,4.22,,4.22,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Anthem,Commerical,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Anthem,Indemnity,,,4.27,,4.27,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Anthem,Individual Exchange,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Anthem,State Preferred,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Cigna,Cigna,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Connecticare,Commerical,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Connecticare,Exchange,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,Multiplan,Multiplan,,,4.85,,4.85,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-800-11,NDC,both,3,mL,5.7,3.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Aetna,Commerical,,,4.4,,4.4,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Aetna,Middlesex Employees,,,4.22,,4.22,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Anthem,Commerical,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Anthem,Indemnity,,,4.27,,4.27,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Anthem,Individual Exchange,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Anthem,State Preferred,,,,,,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Cigna,Cigna,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Connecticare,Commerical,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Connecticare,Exchange,,0.12,,,0.12,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,Multiplan,Multiplan,,,4.85,,4.85,0.06,4.85,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-01,NDC,both,3,mL,5.7,3.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,4.85,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Aetna,Commerical,,,5.28,,5.28,0.06,5.81,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Aetna,Middlesex Employees,,,5.06,,5.06,0.06,5.81,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Anthem,Commerical,,,,,,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Anthem,Indemnity,,,5.12,,5.12,0.06,5.81,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Anthem,Individual Exchange,,,,,,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Anthem,State Preferred,,,,,,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Cigna,Cigna,,0.06,,,0.06,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Connecticare,Commerical,,0.12,,,0.12,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Connecticare,Exchange,,0.12,,,0.12,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,Multiplan,Multiplan,,,5.81,,5.81,0.06,5.81,percent of total billed charges,,
LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,J7614,HCPCS,76204-900-11,NDC,both,1.2,mL,6.84,4.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.06,,,0.06,0.06,5.81,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Aetna,Commerical,,,19,,19,0.31,20.94,percent of total billed charges,,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Aetna,Middlesex Employees,,,18.22,,18.22,0.31,20.94,percent of total billed charges,,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Anthem,Commerical,,,,,,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Anthem,Indemnity,,,18.45,,18.45,0.31,20.94,percent of total billed charges,,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Anthem,Individual Exchange,,,,,,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Anthem,State Preferred,,,,,,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Cigna,Cigna,,0.31,,,0.31,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Connecticare,Commerical,,0.36,,,0.36,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Connecticare,Exchange,,0.36,,,0.36,0.31,20.94,Other,Could be inpatient or outpatient,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,Multiplan,Multiplan,,,20.94,,20.94,0.31,20.94,percent of total billed charges,,
LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,J7612,HCPCS,0378-6993-93,NDC,both,0.4,ea,24.63,14.78,United Healthcare/Oxford,United Healthcare/Oxford,,0.33,,,0.33,0.31,20.94,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Aetna,Commerical,,,14.43,,14.43,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Aetna,Middlesex Employees,,,13.84,,13.84,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Anthem,Commerical,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Anthem,Indemnity,,,14.01,,14.01,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Anthem,Individual Exchange,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Anthem,State Preferred,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Cigna,Cigna,,0.07,,,0.07,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Connecticare,Commerical,,0.08,,,0.08,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Connecticare,Exchange,,0.08,,,0.08,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,Multiplan,Multiplan,,,15.9,,15.9,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML IV UNDILUTED FOR IV FLUID SHORTAGE,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,56.4,33.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Aetna,Commerical,,,62.91,,62.91,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Aetna,Middlesex Employees,,,60.32,,60.32,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Anthem,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Anthem,Indemnity,,,61.07,,61.07,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Anthem,Individual Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Anthem,State Preferred,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Cigna,Cigna,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Connecticare,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Connecticare,Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,Multiplan,Multiplan,,,69.3,,69.3,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0121-0799-16,NDC,both,1,mL,81.53,48.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Aetna,Commerical,,,62.91,,62.91,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Aetna,Middlesex Employees,,,60.32,,60.32,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Anthem,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Anthem,Indemnity,,,61.07,,61.07,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Anthem,Individual Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Anthem,State Preferred,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Cigna,Cigna,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Connecticare,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Connecticare,Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,Multiplan,Multiplan,,,69.3,,69.3,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,51991-651-16,NDC,both,1,mL,81.53,48.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Aetna,Commerical,,,62.91,,62.91,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Aetna,Middlesex Employees,,,60.32,,60.32,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Anthem,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Anthem,Indemnity,,,61.07,,61.07,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Anthem,Individual Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Anthem,State Preferred,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Cigna,Cigna,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Connecticare,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Connecticare,Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,Multiplan,Multiplan,,,69.3,,69.3,60.32,69.3,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54838-548-80,NDC,both,1,mL,81.53,48.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Aetna,Commerical,,,325.7,,325.7,312.32,358.79,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Aetna,Middlesex Employees,,,312.32,,312.32,312.32,358.79,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Anthem,Commerical,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Anthem,Indemnity,,,316.2,,316.2,312.32,358.79,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Anthem,Individual Exchange,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Anthem,State Preferred,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Cigna,Cigna,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Connecticare,Commerical,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Connecticare,Exchange,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,Multiplan,Multiplan,,,358.79,,358.79,312.32,358.79,percent of total billed charges,,
LEVETIRACETAM 100 MG/ML ORAL SOLUTION,J3490,HCPCS,65862-250-47,NDC,both,1,mL,422.11,253.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,312.32,358.79,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Aetna,Commerical,,,0.58,,0.58,0.55,0.64,percent of total billed charges,,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Aetna,Middlesex Employees,,,0.55,,0.55,0.55,0.64,percent of total billed charges,,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Anthem,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Anthem,Indemnity,,,0.56,,0.56,0.55,0.64,percent of total billed charges,,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Anthem,Individual Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Anthem,State Preferred,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Cigna,Cigna,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Connecticare,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Connecticare,Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,Multiplan,Multiplan,,,0.64,,0.64,0.55,0.64,percent of total billed charges,,
LEVETIRACETAM 125 MG ORAL TAB,J3490,HCPCS,40810-0001-71,NDC,both,1,ea,0.75,0.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-6051-61,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,0904-7123-61,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
LEVETIRACETAM 250 MG TABLET,J3490,HCPCS,51079-820-20,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-6052-61,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,0904-7124-61,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-01,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,51079-821-20,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68084-870-01,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
LEVETIRACETAM 500 MG TABLET,J3490,HCPCS,68180-113-16,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Aetna,Commerical,,,14.43,,14.43,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Aetna,Middlesex Employees,,,13.84,,13.84,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Anthem,Commerical,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Anthem,Indemnity,,,14.01,,14.01,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Anthem,Individual Exchange,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Anthem,State Preferred,,,,,,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Cigna,Cigna,,0.07,,,0.07,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Connecticare,Commerical,,0.08,,,0.08,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Connecticare,Exchange,,0.08,,,0.08,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,Multiplan,Multiplan,,,15.9,,15.9,0.07,15.9,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-02,NDC,both,0.1,mL,18.7,11.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,15.9,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-05,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-15,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-1886-22,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-05,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,0409-2011-25,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,25021-780-05,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,39822-4000-1,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Aetna,Commerical,,,11.5,,11.5,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Aetna,Middlesex Employees,,,11.02,,11.02,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Anthem,Commerical,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Anthem,Indemnity,,,11.16,,11.16,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Anthem,Individual Exchange,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Anthem,State Preferred,,,,,,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Cigna,Cigna,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Connecticare,Commerical,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Connecticare,Exchange,,0.08,,,0.08,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,Multiplan,Multiplan,,,12.67,,12.67,0.07,12.67,percent of total billed charges,,
LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,J1953,HCPCS,63323-400-09,NDC,both,0.1,mL,14.9,8.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.07,,,0.07,0.07,12.67,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-6053-61,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,0904-7125-61,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
LEVETIRACETAM 750 MG TABLET,J3490,HCPCS,68084-882-11,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Aetna,Commerical,,,24.37,,24.37,23.37,26.84,percent of total billed charges,,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Aetna,Middlesex Employees,,,23.37,,23.37,23.37,26.84,percent of total billed charges,,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Anthem,Commerical,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Anthem,Indemnity,,,23.66,,23.66,23.37,26.84,percent of total billed charges,,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Anthem,Individual Exchange,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Anthem,State Preferred,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Cigna,Cigna,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Connecticare,Commerical,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Connecticare,Exchange,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,Multiplan,Multiplan,,,26.84,,26.84,23.37,26.84,percent of total billed charges,,
"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50474-598-66,NDC,both,1,ea,31.58,18.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.37,26.84,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Aetna,Commerical,,,103.92,,103.92,99.65,114.48,percent of total billed charges,,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Aetna,Middlesex Employees,,,99.65,,99.65,99.65,114.48,percent of total billed charges,,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Anthem,Commerical,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Anthem,Indemnity,,,100.89,,100.89,99.65,114.48,percent of total billed charges,,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Anthem,Individual Exchange,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Anthem,State Preferred,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Cigna,Cigna,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Connecticare,Commerical,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Connecticare,Exchange,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,Multiplan,Multiplan,,,114.48,,114.48,99.65,114.48,percent of total billed charges,,
LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,J3490,HCPCS,64980-503-12,NDC,both,1,mL,134.68,80.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,99.65,114.48,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Aetna,Commerical,,,88.23,,88.23,84.61,97.2,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Aetna,Middlesex Employees,,,84.61,,84.61,84.61,97.2,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Anthem,Commerical,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Anthem,Indemnity,,,85.66,,85.66,84.61,97.2,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Anthem,Individual Exchange,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Anthem,State Preferred,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Cigna,Cigna,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Connecticare,Commerical,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Connecticare,Exchange,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,Multiplan,Multiplan,,,97.2,,97.2,84.61,97.2,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,54482-148-01,NDC,both,1,mL,114.35,68.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,84.61,97.2,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Aetna,Commerical,,,87.53,,87.53,83.93,96.42,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Aetna,Middlesex Employees,,,83.93,,83.93,83.93,96.42,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Anthem,Commerical,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Anthem,Indemnity,,,84.98,,84.98,83.93,96.42,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Anthem,Individual Exchange,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Anthem,State Preferred,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Cigna,Cigna,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Connecticare,Commerical,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Connecticare,Exchange,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,Multiplan,Multiplan,,,96.42,,96.42,83.93,96.42,percent of total billed charges,,
LEVOCARNITINE 100 MG/ML ORAL SOLUTION,J3490,HCPCS,70954-140-10,NDC,both,1,mL,113.44,68.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,83.93,96.42,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Aetna,Commerical,,,68.9,,68.9,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Aetna,Middlesex Employees,,,66.07,,66.07,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Anthem,Commerical,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Anthem,Indemnity,,,66.89,,66.89,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Anthem,Individual Exchange,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Anthem,State Preferred,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Cigna,Cigna,,34.51,,,34.51,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Connecticare,Commerical,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Connecticare,Exchange,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,Multiplan,Multiplan,,,75.91,,75.91,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-01,NDC,both,5,mL,89.3,53.58,United Healthcare/Oxford,United Healthcare/Oxford,,37.26,,,37.26,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Aetna,Commerical,,,68.9,,68.9,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Aetna,Middlesex Employees,,,66.07,,66.07,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Anthem,Commerical,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Anthem,Indemnity,,,66.89,,66.89,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Anthem,Individual Exchange,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Anthem,State Preferred,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Cigna,Cigna,,34.51,,,34.51,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Connecticare,Commerical,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Connecticare,Exchange,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,Multiplan,Multiplan,,,75.91,,75.91,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,0143-9852-10,NDC,both,5,mL,89.3,53.58,United Healthcare/Oxford,United Healthcare/Oxford,,37.26,,,37.26,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Aetna,Commerical,,,68.9,,68.9,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Aetna,Middlesex Employees,,,66.07,,66.07,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Anthem,Commerical,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Anthem,Indemnity,,,66.89,,66.89,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Anthem,Individual Exchange,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Anthem,State Preferred,,,,,,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Cigna,Cigna,,34.51,,,34.51,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Connecticare,Commerical,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Connecticare,Exchange,,42.33,,,42.33,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,Multiplan,Multiplan,,,75.91,,75.91,34.51,75.91,percent of total billed charges,,
LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,J1955,HCPCS,54482-147-01,NDC,both,5,mL,89.3,53.58,United Healthcare/Oxford,United Healthcare/Oxford,,37.26,,,37.26,34.51,75.91,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,40810-0009-39,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,50383-172-90,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Aetna,Commerical,,,2.47,,2.47,2.37,2.72,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Aetna,Middlesex Employees,,,2.37,,2.37,2.37,2.72,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Anthem,Commerical,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Anthem,Indemnity,,,2.4,,2.4,2.37,2.72,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Anthem,Individual Exchange,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Anthem,State Preferred,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Cigna,Cigna,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Connecticare,Commerical,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Connecticare,Exchange,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,Multiplan,Multiplan,,,2.72,,2.72,2.37,2.72,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,54482-144-07,NDC,both,1,ea,3.2,1.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.37,2.72,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
LEVOCARNITINE 330 MG TABLET,J3490,HCPCS,70954-492-10,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
LEVODOPA 125 MG CAPSULE,J3490,HCPCS,40810-0019-96,NDC,both,1,UN,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 125 MG TABLET,J3490,HCPCS,40810-0013-61,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Aetna,Commerical,,,74.47,,74.47,1.06,82.04,percent of total billed charges,,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Aetna,Middlesex Employees,,,71.42,,71.42,1.06,82.04,percent of total billed charges,,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Anthem,Commerical,,,,,,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Anthem,Indemnity,,,72.3,,72.3,1.06,82.04,percent of total billed charges,,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Anthem,Individual Exchange,,,,,,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Anthem,State Preferred,,,,,,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Cigna,Cigna,,1.06,,,1.06,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Connecticare,Commerical,,1.76,,,1.76,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Connecticare,Exchange,,1.76,,,1.76,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,Multiplan,Multiplan,,,82.04,,82.04,1.06,82.04,percent of total billed charges,,
LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,J1956,HCPCS,17478-107-30,NDC,both,10,mL,96.52,57.91,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,82.04,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
LEVOFLOXACIN 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,55111-279-50,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Aetna,Commerical,,,516.58,,516.58,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Aetna,Middlesex Employees,,,495.36,,495.36,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Commerical,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Indemnity,,,501.51,,501.51,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Individual Exchange,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,State Preferred,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Cigna,Cigna,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Connecticare,Commerical,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Connecticare,Exchange,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Multiplan,Multiplan,,,569.07,,569.07,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Aetna,Commerical,,,281.63,,281.63,270.06,310.25,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Aetna,Middlesex Employees,,,270.06,,270.06,270.06,310.25,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Anthem,Commerical,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Anthem,Indemnity,,,273.42,,273.42,270.06,310.25,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Anthem,Individual Exchange,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Anthem,State Preferred,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Cigna,Cigna,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Connecticare,Commerical,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Connecticare,Exchange,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,Multiplan,Multiplan,,,310.25,,310.25,270.06,310.25,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION,J3490,HCPCS,50383-286-04,NDC,both,1,mL,365,219,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,270.06,310.25,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Aetna,Commerical,,,516.58,,516.58,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Aetna,Middlesex Employees,,,495.36,,495.36,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Commerical,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Indemnity,,,501.51,,501.51,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,Individual Exchange,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Anthem,State Preferred,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Cigna,Cigna,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Connecticare,Commerical,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Connecticare,Exchange,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,Multiplan,Multiplan,,,569.07,,569.07,495.36,569.07,percent of total billed charges,,
LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION FOR PROPHYLAXIS USE,J3490,HCPCS,0527-1948-66,NDC,both,1,mL,669.49,401.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,495.36,569.07,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Aetna,Commerical,,,35.45,,35.45,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Aetna,Middlesex Employees,,,33.99,,33.99,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Commerical,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Indemnity,,,34.41,,34.41,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Individual Exchange,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,State Preferred,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Cigna,Cigna,,1.06,,,1.06,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Connecticare,Commerical,,1.76,,,1.76,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Connecticare,Exchange,,1.76,,,1.76,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Multiplan,Multiplan,,,39.05,,39.05,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Aetna,Commerical,,,35.45,,35.45,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Aetna,Middlesex Employees,,,33.99,,33.99,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Commerical,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Indemnity,,,34.41,,34.41,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,Individual Exchange,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Anthem,State Preferred,,,,,,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Cigna,Cigna,,1.06,,,1.06,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Connecticare,Commerical,,1.76,,,1.76,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Connecticare,Exchange,,1.76,,,1.76,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,Multiplan,Multiplan,,,39.05,,39.05,1.06,39.05,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-81,NDC,both,50,mL,45.94,27.56,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,39.05,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Aetna,Commerical,,,41.65,,41.65,1.06,45.88,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Aetna,Middlesex Employees,,,39.94,,39.94,1.06,45.88,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Anthem,Commerical,,,,,,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Anthem,Indemnity,,,40.44,,40.44,1.06,45.88,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Anthem,Individual Exchange,,,,,,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Anthem,State Preferred,,,,,,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Cigna,Cigna,,1.06,,,1.06,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Connecticare,Commerical,,1.76,,,1.76,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Connecticare,Exchange,,1.76,,,1.76,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,Multiplan,Multiplan,,,45.88,,45.88,1.06,45.88,percent of total billed charges,,
LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,36000-046-24,NDC,both,50,mL,53.98,32.39,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,45.88,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Aetna,Commerical,,,0.69,,0.69,0.67,0.77,percent of total billed charges,,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Anthem,Indemnity,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
LEVOFLOXACIN 500 MG TABLET,J3490,HCPCS,0904-6352-61,NDC,both,1,ea,0.9,0.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Aetna,Commerical,,,35,,35,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Aetna,Middlesex Employees,,,33.56,,33.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Anthem,Commerical,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Anthem,Indemnity,,,33.98,,33.98,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Anthem,Individual Exchange,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Anthem,State Preferred,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Cigna,Cigna,,1.06,,,1.06,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Connecticare,Commerical,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Connecticare,Exchange,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,Multiplan,Multiplan,,,38.56,,38.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9316-24,NDC,both,50,mL,45.36,27.22,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Aetna,Commerical,,,35,,35,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Aetna,Middlesex Employees,,,33.56,,33.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Anthem,Commerical,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Anthem,Indemnity,,,33.98,,33.98,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Anthem,Individual Exchange,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Anthem,State Preferred,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Cigna,Cigna,,1.06,,,1.06,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Connecticare,Commerical,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Connecticare,Exchange,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,Multiplan,Multiplan,,,38.56,,38.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-82,NDC,both,50,mL,45.36,27.22,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Aetna,Commerical,,,35,,35,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Aetna,Middlesex Employees,,,33.56,,33.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Anthem,Commerical,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Anthem,Indemnity,,,33.98,,33.98,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Anthem,Individual Exchange,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Anthem,State Preferred,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Cigna,Cigna,,1.06,,,1.06,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Connecticare,Commerical,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Connecticare,Exchange,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,Multiplan,Multiplan,,,38.56,,38.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-436-24,NDC,both,50,mL,45.36,27.22,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Aetna,Commerical,,,35,,35,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Aetna,Middlesex Employees,,,33.56,,33.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Anthem,Commerical,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Anthem,Indemnity,,,33.98,,33.98,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Anthem,Individual Exchange,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Anthem,State Preferred,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Cigna,Cigna,,1.06,,,1.06,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Connecticare,Commerical,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Connecticare,Exchange,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,Multiplan,Multiplan,,,38.56,,38.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-82,NDC,both,50,mL,46.51,27.91,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Aetna,Commerical,,,35,,35,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Aetna,Middlesex Employees,,,33.56,,33.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Anthem,Commerical,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Anthem,Indemnity,,,33.98,,33.98,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Anthem,Individual Exchange,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Anthem,State Preferred,,,,,,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Cigna,Cigna,,1.06,,,1.06,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Connecticare,Commerical,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Connecticare,Exchange,,1.76,,,1.76,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,Multiplan,Multiplan,,,38.56,,38.56,1.06,38.56,percent of total billed charges,,
LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-436-24,NDC,both,50,mL,46.51,27.91,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Aetna,Commerical,,,0.58,,0.58,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Aetna,Middlesex Employees,,,0.55,,0.55,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Anthem,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Anthem,Indemnity,,,0.56,,0.56,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Anthem,Individual Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Anthem,State Preferred,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Cigna,Cigna,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Connecticare,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Connecticare,Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,Multiplan,Multiplan,,,0.64,,0.64,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,40810-0016-89,NDC,both,1,ea,0.75,0.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Aetna,Commerical,,,0.58,,0.58,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Aetna,Middlesex Employees,,,0.55,,0.55,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Anthem,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Anthem,Indemnity,,,0.56,,0.56,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Anthem,Individual Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Anthem,State Preferred,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Cigna,Cigna,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Connecticare,Commerical,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Connecticare,Exchange,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,Multiplan,Multiplan,,,0.64,,0.64,0.55,0.64,percent of total billed charges,,
LEVOFLOXACIN 750 MG TABLET,J3490,HCPCS,55111-281-30,NDC,both,1,ea,0.75,0.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.55,0.64,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Aetna,Commerical,,,47.71,,47.71,1.06,52.56,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Aetna,Middlesex Employees,,,45.75,,45.75,1.06,52.56,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Anthem,Commerical,,,,,,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Anthem,Indemnity,,,46.32,,46.32,1.06,52.56,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Anthem,Individual Exchange,,,,,,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Anthem,State Preferred,,,,,,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Cigna,Cigna,,1.06,,,1.06,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Connecticare,Commerical,,1.76,,,1.76,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Connecticare,Exchange,,1.76,,,1.76,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,Multiplan,Multiplan,,,52.56,,52.56,1.06,52.56,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,0143-9720-24,NDC,both,50,mL,61.83,37.1,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,52.56,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Aetna,Commerical,,,35.3,,35.3,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Aetna,Middlesex Employees,,,33.85,,33.85,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Anthem,Commerical,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Anthem,Indemnity,,,34.27,,34.27,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Anthem,Individual Exchange,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Anthem,State Preferred,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Cigna,Cigna,,1.06,,,1.06,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Connecticare,Commerical,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Connecticare,Exchange,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,Multiplan,Multiplan,,,38.89,,38.89,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,25021-132-83,NDC,both,50,mL,45.75,27.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Aetna,Commerical,,,35.3,,35.3,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Aetna,Middlesex Employees,,,33.85,,33.85,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Anthem,Commerical,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Anthem,Indemnity,,,34.27,,34.27,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Anthem,Individual Exchange,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Anthem,State Preferred,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Cigna,Cigna,,1.06,,,1.06,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Connecticare,Commerical,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Connecticare,Exchange,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,Multiplan,Multiplan,,,38.89,,38.89,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,J1956,HCPCS,44567-437-24,NDC,both,50,mL,45.75,27.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Aetna,Commerical,,,35.3,,35.3,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Aetna,Middlesex Employees,,,33.85,,33.85,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Anthem,Commerical,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Anthem,Indemnity,,,34.27,,34.27,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Anthem,State Preferred,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Cigna,Cigna,,1.06,,,1.06,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Connecticare,Commerical,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Connecticare,Exchange,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,Multiplan,Multiplan,,,38.89,,38.89,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,25021-132-83,NDC,both,50,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Aetna,Commerical,,,35.3,,35.3,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Aetna,Middlesex Employees,,,33.85,,33.85,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Anthem,Commerical,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Anthem,Indemnity,,,34.27,,34.27,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Anthem,Individual Exchange,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Anthem,State Preferred,,,,,,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Cigna,Cigna,,1.06,,,1.06,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Connecticare,Commerical,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Connecticare,Exchange,,1.76,,,1.76,1.06,38.89,Other,Could be inpatient or outpatient,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,Multiplan,Multiplan,,,38.89,,38.89,1.06,38.89,percent of total billed charges,,
LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK FOR CAROUSEL,J1956,HCPCS,44567-437-24,NDC,both,50,mL,52.64,31.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.06,38.89,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,62756-720-60,NDC,both,1,ea,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
LEVONORGESTREL 1.5 MG TABLET,J3490,HCPCS,68180-852-11,NDC,both,1,ea,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Aetna,Commerical,,,1921.85,,1921.85,1110.2,2117.12,percent of total billed charges,,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Aetna,Middlesex Employees,,,1842.89,,1842.89,1110.2,2117.12,percent of total billed charges,,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Anthem,Commerical,,,,,,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Anthem,Indemnity,,,1865.81,,1865.81,1110.2,2117.12,percent of total billed charges,,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Anthem,Individual Exchange,,,,,,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Anthem,State Preferred,,,,,,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Cigna,Cigna,,1110.2,,,1110.2,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Connecticare,Commerical,,,,,,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Connecticare,Exchange,,,,,,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,Multiplan,Multiplan,,,2117.12,,2117.12,1110.2,2117.12,percent of total billed charges,,
LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,J7301,HCPCS,50419-422-01,NDC,both,1,ea,2490.73,1494.44,United Healthcare/Oxford,United Healthcare/Oxford,,1410.15,,,1410.15,1110.2,2117.12,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Aetna,Commerical,,,3255.78,,3255.78,1333.32,3586.59,percent of total billed charges,,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Aetna,Middlesex Employees,,,3122.02,,3122.02,1333.32,3586.59,percent of total billed charges,,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Anthem,Commerical,,,,,,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Anthem,Indemnity,,,3160.84,,3160.84,1333.32,3586.59,percent of total billed charges,,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Anthem,Individual Exchange,,,,,,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Anthem,State Preferred,,,,,,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Cigna,Cigna,,1333.32,,,1333.32,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Connecticare,Commerical,,,,,,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Connecticare,Exchange,,,,,,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,Multiplan,Multiplan,,,3586.59,,3586.59,1333.32,3586.59,percent of total billed charges,,
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,J7296,HCPCS,50419-424-01,NDC,both,1,ea,4219.52,2531.71,United Healthcare/Oxford,United Healthcare/Oxford,,1693.54,,,1693.54,1333.32,3586.59,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Aetna,Commerical,,,1598.37,,1598.37,1022.77,1760.78,percent of total billed charges,,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Aetna,Middlesex Employees,,,1532.7,,1532.7,1022.77,1760.78,percent of total billed charges,,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Anthem,Commerical,,,,,,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Anthem,Indemnity,,,1551.76,,1551.76,1022.77,1760.78,percent of total billed charges,,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Anthem,Individual Exchange,,,,,,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Anthem,State Preferred,,,,,,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Cigna,Cigna,,1022.77,,,1022.77,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Connecticare,Commerical,,,,,,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Connecticare,Exchange,,,,,,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,Multiplan,Multiplan,,,1760.78,,1760.78,1022.77,1760.78,percent of total billed charges,,
LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,J7297,HCPCS,0023-5858-01,NDC,both,1,ea,2071.5,1242.9,United Healthcare/Oxford,United Healthcare/Oxford,,1299.09,,,1299.09,1022.77,1760.78,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Aetna,Commerical,,,2395.25,,2395.25,1333.32,2638.62,percent of total billed charges,,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Aetna,Middlesex Employees,,,2296.84,,2296.84,1333.32,2638.62,percent of total billed charges,,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Anthem,Commerical,,,,,,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Anthem,Indemnity,,,2325.4,,2325.4,1333.32,2638.62,percent of total billed charges,,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Anthem,Individual Exchange,,,,,,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Anthem,State Preferred,,,,,,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Cigna,Cigna,,1333.32,,,1333.32,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Connecticare,Commerical,,,,,,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Connecticare,Exchange,,,,,,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,Multiplan,Multiplan,,,2638.62,,2638.62,1333.32,2638.62,percent of total billed charges,,
LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,J7298,HCPCS,50419-423-01,NDC,both,1,ea,3104.26,1862.56,United Healthcare/Oxford,United Healthcare/Oxford,,1693.54,,,1693.54,1333.32,2638.62,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Aetna,Commerical,,,131.51,,131.51,3.66,144.87,percent of total billed charges,,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Aetna,Middlesex Employees,,,126.11,,126.11,3.66,144.87,percent of total billed charges,,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Anthem,Commerical,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Anthem,Indemnity,,,127.68,,127.68,3.66,144.87,percent of total billed charges,,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Anthem,Individual Exchange,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Anthem,State Preferred,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Cigna,Cigna,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Connecticare,Commerical,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Connecticare,Exchange,,,,,,3.66,144.87,Other,Could be inpatient or outpatient,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,Multiplan,Multiplan,,,144.87,,144.87,3.66,144.87,percent of total billed charges,,
LEVORPHANOL TARTRATE 2 MG TABLET,J1960,HCPCS,42358-102-10,NDC,both,1,ea,170.44,102.26,United Healthcare/Oxford,United Healthcare/Oxford,,3.66,,,3.66,3.66,144.87,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Aetna,Commerical,,,239.17,,239.17,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Aetna,Middlesex Employees,,,229.35,,229.35,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Anthem,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Anthem,Indemnity,,,232.2,,232.2,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Anthem,Individual Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Anthem,State Preferred,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Cigna,Cigna,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Connecticare,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Connecticare,Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,Multiplan,Multiplan,,,263.47,,263.47,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,42023-201-01,NDC,both,1,ea,309.97,185.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Aetna,Commerical,,,239.17,,239.17,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Aetna,Middlesex Employees,,,229.35,,229.35,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Anthem,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Anthem,Indemnity,,,232.2,,232.2,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Anthem,Individual Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Anthem,State Preferred,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Cigna,Cigna,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Connecticare,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Connecticare,Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,Multiplan,Multiplan,,,263.47,,263.47,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-07,NDC,both,1,ea,309.97,185.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Aetna,Commerical,,,239.17,,239.17,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Aetna,Middlesex Employees,,,229.35,,229.35,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Anthem,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Anthem,Indemnity,,,232.2,,232.2,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Anthem,Individual Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Anthem,State Preferred,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Cigna,Cigna,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Connecticare,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Connecticare,Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,Multiplan,Multiplan,,,263.47,,263.47,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-649-16,NDC,both,1,ea,309.97,185.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Aetna,Commerical,,,239.17,,239.17,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Aetna,Middlesex Employees,,,229.35,,229.35,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Anthem,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Anthem,Indemnity,,,232.2,,232.2,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Anthem,Individual Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Anthem,State Preferred,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Cigna,Cigna,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Connecticare,Commerical,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Connecticare,Exchange,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,Multiplan,Multiplan,,,263.47,,263.47,229.35,263.47,percent of total billed charges,,
LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,70860-451-10,NDC,both,1,ea,309.97,185.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.35,263.47,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
LEVOTHYROXINE 100 MCG TABLET,J3490,HCPCS,51079-442-20,NDC,both,1,ea,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0527-1346-01,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,0904-6954-61,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,40810-0008-63,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 112 MCG TABLET,J3490,HCPCS,42292-039-20,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 12.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-72,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0074-7068-11,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,0904-6955-61,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-01,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Aetna,Commerical,,,1.49,,1.49,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Aetna,Middlesex Employees,,,1.43,,1.43,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Anthem,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Anthem,Indemnity,,,1.45,,1.45,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Anthem,Individual Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Anthem,State Preferred,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Cigna,Cigna,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Connecticare,Commerical,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Connecticare,Exchange,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,Multiplan,Multiplan,,,1.64,,1.64,1.43,1.64,percent of total billed charges,,
LEVOTHYROXINE 125 MCG TABLET,J3490,HCPCS,51079-443-20,NDC,both,1,ea,1.93,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.43,1.64,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Aetna,Commerical,,,202.97,,202.97,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Aetna,Middlesex Employees,,,194.63,,194.63,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Anthem,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Anthem,Indemnity,,,197.05,,197.05,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Anthem,Individual Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Anthem,State Preferred,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Cigna,Cigna,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Connecticare,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Connecticare,Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,Multiplan,Multiplan,,,223.59,,223.59,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-10,NDC,both,1,mL,263.05,157.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Aetna,Commerical,,,202.97,,202.97,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Aetna,Middlesex Employees,,,194.63,,194.63,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Anthem,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Anthem,Indemnity,,,197.05,,197.05,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Anthem,Individual Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Anthem,State Preferred,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Cigna,Cigna,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Connecticare,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Connecticare,Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,Multiplan,Multiplan,,,223.59,,223.59,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-12,NDC,both,1,mL,263.05,157.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Aetna,Commerical,,,202.97,,202.97,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Aetna,Middlesex Employees,,,194.63,,194.63,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Anthem,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Anthem,Indemnity,,,197.05,,197.05,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Anthem,Individual Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Anthem,State Preferred,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Cigna,Cigna,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Connecticare,Commerical,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Connecticare,Exchange,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,Multiplan,Multiplan,,,223.59,,223.59,194.63,223.59,percent of total billed charges,,
LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-885-14,NDC,both,1,mL,263.05,157.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,194.63,223.59,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Aetna,Commerical,,,464.06,,464.06,445,511.22,percent of total billed charges,,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Aetna,Middlesex Employees,,,445,,445,445,511.22,percent of total billed charges,,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Anthem,Commerical,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Anthem,Indemnity,,,450.53,,450.53,445,511.22,percent of total billed charges,,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Anthem,Individual Exchange,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Anthem,State Preferred,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Cigna,Cigna,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Connecticare,Commerical,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Connecticare,Exchange,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,Multiplan,Multiplan,,,511.22,,511.22,445,511.22,percent of total billed charges,,
LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,J3490,HCPCS,63323-647-10,NDC,both,1,ea,601.43,360.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,445,511.22,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Aetna,Commerical,,,1.33,,1.33,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Anthem,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Anthem,Indemnity,,,1.29,,1.29,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Anthem,Individual Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Anthem,State Preferred,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Cigna,Cigna,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Connecticare,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Connecticare,Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,Multiplan,Multiplan,,,1.46,,1.46,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,0904-6949-61,NDC,both,1,ea,1.72,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Aetna,Commerical,,,1.33,,1.33,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Anthem,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Anthem,Indemnity,,,1.29,,1.29,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Anthem,Individual Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Anthem,State Preferred,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Cigna,Cigna,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Connecticare,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Connecticare,Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,Multiplan,Multiplan,,,1.46,,1.46,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,40810-0007-26,NDC,both,1,ea,1.72,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Aetna,Commerical,,,1.33,,1.33,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Anthem,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Anthem,Indemnity,,,1.29,,1.29,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Anthem,Individual Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Anthem,State Preferred,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Cigna,Cigna,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Connecticare,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Connecticare,Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,Multiplan,Multiplan,,,1.46,,1.46,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-01,NDC,both,1,ea,1.72,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Aetna,Commerical,,,1.33,,1.33,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Aetna,Middlesex Employees,,,1.27,,1.27,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Anthem,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Anthem,Indemnity,,,1.29,,1.29,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Anthem,Individual Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Anthem,State Preferred,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Cigna,Cigna,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Connecticare,Commerical,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Connecticare,Exchange,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,Multiplan,Multiplan,,,1.46,,1.46,1.27,1.46,percent of total billed charges,,
LEVOTHYROXINE 25 MCG TABLET,J3490,HCPCS,51079-444-20,NDC,both,1,ea,1.72,1.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.27,1.46,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
LEVOTHYROXINE 37.5 MCG ORAL TAB,J3490,HCPCS,40810-0017-64,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
LEVOTHYROXINE 44 MCG TABLET,J3490,HCPCS,40810-0019-60,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,0904-6950-61,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-01,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
LEVOTHYROXINE 50 MCG TABLET,J3490,HCPCS,51079-440-20,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
LEVOTHYROXINE 6.25 MCG ORAL TAB,J3490,HCPCS,40810-0001-75,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Aetna,Commerical,,,0.46,,0.46,0.44,0.5,percent of total billed charges,,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Aetna,Middlesex Employees,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Anthem,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Anthem,Indemnity,,,0.44,,0.44,0.44,0.5,percent of total billed charges,,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Anthem,Individual Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Anthem,State Preferred,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Cigna,Cigna,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Connecticare,Commerical,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Connecticare,Exchange,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,Multiplan,Multiplan,,,0.5,,0.5,0.44,0.5,percent of total billed charges,,
LEVOTHYROXINE 62.5 MCG ORAL TAB,J3490,HCPCS,40810-0001-76,NDC,both,1,ea,0.59,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.44,0.5,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0378-1805-77,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0527-1343-01,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0781-5182-92,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,0904-6951-61,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-01,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 75 MCG TABLET,J3490,HCPCS,51079-441-20,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0781-5183-92,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,0904-6952-61,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,40810-0008-62,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
LEVOTHYROXINE 88 MCG TABLET,J3490,HCPCS,42292-038-20,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0143-9595-25,NDC,both,1,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Aetna,Commerical,,,25.62,,25.62,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Aetna,Middlesex Employees,,,24.57,,24.57,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Anthem,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Anthem,Indemnity,,,24.88,,24.88,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Anthem,Individual Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Anthem,State Preferred,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Cigna,Cigna,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Connecticare,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Connecticare,Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,Multiplan,Multiplan,,,28.23,,28.23,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,33.21,19.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Aetna,Commerical,,,3.64,,3.64,3.49,4.01,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.49,,3.49,3.49,4.01,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Anthem,Commerical,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Anthem,Indemnity,,,3.54,,3.54,3.49,4.01,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Anthem,State Preferred,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Cigna,Cigna,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Connecticare,Commerical,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Connecticare,Exchange,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,Multiplan,Multiplan,,,4.01,,4.01,3.49,4.01,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-159-74,NDC,both,1,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.49,4.01,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Aetna,Commerical,,,2.22,,2.22,2.13,2.45,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Aetna,Middlesex Employees,,,2.13,,2.13,2.13,2.45,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Anthem,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Anthem,Indemnity,,,2.16,,2.16,2.13,2.45,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Anthem,Individual Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Anthem,State Preferred,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Cigna,Cigna,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Connecticare,Commerical,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Connecticare,Exchange,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,Multiplan,Multiplan,,,2.45,,2.45,2.13,2.45,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-162-05,NDC,both,1,mL,2.88,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.13,2.45,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Aetna,Commerical,,,25.62,,25.62,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Aetna,Middlesex Employees,,,24.57,,24.57,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Anthem,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Anthem,Indemnity,,,24.88,,24.88,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Anthem,Individual Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Anthem,State Preferred,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Cigna,Cigna,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Connecticare,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Connecticare,Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,Multiplan,Multiplan,,,28.23,,28.23,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,55150-163-30,NDC,both,1,mL,33.21,19.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Aetna,Commerical,,,1.71,,1.71,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Aetna,Middlesex Employees,,,1.64,,1.64,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Anthem,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Anthem,Indemnity,,,1.66,,1.66,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Anthem,Individual Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Anthem,State Preferred,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Cigna,Cigna,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Connecticare,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Connecticare,Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,Multiplan,Multiplan,,,1.89,,1.89,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-04,NDC,both,1,mL,2.22,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Aetna,Commerical,,,25.62,,25.62,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Aetna,Middlesex Employees,,,24.57,,24.57,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Anthem,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Anthem,Indemnity,,,24.88,,24.88,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Anthem,Individual Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Anthem,State Preferred,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Cigna,Cigna,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Connecticare,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Connecticare,Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,Multiplan,Multiplan,,,28.23,,28.23,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-07,NDC,both,1,mL,33.21,19.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-09,NDC,both,1,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Aetna,Commerical,,,1.71,,1.71,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Aetna,Middlesex Employees,,,1.64,,1.64,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Anthem,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Anthem,Indemnity,,,1.66,,1.66,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Anthem,Individual Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Anthem,State Preferred,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Cigna,Cigna,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Connecticare,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Connecticare,Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,Multiplan,Multiplan,,,1.89,,1.89,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-16,NDC,both,1,mL,2.22,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Aetna,Commerical,,,6.03,,6.03,5.79,6.65,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Aetna,Middlesex Employees,,,5.79,,5.79,5.79,6.65,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Anthem,Commerical,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Anthem,Indemnity,,,5.86,,5.86,5.79,6.65,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Anthem,Individual Exchange,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Anthem,State Preferred,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Cigna,Cigna,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Connecticare,Commerical,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Connecticare,Exchange,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,Multiplan,Multiplan,,,6.65,,6.65,5.79,6.65,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-27,NDC,both,1,mL,7.82,4.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.79,6.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Aetna,Commerical,,,1.71,,1.71,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Aetna,Middlesex Employees,,,1.64,,1.64,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Anthem,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Anthem,Indemnity,,,1.66,,1.66,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Anthem,Individual Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Anthem,State Preferred,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Cigna,Cigna,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Connecticare,Commerical,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Connecticare,Exchange,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,Multiplan,Multiplan,,,1.89,,1.89,1.64,1.89,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,63323-492-41,NDC,both,1,mL,2.22,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.64,1.89,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-1,NDC,both,1,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,J3490,HCPCS,73293-0001-2,NDC,both,1,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Aetna,Commerical,,,25.62,,25.62,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Aetna,Middlesex Employees,,,24.57,,24.57,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Anthem,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Anthem,Indemnity,,,24.88,,24.88,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Anthem,Individual Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Anthem,State Preferred,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Cigna,Cigna,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Connecticare,Commerical,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Connecticare,Exchange,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,Multiplan,Multiplan,,,28.23,,28.23,24.57,28.23,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4279-02,NDC,both,1,mL,19.08,11.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.57,28.23,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Aetna,Commerical,,,0.99,,0.99,0.95,1.09,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Aetna,Middlesex Employees,,,0.95,,0.95,0.95,1.09,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Anthem,Commerical,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Anthem,Indemnity,,,0.96,,0.96,0.95,1.09,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Anthem,Individual Exchange,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Anthem,State Preferred,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Cigna,Cigna,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Connecticare,Commerical,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Connecticare,Exchange,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,Multiplan,Multiplan,,,1.09,,1.09,0.95,1.09,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4713-32,NDC,both,1,mL,1.28,0.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Aetna,Commerical,,,14.72,,14.72,14.12,16.22,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Aetna,Middlesex Employees,,,14.12,,14.12,14.12,16.22,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Anthem,Commerical,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Anthem,Indemnity,,,14.29,,14.29,14.12,16.22,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Anthem,Individual Exchange,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Anthem,State Preferred,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Cigna,Cigna,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Connecticare,Commerical,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Connecticare,Exchange,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,Multiplan,Multiplan,,,16.22,,16.22,14.12,16.22,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-31,NDC,both,1,mL,19.08,11.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.12,16.22,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-492-57,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Aetna,Commerical,,,11.96,,11.96,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Aetna,Middlesex Employees,,,11.47,,11.47,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Anthem,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Anthem,Indemnity,,,11.61,,11.61,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Anthem,Individual Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Anthem,State Preferred,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Cigna,Cigna,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Connecticare,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Connecticare,Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,Multiplan,Multiplan,,,13.18,,13.18,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-05,NDC,both,5,mL,15.5,9.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Aetna,Commerical,,,11.96,,11.96,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Aetna,Middlesex Employees,,,11.47,,11.47,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Anthem,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Anthem,Indemnity,,,11.61,,11.61,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Anthem,Individual Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Anthem,State Preferred,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Cigna,Cigna,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Connecticare,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Connecticare,Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,Multiplan,Multiplan,,,13.18,,13.18,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-1323-15,NDC,both,0.05,mL,15.5,9.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Aetna,Commerical,,,11.96,,11.96,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Aetna,Middlesex Employees,,,11.47,,11.47,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Anthem,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Anthem,Indemnity,,,11.61,,11.61,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Anthem,Individual Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Anthem,State Preferred,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Cigna,Cigna,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Connecticare,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Connecticare,Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,Multiplan,Multiplan,,,13.18,,13.18,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-11,NDC,both,0.05,mL,15.5,9.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Aetna,Commerical,,,11.96,,11.96,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Aetna,Middlesex Employees,,,11.47,,11.47,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Anthem,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Anthem,Indemnity,,,11.61,,11.61,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Anthem,Individual Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Anthem,State Preferred,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Cigna,Cigna,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Connecticare,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Connecticare,Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,Multiplan,Multiplan,,,13.18,,13.18,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,0409-4903-34,NDC,both,5,mL,15.5,9.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Aetna,Commerical,,,11.96,,11.96,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Aetna,Middlesex Employees,,,11.47,,11.47,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Anthem,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Anthem,Indemnity,,,11.61,,11.61,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Anthem,Individual Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Anthem,State Preferred,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Cigna,Cigna,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Connecticare,Commerical,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Connecticare,Exchange,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,Multiplan,Multiplan,,,13.18,,13.18,11.47,13.18,percent of total billed charges,,
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,J2003,HCPCS,76329-3390-1,NDC,both,0.05,mL,15.5,9.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.47,13.18,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Aetna,Commerical,,,10.67,,10.67,10.23,11.76,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Aetna,Middlesex Employees,,,10.23,,10.23,10.23,11.76,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Anthem,Commerical,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Anthem,Indemnity,,,10.36,,10.36,10.23,11.76,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Anthem,Individual Exchange,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Anthem,State Preferred,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Cigna,Cigna,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Connecticare,Commerical,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Connecticare,Exchange,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,Multiplan,Multiplan,,,11.76,,11.76,10.23,11.76,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0143-9594-25,NDC,both,0.05,mL,13.83,8.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.23,11.76,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-01,NDC,both,0.5,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Aetna,Commerical,,,21.34,,21.34,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Aetna,Middlesex Employees,,,20.47,,20.47,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Anthem,Commerical,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Anthem,Indemnity,,,20.72,,20.72,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Anthem,Individual Exchange,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Anthem,State Preferred,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Cigna,Cigna,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Connecticare,Commerical,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Connecticare,Exchange,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,Multiplan,Multiplan,,,23.51,,23.51,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4282-02,NDC,both,0.5,mL,27.66,16.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-160-72,NDC,both,1,mL,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-164-02,NDC,both,0.05,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Aetna,Commerical,,,6.54,,6.54,6.27,7.2,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Aetna,Middlesex Employees,,,6.27,,6.27,6.27,7.2,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Anthem,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Anthem,Indemnity,,,6.34,,6.34,6.27,7.2,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Anthem,Individual Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Anthem,State Preferred,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Cigna,Cigna,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Connecticare,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Connecticare,Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,Multiplan,Multiplan,,,7.2,,7.2,6.27,7.2,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,55150-165-05,NDC,both,0.05,mL,8.47,5.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Aetna,Commerical,,,4.27,,4.27,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Aetna,Middlesex Employees,,,4.1,,4.1,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Anthem,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Anthem,Indemnity,,,4.15,,4.15,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Anthem,Individual Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Anthem,State Preferred,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Cigna,Cigna,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Connecticare,Commerical,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Connecticare,Exchange,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,Multiplan,Multiplan,,,4.71,,4.71,4.1,4.71,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-495-09,NDC,both,0.05,mL,5.54,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.1,4.71,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Aetna,Commerical,,,21.34,,21.34,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Aetna,Middlesex Employees,,,20.47,,20.47,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Anthem,Commerical,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Anthem,Indemnity,,,20.72,,20.72,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Anthem,Individual Exchange,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Anthem,State Preferred,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Cigna,Cigna,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Connecticare,Commerical,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Connecticare,Exchange,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,Multiplan,Multiplan,,,23.51,,23.51,20.47,23.51,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-496-97,NDC,both,0.5,mL,27.66,16.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.47,23.51,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Aetna,Commerical,,,9.75,,9.75,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Aetna,Middlesex Employees,,,9.35,,9.35,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Anthem,Commerical,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Anthem,Indemnity,,,9.47,,9.47,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Anthem,Individual Exchange,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Anthem,State Preferred,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Cigna,Cigna,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Connecticare,Commerical,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Connecticare,Exchange,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,Multiplan,Multiplan,,,10.74,,10.74,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-208-05,NDC,both,0.05,mL,12.64,7.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Aetna,Commerical,,,9.75,,9.75,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Aetna,Middlesex Employees,,,9.35,,9.35,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Anthem,Commerical,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Anthem,Indemnity,,,9.47,,9.47,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Anthem,Individual Exchange,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Anthem,State Preferred,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Cigna,Cigna,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Connecticare,Commerical,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Connecticare,Exchange,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,Multiplan,Multiplan,,,10.74,,10.74,9.35,10.74,percent of total billed charges,,
LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,J2003,HCPCS,63323-498-89,NDC,both,0.05,mL,12.64,7.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.35,10.74,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Aetna,Commerical,,,8.02,,8.02,7.69,8.84,percent of total billed charges,,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Aetna,Middlesex Employees,,,7.69,,7.69,7.69,8.84,percent of total billed charges,,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Anthem,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Anthem,Indemnity,,,7.79,,7.79,7.69,8.84,percent of total billed charges,,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Anthem,Individual Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Anthem,State Preferred,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Cigna,Cigna,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Connecticare,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Connecticare,Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,Multiplan,Multiplan,,,8.84,,8.84,7.69,8.84,percent of total billed charges,,
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,J2003,HCPCS,0409-4283-01,NDC,both,0.025,mL,10.4,6.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-01,NDC,both,2,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Aetna,Commerical,,,11.53,,11.53,11.05,12.7,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,11.05,12.7,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Anthem,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Anthem,Indemnity,,,11.19,,11.19,11.05,12.7,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Anthem,Individual Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Anthem,State Preferred,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Cigna,Cigna,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Connecticare,Commerical,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Connecticare,Exchange,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,Multiplan,Multiplan,,,12.7,,12.7,11.05,12.7,percent of total billed charges,,
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,0409-4278-16,NDC,both,0.2,mL,14.94,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.05,12.7,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Aetna,Commerical,,,17.58,,17.58,16.86,19.37,percent of total billed charges,,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Aetna,Middlesex Employees,,,16.86,,16.86,16.86,19.37,percent of total billed charges,,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Anthem,Commerical,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Anthem,Indemnity,,,17.07,,17.07,16.86,19.37,percent of total billed charges,,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Anthem,Individual Exchange,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Anthem,State Preferred,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Cigna,Cigna,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Connecticare,Commerical,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Connecticare,Exchange,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,Multiplan,Multiplan,,,19.37,,19.37,16.86,19.37,percent of total billed charges,,
LIDOCAINE 0.9 % BUFFERED WITH SODIUM PHOSHATE (1 ML) INJECTION SYRINGE,J3490,HCPCS,73177-110-12,NDC,both,1,mL,22.79,13.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.86,19.37,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-01,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-02,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-16,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,0409-3178-17,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-03,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-17,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-26,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-27,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Aetna,Commerical,,,5.15,,5.15,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Aetna,Middlesex Employees,,,4.94,,4.94,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Anthem,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Anthem,Indemnity,,,5,,5,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Anthem,Individual Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Anthem,State Preferred,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Cigna,Cigna,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Connecticare,Commerical,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Connecticare,Exchange,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,Multiplan,Multiplan,,,5.67,,5.67,4.94,5.67,percent of total billed charges,,
"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",J3490,HCPCS,63323-482-41,NDC,both,30,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.94,5.67,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR INHALATION,J7699,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 2.1 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Commerical,,,2.45,,2.45,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Indemnity,,,2.38,,2.38,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,Individual Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Anthem,State Preferred,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Cigna,Cigna,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Commerical,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Connecticare,Exchange,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,Multiplan,Multiplan,,,2.7,,2.7,2.35,2.7,percent of total billed charges,,
LIDOCAINE 1% FOR RECONSTITUTION 4.2 ML,J2003,HCPCS,0409-4713-02,NDC,both,1,mL,3.18,1.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.7,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Aetna,Commerical,,,29.32,,29.32,28.12,32.3,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Aetna,Middlesex Employees,,,28.12,,28.12,28.12,32.3,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Anthem,Commerical,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Anthem,Indemnity,,,28.47,,28.47,28.12,32.3,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Anthem,Individual Exchange,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Anthem,State Preferred,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Cigna,Cigna,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Connecticare,Commerical,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Connecticare,Exchange,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,Multiplan,Multiplan,,,32.3,,32.3,28.12,32.3,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,25021-673-76,NDC,both,5,mL,38,22.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.12,32.3,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Aetna,Commerical,,,16.36,,16.36,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Aetna,Middlesex Employees,,,15.69,,15.69,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Anthem,Commerical,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Anthem,Indemnity,,,15.88,,15.88,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Anthem,Individual Exchange,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Anthem,State Preferred,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Cigna,Cigna,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Connecticare,Commerical,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Connecticare,Exchange,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,Multiplan,Multiplan,,,18.02,,18.02,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3011-5,NDC,both,5,mL,21.2,12.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Aetna,Commerical,,,16.36,,16.36,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Aetna,Middlesex Employees,,,15.69,,15.69,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Anthem,Commerical,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Anthem,Indemnity,,,15.88,,15.88,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Anthem,Individual Exchange,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Anthem,State Preferred,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Cigna,Cigna,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Connecticare,Commerical,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Connecticare,Exchange,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,Multiplan,Multiplan,,,18.02,,18.02,15.69,18.02,percent of total billed charges,,
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,J3490,HCPCS,76329-3012-5,NDC,both,5,mL,21.2,12.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.69,18.02,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100,000 INJECTION CARTRIDGE",J3490,HCPCS,66975-425-51,NDC,both,1,mL,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Aetna,Commerical,,,6.09,,6.09,5.84,6.71,percent of total billed charges,,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Aetna,Middlesex Employees,,,5.84,,5.84,5.84,6.71,percent of total billed charges,,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Anthem,Commerical,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Anthem,Indemnity,,,5.91,,5.91,5.84,6.71,percent of total billed charges,,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Anthem,Individual Exchange,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Anthem,State Preferred,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Cigna,Cigna,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Connecticare,Commerical,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Connecticare,Exchange,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,Multiplan,Multiplan,,,6.71,,6.71,5.84,6.71,percent of total billed charges,,
LIDOCAINE 2% FOR INHALATION,J7699,HCPCS,63323-495-07,NDC,both,5,mL,7.89,4.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.84,6.71,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Aetna,Commerical,,,8.63,,8.63,8.28,9.51,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Aetna,Middlesex Employees,,,8.28,,8.28,8.28,9.51,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Anthem,Commerical,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Anthem,Indemnity,,,8.38,,8.38,8.28,9.51,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Anthem,Individual Exchange,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Anthem,State Preferred,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Cigna,Cigna,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Connecticare,Commerical,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Connecticare,Exchange,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,Multiplan,Multiplan,,,9.51,,9.51,8.28,9.51,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-05,NDC,both,1,gm,11.19,6.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.28,9.51,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Aetna,Commerical,,,8.8,,8.8,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Aetna,Middlesex Employees,,,8.43,,8.43,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Anthem,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Anthem,Indemnity,,,8.54,,8.54,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Anthem,Individual Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Anthem,State Preferred,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Cigna,Cigna,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Connecticare,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Connecticare,Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,Multiplan,Multiplan,,,9.69,,9.69,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,0496-0882-06,NDC,both,1,gm,11.4,6.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Aetna,Commerical,,,8.8,,8.8,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Aetna,Middlesex Employees,,,8.43,,8.43,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Anthem,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Anthem,Indemnity,,,8.54,,8.54,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Anthem,Individual Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Anthem,State Preferred,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Cigna,Cigna,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Connecticare,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Connecticare,Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,Multiplan,Multiplan,,,9.69,,9.69,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,24357-701-06,NDC,both,1,gm,11.4,6.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Aetna,Commerical,,,8.8,,8.8,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Aetna,Middlesex Employees,,,8.43,,8.43,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Anthem,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Anthem,Indemnity,,,8.54,,8.54,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Anthem,Individual Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Anthem,State Preferred,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Cigna,Cigna,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Connecticare,Commerical,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Connecticare,Exchange,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,Multiplan,Multiplan,,,9.69,,9.69,8.43,9.69,percent of total billed charges,,
LIDOCAINE 4 % TOPICAL CREAM,A6250,HCPCS,61825-701-05,NDC,both,1,gm,11.4,6.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.43,9.69,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Aetna,Commerical,,,8.02,,8.02,7.69,8.84,percent of total billed charges,,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Aetna,Middlesex Employees,,,7.69,,7.69,7.69,8.84,percent of total billed charges,,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Anthem,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Anthem,Indemnity,,,7.79,,7.79,7.69,8.84,percent of total billed charges,,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Anthem,Individual Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Anthem,State Preferred,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Cigna,Cigna,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Connecticare,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Connecticare,Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,Multiplan,Multiplan,,,8.84,,8.84,7.69,8.84,percent of total billed charges,,
LIDOCAINE 40 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-4283-01,NDC,both,1,mL,10.4,6.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,0591-2679-30,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-01,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,61959-001-30,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,63481-687-06,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-04,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Aetna,Commerical,,,4.22,,4.22,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Aetna,Middlesex Employees,,,4.05,,4.05,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Anthem,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Anthem,Indemnity,,,4.1,,4.1,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Anthem,Individual Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Anthem,State Preferred,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Cigna,Cigna,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Connecticare,Commerical,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Connecticare,Exchange,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,Multiplan,Multiplan,,,4.65,,4.65,4.05,4.65,percent of total billed charges,,
LIDOCAINE 5 % TOPICAL PATCH,J3490,HCPCS,65162-791-08,NDC,both,1,ea,5.47,3.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.05,4.65,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Aetna,Commerical,,,2.43,,2.43,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Aetna,Middlesex Employees,,,2.33,,2.33,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Anthem,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Anthem,Indemnity,,,2.36,,2.36,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Anthem,Individual Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Anthem,State Preferred,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Cigna,Cigna,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Connecticare,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Connecticare,Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,Multiplan,Multiplan,,,2.68,,2.68,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,0409-4276-01,NDC,both,0.1,mL,3.15,1.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Aetna,Commerical,,,2.43,,2.43,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Aetna,Middlesex Employees,,,2.33,,2.33,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Anthem,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Anthem,Indemnity,,,2.36,,2.36,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Anthem,Individual Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Anthem,State Preferred,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Cigna,Cigna,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Connecticare,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Connecticare,Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,Multiplan,Multiplan,,,2.68,,2.68,2.33,2.68,percent of total billed charges,,
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,J2003,HCPCS,63323-485-27,NDC,both,0.1,mL,3.15,1.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Aetna,Commerical,,,16.85,,16.85,16.16,18.56,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Aetna,Middlesex Employees,,,16.16,,16.16,16.16,18.56,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Anthem,Commerical,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Anthem,Indemnity,,,16.36,,16.36,16.16,18.56,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Anthem,Individual Exchange,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Anthem,State Preferred,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Cigna,Cigna,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Connecticare,Commerical,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Connecticare,Exchange,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,Multiplan,Multiplan,,,18.56,,18.56,16.16,18.56,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL JELLY,J3490,HCPCS,17478-711-30,NDC,both,30,mL,21.84,13.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.16,18.56,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Aetna,Commerical,,,10.2,,10.2,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Aetna,Middlesex Employees,,,9.78,,9.78,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Anthem,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Anthem,Indemnity,,,9.9,,9.9,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Anthem,Individual Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Anthem,State Preferred,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Cigna,Cigna,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Connecticare,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Connecticare,Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,Multiplan,Multiplan,,,11.24,,11.24,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-15,NDC,both,1,mL,13.22,7.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Aetna,Commerical,,,10.2,,10.2,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Aetna,Middlesex Employees,,,9.78,,9.78,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Anthem,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Anthem,Indemnity,,,9.9,,9.9,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Anthem,Individual Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Anthem,State Preferred,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Cigna,Cigna,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Connecticare,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Connecticare,Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,Multiplan,Multiplan,,,11.24,,11.24,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-0903-40,NDC,both,1,mL,13.22,7.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Aetna,Commerical,,,10.2,,10.2,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Aetna,Middlesex Employees,,,9.78,,9.78,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Anthem,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Anthem,Indemnity,,,9.9,,9.9,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Anthem,Individual Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Anthem,State Preferred,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Cigna,Cigna,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Connecticare,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Connecticare,Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,Multiplan,Multiplan,,,11.24,,11.24,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,0121-4950-15,NDC,both,1,mL,13.22,7.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Aetna,Commerical,,,10.2,,10.2,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Aetna,Middlesex Employees,,,9.78,,9.78,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Anthem,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Anthem,Indemnity,,,9.9,,9.9,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Anthem,Individual Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Anthem,State Preferred,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Cigna,Cigna,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Connecticare,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Connecticare,Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,Multiplan,Multiplan,,,11.24,,11.24,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-363-15,NDC,both,1,mL,13.22,7.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-15,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Aetna,Commerical,,,10.2,,10.2,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Aetna,Middlesex Employees,,,9.78,,9.78,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Anthem,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Anthem,Indemnity,,,9.9,,9.9,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Anthem,Individual Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Anthem,State Preferred,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Cigna,Cigna,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Connecticare,Commerical,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Connecticare,Exchange,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,Multiplan,Multiplan,,,11.24,,11.24,9.78,11.24,percent of total billed charges,,
LIDOCAINE HCL 2 % MUCOSAL SOLUTION,J3490,HCPCS,50383-775-17,NDC,both,15,mL,13.22,7.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.78,11.24,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Aetna,Commerical,,,5.79,,5.79,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Aetna,Middlesex Employees,,,5.56,,5.56,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Anthem,Commerical,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Anthem,Indemnity,,,5.63,,5.63,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Anthem,Individual Exchange,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Anthem,State Preferred,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Cigna,Cigna,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Connecticare,Commerical,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Connecticare,Exchange,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,Multiplan,Multiplan,,,6.38,,6.38,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,0409-4277-01,NDC,both,0.05,mL,7.51,4.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Aetna,Commerical,,,5.79,,5.79,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Aetna,Middlesex Employees,,,5.56,,5.56,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Anthem,Commerical,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Anthem,Indemnity,,,5.63,,5.63,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Anthem,Individual Exchange,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Anthem,State Preferred,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Cigna,Cigna,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Connecticare,Commerical,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Connecticare,Exchange,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,Multiplan,Multiplan,,,6.38,,6.38,5.56,6.38,percent of total billed charges,,
LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,J2003,HCPCS,63323-486-02,NDC,both,0.05,mL,7.51,4.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.56,6.38,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Aetna,Commerical,,,79.64,,79.64,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Aetna,Middlesex Employees,,,76.37,,76.37,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Anthem,Commerical,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Anthem,Indemnity,,,77.32,,77.32,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Anthem,Individual Exchange,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Anthem,State Preferred,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Cigna,Cigna,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Connecticare,Commerical,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Connecticare,Exchange,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,Multiplan,Multiplan,,,87.74,,87.74,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0054-3505-47,NDC,both,1,mL,103.22,61.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Aetna,Commerical,,,79.64,,79.64,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Aetna,Middlesex Employees,,,76.37,,76.37,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Anthem,Commerical,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Anthem,Indemnity,,,77.32,,77.32,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Anthem,Individual Exchange,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Anthem,State Preferred,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Cigna,Cigna,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Connecticare,Commerical,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Connecticare,Exchange,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,Multiplan,Multiplan,,,87.74,,87.74,76.37,87.74,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,0527-6004-80,NDC,both,1,mL,103.22,61.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.37,87.74,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Aetna,Commerical,,,15.37,,15.37,14.74,16.93,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Aetna,Middlesex Employees,,,14.74,,14.74,14.74,16.93,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Anthem,Commerical,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Anthem,Indemnity,,,14.92,,14.92,14.74,16.93,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Anthem,Individual Exchange,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Anthem,State Preferred,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Cigna,Cigna,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Connecticare,Commerical,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Connecticare,Exchange,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,Multiplan,Multiplan,,,16.93,,16.93,14.74,16.93,percent of total billed charges,,
LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,J3490,HCPCS,52565-009-50,NDC,both,1,mL,19.92,11.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.74,16.93,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Aetna,Commerical,,,16.4,,16.4,15.73,18.07,percent of total billed charges,,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Aetna,Middlesex Employees,,,15.73,,15.73,15.73,18.07,percent of total billed charges,,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Anthem,Commerical,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Anthem,Indemnity,,,15.93,,15.93,15.73,18.07,percent of total billed charges,,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Anthem,Individual Exchange,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Anthem,State Preferred,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Cigna,Cigna,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Connecticare,Commerical,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Connecticare,Exchange,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,Multiplan,Multiplan,,,18.07,,18.07,15.73,18.07,percent of total billed charges,,
LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,J2003,HCPCS,63323-484-57,NDC,both,0.2,mL,21.26,12.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.73,18.07,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Aetna,Commerical,,,25.39,,25.39,24.34,27.97,percent of total billed charges,,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Aetna,Middlesex Employees,,,24.34,,24.34,24.34,27.97,percent of total billed charges,,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Anthem,Commerical,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Anthem,Indemnity,,,24.65,,24.65,24.34,27.97,percent of total billed charges,,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Anthem,Individual Exchange,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Anthem,State Preferred,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Cigna,Cigna,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Connecticare,Commerical,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Connecticare,Exchange,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,Multiplan,Multiplan,,,27.97,,27.97,24.34,27.97,percent of total billed charges,,
LIDOCAINE-ALOE VERA 0.5 % TOPICAL GEL,J3490,HCPCS,1191714124,NDC,both,1,gm,32.9,19.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.34,27.97,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Aetna,Commerical,,,15.61,,15.61,14.97,17.2,percent of total billed charges,,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Aetna,Middlesex Employees,,,14.97,,14.97,14.97,17.2,percent of total billed charges,,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Anthem,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Anthem,Indemnity,,,15.15,,15.15,14.97,17.2,percent of total billed charges,,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Anthem,Individual Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Anthem,State Preferred,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Cigna,Cigna,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Connecticare,Commerical,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Connecticare,Exchange,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,Multiplan,Multiplan,,,17.2,,17.2,14.97,17.2,percent of total billed charges,,
"LIDOCAINE-EPI (PF) 0.5%-1:200,000 ON Q PUMP",J2004,HCPCS,40810-0205-06,NDC,both,0.2,mL,20.23,12.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.97,17.2,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Aetna,Commerical,,,29.14,,29.14,27.95,32.1,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Aetna,Middlesex Employees,,,27.95,,27.95,27.95,32.1,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Anthem,Commerical,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Anthem,Indemnity,,,28.29,,28.29,27.95,32.1,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Anthem,Individual Exchange,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Anthem,State Preferred,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Cigna,Cigna,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Connecticare,Commerical,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Connecticare,Exchange,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,Multiplan,Multiplan,,,32.1,,32.1,27.95,32.1,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:100,000 INJECTION SOLUTION",J2004,HCPCS,81483-0037-0,NDC,both,0.1,mL,37.77,22.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.95,32.1,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Aetna,Commerical,,,2.4,,2.4,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Aetna,Middlesex Employees,,,2.3,,2.3,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Anthem,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Anthem,Indemnity,,,2.33,,2.33,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Anthem,Individual Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Anthem,State Preferred,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Cigna,Cigna,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Connecticare,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Connecticare,Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,Multiplan,Multiplan,,,2.64,,2.64,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-01,NDC,both,10,mL,3.11,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Aetna,Commerical,,,7.18,,7.18,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Aetna,Middlesex Employees,,,6.89,,6.89,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Anthem,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Anthem,Indemnity,,,6.97,,6.97,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Anthem,Individual Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Anthem,State Preferred,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Cigna,Cigna,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Connecticare,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Connecticare,Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,Multiplan,Multiplan,,,7.91,,7.91,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-03,NDC,both,0.1,mL,9.31,5.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Aetna,Commerical,,,7.18,,7.18,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Aetna,Middlesex Employees,,,6.89,,6.89,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Anthem,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Anthem,Indemnity,,,6.97,,6.97,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Anthem,Individual Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Anthem,State Preferred,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Cigna,Cigna,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Connecticare,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Connecticare,Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,Multiplan,Multiplan,,,7.91,,7.91,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-07,NDC,both,30,mL,9.31,5.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Aetna,Commerical,,,2.4,,2.4,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Aetna,Middlesex Employees,,,2.3,,2.3,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Anthem,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Anthem,Indemnity,,,2.33,,2.33,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Anthem,Individual Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Anthem,State Preferred,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Cigna,Cigna,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Connecticare,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Connecticare,Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,Multiplan,Multiplan,,,2.64,,2.64,2.3,2.64,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-17,NDC,both,10,mL,3.11,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Aetna,Commerical,,,7.18,,7.18,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Aetna,Middlesex Employees,,,6.89,,6.89,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Anthem,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Anthem,Indemnity,,,6.97,,6.97,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Anthem,Individual Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Anthem,State Preferred,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Cigna,Cigna,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Connecticare,Commerical,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Connecticare,Exchange,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,Multiplan,Multiplan,,,7.91,,7.91,6.89,7.91,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-31,NDC,both,30,mL,9.31,5.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.89,7.91,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Aetna,Commerical,,,30.42,,30.42,29.17,33.51,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Aetna,Middlesex Employees,,,29.17,,29.17,29.17,33.51,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Anthem,Commerical,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Anthem,Indemnity,,,29.53,,29.53,29.17,33.51,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Anthem,Individual Exchange,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Anthem,State Preferred,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Cigna,Cigna,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Connecticare,Commerical,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Connecticare,Exchange,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,Multiplan,Multiplan,,,33.51,,33.51,29.17,33.51,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-37,NDC,both,30,mL,39.42,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.17,33.51,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Aetna,Commerical,,,32.72,,32.72,31.37,36.04,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Aetna,Middlesex Employees,,,31.37,,31.37,31.37,36.04,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Anthem,Commerical,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Anthem,Indemnity,,,31.76,,31.76,31.37,36.04,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Anthem,Individual Exchange,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Anthem,State Preferred,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Cigna,Cigna,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Connecticare,Commerical,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Connecticare,Exchange,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,Multiplan,Multiplan,,,36.04,,36.04,31.37,36.04,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-487-92,NDC,both,30,mL,42.4,25.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.37,36.04,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Aetna,Commerical,,,6.66,,6.66,6.39,7.34,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Aetna,Middlesex Employees,,,6.39,,6.39,6.39,7.34,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Anthem,Commerical,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Anthem,Indemnity,,,6.46,,6.46,6.39,7.34,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Anthem,Individual Exchange,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Anthem,State Preferred,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Cigna,Cigna,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Connecticare,Commerical,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Connecticare,Exchange,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,Multiplan,Multiplan,,,7.34,,7.34,6.39,7.34,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-01,NDC,both,0.067,mL,8.63,5.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.39,7.34,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Aetna,Commerical,,,8.97,,8.97,8.61,9.89,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Aetna,Middlesex Employees,,,8.61,,8.61,8.61,9.89,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Anthem,Commerical,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Anthem,Indemnity,,,8.71,,8.71,8.61,9.89,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Anthem,Individual Exchange,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Anthem,State Preferred,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Cigna,Cigna,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Connecticare,Commerical,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Connecticare,Exchange,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,Multiplan,Multiplan,,,9.89,,9.89,8.61,9.89,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-1209-10,NDC,both,0.067,mL,11.63,6.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Aetna,Commerical,,,21.99,,21.99,21.09,24.23,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Aetna,Middlesex Employees,,,21.09,,21.09,21.09,24.23,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Anthem,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Anthem,Indemnity,,,21.35,,21.35,21.09,24.23,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Anthem,Individual Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Anthem,State Preferred,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Cigna,Cigna,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Connecticare,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Connecticare,Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,Multiplan,Multiplan,,,24.23,,24.23,21.09,24.23,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-01,NDC,both,0.05,mL,28.5,17.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,0409-3183-11,NDC,both,0.05,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-02,NDC,both,0.05,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",J2004,HCPCS,63323-489-03,NDC,both,0.05,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Aetna,Commerical,,,7.63,,7.63,7.32,8.41,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Aetna,Middlesex Employees,,,7.32,,7.32,7.32,8.41,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Anthem,Commerical,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Anthem,Indemnity,,,7.41,,7.41,7.32,8.41,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Anthem,Individual Exchange,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Anthem,State Preferred,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Cigna,Cigna,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Connecticare,Commerical,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Connecticare,Exchange,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,Multiplan,Multiplan,,,8.41,,8.41,7.32,8.41,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,0409-3177-01,NDC,both,30,mL,9.89,5.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.32,8.41,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Aetna,Commerical,,,21.64,,21.64,20.75,23.83,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Aetna,Middlesex Employees,,,20.75,,20.75,20.75,23.83,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Anthem,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Anthem,Indemnity,,,21,,21,20.75,23.83,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Anthem,Individual Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Anthem,State Preferred,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Cigna,Cigna,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Connecticare,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Connecticare,Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,Multiplan,Multiplan,,,23.83,,23.83,20.75,23.83,percent of total billed charges,,
"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",J3490,HCPCS,63323-481-57,NDC,both,30,mL,28.04,16.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Aetna,Commerical,,,10.51,,10.51,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Aetna,Middlesex Employees,,,10.08,,10.08,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Anthem,Commerical,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Anthem,Indemnity,,,10.2,,10.2,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Anthem,Individual Exchange,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Anthem,State Preferred,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Cigna,Cigna,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Connecticare,Commerical,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Connecticare,Exchange,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,Multiplan,Multiplan,,,11.58,,11.58,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0115-1468-60,NDC,both,5,gm,13.62,8.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Aetna,Commerical,,,10.51,,10.51,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Aetna,Middlesex Employees,,,10.08,,10.08,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Anthem,Commerical,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Anthem,Indemnity,,,10.2,,10.2,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Anthem,Individual Exchange,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Anthem,State Preferred,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Cigna,Cigna,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Connecticare,Commerical,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Connecticare,Exchange,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,Multiplan,Multiplan,,,11.58,,11.58,10.08,11.58,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,J3490,HCPCS,0168-0357-55,NDC,both,5,gm,13.62,8.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.08,11.58,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Aetna,Commerical,,,11.75,,11.75,11.27,12.95,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Aetna,Middlesex Employees,,,11.27,,11.27,11.27,12.95,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Anthem,Commerical,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Anthem,Indemnity,,,11.41,,11.41,11.27,12.95,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Anthem,Individual Exchange,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Anthem,State Preferred,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Cigna,Cigna,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Connecticare,Commerical,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Connecticare,Exchange,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,Multiplan,Multiplan,,,12.95,,12.95,11.27,12.95,percent of total billed charges,,
LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,J3490,HCPCS,0168-0357-56,NDC,both,1,ea,15.23,9.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.27,12.95,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Aetna,Commerical,,,58.6,,58.6,56.2,64.56,percent of total billed charges,,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Aetna,Middlesex Employees,,,56.2,,56.2,56.2,64.56,percent of total billed charges,,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Anthem,Commerical,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Anthem,Indemnity,,,56.89,,56.89,56.2,64.56,percent of total billed charges,,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Anthem,Individual Exchange,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Anthem,State Preferred,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Cigna,Cigna,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Connecticare,Commerical,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Connecticare,Exchange,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,Multiplan,Multiplan,,,64.56,,64.56,56.2,64.56,percent of total billed charges,,
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT,J3490,HCPCS,0496-0882-07,NDC,both,1,ea,75.95,45.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.2,64.56,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Aetna,Commerical,,,24.93,,24.93,23.91,27.46,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Aetna,Middlesex Employees,,,23.91,,23.91,23.91,27.46,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Anthem,Commerical,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Anthem,Indemnity,,,24.2,,24.2,23.91,27.46,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Anthem,Individual Exchange,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Anthem,State Preferred,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Cigna,Cigna,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Connecticare,Commerical,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Connecticare,Exchange,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,Multiplan,Multiplan,,,27.46,,27.46,23.91,27.46,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,0456-1201-30,NDC,both,1,ea,32.31,19.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.91,27.46,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Aetna,Commerical,,,46.54,,46.54,44.62,51.26,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Aetna,Middlesex Employees,,,44.62,,44.62,44.62,51.26,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Anthem,Commerical,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Anthem,Indemnity,,,45.18,,45.18,44.62,51.26,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Anthem,Individual Exchange,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Anthem,State Preferred,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Cigna,Cigna,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Connecticare,Commerical,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Connecticare,Exchange,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,Multiplan,Multiplan,,,51.26,,51.26,44.62,51.26,percent of total billed charges,,
LINACLOTIDE 145 MCG CAPSULE,J8499,HCPCS,40810-0207-68,NDC,both,1,ea,60.31,36.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.62,51.26,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Aetna,Commerical,,,51.18,,51.18,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Aetna,Middlesex Employees,,,49.08,,49.08,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Anthem,Commerical,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Anthem,Indemnity,,,49.69,,49.69,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Anthem,Individual Exchange,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Anthem,State Preferred,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Cigna,Cigna,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Connecticare,Commerical,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Connecticare,Exchange,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,Multiplan,Multiplan,,,56.38,,56.38,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,0456-1203-30,NDC,both,1,ea,66.33,39.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Aetna,Commerical,,,51.18,,51.18,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Aetna,Middlesex Employees,,,49.08,,49.08,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Anthem,Commerical,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Anthem,Indemnity,,,49.69,,49.69,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Anthem,Individual Exchange,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Anthem,State Preferred,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Cigna,Cigna,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Connecticare,Commerical,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Connecticare,Exchange,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,Multiplan,Multiplan,,,56.38,,56.38,49.08,56.38,percent of total billed charges,,
LINACLOTIDE 72 MCG CAPSULE,J8499,HCPCS,40810-0209-62,NDC,both,1,ea,66.33,39.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.08,56.38,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Aetna,Commerical,,,404.46,,404.46,387.84,445.55,percent of total billed charges,,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Aetna,Middlesex Employees,,,387.84,,387.84,387.84,445.55,percent of total billed charges,,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Anthem,Commerical,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Anthem,Indemnity,,,392.66,,392.66,387.84,445.55,percent of total billed charges,,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Anthem,Individual Exchange,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Anthem,State Preferred,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Cigna,Cigna,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Connecticare,Commerical,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Connecticare,Exchange,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,Multiplan,Multiplan,,,445.55,,445.55,387.84,445.55,percent of total billed charges,,
LINDANE 1 % SHAMPOO,J3490,HCPCS,60432-834-60,NDC,both,60,mL,524.18,314.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,387.84,445.55,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Aetna,Commerical,,,1400.78,,1400.78,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Aetna,Middlesex Employees,,,1343.23,,1343.23,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Anthem,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Anthem,Indemnity,,,1359.93,,1359.93,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Anthem,Individual Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Anthem,State Preferred,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Cigna,Cigna,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Connecticare,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Connecticare,Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,Multiplan,Multiplan,,,1543.11,,1543.11,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0009-5136-01,NDC,both,1,mL,1815.42,1089.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Aetna,Commerical,,,1400.78,,1400.78,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Aetna,Middlesex Employees,,,1343.23,,1343.23,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Anthem,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Anthem,Indemnity,,,1359.93,,1359.93,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Anthem,Individual Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Anthem,State Preferred,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Cigna,Cigna,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Connecticare,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Connecticare,Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,Multiplan,Multiplan,,,1543.11,,1543.11,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-1,NDC,both,1,mL,1815.42,1089.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Aetna,Commerical,,,1400.78,,1400.78,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Aetna,Middlesex Employees,,,1343.23,,1343.23,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Anthem,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Anthem,Indemnity,,,1359.93,,1359.93,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Anthem,Individual Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Anthem,State Preferred,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Cigna,Cigna,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Connecticare,Commerical,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Connecticare,Exchange,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,Multiplan,Multiplan,,,1543.11,,1543.11,1343.23,1543.11,percent of total billed charges,,
LINEZOLID 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,59762-1308-4,NDC,both,1,mL,1815.42,1089.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1343.23,1543.11,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Aetna,Commerical,,,123.07,,123.07,2.96,135.58,percent of total billed charges,,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Aetna,Middlesex Employees,,,118.01,,118.01,2.96,135.58,percent of total billed charges,,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Commerical,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Indemnity,,,119.48,,119.48,2.96,135.58,percent of total billed charges,,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Individual Exchange,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,State Preferred,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Cigna,Cigna,,2.96,,,2.96,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Connecticare,Commerical,,4.7,,,4.7,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Connecticare,Exchange,,4.7,,,4.7,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Multiplan,Multiplan,,,135.58,,135.58,2.96,135.58,percent of total billed charges,,
LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Aetna,Commerical,,,168.63,,168.63,161.7,185.76,percent of total billed charges,,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Aetna,Middlesex Employees,,,161.7,,161.7,161.7,185.76,percent of total billed charges,,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Anthem,Commerical,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Anthem,Indemnity,,,163.71,,163.71,161.7,185.76,percent of total billed charges,,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Anthem,Individual Exchange,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Anthem,State Preferred,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Cigna,Cigna,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Connecticare,Commerical,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Connecticare,Exchange,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,Multiplan,Multiplan,,,185.76,,185.76,161.7,185.76,percent of total billed charges,,
LINEZOLID 300 MG TABLET,J3490,HCPCS,40810-0020-04,NDC,both,1,ea,218.54,131.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,161.7,185.76,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Aetna,Commerical,,,6.3,,6.3,6.04,6.94,percent of total billed charges,,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Aetna,Middlesex Employees,,,6.04,,6.04,6.04,6.94,percent of total billed charges,,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Anthem,Commerical,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Anthem,Indemnity,,,6.12,,6.12,6.04,6.94,percent of total billed charges,,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Anthem,Individual Exchange,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Anthem,State Preferred,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Cigna,Cigna,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Connecticare,Commerical,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Connecticare,Exchange,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,Multiplan,Multiplan,,,6.94,,6.94,6.04,6.94,percent of total billed charges,,
LINEZOLID 600 MG TABLET,J3490,HCPCS,0904-6553-04,NDC,both,1,ea,8.17,4.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.04,6.94,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FIRST ORDER,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-03,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,63323-713-13,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION FOR CAROUSEL,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-01,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,0143-9534-10,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-43,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Commerical,,,60.12,,60.12,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Aetna,Middlesex Employees,,,57.65,,57.65,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Commerical,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Indemnity,,,58.37,,58.37,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,Individual Exchange,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Anthem,State Preferred,,,,,,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Cigna,Cigna,,2.96,,,2.96,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Commerical,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Connecticare,Exchange,,4.7,,,4.7,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,Multiplan,Multiplan,,,66.23,,66.23,2.96,66.23,percent of total billed charges,,
LINEZOLID 600 MG/300 ML IV SOLN - SEPTIC SHOCK ORDER SET,J2020,HCPCS,66794-219-63,NDC,both,100,mL,77.92,46.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,66.23,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Aetna,Commerical,,,123.07,,123.07,2.96,135.58,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Aetna,Middlesex Employees,,,118.01,,118.01,2.96,135.58,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Commerical,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Indemnity,,,119.48,,119.48,2.96,135.58,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,Individual Exchange,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Anthem,State Preferred,,,,,,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Cigna,Cigna,,2.96,,,2.96,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Connecticare,Commerical,,4.7,,,4.7,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Connecticare,Exchange,,4.7,,,4.7,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,Multiplan,Multiplan,,,135.58,,135.58,2.96,135.58,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 200 MG/100 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5137-04,NDC,both,100,mL,159.5,95.7,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,135.58,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-01,NDC,both,300,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0009-5140-04,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,0781-3433-46,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,55150-242-51,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,57664-683-31,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,66794-236-63,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Aetna,Commerical,,,92.04,,92.04,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Aetna,Middlesex Employees,,,88.26,,88.26,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Anthem,Commerical,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Anthem,Indemnity,,,89.35,,89.35,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Anthem,Individual Exchange,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Anthem,State Preferred,,,,,,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Cigna,Cigna,,2.96,,,2.96,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Connecticare,Commerical,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Connecticare,Exchange,,4.7,,,4.7,2.96,101.39,Other,Could be inpatient or outpatient,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,Multiplan,Multiplan,,,101.39,,101.39,2.96,101.39,percent of total billed charges,,
LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,J2020,HCPCS,67457-843-00,NDC,both,100,mL,119.28,71.57,United Healthcare/Oxford,United Healthcare/Oxford,,3.2,,,3.2,2.96,101.39,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Aetna,Commerical,,,1175.92,,1175.92,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Aetna,Middlesex Employees,,,1127.61,,1127.61,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Anthem,Commerical,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Anthem,Indemnity,,,1141.63,,1141.63,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Anthem,Individual Exchange,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Anthem,State Preferred,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Cigna,Cigna,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Connecticare,Commerical,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Connecticare,Exchange,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,Multiplan,Multiplan,,,1295.4,,1295.4,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-0151-1,NDC,both,1,mL,1524,914.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Aetna,Commerical,,,1175.92,,1175.92,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Aetna,Middlesex Employees,,,1127.61,,1127.61,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Anthem,Commerical,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Anthem,Indemnity,,,1141.63,,1141.63,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Anthem,Individual Exchange,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Anthem,State Preferred,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Cigna,Cigna,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Connecticare,Commerical,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Connecticare,Exchange,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,Multiplan,Multiplan,,,1295.4,,1295.4,1127.61,1295.4,percent of total billed charges,,
LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-120-01,NDC,both,1,mL,1524,914.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1127.61,1295.4,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Aetna,Commerical,,,2.11,,2.11,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Anthem,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Anthem,Indemnity,,,2.05,,2.05,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Anthem,Individual Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Anthem,State Preferred,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Cigna,Cigna,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Connecticare,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Connecticare,Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,Multiplan,Multiplan,,,2.33,,2.33,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,40810-0208-46,NDC,both,1,ea,2.74,1.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Aetna,Commerical,,,2.11,,2.11,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Anthem,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Anthem,Indemnity,,,2.05,,2.05,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Anthem,Individual Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Anthem,State Preferred,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Cigna,Cigna,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Connecticare,Commerical,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Connecticare,Exchange,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,Multiplan,Multiplan,,,2.33,,2.33,2.03,2.33,percent of total billed charges,,
"LIPASE 2,600-PROTEASE 8,800-AMYLASE 15,200 UNIT CAPSULE, DELAYED REL",J3490,HCPCS,62541-401-10,NDC,both,1,ea,2.74,1.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
"LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Aetna,Commerical,,,22.64,,22.64,21.71,24.94,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Aetna,Middlesex Employees,,,21.71,,21.71,21.71,24.94,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Anthem,Commerical,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Anthem,Indemnity,,,21.98,,21.98,21.71,24.94,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Anthem,Individual Exchange,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Anthem,State Preferred,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Cigna,Cigna,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Connecticare,Commerical,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Connecticare,Exchange,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,Multiplan,Multiplan,,,24.94,,24.94,21.71,24.94,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0018-56,NDC,both,1,ea,29.34,17.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.71,24.94,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Aetna,Commerical,,,35.02,,35.02,33.58,38.58,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Aetna,Middlesex Employees,,,33.58,,33.58,33.58,38.58,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Anthem,Commerical,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Anthem,Indemnity,,,34,,34,33.58,38.58,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Anthem,Individual Exchange,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Anthem,State Preferred,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Cigna,Cigna,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Connecticare,Commerical,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Connecticare,Exchange,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,Multiplan,Multiplan,,,38.58,,38.58,33.58,38.58,percent of total billed charges,,
LISDEXAMFETAMINE 10 MG CAPSULE,J3490,HCPCS,59417-101-10,NDC,both,1,ea,45.39,27.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.58,38.58,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Aetna,Commerical,,,19.61,,19.61,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Aetna,Middlesex Employees,,,18.8,,18.8,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Anthem,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Anthem,Indemnity,,,19.03,,19.03,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Anthem,Individual Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Anthem,State Preferred,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Cigna,Cigna,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Connecticare,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Connecticare,Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,Multiplan,Multiplan,,,21.6,,21.6,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,40810-0018-26,NDC,both,1,ea,25.41,15.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Aetna,Commerical,,,19.61,,19.61,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Aetna,Middlesex Employees,,,18.8,,18.8,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Anthem,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Anthem,Indemnity,,,19.03,,19.03,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Anthem,Individual Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Anthem,State Preferred,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Cigna,Cigna,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Connecticare,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Connecticare,Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,Multiplan,Multiplan,,,21.6,,21.6,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 20 MG CAPSULE,J3490,HCPCS,59417-102-10,NDC,both,1,ea,25.41,15.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Aetna,Commerical,,,19.61,,19.61,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Aetna,Middlesex Employees,,,18.8,,18.8,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Anthem,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Anthem,Indemnity,,,19.03,,19.03,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Anthem,Individual Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Anthem,State Preferred,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Cigna,Cigna,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Connecticare,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Connecticare,Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,Multiplan,Multiplan,,,21.6,,21.6,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,40810-0018-25,NDC,both,1,ea,25.41,15.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Aetna,Commerical,,,19.61,,19.61,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Aetna,Middlesex Employees,,,18.8,,18.8,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Anthem,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Anthem,Indemnity,,,19.03,,19.03,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Anthem,Individual Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Anthem,State Preferred,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Cigna,Cigna,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Connecticare,Commerical,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Connecticare,Exchange,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,Multiplan,Multiplan,,,21.6,,21.6,18.8,21.6,percent of total billed charges,,
LISDEXAMFETAMINE 30 MG CAPSULE,J3490,HCPCS,59417-103-10,NDC,both,1,ea,25.41,15.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.8,21.6,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Aetna,Commerical,,,20.75,,20.75,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Aetna,Middlesex Employees,,,19.9,,19.9,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Anthem,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Anthem,Indemnity,,,20.14,,20.14,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Anthem,Individual Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Anthem,State Preferred,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Cigna,Cigna,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Connecticare,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Connecticare,Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,Multiplan,Multiplan,,,22.86,,22.86,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,40810-0017-89,NDC,both,1,ea,26.89,16.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Aetna,Commerical,,,20.75,,20.75,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Aetna,Middlesex Employees,,,19.9,,19.9,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Anthem,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Anthem,Indemnity,,,20.14,,20.14,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Anthem,Individual Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Anthem,State Preferred,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Cigna,Cigna,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Connecticare,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Connecticare,Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,Multiplan,Multiplan,,,22.86,,22.86,19.9,22.86,percent of total billed charges,,
LISDEXAMFETAMINE 70 MG CAPSULE,J3490,HCPCS,59417-107-10,NDC,both,1,ea,26.89,16.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
LISINOPRIL 1.25 MG ORAL TAB,J3490,HCPCS,40810-0001-81,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,0904-6798-61,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
LISINOPRIL 10 MG TABLET,J3490,HCPCS,68180-980-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Aetna,Commerical,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Anthem,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Anthem,Indemnity,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Anthem,Individual Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Anthem,State Preferred,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Cigna,Cigna,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Connecticare,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Connecticare,Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,Multiplan,Multiplan,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,40810-0009-00,NDC,both,1,ea,0.05,0.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
LISINOPRIL 2.5 MG TABLET,J3490,HCPCS,68180-512-01,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,0904-6799-61,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
LISINOPRIL 20 MG TABLET,J3490,HCPCS,68180-981-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
LISINOPRIL 5 MG TABLET,J3490,HCPCS,68180-513-01,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-2526-25,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Aetna,Commerical,,,0.43,,0.43,0.41,0.48,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.48,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Anthem,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Anthem,Indemnity,,,0.42,,0.42,0.41,0.48,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Anthem,Individual Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Anthem,State Preferred,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Cigna,Cigna,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Connecticare,Commerical,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Connecticare,Exchange,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.41,0.48,percent of total billed charges,,
LITHIUM CARBONATE 150 MG CAPSULE,J3490,HCPCS,0054-8526-25,NDC,both,1,ea,0.56,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.48,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-2527-25,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,0054-8527-25,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,31722-545-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-01,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
LITHIUM CARBONATE 300 MG CAPSULE,J3490,HCPCS,60687-806-11,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0021-25,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Aetna,Commerical,,,0.99,,0.99,0.95,1.09,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Aetna,Middlesex Employees,,,0.95,,0.95,0.95,1.09,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Anthem,Commerical,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Anthem,Indemnity,,,0.96,,0.96,0.95,1.09,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Anthem,Individual Exchange,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Anthem,State Preferred,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Cigna,Cigna,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Connecticare,Commerical,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Connecticare,Exchange,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,Multiplan,Multiplan,,,1.09,,1.09,0.95,1.09,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0378-1300-01,NDC,both,1,ea,1.28,0.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.95,1.09,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-01,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Aetna,Commerical,,,1.04,,1.04,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Aetna,Middlesex Employees,,,1,,1,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Anthem,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Anthem,Indemnity,,,1.01,,1.01,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Anthem,Individual Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Anthem,State Preferred,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Cigna,Cigna,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Connecticare,Commerical,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Connecticare,Exchange,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,Multiplan,Multiplan,,,1.15,,1.15,1,1.15,percent of total billed charges,,
"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-180-20,NDC,both,1,ea,1.35,0.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1,1.15,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Aetna,Commerical,,,1.2,,1.2,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Aetna,Middlesex Employees,,,1.15,,1.15,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Anthem,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Anthem,Indemnity,,,1.17,,1.17,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Anthem,Individual Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Anthem,State Preferred,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Cigna,Cigna,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Connecticare,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Connecticare,Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,Multiplan,Multiplan,,,1.33,,1.33,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0054-0020-25,NDC,both,1,ea,1.56,0.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Aetna,Commerical,,,1.2,,1.2,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Aetna,Middlesex Employees,,,1.15,,1.15,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Anthem,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Anthem,Indemnity,,,1.17,,1.17,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Anthem,Individual Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Anthem,State Preferred,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Cigna,Cigna,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Connecticare,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Connecticare,Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,Multiplan,Multiplan,,,1.33,,1.33,1.15,1.33,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,51079-142-20,NDC,both,1,ea,1.56,0.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Aetna,Commerical,,,1.66,,1.66,1.59,1.83,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Aetna,Middlesex Employees,,,1.59,,1.59,1.59,1.83,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Anthem,Commerical,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Anthem,Indemnity,,,1.61,,1.61,1.59,1.83,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Anthem,Individual Exchange,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Anthem,State Preferred,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Cigna,Cigna,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Connecticare,Commerical,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Connecticare,Exchange,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,Multiplan,Multiplan,,,1.83,,1.83,1.59,1.83,percent of total billed charges,,
"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-655-01,NDC,both,1,ea,2.15,1.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.59,1.83,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Aetna,Commerical,,,738.81,,738.81,708.45,813.88,percent of total billed charges,,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Aetna,Middlesex Employees,,,708.45,,708.45,708.45,813.88,percent of total billed charges,,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Anthem,Commerical,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Anthem,Indemnity,,,717.26,,717.26,708.45,813.88,percent of total billed charges,,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Anthem,Individual Exchange,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Anthem,State Preferred,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Cigna,Cigna,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Connecticare,Commerical,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Connecticare,Exchange,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,Multiplan,Multiplan,,,813.88,,813.88,708.45,813.88,percent of total billed charges,,
LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,J3490,HCPCS,72888-172-46,NDC,both,1,mL,957.5,574.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,708.45,813.88,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Aetna,Commerical,,,296.28,,296.28,129.66,326.38,percent of total billed charges,,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Aetna,Middlesex Employees,,,284.11,,284.11,129.66,326.38,percent of total billed charges,,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Anthem,Commerical,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Anthem,Indemnity,,,287.64,,287.64,129.66,326.38,percent of total billed charges,,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Anthem,Individual Exchange,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Anthem,State Preferred,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Cigna,Cigna,,129.66,,,129.66,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Connecticare,Commerical,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Connecticare,Exchange,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,Multiplan,Multiplan,,,326.38,,326.38,129.66,326.38,percent of total billed charges,,
LOMUSTINE 10 MG CAPSULE,S0178,HCPCS,58181-3040-5,NDC,both,1,ea,383.98,230.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,129.66,326.38,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Aetna,Commerical,,,1185.04,,1185.04,129.66,1305.45,percent of total billed charges,,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Aetna,Middlesex Employees,,,1136.35,,1136.35,129.66,1305.45,percent of total billed charges,,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Anthem,Commerical,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Anthem,Indemnity,,,1150.48,,1150.48,129.66,1305.45,percent of total billed charges,,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Anthem,Individual Exchange,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Anthem,State Preferred,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Cigna,Cigna,,129.66,,,129.66,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Connecticare,Commerical,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Connecticare,Exchange,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,Multiplan,Multiplan,,,1305.45,,1305.45,129.66,1305.45,percent of total billed charges,,
LOMUSTINE 40 MG CAPSULE,S0178,HCPCS,58181-3041-5,NDC,both,0.25,ea,1535.82,921.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,129.66,1305.45,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
LOPERAMIDE 1 MG TABLET,J3490,HCPCS,40810-0205-44,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Aetna,Commerical,,,12.77,,12.77,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Aetna,Middlesex Employees,,,12.25,,12.25,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Anthem,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Anthem,Indemnity,,,12.4,,12.4,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Anthem,Individual Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Anthem,State Preferred,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Cigna,Cigna,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Connecticare,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Connecticare,Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,Multiplan,Multiplan,,,14.07,,14.07,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,45013404,NDC,both,1,mL,16.55,9.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,0904-6836-20,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Aetna,Commerical,,,12.77,,12.77,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Aetna,Middlesex Employees,,,12.25,,12.25,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Anthem,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Anthem,Indemnity,,,12.4,,12.4,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Anthem,Individual Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Anthem,State Preferred,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Cigna,Cigna,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Connecticare,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Connecticare,Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,Multiplan,Multiplan,,,14.07,,14.07,12.25,14.07,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,50580-134-44,NDC,both,1,mL,16.55,9.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,J3490,HCPCS,70000-0418-1,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
LOPERAMIDE 2 MG TABLET,J3490,HCPCS,57896-381-24,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Aetna,Commerical,,,24.27,,24.27,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Aetna,Middlesex Employees,,,23.28,,23.28,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Anthem,Commerical,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Anthem,Indemnity,,,23.57,,23.57,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Anthem,Individual Exchange,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Anthem,State Preferred,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Cigna,Cigna,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Connecticare,Commerical,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Connecticare,Exchange,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,Multiplan,Multiplan,,,26.74,,26.74,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,0074-6799-22,NDC,both,1,ea,31.46,18.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Aetna,Commerical,,,24.27,,24.27,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Aetna,Middlesex Employees,,,23.28,,23.28,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Anthem,Commerical,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Anthem,Indemnity,,,23.57,,23.57,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Anthem,Individual Exchange,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Anthem,State Preferred,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Cigna,Cigna,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Connecticare,Commerical,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Connecticare,Exchange,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,Multiplan,Multiplan,,,26.74,,26.74,23.28,26.74,percent of total billed charges,,
LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,J3490,HCPCS,40810-0010-05,NDC,both,1,ea,31.46,18.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.28,26.74,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Aetna,Commerical,,,1456.34,,1456.34,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Aetna,Middlesex Employees,,,1396.51,,1396.51,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Anthem,Commerical,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Anthem,Indemnity,,,1413.87,,1413.87,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Anthem,Individual Exchange,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Anthem,State Preferred,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Cigna,Cigna,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Connecticare,Commerical,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Connecticare,Exchange,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,Multiplan,Multiplan,,,1604.32,,1604.32,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0074-3956-46,NDC,both,1,mL,1887.43,1132.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Aetna,Commerical,,,1456.34,,1456.34,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Aetna,Middlesex Employees,,,1396.51,,1396.51,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Anthem,Commerical,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Anthem,Indemnity,,,1413.87,,1413.87,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Anthem,Individual Exchange,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Anthem,State Preferred,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Cigna,Cigna,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Connecticare,Commerical,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Connecticare,Exchange,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,Multiplan,Multiplan,,,1604.32,,1604.32,1396.51,1604.32,percent of total billed charges,,
LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0527-1947-48,NDC,both,1,mL,1887.43,1132.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1396.51,1604.32,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Aetna,Commerical,,,1.94,,1.94,1.86,2.13,percent of total billed charges,,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Aetna,Middlesex Employees,,,1.86,,1.86,1.86,2.13,percent of total billed charges,,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Anthem,Commerical,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Anthem,Indemnity,,,1.88,,1.88,1.86,2.13,percent of total billed charges,,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Anthem,Individual Exchange,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Anthem,State Preferred,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Cigna,Cigna,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Connecticare,Commerical,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Connecticare,Exchange,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,Multiplan,Multiplan,,,2.13,,2.13,1.86,2.13,percent of total billed charges,,
LORAZEPAM 0.2 MG/0.1 ML ORAL SYRINGE,J3490,HCPCS,40810-0005-10,NDC,both,1,mL,2.51,1.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.86,2.13,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
LORAZEPAM 0.25 MG ORAL TAB,J3490,HCPCS,40810-0001-82,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,0904-6007-61,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
LORAZEPAM 0.5 MG TABLET,J3490,HCPCS,60687-401-11,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
LORAZEPAM 1 MG TABLET,J3490,HCPCS,0904-6008-61,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Aetna,Commerical,,,0.83,,0.83,0.8,0.92,percent of total billed charges,,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Aetna,Middlesex Employees,,,0.8,,0.8,0.8,0.92,percent of total billed charges,,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Anthem,Commerical,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Anthem,Indemnity,,,0.81,,0.81,0.8,0.92,percent of total billed charges,,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Anthem,Individual Exchange,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Anthem,State Preferred,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Cigna,Cigna,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Connecticare,Commerical,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Connecticare,Exchange,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,Multiplan,Multiplan,,,0.92,,0.92,0.8,0.92,percent of total billed charges,,
LORAZEPAM 1 MG/0.5 ML ORAL SYRINGE,J3490,HCPCS,40810-0017-44,NDC,both,0.5,mL,1.08,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.8,0.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Aetna,Commerical,,,3.9,,3.9,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Aetna,Middlesex Employees,,,3.74,,3.74,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Anthem,Commerical,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Anthem,Indemnity,,,3.79,,3.79,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Anthem,Individual Exchange,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Anthem,State Preferred,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Cigna,Cigna,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Connecticare,Commerical,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Connecticare,Exchange,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,Multiplan,Multiplan,,,4.3,,4.3,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-01,NDC,both,1,ea,5.06,3.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Aetna,Commerical,,,3.9,,3.9,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Aetna,Middlesex Employees,,,3.74,,3.74,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Anthem,Commerical,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Anthem,Indemnity,,,3.79,,3.79,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Anthem,Individual Exchange,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Anthem,State Preferred,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Cigna,Cigna,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Connecticare,Commerical,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Connecticare,Exchange,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,Multiplan,Multiplan,,,4.3,,4.3,3.74,4.3,percent of total billed charges,,
LORAZEPAM 2 MG TABLET,J3490,HCPCS,51079-387-20,NDC,both,1,ea,5.06,3.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.74,4.3,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR AGITATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR ANXIETY/SEDATION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR NAUSEA/VOMITING,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION FOR STATUS EPILEPTICUS,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-03,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Aetna,Commerical,,,4.94,,4.94,1.48,5.44,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Aetna,Middlesex Employees,,,4.74,,4.74,1.48,5.44,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Anthem,Commerical,,,,,,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Anthem,Indemnity,,,4.79,,4.79,1.48,5.44,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Anthem,Individual Exchange,,,,,,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Anthem,State Preferred,,,,,,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Cigna,Cigna,,1.48,,,1.48,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Connecticare,Commerical,,2.22,,,2.22,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Connecticare,Exchange,,2.22,,,2.22,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,Multiplan,Multiplan,,,5.44,,5.44,1.48,5.44,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-1985-05,NDC,both,1,mL,6.4,3.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,5.44,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Aetna,Commerical,,,26.45,,26.45,1.48,29.14,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Aetna,Middlesex Employees,,,25.36,,25.36,1.48,29.14,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Anthem,Commerical,,,,,,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Anthem,Indemnity,,,25.68,,25.68,1.48,29.14,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Anthem,Individual Exchange,,,,,,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Anthem,State Preferred,,,,,,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Cigna,Cigna,,1.48,,,1.48,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Connecticare,Commerical,,2.22,,,2.22,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Connecticare,Exchange,,2.22,,,2.22,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,Multiplan,Multiplan,,,29.14,,29.14,1.48,29.14,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6780-02,NDC,both,10,mL,34.28,20.57,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,29.14,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-01,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6001-25,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-01,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6044-25,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-01,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6048-25,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,1.48,,,1.48,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,2.22,,,2.22,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,1.48,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INJECTION SOLUTION,J2060,HCPCS,17478-040-01,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML INTRANASAL SOLN,J3490,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Aetna,Commerical,,,53.29,,53.29,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Aetna,Middlesex Employees,,,51.1,,51.1,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Anthem,Commerical,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Anthem,Indemnity,,,51.73,,51.73,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Anthem,Individual Exchange,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Anthem,State Preferred,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Cigna,Cigna,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Connecticare,Commerical,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Connecticare,Exchange,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,Multiplan,Multiplan,,,58.7,,58.7,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0054-3532-44,NDC,both,1,mL,69.06,41.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Aetna,Commerical,,,53.29,,53.29,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Aetna,Middlesex Employees,,,51.1,,51.1,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Anthem,Commerical,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Anthem,Indemnity,,,51.73,,51.73,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Anthem,Individual Exchange,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Anthem,State Preferred,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Cigna,Cigna,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Connecticare,Commerical,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Connecticare,Exchange,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,Multiplan,Multiplan,,,58.7,,58.7,51.1,58.7,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL CONCENTRATE,J8499,HCPCS,0121-0770-01,NDC,both,1,mL,69.06,41.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.1,58.7,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Commerical,,,2.65,,2.65,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Aetna,Middlesex Employees,,,2.54,,2.54,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Commerical,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Indemnity,,,2.57,,2.57,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,Individual Exchange,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Anthem,State Preferred,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Cigna,Cigna,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Commerical,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Connecticare,Exchange,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,Multiplan,Multiplan,,,2.92,,2.92,2.54,2.92,percent of total billed charges,,
LORAZEPAM 2 MG/ML ORAL SOLN KETOGENIC,J8499,HCPCS,0409-6778-02,NDC,both,1,mL,3.43,2.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.54,2.92,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Aetna,Commerical,,,7.24,,7.24,1.48,7.97,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Aetna,Middlesex Employees,,,6.94,,6.94,1.48,7.97,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Anthem,Commerical,,,,,,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Anthem,Indemnity,,,7.03,,7.03,1.48,7.97,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Anthem,Individual Exchange,,,,,,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Anthem,State Preferred,,,,,,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Cigna,Cigna,,1.48,,,1.48,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Connecticare,Commerical,,2.22,,,2.22,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Connecticare,Exchange,,2.22,,,2.22,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,Multiplan,Multiplan,,,7.97,,7.97,1.48,7.97,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0409-6779-02,NDC,both,0.5,mL,9.38,5.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,7.97,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Commerical,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Anthem,State Preferred,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Cigna,Cigna,,1.48,,,1.48,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Connecticare,Commerical,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Connecticare,Exchange,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-01,NDC,both,0.5,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Commerical,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Anthem,State Preferred,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Cigna,Cigna,,1.48,,,1.48,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Connecticare,Commerical,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Connecticare,Exchange,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6045-25,NDC,both,0.5,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Commerical,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Anthem,State Preferred,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Cigna,Cigna,,1.48,,,1.48,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Connecticare,Commerical,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Connecticare,Exchange,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-01,NDC,both,0.5,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Commerical,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Anthem,State Preferred,,,,,,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Cigna,Cigna,,1.48,,,1.48,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Connecticare,Commerical,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Connecticare,Exchange,,2.22,,,2.22,1.48,5.87,Other,Could be inpatient or outpatient,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,1.48,5.87,percent of total billed charges,,
LORAZEPAM 4 MG/ML INJECTION SOLUTION,J2060,HCPCS,0641-6049-25,NDC,both,0.5,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,1.6,,,1.6,1.48,5.87,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Aetna,Commerical,,,581.25,,581.25,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Aetna,Middlesex Employees,,,557.37,,557.37,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Anthem,Commerical,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Anthem,Indemnity,,,564.3,,564.3,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Anthem,Individual Exchange,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Anthem,State Preferred,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Cigna,Cigna,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Connecticare,Commerical,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Connecticare,Exchange,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,Multiplan,Multiplan,,,640.31,,640.31,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,0069-0227-01,NDC,both,1,ea,753.3,451.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Aetna,Commerical,,,581.25,,581.25,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Aetna,Middlesex Employees,,,557.37,,557.37,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Anthem,Commerical,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Anthem,Indemnity,,,564.3,,564.3,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Anthem,Individual Exchange,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Anthem,State Preferred,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Cigna,Cigna,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Connecticare,Commerical,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Connecticare,Exchange,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,Multiplan,Multiplan,,,640.31,,640.31,557.37,640.31,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-82,NDC,both,1,ea,753.3,451.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,557.37,640.31,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Aetna,Commerical,,,14531.16,,14531.16,13934.17,16007.63,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Aetna,Middlesex Employees,,,13934.17,,13934.17,13934.17,16007.63,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Anthem,Commerical,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Anthem,Indemnity,,,14107.43,,14107.43,13934.17,16007.63,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Anthem,Individual Exchange,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Anthem,State Preferred,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Cigna,Cigna,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Connecticare,Commerical,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Connecticare,Exchange,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,Multiplan,Multiplan,,,16007.63,,16007.63,13934.17,16007.63,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-83,NDC,both,25,ME,18832.5,11299.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13934.17,16007.63,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Aetna,Commerical,,,29062.31,,29062.31,27868.33,32015.24,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Aetna,Middlesex Employees,,,27868.33,,27868.33,27868.33,32015.24,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Anthem,Commerical,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Anthem,Indemnity,,,28214.84,,28214.84,27868.33,32015.24,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Anthem,Individual Exchange,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Anthem,State Preferred,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Cigna,Cigna,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Connecticare,Commerical,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Connecticare,Exchange,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,Multiplan,Multiplan,,,32015.24,,32015.24,27868.33,32015.24,percent of total billed charges,,
LORLATINIB 25 MG TABLET,J8999,HCPCS,40810-0205-84,NDC,both,25,ME,37664.99,22598.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27868.33,32015.24,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,0781-5702-31,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,40810-0009-52,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-30,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
LOSARTAN 100 MG TABLET,J3490,HCPCS,65862-203-90,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
LOSARTAN 12.5 MG TABLET,J3490,HCPCS,40810-0018-68,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Aetna,Commerical,,,19.15,,19.15,18.36,21.1,percent of total billed charges,,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Aetna,Middlesex Employees,,,18.36,,18.36,18.36,21.1,percent of total billed charges,,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Anthem,Commerical,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Anthem,Indemnity,,,18.59,,18.59,18.36,21.1,percent of total billed charges,,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Anthem,Individual Exchange,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Anthem,State Preferred,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Cigna,Cigna,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Connecticare,Commerical,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Connecticare,Exchange,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,Multiplan,Multiplan,,,21.1,,21.1,18.36,21.1,percent of total billed charges,,
LOSARTAN 2.5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0001-85,NDC,both,20,mL,24.82,14.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.36,21.1,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Aetna,Commerical,,,9.64,,9.64,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Aetna,Middlesex Employees,,,9.24,,9.24,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Anthem,Commerical,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Anthem,Indemnity,,,9.36,,9.36,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Anthem,Individual Exchange,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Anthem,State Preferred,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Cigna,Cigna,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Connecticare,Commerical,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Connecticare,Exchange,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,Multiplan,Multiplan,,,10.62,,10.62,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,40810-0019-74,NDC,both,1,ea,12.49,7.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Aetna,Commerical,,,9.64,,9.64,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Aetna,Middlesex Employees,,,9.24,,9.24,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Anthem,Commerical,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Anthem,Indemnity,,,9.36,,9.36,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Anthem,Individual Exchange,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Anthem,State Preferred,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Cigna,Cigna,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Connecticare,Commerical,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Connecticare,Exchange,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,Multiplan,Multiplan,,,10.62,,10.62,9.24,10.62,percent of total billed charges,,
LOSARTAN 25 MG TABLET,J3490,HCPCS,65862-201-90,NDC,both,1,ea,12.49,7.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.24,10.62,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Aetna,Commerical,,,4.73,,4.73,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Aetna,Middlesex Employees,,,4.54,,4.54,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Anthem,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Anthem,Indemnity,,,4.59,,4.59,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Anthem,Individual Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Anthem,State Preferred,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Cigna,Cigna,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Connecticare,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Connecticare,Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,Multiplan,Multiplan,,,5.21,,5.21,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,0480-4138-06,NDC,both,1,ea,6.13,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Aetna,Commerical,,,4.73,,4.73,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Aetna,Middlesex Employees,,,4.54,,4.54,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Anthem,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Anthem,Indemnity,,,4.59,,4.59,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Anthem,Individual Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Anthem,State Preferred,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Cigna,Cigna,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Connecticare,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Connecticare,Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,Multiplan,Multiplan,,,5.21,,5.21,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,40810-0005-94,NDC,both,1,ea,6.13,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Aetna,Commerical,,,4.73,,4.73,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Aetna,Middlesex Employees,,,4.54,,4.54,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Anthem,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Anthem,Indemnity,,,4.59,,4.59,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Anthem,Individual Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Anthem,State Preferred,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Cigna,Cigna,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Connecticare,Commerical,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Connecticare,Exchange,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,Multiplan,Multiplan,,,5.21,,5.21,4.54,5.21,percent of total billed charges,,
LUBIPROSTONE 24 MCG CAPSULE,J3490,HCPCS,64764-240-60,NDC,both,1,ea,6.13,3.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.54,5.21,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Aetna,Commerical,,,17.59,,17.59,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Aetna,Middlesex Employees,,,16.87,,16.87,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Anthem,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Anthem,Indemnity,,,17.08,,17.08,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Anthem,Individual Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Anthem,State Preferred,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Cigna,Cigna,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Connecticare,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Connecticare,Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,Multiplan,Multiplan,,,19.38,,19.38,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,0480-3479-06,NDC,both,1,ea,22.8,13.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Aetna,Commerical,,,17.59,,17.59,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Aetna,Middlesex Employees,,,16.87,,16.87,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Anthem,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Anthem,Indemnity,,,17.08,,17.08,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Anthem,Individual Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Anthem,State Preferred,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Cigna,Cigna,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Connecticare,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Connecticare,Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,Multiplan,Multiplan,,,19.38,,19.38,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,40810-0005-97,NDC,both,1,ea,22.8,13.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Aetna,Commerical,,,17.59,,17.59,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Aetna,Middlesex Employees,,,16.87,,16.87,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Anthem,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Anthem,Indemnity,,,17.08,,17.08,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Anthem,Individual Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Anthem,State Preferred,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Cigna,Cigna,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Connecticare,Commerical,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Connecticare,Exchange,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,Multiplan,Multiplan,,,19.38,,19.38,16.87,19.38,percent of total billed charges,,
LUBIPROSTONE 8 MCG CAPSULE,J8499,HCPCS,64764-080-60,NDC,both,1,ea,22.8,13.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.87,19.38,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Aetna,Commerical,,,38.8,,38.8,37.21,42.75,percent of total billed charges,,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Aetna,Middlesex Employees,,,37.21,,37.21,37.21,42.75,percent of total billed charges,,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Anthem,Commerical,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Anthem,Indemnity,,,37.67,,37.67,37.21,42.75,percent of total billed charges,,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Anthem,Individual Exchange,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Anthem,State Preferred,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Cigna,Cigna,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Connecticare,Commerical,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Connecticare,Exchange,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,Multiplan,Multiplan,,,42.75,,42.75,37.21,42.75,percent of total billed charges,,
LURASIDONE 10 MG SPLIT TABLET,J3490,HCPCS,40810-0204-18,NDC,both,1,ea,50.29,30.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.21,42.75,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,0904-7355-04,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,40810-0018-28,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,43598-351-30,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-11,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,60687-747-21,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,63402-302-30,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,67877-638-30,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
LURASIDONE 20 MG TABLET,J3490,HCPCS,72205-207-30,NDC,both,1,ea,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,40810-0017-06,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,63402-308-30,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,67877-641-30,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
LURASIDONE 80 MG TABLET,J3490,HCPCS,72205-210-30,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Aetna,Commerical,,,2976.44,,2976.44,2854.16,6059.74,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Aetna,Middlesex Employees,,,2854.16,,2854.16,2854.16,6059.74,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Anthem,Commerical,,,,,,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Anthem,Indemnity,,,2889.65,,2889.65,2854.16,6059.74,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Anthem,Individual Exchange,,,,,,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Anthem,State Preferred,,,,,,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Cigna,Cigna,,4500.33,,,4500.33,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Connecticare,Commerical,,6059.74,,,6059.74,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Connecticare,Exchange,,6059.74,,,6059.74,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,Multiplan,Multiplan,,,3278.87,,3278.87,2854.16,6059.74,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-01,NDC,both,5,mL,3857.49,2314.49,United Healthcare/Oxford,United Healthcare/Oxford,,4858.76,,,4858.76,2854.16,6059.74,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Aetna,Commerical,,,12387.02,,12387.02,4500.33,13645.63,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Aetna,Middlesex Employees,,,11878.12,,11878.12,4500.33,13645.63,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Anthem,Commerical,,,,,,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Anthem,Indemnity,,,12025.81,,12025.81,4500.33,13645.63,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Anthem,Individual Exchange,,,,,,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Anthem,State Preferred,,,,,,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Cigna,Cigna,,4500.33,,,4500.33,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Connecticare,Commerical,,6059.74,,,6059.74,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Connecticare,Exchange,,6059.74,,,6059.74,4500.33,13645.63,Other,Could be inpatient or outpatient,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,Multiplan,Multiplan,,,13645.63,,13645.63,4500.33,13645.63,percent of total billed charges,,
"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",J7504,HCPCS,0009-7224-02,NDC,both,1,mL,16053.68,9632.21,United Healthcare/Oxford,United Healthcare/Oxford,,4858.76,,,4858.76,4500.33,13645.63,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Aetna,Commerical,,,100.72,,100.72,96.58,110.95,percent of total billed charges,,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Aetna,Middlesex Employees,,,96.58,,96.58,96.58,110.95,percent of total billed charges,,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Anthem,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Anthem,Indemnity,,,97.78,,97.78,96.58,110.95,percent of total billed charges,,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Anthem,Individual Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Anthem,State Preferred,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Cigna,Cigna,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Connecticare,Commerical,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Connecticare,Exchange,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,Multiplan,Multiplan,,,110.95,,110.95,96.58,110.95,percent of total billed charges,,
MAALOX FOR TOPICAL USE,J3490,HCPCS,57896-629-12,NDC,both,355,mL,12.24,7.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,96.58,110.95,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
MAGNESIUM 500 MG (AS MAGNESIUM OXIDE) TABLET,J3490,HCPCS,904423960,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,6056949501,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
MAGNESIUM 84.5 MG (AS MAGNESIUM OXIDE 140 MG) CAPSULE,J3490,HCPCS,40810-0005-36,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Aetna,Commerical,,,24.14,,24.14,23.14,26.59,percent of total billed charges,,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Aetna,Middlesex Employees,,,23.14,,23.14,23.14,26.59,percent of total billed charges,,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Anthem,Commerical,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Anthem,Indemnity,,,23.43,,23.43,23.14,26.59,percent of total billed charges,,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Anthem,Individual Exchange,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Anthem,State Preferred,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Cigna,Cigna,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Connecticare,Commerical,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Connecticare,Exchange,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,Multiplan,Multiplan,,,26.59,,26.59,23.14,26.59,percent of total billed charges,,
MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID,J3490,HCPCS,187526701,NDC,both,1,mL,31.28,18.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Aetna,Commerical,,,25.86,,25.86,24.8,28.49,percent of total billed charges,,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Aetna,Middlesex Employees,,,24.8,,24.8,24.8,28.49,percent of total billed charges,,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Anthem,Commerical,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Anthem,Indemnity,,,25.11,,25.11,24.8,28.49,percent of total billed charges,,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Anthem,Individual Exchange,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Anthem,State Preferred,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Cigna,Cigna,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Connecticare,Commerical,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Connecticare,Exchange,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,Multiplan,Multiplan,,,28.49,,28.49,24.8,28.49,percent of total billed charges,,
MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,J3490,HCPCS,67457-134-50,NDC,both,1,mL,33.52,20.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.8,28.49,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Aetna,Commerical,,,8.75,,8.75,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Aetna,Middlesex Employees,,,8.39,,8.39,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Anthem,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Anthem,Indemnity,,,8.49,,8.49,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Anthem,Individual Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Anthem,State Preferred,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Cigna,Cigna,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Connecticare,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Connecticare,Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,Multiplan,Multiplan,,,9.64,,9.64,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0869-0693-38,NDC,both,1,mL,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Aetna,Commerical,,,8.75,,8.75,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Aetna,Middlesex Employees,,,8.39,,8.39,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Anthem,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Anthem,Indemnity,,,8.49,,8.49,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Anthem,Individual Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Anthem,State Preferred,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Cigna,Cigna,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Connecticare,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Connecticare,Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,Multiplan,Multiplan,,,9.64,,9.64,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,0904-7418-44,NDC,both,1,mL,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Aetna,Commerical,,,8.75,,8.75,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Aetna,Middlesex Employees,,,8.39,,8.39,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Anthem,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Anthem,Indemnity,,,8.49,,8.49,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Anthem,Individual Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Anthem,State Preferred,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Cigna,Cigna,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Connecticare,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Connecticare,Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,Multiplan,Multiplan,,,9.64,,9.64,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,69452-389-98,NDC,both,1,mL,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Aetna,Commerical,,,8.75,,8.75,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Aetna,Middlesex Employees,,,8.39,,8.39,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Anthem,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Anthem,Indemnity,,,8.49,,8.49,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Anthem,Individual Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Anthem,State Preferred,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Cigna,Cigna,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Connecticare,Commerical,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Connecticare,Exchange,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,Multiplan,Multiplan,,,9.64,,9.64,8.39,9.64,percent of total billed charges,,
MAGNESIUM CITRATE ORAL SOLUTION,J3490,HCPCS,71399-7889-1,NDC,both,1,mL,11.34,6.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.39,9.64,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
MAGNESIUM GLUCONATE 250 MG TABLET,J3490,HCPCS,40810-0013-62,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,3504600322,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,6025817201,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,J3490,HCPCS,40810-0010-23,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Aetna,Commerical,,,24.14,,24.14,23.14,26.59,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Aetna,Middlesex Employees,,,23.14,,23.14,23.14,26.59,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Anthem,Commerical,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Anthem,Indemnity,,,23.43,,23.43,23.14,26.59,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Anthem,Individual Exchange,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Anthem,State Preferred,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Cigna,Cigna,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Connecticare,Commerical,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Connecticare,Exchange,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,Multiplan,Multiplan,,,26.59,,26.59,23.14,26.59,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0536-1319-83,NDC,both,1,mL,31.28,18.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.14,26.59,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Aetna,Commerical,,,8.02,,8.02,7.69,8.84,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Aetna,Middlesex Employees,,,7.69,,7.69,7.69,8.84,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Anthem,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Anthem,Indemnity,,,7.79,,7.79,7.69,8.84,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Anthem,Individual Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Anthem,State Preferred,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Cigna,Cigna,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Connecticare,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Connecticare,Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,Multiplan,Multiplan,,,8.84,,8.84,7.69,8.84,percent of total billed charges,,
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,12843-55104,NDC,both,1,mL,10.4,6.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Aetna,Commerical,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Anthem,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Anthem,Indemnity,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Anthem,Individual Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Anthem,State Preferred,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Cigna,Cigna,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Connecticare,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Connecticare,Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,Multiplan,Multiplan,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
MAGNESIUM OXIDE 100 MG ORAL TAB,J3490,HCPCS,40810-0001-88,NDC,both,1,ea,0.05,0.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,40810-0001-89,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 200 MG ORAL TAB,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,1000673038,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,0603-0209-22,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,J3490,HCPCS,63739-354-10,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Commerical,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,State Preferred,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Cigna,Cigna,,0.57,,,0.57,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Connecticare,Commerical,,0.71,,,0.71,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Connecticare,Exchange,,0.71,,,0.71,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Commerical,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Anthem,State Preferred,,,,,,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Cigna,Cigna,,0.57,,,0.57,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Connecticare,Commerical,,0.71,,,0.71,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Connecticare,Exchange,,0.71,,,0.71,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,0.57,14.98,percent of total billed charges,,
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK FOR CAROUSEL,J3475,HCPCS,25021-612-81,NDC,both,12.5,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,14.98,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Aetna,Commerical,,,10.35,,10.35,0.57,11.4,percent of total billed charges,,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Aetna,Middlesex Employees,,,9.92,,9.92,0.57,11.4,percent of total billed charges,,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Anthem,Commerical,,,,,,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Anthem,Indemnity,,,10.05,,10.05,0.57,11.4,percent of total billed charges,,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Anthem,Individual Exchange,,,,,,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Anthem,State Preferred,,,,,,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Cigna,Cigna,,0.57,,,0.57,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Connecticare,Commerical,,0.71,,,0.71,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Connecticare,Exchange,,0.71,,,0.71,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,Multiplan,Multiplan,,,11.4,,11.4,0.57,11.4,percent of total billed charges,,
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,J3475,HCPCS,63323-106-15,NDC,both,12.5,mL,13.41,8.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,11.4,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Aetna,Commerical,,,6.8,,6.8,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Aetna,Middlesex Employees,,,6.52,,6.52,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Anthem,Commerical,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Anthem,Indemnity,,,6.6,,6.6,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Anthem,Individual Exchange,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Anthem,State Preferred,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Cigna,Cigna,,0.57,,,0.57,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Connecticare,Commerical,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Connecticare,Exchange,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,Multiplan,Multiplan,,,7.49,,7.49,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,0264-4206-54,NDC,both,12.5,mL,8.81,5.29,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Aetna,Commerical,,,6.8,,6.8,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Aetna,Middlesex Employees,,,6.52,,6.52,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Anthem,Commerical,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Anthem,Indemnity,,,6.6,,6.6,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Anthem,Individual Exchange,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Anthem,State Preferred,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Cigna,Cigna,,0.57,,,0.57,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Connecticare,Commerical,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Connecticare,Exchange,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,Multiplan,Multiplan,,,7.49,,7.49,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,63323-106-00,NDC,both,12.5,mL,8.81,5.29,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Aetna,Commerical,,,6.8,,6.8,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Aetna,Middlesex Employees,,,6.52,,6.52,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Anthem,Commerical,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Anthem,Indemnity,,,6.6,,6.6,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Anthem,Individual Exchange,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Anthem,State Preferred,,,,,,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Cigna,Cigna,,0.57,,,0.57,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Connecticare,Commerical,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Connecticare,Exchange,,0.71,,,0.71,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,Multiplan,Multiplan,,,7.49,,7.49,0.57,7.49,percent of total billed charges,,
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,J3475,HCPCS,70860-501-42,NDC,both,12.5,mL,8.81,5.29,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,7.49,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Aetna,Commerical,,,5.86,,5.86,0.57,6.45,percent of total billed charges,,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Aetna,Middlesex Employees,,,5.62,,5.62,0.57,6.45,percent of total billed charges,,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Anthem,Commerical,,,,,,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Anthem,Indemnity,,,5.69,,5.69,0.57,6.45,percent of total billed charges,,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Anthem,Individual Exchange,,,,,,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Anthem,State Preferred,,,,,,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Cigna,Cigna,,0.57,,,0.57,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Connecticare,Commerical,,0.71,,,0.71,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Connecticare,Exchange,,0.71,,,0.71,0.57,6.45,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,Multiplan,Multiplan,,,6.45,,6.45,0.57,6.45,percent of total billed charges,,
MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION FOR MATERNAL FETAL MEDICINE,J3475,HCPCS,63323-064-11,NDC,both,1,mL,7.59,4.55,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,6.45,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Anthem,Commerical,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Anthem,State Preferred,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Cigna,Cigna,,0.57,,,0.57,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Connecticare,Commerical,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Connecticare,Exchange,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-01,NDC,both,12.5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Anthem,Commerical,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Anthem,State Preferred,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Cigna,Cigna,,0.57,,,0.57,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Connecticare,Commerical,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Connecticare,Exchange,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,0409-3164-12,NDC,both,12.5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Commerical,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,State Preferred,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Cigna,Cigna,,0.57,,,0.57,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Connecticare,Commerical,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Connecticare,Exchange,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,0.57,16.28,percent of total billed charges,,
"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,0.57,16.28,percent of total billed charges,,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,0.57,16.28,percent of total billed charges,,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Commerical,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,0.57,16.28,percent of total billed charges,,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Anthem,State Preferred,,,,,,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Cigna,Cigna,,0.57,,,0.57,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Connecticare,Commerical,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Connecticare,Exchange,,0.71,,,0.71,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,0.57,16.28,percent of total billed charges,,
MAGNESIUM SULFATE 40 MG/ML (4 %) IN WATER INFUSION FOR STATUS ASTHMATICUS,J3475,HCPCS,63323-106-10,NDC,both,12.5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,16.28,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Aetna,Commerical,,,16.34,,16.34,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Aetna,Middlesex Employees,,,15.67,,15.67,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Anthem,Commerical,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Anthem,Indemnity,,,15.87,,15.87,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Anthem,Individual Exchange,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Anthem,State Preferred,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Cigna,Cigna,,0.57,,,0.57,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Connecticare,Commerical,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Connecticare,Exchange,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,Multiplan,Multiplan,,,18,,18,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-1,NDC,both,1,mL,21.18,12.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Aetna,Commerical,,,16.34,,16.34,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Aetna,Middlesex Employees,,,15.67,,15.67,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Anthem,Commerical,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Anthem,Indemnity,,,15.87,,15.87,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Anthem,Individual Exchange,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Anthem,State Preferred,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Cigna,Cigna,,0.57,,,0.57,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Connecticare,Commerical,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Connecticare,Exchange,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,Multiplan,Multiplan,,,18,,18,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,51754-1000-4,NDC,both,1,mL,21.18,12.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Aetna,Commerical,,,3.27,,3.27,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Aetna,Middlesex Employees,,,3.14,,3.14,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Anthem,Commerical,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Anthem,Indemnity,,,3.18,,3.18,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Anthem,Individual Exchange,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Anthem,State Preferred,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Cigna,Cigna,,0.57,,,0.57,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Connecticare,Commerical,,0.71,,,0.71,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Connecticare,Exchange,,0.71,,,0.71,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,Multiplan,Multiplan,,,3.6,,3.6,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-01,NDC,both,1,mL,4.24,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Aetna,Commerical,,,3.27,,3.27,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Aetna,Middlesex Employees,,,3.14,,3.14,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Commerical,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Indemnity,,,3.18,,3.18,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Individual Exchange,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,State Preferred,,,,,,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Cigna,Cigna,,0.57,,,0.57,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Connecticare,Commerical,,0.71,,,0.71,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Connecticare,Exchange,,0.71,,,0.71,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Multiplan,Multiplan,,,3.6,,3.6,0.57,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Aetna,Commerical,,,16.34,,16.34,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Aetna,Middlesex Employees,,,15.67,,15.67,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Anthem,Commerical,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Anthem,Indemnity,,,15.87,,15.87,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Anthem,Individual Exchange,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Anthem,State Preferred,,,,,,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Cigna,Cigna,,0.57,,,0.57,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Connecticare,Commerical,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Connecticare,Exchange,,0.71,,,0.71,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,Multiplan,Multiplan,,,18,,18,0.57,18,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-04,NDC,both,1,mL,21.18,12.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,18,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Aetna,Commerical,,,3.94,,3.94,0.57,4.34,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Aetna,Middlesex Employees,,,3.77,,3.77,0.57,4.34,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Anthem,Commerical,,,,,,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Anthem,Indemnity,,,3.82,,3.82,0.57,4.34,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Anthem,Individual Exchange,,,,,,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Anthem,State Preferred,,,,,,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Cigna,Cigna,,0.57,,,0.57,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Connecticare,Commerical,,0.71,,,0.71,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Connecticare,Exchange,,0.71,,,0.71,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,Multiplan,Multiplan,,,4.34,,4.34,0.57,4.34,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-064-10,NDC,both,1,mL,5.1,3.06,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,4.34,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Aetna,Commerical,,,32.68,,32.68,0.57,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Aetna,Middlesex Employees,,,31.34,,31.34,0.57,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Anthem,Commerical,,,,,,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Anthem,Indemnity,,,31.73,,31.73,0.57,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Anthem,Individual Exchange,,,,,,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Anthem,State Preferred,,,,,,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Cigna,Cigna,,0.57,,,0.57,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Connecticare,Commerical,,0.71,,,0.71,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Connecticare,Exchange,,0.71,,,0.71,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,Multiplan,Multiplan,,,36.01,,36.01,0.57,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,J3475,HCPCS,63323-642-01,NDC,both,1,mL,42.36,25.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Aetna,Commerical,,,32.68,,32.68,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Aetna,Middlesex Employees,,,31.34,,31.34,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Anthem,Commerical,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Anthem,Indemnity,,,31.73,,31.73,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Anthem,Individual Exchange,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Anthem,State Preferred,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Cigna,Cigna,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Connecticare,Commerical,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Connecticare,Exchange,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,Multiplan,Multiplan,,,36.01,,36.01,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-17,NDC,both,1,mL,42.36,25.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Aetna,Commerical,,,32.68,,32.68,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Aetna,Middlesex Employees,,,31.34,,31.34,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Anthem,Commerical,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Anthem,Indemnity,,,31.73,,31.73,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Anthem,Individual Exchange,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Anthem,State Preferred,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Cigna,Cigna,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Connecticare,Commerical,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Connecticare,Exchange,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,Multiplan,Multiplan,,,36.01,,36.01,31.34,36.01,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,0409-2168-77,NDC,both,1,mL,42.36,25.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.34,36.01,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Aetna,Commerical,,,3.27,,3.27,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Aetna,Middlesex Employees,,,3.14,,3.14,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Commerical,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Indemnity,,,3.18,,3.18,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,Individual Exchange,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Anthem,State Preferred,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Cigna,Cigna,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Connecticare,Commerical,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Connecticare,Exchange,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,Multiplan,Multiplan,,,3.6,,3.6,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-02,NDC,both,1,mL,4.24,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Aetna,Commerical,,,3.27,,3.27,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Aetna,Middlesex Employees,,,3.14,,3.14,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Anthem,Commerical,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Anthem,Indemnity,,,3.18,,3.18,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Anthem,Individual Exchange,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Anthem,State Preferred,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Cigna,Cigna,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Connecticare,Commerical,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Connecticare,Exchange,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,Multiplan,Multiplan,,,3.6,,3.6,3.14,3.6,percent of total billed charges,,
MAGNESIUM SULFATE 500 MG/ML ORAL SOLN,J3490,HCPCS,63323-064-23,NDC,both,1,mL,4.24,2.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.14,3.6,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Aetna,Commerical,,,84.05,,84.05,80.6,92.59,percent of total billed charges,,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Aetna,Middlesex Employees,,,80.6,,80.6,80.6,92.59,percent of total billed charges,,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Anthem,Commerical,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Anthem,Indemnity,,,81.6,,81.6,80.6,92.59,percent of total billed charges,,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Anthem,Individual Exchange,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Anthem,State Preferred,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Cigna,Cigna,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Connecticare,Commerical,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Connecticare,Exchange,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,Multiplan,Multiplan,,,92.59,,92.59,80.6,92.59,percent of total billed charges,,
MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4091-01,NDC,both,10,mL,108.93,65.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.6,92.59,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Commerical,,,169.93,,169.93,162.95,187.2,percent of total billed charges,,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Middlesex Employees,,,162.95,,162.95,162.95,187.2,percent of total billed charges,,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Indemnity,,,164.97,,164.97,162.95,187.2,percent of total billed charges,,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Individual Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,State Preferred,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Cigna,Cigna,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Multiplan,Multiplan,,,187.2,,187.2,162.95,187.2,percent of total billed charges,,
MANNITOL 20 % INTRAVENOUS SOLUTION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Aetna,Commerical,,,81.57,,81.57,78.21,89.85,percent of total billed charges,,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Aetna,Middlesex Employees,,,78.21,,78.21,78.21,89.85,percent of total billed charges,,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Anthem,Commerical,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Anthem,Indemnity,,,79.19,,79.19,78.21,89.85,percent of total billed charges,,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Anthem,Individual Exchange,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Anthem,State Preferred,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Cigna,Cigna,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Connecticare,Commerical,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Connecticare,Exchange,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,Multiplan,Multiplan,,,89.85,,89.85,78.21,89.85,percent of total billed charges,,
MANNITOL 20 % TOPICAL FOR TONGUE SWELLING,J3490,HCPCS,40810-208-54,NDC,both,1,mL,105.71,63.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,78.21,89.85,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Commerical,,,169.93,,169.93,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Middlesex Employees,,,162.95,,162.95,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Indemnity,,,164.97,,164.97,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Individual Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,State Preferred,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Cigna,Cigna,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Multiplan,Multiplan,,,187.2,,187.2,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR ACUTE HERNIATION,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Commerical,,,169.93,,169.93,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Aetna,Middlesex Employees,,,162.95,,162.95,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Indemnity,,,164.97,,164.97,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,Individual Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Anthem,State Preferred,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Cigna,Cigna,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Commerical,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Connecticare,Exchange,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,Multiplan,Multiplan,,,187.2,,187.2,162.95,187.2,percent of total billed charges,,
MANNITOL 20% IV BOLUS FOR INCREASED ICP,J3490,HCPCS,0338-0357-03,NDC,both,500,mL,220.23,132.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,162.95,187.2,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Aetna,Commerical,,,250.51,,250.51,112.96,275.96,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Aetna,Middlesex Employees,,,240.22,,240.22,112.96,275.96,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Anthem,Commerical,,141.2,,,141.2,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Anthem,Indemnity,,,243.2,,243.2,112.96,275.96,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Anthem,Individual Exchange,,112.96,,,112.96,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Anthem,State Preferred,,141.2,,,141.2,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Cigna,Cigna,,,,,,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Connecticare,Commerical,,,,,,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Connecticare,Exchange,,,,,,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,Multiplan,Multiplan,,,275.96,,275.96,112.96,275.96,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-00,NDC,both,1,ea,324.66,194.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.96,275.96,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Aetna,Commerical,,,170.41,,170.41,112.96,187.72,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Aetna,Middlesex Employees,,,163.41,,163.41,112.96,187.72,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Anthem,Commerical,,141.2,,,141.2,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Anthem,Indemnity,,,165.44,,165.44,112.96,187.72,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Anthem,Individual Exchange,,112.96,,,112.96,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Anthem,State Preferred,,141.2,,,141.2,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Cigna,Cigna,,,,,,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Connecticare,Commerical,,,,,,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Connecticare,Exchange,,,,,,112.96,187.72,Other,Could be inpatient or outpatient,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,Multiplan,Multiplan,,,187.72,,187.72,112.96,187.72,percent of total billed charges,,
"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",90707,HCPCS,0006-4681-01,NDC,both,1,ea,220.85,132.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.96,187.72,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Aetna,Commerical,,,1.26,,1.26,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Anthem,Indemnity,,,1.22,,1.22,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0536-1297-01,NDC,both,1,ea,1.63,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Aetna,Commerical,,,1.26,,1.26,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Anthem,Indemnity,,,1.22,,1.22,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,0904-6516-61,NDC,both,1,ea,1.63,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
MECLIZINE 12.5 MG TABLET,J3490,HCPCS,65162-441-11,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Aetna,Commerical,,,1.37,,1.37,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Aetna,Middlesex Employees,,,1.31,,1.31,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Anthem,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Anthem,Indemnity,,,1.33,,1.33,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Anthem,Individual Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Anthem,State Preferred,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Cigna,Cigna,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Connecticare,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Connecticare,Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,Multiplan,Multiplan,,,1.5,,1.5,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,0904-6517-61,NDC,both,1,ea,1.77,1.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Aetna,Commerical,,,1.37,,1.37,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Aetna,Middlesex Employees,,,1.31,,1.31,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Anthem,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Anthem,Indemnity,,,1.33,,1.33,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Anthem,Individual Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Anthem,State Preferred,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Cigna,Cigna,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Connecticare,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Connecticare,Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,Multiplan,Multiplan,,,1.5,,1.5,1.31,1.5,percent of total billed charges,,
MECLIZINE 25 MG TABLET,J3490,HCPCS,53746-442-01,NDC,both,1,ea,1.77,1.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Aetna,Commerical,,,1.33,,1.33,1.28,1.47,percent of total billed charges,,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Aetna,Middlesex Employees,,,1.28,,1.28,1.28,1.47,percent of total billed charges,,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Anthem,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Anthem,Indemnity,,,1.3,,1.3,1.28,1.47,percent of total billed charges,,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Anthem,Individual Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Anthem,State Preferred,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Cigna,Cigna,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Connecticare,Commerical,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Connecticare,Exchange,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,Multiplan,Multiplan,,,1.47,,1.47,1.28,1.47,percent of total billed charges,,
MECLIZINE 6.25 MG TABLET,J3490,HCPCS,40810-0013-63,NDC,both,1,ea,1.73,1.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.28,1.47,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.75,0.87,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.87,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Anthem,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.87,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Cigna,Cigna,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Connecticare,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Connecticare,Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.75,0.87,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-02,NDC,both,1,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
MEDROXYPROGESTERONE 10 MG TABLET,J3490,HCPCS,0555-0779-04,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Aetna,Commerical,,,149.71,,149.71,0.64,164.93,percent of total billed charges,,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Aetna,Middlesex Employees,,,143.56,,143.56,0.64,164.93,percent of total billed charges,,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Anthem,Commerical,,,,,,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Anthem,Indemnity,,,145.35,,145.35,0.64,164.93,percent of total billed charges,,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Anthem,Individual Exchange,,,,,,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Anthem,State Preferred,,,,,,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Cigna,Cigna,,0.64,,,0.64,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Connecticare,Commerical,,0.87,,,0.87,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Connecticare,Exchange,,0.87,,,0.87,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,Multiplan,Multiplan,,,164.93,,164.93,0.64,164.93,percent of total billed charges,,
MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,J1050,HCPCS,0009-4709-13,NDC,both,0.65,mL,194.03,116.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,164.93,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Aetna,Commerical,,,128.12,,128.12,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Aetna,Middlesex Employees,,,122.86,,122.86,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Commerical,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Indemnity,,,124.39,,124.39,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Individual Exchange,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Anthem,State Preferred,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Cigna,Cigna,,0.64,,,0.64,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Connecticare,Commerical,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Connecticare,Exchange,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,Multiplan,Multiplan,,,141.14,,141.14,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-00,NDC,both,0.007,mL,166.05,99.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Aetna,Commerical,,,128.12,,128.12,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Aetna,Middlesex Employees,,,122.86,,122.86,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Anthem,Commerical,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Anthem,Indemnity,,,124.39,,124.39,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Anthem,Individual Exchange,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Anthem,State Preferred,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Cigna,Cigna,,0.64,,,0.64,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Connecticare,Commerical,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Connecticare,Exchange,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,Multiplan,Multiplan,,,141.14,,141.14,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0548-5400-25,NDC,both,0.007,mL,166.05,99.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Aetna,Commerical,,,127.99,,127.99,0.64,141,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Aetna,Middlesex Employees,,,122.73,,122.73,0.64,141,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Anthem,Commerical,,,,,,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Anthem,Indemnity,,,124.26,,124.26,0.64,141,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Anthem,Individual Exchange,,,,,,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Anthem,State Preferred,,,,,,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Cigna,Cigna,,0.64,,,0.64,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Connecticare,Commerical,,0.87,,,0.87,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Connecticare,Exchange,,0.87,,,0.87,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,Multiplan,Multiplan,,,141,,141,0.64,141,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,0703-6801-01,NDC,both,0.005,mL,165.88,99.53,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,141,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Aetna,Commerical,,,128.12,,128.12,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Aetna,Middlesex Employees,,,122.86,,122.86,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Commerical,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Indemnity,,,124.39,,124.39,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Anthem,Individual Exchange,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Anthem,State Preferred,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Cigna,Cigna,,0.64,,,0.64,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Connecticare,Commerical,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Connecticare,Exchange,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,Multiplan,Multiplan,,,141.14,,141.14,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-00,NDC,both,0.007,mL,166.05,99.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Aetna,Commerical,,,128.12,,128.12,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Aetna,Middlesex Employees,,,122.86,,122.86,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Anthem,Commerical,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Anthem,Indemnity,,,124.39,,124.39,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Anthem,Individual Exchange,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Anthem,State Preferred,,,,,,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Cigna,Cigna,,0.64,,,0.64,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Connecticare,Commerical,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Connecticare,Exchange,,0.87,,,0.87,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,Multiplan,Multiplan,,,141.14,,141.14,0.64,141.14,percent of total billed charges,,
MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,J1050,HCPCS,67457-887-99,NDC,both,0.007,mL,166.05,99.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.65,,,0.65,0.64,141.14,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
MEDROXYPROGESTERONE 2.5 MG TABLET,J3490,HCPCS,40810-0001-91,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
MEDROXYPROGESTERONE 5 MG TABLET,J8499,HCPCS,0555-0873-02,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
MEGESTROL 20 MG ORAL TAB,J8999,HCPCS,40810-0001-93,NDC,both,2,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Aetna,Commerical,,,2.07,,2.07,1.98,2.28,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Aetna,Middlesex Employees,,,1.98,,1.98,1.98,2.28,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Anthem,Commerical,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Anthem,Indemnity,,,2.01,,2.01,1.98,2.28,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Anthem,Individual Exchange,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Anthem,State Preferred,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Cigna,Cigna,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Connecticare,Commerical,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Connecticare,Exchange,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,Multiplan,Multiplan,,,2.28,,2.28,1.98,2.28,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0555-0607-02,NDC,both,1,ea,2.68,1.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.98,2.28,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-3571-61,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,0904-7236-61,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Aetna,Commerical,,,0.87,,0.87,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Anthem,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Anthem,Individual Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Anthem,State Preferred,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Cigna,Cigna,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Connecticare,Commerical,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Connecticare,Exchange,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,Multiplan,Multiplan,,,0.96,,0.96,0.84,0.96,percent of total billed charges,,
MEGESTROL 40 MG TABLET,J8999,HCPCS,49884-290-01,NDC,both,1,ea,1.13,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.96,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Aetna,Commerical,,,149.66,,149.66,143.51,164.87,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Aetna,Middlesex Employees,,,143.51,,143.51,143.51,164.87,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Anthem,Commerical,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Anthem,Indemnity,,,145.3,,145.3,143.51,164.87,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Anthem,Individual Exchange,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Anthem,State Preferred,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Cigna,Cigna,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Connecticare,Commerical,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Connecticare,Exchange,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,Multiplan,Multiplan,,,164.87,,164.87,143.51,164.87,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,49884-907-38,NDC,both,1,mL,193.96,116.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.51,164.87,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,50383-859-24,NDC,both,1,mL,137.88,82.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,60432-126-08,NDC,both,1,mL,137.88,82.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Aetna,Commerical,,,106.39,,106.39,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Aetna,Middlesex Employees,,,102.02,,102.02,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Anthem,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Anthem,Indemnity,,,103.29,,103.29,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Anthem,Individual Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Anthem,State Preferred,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Cigna,Cigna,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Connecticare,Commerical,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Connecticare,Exchange,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,Multiplan,Multiplan,,,117.2,,117.2,102.02,117.2,percent of total billed charges,,
MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,J8999,HCPCS,64380-160-01,NDC,both,1,mL,137.88,82.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,102.02,117.2,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MELATONIN 0.5 MG TABLET,J3490,HCPCS,40810-0013-64,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,03504-6003-91,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,04746-9004-66,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MELATONIN 1 MG TABLET,J3490,HCPCS,40810-0010-08,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Aetna,Commerical,,,15.52,,15.52,14.89,17.1,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Aetna,Middlesex Employees,,,14.89,,14.89,14.89,17.1,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Anthem,Commerical,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Anthem,Indemnity,,,15.07,,15.07,14.89,17.1,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Anthem,Individual Exchange,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Anthem,State Preferred,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Cigna,Cigna,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Connecticare,Commerical,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Connecticare,Exchange,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,Multiplan,Multiplan,,,17.1,,17.1,14.89,17.1,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,3076816836,NDC,both,1,mL,20.12,12.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.89,17.1,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Aetna,Commerical,,,9.49,,9.49,9.1,10.46,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Aetna,Middlesex Employees,,,9.1,,9.1,9.1,10.46,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Anthem,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Anthem,Indemnity,,,9.21,,9.21,9.1,10.46,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Anthem,Individual Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Anthem,State Preferred,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Cigna,Cigna,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Connecticare,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Connecticare,Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,Multiplan,Multiplan,,,10.46,,10.46,9.1,10.46,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,5843800571,NDC,both,1,mL,12.3,7.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Aetna,Commerical,,,18.97,,18.97,18.19,20.9,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Aetna,Middlesex Employees,,,18.19,,18.19,18.19,20.9,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Anthem,Commerical,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Anthem,Indemnity,,,18.42,,18.42,18.19,20.9,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Anthem,Individual Exchange,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Anthem,State Preferred,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Cigna,Cigna,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Connecticare,Commerical,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Connecticare,Exchange,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,Multiplan,Multiplan,,,20.9,,20.9,18.19,20.9,percent of total billed charges,,
MELATONIN 1 MG/ML ORAL LIQUID,J3490,HCPCS,10013-0910-97,NDC,both,1,mL,24.59,14.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.19,20.9,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MELATONIN 10 MG TABLET,J3490,HCPCS,9629513917,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,1000670031,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503600,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,2055503601,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,3160402741,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852411,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Aetna,Commerical,,,0.74,,0.74,0.71,0.82,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Aetna,Middlesex Employees,,,0.71,,0.71,0.71,0.82,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Anthem,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Anthem,Indemnity,,,0.72,,0.72,0.71,0.82,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Anthem,Individual Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Anthem,State Preferred,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Cigna,Cigna,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Connecticare,Commerical,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Connecticare,Exchange,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.71,0.82,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,5026852415,NDC,both,1,ea,0.96,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.71,0.82,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,7733351610,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELATONIN 3 MG TABLET,J3490,HCPCS,40810-0009-23,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,2055503901,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3076815745,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,3160402743,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,5026853315,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352010,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,7733352025,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Aetna,Commerical,,,0.52,,0.52,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Anthem,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Anthem,Indemnity,,,0.51,,0.51,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Anthem,Individual Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Anthem,State Preferred,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Cigna,Cigna,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Connecticare,Commerical,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Connecticare,Exchange,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,Multiplan,Multiplan,,,0.58,,0.58,0.5,0.58,percent of total billed charges,,
MELATONIN 5 MG TABLET,J3490,HCPCS,40810-0014-05,NDC,both,1,ea,0.68,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.58,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
MELATONIN 5 MG-PYRIDOXINE (VITAMIN B6) 1 MG TABLET,J3490,HCPCS,1184511145,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (B6) 0.5-5 MG ORAL TAB,J3490,HCPCS,40810-0004-05,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
MELATONIN-PYRIDOXINE HCL (VITAMIN B6) 1 MG-10 MG TABLET,J3490,HCPCS,4746900466,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MELOXICAM 15 MG TABLET,J3490,HCPCS,50268-526-15,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,40810-0209-47,NDC,both,2,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
MELOXICAM 3.75 MG SPLIT TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
MELOXICAM 7.5 MG TABLET,J3490,HCPCS,69097-158-07,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Aetna,Commerical,,,25.18,,25.18,13.17,27.74,percent of total billed charges,,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Aetna,Middlesex Employees,,,24.14,,24.14,13.17,27.74,percent of total billed charges,,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Anthem,Commerical,,,,,,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Anthem,Indemnity,,,24.44,,24.44,13.17,27.74,percent of total billed charges,,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Anthem,Individual Exchange,,,,,,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Anthem,State Preferred,,,,,,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Cigna,Cigna,,13.17,,,13.17,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Connecticare,Commerical,,18.32,,,18.32,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Connecticare,Exchange,,18.32,,,18.32,13.17,27.74,Other,Could be inpatient or outpatient,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,Multiplan,Multiplan,,,27.74,,27.74,13.17,27.74,percent of total billed charges,,
MELPHALAN 2 MG TABLET,J8600,HCPCS,52609-0001-5,NDC,both,1,ea,32.63,19.58,United Healthcare/Oxford,United Healthcare/Oxford,,15.74,,,15.74,13.17,27.74,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Aetna,Commerical,,,56.2,,56.2,53.89,240.21,percent of total billed charges,,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Aetna,Middlesex Employees,,,53.89,,53.89,53.89,240.21,percent of total billed charges,,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Anthem,Commerical,,240.21,,,240.21,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Anthem,Indemnity,,,54.56,,54.56,53.89,240.21,percent of total billed charges,,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Anthem,Individual Exchange,,192.17,,,192.17,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Anthem,State Preferred,,240.21,,,240.21,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Cigna,Cigna,,,,,,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Connecticare,Commerical,,,,,,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Connecticare,Exchange,,,,,,53.89,240.21,Other,Could be inpatient or outpatient,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,Multiplan,Multiplan,,,61.91,,61.91,53.89,240.21,percent of total billed charges,,
"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION",90734,HCPCS,49281-589-05,NDC,both,0.5,mL,72.84,43.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.89,240.21,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Aetna,Commerical,,,313.19,,313.19,192.17,345.02,percent of total billed charges,,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Aetna,Middlesex Employees,,,300.33,,300.33,192.17,345.02,percent of total billed charges,,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Anthem,Commerical,,240.21,,,240.21,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Anthem,Indemnity,,,304.06,,304.06,192.17,345.02,percent of total billed charges,,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Anthem,Individual Exchange,,192.17,,,192.17,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Anthem,State Preferred,,240.21,,,240.21,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Cigna,Cigna,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Connecticare,Commerical,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Connecticare,Exchange,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,Multiplan,Multiplan,,,345.02,,345.02,192.17,345.02,percent of total billed charges,,
MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION,90734,HCPCS,58160-958-01,NDC,both,1,ea,405.9,243.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Aetna,Commerical,,,498.33,,498.33,273.26,548.96,percent of total billed charges,,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Aetna,Middlesex Employees,,,477.86,,477.86,273.26,548.96,percent of total billed charges,,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Anthem,Commerical,,341.58,,,341.58,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Anthem,Indemnity,,,483.8,,483.8,273.26,548.96,percent of total billed charges,,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Anthem,Individual Exchange,,273.26,,,273.26,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Anthem,State Preferred,,341.58,,,341.58,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Cigna,Cigna,,,,,,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Connecticare,Commerical,,,,,,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Connecticare,Exchange,,,,,,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,Multiplan,Multiplan,,,548.96,,548.96,273.26,548.96,percent of total billed charges,,
"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",90620,HCPCS,58160-976-02,NDC,both,0.5,mL,645.84,387.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,273.26,548.96,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Aetna,Commerical,,,313.19,,313.19,192.17,345.02,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Aetna,Middlesex Employees,,,300.33,,300.33,192.17,345.02,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Anthem,Commerical,,240.21,,,240.21,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Anthem,Indemnity,,,304.06,,304.06,192.17,345.02,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Anthem,Individual Exchange,,192.17,,,192.17,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Anthem,State Preferred,,240.21,,,240.21,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Cigna,Cigna,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Connecticare,Commerical,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Connecticare,Exchange,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,Multiplan,Multiplan,,,345.02,,345.02,192.17,345.02,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION",90734,HCPCS,58160-827-03,NDC,both,0.5,mL,405.9,243.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,192.17,345.02,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Aetna,Commerical,,,421.09,,421.09,203.93,463.87,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Aetna,Middlesex Employees,,,403.79,,403.79,203.93,463.87,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Anthem,Commerical,,254.91,,,254.91,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Anthem,Indemnity,,,408.81,,408.81,203.93,463.87,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Anthem,Individual Exchange,,203.93,,,203.93,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Anthem,State Preferred,,254.91,,,254.91,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Cigna,Cigna,,,,,,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Connecticare,Commerical,,,,,,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Connecticare,Exchange,,,,,,203.93,463.87,Other,Could be inpatient or outpatient,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,Multiplan,Multiplan,,,463.87,,463.87,203.93,463.87,percent of total billed charges,,
"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",90619,HCPCS,49281-590-05,NDC,both,0.5,mL,545.73,327.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,203.93,463.87,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Aetna,Commerical,,,6.09,,6.09,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Aetna,Middlesex Employees,,,5.84,,5.84,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Anthem,Commerical,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Anthem,Indemnity,,,5.91,,5.91,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Anthem,Individual Exchange,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Anthem,State Preferred,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Cigna,Cigna,,6.8,,,6.8,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Connecticare,Commerical,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Connecticare,Exchange,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,Multiplan,Multiplan,,,6.71,,6.71,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0409-1253-01,NDC,both,1,mL,7.89,4.73,United Healthcare/Oxford,United Healthcare/Oxford,,7.34,,,7.34,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Aetna,Commerical,,,6.09,,6.09,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Aetna,Middlesex Employees,,,5.84,,5.84,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Anthem,Commerical,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Anthem,Indemnity,,,5.91,,5.91,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Anthem,Individual Exchange,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Anthem,State Preferred,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Cigna,Cigna,,6.8,,,6.8,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Connecticare,Commerical,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Connecticare,Exchange,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,Multiplan,Multiplan,,,6.71,,6.71,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-01,NDC,both,1,mL,7.89,4.73,United Healthcare/Oxford,United Healthcare/Oxford,,7.34,,,7.34,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Aetna,Commerical,,,6.09,,6.09,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Aetna,Middlesex Employees,,,5.84,,5.84,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Anthem,Commerical,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Anthem,Indemnity,,,5.91,,5.91,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Anthem,Individual Exchange,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Anthem,State Preferred,,,,,,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Cigna,Cigna,,6.8,,,6.8,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Connecticare,Commerical,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Connecticare,Exchange,,9.95,,,9.95,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,Multiplan,Multiplan,,,6.71,,6.71,5.84,9.95,percent of total billed charges,,
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,J2175,HCPCS,0641-6053-25,NDC,both,1,mL,7.89,4.73,United Healthcare/Oxford,United Healthcare/Oxford,,7.34,,,7.34,5.84,9.95,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Aetna,Commerical,,,106.07,,106.07,101.71,116.85,percent of total billed charges,,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Aetna,Middlesex Employees,,,101.71,,101.71,101.71,116.85,percent of total billed charges,,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Anthem,Commerical,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Anthem,Indemnity,,,102.98,,102.98,101.71,116.85,percent of total billed charges,,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Anthem,Individual Exchange,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Anthem,State Preferred,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Cigna,Cigna,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Connecticare,Commerical,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Connecticare,Exchange,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,Multiplan,Multiplan,,,116.85,,116.85,101.71,116.85,percent of total billed charges,,
MEPERIDINE 50 MG TABLET,J3490,HCPCS,42806-050-30,NDC,both,1,ea,137.47,82.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,101.71,116.85,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Aetna,Commerical,,,236.42,,236.42,226.71,260.44,percent of total billed charges,,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Aetna,Middlesex Employees,,,226.71,,226.71,226.71,260.44,percent of total billed charges,,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Anthem,Commerical,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Anthem,Indemnity,,,229.52,,229.52,226.71,260.44,percent of total billed charges,,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Anthem,Individual Exchange,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Anthem,State Preferred,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Cigna,Cigna,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Connecticare,Commerical,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Connecticare,Exchange,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,Multiplan,Multiplan,,,260.44,,260.44,226.71,260.44,percent of total billed charges,,
MEPERIDINE 50 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3545-63,NDC,both,1,mL,306.4,183.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,226.71,260.44,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 12.5 MG TABLET CHEMO,J8999,HCPCS,40810-0001-94,NDC,both,1,ea,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Aetna,Commerical,,,4234.55,,4234.55,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Aetna,Middlesex Employees,,,4060.58,,4060.58,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Commerical,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Indemnity,,,4111.07,,4111.07,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Individual Exchange,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,State Preferred,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Cigna,Cigna,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Connecticare,Commerical,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Connecticare,Exchange,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Multiplan,Multiplan,,,4664.81,,4664.81,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Aetna,Commerical,,,4234.55,,4234.55,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Aetna,Middlesex Employees,,,4060.58,,4060.58,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Commerical,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Indemnity,,,4111.07,,4111.07,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,Individual Exchange,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Anthem,State Preferred,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Cigna,Cigna,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Connecticare,Commerical,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Connecticare,Exchange,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,Multiplan,Multiplan,,,4664.81,,4664.81,4060.58,4664.81,percent of total billed charges,,
MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,62484-0020-2,NDC,both,1,mL,5488.01,3292.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4060.58,4664.81,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
MERCAPTOPURINE 25 MG ORAL TABLET CHEMO,J8999,HCPCS,40810-0001-95,NDC,both,1,ea,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Anthem,State Preferred,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Cigna,Cigna,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Commerical,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Connecticare,Exchange,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,2.73,percent of total billed charges,,
MERCAPTOPURINE 50 MG TABLET BEACON,J8999,HCPCS,0054-4581-11,NDC,both,1,ea,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.38,2.73,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Commerical,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Individual Exchange,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Anthem,State Preferred,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Cigna,Cigna,,0.36,,,0.36,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Connecticare,Commerical,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Connecticare,Exchange,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0409-1391-21,NDC,both,0.1,ea,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Anthem,Commerical,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Anthem,Individual Exchange,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Anthem,State Preferred,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Cigna,Cigna,,0.36,,,0.36,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Connecticare,Commerical,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Connecticare,Exchange,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,0781-3098-96,NDC,both,0.1,ea,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Commerical,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Anthem,Individual Exchange,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Anthem,State Preferred,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Cigna,Cigna,,0.36,,,0.36,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Connecticare,Commerical,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Connecticare,Exchange,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-21,NDC,both,0.1,ea,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Aetna,Commerical,,,30.71,,30.71,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Aetna,Middlesex Employees,,,29.45,,29.45,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Anthem,Commerical,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Anthem,Indemnity,,,29.81,,29.81,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Anthem,Individual Exchange,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Anthem,State Preferred,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Cigna,Cigna,,0.36,,,0.36,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Connecticare,Commerical,,0.54,,,0.54,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Connecticare,Exchange,,0.54,,,0.54,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,Multiplan,Multiplan,,,33.83,,33.83,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-30,NDC,both,0.1,ea,39.8,23.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Aetna,Commerical,,,30.71,,30.71,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Aetna,Middlesex Employees,,,29.45,,29.45,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Anthem,Commerical,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Anthem,Indemnity,,,29.81,,29.81,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Anthem,Individual Exchange,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Anthem,State Preferred,,,,,,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Cigna,Cigna,,0.36,,,0.36,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Connecticare,Commerical,,0.54,,,0.54,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Connecticare,Exchange,,0.54,,,0.54,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,Multiplan,Multiplan,,,33.83,,33.83,0.36,33.83,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,63323-508-31,NDC,both,0.1,ea,39.8,23.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,33.83,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Anthem,Commerical,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Anthem,Individual Exchange,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Anthem,State Preferred,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Cigna,Cigna,,0.36,,,0.36,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Connecticare,Commerical,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Connecticare,Exchange,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-1,NDC,both,0.1,ea,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Aetna,Commerical,,,12.8,,12.8,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Aetna,Middlesex Employees,,,12.27,,12.27,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Anthem,Commerical,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Anthem,Indemnity,,,12.43,,12.43,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Anthem,Individual Exchange,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Anthem,State Preferred,,,,,,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Cigna,Cigna,,0.36,,,0.36,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Connecticare,Commerical,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Connecticare,Exchange,,0.54,,,0.54,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,Multiplan,Multiplan,,,14.1,,14.1,0.36,14.1,percent of total billed charges,,
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,J2185,HCPCS,70121-1453-7,NDC,both,0.1,ea,16.59,9.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,14.1,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Aetna,Commerical,,,214.85,,214.85,0.36,236.68,percent of total billed charges,,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Aetna,Middlesex Employees,,,206.03,,206.03,0.36,236.68,percent of total billed charges,,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Anthem,Commerical,,,,,,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Anthem,Indemnity,,,208.59,,208.59,0.36,236.68,percent of total billed charges,,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Anthem,Individual Exchange,,,,,,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Anthem,State Preferred,,,,,,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Cigna,Cigna,,0.36,,,0.36,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Connecticare,Commerical,,0.54,,,0.54,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Connecticare,Exchange,,0.54,,,0.54,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,Multiplan,Multiplan,,,236.68,,236.68,0.36,236.68,percent of total billed charges,,
MEROPENEM 1 MG/ML DILUTION FOR DESENSITIZATION,J2185,HCPCS,40810-0208-36,NDC,both,100,mL,278.45,167.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,236.68,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Aetna,Commerical,,,72.06,,72.06,0.36,79.38,percent of total billed charges,,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Aetna,Middlesex Employees,,,69.1,,69.1,0.36,79.38,percent of total billed charges,,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Anthem,Commerical,,,,,,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Anthem,Indemnity,,,69.96,,69.96,0.36,79.38,percent of total billed charges,,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Anthem,Individual Exchange,,,,,,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Anthem,State Preferred,,,,,,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Cigna,Cigna,,0.36,,,0.36,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Connecticare,Commerical,,0.54,,,0.54,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Connecticare,Exchange,,0.54,,,0.54,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,Multiplan,Multiplan,,,79.38,,79.38,0.36,79.38,percent of total billed charges,,
MEROPENEM 10 MG/ML IN NS NICU,J2185,HCPCS,40810-0004-63,NDC,both,10,mL,93.39,56.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,79.38,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Aetna,Commerical,,,4.61,,4.61,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Aetna,Middlesex Employees,,,4.42,,4.42,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Anthem,Commerical,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Anthem,Indemnity,,,4.48,,4.48,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Anthem,Individual Exchange,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Anthem,State Preferred,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Cigna,Cigna,,0.36,,,0.36,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Connecticare,Commerical,,0.54,,,0.54,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Connecticare,Exchange,,0.54,,,0.54,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,Multiplan,Multiplan,,,5.08,,5.08,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-01,NDC,both,0.2,ea,5.98,3.59,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Aetna,Commerical,,,4.61,,4.61,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Aetna,Middlesex Employees,,,4.42,,4.42,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Anthem,Commerical,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Anthem,Indemnity,,,4.48,,4.48,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Anthem,Individual Exchange,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Anthem,State Preferred,,,,,,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Cigna,Cigna,,0.36,,,0.36,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Connecticare,Commerical,,0.54,,,0.54,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Connecticare,Exchange,,0.54,,,0.54,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,Multiplan,Multiplan,,,5.08,,5.08,0.36,5.08,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-19,NDC,both,0.2,ea,5.98,3.59,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,5.08,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Aetna,Commerical,,,2.28,,2.28,0.36,2.51,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Aetna,Middlesex Employees,,,2.18,,2.18,0.36,2.51,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Anthem,Commerical,,,,,,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Anthem,Indemnity,,,2.21,,2.21,0.36,2.51,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Anthem,Individual Exchange,,,,,,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Anthem,State Preferred,,,,,,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Cigna,Cigna,,0.36,,,0.36,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Connecticare,Commerical,,0.54,,,0.54,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Connecticare,Exchange,,0.54,,,0.54,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,Multiplan,Multiplan,,,2.51,,2.51,0.36,2.51,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2185,HCPCS,63323-507-20,NDC,both,0.2,ea,2.95,1.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.39,,,0.39,0.36,2.51,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Aetna,Commerical,,,13.37,,13.37,12.82,14.73,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Aetna,Middlesex Employees,,,12.82,,12.82,12.82,14.73,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Anthem,Commerical,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Anthem,Indemnity,,,12.98,,12.98,12.82,14.73,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Anthem,Individual Exchange,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Anthem,State Preferred,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Cigna,Cigna,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Connecticare,Commerical,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Connecticare,Exchange,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,Multiplan,Multiplan,,,14.73,,14.73,12.82,14.73,percent of total billed charges,,
MEROPENEM 500 MG INTRAVENOUS SOLUTION,J2815,HCPCS,63323-507-21,NDC,both,0.2,ea,17.33,10.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.82,14.73,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,58914-501-56,NDC,both,1,ea,11.88,7.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Aetna,Commerical,,,9.17,,9.17,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Aetna,Middlesex Employees,,,8.79,,8.79,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Anthem,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Anthem,Indemnity,,,8.9,,8.9,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Anthem,Individual Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Anthem,State Preferred,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Cigna,Cigna,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Connecticare,Commerical,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Connecticare,Exchange,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,Multiplan,Multiplan,,,10.1,,10.1,8.79,10.1,percent of total billed charges,,
"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",J3490,HCPCS,64980-282-03,NDC,both,1,ea,11.88,7.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.79,10.1,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Aetna,Commerical,,,26.63,,26.63,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Aetna,Middlesex Employees,,,25.53,,25.53,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Anthem,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Anthem,Indemnity,,,25.85,,25.85,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Anthem,Individual Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Anthem,State Preferred,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Cigna,Cigna,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Connecticare,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Connecticare,Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,Multiplan,Multiplan,,,29.33,,29.33,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0015-52,NDC,both,1,ea,34.51,20.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Aetna,Commerical,,,26.63,,26.63,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Aetna,Middlesex Employees,,,25.53,,25.53,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Anthem,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Anthem,Indemnity,,,25.85,,25.85,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Anthem,Individual Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Anthem,State Preferred,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Cigna,Cigna,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Connecticare,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Connecticare,Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,Multiplan,Multiplan,,,29.33,,29.33,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,54092-476-12,NDC,both,1,ea,34.51,20.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Aetna,Commerical,,,26.63,,26.63,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Aetna,Middlesex Employees,,,25.53,,25.53,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Anthem,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Anthem,Indemnity,,,25.85,,25.85,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Anthem,Individual Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Anthem,State Preferred,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Cigna,Cigna,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Connecticare,Commerical,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Connecticare,Exchange,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,Multiplan,Multiplan,,,29.33,,29.33,25.53,29.33,percent of total billed charges,,
"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",J3490,HCPCS,68382-711-19,NDC,both,1,ea,34.51,20.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.53,29.33,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Aetna,Commerical,,,21.64,,21.64,20.75,23.83,percent of total billed charges,,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Aetna,Middlesex Employees,,,20.75,,20.75,20.75,23.83,percent of total billed charges,,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Anthem,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Anthem,Indemnity,,,21,,21,20.75,23.83,percent of total billed charges,,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Anthem,Individual Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Anthem,State Preferred,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Cigna,Cigna,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Connecticare,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Connecticare,Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,Multiplan,Multiplan,,,23.83,,23.83,20.75,23.83,percent of total billed charges,,
MESALAMINE 4 GRAM/60 ML ENEMA,J3490,HCPCS,45802-098-51,NDC,both,60,mL,28.04,16.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Aetna,Commerical,,,4.65,,4.65,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Aetna,Middlesex Employees,,,4.46,,4.46,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Anthem,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Anthem,Indemnity,,,4.52,,4.52,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Anthem,Individual Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Anthem,State Preferred,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Cigna,Cigna,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Connecticare,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Connecticare,Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,Multiplan,Multiplan,,,5.13,,5.13,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0023-5853-18,NDC,both,1,ea,6.03,3.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Aetna,Commerical,,,4.65,,4.65,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Aetna,Middlesex Employees,,,4.46,,4.46,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Anthem,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Anthem,Indemnity,,,4.52,,4.52,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Anthem,Individual Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Anthem,State Preferred,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Cigna,Cigna,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Connecticare,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Connecticare,Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,Multiplan,Multiplan,,,5.13,,5.13,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,0093-5907-86,NDC,both,1,ea,6.03,3.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Aetna,Commerical,,,4.65,,4.65,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Aetna,Middlesex Employees,,,4.46,,4.46,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Anthem,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Anthem,Indemnity,,,4.52,,4.52,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Anthem,Individual Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Anthem,State Preferred,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Cigna,Cigna,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Connecticare,Commerical,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Connecticare,Exchange,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,Multiplan,Multiplan,,,5.13,,5.13,4.46,5.13,percent of total billed charges,,
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),J3490,HCPCS,59762-0117-1,NDC,both,1,ea,6.03,3.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.46,5.13,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Aetna,Commerical,,,47.98,,47.98,46.01,52.85,percent of total billed charges,,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Aetna,Middlesex Employees,,,46.01,,46.01,46.01,52.85,percent of total billed charges,,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Anthem,Commerical,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Anthem,Indemnity,,,46.58,,46.58,46.01,52.85,percent of total billed charges,,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Anthem,Individual Exchange,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Anthem,State Preferred,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Cigna,Cigna,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Connecticare,Commerical,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Connecticare,Exchange,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,Multiplan,Multiplan,,,52.85,,52.85,46.01,52.85,percent of total billed charges,,
MESALAMINE 500 MG RECTAL SUPPOSITORY,J3490,HCPCS,40810-0013-84,NDC,both,1,ea,62.18,37.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.01,52.85,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Aetna,Commerical,,,18.34,,18.34,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Aetna,Middlesex Employees,,,17.59,,17.59,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Anthem,Commerical,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Anthem,Indemnity,,,17.81,,17.81,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Anthem,Individual Exchange,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Anthem,State Preferred,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Cigna,Cigna,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Connecticare,Commerical,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Connecticare,Exchange,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,Multiplan,Multiplan,,,20.2,,20.2,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-81,NDC,both,1,ea,23.77,14.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Aetna,Commerical,,,18.34,,18.34,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Aetna,Middlesex Employees,,,17.59,,17.59,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Anthem,Commerical,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Anthem,Indemnity,,,17.81,,17.81,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Anthem,Individual Exchange,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Anthem,State Preferred,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Cigna,Cigna,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Connecticare,Commerical,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Connecticare,Exchange,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,Multiplan,Multiplan,,,20.2,,20.2,17.59,20.2,percent of total billed charges,,
"MESALAMINE 800 MG TABLET,DELAYED RELEASE",J3490,HCPCS,68382-435-28,NDC,both,1,ea,23.77,14.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.59,20.2,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Aetna,Commerical,,,8.64,,8.64,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Aetna,Middlesex Employees,,,8.29,,8.29,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Anthem,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Anthem,Indemnity,,,8.39,,8.39,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Anthem,Individual Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Anthem,State Preferred,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Cigna,Cigna,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Connecticare,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Connecticare,Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,Multiplan,Multiplan,,,9.52,,9.52,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-23,NDC,both,1,ea,11.2,6.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Aetna,Commerical,,,8.64,,8.64,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Aetna,Middlesex Employees,,,8.29,,8.29,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Anthem,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Anthem,Indemnity,,,8.39,,8.39,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Anthem,Individual Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Anthem,State Preferred,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Cigna,Cigna,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Connecticare,Commerical,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Connecticare,Exchange,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,Multiplan,Multiplan,,,9.52,,9.52,8.29,9.52,percent of total billed charges,,
"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-189-81,NDC,both,1,ea,11.2,6.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.29,9.52,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Aetna,Commerical,,,17.28,,17.28,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Aetna,Middlesex Employees,,,16.57,,16.57,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Anthem,Commerical,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Anthem,Indemnity,,,16.77,,16.77,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Anthem,Individual Exchange,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Anthem,State Preferred,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Cigna,Cigna,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Connecticare,Commerical,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Connecticare,Exchange,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,Multiplan,Multiplan,,,19.03,,19.03,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,40810-0006-24,NDC,both,1,ea,22.39,13.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Aetna,Commerical,,,17.28,,17.28,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Aetna,Middlesex Employees,,,16.57,,16.57,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Anthem,Commerical,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Anthem,Indemnity,,,16.77,,16.77,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Anthem,Individual Exchange,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Anthem,State Preferred,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Cigna,Cigna,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Connecticare,Commerical,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Connecticare,Exchange,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,Multiplan,Multiplan,,,19.03,,19.03,16.57,19.03,percent of total billed charges,,
"MESALAMINE ER 500 MG CAPSULE,EXTENDED RELEASE",J3490,HCPCS,54092-191-12,NDC,both,1,ea,22.39,13.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.57,19.03,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Aetna,Commerical,,,73.86,,73.86,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Aetna,Middlesex Employees,,,70.82,,70.82,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Anthem,Commerical,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Anthem,Indemnity,,,71.7,,71.7,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Anthem,Individual Exchange,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Anthem,State Preferred,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Cigna,Cigna,,2.51,,,2.51,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Connecticare,Commerical,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Connecticare,Exchange,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,Multiplan,Multiplan,,,81.36,,81.36,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,10019-953-01,NDC,both,2,mL,95.72,57.43,United Healthcare/Oxford,United Healthcare/Oxford,,2.17,,,2.17,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Aetna,Commerical,,,73.86,,73.86,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Aetna,Middlesex Employees,,,70.82,,70.82,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Anthem,Commerical,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Anthem,Indemnity,,,71.7,,71.7,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Anthem,Individual Exchange,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Anthem,State Preferred,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Cigna,Cigna,,2.51,,,2.51,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Connecticare,Commerical,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Connecticare,Exchange,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,Multiplan,Multiplan,,,81.36,,81.36,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-10,NDC,both,2,mL,95.72,57.43,United Healthcare/Oxford,United Healthcare/Oxford,,2.17,,,2.17,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Aetna,Commerical,,,73.86,,73.86,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Aetna,Middlesex Employees,,,70.82,,70.82,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Anthem,Commerical,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Anthem,Indemnity,,,71.7,,71.7,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Anthem,Individual Exchange,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Anthem,State Preferred,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Cigna,Cigna,,2.51,,,2.51,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Connecticare,Commerical,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Connecticare,Exchange,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,Multiplan,Multiplan,,,81.36,,81.36,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,25021-201-11,NDC,both,2,mL,95.72,57.43,United Healthcare/Oxford,United Healthcare/Oxford,,2.17,,,2.17,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Aetna,Commerical,,,73.86,,73.86,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Aetna,Middlesex Employees,,,70.82,,70.82,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Anthem,Commerical,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Anthem,Indemnity,,,71.7,,71.7,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Anthem,Individual Exchange,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Anthem,State Preferred,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Cigna,Cigna,,2.51,,,2.51,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Connecticare,Commerical,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Connecticare,Exchange,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,Multiplan,Multiplan,,,81.36,,81.36,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-10,NDC,both,2,mL,95.72,57.43,United Healthcare/Oxford,United Healthcare/Oxford,,2.17,,,2.17,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Aetna,Commerical,,,73.86,,73.86,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Aetna,Middlesex Employees,,,70.82,,70.82,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Anthem,Commerical,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Anthem,Indemnity,,,71.7,,71.7,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Anthem,Individual Exchange,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Anthem,State Preferred,,,,,,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Cigna,Cigna,,2.51,,,2.51,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Connecticare,Commerical,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Connecticare,Exchange,,2.88,,,2.88,2.17,81.36,Other,Could be inpatient or outpatient,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,Multiplan,Multiplan,,,81.36,,81.36,2.17,81.36,percent of total billed charges,,
MESNA 100 MG/ML INTRAVENOUS SOLUTION,J9209,HCPCS,63323-733-11,NDC,both,2,mL,95.72,57.43,United Healthcare/Oxford,United Healthcare/Oxford,,2.17,,,2.17,2.17,81.36,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Aetna,Commerical,,,494.83,,494.83,474.51,545.11,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Aetna,Middlesex Employees,,,474.51,,474.51,474.51,545.11,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Anthem,Commerical,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Anthem,Indemnity,,,480.41,,480.41,474.51,545.11,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Anthem,Individual Exchange,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Anthem,State Preferred,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Cigna,Cigna,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Connecticare,Commerical,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Connecticare,Exchange,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,Multiplan,Multiplan,,,545.11,,545.11,474.51,545.11,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,10631-206-02,NDC,both,1,mL,1659.42,995.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Aetna,Commerical,,,1280.41,,1280.41,1227.8,1410.51,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Aetna,Middlesex Employees,,,1227.8,,1227.8,1227.8,1410.51,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Anthem,Commerical,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Anthem,Indemnity,,,1243.07,,1243.07,1227.8,1410.51,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Anthem,Individual Exchange,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Anthem,State Preferred,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Cigna,Cigna,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Connecticare,Commerical,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Connecticare,Exchange,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,Multiplan,Multiplan,,,1410.51,,1410.51,1227.8,1410.51,percent of total billed charges,,
METFORMIN 100 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,42571-360-07,NDC,both,1,mL,1659.42,995.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1227.8,1410.51,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Aetna,Commerical,,,2.13,,2.13,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Aetna,Middlesex Employees,,,2.04,,2.04,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Commerical,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Indemnity,,,2.07,,2.07,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Individual Exchange,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,State Preferred,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Cigna,Cigna,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Connecticare,Commerical,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Connecticare,Exchange,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Multiplan,Multiplan,,,2.35,,2.35,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Aetna,Commerical,,,2.13,,2.13,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Aetna,Middlesex Employees,,,2.04,,2.04,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Commerical,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Indemnity,,,2.07,,2.07,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,Individual Exchange,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Anthem,State Preferred,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Cigna,Cigna,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Connecticare,Commerical,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Connecticare,Exchange,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,Multiplan,Multiplan,,,2.35,,2.35,2.04,2.35,percent of total billed charges,,
METFORMIN 250 MG TABLET CHEMO,J3490,HCPCS,40810-0013-65,NDC,both,1,ea,2.76,1.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.04,2.35,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,23155-102-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
METFORMIN 500 MG TABLET,J3490,HCPCS,60687-155-11,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Aetna,Commerical,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Aetna,Middlesex Employees,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Anthem,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Anthem,Indemnity,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Anthem,Individual Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Anthem,State Preferred,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Cigna,Cigna,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Connecticare,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Connecticare,Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.12,0.14,percent of total billed charges,,
METFORMIN 500 MG TABLET CHEMO,J3490,HCPCS,40810-0008-68,NDC,both,1,ea,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Aetna,Commerical,,,494.83,,494.83,474.51,545.11,percent of total billed charges,,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Aetna,Middlesex Employees,,,474.51,,474.51,474.51,545.11,percent of total billed charges,,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Anthem,Commerical,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Anthem,Indemnity,,,480.41,,480.41,474.51,545.11,percent of total billed charges,,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Anthem,Individual Exchange,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Anthem,State Preferred,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Cigna,Cigna,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Connecticare,Commerical,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Connecticare,Exchange,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,Multiplan,Multiplan,,,545.11,,545.11,474.51,545.11,percent of total billed charges,,
METFORMIN 500 MG/5 ML ORAL SOLUTION,J3490,HCPCS,10631-206-02,NDC,both,1,mL,641.31,384.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,474.51,545.11,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
METFORMIN 850 MG TABLET,J3490,HCPCS,23155-103-01,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Aetna,Commerical,,,3.54,,3.54,3.4,3.9,percent of total billed charges,,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.9,percent of total billed charges,,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Anthem,Commerical,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Anthem,Indemnity,,,3.44,,3.44,3.4,3.9,percent of total billed charges,,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Anthem,Individual Exchange,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Anthem,State Preferred,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Cigna,Cigna,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Connecticare,Commerical,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Connecticare,Exchange,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,Multiplan,Multiplan,,,3.9,,3.9,3.4,3.9,percent of total billed charges,,
METFORMIN 850 MG TABLET CHEMO,J3490,HCPCS,40810-0009-08,NDC,both,1,ea,4.59,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.9,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-531-15,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62756-142-01,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Aetna,Commerical,,,2.29,,2.29,2.2,2.52,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Aetna,Middlesex Employees,,,2.2,,2.2,2.2,2.52,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Anthem,Commerical,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Anthem,Indemnity,,,2.22,,2.22,2.2,2.52,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Anthem,Individual Exchange,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Anthem,State Preferred,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Cigna,Cigna,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Connecticare,Commerical,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Connecticare,Exchange,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,Multiplan,Multiplan,,,2.52,,2.52,2.2,2.52,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-159-01,NDC,both,1,ea,2.97,1.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.2,2.52,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,67877-413-01,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Aetna,Commerical,,,112.24,,112.24,107.63,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Aetna,Middlesex Employees,,,107.63,,107.63,107.63,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Anthem,Commerical,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Anthem,Indemnity,,,108.97,,108.97,107.63,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Anthem,Individual Exchange,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Anthem,State Preferred,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Cigna,Cigna,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Connecticare,Commerical,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Connecticare,Exchange,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,Multiplan,Multiplan,,,123.65,,123.65,107.63,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.0625 MG/ML SOLUTION FOR INHALATION,J3490,HCPCS,05446-1249-01,NDC,both,1,mL,145.47,87.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.63,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Aetna,Commerical,,,112.24,,112.24,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Aetna,Middlesex Employees,,,107.63,,107.63,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Anthem,Commerical,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Anthem,Indemnity,,,108.97,,108.97,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Anthem,Individual Exchange,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Anthem,State Preferred,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Cigna,Cigna,,1.68,,,1.68,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Connecticare,Commerical,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Connecticare,Exchange,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,Multiplan,Multiplan,,,123.65,,123.65,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1248-01,NDC,both,1,mL,145.47,87.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Aetna,Commerical,,,449.17,,449.17,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Aetna,Middlesex Employees,,,430.72,,430.72,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Anthem,Commerical,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Anthem,Indemnity,,,436.07,,436.07,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Anthem,Individual Exchange,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Anthem,State Preferred,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Cigna,Cigna,,1.68,,,1.68,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Connecticare,Commerical,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Connecticare,Exchange,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,Multiplan,Multiplan,,,494.81,,494.81,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-26,NDC,both,4,mL,582.13,349.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Aetna,Commerical,,,512,,512,1.68,564.03,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Aetna,Middlesex Employees,,,490.97,,490.97,1.68,564.03,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Anthem,Commerical,,,,,,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Anthem,Indemnity,,,497.07,,497.07,1.68,564.03,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Anthem,Individual Exchange,,,,,,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Anthem,State Preferred,,,,,,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Cigna,Cigna,,1.68,,,1.68,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Connecticare,Commerical,,2.37,,,2.37,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Connecticare,Exchange,,2.37,,,2.37,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,Multiplan,Multiplan,,,564.03,,564.03,1.68,564.03,percent of total billed charges,,
METHACHOLINE CHLORIDE 0.25 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-113-00,NDC,both,4,mL,663.56,398.14,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,564.03,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Aetna,Commerical,,,112.24,,112.24,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Aetna,Middlesex Employees,,,107.63,,107.63,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Anthem,Commerical,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Anthem,Indemnity,,,108.97,,108.97,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Anthem,Individual Exchange,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Anthem,State Preferred,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Cigna,Cigna,,1.68,,,1.68,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Connecticare,Commerical,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Connecticare,Exchange,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,Multiplan,Multiplan,,,123.65,,123.65,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1247-01,NDC,both,1,mL,145.47,87.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Aetna,Commerical,,,449.17,,449.17,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Aetna,Middlesex Employees,,,430.72,,430.72,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Anthem,Commerical,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Anthem,Indemnity,,,436.07,,436.07,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Anthem,Individual Exchange,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Anthem,State Preferred,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Cigna,Cigna,,1.68,,,1.68,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Connecticare,Commerical,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Connecticare,Exchange,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,Multiplan,Multiplan,,,494.81,,494.81,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-25,NDC,both,1,mL,582.13,349.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Aetna,Commerical,,,384,,384,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Aetna,Middlesex Employees,,,368.23,,368.23,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Anthem,Commerical,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Anthem,Indemnity,,,372.8,,372.8,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Anthem,Individual Exchange,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Anthem,State Preferred,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Cigna,Cigna,,1.68,,,1.68,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Connecticare,Commerical,,2.37,,,2.37,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Connecticare,Exchange,,2.37,,,2.37,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,Multiplan,Multiplan,,,423.02,,423.02,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 1 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-114-00,NDC,both,1,mL,497.67,298.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Aetna,Commerical,,,112.24,,112.24,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Aetna,Middlesex Employees,,,107.63,,107.63,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Anthem,Commerical,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Anthem,Indemnity,,,108.97,,108.97,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Anthem,Individual Exchange,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Anthem,State Preferred,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Cigna,Cigna,,1.68,,,1.68,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Connecticare,Commerical,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Connecticare,Exchange,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,Multiplan,Multiplan,,,123.65,,123.65,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1241-01,NDC,both,1,mL,145.47,87.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Aetna,Commerical,,,235.82,,235.82,1.68,259.78,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Aetna,Middlesex Employees,,,226.13,,226.13,1.68,259.78,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Anthem,Commerical,,,,,,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Anthem,Indemnity,,,228.94,,228.94,1.68,259.78,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Anthem,Individual Exchange,,,,,,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Anthem,State Preferred,,,,,,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Cigna,Cigna,,1.68,,,1.68,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Connecticare,Commerical,,2.37,,,2.37,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Connecticare,Exchange,,2.37,,,2.37,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,Multiplan,Multiplan,,,259.78,,259.78,1.68,259.78,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-23,NDC,both,0.063,mL,305.62,183.37,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,259.78,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Aetna,Commerical,,,387.07,,387.07,1.68,426.4,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Aetna,Middlesex Employees,,,371.17,,371.17,1.68,426.4,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Anthem,Commerical,,,,,,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Anthem,Indemnity,,,375.79,,375.79,1.68,426.4,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Anthem,Individual Exchange,,,,,,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Anthem,State Preferred,,,,,,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Cigna,Cigna,,1.68,,,1.68,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Connecticare,Commerical,,2.37,,,2.37,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Connecticare,Exchange,,2.37,,,2.37,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,Multiplan,Multiplan,,,426.4,,426.4,1.68,426.4,percent of total billed charges,,
METHACHOLINE CHLORIDE 16 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-116-00,NDC,both,0.063,mL,501.65,300.99,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,426.4,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Aetna,Commerical,,,112.24,,112.24,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Aetna,Middlesex Employees,,,107.63,,107.63,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Anthem,Commerical,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Anthem,Indemnity,,,108.97,,108.97,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Anthem,Individual Exchange,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Anthem,State Preferred,,,,,,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Cigna,Cigna,,1.68,,,1.68,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Connecticare,Commerical,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Connecticare,Exchange,,2.37,,,2.37,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,Multiplan,Multiplan,,,123.65,,123.65,1.68,123.65,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,05446-1246-01,NDC,both,1,mL,145.47,87.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,123.65,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Aetna,Commerical,,,449.17,,449.17,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Aetna,Middlesex Employees,,,430.72,,430.72,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Anthem,Commerical,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Anthem,Indemnity,,,436.07,,436.07,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Anthem,Individual Exchange,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Anthem,State Preferred,,,,,,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Cigna,Cigna,,1.68,,,1.68,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Connecticare,Commerical,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Connecticare,Exchange,,2.37,,,2.37,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,Multiplan,Multiplan,,,494.81,,494.81,1.68,494.81,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,40810-0203-24,NDC,both,0.25,mL,582.13,349.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,494.81,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Aetna,Commerical,,,384,,384,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Aetna,Middlesex Employees,,,368.23,,368.23,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Anthem,Commerical,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Anthem,Indemnity,,,372.8,,372.8,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Anthem,Individual Exchange,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Anthem,State Preferred,,,,,,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Cigna,Cigna,,1.68,,,1.68,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Connecticare,Commerical,,2.37,,,2.37,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Connecticare,Exchange,,2.37,,,2.37,1.68,423.02,Other,Could be inpatient or outpatient,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,Multiplan,Multiplan,,,423.02,,423.02,1.68,423.02,percent of total billed charges,,
METHACHOLINE CHLORIDE 4 MG/ML SOLUTION FOR INHALATION,J7674,HCPCS,64281-115-00,NDC,both,0.25,mL,497.67,298.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.82,,,1.82,1.68,423.02,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Aetna,Commerical,,,2068.66,,2068.66,23.38,2278.85,percent of total billed charges,,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Aetna,Middlesex Employees,,,1983.67,,1983.67,23.38,2278.85,percent of total billed charges,,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Anthem,Commerical,,,,,,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Anthem,Indemnity,,,2008.34,,2008.34,23.38,2278.85,percent of total billed charges,,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Anthem,Individual Exchange,,,,,,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Anthem,State Preferred,,,,,,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Cigna,Cigna,,23.38,,,23.38,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Connecticare,Commerical,,31.83,,,31.83,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Connecticare,Exchange,,31.83,,,31.83,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,Multiplan,Multiplan,,,2278.85,,2278.85,23.38,2278.85,percent of total billed charges,,
METHADONE 0.01 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0017-77,NDC,both,1000,mL,2681,1608.6,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,23.38,2278.85,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Aetna,Commerical,,,10.35,,10.35,9.92,31.83,percent of total billed charges,,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Aetna,Middlesex Employees,,,9.92,,9.92,9.92,31.83,percent of total billed charges,,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Anthem,Commerical,,,,,,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Anthem,Indemnity,,,10.05,,10.05,9.92,31.83,percent of total billed charges,,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Anthem,Individual Exchange,,,,,,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Anthem,State Preferred,,,,,,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Cigna,Cigna,,23.38,,,23.38,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Connecticare,Commerical,,31.83,,,31.83,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Connecticare,Exchange,,31.83,,,31.83,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,Multiplan,Multiplan,,,11.4,,11.4,9.92,31.83,percent of total billed charges,,
METHADONE 0.1 MG/ML INJECTION SOLUTION,J1230,HCPCS,40810-0018-54,NDC,both,100,mL,13.41,8.05,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,9.92,31.83,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
METHADONE 1 MG/1 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0014-25,NDC,both,1,mL,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0054-8554-24,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,0406-5771-62,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHADONE 10 MG TABLET,J3490,HCPCS,68084-738-11,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Aetna,Commerical,,,26.77,,26.77,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Aetna,Middlesex Employees,,,25.67,,25.67,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Anthem,Commerical,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Anthem,Indemnity,,,25.99,,25.99,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Anthem,Individual Exchange,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Anthem,State Preferred,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Cigna,Cigna,,23.38,,,23.38,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Connecticare,Commerical,,31.83,,,31.83,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Connecticare,Exchange,,31.83,,,31.83,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,Multiplan,Multiplan,,,29.5,,29.5,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,70004-380-05,NDC,both,1,mL,160.86,96.52,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Aetna,Commerical,,,124.12,,124.12,23.38,136.73,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Aetna,Middlesex Employees,,,119.02,,119.02,23.38,136.73,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Anthem,Commerical,,,,,,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Anthem,Indemnity,,,120.5,,120.5,23.38,136.73,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Anthem,Individual Exchange,,,,,,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Anthem,State Preferred,,,,,,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Cigna,Cigna,,23.38,,,23.38,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Connecticare,Commerical,,31.83,,,31.83,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Connecticare,Exchange,,31.83,,,31.83,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,Multiplan,Multiplan,,,136.73,,136.73,23.38,136.73,percent of total billed charges,,
METHADONE 10 MG/ML INJ 1 ML SYRINGE,J1230,HCPCS,73177-161-43,NDC,both,1,mL,160.86,96.52,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,23.38,136.73,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Aetna,Commerical,,,26.77,,26.77,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Aetna,Middlesex Employees,,,25.67,,25.67,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Anthem,Commerical,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Anthem,Indemnity,,,25.99,,25.99,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Anthem,Individual Exchange,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Anthem,State Preferred,,,,,,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Cigna,Cigna,,23.38,,,23.38,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Connecticare,Commerical,,31.83,,,31.83,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Connecticare,Exchange,,31.83,,,31.83,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,Multiplan,Multiplan,,,29.5,,29.5,23.38,31.83,percent of total billed charges,,
METHADONE 10 MG/ML INJECTION SOLUTION,J1230,HCPCS,70004-380-05,NDC,both,1,mL,34.7,20.82,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,23.38,31.83,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
METHADONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0001-97,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0054-8553-24,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
METHADONE 5 MG TABLET,J3490,HCPCS,0406-5755-62,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Aetna,Commerical,,,118.21,,118.21,23.38,130.22,percent of total billed charges,,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Aetna,Middlesex Employees,,,113.35,,113.35,23.38,130.22,percent of total billed charges,,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Anthem,Commerical,,,,,,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Anthem,Indemnity,,,114.76,,114.76,23.38,130.22,percent of total billed charges,,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Anthem,Individual Exchange,,,,,,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Anthem,State Preferred,,,,,,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Cigna,Cigna,,23.38,,,23.38,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Connecticare,Commerical,,31.83,,,31.83,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Connecticare,Exchange,,31.83,,,31.83,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,Multiplan,Multiplan,,,130.22,,130.22,23.38,130.22,percent of total billed charges,,
METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,J1230,HCPCS,73177-149-02,NDC,both,10,mL,153.2,91.92,United Healthcare/Oxford,United Healthcare/Oxford,,25.24,,,25.24,23.38,130.22,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Aetna,Commerical,,,90.14,,90.14,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Aetna,Middlesex Employees,,,86.44,,86.44,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Anthem,Commerical,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Anthem,Indemnity,,,87.51,,87.51,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Anthem,Individual Exchange,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Anthem,State Preferred,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Cigna,Cigna,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Connecticare,Commerical,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Connecticare,Exchange,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,Multiplan,Multiplan,,,99.3,,99.3,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-3555-63,NDC,both,1,mL,116.82,70.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Aetna,Commerical,,,90.14,,90.14,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Aetna,Middlesex Employees,,,86.44,,86.44,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Anthem,Commerical,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Anthem,Indemnity,,,87.51,,87.51,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Anthem,Individual Exchange,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Anthem,State Preferred,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Cigna,Cigna,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Connecticare,Commerical,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Connecticare,Exchange,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,Multiplan,Multiplan,,,99.3,,99.3,86.44,99.3,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-711-16,NDC,both,1,mL,116.82,70.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.44,99.3,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
METHADONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0017-45,NDC,both,5,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,23155-071-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
METHIMAZOLE 10 MG TABLET,J3490,HCPCS,68084-276-11,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
METHIMAZOLE 2.5 MG TABLET,J3490,HCPCS,40810-0205-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Aetna,Commerical,,,1.02,,1.02,0.98,1.12,percent of total billed charges,,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Aetna,Middlesex Employees,,,0.98,,0.98,0.98,1.12,percent of total billed charges,,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Anthem,Commerical,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Anthem,Indemnity,,,0.99,,0.99,0.98,1.12,percent of total billed charges,,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Anthem,Individual Exchange,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Anthem,State Preferred,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Cigna,Cigna,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Connecticare,Commerical,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Connecticare,Exchange,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,Multiplan,Multiplan,,,1.12,,1.12,0.98,1.12,percent of total billed charges,,
METHIMAZOLE 5 MG TABLET,J3490,HCPCS,40810-0001-98,NDC,both,1,ea,1.32,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
METHOCARBAMOL 250 MG ORAL TAB,J3490,HCPCS,40810-0001-99,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,0904-7057-61,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,60687-559-11,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,63739-991-10,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METHOCARBAMOL 500 MG TABLET,J3490,HCPCS,76385-123-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,0904-7058-61,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-01,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,60687-568-11,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
METHOCARBAMOL 750 MG TABLET,J3490,HCPCS,70010-770-01,NDC,both,1,ea,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Aetna,Commerical,,,4.1,,4.1,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Aetna,Middlesex Employees,,,3.93,,3.93,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Commerical,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Indemnity,,,3.98,,3.98,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Individual Exchange,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,State Preferred,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Cigna,Cigna,,0.27,,,0.27,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Connecticare,Commerical,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Connecticare,Exchange,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Multiplan,Multiplan,,,4.51,,4.51,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Aetna,Commerical,,,4.1,,4.1,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Aetna,Middlesex Employees,,,3.93,,3.93,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Commerical,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Indemnity,,,3.98,,3.98,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Individual Exchange,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,State Preferred,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Cigna,Cigna,,0.27,,,0.27,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Connecticare,Commerical,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Connecticare,Exchange,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Multiplan,Multiplan,,,4.51,,4.51,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Aetna,Commerical,,,4.1,,4.1,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Aetna,Middlesex Employees,,,3.93,,3.93,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Commerical,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Indemnity,,,3.98,,3.98,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,Individual Exchange,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Anthem,State Preferred,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Cigna,Cigna,,0.27,,,0.27,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Connecticare,Commerical,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Connecticare,Exchange,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,Multiplan,Multiplan,,,4.51,,4.51,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,40810-0013-66,NDC,both,2,ea,5.31,3.19,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Aetna,Commerical,,,4.1,,4.1,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Aetna,Middlesex Employees,,,3.93,,3.93,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Commerical,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Indemnity,,,3.98,,3.98,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,Individual Exchange,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Anthem,State Preferred,,,,,,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Cigna,Cigna,,0.27,,,0.27,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Connecticare,Commerical,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Connecticare,Exchange,,0.34,,,0.34,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,Multiplan,Multiplan,,,4.51,,4.51,0.27,4.51,percent of total billed charges,,
METHOTREXATE 1.25 MG TABLET CHEMO,J8610,HCPCS,47335-235-96,NDC,both,2,ea,5.31,3.19,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,4.51,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Aetna,Commerical,,,3116.11,,3116.11,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Aetna,Middlesex Employees,,,2988.09,,2988.09,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Commerical,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Indemnity,,,3025.25,,3025.25,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Individual Exchange,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,State Preferred,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Cigna,Cigna,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Connecticare,Commerical,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Connecticare,Exchange,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Multiplan,Multiplan,,,3432.73,,3432.73,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Aetna,Commerical,,,3116.11,,3116.11,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Aetna,Middlesex Employees,,,2988.09,,2988.09,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Commerical,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Indemnity,,,3025.25,,3025.25,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,Individual Exchange,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Anthem,State Preferred,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Cigna,Cigna,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Connecticare,Commerical,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Connecticare,Exchange,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,Multiplan,Multiplan,,,3432.73,,3432.73,2988.09,3432.73,percent of total billed charges,,
METHOTREXATE 2.5 MG/ML ORAL SOLUTION CHEMO,J3490,HCPCS,52652-2001-6,NDC,both,1,mL,4038.51,2423.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2988.09,3432.73,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Commerical,,,9.54,,9.54,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Middlesex Employees,,,9.15,,9.15,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Commerical,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Indemnity,,,9.27,,9.27,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Individual Exchange,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,State Preferred,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Cigna,Cigna,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Commerical,,0.47,,,0.47,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Exchange,,0.47,,,0.47,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Multiplan,Multiplan,,,10.51,,10.51,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV BAG FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Commerical,,,9.54,,9.54,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Middlesex Employees,,,9.15,,9.15,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Commerical,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Indemnity,,,9.27,,9.27,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Individual Exchange,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,State Preferred,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Cigna,Cigna,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Commerical,,0.47,,,0.47,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Exchange,,0.47,,,0.47,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Multiplan,Multiplan,,,10.51,,10.51,0.47,10.51,percent of total billed charges,,
METHOTREXATE IV SYRINGE FOR INFANTS,J9250,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Commerical,,,9.54,,9.54,3.15,10.51,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Aetna,Middlesex Employees,,,9.15,,9.15,3.15,10.51,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Commerical,,,,,,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Indemnity,,,9.27,,9.27,3.15,10.51,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,Individual Exchange,,,,,,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Anthem,State Preferred,,,,,,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Cigna,Cigna,,3.64,,,3.64,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Commerical,,4.16,,,4.16,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Connecticare,Exchange,,4.16,,,4.16,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,Multiplan,Multiplan,,,10.51,,10.51,3.15,10.51,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0143-9519-10,NDC,both,2,mL,12.37,7.42,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,10.51,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Aetna,Commerical,,,11.23,,11.23,3.15,12.38,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Aetna,Middlesex Employees,,,10.77,,10.77,3.15,12.38,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Anthem,Commerical,,,,,,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Anthem,Indemnity,,,10.91,,10.91,3.15,12.38,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Anthem,Individual Exchange,,,,,,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Anthem,State Preferred,,,,,,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Cigna,Cigna,,3.64,,,3.64,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Connecticare,Commerical,,4.16,,,4.16,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Connecticare,Exchange,,4.16,,,4.16,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,Multiplan,Multiplan,,,12.38,,12.38,3.15,12.38,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3671-01,NDC,both,2,mL,14.56,8.74,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,12.38,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Aetna,Commerical,,,26.69,,26.69,3.15,29.4,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Aetna,Middlesex Employees,,,25.59,,25.59,3.15,29.4,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Anthem,Commerical,,,,,,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Anthem,Indemnity,,,25.91,,25.91,3.15,29.4,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Anthem,Individual Exchange,,,,,,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Anthem,State Preferred,,,,,,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Cigna,Cigna,,3.64,,,3.64,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Connecticare,Commerical,,4.16,,,4.16,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Connecticare,Exchange,,4.16,,,4.16,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,Multiplan,Multiplan,,,29.4,,29.4,3.15,29.4,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3675-01,NDC,both,2,mL,34.59,20.75,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,29.4,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Aetna,Commerical,,,98.23,,98.23,3.15,108.21,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Aetna,Middlesex Employees,,,94.2,,94.2,3.15,108.21,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Anthem,Commerical,,,,,,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Anthem,Indemnity,,,95.37,,95.37,3.15,108.21,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Anthem,Individual Exchange,,,,,,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Anthem,State Preferred,,,,,,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Cigna,Cigna,,3.64,,,3.64,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Connecticare,Commerical,,4.16,,,4.16,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Connecticare,Exchange,,4.16,,,4.16,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,Multiplan,Multiplan,,,108.21,,108.21,3.15,108.21,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,0703-3678-01,NDC,both,2,mL,127.31,76.39,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,108.21,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Aetna,Commerical,,,11.59,,11.59,3.15,12.77,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Aetna,Middlesex Employees,,,11.11,,11.11,3.15,12.77,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Anthem,Commerical,,,,,,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Anthem,Indemnity,,,11.25,,11.25,3.15,12.77,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Anthem,Individual Exchange,,,,,,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Anthem,State Preferred,,,,,,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Cigna,Cigna,,3.64,,,3.64,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Connecticare,Commerical,,4.16,,,4.16,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Connecticare,Exchange,,4.16,,,4.16,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,Multiplan,Multiplan,,,12.77,,12.77,3.15,12.77,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,16729-277-30,NDC,both,2,mL,15.02,9.01,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,12.77,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Aetna,Commerical,,,190.79,,190.79,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Aetna,Middlesex Employees,,,182.96,,182.96,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Anthem,Commerical,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Anthem,Indemnity,,,185.23,,185.23,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Anthem,Individual Exchange,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Anthem,State Preferred,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Cigna,Cigna,,3.64,,,3.64,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Connecticare,Commerical,,4.16,,,4.16,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Connecticare,Exchange,,4.16,,,4.16,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,Multiplan,Multiplan,,,210.18,,210.18,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,61703-408-41,NDC,both,1,mL,247.27,148.36,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Commerical,,,164.78,,164.78,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Middlesex Employees,,,158.01,,158.01,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Commerical,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Indemnity,,,159.97,,159.97,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Individual Exchange,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,State Preferred,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Cigna,Cigna,,0.27,,,0.27,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Commerical,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Exchange,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Multiplan,Multiplan,,,181.52,,181.52,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Commerical,,,164.78,,164.78,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Middlesex Employees,,,158.01,,158.01,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Commerical,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Indemnity,,,159.97,,159.97,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Individual Exchange,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,State Preferred,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Cigna,Cigna,,0.27,,,0.27,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Commerical,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Exchange,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Multiplan,Multiplan,,,181.52,,181.52,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Commerical,,,164.78,,164.78,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Middlesex Employees,,,158.01,,158.01,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Commerical,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Indemnity,,,159.97,,159.97,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Individual Exchange,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Anthem,State Preferred,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Cigna,Cigna,,0.27,,,0.27,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Commerical,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Exchange,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,Multiplan,Multiplan,,,181.52,,181.52,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,40810-0019-01,NDC,both,0.167,ea,213.55,128.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Commerical,,,164.78,,164.78,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Aetna,Middlesex Employees,,,158.01,,158.01,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Commerical,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Indemnity,,,159.97,,159.97,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,Individual Exchange,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Anthem,State Preferred,,,,,,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Cigna,Cigna,,0.27,,,0.27,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Commerical,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Connecticare,Exchange,,0.34,,,0.34,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,Multiplan,Multiplan,,,181.52,,181.52,0.27,181.52,percent of total billed charges,,
METHOTREXATE SODIUM 15 MG TABLET BEACON,J8610,HCPCS,51285-369-01,NDC,both,0.167,ea,213.55,128.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,181.52,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Aetna,Commerical,,,9.69,,9.69,0.27,10.68,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Aetna,Middlesex Employees,,,9.29,,9.29,0.27,10.68,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Anthem,Commerical,,,,,,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Anthem,Indemnity,,,9.41,,9.41,0.27,10.68,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Anthem,Individual Exchange,,,,,,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Anthem,State Preferred,,,,,,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Cigna,Cigna,,0.27,,,0.27,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Connecticare,Commerical,,0.34,,,0.34,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Connecticare,Exchange,,0.34,,,0.34,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,Multiplan,Multiplan,,,10.68,,10.68,0.27,10.68,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0054-4550-15,NDC,both,1,ea,12.56,7.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,10.68,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,0904-7141-10,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-01,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Commerical,,,6.77,,6.77,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Aetna,Middlesex Employees,,,6.5,,6.5,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Commerical,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Indemnity,,,6.58,,6.58,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,Individual Exchange,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Anthem,State Preferred,,,,,,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Cigna,Cigna,,0.27,,,0.27,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Commerical,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Connecticare,Exchange,,0.34,,,0.34,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,Multiplan,Multiplan,,,7.46,,7.46,0.27,7.46,percent of total billed charges,,
METHOTREXATE SODIUM 2.5 MG TABLET BEACON,J8610,HCPCS,51079-670-05,NDC,both,1,ea,8.78,5.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,7.46,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Aetna,Commerical,,,57.31,,57.31,3.15,63.13,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Aetna,Middlesex Employees,,,54.95,,54.95,3.15,63.13,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Anthem,Commerical,,,,,,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Anthem,Indemnity,,,55.64,,55.64,3.15,63.13,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Anthem,Individual Exchange,,,,,,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Anthem,State Preferred,,,,,,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Cigna,Cigna,,3.64,,,3.64,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Connecticare,Commerical,,4.16,,,4.16,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Connecticare,Exchange,,4.16,,,4.16,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,Multiplan,Multiplan,,,63.13,,63.13,3.15,63.13,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,J9260,HCPCS,63323-123-10,NDC,both,2,mL,74.27,44.56,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,63.13,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Aetna,Commerical,,,190.79,,190.79,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Aetna,Middlesex Employees,,,182.96,,182.96,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Anthem,Commerical,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Anthem,Indemnity,,,185.23,,185.23,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Anthem,Individual Exchange,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Anthem,State Preferred,,,,,,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Cigna,Cigna,,3.64,,,3.64,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Connecticare,Commerical,,4.16,,,4.16,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Connecticare,Exchange,,4.16,,,4.16,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,Multiplan,Multiplan,,,210.18,,210.18,3.15,210.18,percent of total billed charges,,
METHOTREXATE SODIUM 25 MG/ML IV,J9260,HCPCS,61703-408-41,NDC,both,1,mL,42.44,25.46,United Healthcare/Oxford,United Healthcare/Oxford,,3.15,,,3.15,3.15,210.18,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Aetna,Commerical,,,34.92,,34.92,0.27,38.47,percent of total billed charges,,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Aetna,Middlesex Employees,,,33.49,,33.49,0.27,38.47,percent of total billed charges,,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Anthem,Commerical,,,,,,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Anthem,Indemnity,,,33.9,,33.9,0.27,38.47,percent of total billed charges,,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Anthem,Individual Exchange,,,,,,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Anthem,State Preferred,,,,,,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Cigna,Cigna,,0.27,,,0.27,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Connecticare,Commerical,,0.34,,,0.34,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Connecticare,Exchange,,0.34,,,0.34,0.27,38.47,Other,Could be inpatient or outpatient,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,Multiplan,Multiplan,,,38.47,,38.47,0.27,38.47,percent of total billed charges,,
METHOTREXATE SODIUM 5 MG TABLET BEACON,J8610,HCPCS,40810-0019-00,NDC,both,0.5,ea,45.26,27.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,38.47,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Aetna,Commerical,,,56.15,,56.15,53.84,61.85,percent of total billed charges,,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,53.84,61.85,percent of total billed charges,,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Anthem,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Anthem,Indemnity,,,54.51,,54.51,53.84,61.85,percent of total billed charges,,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Anthem,Individual Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Anthem,State Preferred,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Cigna,Cigna,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Connecticare,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Connecticare,Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,Multiplan,Multiplan,,,61.85,,61.85,53.84,61.85,percent of total billed charges,,
METHYLCELLULOSE (BULK) 1 % GEL,J3490,HCPCS,3877930608,NDC,both,1,mL,72.77,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Aetna,Commerical,,,17095.99,,17095.99,10.31,18833.07,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Aetna,Middlesex Employees,,,16393.63,,16393.63,10.31,18833.07,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Anthem,Commerical,,,,,,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Anthem,Indemnity,,,16597.47,,16597.47,10.31,18833.07,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Anthem,Individual Exchange,,,,,,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Anthem,State Preferred,,,,,,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Cigna,Cigna,,10.77,,,10.77,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Connecticare,Commerical,,,,,,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Connecticare,Exchange,,,,,,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,Multiplan,Multiplan,,,18833.07,,18833.07,10.31,18833.07,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,40810-0202-65,NDC,both,0.1,ME,22156.55,13293.93,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,18833.07,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Aetna,Commerical,,,426.68,,426.68,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Aetna,Middlesex Employees,,,409.15,,409.15,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Anthem,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Anthem,Indemnity,,,414.24,,414.24,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Anthem,Individual Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Anthem,State Preferred,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Cigna,Cigna,,10.77,,,10.77,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Connecticare,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Connecticare,Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,Multiplan,Multiplan,,,470.03,,470.03,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (10 MG/ML) CONTINUOUS INFUSION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,443.14,265.88,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Aetna,Commerical,,,426.68,,426.68,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Aetna,Middlesex Employees,,,409.15,,409.15,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Anthem,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Anthem,Indemnity,,,414.24,,414.24,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Anthem,Individual Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Anthem,State Preferred,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Cigna,Cigna,,10.77,,,10.77,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Connecticare,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Connecticare,Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,Multiplan,Multiplan,,,470.03,,470.03,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,17478-504-10,NDC,both,0.1,mL,552.98,331.79,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Aetna,Commerical,,,426.68,,426.68,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Aetna,Middlesex Employees,,,409.15,,409.15,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Indemnity,,,414.24,,414.24,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Individual Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Anthem,State Preferred,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Cigna,Cigna,,10.77,,,10.77,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Connecticare,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Connecticare,Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,Multiplan,Multiplan,,,470.03,,470.03,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-01,NDC,both,0.1,mL,552.98,331.79,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Aetna,Commerical,,,426.68,,426.68,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Aetna,Middlesex Employees,,,409.15,,409.15,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Anthem,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Anthem,Indemnity,,,414.24,,414.24,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Anthem,Individual Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Anthem,State Preferred,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Cigna,Cigna,,10.77,,,10.77,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Connecticare,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Connecticare,Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,Multiplan,Multiplan,,,470.03,,470.03,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,42494-419-05,NDC,both,0.1,mL,552.98,331.79,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Aetna,Commerical,,,426.68,,426.68,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Aetna,Middlesex Employees,,,409.15,,409.15,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Indemnity,,,414.24,,414.24,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Anthem,Individual Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Anthem,State Preferred,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Cigna,Cigna,,10.77,,,10.77,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Connecticare,Commerical,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Connecticare,Exchange,,,,,,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,Multiplan,Multiplan,,,470.03,,470.03,10.31,470.03,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,Q9968,HCPCS,54288-147-01,NDC,both,0.1,mL,552.98,331.79,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,470.03,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Aetna,Commerical,,,740.71,,740.71,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Aetna,Middlesex Employees,,,710.27,,710.27,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Anthem,Commerical,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Anthem,Indemnity,,,719.11,,719.11,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Anthem,Individual Exchange,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Anthem,State Preferred,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Cigna,Cigna,,10.77,,,10.77,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Connecticare,Commerical,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Connecticare,Exchange,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,Multiplan,Multiplan,,,815.97,,815.97,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-01,NDC,both,0.2,mL,959.96,575.98,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Aetna,Commerical,,,740.71,,740.71,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Aetna,Middlesex Employees,,,710.27,,710.27,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Anthem,Commerical,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Anthem,Indemnity,,,719.11,,719.11,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Anthem,Individual Exchange,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Anthem,State Preferred,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Cigna,Cigna,,10.77,,,10.77,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Connecticare,Commerical,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Connecticare,Exchange,,,,,,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,Multiplan,Multiplan,,,815.97,,815.97,10.31,815.97,percent of total billed charges,,
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,Q9968,HCPCS,0517-0374-05,NDC,both,0.2,mL,959.96,575.98,United Healthcare/Oxford,United Healthcare/Oxford,,10.31,,,10.31,10.31,815.97,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Aetna,Commerical,,,46.79,,46.79,23.49,51.54,percent of total billed charges,,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Aetna,Middlesex Employees,,,44.87,,44.87,23.49,51.54,percent of total billed charges,,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Anthem,Commerical,,,,,,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Anthem,Indemnity,,,45.43,,45.43,23.49,51.54,percent of total billed charges,,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Anthem,Individual Exchange,,,,,,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Anthem,State Preferred,,,,,,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Cigna,Cigna,,23.49,,,23.49,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Connecticare,Commerical,,34.26,,,34.26,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Connecticare,Exchange,,34.26,,,34.26,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,Multiplan,Multiplan,,,51.54,,51.54,23.49,51.54,percent of total billed charges,,
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,J2210,HCPCS,51991-144-17,NDC,both,1,mL,60.64,36.38,United Healthcare/Oxford,United Healthcare/Oxford,,25.36,,,25.36,23.49,51.54,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Aetna,Commerical,,,437.58,,437.58,1.44,482.04,percent of total billed charges,,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Aetna,Middlesex Employees,,,419.6,,419.6,1.44,482.04,percent of total billed charges,,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Anthem,Commerical,,,,,,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Anthem,Indemnity,,,424.82,,424.82,1.44,482.04,percent of total billed charges,,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Anthem,Individual Exchange,,,,,,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Anthem,State Preferred,,,,,,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Cigna,Cigna,,1.54,,,1.54,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Connecticare,Commerical,,,,,,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Connecticare,Exchange,,,,,,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,Multiplan,Multiplan,,,482.04,,482.04,1.44,482.04,percent of total billed charges,,
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,J2212,HCPCS,65649-551-02,NDC,both,0.005,mL,567.11,340.27,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.44,482.04,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,0406-1144-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Aetna,Commerical,,,2.49,,2.49,2.39,2.75,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Aetna,Middlesex Employees,,,2.39,,2.39,2.39,2.75,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Anthem,Commerical,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Anthem,Indemnity,,,2.42,,2.42,2.39,2.75,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Anthem,Individual Exchange,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Anthem,State Preferred,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Cigna,Cigna,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Connecticare,Commerical,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Connecticare,Exchange,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,Multiplan,Multiplan,,,2.75,,2.75,2.39,2.75,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,57664-229-88,NDC,both,1,ea,3.23,1.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.39,2.75,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Aetna,Commerical,,,3.37,,3.37,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Aetna,Middlesex Employees,,,3.23,,3.23,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Anthem,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Anthem,Indemnity,,,3.27,,3.27,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Anthem,Individual Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Anthem,State Preferred,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Cigna,Cigna,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Connecticare,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Connecticare,Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,Multiplan,Multiplan,,,3.71,,3.71,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-11,NDC,both,1,ea,4.37,2.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Aetna,Commerical,,,3.37,,3.37,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Aetna,Middlesex Employees,,,3.23,,3.23,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Anthem,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Anthem,Indemnity,,,3.27,,3.27,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Anthem,Individual Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Anthem,State Preferred,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Cigna,Cigna,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Connecticare,Commerical,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Connecticare,Exchange,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,Multiplan,Multiplan,,,3.71,,3.71,3.23,3.71,percent of total billed charges,,
METHYLPHENIDATE 10 MG TABLET,J3490,HCPCS,68084-823-21,NDC,both,1,ea,4.37,2.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.23,3.71,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
METHYLPHENIDATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-00,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
METHYLPHENIDATE 5 MG TABLET,J3490,HCPCS,16729-478-01,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Aetna,Commerical,,,21.64,,21.64,20.75,23.83,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Aetna,Middlesex Employees,,,20.75,,20.75,20.75,23.83,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Anthem,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Anthem,Indemnity,,,21,,21,20.75,23.83,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Anthem,Individual Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Anthem,State Preferred,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Cigna,Cigna,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Connecticare,Commerical,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Connecticare,Exchange,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,Multiplan,Multiplan,,,23.83,,23.83,20.75,23.83,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-706-10,NDC,both,1,ea,28.04,16.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.75,23.83,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Aetna,Commerical,,,36.69,,36.69,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Aetna,Middlesex Employees,,,35.18,,35.18,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Anthem,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Anthem,Indemnity,,,35.62,,35.62,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Anthem,Individual Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Anthem,State Preferred,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Cigna,Cigna,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Connecticare,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Connecticare,Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,Multiplan,Multiplan,,,40.42,,40.42,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-585-01,NDC,both,1,ea,47.55,28.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Aetna,Commerical,,,36.69,,36.69,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Aetna,Middlesex Employees,,,35.18,,35.18,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Anthem,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Anthem,Indemnity,,,35.62,,35.62,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Anthem,Individual Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Anthem,State Preferred,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Cigna,Cigna,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Connecticare,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Connecticare,Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,Multiplan,Multiplan,,,40.42,,40.42,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-11,NDC,both,1,ea,47.55,28.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Aetna,Commerical,,,36.69,,36.69,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Aetna,Middlesex Employees,,,35.18,,35.18,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Anthem,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Anthem,Indemnity,,,35.62,,35.62,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Anthem,Individual Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Anthem,State Preferred,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Cigna,Cigna,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Connecticare,Commerical,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Connecticare,Exchange,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,Multiplan,Multiplan,,,40.42,,40.42,35.18,40.42,percent of total billed charges,,
"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,60687-532-21,NDC,both,1,ea,47.55,28.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.18,40.42,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Aetna,Commerical,,,37.62,,37.62,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Aetna,Middlesex Employees,,,36.07,,36.07,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Anthem,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Anthem,Indemnity,,,36.52,,36.52,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Anthem,Individual Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Anthem,State Preferred,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Cigna,Cigna,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Connecticare,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Connecticare,Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,Multiplan,Multiplan,,,41.44,,41.44,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0527-3311-37,NDC,both,1,ea,48.75,29.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Aetna,Commerical,,,37.62,,37.62,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Aetna,Middlesex Employees,,,36.07,,36.07,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Anthem,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Anthem,Indemnity,,,36.52,,36.52,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Anthem,Individual Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Anthem,State Preferred,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Cigna,Cigna,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Connecticare,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Connecticare,Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,Multiplan,Multiplan,,,41.44,,41.44,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,13811-707-10,NDC,both,1,ea,48.75,29.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Aetna,Commerical,,,37.62,,37.62,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Aetna,Middlesex Employees,,,36.07,,36.07,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Anthem,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Anthem,Indemnity,,,36.52,,36.52,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Anthem,Individual Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Anthem,State Preferred,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Cigna,Cigna,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Connecticare,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Connecticare,Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,Multiplan,Multiplan,,,41.44,,41.44,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-588-01,NDC,both,1,ea,48.75,29.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Aetna,Commerical,,,15.71,,15.71,15.06,17.31,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Aetna,Middlesex Employees,,,15.06,,15.06,15.06,17.31,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Anthem,Commerical,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Anthem,Indemnity,,,15.25,,15.25,15.06,17.31,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Anthem,Individual Exchange,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Anthem,State Preferred,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Cigna,Cigna,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Connecticare,Commerical,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Connecticare,Exchange,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,Multiplan,Multiplan,,,17.31,,17.31,15.06,17.31,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,62175-311-37,NDC,both,1,ea,20.36,12.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.06,17.31,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Aetna,Commerical,,,37.62,,37.62,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Aetna,Middlesex Employees,,,36.07,,36.07,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Anthem,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Anthem,Indemnity,,,36.52,,36.52,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Anthem,Individual Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Anthem,State Preferred,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Cigna,Cigna,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Connecticare,Commerical,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Connecticare,Exchange,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,Multiplan,Multiplan,,,41.44,,41.44,36.07,41.44,percent of total billed charges,,
"METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-233-09,NDC,both,1,ea,48.75,29.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.07,41.44,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,31722-954-01,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
"METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50458-586-01,NDC,both,1,ea,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Aetna,Commerical,,,13.71,,13.71,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Aetna,Middlesex Employees,,,13.15,,13.15,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Commerical,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Indemnity,,,13.31,,13.31,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Individual Exchange,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,State Preferred,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Cigna,Cigna,,0.34,,,0.34,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Connecticare,Commerical,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Connecticare,Exchange,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Multiplan,Multiplan,,,15.1,,15.1,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE (PF) 40 MG/ML SOLN FOR IFC,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Aetna,Commerical,,,2.58,,2.58,2.47,2.84,percent of total billed charges,,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Aetna,Middlesex Employees,,,2.47,,2.47,2.47,2.84,percent of total billed charges,,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Anthem,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Anthem,Indemnity,,,2.5,,2.5,2.47,2.84,percent of total billed charges,,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Anthem,Individual Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Anthem,State Preferred,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Cigna,Cigna,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Connecticare,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Connecticare,Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,Multiplan,Multiplan,,,2.84,,2.84,2.47,2.84,percent of total billed charges,,
METHYLPREDNISOLONE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-02,NDC,both,1,ea,3.34,2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Aetna,Commerical,,,4.96,,4.96,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Aetna,Middlesex Employees,,,4.76,,4.76,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Anthem,Commerical,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Anthem,Indemnity,,,4.82,,4.82,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Anthem,Individual Exchange,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Anthem,State Preferred,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Cigna,Cigna,,0.27,,,0.27,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Connecticare,Commerical,,0.37,,,0.37,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Connecticare,Exchange,,0.37,,,0.37,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,Multiplan,Multiplan,,,5.47,,5.47,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59746-003-14,NDC,both,0.25,ea,6.43,3.86,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Aetna,Commerical,,,4.96,,4.96,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Aetna,Middlesex Employees,,,4.76,,4.76,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Anthem,Commerical,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Anthem,Indemnity,,,4.82,,4.82,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Anthem,Individual Exchange,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Anthem,State Preferred,,,,,,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Cigna,Cigna,,0.27,,,0.27,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Connecticare,Commerical,,0.37,,,0.37,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Connecticare,Exchange,,0.37,,,0.37,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,Multiplan,Multiplan,,,5.47,,5.47,0.27,5.47,percent of total billed charges,,
METHYLPREDNISOLONE 16 MG TABLET,J7509,HCPCS,59762-0050-1,NDC,both,0.25,ea,6.43,3.86,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,5.47,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Aetna,Commerical,,,9.34,,9.34,0.27,10.29,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Aetna,Middlesex Employees,,,8.96,,8.96,0.27,10.29,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Anthem,Commerical,,,,,,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Anthem,Indemnity,,,9.07,,9.07,0.27,10.29,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Anthem,Individual Exchange,,,,,,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Anthem,State Preferred,,,,,,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Cigna,Cigna,,0.27,,,0.27,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Connecticare,Commerical,,0.37,,,0.37,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Connecticare,Exchange,,0.37,,,0.37,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,Multiplan,Multiplan,,,10.29,,10.29,0.27,10.29,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG TABLET,J7509,HCPCS,0009-0020-01,NDC,both,2,ea,12.11,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Aetna,Commerical,,,33.72,,33.72,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Aetna,Middlesex Employees,,,32.33,,32.33,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Anthem,Commerical,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Anthem,Indemnity,,,32.74,,32.74,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Anthem,Individual Exchange,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Anthem,State Preferred,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Cigna,Cigna,,0.34,,,0.34,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Connecticare,Commerical,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Connecticare,Exchange,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,Multiplan,Multiplan,,,37.15,,37.15,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN D5W NICU,J2919,HCPCS,40810-0004-64,NDC,both,2.5,mL,43.7,26.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Aetna,Commerical,,,33.72,,33.72,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Aetna,Middlesex Employees,,,32.33,,32.33,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Anthem,Commerical,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Anthem,Indemnity,,,32.74,,32.74,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Anthem,Individual Exchange,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Anthem,State Preferred,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Cigna,Cigna,,0.34,,,0.34,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Connecticare,Commerical,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Connecticare,Exchange,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,Multiplan,Multiplan,,,37.15,,37.15,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS,J2919,HCPCS,40810-0004-65,NDC,both,2.5,mL,43.7,26.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Aetna,Commerical,,,33.72,,33.72,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Aetna,Middlesex Employees,,,32.33,,32.33,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Anthem,Commerical,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Anthem,Indemnity,,,32.74,,32.74,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Anthem,Individual Exchange,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Anthem,State Preferred,,,,,,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Cigna,Cigna,,0.34,,,0.34,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Connecticare,Commerical,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Connecticare,Exchange,,0.46,,,0.46,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,Multiplan,Multiplan,,,37.15,,37.15,0.34,37.15,percent of total billed charges,,
METHYLPREDNISOLONE 2 MG/ML IN NS CHEMO,J2919,HCPCS,40810-0203-77,NDC,both,2.5,mL,43.7,26.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,37.15,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,0.27,,,0.27,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,0781-5022-01,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,0.27,,,0.27,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,40810-0007-48,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,0.27,,,0.27,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,0.37,,,0.37,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.27,0.89,percent of total billed charges,,
METHYLPREDNISOLONE 4 MG TABLET,J7509,HCPCS,59746-001-06,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.89,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Anthem,Commerical,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Anthem,State Preferred,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Cigna,Cigna,,0.16,,,0.16,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Connecticare,Commerical,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Connecticare,Exchange,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-01,NDC,both,0.025,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Anthem,Commerical,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Anthem,State Preferred,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Cigna,Cigna,,0.16,,,0.16,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Connecticare,Commerical,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Connecticare,Exchange,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-03,NDC,both,0.025,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Aetna,Commerical,,,9.34,,9.34,0.16,10.29,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Aetna,Middlesex Employees,,,8.96,,8.96,0.16,10.29,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Anthem,Commerical,,,,,,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Anthem,Indemnity,,,9.07,,9.07,0.16,10.29,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Anthem,Individual Exchange,,,,,,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Anthem,State Preferred,,,,,,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Cigna,Cigna,,0.16,,,0.16,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Connecticare,Commerical,,0.18,,,0.18,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Connecticare,Exchange,,0.18,,,0.18,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,Multiplan,Multiplan,,,10.29,,10.29,0.16,10.29,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-22,NDC,both,0.025,mL,12.11,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,10.29,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Aetna,Commerical,,,9.35,,9.35,0.16,10.3,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Aetna,Middlesex Employees,,,8.97,,8.97,0.16,10.3,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Anthem,Commerical,,,,,,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Anthem,Indemnity,,,9.08,,9.08,0.16,10.3,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Anthem,Individual Exchange,,,,,,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Anthem,State Preferred,,,,,,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Cigna,Cigna,,0.16,,,0.16,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Connecticare,Commerical,,0.18,,,0.18,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Connecticare,Exchange,,0.18,,,0.18,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,Multiplan,Multiplan,,,10.3,,10.3,0.16,10.3,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,0009-3073-23,NDC,both,0.025,mL,12.12,7.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,10.3,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Anthem,Commerical,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Anthem,State Preferred,,,,,,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Cigna,Cigna,,0.16,,,0.16,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Connecticare,Commerical,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Connecticare,Exchange,,0.18,,,0.18,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,0.16,11.72,percent of total billed charges,,
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,J1010,HCPCS,70121-1573-1,NDC,both,0.025,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,11.72,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Aetna,Commerical,,,21.82,,21.82,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Aetna,Middlesex Employees,,,20.92,,20.92,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Anthem,Commerical,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Anthem,Indemnity,,,21.18,,21.18,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Anthem,Individual Exchange,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Anthem,State Preferred,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Cigna,Cigna,,0.34,,,0.34,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Connecticare,Commerical,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Connecticare,Exchange,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,Multiplan,Multiplan,,,24.04,,24.04,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUC (PF) 62.5 MG/ML UNDILUTED FOR IV FLUID SHORTAGE,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,65.98,39.59,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Aetna,Commerical,,,21.82,,21.82,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Aetna,Middlesex Employees,,,20.92,,20.92,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Anthem,Commerical,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Anthem,Indemnity,,,21.18,,21.18,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Anthem,Individual Exchange,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Anthem,State Preferred,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Cigna,Cigna,,0.34,,,0.34,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Connecticare,Commerical,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Connecticare,Exchange,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,Multiplan,Multiplan,,,24.04,,24.04,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-22,NDC,both,1,ea,28.28,16.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Aetna,Commerical,,,21.82,,21.82,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Aetna,Middlesex Employees,,,20.92,,20.92,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Anthem,Commerical,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Anthem,Indemnity,,,21.18,,21.18,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Anthem,Individual Exchange,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Anthem,State Preferred,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Cigna,Cigna,,0.34,,,0.34,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Connecticare,Commerical,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Connecticare,Exchange,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,Multiplan,Multiplan,,,24.04,,24.04,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-25,NDC,both,1,ea,28.28,16.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Aetna,Commerical,,,21.82,,21.82,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Aetna,Middlesex Employees,,,20.92,,20.92,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Anthem,Commerical,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Anthem,Indemnity,,,21.18,,21.18,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Anthem,Individual Exchange,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Anthem,State Preferred,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Cigna,Cigna,,0.34,,,0.34,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Connecticare,Commerical,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Connecticare,Exchange,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,Multiplan,Multiplan,,,24.04,,24.04,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-26,NDC,both,1,ea,28.28,16.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Aetna,Commerical,,,21.82,,21.82,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Aetna,Middlesex Employees,,,20.92,,20.92,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Anthem,Commerical,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Anthem,Indemnity,,,21.18,,21.18,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Anthem,Individual Exchange,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Anthem,State Preferred,,,,,,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Cigna,Cigna,,0.34,,,0.34,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Connecticare,Commerical,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Connecticare,Exchange,,0.46,,,0.46,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,Multiplan,Multiplan,,,24.04,,24.04,0.34,24.04,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0047-27,NDC,both,1,ea,28.28,16.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,24.04,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Aetna,Commerical,,,13.71,,13.71,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Aetna,Middlesex Employees,,,13.15,,13.15,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Commerical,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Indemnity,,,13.31,,13.31,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,Individual Exchange,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Anthem,State Preferred,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Cigna,Cigna,,0.34,,,0.34,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Connecticare,Commerical,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Connecticare,Exchange,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,Multiplan,Multiplan,,,15.1,,15.1,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-28,NDC,both,0.125,ea,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Aetna,Commerical,,,13.71,,13.71,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Aetna,Middlesex Employees,,,13.15,,13.15,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Anthem,Commerical,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Anthem,Indemnity,,,13.31,,13.31,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Anthem,Individual Exchange,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Anthem,State Preferred,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Cigna,Cigna,,0.34,,,0.34,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Connecticare,Commerical,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Connecticare,Exchange,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,Multiplan,Multiplan,,,15.1,,15.1,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-30,NDC,both,0.125,ea,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Aetna,Commerical,,,13.71,,13.71,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Aetna,Middlesex Employees,,,13.15,,13.15,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Anthem,Commerical,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Anthem,Indemnity,,,13.31,,13.31,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Anthem,Individual Exchange,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Anthem,State Preferred,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Cigna,Cigna,,0.34,,,0.34,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Connecticare,Commerical,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Connecticare,Exchange,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,Multiplan,Multiplan,,,15.1,,15.1,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-32,NDC,both,1,ea,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Aetna,Commerical,,,13.71,,13.71,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Aetna,Middlesex Employees,,,13.15,,13.15,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Anthem,Commerical,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Anthem,Indemnity,,,13.31,,13.31,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Anthem,Individual Exchange,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Anthem,State Preferred,,,,,,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Cigna,Cigna,,0.34,,,0.34,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Connecticare,Commerical,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Connecticare,Exchange,,0.46,,,0.46,0.34,15.1,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,Multiplan,Multiplan,,,15.1,,15.1,0.34,15.1,percent of total billed charges,,
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,J2919,HCPCS,0009-0039-33,NDC,both,0.125,ea,17.77,10.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,15.1,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Aetna,Commerical,,,99,,99,0.34,109.06,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Aetna,Middlesex Employees,,,94.94,,94.94,0.34,109.06,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Anthem,Commerical,,,,,,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Anthem,Indemnity,,,96.12,,96.12,0.34,109.06,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Anthem,Individual Exchange,,,,,,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Anthem,State Preferred,,,,,,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Cigna,Cigna,,0.34,,,0.34,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Connecticare,Commerical,,0.46,,,0.46,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Connecticare,Exchange,,0.46,,,0.46,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,Multiplan,Multiplan,,,109.06,,109.06,0.34,109.06,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0018-20,NDC,both,0.005,ea,128.31,76.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,109.06,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Aetna,Commerical,,,160.24,,160.24,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Aetna,Middlesex Employees,,,153.66,,153.66,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Anthem,Commerical,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Anthem,Indemnity,,,155.57,,155.57,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Anthem,Individual Exchange,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Anthem,State Preferred,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Cigna,Cigna,,0.34,,,0.34,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Connecticare,Commerical,,0.46,,,0.46,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Connecticare,Exchange,,0.46,,,0.46,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,Multiplan,Multiplan,,,176.52,,176.52,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,0009-0698-01,NDC,both,0.005,ea,207.67,124.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Aetna,Commerical,,,160.24,,160.24,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Aetna,Middlesex Employees,,,153.66,,153.66,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Anthem,Commerical,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Anthem,Indemnity,,,155.57,,155.57,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Anthem,Individual Exchange,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Anthem,State Preferred,,,,,,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Cigna,Cigna,,0.34,,,0.34,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Connecticare,Commerical,,0.46,,,0.46,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Connecticare,Exchange,,0.46,,,0.46,0.34,176.52,Other,Could be inpatient or outpatient,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,Multiplan,Multiplan,,,176.52,,176.52,0.34,176.52,percent of total billed charges,,
"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",J2919,HCPCS,63323-265-30,NDC,both,0.005,ea,207.67,124.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,176.52,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Aetna,Commerical,,,62.45,,62.45,0.34,68.79,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Aetna,Middlesex Employees,,,59.88,,59.88,0.34,68.79,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Anthem,Commerical,,,,,,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Anthem,Indemnity,,,60.62,,60.62,0.34,68.79,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Anthem,Individual Exchange,,,,,,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Anthem,State Preferred,,,,,,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Cigna,Cigna,,0.34,,,0.34,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Connecticare,Commerical,,0.46,,,0.46,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Connecticare,Exchange,,0.46,,,0.46,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,Multiplan,Multiplan,,,68.79,,68.79,0.34,68.79,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0003-02,NDC,both,0.01,ea,80.93,48.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,68.79,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Aetna,Commerical,,,123.24,,123.24,0.34,135.76,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Aetna,Middlesex Employees,,,118.18,,118.18,0.34,135.76,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Anthem,Commerical,,,,,,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Anthem,Indemnity,,,119.65,,119.65,0.34,135.76,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Anthem,Individual Exchange,,,,,,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Anthem,State Preferred,,,,,,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Cigna,Cigna,,0.34,,,0.34,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Connecticare,Commerical,,0.46,,,0.46,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Connecticare,Exchange,,0.46,,,0.46,0.34,135.76,Other,Could be inpatient or outpatient,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,Multiplan,Multiplan,,,135.76,,135.76,0.34,135.76,percent of total billed charges,,
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,J2919,HCPCS,0009-0758-01,NDC,both,0.01,ea,159.72,95.83,United Healthcare/Oxford,United Healthcare/Oxford,,0.37,,,0.37,0.34,135.76,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,0093-2203-01,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-01,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,60687-631-11,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-01,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Aetna,Commerical,,,1.77,,1.77,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Aetna,Middlesex Employees,,,1.7,,1.7,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Anthem,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Anthem,Indemnity,,,1.72,,1.72,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Anthem,Individual Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Anthem,State Preferred,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Cigna,Cigna,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Connecticare,Commerical,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Connecticare,Exchange,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,Multiplan,Multiplan,,,1.96,,1.96,1.7,1.96,percent of total billed charges,,
METOCLOPRAMIDE 10 MG TABLET,J3490,HCPCS,68084-676-11,NDC,both,1,ea,2.3,1.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.7,1.96,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-05,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
METOCLOPRAMIDE 5 MG TABLET,J3490,HCPCS,0093-2204-01,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Aetna,Commerical,,,37.75,,37.75,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Aetna,Middlesex Employees,,,36.2,,36.2,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Anthem,Commerical,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Anthem,Indemnity,,,36.65,,36.65,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Anthem,Individual Exchange,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Anthem,State Preferred,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Cigna,Cigna,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Connecticare,Commerical,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Connecticare,Exchange,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,Multiplan,Multiplan,,,41.58,,41.58,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0576-16,NDC,both,1,mL,48.92,29.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Aetna,Commerical,,,37.75,,37.75,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Aetna,Middlesex Employees,,,36.2,,36.2,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Anthem,Commerical,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Anthem,Indemnity,,,36.65,,36.65,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Anthem,Individual Exchange,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Anthem,State Preferred,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Cigna,Cigna,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Connecticare,Commerical,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Connecticare,Exchange,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,Multiplan,Multiplan,,,41.58,,41.58,36.2,41.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,62559-190-16,NDC,both,1,mL,48.92,29.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.2,41.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,3.91,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,3.91,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,3.91,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Anthem,Commerical,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Anthem,State Preferred,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Cigna,Cigna,,1.05,,,1.05,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Connecticare,Commerical,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Connecticare,Exchange,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Anthem,Commerical,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Anthem,State Preferred,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Cigna,Cigna,,1.05,,,1.05,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Connecticare,Commerical,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Connecticare,Exchange,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Aetna,Commerical,,,2.34,,2.34,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Aetna,Middlesex Employees,,,2.24,,2.24,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Anthem,Commerical,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Anthem,Indemnity,,,2.27,,2.27,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Anthem,Individual Exchange,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Anthem,State Preferred,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Cigna,Cigna,,1.05,,,1.05,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Connecticare,Commerical,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Connecticare,Exchange,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,Multiplan,Multiplan,,,2.58,,2.58,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-31,NDC,both,2,mL,3.03,1.82,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Aetna,Commerical,,,2.34,,2.34,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Aetna,Middlesex Employees,,,2.24,,2.24,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Anthem,Commerical,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Anthem,Indemnity,,,2.27,,2.27,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Anthem,Individual Exchange,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Anthem,State Preferred,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Cigna,Cigna,,1.05,,,1.05,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Connecticare,Commerical,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Connecticare,Exchange,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,Multiplan,Multiplan,,,2.58,,2.58,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,23155-240-41,NDC,both,2,mL,3.03,1.82,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-02,NDC,both,2,mL,3.91,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,J2765,HCPCS,83634-779-41,NDC,both,2,mL,3.91,2.35,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-01,NDC,both,2,mL,41.61,24.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-11,NDC,both,2,mL,41.61,24.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Aetna,Commerical,,,3.02,,3.02,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Aetna,Middlesex Employees,,,2.89,,2.89,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Anthem,Commerical,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Anthem,Indemnity,,,2.93,,2.93,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Anthem,Individual Exchange,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Anthem,State Preferred,,,,,,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Cigna,Cigna,,1.05,,,1.05,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Connecticare,Commerical,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Connecticare,Exchange,,1.52,,,1.52,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,Multiplan,Multiplan,,,3.32,,3.32,1.05,3.32,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0409-3414-21,NDC,both,2,mL,41.61,24.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,3.32,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Aetna,Commerical,,,2.66,,2.66,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Aetna,Middlesex Employees,,,2.55,,2.55,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Anthem,Commerical,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Anthem,Indemnity,,,2.58,,2.58,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Anthem,Individual Exchange,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Anthem,State Preferred,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Cigna,Cigna,,1.05,,,1.05,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Connecticare,Commerical,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Connecticare,Exchange,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,Multiplan,Multiplan,,,2.93,,2.93,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-01,NDC,both,2,mL,41.15,24.69,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Aetna,Commerical,,,2.66,,2.66,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Aetna,Middlesex Employees,,,2.55,,2.55,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Anthem,Commerical,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Anthem,Indemnity,,,2.58,,2.58,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Anthem,Individual Exchange,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Anthem,State Preferred,,,,,,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Cigna,Cigna,,1.05,,,1.05,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Connecticare,Commerical,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Connecticare,Exchange,,1.52,,,1.52,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,Multiplan,Multiplan,,,2.93,,2.93,1.05,2.93,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,0703-4502-04,NDC,both,2,mL,41.15,24.69,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.93,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Aetna,Commerical,,,2.34,,2.34,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Aetna,Middlesex Employees,,,2.24,,2.24,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Anthem,Commerical,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Anthem,Indemnity,,,2.27,,2.27,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Anthem,Individual Exchange,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Anthem,State Preferred,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Cigna,Cigna,,1.05,,,1.05,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Connecticare,Commerical,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Connecticare,Exchange,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,Multiplan,Multiplan,,,2.58,,2.58,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-31,NDC,both,2,mL,40.73,24.44,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Aetna,Commerical,,,2.34,,2.34,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Aetna,Middlesex Employees,,,2.24,,2.24,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Anthem,Commerical,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Anthem,Indemnity,,,2.27,,2.27,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Anthem,Individual Exchange,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Anthem,State Preferred,,,,,,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Cigna,Cigna,,1.05,,,1.05,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Connecticare,Commerical,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Connecticare,Exchange,,1.52,,,1.52,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,Multiplan,Multiplan,,,2.58,,2.58,1.05,2.58,percent of total billed charges,,
METOCLOPRAMIDE 5 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2765,HCPCS,23155-240-41,NDC,both,2,mL,40.73,24.44,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,2.58,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Aetna,Commerical,,,62.79,,62.79,1.05,69.16,percent of total billed charges,,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Aetna,Middlesex Employees,,,60.21,,60.21,1.05,69.16,percent of total billed charges,,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Anthem,Commerical,,,,,,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Anthem,Indemnity,,,60.95,,60.95,1.05,69.16,percent of total billed charges,,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Anthem,Individual Exchange,,,,,,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Anthem,State Preferred,,,,,,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Cigna,Cigna,,1.05,,,1.05,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Connecticare,Commerical,,1.52,,,1.52,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Connecticare,Exchange,,1.52,,,1.52,1.05,69.16,Other,Could be inpatient or outpatient,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,Multiplan,Multiplan,,,69.16,,69.16,1.05,69.16,percent of total billed charges,,
METOCLOPRAMIDE IV 0.1 MG/ML IN D5W DILUTION,J2765,HCPCS,40810-0004-66,NDC,both,100,mL,81.37,48.82,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,69.16,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Aetna,Commerical,,,61.71,,61.71,59.18,67.98,percent of total billed charges,,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Aetna,Middlesex Employees,,,59.18,,59.18,59.18,67.98,percent of total billed charges,,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Anthem,Commerical,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Anthem,Indemnity,,,59.91,,59.91,59.18,67.98,percent of total billed charges,,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Anthem,Individual Exchange,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Anthem,State Preferred,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Cigna,Cigna,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Connecticare,Commerical,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Connecticare,Exchange,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,Multiplan,Multiplan,,,67.98,,67.98,59.18,67.98,percent of total billed charges,,
METOLAZONE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0004-06,NDC,both,1,mL,79.98,47.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.18,67.98,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
METOLAZONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0004-07,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Aetna,Commerical,,,7.73,,7.73,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Aetna,Middlesex Employees,,,7.41,,7.41,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Anthem,Commerical,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Anthem,Indemnity,,,7.51,,7.51,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Anthem,Individual Exchange,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Anthem,State Preferred,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Cigna,Cigna,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Connecticare,Commerical,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Connecticare,Exchange,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,Multiplan,Multiplan,,,8.52,,8.52,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-01,NDC,both,1,ea,10.02,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Aetna,Commerical,,,7.73,,7.73,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Aetna,Middlesex Employees,,,7.41,,7.41,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Anthem,Commerical,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Anthem,Indemnity,,,7.51,,7.51,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Anthem,Individual Exchange,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Anthem,State Preferred,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Cigna,Cigna,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Connecticare,Commerical,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Connecticare,Exchange,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,Multiplan,Multiplan,,,8.52,,8.52,7.41,8.52,percent of total billed charges,,
METOLAZONE 2.5 MG TABLET,J3490,HCPCS,51079-023-20,NDC,both,1,ea,10.02,6.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.41,8.52,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Aetna,Commerical,,,1.92,,1.92,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Aetna,Middlesex Employees,,,1.84,,1.84,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Anthem,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Anthem,Indemnity,,,1.87,,1.87,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Anthem,Individual Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Anthem,State Preferred,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Cigna,Cigna,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Connecticare,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Connecticare,Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,Multiplan,Multiplan,,,2.12,,2.12,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,0185-0055-01,NDC,both,1,ea,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Aetna,Commerical,,,1.92,,1.92,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Aetna,Middlesex Employees,,,1.84,,1.84,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Anthem,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Anthem,Indemnity,,,1.87,,1.87,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Anthem,Individual Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Anthem,State Preferred,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Cigna,Cigna,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Connecticare,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Connecticare,Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,Multiplan,Multiplan,,,2.12,,2.12,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-01,NDC,both,1,ea,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Aetna,Commerical,,,1.92,,1.92,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Aetna,Middlesex Employees,,,1.84,,1.84,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Anthem,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Anthem,Indemnity,,,1.87,,1.87,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Anthem,Individual Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Anthem,State Preferred,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Cigna,Cigna,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Connecticare,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Connecticare,Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,Multiplan,Multiplan,,,2.12,,2.12,1.84,2.12,percent of total billed charges,,
METOLAZONE 5 MG TABLET,J3490,HCPCS,51079-024-20,NDC,both,1,ea,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6324-61,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-11,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-542-15,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Aetna,Commerical,,,1.17,,1.17,1.12,1.28,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Aetna,Middlesex Employees,,,1.12,,1.12,1.12,1.28,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Anthem,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Anthem,Indemnity,,,1.13,,1.13,1.12,1.28,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Anthem,Individual Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Anthem,State Preferred,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Cigna,Cigna,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Connecticare,Commerical,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Connecticare,Exchange,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,Multiplan,Multiplan,,,1.28,,1.28,1.12,1.28,percent of total billed charges,,
"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6323-61,NDC,both,1,ea,1.51,0.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.12,1.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Aetna,Commerical,,,85.38,,85.38,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Aetna,Middlesex Employees,,,81.87,,81.87,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Anthem,Commerical,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Anthem,Indemnity,,,82.89,,82.89,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Anthem,Individual Exchange,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Anthem,State Preferred,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Cigna,Cigna,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Connecticare,Commerical,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Connecticare,Exchange,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,Multiplan,Multiplan,,,94.05,,94.05,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0203-47,NDC,both,1,mL,110.65,66.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Aetna,Commerical,,,85.38,,85.38,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Aetna,Middlesex Employees,,,81.87,,81.87,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Anthem,Commerical,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Anthem,Indemnity,,,82.89,,82.89,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Anthem,Individual Exchange,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Anthem,State Preferred,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Cigna,Cigna,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Connecticare,Commerical,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Connecticare,Exchange,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,Multiplan,Multiplan,,,94.05,,94.05,81.87,94.05,percent of total billed charges,,
METOPROLOL TARTRATE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-230-03,NDC,both,1,mL,110.65,66.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,81.87,94.05,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0004-09,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
METOPROLOL TARTRATE 25 MG TABLET,J3490,HCPCS,62584-265-11,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1778-05,NDC,both,1,mL,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-05,NDC,both,1,mL,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-2016-10,NDC,both,1,mL,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-660-05,NDC,both,1,mL,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,0904-7118-61,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-01,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,51079-801-20,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
METOPROLOL TARTRATE 50 MG TABLET,J3490,HCPCS,62584-266-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
METOPROLOL TARTRATE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0004-10,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Aetna,Commerical,,,38.43,,38.43,36.85,42.34,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Aetna,Middlesex Employees,,,36.85,,36.85,36.85,42.34,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Anthem,Commerical,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Anthem,Indemnity,,,37.31,,37.31,36.85,42.34,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Anthem,Individual Exchange,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Anthem,State Preferred,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Cigna,Cigna,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Connecticare,Commerical,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Connecticare,Exchange,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,Multiplan,Multiplan,,,42.34,,42.34,36.85,42.34,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0115-1474-46,NDC,both,45,gm,49.81,29.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,36.85,42.34,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Aetna,Commerical,,,407.74,,407.74,390.99,449.17,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Aetna,Middlesex Employees,,,390.99,,390.99,390.99,449.17,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Anthem,Commerical,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Anthem,Indemnity,,,395.85,,395.85,390.99,449.17,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Anthem,Individual Exchange,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Anthem,State Preferred,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Cigna,Cigna,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Connecticare,Commerical,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Connecticare,Exchange,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,Multiplan,Multiplan,,,449.17,,449.17,390.99,449.17,percent of total billed charges,,
METRONIDAZOLE 0.75 % TOPICAL GEL,J3490,HCPCS,0713-0637-37,NDC,both,1,gm,528.43,317.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,390.99,449.17,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Aetna,Commerical,,,1070.8,,1070.8,1026.81,1179.6,percent of total billed charges,,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Aetna,Middlesex Employees,,,1026.81,,1026.81,1026.81,1179.6,percent of total billed charges,,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Anthem,Commerical,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Anthem,Indemnity,,,1039.58,,1039.58,1026.81,1179.6,percent of total billed charges,,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Anthem,Individual Exchange,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Anthem,State Preferred,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Cigna,Cigna,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Connecticare,Commerical,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Connecticare,Exchange,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,Multiplan,Multiplan,,,1179.6,,1179.6,1026.81,1179.6,percent of total billed charges,,
METRONIDAZOLE 1 % TOPICAL GEL,J3490,HCPCS,0299-3820-60,NDC,both,60,gm,1387.77,832.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1026.81,1179.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
METRONIDAZOLE 125 MG ORAL TAB,J3490,HCPCS,40810-0002-06,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-1453-61,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
METRONIDAZOLE 250 MG TABLET,J3490,HCPCS,0904-7156-61,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Aetna,Commerical,,,17.5,,17.5,16.78,19.28,percent of total billed charges,,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Aetna,Middlesex Employees,,,16.78,,16.78,16.78,19.28,percent of total billed charges,,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Anthem,Commerical,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Anthem,Indemnity,,,16.99,,16.99,16.78,19.28,percent of total billed charges,,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Anthem,Individual Exchange,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Anthem,State Preferred,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Cigna,Cigna,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Connecticare,Commerical,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Connecticare,Exchange,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,Multiplan,Multiplan,,,19.28,,19.28,16.78,19.28,percent of total billed charges,,
METRONIDAZOLE 375 MG CAPSULE,J3490,HCPCS,0025-1942-50,NDC,both,1,ea,22.68,13.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.78,19.28,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 5 MG/ML IV,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Aetna,Commerical,,,129.44,,129.44,124.13,142.6,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Aetna,Middlesex Employees,,,124.13,,124.13,124.13,142.6,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Anthem,Commerical,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Anthem,Indemnity,,,125.67,,125.67,124.13,142.6,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Anthem,Individual Exchange,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Anthem,State Preferred,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Cigna,Cigna,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Connecticare,Commerical,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Connecticare,Exchange,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,Multiplan,Multiplan,,,142.6,,142.6,124.13,142.6,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-07,NDC,both,1,mL,167.76,100.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,124.13,142.6,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Aetna,Commerical,,,258.88,,258.88,248.24,285.18,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Aetna,Middlesex Employees,,,248.24,,248.24,248.24,285.18,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Anthem,Commerical,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Anthem,Indemnity,,,251.33,,251.33,248.24,285.18,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Anthem,Individual Exchange,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Anthem,State Preferred,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Cigna,Cigna,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Connecticare,Commerical,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Connecticare,Exchange,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,Multiplan,Multiplan,,,285.18,,285.18,248.24,285.18,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-38,NDC,both,1,mL,335.51,201.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,248.24,285.18,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Aetna,Commerical,,,161.8,,161.8,155.16,178.25,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Aetna,Middlesex Employees,,,155.16,,155.16,155.16,178.25,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Anthem,Commerical,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Anthem,Indemnity,,,157.09,,157.09,155.16,178.25,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Anthem,Individual Exchange,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Anthem,State Preferred,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Cigna,Cigna,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Connecticare,Commerical,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Connecticare,Exchange,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,Multiplan,Multiplan,,,178.25,,178.25,155.16,178.25,percent of total billed charges,,
METRONIDAZOLE 50 MG/ML ORAL SUSP,J8499,HCPCS,65628-202-05,NDC,both,10,mL,209.7,125.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,155.16,178.25,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,0904-7126-61,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,42292-001-20,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50111-334-01,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-11,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,50268-535-15,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-01,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
METRONIDAZOLE 500 MG TABLET,J3490,HCPCS,60687-550-11,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,25021-131-82,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0338-1055-48,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-01,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-0152-24,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-11,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,0409-7811-24,NDC,both,1,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Aetna,Commerical,,,33.53,,33.53,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Aetna,Middlesex Employees,,,32.15,,32.15,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Commerical,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Indemnity,,,32.55,,32.55,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,Individual Exchange,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Anthem,State Preferred,,,,,,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Cigna,Cigna,,0.03,,,0.03,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Connecticare,Commerical,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Connecticare,Exchange,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,Multiplan,Multiplan,,,36.93,,36.93,0.03,36.93,percent of total billed charges,,
METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE (ISO) INTRAVENOUS PIGGYYBACK FOR CAROUSEL,J1836,HCPCS,47335-993-01,NDC,both,2,mL,43.45,26.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,36.93,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Aetna,Commerical,,,670.43,,670.43,642.88,738.55,percent of total billed charges,,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Aetna,Middlesex Employees,,,642.88,,642.88,642.88,738.55,percent of total billed charges,,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Anthem,Commerical,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Anthem,Indemnity,,,650.88,,650.88,642.88,738.55,percent of total billed charges,,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Anthem,Individual Exchange,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Anthem,State Preferred,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Cigna,Cigna,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Connecticare,Commerical,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Connecticare,Exchange,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,Multiplan,Multiplan,,,738.55,,738.55,642.88,738.55,percent of total billed charges,,
METYROSINE 250 MG CAPSULE,J8499,HCPCS,25010-305-15,NDC,both,1,ea,868.88,521.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,642.88,738.55,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Aetna,Commerical,,,16.28,,16.28,15.61,17.94,percent of total billed charges,,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Aetna,Middlesex Employees,,,15.61,,15.61,15.61,17.94,percent of total billed charges,,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Anthem,Commerical,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Anthem,Indemnity,,,15.81,,15.81,15.61,17.94,percent of total billed charges,,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Anthem,Individual Exchange,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Anthem,State Preferred,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Cigna,Cigna,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Connecticare,Commerical,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Connecticare,Exchange,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,Multiplan,Multiplan,,,17.94,,17.94,15.61,17.94,percent of total billed charges,,
MEXILETINE 10 MG/ML ORAL SOLUTION,J3490,HCPCS,40810-0012-39,NDC,both,14.926,mL,21.1,12.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.61,17.94,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Aetna,Commerical,,,3.56,,3.56,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Aetna,Middlesex Employees,,,3.41,,3.41,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Anthem,Commerical,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Anthem,Indemnity,,,3.45,,3.45,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Anthem,Individual Exchange,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Anthem,State Preferred,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Cigna,Cigna,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Connecticare,Commerical,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Connecticare,Exchange,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,Multiplan,Multiplan,,,3.92,,3.92,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,0093-8739-01,NDC,both,1,ea,4.61,2.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Aetna,Commerical,,,3.56,,3.56,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Aetna,Middlesex Employees,,,3.41,,3.41,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Anthem,Commerical,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Anthem,Indemnity,,,3.45,,3.45,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Anthem,Individual Exchange,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Anthem,State Preferred,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Cigna,Cigna,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Connecticare,Commerical,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Connecticare,Exchange,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,Multiplan,Multiplan,,,3.92,,3.92,3.41,3.92,percent of total billed charges,,
MEXILETINE 150 MG CAPSULE,J3490,HCPCS,40810-0015-78,NDC,both,1,ea,4.61,2.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.41,3.92,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Aetna,Commerical,,,4.33,,4.33,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Aetna,Middlesex Employees,,,4.15,,4.15,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Anthem,Commerical,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Anthem,Indemnity,,,4.2,,4.2,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Anthem,Individual Exchange,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Anthem,State Preferred,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Cigna,Cigna,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Connecticare,Commerical,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Connecticare,Exchange,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,Multiplan,Multiplan,,,4.77,,4.77,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,0093-8740-01,NDC,both,1,ea,5.61,3.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Aetna,Commerical,,,4.33,,4.33,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Aetna,Middlesex Employees,,,4.15,,4.15,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Anthem,Commerical,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Anthem,Indemnity,,,4.2,,4.2,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Anthem,Individual Exchange,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Anthem,State Preferred,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Cigna,Cigna,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Connecticare,Commerical,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Connecticare,Exchange,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,Multiplan,Multiplan,,,4.77,,4.77,4.15,4.77,percent of total billed charges,,
MEXILETINE 200 MG CAPSULE,J3490,HCPCS,40810-0015-79,NDC,both,1,ea,5.61,3.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.15,4.77,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Aetna,Commerical,,,96.71,,96.71,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Aetna,Middlesex Employees,,,92.74,,92.74,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Commerical,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Indemnity,,,93.89,,93.89,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Individual Exchange,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Anthem,State Preferred,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Cigna,Cigna,,0.55,,,0.55,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Connecticare,Commerical,,0.53,,,0.53,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Connecticare,Exchange,,0.53,,,0.53,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,Multiplan,Multiplan,,,106.54,,106.54,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-01,NDC,both,0.01,ea,125.34,75.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.6,,,0.6,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Commerical,,,96.71,,96.71,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Middlesex Employees,,,92.74,,92.74,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Commerical,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Indemnity,,,93.89,,93.89,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Individual Exchange,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Anthem,State Preferred,,,,,,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Cigna,Cigna,,0.55,,,0.55,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Commerical,,0.53,,,0.53,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Exchange,,0.53,,,0.53,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,Multiplan,Multiplan,,,106.54,,106.54,0.53,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-230-10,NDC,both,0.01,ea,125.34,75.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.6,,,0.6,0.53,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Aetna,Commerical,,,188.13,,188.13,0.44,207.25,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Aetna,Middlesex Employees,,,180.4,,180.4,0.44,207.25,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Anthem,Commerical,,,,,,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Anthem,Indemnity,,,182.65,,182.65,0.44,207.25,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Anthem,Individual Exchange,,,,,,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Anthem,State Preferred,,,,,,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Cigna,Cigna,,0.47,,,0.47,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Connecticare,Commerical,,0.44,,,0.44,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Connecticare,Exchange,,0.44,,,0.44,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,Multiplan,Multiplan,,,207.25,,207.25,0.44,207.25,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3211-10,NDC,both,0.01,ea,243.82,146.29,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,207.25,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Commerical,,,96.71,,96.71,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Middlesex Employees,,,92.74,,92.74,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Commerical,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Indemnity,,,93.89,,93.89,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Individual Exchange,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Anthem,State Preferred,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Cigna,Cigna,,0.47,,,0.47,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Commerical,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Exchange,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,Multiplan,Multiplan,,,106.54,,106.54,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-191-10,NDC,both,0.01,ea,125.34,75.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Aetna,Commerical,,,96.71,,96.71,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Aetna,Middlesex Employees,,,92.74,,92.74,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Commerical,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Indemnity,,,93.89,,93.89,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Anthem,Individual Exchange,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Anthem,State Preferred,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Cigna,Cigna,,0.47,,,0.47,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Connecticare,Commerical,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Connecticare,Exchange,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,Multiplan,Multiplan,,,106.54,,106.54,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-01,NDC,both,0.01,ea,125.34,75.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Commerical,,,96.71,,96.71,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Aetna,Middlesex Employees,,,92.74,,92.74,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Commerical,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Indemnity,,,93.89,,93.89,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Anthem,Individual Exchange,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Anthem,State Preferred,,,,,,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Cigna,Cigna,,0.47,,,0.47,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Commerical,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Connecticare,Exchange,,0.44,,,0.44,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,Multiplan,Multiplan,,,106.54,,106.54,0.44,106.54,percent of total billed charges,,
MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-729-10,NDC,both,0.01,ea,125.34,75.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,106.54,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.55,,,0.55,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.53,,,0.53,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.53,,,0.53,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-01,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.6,,,0.6,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.55,,,0.55,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.53,,,0.53,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.53,,,0.53,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.53,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2247,HCPCS,42023-229-10,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.6,,,0.6,0.53,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Aetna,Commerical,,,94.19,,94.19,0.44,103.76,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Aetna,Middlesex Employees,,,90.32,,90.32,0.44,103.76,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Anthem,Commerical,,,,,,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Anthem,Indemnity,,,91.44,,91.44,0.44,103.76,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Anthem,Individual Exchange,,,,,,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Anthem,State Preferred,,,,,,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Cigna,Cigna,,0.47,,,0.47,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Connecticare,Commerical,,0.44,,,0.44,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Connecticare,Exchange,,0.44,,,0.44,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,Multiplan,Multiplan,,,103.76,,103.76,0.44,103.76,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,0469-3250-10,NDC,both,0.02,ea,122.07,73.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,103.76,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-10,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,25021-190-11,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-0,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,60505-6119-5,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-01,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,63323-728-10,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-10,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Aetna,Commerical,,,55.47,,55.47,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Aetna,Middlesex Employees,,,53.19,,53.19,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Commerical,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Indemnity,,,53.85,,53.85,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Anthem,Individual Exchange,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Anthem,State Preferred,,,,,,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Cigna,Cigna,,0.47,,,0.47,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Connecticare,Commerical,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Connecticare,Exchange,,0.44,,,0.44,0.44,61.11,Other,Could be inpatient or outpatient,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,Multiplan,Multiplan,,,61.11,,61.11,0.44,61.11,percent of total billed charges,,
MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,J2248,HCPCS,71288-028-11,NDC,both,0.02,ea,71.89,43.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.51,,,0.51,0.44,61.11,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Aetna,Commerical,,,7.77,,7.77,7.45,8.56,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Aetna,Middlesex Employees,,,7.45,,7.45,7.45,8.56,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Anthem,Commerical,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Anthem,Indemnity,,,7.54,,7.54,7.45,8.56,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Anthem,Individual Exchange,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Anthem,State Preferred,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Cigna,Cigna,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Connecticare,Commerical,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Connecticare,Exchange,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,Multiplan,Multiplan,,,8.56,,8.56,7.45,8.56,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,J3490,HCPCS,8438913551,NDC,both,71,gm,10.07,6.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.45,8.56,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Aetna,Commerical,,,10.56,,10.56,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Aetna,Middlesex Employees,,,10.12,,10.12,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Anthem,Commerical,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Anthem,Indemnity,,,10.25,,10.25,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Anthem,Individual Exchange,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Anthem,State Preferred,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Cigna,Cigna,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Connecticare,Commerical,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Connecticare,Exchange,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,Multiplan,Multiplan,,,11.63,,11.63,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,8019652856,NDC,both,1,gm,13.68,8.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Aetna,Commerical,,,10.56,,10.56,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Aetna,Middlesex Employees,,,10.12,,10.12,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Anthem,Commerical,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Anthem,Indemnity,,,10.25,,10.25,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Anthem,Individual Exchange,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Anthem,State Preferred,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Cigna,Cigna,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Connecticare,Commerical,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Connecticare,Exchange,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,Multiplan,Multiplan,,,11.63,,11.63,10.12,11.63,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,0316-0225-30,NDC,both,1,gm,13.68,8.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.12,11.63,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Aetna,Commerical,,,20.1,,20.1,19.27,22.14,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Aetna,Middlesex Employees,,,19.27,,19.27,19.27,22.14,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Anthem,Commerical,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Anthem,Indemnity,,,19.51,,19.51,19.27,22.14,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Anthem,Individual Exchange,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Anthem,State Preferred,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Cigna,Cigna,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Connecticare,Commerical,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Connecticare,Exchange,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,Multiplan,Multiplan,,,22.14,,22.14,19.27,22.14,percent of total billed charges,,
MICONAZOLE NITRATE 2 % TOPICAL POWDER,J3490,HCPCS,11701-038-16,NDC,both,1,gm,26.05,15.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.27,22.14,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Aetna,Commerical,,,14.9,,14.9,14.29,16.41,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Aetna,Middlesex Employees,,,14.29,,14.29,14.29,16.41,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Anthem,Commerical,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Anthem,Indemnity,,,14.47,,14.47,14.29,16.41,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Anthem,Individual Exchange,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Anthem,State Preferred,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Cigna,Cigna,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Connecticare,Commerical,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Connecticare,Exchange,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,Multiplan,Multiplan,,,16.41,,16.41,14.29,16.41,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,0904-7734-45,NDC,both,1,gm,19.31,11.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.29,16.41,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Aetna,Commerical,,,10.78,,10.78,10.34,11.87,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Aetna,Middlesex Employees,,,10.34,,10.34,10.34,11.87,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Anthem,Commerical,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Anthem,Indemnity,,,10.46,,10.46,10.34,11.87,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Anthem,Individual Exchange,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Anthem,State Preferred,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Cigna,Cigna,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Connecticare,Commerical,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Connecticare,Exchange,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,Multiplan,Multiplan,,,11.87,,11.87,10.34,11.87,percent of total billed charges,,
MICONAZOLE NITRATE 2 % VAGINAL CREAM,J3490,HCPCS,51672-2035-6,NDC,both,1,gm,13.97,8.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.34,11.87,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Aetna,Commerical,,,99.59,,99.59,95.5,109.71,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Aetna,Middlesex Employees,,,95.5,,95.5,95.5,109.71,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Anthem,Commerical,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Anthem,Indemnity,,,96.69,,96.69,95.5,109.71,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Anthem,Individual Exchange,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Anthem,State Preferred,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Cigna,Cigna,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Connecticare,Commerical,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Connecticare,Exchange,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,Multiplan,Multiplan,,,109.71,,109.71,95.5,109.71,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,J3490,HCPCS,0472-1738-03,NDC,both,3,ea,129.07,77.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,95.5,109.71,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Aetna,Commerical,,,31,,31,29.73,34.15,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Aetna,Middlesex Employees,,,29.73,,29.73,29.73,34.15,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Anthem,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Anthem,Indemnity,,,30.1,,30.1,29.73,34.15,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Anthem,Individual Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Anthem,State Preferred,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Cigna,Cigna,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Connecticare,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Connecticare,Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,Multiplan,Multiplan,,,34.15,,34.15,29.73,34.15,percent of total billed charges,,
MICONAZOLE NITRATE 200 MG-2 % (9 GRAM) VAGINAL KIT,J3490,HCPCS,37205-589-03,NDC,both,1,ea,40.18,24.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Aetna,Commerical,,,339.85,,339.85,325.89,374.38,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Aetna,Middlesex Employees,,,325.89,,325.89,325.89,374.38,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Anthem,Commerical,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Anthem,Indemnity,,,329.94,,329.94,325.89,374.38,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Anthem,Individual Exchange,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Anthem,State Preferred,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Cigna,Cigna,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Connecticare,Commerical,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Connecticare,Exchange,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,Multiplan,Multiplan,,,374.38,,374.38,325.89,374.38,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT 35 MM X 35 MM SHEETS,J3490,HCPCS,53276-1010-08,NDC,both,1,ea,440.45,264.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,325.89,374.38,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Aetna,Commerical,,,714.19,,714.19,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Aetna,Middlesex Employees,,,684.84,,684.84,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Anthem,Commerical,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Anthem,Indemnity,,,693.36,,693.36,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Anthem,Individual Exchange,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Anthem,State Preferred,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Cigna,Cigna,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Connecticare,Commerical,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Connecticare,Exchange,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,Multiplan,Multiplan,,,786.75,,786.75,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-02,NDC,both,1,gm,925.59,555.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Aetna,Commerical,,,3570.91,,3570.91,3424.21,3933.74,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Aetna,Middlesex Employees,,,3424.21,,3424.21,3424.21,3933.74,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Anthem,Commerical,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Anthem,Indemnity,,,3466.78,,3466.78,3424.21,3933.74,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Anthem,Individual Exchange,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Anthem,State Preferred,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Cigna,Cigna,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Connecticare,Commerical,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Connecticare,Exchange,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,Multiplan,Multiplan,,,3933.74,,3933.74,3424.21,3933.74,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,53276-1010-59,NDC,both,1,gm,4627.93,2776.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3424.21,3933.74,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Aetna,Commerical,,,714.19,,714.19,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Aetna,Middlesex Employees,,,684.84,,684.84,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Anthem,Commerical,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Anthem,Indemnity,,,693.36,,693.36,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Anthem,Individual Exchange,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Anthem,State Preferred,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Cigna,Cigna,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Connecticare,Commerical,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Connecticare,Exchange,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,Multiplan,Multiplan,,,786.75,,786.75,684.84,786.75,percent of total billed charges,,
MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,J3490,HCPCS,63713-0019-85,NDC,both,1,gm,925.59,555.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,684.84,786.75,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Aetna,Commerical,,,1.43,,1.43,0.16,1.57,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Aetna,Middlesex Employees,,,1.37,,1.37,0.16,1.57,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Anthem,Commerical,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Anthem,Indemnity,,,1.39,,1.39,0.16,1.57,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Anthem,Individual Exchange,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Anthem,State Preferred,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Cigna,Cigna,,0.16,,,0.16,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Connecticare,Commerical,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Connecticare,Exchange,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,Multiplan,Multiplan,,,1.57,,1.57,0.16,1.57,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,6.64,3.98,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Aetna,Commerical,,,17.38,,17.38,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Aetna,Middlesex Employees,,,16.67,,16.67,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Anthem,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Anthem,Indemnity,,,16.88,,16.88,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Anthem,Individual Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Anthem,State Preferred,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Cigna,Cigna,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Connecticare,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Connecticare,Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,Multiplan,Multiplan,,,19.15,,19.15,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-59,NDC,both,5,mL,22.53,13.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Aetna,Commerical,,,17.38,,17.38,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Aetna,Middlesex Employees,,,16.67,,16.67,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Anthem,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Anthem,Indemnity,,,16.88,,16.88,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Anthem,Individual Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Anthem,State Preferred,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Cigna,Cigna,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Connecticare,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Connecticare,Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,Multiplan,Multiplan,,,19.15,,19.15,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,J3490,HCPCS,68094-764-62,NDC,both,5,mL,22.53,13.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Aetna,Commerical,,,4.16,,4.16,3.99,4.58,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Aetna,Middlesex Employees,,,3.99,,3.99,3.99,4.58,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Anthem,Commerical,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Anthem,Indemnity,,,4.04,,4.04,3.99,4.58,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Anthem,Individual Exchange,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Anthem,State Preferred,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Cigna,Cigna,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Connecticare,Commerical,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Connecticare,Exchange,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,Multiplan,Multiplan,,,4.58,,4.58,3.99,4.58,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0005-11,NDC,both,5,mL,5.39,3.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Aetna,Commerical,,,17.38,,17.38,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Aetna,Middlesex Employees,,,16.67,,16.67,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Anthem,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Anthem,Indemnity,,,16.88,,16.88,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Anthem,Individual Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Anthem,State Preferred,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Cigna,Cigna,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Connecticare,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Connecticare,Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,Multiplan,Multiplan,,,19.15,,19.15,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-59,NDC,both,5,mL,5.39,3.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Aetna,Commerical,,,17.38,,17.38,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Aetna,Middlesex Employees,,,16.67,,16.67,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Anthem,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Anthem,Indemnity,,,16.88,,16.88,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Anthem,Individual Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Anthem,State Preferred,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Cigna,Cigna,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Connecticare,Commerical,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Connecticare,Exchange,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,Multiplan,Multiplan,,,19.15,,19.15,16.67,19.15,percent of total billed charges,,
MIDAZOLAM 10 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,68094-764-62,NDC,both,5,mL,5.39,3.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.67,19.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Aetna,Commerical,,,2,,2,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Anthem,Commerical,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Anthem,Individual Exchange,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Anthem,State Preferred,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Cigna,Cigna,,0.16,,,0.16,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Connecticare,Commerical,,0.2,,,0.2,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Connecticare,Exchange,,0.2,,,0.2,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,0409-2305-17,NDC,both,1,mL,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Aetna,Commerical,,,2,,2,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Anthem,Commerical,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Anthem,Individual Exchange,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Anthem,State Preferred,,,,,,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Cigna,Cigna,,0.16,,,0.16,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Connecticare,Commerical,,0.2,,,0.2,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Connecticare,Exchange,,0.2,,,0.2,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,0.16,2.2,percent of total billed charges,,
MIDAZOLAM 1MG/ML INJECTION CCMC,J2250,HCPCS,63323-411-12,NDC,both,1,mL,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,2.2,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Aetna,Commerical,,,701.97,,701.97,673.13,773.3,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Aetna,Middlesex Employees,,,673.13,,673.13,673.13,773.3,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Anthem,Commerical,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Anthem,Indemnity,,,681.5,,681.5,673.13,773.3,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Anthem,Individual Exchange,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Anthem,State Preferred,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Cigna,Cigna,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Connecticare,Commerical,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Connecticare,Exchange,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,Multiplan,Multiplan,,,773.3,,773.3,673.13,773.3,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,0054-3566-99,NDC,both,1,mL,909.76,545.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,673.13,773.3,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Aetna,Commerical,,,17.85,,17.85,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Aetna,Middlesex Employees,,,17.11,,17.11,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Anthem,Commerical,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Anthem,Indemnity,,,17.33,,17.33,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Anthem,Individual Exchange,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Anthem,State Preferred,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Cigna,Cigna,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Connecticare,Commerical,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Connecticare,Exchange,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,Multiplan,Multiplan,,,19.66,,19.66,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-59,NDC,both,1,mL,23.13,13.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Aetna,Commerical,,,17.85,,17.85,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Aetna,Middlesex Employees,,,17.11,,17.11,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Anthem,Commerical,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Anthem,Indemnity,,,17.33,,17.33,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Anthem,Individual Exchange,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Anthem,State Preferred,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Cigna,Cigna,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Connecticare,Commerical,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Connecticare,Exchange,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,Multiplan,Multiplan,,,19.66,,19.66,17.11,19.66,percent of total billed charges,,
MIDAZOLAM 2 MG/ML ORAL SYRUP,J3490,HCPCS,68094-762-62,NDC,both,1,mL,23.13,13.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.11,19.66,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Anthem,Commerical,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Anthem,Individual Exchange,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Anthem,State Preferred,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Cigna,Cigna,,0.16,,,0.16,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Connecticare,Commerical,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Connecticare,Exchange,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-01,NDC,both,0.2,mL,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2308-50,NDC,both,0.2,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Aetna,Commerical,,,14.25,,14.25,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Aetna,Middlesex Employees,,,13.67,,13.67,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Anthem,Commerical,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Anthem,Indemnity,,,13.84,,13.84,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Anthem,Individual Exchange,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Anthem,State Preferred,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Cigna,Cigna,,0.16,,,0.16,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Connecticare,Commerical,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Connecticare,Exchange,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,Multiplan,Multiplan,,,15.7,,15.7,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,0409-2596-05,NDC,both,0.2,mL,18.47,11.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Aetna,Commerical,,,14.25,,14.25,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Aetna,Middlesex Employees,,,13.67,,13.67,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Commerical,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Indemnity,,,13.84,,13.84,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Individual Exchange,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Anthem,State Preferred,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Cigna,Cigna,,0.16,,,0.16,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Connecticare,Commerical,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Connecticare,Exchange,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,Multiplan,Multiplan,,,15.7,,15.7,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-126-10,NDC,both,0.2,mL,18.47,11.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,55390-138-02,NDC,both,0.2,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Aetna,Commerical,,,7.13,,7.13,0.16,7.85,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Aetna,Middlesex Employees,,,6.84,,6.84,0.16,7.85,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Anthem,Commerical,,,,,,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Anthem,Indemnity,,,6.92,,6.92,0.16,7.85,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Anthem,Individual Exchange,,,,,,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Anthem,State Preferred,,,,,,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Cigna,Cigna,,0.16,,,0.16,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Connecticare,Commerical,,0.2,,,0.2,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Connecticare,Exchange,,0.2,,,0.2,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,Multiplan,Multiplan,,,7.85,,7.85,0.16,7.85,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-05,NDC,both,0.2,mL,9.24,5.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,7.85,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Aetna,Commerical,,,14.25,,14.25,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Aetna,Middlesex Employees,,,13.67,,13.67,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Commerical,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Indemnity,,,13.84,,13.84,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Anthem,Individual Exchange,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Anthem,State Preferred,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Cigna,Cigna,,0.16,,,0.16,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Connecticare,Commerical,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Connecticare,Exchange,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,Multiplan,Multiplan,,,15.7,,15.7,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJ CCMC,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,18.47,11.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Anthem,Commerical,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Anthem,Individual Exchange,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Anthem,State Preferred,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Cigna,Cigna,,0.16,,,0.16,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Connecticare,Commerical,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Connecticare,Exchange,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION CCMC,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Aetna,Commerical,,,10.94,,10.94,0.16,12.05,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Aetna,Middlesex Employees,,,10.49,,10.49,0.16,12.05,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Anthem,Commerical,,,,,,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Anthem,Indemnity,,,10.62,,10.62,0.16,12.05,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Anthem,Individual Exchange,,,,,,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Anthem,State Preferred,,,,,,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Cigna,Cigna,,0.16,,,0.16,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Connecticare,Commerical,,0.2,,,0.2,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Connecticare,Exchange,,0.2,,,0.2,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,Multiplan,Multiplan,,,12.05,,12.05,0.16,12.05,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0409-2596-03,NDC,both,1,mL,14.18,8.51,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,12.05,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Aetna,Commerical,,,3.41,,3.41,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Aetna,Middlesex Employees,,,3.27,,3.27,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Anthem,Commerical,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Anthem,Indemnity,,,3.31,,3.31,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Anthem,Individual Exchange,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Anthem,State Preferred,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Cigna,Cigna,,0.16,,,0.16,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Connecticare,Commerical,,0.2,,,0.2,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Connecticare,Exchange,,0.2,,,0.2,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,Multiplan,Multiplan,,,3.76,,3.76,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-01,NDC,both,0.2,mL,4.42,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Aetna,Commerical,,,3.41,,3.41,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Aetna,Middlesex Employees,,,3.27,,3.27,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Anthem,Commerical,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Anthem,Indemnity,,,3.31,,3.31,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Anthem,Individual Exchange,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Anthem,State Preferred,,,,,,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Cigna,Cigna,,0.16,,,0.16,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Connecticare,Commerical,,0.2,,,0.2,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Connecticare,Exchange,,0.2,,,0.2,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,Multiplan,Multiplan,,,3.76,,3.76,0.16,3.76,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,0641-6061-25,NDC,both,1,mL,4.42,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.76,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Aetna,Commerical,,,14.25,,14.25,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Aetna,Middlesex Employees,,,13.67,,13.67,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Anthem,Commerical,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Anthem,Indemnity,,,13.84,,13.84,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Anthem,Individual Exchange,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Anthem,State Preferred,,,,,,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Cigna,Cigna,,0.16,,,0.16,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Connecticare,Commerical,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Connecticare,Exchange,,0.2,,,0.2,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,Multiplan,Multiplan,,,15.7,,15.7,0.16,15.7,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-10,NDC,both,0.2,mL,44.16,26.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,15.7,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Aetna,Commerical,,,1.43,,1.43,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Aetna,Middlesex Employees,,,1.37,,1.37,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Anthem,Commerical,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Anthem,Indemnity,,,1.39,,1.39,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Anthem,Individual Exchange,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Anthem,State Preferred,,,,,,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Cigna,Cigna,,0.16,,,0.16,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Connecticare,Commerical,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Connecticare,Exchange,,0.2,,,0.2,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,Multiplan,Multiplan,,,1.57,,1.57,0.16,1.57,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INJECTION SOLUTION,J2250,HCPCS,63323-412-18,NDC,both,0.2,mL,4.42,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,1.57,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Commerical,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Cigna,Cigna,,0.16,,,0.16,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Commerical,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Connecticare,Exchange,,0.2,,,0.2,0.16,3.15,Other,Could be inpatient or outpatient,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.16,3.15,percent of total billed charges,,
MIDAZOLAM 5 MG/ML INTRANASAL SOLN,J2250,HCPCS,0409-2308-02,NDC,both,0.2,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.17,,,0.17,0.16,3.15,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0115-4233-01,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Aetna,Commerical,,,1.57,,1.57,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Aetna,Middlesex Employees,,,1.5,,1.5,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Anthem,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Anthem,Indemnity,,,1.52,,1.52,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Anthem,Individual Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Anthem,State Preferred,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Cigna,Cigna,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Connecticare,Commerical,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Connecticare,Exchange,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.5,1.73,percent of total billed charges,,
MIDODRINE 10 MG TABLET,J3490,HCPCS,0245-0213-11,NDC,both,1,ea,2.03,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.5,1.73,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0115-4211-01,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0245-0211-11,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-06,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Aetna,Commerical,,,0.4,,0.4,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Anthem,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Anthem,Indemnity,,,0.39,,0.39,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Anthem,Individual Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Anthem,State Preferred,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Cigna,Cigna,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Connecticare,Commerical,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Connecticare,Exchange,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,Multiplan,Multiplan,,,0.44,,0.44,0.38,0.44,percent of total billed charges,,
MIDODRINE 2.5 MG TABLET,J3490,HCPCS,0904-6817-61,NDC,both,1,ea,0.52,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.44,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Aetna,Commerical,,,8.71,,8.71,8.35,9.6,percent of total billed charges,,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Aetna,Middlesex Employees,,,8.35,,8.35,8.35,9.6,percent of total billed charges,,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Anthem,Commerical,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Anthem,Indemnity,,,8.46,,8.46,8.35,9.6,percent of total billed charges,,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Anthem,Individual Exchange,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Anthem,State Preferred,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Cigna,Cigna,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Connecticare,Commerical,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Connecticare,Exchange,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,Multiplan,Multiplan,,,9.6,,9.6,8.35,9.6,percent of total billed charges,,
MIDODRINE 5 MG TABLET,J3490,HCPCS,0245-0212-01,NDC,both,1,ea,11.29,6.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.35,9.6,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-01,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9373-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-01,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9374-10,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9709-10,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-01,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0143-9710-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-02,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,0409-0212-11,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,63323-617-20,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-01,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-807-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-01,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,70069-808-10,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-11,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Aetna,Commerical,,,17.08,,17.08,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Aetna,Middlesex Employees,,,16.38,,16.38,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Anthem,Commerical,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Anthem,Indemnity,,,16.59,,16.59,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Anthem,Individual Exchange,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Anthem,State Preferred,,,,,,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Cigna,Cigna,,1.57,,,1.57,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Connecticare,Commerical,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Connecticare,Exchange,,2.16,,,2.16,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,Multiplan,Multiplan,,,18.82,,18.82,1.57,18.82,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,71288-200-20,NDC,both,5,mL,22.14,13.28,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,18.82,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Anthem,Commerical,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Anthem,Individual Exchange,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Anthem,State Preferred,,,,,,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Cigna,Cigna,,1.57,,,1.57,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Connecticare,Commerical,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Connecticare,Exchange,,2.16,,,2.16,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,1.57,9.41,percent of total billed charges,,
MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,J2260,HCPCS,72485-501-10,NDC,both,5,mL,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,9.41,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Anthem,Commerical,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Anthem,State Preferred,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Cigna,Cigna,,1.57,,,1.57,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Connecticare,Commerical,,2.16,,,2.16,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Connecticare,Exchange,,2.16,,,2.16,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-01,NDC,both,25,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Aetna,Commerical,,,44.92,,44.92,1.57,49.49,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Aetna,Middlesex Employees,,,43.08,,43.08,1.57,49.49,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Anthem,Commerical,,,,,,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Anthem,Indemnity,,,43.61,,43.61,1.57,49.49,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Anthem,Individual Exchange,,,,,,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Anthem,State Preferred,,,,,,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Cigna,Cigna,,1.57,,,1.57,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Connecticare,Commerical,,2.16,,,2.16,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Connecticare,Exchange,,2.16,,,2.16,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,Multiplan,Multiplan,,,49.49,,49.49,1.57,49.49,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,0143-9719-10,NDC,both,25,mL,58.22,34.93,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,49.49,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Aetna,Commerical,,,13.6,,13.6,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Aetna,Middlesex Employees,,,13.04,,13.04,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Anthem,Commerical,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Anthem,Indemnity,,,13.2,,13.2,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Anthem,Individual Exchange,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Anthem,State Preferred,,,,,,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Cigna,Cigna,,1.57,,,1.57,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Connecticare,Commerical,,2.16,,,2.16,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Connecticare,Exchange,,2.16,,,2.16,1.57,14.98,Other,Could be inpatient or outpatient,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,Multiplan,Multiplan,,,14.98,,14.98,1.57,14.98,percent of total billed charges,,
MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,J2260,HCPCS,25021-313-82,NDC,both,25,mL,17.62,10.57,United Healthcare/Oxford,United Healthcare/Oxford,,1.7,,,1.7,1.57,14.98,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Aetna,Commerical,,,7.08,,7.08,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Aetna,Middlesex Employees,,,6.78,,6.78,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Anthem,Commerical,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Anthem,Indemnity,,,6.87,,6.87,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Anthem,Individual Exchange,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Anthem,State Preferred,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Cigna,Cigna,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Connecticare,Commerical,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Connecticare,Exchange,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,Multiplan,Multiplan,,,7.79,,7.79,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,9629512753,NDC,both,1,mL,9.17,5.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,0132-0301-40,NDC,both,133,mL,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Aetna,Commerical,,,7.08,,7.08,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Aetna,Middlesex Employees,,,6.78,,6.78,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Anthem,Commerical,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Anthem,Indemnity,,,6.87,,6.87,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Anthem,Individual Exchange,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Anthem,State Preferred,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Cigna,Cigna,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Connecticare,Commerical,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Connecticare,Exchange,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,Multiplan,Multiplan,,,7.79,,7.79,6.78,7.79,percent of total billed charges,,
MINERAL OIL ENEMA,J3490,HCPCS,70000-0109-1,NDC,both,1,mL,9.17,5.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.78,7.79,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Aetna,Commerical,,,12.58,,12.58,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Aetna,Middlesex Employees,,,12.07,,12.07,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Indemnity,,,12.22,,12.22,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Individual Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,State Preferred,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Cigna,Cigna,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Connecticare,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Connecticare,Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Multiplan,Multiplan,,,13.86,,13.86,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Aetna,Commerical,,,12.58,,12.58,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Aetna,Middlesex Employees,,,12.07,,12.07,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Anthem,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Anthem,Indemnity,,,12.22,,12.22,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Anthem,Individual Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Anthem,State Preferred,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Cigna,Cigna,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Connecticare,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Connecticare,Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,Multiplan,Multiplan,,,13.86,,13.86,12.07,13.86,percent of total billed charges,,
MINERAL OIL ORAL,J3490,HCPCS,70000-0663-1,NDC,both,1,mL,16.31,9.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Aetna,Commerical,,,12.77,,12.77,12.25,14.07,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Aetna,Middlesex Employees,,,12.25,,12.25,12.25,14.07,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Anthem,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Anthem,Indemnity,,,12.4,,12.4,12.25,14.07,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Anthem,Individual Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Anthem,State Preferred,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Cigna,Cigna,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Connecticare,Commerical,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Connecticare,Exchange,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,Multiplan,Multiplan,,,14.07,,14.07,12.25,14.07,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,09629-5101-83,NDC,both,480,mL,16.55,9.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.25,14.07,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Aetna,Commerical,,,12.58,,12.58,12.07,13.86,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Aetna,Middlesex Employees,,,12.07,,12.07,12.07,13.86,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Indemnity,,,12.22,,12.22,12.07,13.86,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,Individual Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Anthem,State Preferred,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Cigna,Cigna,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Connecticare,Commerical,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Connecticare,Exchange,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,Multiplan,Multiplan,,,13.86,,13.86,12.07,13.86,percent of total billed charges,,
MINERAL OIL TOPICAL,J3490,HCPCS,70000-0448-1,NDC,both,1,mL,16.31,9.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.07,13.86,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
MINOCYCLINE 100 MG CAPSULE,J3490,HCPCS,68382-318-18,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Aetna,Commerical,,,706.3,,706.3,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Aetna,Middlesex Employees,,,677.28,,677.28,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Anthem,Commerical,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Anthem,Indemnity,,,685.7,,685.7,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Anthem,Individual Exchange,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Anthem,State Preferred,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Cigna,Cigna,,2.89,,,2.89,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Connecticare,Commerical,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Connecticare,Exchange,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,Multiplan,Multiplan,,,778.06,,778.06,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-01,NDC,both,0.01,ea,915.37,549.22,United Healthcare/Oxford,United Healthcare/Oxford,,3.16,,,3.16,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Aetna,Commerical,,,706.3,,706.3,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Aetna,Middlesex Employees,,,677.28,,677.28,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Anthem,Commerical,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Anthem,Indemnity,,,685.7,,685.7,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Anthem,Individual Exchange,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Anthem,State Preferred,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Cigna,Cigna,,2.89,,,2.89,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Connecticare,Commerical,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Connecticare,Exchange,,,,,,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,Multiplan,Multiplan,,,778.06,,778.06,2.89,778.06,percent of total billed charges,,
MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,J2265,HCPCS,70842-160-10,NDC,both,0.01,ea,915.37,549.22,United Healthcare/Oxford,United Healthcare/Oxford,,3.16,,,3.16,2.89,778.06,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,0591-5694-01,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
MINOCYCLINE 50 MG CAPSULE,J8499,HCPCS,68382-316-01,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Aetna,Commerical,,,2.51,,2.51,2.4,2.76,percent of total billed charges,,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Aetna,Middlesex Employees,,,2.4,,2.4,2.4,2.76,percent of total billed charges,,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Anthem,Commerical,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Anthem,Indemnity,,,2.43,,2.43,2.4,2.76,percent of total billed charges,,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Anthem,Individual Exchange,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Anthem,State Preferred,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Cigna,Cigna,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Connecticare,Commerical,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Connecticare,Exchange,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,Multiplan,Multiplan,,,2.76,,2.76,2.4,2.76,percent of total billed charges,,
MINOXIDIL 1.25 MG SPLIT TABLET,J8499,HCPCS,40810-0207-62,NDC,both,1,ea,3.25,1.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.4,2.76,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Aetna,Commerical,,,1.37,,1.37,1.31,1.5,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Aetna,Middlesex Employees,,,1.31,,1.31,1.31,1.5,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Anthem,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Anthem,Indemnity,,,1.33,,1.33,1.31,1.5,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Anthem,Individual Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Anthem,State Preferred,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Cigna,Cigna,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Connecticare,Commerical,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Connecticare,Exchange,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,Multiplan,Multiplan,,,1.5,,1.5,1.31,1.5,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,49884-257-01,NDC,both,1,ea,1.77,1.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.31,1.5,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,1.61,1.84,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,1.61,1.84,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Anthem,Commerical,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,1.61,1.84,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Anthem,State Preferred,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Cigna,Cigna,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Connecticare,Commerical,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Connecticare,Exchange,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,1.61,1.84,percent of total billed charges,,
MINOXIDIL 10 MG TABLET,J8499,HCPCS,68084-205-01,NDC,both,1,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.61,1.84,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
MINOXIDIL 2.5 MG TABLET,J8499,HCPCS,68084-204-11,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Aetna,Commerical,,,36.17,,36.17,34.69,39.85,percent of total billed charges,,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Aetna,Middlesex Employees,,,34.69,,34.69,34.69,39.85,percent of total billed charges,,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Anthem,Commerical,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Anthem,Indemnity,,,35.12,,35.12,34.69,39.85,percent of total billed charges,,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Anthem,Individual Exchange,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Anthem,State Preferred,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Cigna,Cigna,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Connecticare,Commerical,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Connecticare,Exchange,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,Multiplan,Multiplan,,,39.85,,39.85,34.69,39.85,percent of total billed charges,,
MIRACLE MOUTHWASH,J3490,HCPCS,40810-0012-40,NDC,both,180,mL,46.88,28.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Aetna,Commerical,,,24.12,,24.12,23.13,26.57,percent of total billed charges,,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Aetna,Middlesex Employees,,,23.13,,23.13,23.13,26.57,percent of total billed charges,,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Anthem,Commerical,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Anthem,Indemnity,,,23.42,,23.42,23.13,26.57,percent of total billed charges,,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Anthem,Individual Exchange,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Anthem,State Preferred,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Cigna,Cigna,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Connecticare,Commerical,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Connecticare,Exchange,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,Multiplan,Multiplan,,,26.57,,26.57,23.13,26.57,percent of total billed charges,,
MIRACLE MOUTHWASH NO LIDOCAINE,J3490,HCPCS,40810-0013-08,NDC,both,120,mL,31.26,18.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.13,26.57,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Aetna,Commerical,,,5.22,,5.22,5.01,5.75,percent of total billed charges,,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Aetna,Middlesex Employees,,,5.01,,5.01,5.01,5.75,percent of total billed charges,,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Anthem,Commerical,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Anthem,Indemnity,,,5.07,,5.07,5.01,5.75,percent of total billed charges,,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Anthem,Individual Exchange,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Anthem,State Preferred,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Cigna,Cigna,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Connecticare,Commerical,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Connecticare,Exchange,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,Multiplan,Multiplan,,,5.75,,5.75,5.01,5.75,percent of total billed charges,,
MIRTAZAPINE 15 MG DISINTEGRATING TABLET,J3490,HCPCS,65862-021-06,NDC,both,1,ea,6.77,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.01,5.75,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,0904-6519-61,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,51079-086-20,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,60505-0247-1,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-01,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
MIRTAZAPINE 15 MG TABLET,J3490,HCPCS,68084-119-11,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Aetna,Commerical,,,8.02,,8.02,7.69,8.84,percent of total billed charges,,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Aetna,Middlesex Employees,,,7.69,,7.69,7.69,8.84,percent of total billed charges,,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Anthem,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Anthem,Indemnity,,,7.79,,7.79,7.69,8.84,percent of total billed charges,,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Anthem,Individual Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Anthem,State Preferred,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Cigna,Cigna,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Connecticare,Commerical,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Connecticare,Exchange,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,Multiplan,Multiplan,,,8.84,,8.84,7.69,8.84,percent of total billed charges,,
MIRTAZAPINE 3.75 MG TABLET,J3490,HCPCS,40810-0013-67,NDC,both,1,ea,10.4,6.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.69,8.84,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Aetna,Commerical,,,1.26,,1.26,1.21,1.39,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Anthem,Indemnity,,,1.22,,1.22,1.21,1.39,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,13107-032-34,NDC,both,1,ea,1.63,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-01,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Aetna,Commerical,,,0.84,,0.84,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Anthem,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Anthem,Indemnity,,,0.82,,0.82,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Anthem,Individual Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Anthem,State Preferred,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Cigna,Cigna,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Connecticare,Commerical,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Connecticare,Exchange,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,Multiplan,Multiplan,,,0.93,,0.93,0.81,0.93,percent of total billed charges,,
MIRTAZAPINE 45 MG TABLET,J3490,HCPCS,51079-088-20,NDC,both,1,ea,1.09,0.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.93,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Aetna,Commerical,,,1.54,,1.54,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Aetna,Middlesex Employees,,,1.48,,1.48,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Anthem,Commerical,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Anthem,Indemnity,,,1.5,,1.5,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Anthem,Individual Exchange,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Anthem,State Preferred,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Cigna,Cigna,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Connecticare,Commerical,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Connecticare,Exchange,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,Multiplan,Multiplan,,,1.7,,1.7,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,13107-001-30,NDC,both,1,ea,2,1.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Aetna,Commerical,,,1.54,,1.54,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Aetna,Middlesex Employees,,,1.48,,1.48,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Anthem,Commerical,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Anthem,Indemnity,,,1.5,,1.5,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Anthem,Individual Exchange,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Anthem,State Preferred,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Cigna,Cigna,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Connecticare,Commerical,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Connecticare,Exchange,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,Multiplan,Multiplan,,,1.7,,1.7,1.48,1.7,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,40810-0002-15,NDC,both,1,ea,2,1.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.48,1.7,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Aetna,Commerical,,,7.59,,7.59,7.28,8.36,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Aetna,Middlesex Employees,,,7.28,,7.28,7.28,8.36,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Anthem,Commerical,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Anthem,Indemnity,,,7.37,,7.37,7.28,8.36,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Anthem,Individual Exchange,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Anthem,State Preferred,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Cigna,Cigna,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Connecticare,Commerical,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Connecticare,Exchange,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,Multiplan,Multiplan,,,8.36,,8.36,7.28,8.36,percent of total billed charges,,
MIRTAZAPINE 7.5 MG TABLET,J3490,HCPCS,57664-510-83,NDC,both,1,ea,9.84,5.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.28,8.36,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
MISOPROSTOL 100 MCG TABLET,J3490,HCPCS,10135-745-60,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,10135-746-60,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Aetna,Commerical,,,2.21,,2.21,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Aetna,Middlesex Employees,,,2.12,,2.12,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Anthem,Commerical,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Anthem,Indemnity,,,2.14,,2.14,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Anthem,Individual Exchange,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Anthem,State Preferred,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Cigna,Cigna,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Connecticare,Commerical,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Connecticare,Exchange,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,Multiplan,Multiplan,,,2.43,,2.43,2.12,2.43,percent of total billed charges,,
MISOPROSTOL 200 MCG TABLET,J3490,HCPCS,70954-444-10,NDC,both,1,ea,2.86,1.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.12,2.43,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Aetna,Commerical,,,1867.62,,1867.62,64.9,2057.38,percent of total billed charges,,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Aetna,Middlesex Employees,,,1790.89,,1790.89,64.9,2057.38,percent of total billed charges,,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Anthem,Commerical,,,,,,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Anthem,Indemnity,,,1813.16,,1813.16,64.9,2057.38,percent of total billed charges,,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Anthem,Individual Exchange,,,,,,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Anthem,State Preferred,,,,,,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Cigna,Cigna,,76.37,,,76.37,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Connecticare,Commerical,,64.9,,,64.9,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Connecticare,Exchange,,64.9,,,64.9,64.9,2057.38,Other,Could be inpatient or outpatient,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,Multiplan,Multiplan,,,2057.38,,2057.38,64.9,2057.38,percent of total billed charges,,
MITOMYCIN 20 MG INTRAVENOUS SOLUTION,J9280,HCPCS,16729-108-11,NDC,both,0.25,ea,2420.45,1452.27,United Healthcare/Oxford,United Healthcare/Oxford,,66.08,,,66.08,64.9,2057.38,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Aetna,Commerical,,,276.61,,276.61,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Aetna,Middlesex Employees,,,265.25,,265.25,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Anthem,Commerical,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Anthem,Indemnity,,,268.54,,268.54,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Anthem,Individual Exchange,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Anthem,State Preferred,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Cigna,Cigna,,77.71,,,77.71,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Connecticare,Commerical,,83.45,,,83.45,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Connecticare,Exchange,,83.45,,,83.45,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,Multiplan,Multiplan,,,304.72,,304.72,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,0703-4685-01,NDC,both,2.5,mL,358.49,215.09,United Healthcare/Oxford,United Healthcare/Oxford,,67.23,,,67.23,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Aetna,Commerical,,,276.61,,276.61,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Aetna,Middlesex Employees,,,265.25,,265.25,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Anthem,Commerical,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Anthem,Indemnity,,,268.54,,268.54,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Anthem,Individual Exchange,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Anthem,State Preferred,,,,,,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Cigna,Cigna,,77.71,,,77.71,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Connecticare,Commerical,,83.45,,,83.45,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Connecticare,Exchange,,83.45,,,83.45,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,Multiplan,Multiplan,,,304.72,,304.72,67.23,304.72,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,61703-343-18,NDC,both,2.5,mL,358.49,215.09,United Healthcare/Oxford,United Healthcare/Oxford,,67.23,,,67.23,67.23,304.72,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Aetna,Commerical,,,1204.73,,1204.73,67.23,1327.14,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Aetna,Middlesex Employees,,,1155.24,,1155.24,67.23,1327.14,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Anthem,Commerical,,,,,,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Anthem,Indemnity,,,1169.6,,1169.6,67.23,1327.14,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Anthem,Individual Exchange,,,,,,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Anthem,State Preferred,,,,,,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Cigna,Cigna,,77.71,,,77.71,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Connecticare,Commerical,,83.45,,,83.45,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Connecticare,Exchange,,83.45,,,83.45,67.23,1327.14,Other,Could be inpatient or outpatient,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,Multiplan,Multiplan,,,1327.14,,1327.14,67.23,1327.14,percent of total billed charges,,
"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",J9293,HCPCS,63323-132-10,NDC,both,2.5,mL,1561.34,936.8,United Healthcare/Oxford,United Healthcare/Oxford,,67.23,,,67.23,67.23,1327.14,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
MODAFINIL 100 MG TABLET,J8499,HCPCS,62332-385-30,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-50,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
MODAFINIL 50 MG SPLIT TABLET,J8499,HCPCS,40810-0209-51,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Aetna,Commerical,,,49.78,,49.78,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Aetna,Middlesex Employees,,,47.74,,47.74,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Anthem,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Anthem,Indemnity,,,48.33,,48.33,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Anthem,Individual Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Anthem,State Preferred,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Cigna,Cigna,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Connecticare,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Connecticare,Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,Multiplan,Multiplan,,,54.84,,54.84,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,0713-0634-15,NDC,both,1,gm,64.52,38.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Aetna,Commerical,,,49.78,,49.78,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Aetna,Middlesex Employees,,,47.74,,47.74,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Anthem,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Anthem,Indemnity,,,48.33,,48.33,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Anthem,Individual Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Anthem,State Preferred,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Cigna,Cigna,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Connecticare,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Connecticare,Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,Multiplan,Multiplan,,,54.84,,54.84,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-257-35,NDC,both,1,gm,64.52,38.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Aetna,Commerical,,,49.78,,49.78,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Aetna,Middlesex Employees,,,47.74,,47.74,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Anthem,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Anthem,Indemnity,,,48.33,,48.33,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Anthem,Individual Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Anthem,State Preferred,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Cigna,Cigna,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Connecticare,Commerical,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Connecticare,Exchange,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,Multiplan,Multiplan,,,54.84,,54.84,47.74,54.84,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL CREAM,J3490,HCPCS,68462-192-17,NDC,both,1,gm,64.52,38.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.74,54.84,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Aetna,Commerical,,,14.41,,14.41,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Aetna,Middlesex Employees,,,13.82,,13.82,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Anthem,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Anthem,Indemnity,,,13.99,,13.99,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Anthem,Individual Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Anthem,State Preferred,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Cigna,Cigna,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Connecticare,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Connecticare,Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,Multiplan,Multiplan,,,15.88,,15.88,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0271-15,NDC,both,1,gm,18.68,11.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Aetna,Commerical,,,14.41,,14.41,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Aetna,Middlesex Employees,,,13.82,,13.82,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Anthem,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Anthem,Indemnity,,,13.99,,13.99,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Anthem,Individual Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Anthem,State Preferred,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Cigna,Cigna,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Connecticare,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Connecticare,Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,Multiplan,Multiplan,,,15.88,,15.88,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0713-0635-15,NDC,both,1,gm,18.68,11.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Aetna,Commerical,,,46.81,,46.81,44.89,51.57,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Aetna,Middlesex Employees,,,44.89,,44.89,44.89,51.57,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Anthem,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Anthem,Indemnity,,,45.45,,45.45,44.89,51.57,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Anthem,Individual Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Anthem,State Preferred,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Cigna,Cigna,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Connecticare,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Connecticare,Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,Multiplan,Multiplan,,,51.57,,51.57,44.89,51.57,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-119-37,NDC,both,1,gm,60.67,36.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Aetna,Commerical,,,14.41,,14.41,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Aetna,Middlesex Employees,,,13.82,,13.82,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Anthem,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Anthem,Indemnity,,,13.99,,13.99,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Anthem,Individual Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Anthem,State Preferred,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Cigna,Cigna,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Connecticare,Commerical,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Connecticare,Exchange,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,Multiplan,Multiplan,,,15.88,,15.88,13.82,15.88,percent of total billed charges,,
MOMETASONE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,68462-225-17,NDC,both,1,gm,18.68,11.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.82,15.88,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Aetna,Commerical,,,570.81,,570.81,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Aetna,Middlesex Employees,,,547.36,,547.36,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Anthem,Commerical,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Anthem,Indemnity,,,554.17,,554.17,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Anthem,Individual Exchange,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Anthem,State Preferred,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Cigna,Cigna,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Connecticare,Commerical,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Connecticare,Exchange,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,Multiplan,Multiplan,,,628.81,,628.81,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4333-01,NDC,both,13,gm,739.78,443.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Aetna,Commerical,,,570.81,,570.81,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Aetna,Middlesex Employees,,,547.36,,547.36,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Anthem,Commerical,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Anthem,Indemnity,,,554.17,,554.17,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Anthem,Individual Exchange,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Anthem,State Preferred,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Cigna,Cigna,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Connecticare,Commerical,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Connecticare,Exchange,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,Multiplan,Multiplan,,,628.81,,628.81,547.36,628.81,percent of total billed charges,,
MOMETASONE 100 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-112-01,NDC,both,13,gm,739.78,443.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,547.36,628.81,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Aetna,Commerical,,,641.01,,641.01,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Aetna,Middlesex Employees,,,614.67,,614.67,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Anthem,Commerical,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Anthem,Indemnity,,,622.31,,622.31,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Anthem,Individual Exchange,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Anthem,State Preferred,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Cigna,Cigna,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Connecticare,Commerical,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Connecticare,Exchange,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,Multiplan,Multiplan,,,706.14,,706.14,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,0085-4334-01,NDC,both,13,gm,830.75,498.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Aetna,Commerical,,,641.01,,641.01,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Aetna,Middlesex Employees,,,614.67,,614.67,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Anthem,Commerical,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Anthem,Indemnity,,,622.31,,622.31,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Anthem,Individual Exchange,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Anthem,State Preferred,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Cigna,Cigna,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Connecticare,Commerical,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Connecticare,Exchange,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,Multiplan,Multiplan,,,706.14,,706.14,614.67,706.14,percent of total billed charges,,
MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER,J3535,HCPCS,78206-113-01,NDC,both,13,gm,830.75,498.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,614.67,706.14,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Aetna,Commerical,,,25.16,,25.16,24.13,27.72,percent of total billed charges,,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Aetna,Middlesex Employees,,,24.13,,24.13,24.13,27.72,percent of total billed charges,,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Anthem,Commerical,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Anthem,Indemnity,,,24.43,,24.43,24.13,27.72,percent of total billed charges,,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Anthem,Individual Exchange,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Anthem,State Preferred,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Cigna,Cigna,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Connecticare,Commerical,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Connecticare,Exchange,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,Multiplan,Multiplan,,,27.72,,27.72,24.13,27.72,percent of total billed charges,,
MOMETASONE 50 MCG/ACTUATION FOR TOPICAL USE,J3490,HCPCS,0113-1999-01,NDC,both,1,mL,32.61,19.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,0904-6808-61,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Anthem,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Anthem,State Preferred,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Cigna,Cigna,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Connecticare,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Connecticare,Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-10,NDC,both,1,ea,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Anthem,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Anthem,State Preferred,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Cigna,Cigna,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Connecticare,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Connecticare,Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,2.61,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,16729-119-15,NDC,both,1,ea,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
MONTELUKAST 10 MG TABLET,J3490,HCPCS,68084-875-01,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Aetna,Commerical,,,2.11,,2.11,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Aetna,Middlesex Employees,,,2.02,,2.02,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Anthem,Commerical,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Anthem,Indemnity,,,2.05,,2.05,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Anthem,Individual Exchange,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Anthem,State Preferred,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Cigna,Cigna,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Connecticare,Commerical,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Connecticare,Exchange,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,Multiplan,Multiplan,,,2.32,,2.32,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,33342-110-07,NDC,both,1,ea,2.73,1.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Aetna,Commerical,,,2.11,,2.11,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Aetna,Middlesex Employees,,,2.02,,2.02,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Anthem,Commerical,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Anthem,Indemnity,,,2.05,,2.05,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Anthem,Individual Exchange,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Anthem,State Preferred,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Cigna,Cigna,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Connecticare,Commerical,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Connecticare,Exchange,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,Multiplan,Multiplan,,,2.32,,2.32,2.02,2.32,percent of total billed charges,,
MONTELUKAST 4 MG CHEWABLE TABLET,J3490,HCPCS,50268-573-15,NDC,both,1,ea,2.73,1.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.02,2.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-07,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,33342-111-10,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,57237-213-30,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Aetna,Commerical,,,0.29,,0.29,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Aetna,Middlesex Employees,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Anthem,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Anthem,Indemnity,,,0.28,,0.28,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Anthem,Individual Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Anthem,State Preferred,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Cigna,Cigna,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Connecticare,Commerical,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Connecticare,Exchange,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,Multiplan,Multiplan,,,0.32,,0.32,0.28,0.32,percent of total billed charges,,
MONTELUKAST 5 MG CHEWABLE TABLET,J3490,HCPCS,69452-107-13,NDC,both,1,ea,0.38,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.28,0.32,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Aetna,Commerical,,,9.45,,9.45,9.06,10.41,percent of total billed charges,,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Aetna,Middlesex Employees,,,9.06,,9.06,9.06,10.41,percent of total billed charges,,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Anthem,Commerical,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Anthem,Indemnity,,,9.18,,9.18,9.06,10.41,percent of total billed charges,,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Anthem,Individual Exchange,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Anthem,State Preferred,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Cigna,Cigna,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Connecticare,Commerical,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Connecticare,Exchange,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,Multiplan,Multiplan,,,10.41,,10.41,9.06,10.41,percent of total billed charges,,
MONTELUKAST 5 MG TABLET,J3490,HCPCS,40810-0201-57,NDC,both,1,ea,12.25,7.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.06,10.41,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Aetna,Commerical,,,23.23,,23.23,11.84,25.59,percent of total billed charges,,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Aetna,Middlesex Employees,,,22.28,,22.28,11.84,25.59,percent of total billed charges,,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Anthem,Commerical,,,,,,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Anthem,Indemnity,,,22.56,,22.56,11.84,25.59,percent of total billed charges,,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Anthem,Individual Exchange,,,,,,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Anthem,State Preferred,,,,,,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Cigna,Cigna,,11.84,,,11.84,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Connecticare,Commerical,,15.98,,,15.98,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Connecticare,Exchange,,15.98,,,15.98,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,Multiplan,Multiplan,,,25.59,,25.59,11.84,25.59,percent of total billed charges,,
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,J2274,HCPCS,0409-3815-12,NDC,both,10,mL,30.11,18.07,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,25.59,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Aetna,Commerical,,,45.55,,45.55,11.84,50.18,percent of total billed charges,,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Aetna,Middlesex Employees,,,43.68,,43.68,11.84,50.18,percent of total billed charges,,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Anthem,Commerical,,,,,,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Anthem,Indemnity,,,44.22,,44.22,11.84,50.18,percent of total billed charges,,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Anthem,Individual Exchange,,,,,,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Anthem,State Preferred,,,,,,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Cigna,Cigna,,11.84,,,11.84,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Connecticare,Commerical,,15.98,,,15.98,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Connecticare,Exchange,,15.98,,,15.98,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,Multiplan,Multiplan,,,50.18,,50.18,11.84,50.18,percent of total billed charges,,
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,J2274,HCPCS,66794-162-02,NDC,both,0.4,mL,59.03,35.42,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,50.18,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,3.66,31.36,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,3.66,31.36,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Anthem,Commerical,,,,,,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,3.66,31.36,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Anthem,State Preferred,,,,,,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Cigna,Cigna,,3.66,,,3.66,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Connecticare,Commerical,,7.39,,,7.39,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Connecticare,Exchange,,7.39,,,7.39,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,3.66,31.36,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML (1 MG/ML) PCA INTRAVENOUS SOLUTION,J2270,HCPCS,76329-1912-1,NDC,both,10,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,31.36,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Aetna,Commerical,,,22.61,,22.61,11.84,24.91,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Aetna,Middlesex Employees,,,21.68,,21.68,11.84,24.91,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Anthem,Commerical,,,,,,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Anthem,Indemnity,,,21.95,,21.95,11.84,24.91,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Anthem,Individual Exchange,,,,,,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Anthem,State Preferred,,,,,,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Cigna,Cigna,,11.84,,,11.84,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Connecticare,Commerical,,15.98,,,15.98,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Connecticare,Exchange,,15.98,,,15.98,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,Multiplan,Multiplan,,,24.91,,24.91,11.84,24.91,percent of total billed charges,,
MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,69374-979-30,NDC,both,10,mL,29.3,17.58,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,24.91,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Commerical,,,35.76,,35.76,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Middlesex Employees,,,34.29,,34.29,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Commerical,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Indemnity,,,34.72,,34.72,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Individual Exchange,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,State Preferred,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Cigna,Cigna,,11.84,,,11.84,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Commerical,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Exchange,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Multiplan,Multiplan,,,39.4,,39.4,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML IN 0.9% SODIUM CHLORIDE PCA OPIOID NAIVE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Commerical,,,35.76,,35.76,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Middlesex Employees,,,34.29,,34.29,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Commerical,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Indemnity,,,34.72,,34.72,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Individual Exchange,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,State Preferred,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Cigna,Cigna,,11.84,,,11.84,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Commerical,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Exchange,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Multiplan,Multiplan,,,39.4,,39.4,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,11.84,39.07,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,11.84,39.07,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Anthem,Commerical,,,,,,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,11.84,39.07,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Anthem,State Preferred,,,,,,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Cigna,Cigna,,11.84,,,11.84,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Connecticare,Commerical,,15.98,,,15.98,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Connecticare,Exchange,,15.98,,,15.98,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,11.84,39.07,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML IN 0.9% SODIUM CHLORIDE PCA ADULT,J2274,HCPCS,73177-105-05,NDC,both,10,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,39.07,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Commerical,,,35.76,,35.76,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Aetna,Middlesex Employees,,,34.29,,34.29,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Commerical,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Indemnity,,,34.72,,34.72,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,Individual Exchange,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Anthem,State Preferred,,,,,,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Cigna,Cigna,,11.84,,,11.84,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Commerical,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Connecticare,Exchange,,15.98,,,15.98,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,Multiplan,Multiplan,,,39.4,,39.4,11.84,39.4,percent of total billed charges,,
MORPHINE (PF) 50 MG/50ML ON 0.9% SODIUM CHLORIDE PCA OPIOID TOLERANT,J2274,HCPCS,70092-1523-50,NDC,both,10,mL,46.35,27.81,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,39.4,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,3.13,percent of total billed charges,,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,3.13,percent of total billed charges,,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,3.13,percent of total billed charges,,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Cigna,Cigna,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Connecticare,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Connecticare,Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,3.13,percent of total billed charges,,
MORPHINE 0.1 MG/ML DILUTION NICU,J3490,HCPCS,40810-0201-37,NDC,both,1,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Aetna,Commerical,,,10.94,,10.94,10.49,12.05,percent of total billed charges,,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Aetna,Middlesex Employees,,,10.49,,10.49,10.49,12.05,percent of total billed charges,,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Anthem,Commerical,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Anthem,Indemnity,,,10.62,,10.62,10.49,12.05,percent of total billed charges,,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Anthem,Individual Exchange,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Anthem,State Preferred,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Cigna,Cigna,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Connecticare,Commerical,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Connecticare,Exchange,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,Multiplan,Multiplan,,,12.05,,12.05,10.49,12.05,percent of total billed charges,,
MORPHINE 0.1% TOPICAL GEL SYRINGE,J3490,HCPCS,40810-0011-48,NDC,both,50,mL,14.18,8.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.49,12.05,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Aetna,Commerical,,,192.09,,192.09,184.2,211.61,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Aetna,Middlesex Employees,,,184.2,,184.2,184.2,211.61,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Anthem,Commerical,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Anthem,Indemnity,,,186.49,,186.49,184.2,211.61,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Anthem,Individual Exchange,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Anthem,State Preferred,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Cigna,Cigna,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Connecticare,Commerical,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Connecticare,Exchange,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,Multiplan,Multiplan,,,211.61,,211.61,184.2,211.61,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-0012-41,NDC,both,1,mL,248.95,149.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,184.2,211.61,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Aetna,Commerical,,,96.05,,96.05,92.1,105.81,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Aetna,Middlesex Employees,,,92.1,,92.1,92.1,105.81,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Anthem,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Anthem,Indemnity,,,93.25,,93.25,92.1,105.81,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Anthem,Individual Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Anthem,State Preferred,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Cigna,Cigna,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Connecticare,Commerical,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Connecticare,Exchange,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,Multiplan,Multiplan,,,105.81,,105.81,92.1,105.81,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN,J3490,HCPCS,40810-018-95 ,NDC,both,1,mL,124.48,74.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,92.1,105.81,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Aetna,Commerical,,,1.92,,1.92,1.84,2.12,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Aetna,Middlesex Employees,,,1.84,,1.84,1.84,2.12,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Anthem,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Anthem,Indemnity,,,1.87,,1.87,1.84,2.12,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Anthem,Individual Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Anthem,State Preferred,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Cigna,Cigna,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Connecticare,Commerical,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Connecticare,Exchange,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,Multiplan,Multiplan,,,2.12,,2.12,1.84,2.12,percent of total billed charges,,
MORPHINE 0.4 MG/ML ORAL SOLN SYRINGE,J3490,HCPCS,40810-0015-10,NDC,both,1,mL,2.49,1.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.84,2.12,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0054-0237-63,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-05,NDC,both,1,mL,4.1,2.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Aetna,Commerical,,,3.16,,3.16,3.03,3.49,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Aetna,Middlesex Employees,,,3.03,,3.03,3.03,3.49,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Anthem,Commerical,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Anthem,Indemnity,,,3.07,,3.07,3.03,3.49,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Anthem,Individual Exchange,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Anthem,State Preferred,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Cigna,Cigna,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Connecticare,Commerical,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Connecticare,Exchange,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,Multiplan,Multiplan,,,3.49,,3.49,3.03,3.49,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,0121-0904-94,NDC,both,1,mL,4.1,2.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.03,3.49,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
MORPHINE 10 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-12,NDC,both,5,mL,4.1,2.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Aetna,Commerical,,,5.61,,5.61,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Aetna,Middlesex Employees,,,5.38,,5.38,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Anthem,Commerical,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Anthem,Indemnity,,,5.45,,5.45,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Anthem,Individual Exchange,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Anthem,State Preferred,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Cigna,Cigna,,5.14,,,5.14,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Connecticare,Commerical,,7.74,,,7.74,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Connecticare,Exchange,,7.74,,,7.74,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,Multiplan,Multiplan,,,6.18,,6.18,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-00,NDC,both,1,mL,7.27,4.36,United Healthcare/Oxford,United Healthcare/Oxford,,5.55,,,5.55,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Aetna,Commerical,,,5.61,,5.61,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Aetna,Middlesex Employees,,,5.38,,5.38,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Anthem,Commerical,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Anthem,Indemnity,,,5.45,,5.45,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Anthem,Individual Exchange,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Anthem,State Preferred,,,,,,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Cigna,Cigna,,5.14,,,5.14,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Connecticare,Commerical,,7.74,,,7.74,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Connecticare,Exchange,,7.74,,,7.74,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,Multiplan,Multiplan,,,6.18,,6.18,5.14,7.74,percent of total billed charges,,
MORPHINE 10 MG/ML INJECTION SOLUTION,J2272,HCPCS,63323-451-01,NDC,both,1,mL,7.27,4.36,United Healthcare/Oxford,United Healthcare/Oxford,,5.55,,,5.55,5.14,7.74,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Commerical,,,7.11,,7.11,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Middlesex Employees,,,6.81,,6.81,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Commerical,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Indemnity,,,6.9,,6.9,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Individual Exchange,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,State Preferred,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Cigna,Cigna,,3.66,,,3.66,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Commerical,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Exchange,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Multiplan,Multiplan,,,7.83,,7.83,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Commerical,,,7.11,,7.11,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Middlesex Employees,,,6.81,,6.81,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Commerical,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Indemnity,,,6.9,,6.9,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Individual Exchange,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,State Preferred,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Cigna,Cigna,,3.66,,,3.66,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Commerical,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Exchange,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Multiplan,Multiplan,,,7.83,,7.83,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION ADULT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Commerical,,,7.11,,7.11,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Middlesex Employees,,,6.81,,6.81,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Commerical,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Indemnity,,,6.9,,6.9,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Individual Exchange,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,State Preferred,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Cigna,Cigna,,3.66,,,3.66,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Commerical,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Exchange,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Multiplan,Multiplan,,,7.83,,7.83,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID NAIVE,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Commerical,,,7.11,,7.11,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Aetna,Middlesex Employees,,,6.81,,6.81,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Commerical,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Indemnity,,,6.9,,6.9,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,Individual Exchange,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Anthem,State Preferred,,,,,,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Cigna,Cigna,,3.66,,,3.66,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Commerical,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Connecticare,Exchange,,7.39,,,7.39,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,Multiplan,Multiplan,,,7.83,,7.83,3.66,7.83,percent of total billed charges,,
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION OPIOID TOLERANT,J2270,HCPCS,0641-6127-25,NDC,both,1,mL,9.21,5.53,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,7.83,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Aetna,Commerical,,,2.16,,2.16,2.07,2.38,percent of total billed charges,,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Aetna,Middlesex Employees,,,2.07,,2.07,2.07,2.38,percent of total billed charges,,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Anthem,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Anthem,Indemnity,,,2.1,,2.1,2.07,2.38,percent of total billed charges,,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Anthem,Individual Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Anthem,State Preferred,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Cigna,Cigna,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Connecticare,Commerical,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Connecticare,Exchange,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,Multiplan,Multiplan,,,2.38,,2.38,2.07,2.38,percent of total billed charges,,
MORPHINE 15 MG IMMEDIATE RELEASE TABLET,J3490,HCPCS,0054-0235-24,NDC,both,1,ea,2.8,1.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.07,2.38,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Aetna,Commerical,,,93.09,,93.09,89.27,102.55,percent of total billed charges,,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Aetna,Middlesex Employees,,,89.27,,89.27,89.27,102.55,percent of total billed charges,,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Anthem,Commerical,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Anthem,Indemnity,,,90.38,,90.38,89.27,102.55,percent of total billed charges,,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Anthem,Individual Exchange,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Anthem,State Preferred,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Cigna,Cigna,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Connecticare,Commerical,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Connecticare,Exchange,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,Multiplan,Multiplan,,,102.55,,102.55,89.27,102.55,percent of total billed charges,,
MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0238-63,NDC,both,1,mL,120.65,72.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,89.27,102.55,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Aetna,Commerical,,,15.25,,15.25,11.84,16.8,percent of total billed charges,,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Aetna,Middlesex Employees,,,14.63,,14.63,11.84,16.8,percent of total billed charges,,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Anthem,Commerical,,,,,,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Anthem,Indemnity,,,14.81,,14.81,11.84,16.8,percent of total billed charges,,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Anthem,Individual Exchange,,,,,,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Anthem,State Preferred,,,,,,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Cigna,Cigna,,11.84,,,11.84,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Connecticare,Commerical,,15.98,,,15.98,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Connecticare,Exchange,,15.98,,,15.98,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,Multiplan,Multiplan,,,16.8,,16.8,11.84,16.8,percent of total billed charges,,
MORPHINE 30 MG/30 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,J2274,HCPCS,70004-100-16,NDC,both,10,mL,19.77,11.86,United Healthcare/Oxford,United Healthcare/Oxford,,12.79,,,12.79,11.84,16.8,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Cigna,Cigna,,3.66,,,3.66,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Connecticare,Commerical,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Connecticare,Exchange,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-01,NDC,both,1,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Cigna,Cigna,,3.66,,,3.66,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Connecticare,Commerical,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Connecticare,Exchange,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INJECTION SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Cigna,Cigna,,3.66,,,3.66,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Connecticare,Commerical,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Connecticare,Exchange,,7.39,,,7.39,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,7.39,percent of total billed charges,,
MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0641-6125-25,NDC,both,1,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,2.72,7.39,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Aetna,Commerical,,,33.81,,33.81,3.66,37.25,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Aetna,Middlesex Employees,,,32.42,,32.42,3.66,37.25,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Anthem,Commerical,,,,,,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Anthem,Indemnity,,,32.83,,32.83,3.66,37.25,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Anthem,Individual Exchange,,,,,,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Anthem,State Preferred,,,,,,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Cigna,Cigna,,3.66,,,3.66,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Connecticare,Commerical,,7.39,,,7.39,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Connecticare,Exchange,,7.39,,,7.39,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,Multiplan,Multiplan,,,37.25,,37.25,3.66,37.25,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-03,NDC,both,1,mL,43.82,26.29,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,37.25,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Aetna,Commerical,,,84.52,,84.52,3.66,93.11,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Aetna,Middlesex Employees,,,81.05,,81.05,3.66,93.11,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Anthem,Commerical,,,,,,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Anthem,Indemnity,,,82.06,,82.06,3.66,93.11,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Anthem,Individual Exchange,,,,,,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Anthem,State Preferred,,,,,,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Cigna,Cigna,,3.66,,,3.66,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Connecticare,Commerical,,7.39,,,7.39,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Connecticare,Exchange,,7.39,,,7.39,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,Multiplan,Multiplan,,,93.11,,93.11,3.66,93.11,percent of total billed charges,,
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,J2270,HCPCS,0409-1134-05,NDC,both,0.2,mL,109.54,65.72,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,3.66,93.11,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.83,percent of total billed charges,,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Anthem,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.73,0.83,percent of total billed charges,,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Anthem,Individual Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Anthem,State Preferred,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Cigna,Cigna,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Connecticare,Commerical,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Connecticare,Exchange,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.73,0.83,percent of total billed charges,,
MORPHINE 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-18,NDC,both,1,ea,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.83,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Aetna,Commerical,,,14.63,,14.63,14.03,16.12,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Aetna,Middlesex Employees,,,14.03,,14.03,14.03,16.12,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Anthem,Commerical,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Anthem,Indemnity,,,14.2,,14.2,14.03,16.12,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Anthem,Individual Exchange,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Anthem,State Preferred,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Cigna,Cigna,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Connecticare,Commerical,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Connecticare,Exchange,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,Multiplan,Multiplan,,,16.12,,16.12,14.03,16.12,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-41,NDC,both,1,mL,18.96,11.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Aetna,Commerical,,,29.26,,29.26,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Aetna,Middlesex Employees,,,28.06,,28.06,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Anthem,Commerical,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Anthem,Indemnity,,,28.41,,28.41,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Anthem,Individual Exchange,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Anthem,State Preferred,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Cigna,Cigna,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Connecticare,Commerical,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Connecticare,Exchange,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,Multiplan,Multiplan,,,32.23,,32.23,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,38.04,22.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 18 MG/0.9 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-40,NDC,both,1,mL,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Aetna,Commerical,,,29.26,,29.26,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Aetna,Middlesex Employees,,,28.06,,28.06,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Anthem,Commerical,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Anthem,Indemnity,,,28.41,,28.41,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Anthem,Individual Exchange,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Anthem,State Preferred,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Cigna,Cigna,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Connecticare,Commerical,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Connecticare,Exchange,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,Multiplan,Multiplan,,,32.23,,32.23,28.06,32.23,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-0517-44,NDC,both,1,mL,37.92,22.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.06,32.23,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
MORPHINE CONCENTRATE 2 MG/0.1 ML (20 MG/ML) ORAL SOLUTION,J3490,HCPCS,40810-0208-39,NDC,both,1,mL,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Aetna,Commerical,,,2.38,,2.38,2.29,2.63,percent of total billed charges,,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Aetna,Middlesex Employees,,,2.29,,2.29,2.29,2.63,percent of total billed charges,,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Anthem,Commerical,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Anthem,Indemnity,,,2.31,,2.31,2.29,2.63,percent of total billed charges,,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Anthem,Individual Exchange,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Anthem,State Preferred,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Cigna,Cigna,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Connecticare,Commerical,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Connecticare,Exchange,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,Multiplan,Multiplan,,,2.63,,2.63,2.29,2.63,percent of total billed charges,,
"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8315-62,NDC,both,1,ea,3.09,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.29,2.63,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Aetna,Commerical,,,20.75,,20.75,19.9,22.86,percent of total billed charges,,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Aetna,Middlesex Employees,,,19.9,,19.9,19.9,22.86,percent of total billed charges,,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Anthem,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Anthem,Indemnity,,,20.14,,20.14,19.9,22.86,percent of total billed charges,,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Anthem,Individual Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Anthem,State Preferred,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Cigna,Cigna,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Connecticare,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Connecticare,Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,Multiplan,Multiplan,,,22.86,,22.86,19.9,22.86,percent of total billed charges,,
"MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE PELLETS",J3490,HCPCS,40810-0006-21,NDC,both,1,ea,26.89,16.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Aetna,Commerical,,,3.4,,3.4,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Aetna,Middlesex Employees,,,3.26,,3.26,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Anthem,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Anthem,Indemnity,,,3.3,,3.3,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Anthem,Individual Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Anthem,State Preferred,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Cigna,Cigna,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Connecticare,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Connecticare,Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,Multiplan,Multiplan,,,3.75,,3.75,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-23,NDC,both,1,ea,4.41,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Aetna,Commerical,,,3.4,,3.4,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Aetna,Middlesex Employees,,,3.26,,3.26,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Anthem,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Anthem,Indemnity,,,3.3,,3.3,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Anthem,Individual Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Anthem,State Preferred,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Cigna,Cigna,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Connecticare,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Connecticare,Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,Multiplan,Multiplan,,,3.75,,3.75,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0406-8330-62,NDC,both,1,ea,4.41,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Aetna,Commerical,,,3.4,,3.4,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Aetna,Middlesex Employees,,,3.26,,3.26,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Anthem,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Anthem,Indemnity,,,3.3,,3.3,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Anthem,Individual Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Anthem,State Preferred,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Cigna,Cigna,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Connecticare,Commerical,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Connecticare,Exchange,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,Multiplan,Multiplan,,,3.75,,3.75,3.26,3.75,percent of total billed charges,,
"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-158-01,NDC,both,1,ea,4.41,2.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.26,3.75,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Aetna,Commerical,,,2.48,,2.48,2.38,7.39,percent of total billed charges,,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Aetna,Middlesex Employees,,,2.38,,2.38,2.38,7.39,percent of total billed charges,,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Anthem,Commerical,,,,,,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Anthem,Indemnity,,,2.4,,2.4,2.38,7.39,percent of total billed charges,,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Anthem,Individual Exchange,,,,,,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Anthem,State Preferred,,,,,,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Cigna,Cigna,,3.66,,,3.66,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Connecticare,Commerical,,7.39,,,7.39,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Connecticare,Exchange,,7.39,,,7.39,2.38,7.39,Other,Could be inpatient or outpatient,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,Multiplan,Multiplan,,,2.73,,2.73,2.38,7.39,percent of total billed charges,,
MORPHINE FOR INHALATION,J2270,HCPCS,40810-0002-19,NDC,both,1,mL,3.21,1.93,United Healthcare/Oxford,United Healthcare/Oxford,,3.95,,,3.95,2.38,7.39,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Aetna,Commerical,,,53.73,,53.73,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Aetna,Middlesex Employees,,,51.52,,51.52,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Anthem,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Anthem,Indemnity,,,52.16,,52.16,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Anthem,Individual Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Anthem,State Preferred,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Cigna,Cigna,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Connecticare,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Connecticare,Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,Multiplan,Multiplan,,,59.19,,59.19,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,60505-0582-4,NDC,both,1,mL,69.63,41.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Aetna,Commerical,,,53.73,,53.73,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Aetna,Middlesex Employees,,,51.52,,51.52,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Anthem,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Anthem,Indemnity,,,52.16,,52.16,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Anthem,Individual Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Anthem,State Preferred,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Cigna,Cigna,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Connecticare,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Connecticare,Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,Multiplan,Multiplan,,,59.19,,59.19,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,65862-840-03,NDC,both,1,mL,69.63,41.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Aetna,Commerical,,,53.73,,53.73,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Aetna,Middlesex Employees,,,51.52,,51.52,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Anthem,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Anthem,Indemnity,,,52.16,,52.16,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Anthem,Individual Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Anthem,State Preferred,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Cigna,Cigna,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Connecticare,Commerical,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Connecticare,Exchange,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,Multiplan,Multiplan,,,59.19,,59.19,51.52,59.19,percent of total billed charges,,
MOXIFLOXACIN 0.5 % EYE DROPS,J3490,HCPCS,68180-422-01,NDC,both,1,mL,69.63,41.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.52,59.19,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Aetna,Commerical,,,16.74,,16.74,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Aetna,Middlesex Employees,,,16.06,,16.06,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Anthem,Commerical,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Anthem,Indemnity,,,16.26,,16.26,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Anthem,Individual Exchange,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Anthem,State Preferred,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Cigna,Cigna,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Connecticare,Commerical,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Connecticare,Exchange,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,Multiplan,Multiplan,,,18.45,,18.45,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,5434462,NDC,both,1,mL,21.7,13.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Aetna,Commerical,,,16.74,,16.74,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Aetna,Middlesex Employees,,,16.06,,16.06,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Anthem,Commerical,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Anthem,Indemnity,,,16.26,,16.26,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Anthem,Individual Exchange,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Anthem,State Preferred,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Cigna,Cigna,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Connecticare,Commerical,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Connecticare,Exchange,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,Multiplan,Multiplan,,,18.45,,18.45,16.06,18.45,percent of total billed charges,,
MULTIVIT AND MINERALS-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQUID,J3490,HCPCS,6961800858,NDC,both,1,mL,21.7,13.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.06,18.45,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-40,NDC,both,0.5,mL,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
MULTIVITAMIN DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-41,NDC,both,1,mL,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
MULTIVITAMIN MIN-IRON 1/2 CHEW KETOGENIC,J3490,HCPCS,40810-0002-20,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053060,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,904053061,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
MULTIVITAMIN TABLET,J3490,HCPCS,40810-0015-32,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 0.5 ML SYRINGE,J3490,HCPCS,40810-0013-42,NDC,both,0.5,mL,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN WITH IRON DROPS 1 ML SYRINGE,J3490,HCPCS,40810-0013-43,NDC,both,1,mL,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,904549261,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,4098522368,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
MULTIVITAMIN-IRON 9 MG-FOLIC ACID 400 MCG-CALCIUM AND MINERALS TABLET,J3490,HCPCS,40810-0015-56,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,6817600015,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
"MULTIVIT-MINS NO.56-FA 200 MCG-VIT K 1,000 MCG-COQ10 10 MG CHEW TABLET",A9153,HCPCS,40810-0205-63,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Aetna,Commerical,,,13.72,,13.72,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Aetna,Middlesex Employees,,,13.16,,13.16,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Anthem,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Anthem,Indemnity,,,13.32,,13.32,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Anthem,Individual Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Anthem,State Preferred,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Cigna,Cigna,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Connecticare,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Connecticare,Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,Multiplan,Multiplan,,,15.11,,15.11,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,0093-1010-42,NDC,both,1,gm,17.78,10.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Aetna,Commerical,,,13.72,,13.72,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Aetna,Middlesex Employees,,,13.16,,13.16,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Anthem,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Anthem,Indemnity,,,13.32,,13.32,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Anthem,Individual Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Anthem,State Preferred,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Cigna,Cigna,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Connecticare,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Connecticare,Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,Multiplan,Multiplan,,,15.11,,15.11,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,45802-112-22,NDC,both,1,gm,17.78,10.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Aetna,Commerical,,,13.72,,13.72,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Aetna,Middlesex Employees,,,13.16,,13.16,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Anthem,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Anthem,Indemnity,,,13.32,,13.32,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Anthem,Individual Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Anthem,State Preferred,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Cigna,Cigna,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Connecticare,Commerical,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Connecticare,Exchange,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,Multiplan,Multiplan,,,15.11,,15.11,13.16,15.11,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,51672-1312-0,NDC,both,1,gm,17.78,10.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.16,15.11,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Aetna,Commerical,,,94.73,,94.73,90.84,104.35,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Aetna,Middlesex Employees,,,90.84,,90.84,90.84,104.35,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Anthem,Commerical,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Anthem,Indemnity,,,91.97,,91.97,90.84,104.35,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Anthem,Individual Exchange,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Anthem,State Preferred,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Cigna,Cigna,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Connecticare,Commerical,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Connecticare,Exchange,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,Multiplan,Multiplan,,,104.35,,104.35,90.84,104.35,percent of total billed charges,,
MUPIROCIN 2 % TOPICAL OINTMENT,J3490,HCPCS,68462-180-22,NDC,both,1,gm,122.77,73.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,90.84,104.35,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Aetna,Commerical,,,145.05,,145.05,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Aetna,Middlesex Employees,,,139.09,,139.09,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Anthem,Commerical,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Anthem,Indemnity,,,140.82,,140.82,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Anthem,Individual Exchange,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Anthem,State Preferred,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Cigna,Cigna,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Connecticare,Commerical,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Connecticare,Exchange,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,Multiplan,Multiplan,,,159.78,,159.78,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,21922-029-04,NDC,both,1,gm,187.98,112.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Aetna,Commerical,,,145.05,,145.05,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Aetna,Middlesex Employees,,,139.09,,139.09,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Anthem,Commerical,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Anthem,Indemnity,,,140.82,,140.82,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Anthem,Individual Exchange,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Anthem,State Preferred,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Cigna,Cigna,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Connecticare,Commerical,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Connecticare,Exchange,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,Multiplan,Multiplan,,,159.78,,159.78,139.09,159.78,percent of total billed charges,,
MUPIROCIN CALCIUM 2 % TOPICAL CREAM,J3490,HCPCS,68462-564-17,NDC,both,1,gm,187.98,112.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,139.09,159.78,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Aetna,Commerical,,,341.77,,341.77,327.73,376.5,percent of total billed charges,,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Aetna,Middlesex Employees,,,327.73,,327.73,327.73,376.5,percent of total billed charges,,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Anthem,Commerical,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Anthem,Indemnity,,,331.81,,331.81,327.73,376.5,percent of total billed charges,,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Anthem,Individual Exchange,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Anthem,State Preferred,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Cigna,Cigna,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Connecticare,Commerical,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Connecticare,Exchange,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,Multiplan,Multiplan,,,376.5,,376.5,327.73,376.5,percent of total billed charges,,
"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",J3490,HCPCS,54643-5647-0,NDC,both,1,mL,442.94,265.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,327.73,376.5,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Aetna,Commerical,,,23.23,,23.23,22.28,25.59,percent of total billed charges,,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Aetna,Middlesex Employees,,,22.28,,22.28,22.28,25.59,percent of total billed charges,,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Anthem,Commerical,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Anthem,Indemnity,,,22.56,,22.56,22.28,25.59,percent of total billed charges,,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Anthem,Individual Exchange,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Anthem,State Preferred,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Cigna,Cigna,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Connecticare,Commerical,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Connecticare,Exchange,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,Multiplan,Multiplan,,,25.59,,25.59,22.28,25.59,percent of total billed charges,,
"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",J3490,HCPCS,54643-5649-1,NDC,both,1,mL,30.11,18.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.28,25.59,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Aetna,Commerical,,,51.54,,51.54,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Aetna,Middlesex Employees,,,49.43,,49.43,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Anthem,Commerical,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Anthem,Indemnity,,,50.04,,50.04,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Anthem,Individual Exchange,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Anthem,State Preferred,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Cigna,Cigna,,0.61,,,0.61,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Connecticare,Commerical,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Connecticare,Exchange,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,Multiplan,Multiplan,,,56.78,,56.78,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,0004-0298-09,NDC,both,0.02,ea,66.8,40.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.66,,,0.66,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Aetna,Commerical,,,51.54,,51.54,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Aetna,Middlesex Employees,,,49.43,,49.43,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Anthem,Commerical,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Anthem,Indemnity,,,50.04,,50.04,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Anthem,Individual Exchange,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Anthem,State Preferred,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Cigna,Cigna,,0.61,,,0.61,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Connecticare,Commerical,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Connecticare,Exchange,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,Multiplan,Multiplan,,,56.78,,56.78,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-20,NDC,both,0.02,ea,66.8,40.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.66,,,0.66,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Aetna,Commerical,,,51.54,,51.54,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Aetna,Middlesex Employees,,,49.43,,49.43,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Anthem,Commerical,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Anthem,Indemnity,,,50.04,,50.04,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Anthem,Individual Exchange,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Anthem,State Preferred,,,,,,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Cigna,Cigna,,0.61,,,0.61,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Connecticare,Commerical,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Connecticare,Exchange,,0.79,,,0.79,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,Multiplan,Multiplan,,,56.78,,56.78,0.61,56.78,percent of total billed charges,,
MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,J7519,HCPCS,71288-803-21,NDC,both,0.02,ea,66.8,40.08,United Healthcare/Oxford,United Healthcare/Oxford,,0.66,,,0.66,0.61,56.78,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Commerical,,,1756.12,,1756.12,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Middlesex Employees,,,1683.97,,1683.97,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Commerical,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Indemnity,,,1704.91,,1704.91,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Individual Exchange,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Anthem,State Preferred,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Cigna,Cigna,,0.18,,,0.18,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Commerical,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Exchange,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,Multiplan,Multiplan,,,1934.55,,1934.55,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0004-0261-29,NDC,both,1.25,mL,2275.94,1365.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Commerical,,,1756.12,,1756.12,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Middlesex Employees,,,1683.97,,1683.97,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Commerical,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Indemnity,,,1704.91,,1704.91,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Individual Exchange,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Anthem,State Preferred,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Cigna,Cigna,,0.18,,,0.18,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Commerical,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Exchange,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,Multiplan,Multiplan,,,1934.55,,1934.55,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,0527-5160-82,NDC,both,1.25,mL,2275.94,1365.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Commerical,,,1756.12,,1756.12,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Middlesex Employees,,,1683.97,,1683.97,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Commerical,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Indemnity,,,1704.91,,1704.91,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Individual Exchange,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Anthem,State Preferred,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Cigna,Cigna,,0.18,,,0.18,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Commerical,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Exchange,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,Multiplan,Multiplan,,,1934.55,,1934.55,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,66689-307-08,NDC,both,1.25,mL,2275.94,1365.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Commerical,,,1756.12,,1756.12,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Aetna,Middlesex Employees,,,1683.97,,1683.97,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Commerical,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Indemnity,,,1704.91,,1704.91,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Anthem,Individual Exchange,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Anthem,State Preferred,,,,,,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Cigna,Cigna,,0.18,,,0.18,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Commerical,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Connecticare,Exchange,,0.27,,,0.27,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,Multiplan,Multiplan,,,1934.55,,1934.55,0.18,1934.55,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,J7517,HCPCS,67877-230-22,NDC,both,1.25,mL,2275.94,1365.56,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1934.55,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Aetna,Commerical,,,1.2,,1.2,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Aetna,Middlesex Employees,,,1.15,,1.15,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Anthem,Commerical,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Anthem,Indemnity,,,1.16,,1.16,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Anthem,Individual Exchange,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Anthem,State Preferred,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Cigna,Cigna,,0.18,,,0.18,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Connecticare,Commerical,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Connecticare,Exchange,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,Multiplan,Multiplan,,,1.32,,1.32,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0004-0259-01,NDC,both,1,ea,1.55,0.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Aetna,Commerical,,,1.2,,1.2,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Aetna,Middlesex Employees,,,1.15,,1.15,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Anthem,Commerical,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Anthem,Indemnity,,,1.16,,1.16,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Anthem,Individual Exchange,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Anthem,State Preferred,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Cigna,Cigna,,0.18,,,0.18,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Connecticare,Commerical,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Connecticare,Exchange,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,Multiplan,Multiplan,,,1.32,,1.32,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,0904-7074-61,NDC,both,1,ea,1.55,0.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Aetna,Commerical,,,1.2,,1.2,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Aetna,Middlesex Employees,,,1.15,,1.15,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Anthem,Commerical,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Anthem,Indemnity,,,1.16,,1.16,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Anthem,Individual Exchange,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Anthem,State Preferred,,,,,,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Cigna,Cigna,,0.18,,,0.18,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Connecticare,Commerical,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Connecticare,Exchange,,0.27,,,0.27,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,Multiplan,Multiplan,,,1.32,,1.32,0.18,1.32,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 250 MG CAPSULE,J7517,HCPCS,51079-721-20,NDC,both,1,ea,1.55,0.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,1.32,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Aetna,Commerical,,,2.17,,2.17,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Aetna,Middlesex Employees,,,2.08,,2.08,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Anthem,Commerical,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Anthem,Indemnity,,,2.1,,2.1,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Anthem,Individual Exchange,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Anthem,State Preferred,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Cigna,Cigna,,0.18,,,0.18,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Connecticare,Commerical,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Connecticare,Exchange,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,Multiplan,Multiplan,,,2.39,,2.39,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,0904-7078-61,NDC,both,0.5,ea,2.81,1.69,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Aetna,Commerical,,,2.17,,2.17,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Aetna,Middlesex Employees,,,2.08,,2.08,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Anthem,Commerical,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Anthem,Indemnity,,,2.1,,2.1,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Anthem,Individual Exchange,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Anthem,State Preferred,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Cigna,Cigna,,0.18,,,0.18,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Connecticare,Commerical,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Connecticare,Exchange,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,Multiplan,Multiplan,,,2.39,,2.39,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,51079-379-20,NDC,both,0.5,ea,2.81,1.69,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Aetna,Commerical,,,2.17,,2.17,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Aetna,Middlesex Employees,,,2.08,,2.08,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Anthem,Commerical,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Anthem,Indemnity,,,2.1,,2.1,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Anthem,Individual Exchange,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Anthem,State Preferred,,,,,,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Cigna,Cigna,,0.18,,,0.18,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Connecticare,Commerical,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Connecticare,Exchange,,0.27,,,0.27,0.18,2.39,Other,Could be inpatient or outpatient,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,Multiplan,Multiplan,,,2.39,,2.39,0.18,2.39,percent of total billed charges,,
MYCOPHENOLATE MOFETIL 500 MG TABLET,J7517,HCPCS,67877-225-01,NDC,both,0.5,ea,2.81,1.69,United Healthcare/Oxford,United Healthcare/Oxford,,0.2,,,0.2,0.18,2.39,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,0.42,,,0.42,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,16729-261-29,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.45,,,0.45,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,0.42,,,0.42,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,40810-0020-51,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.45,,,0.45,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,0.42,,,0.42,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,60505-2965-7,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.45,,,0.45,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,0.42,,,0.42,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,0.67,,,0.67,0.42,0.67,Other,Could be inpatient or outpatient,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.42,0.67,percent of total billed charges,,
"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",J7518,HCPCS,67877-426-12,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.45,,,0.45,0.42,0.67,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Aetna,Commerical,,,8.72,,8.72,8.36,9.61,percent of total billed charges,,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Aetna,Middlesex Employees,,,8.36,,8.36,8.36,9.61,percent of total billed charges,,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Anthem,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Anthem,Indemnity,,,8.46,,8.46,8.36,9.61,percent of total billed charges,,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Anthem,Individual Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Anthem,State Preferred,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Cigna,Cigna,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Connecticare,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Connecticare,Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,Multiplan,Multiplan,,,9.61,,9.61,8.36,9.61,percent of total billed charges,,
NADOLOL 10 MG ORAL TAB,J3490,HCPCS,40810-0002-22,NDC,both,1,ea,11.3,6.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
NADOLOL 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-23,NDC,both,1,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,0904-7070-61,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,51079-812-20,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
NADOLOL 20 MG TABLET,J3490,HCPCS,76385-133-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,62332-403-31,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Aetna,Commerical,,,0.98,,0.98,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Aetna,Middlesex Employees,,,0.94,,0.94,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Anthem,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Anthem,Indemnity,,,0.95,,0.95,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Anthem,Individual Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Anthem,State Preferred,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Cigna,Cigna,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Connecticare,Commerical,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Connecticare,Exchange,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,Multiplan,Multiplan,,,1.08,,1.08,0.94,1.08,percent of total billed charges,,
NADOLOL 40 MG TABLET,J3490,HCPCS,69238-1124-9,NDC,both,1,ea,1.27,0.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.94,1.08,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Aetna,Commerical,,,8.72,,8.72,8.36,9.61,percent of total billed charges,,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Aetna,Middlesex Employees,,,8.36,,8.36,8.36,9.61,percent of total billed charges,,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Anthem,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Anthem,Indemnity,,,8.46,,8.46,8.36,9.61,percent of total billed charges,,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Anthem,Individual Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Anthem,State Preferred,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Cigna,Cigna,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Connecticare,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Connecticare,Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,Multiplan,Multiplan,,,9.61,,9.61,8.36,9.61,percent of total billed charges,,
NADOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-24,NDC,both,1,ea,11.3,6.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Aetna,Commerical,,,8.82,,8.82,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Aetna,Middlesex Employees,,,8.46,,8.46,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Anthem,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Anthem,Indemnity,,,8.56,,8.56,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Anthem,Individual Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Anthem,State Preferred,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Cigna,Cigna,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Connecticare,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Connecticare,Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,Multiplan,Multiplan,,,9.72,,9.72,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3124-95,NDC,both,1,ea,11.43,6.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Aetna,Commerical,,,8.82,,8.82,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Aetna,Middlesex Employees,,,8.46,,8.46,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Anthem,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Anthem,Indemnity,,,8.56,,8.56,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Anthem,Individual Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Anthem,State Preferred,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Cigna,Cigna,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Connecticare,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Connecticare,Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,Multiplan,Multiplan,,,9.72,,9.72,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-9124-85,NDC,both,1,ea,11.43,6.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Aetna,Commerical,,,27.34,,27.34,26.21,30.12,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Aetna,Middlesex Employees,,,26.21,,26.21,26.21,30.12,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Anthem,Commerical,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Anthem,Indemnity,,,26.54,,26.54,26.21,30.12,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Anthem,Individual Exchange,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Anthem,State Preferred,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Cigna,Cigna,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Connecticare,Commerical,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Connecticare,Exchange,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,Multiplan,Multiplan,,,30.12,,30.12,26.21,30.12,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-139-10,NDC,both,1,ea,35.43,21.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.21,30.12,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,44567-221-10,NDC,both,1,ea,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Aetna,Commerical,,,8.82,,8.82,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Aetna,Middlesex Employees,,,8.46,,8.46,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Anthem,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Anthem,Indemnity,,,8.56,,8.56,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Anthem,Individual Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Anthem,State Preferred,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Cigna,Cigna,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Connecticare,Commerical,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Connecticare,Exchange,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,Multiplan,Multiplan,,,9.72,,9.72,8.46,9.72,percent of total billed charges,,
NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-327-10,NDC,both,1,ea,11.43,6.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.46,9.72,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Aetna,Commerical,,,20.82,,20.82,19.96,22.93,percent of total billed charges,,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Aetna,Middlesex Employees,,,19.96,,19.96,19.96,22.93,percent of total billed charges,,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Anthem,Commerical,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Anthem,Indemnity,,,20.21,,20.21,19.96,22.93,percent of total billed charges,,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Anthem,Individual Exchange,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Anthem,State Preferred,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Cigna,Cigna,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Connecticare,Commerical,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Connecticare,Exchange,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,Multiplan,Multiplan,,,22.93,,22.93,19.96,22.93,percent of total billed charges,,
NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,0781-3126-95,NDC,both,1,ea,26.98,16.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.96,22.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Aetna,Commerical,,,51.68,,51.68,49.56,56.93,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Aetna,Middlesex Employees,,,49.56,,49.56,49.56,56.93,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Commerical,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Indemnity,,,50.17,,50.17,49.56,56.93,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Individual Exchange,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,State Preferred,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Cigna,Cigna,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Connecticare,Commerical,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Connecticare,Exchange,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Multiplan,Multiplan,,,56.93,,56.93,49.56,56.93,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-01,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,J3490,HCPCS,72485-406-10,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Aetna,Commerical,,,767.9,,767.9,736.35,845.92,percent of total billed charges,,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Aetna,Middlesex Employees,,,736.35,,736.35,736.35,845.92,percent of total billed charges,,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Anthem,Commerical,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Anthem,Indemnity,,,745.5,,745.5,736.35,845.92,percent of total billed charges,,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Anthem,Individual Exchange,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Anthem,State Preferred,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Cigna,Cigna,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Connecticare,Commerical,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Connecticare,Exchange,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,Multiplan,Multiplan,,,845.92,,845.92,736.35,845.92,percent of total billed charges,,
NAFCILLIN 25 MG/ML,J3490,HCPCS,40810-0013-25,NDC,both,1,mL,995.2,597.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,736.35,845.92,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Aetna,Commerical,,,51.91,,51.91,49.77,57.18,percent of total billed charges,,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Aetna,Middlesex Employees,,,49.77,,49.77,49.77,57.18,percent of total billed charges,,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Anthem,Commerical,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Anthem,Indemnity,,,50.39,,50.39,49.77,57.18,percent of total billed charges,,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Anthem,Individual Exchange,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Anthem,State Preferred,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Cigna,Cigna,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Connecticare,Commerical,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Connecticare,Exchange,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,Multiplan,Multiplan,,,57.18,,57.18,49.77,57.18,percent of total billed charges,,
NAFCILLIN 25 MG/ML IN D10W NICU,J3490,HCPCS,40810-0004-67,NDC,both,1,mL,67.27,40.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.77,57.18,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Aetna,Commerical,,,51.68,,51.68,49.56,56.93,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Aetna,Middlesex Employees,,,49.56,,49.56,49.56,56.93,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Commerical,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Indemnity,,,50.17,,50.17,49.56,56.93,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,Individual Exchange,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Anthem,State Preferred,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Cigna,Cigna,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Connecticare,Commerical,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Connecticare,Exchange,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,Multiplan,Multiplan,,,56.93,,56.93,49.56,56.93,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,25021-140-10,NDC,both,1,ea,66.98,40.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.56,56.93,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,55150-123-15,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-21,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,63323-328-22,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-00,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,67850-032-10,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-26,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Aetna,Commerical,,,16.56,,16.56,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Aetna,Middlesex Employees,,,15.88,,15.88,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Indemnity,,,16.08,,16.08,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,Individual Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Anthem,State Preferred,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Cigna,Cigna,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Connecticare,Commerical,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Connecticare,Exchange,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,Multiplan,Multiplan,,,18.24,,18.24,15.88,18.24,percent of total billed charges,,
NAFCILLIN FOR INTRA-AMNIOTIC INJECTION,J3490,HCPCS,70860-117-41,NDC,both,1,ea,21.46,12.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.88,18.24,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,5.52,percent of total billed charges,,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,5.52,percent of total billed charges,,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Anthem,Commerical,,,,,,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,5.52,percent of total billed charges,,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Anthem,State Preferred,,,,,,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Cigna,Cigna,,3.65,,,3.65,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Connecticare,Commerical,,5.52,,,5.52,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Connecticare,Exchange,,5.52,,,5.52,0.21,5.52,Other,Could be inpatient or outpatient,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,5.52,percent of total billed charges,,
NALBUPHINE 10 MG/ML INJECTION SOLUTION,J2300,HCPCS,0409-1463-01,NDC,both,1,mL,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,3.94,,,3.94,0.21,5.52,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Aetna,Commerical,,,12.97,,12.97,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Aetna,Middlesex Employees,,,12.44,,12.44,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Anthem,Commerical,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Anthem,Indemnity,,,12.59,,12.59,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Anthem,Individual Exchange,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Anthem,State Preferred,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Cigna,Cigna,,10.55,,,10.55,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Connecticare,Commerical,,13.33,,,13.33,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Connecticare,Exchange,,13.33,,,13.33,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,Multiplan,Multiplan,,,14.29,,14.29,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-292-02,NDC,both,1,mL,16.81,10.09,United Healthcare/Oxford,United Healthcare/Oxford,,11.39,,,11.39,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Aetna,Commerical,,,12.97,,12.97,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Aetna,Middlesex Employees,,,12.44,,12.44,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Anthem,Commerical,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Anthem,Indemnity,,,12.59,,12.59,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Anthem,Individual Exchange,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Anthem,State Preferred,,,,,,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Cigna,Cigna,,10.55,,,10.55,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Connecticare,Commerical,,13.33,,,13.33,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Connecticare,Exchange,,13.33,,,13.33,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,Multiplan,Multiplan,,,14.29,,14.29,10.55,14.29,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SOLUTION,J2310,HCPCS,67457-645-02,NDC,both,1,mL,16.81,10.09,United Healthcare/Oxford,United Healthcare/Oxford,,11.39,,,11.39,10.55,14.29,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Aetna,Commerical,,,41.82,,41.82,10.55,46.07,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Aetna,Middlesex Employees,,,40.1,,40.1,10.55,46.07,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Anthem,Commerical,,,,,,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Anthem,Indemnity,,,40.6,,40.6,10.55,46.07,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Anthem,Individual Exchange,,,,,,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Anthem,State Preferred,,,,,,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Cigna,Cigna,,10.55,,,10.55,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Connecticare,Commerical,,13.33,,,13.33,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Connecticare,Exchange,,13.33,,,13.33,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,Multiplan,Multiplan,,,46.07,,46.07,10.55,46.07,percent of total billed charges,,
NALOXONE 0.4 MG/ML INJECTION SYRINGE,J2310,HCPCS,0409-1782-69,NDC,both,1,mL,54.2,32.52,United Healthcare/Oxford,United Healthcare/Oxford,,11.39,,,11.39,10.55,46.07,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Aetna,Commerical,,,43.7,,43.7,10.55,48.14,percent of total billed charges,,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Aetna,Middlesex Employees,,,41.9,,41.9,10.55,48.14,percent of total billed charges,,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Anthem,Commerical,,,,,,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Anthem,Indemnity,,,42.42,,42.42,10.55,48.14,percent of total billed charges,,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Anthem,Individual Exchange,,,,,,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Anthem,State Preferred,,,,,,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Cigna,Cigna,,10.55,,,10.55,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Connecticare,Commerical,,13.33,,,13.33,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Connecticare,Exchange,,13.33,,,13.33,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,Multiplan,Multiplan,,,48.14,,48.14,10.55,48.14,percent of total billed charges,,
NALOXONE 0.4 MG/ML INTRANASAL SOLN,J2310,HCPCS,0409-1215-01,NDC,both,1,mL,56.63,33.98,United Healthcare/Oxford,United Healthcare/Oxford,,11.39,,,11.39,10.55,48.14,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Aetna,Commerical,,,113.76,,113.76,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Aetna,Middlesex Employees,,,109.09,,109.09,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Anthem,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Anthem,Indemnity,,,110.45,,110.45,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Anthem,Individual Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Anthem,State Preferred,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Cigna,Cigna,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Connecticare,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Connecticare,Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,Multiplan,Multiplan,,,125.32,,125.32,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-7176-06,NDC,both,0.25,ea,147.44,88.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Aetna,Commerical,,,113.76,,113.76,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Aetna,Middlesex Employees,,,109.09,,109.09,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Anthem,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Anthem,Indemnity,,,110.45,,110.45,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Anthem,Individual Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Anthem,State Preferred,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Cigna,Cigna,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Connecticare,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Connecticare,Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,Multiplan,Multiplan,,,125.32,,125.32,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-00,NDC,both,0.25,ea,147.44,88.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Aetna,Commerical,,,113.76,,113.76,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Aetna,Middlesex Employees,,,109.09,,109.09,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Indemnity,,,110.45,,110.45,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Individual Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Anthem,State Preferred,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Cigna,Cigna,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Connecticare,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Connecticare,Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,Multiplan,Multiplan,,,125.32,,125.32,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-578-84,NDC,both,0.25,ea,147.44,88.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Aetna,Commerical,,,113.76,,113.76,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Aetna,Middlesex Employees,,,109.09,,109.09,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Anthem,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Anthem,Indemnity,,,110.45,,110.45,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Anthem,Individual Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Anthem,State Preferred,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Cigna,Cigna,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Connecticare,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Connecticare,Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,Multiplan,Multiplan,,,125.32,,125.32,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-00,NDC,both,1,ea,147.44,88.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Aetna,Commerical,,,113.76,,113.76,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Aetna,Middlesex Employees,,,109.09,,109.09,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Indemnity,,,110.45,,110.45,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Anthem,Individual Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Anthem,State Preferred,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Cigna,Cigna,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Connecticare,Commerical,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Connecticare,Exchange,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,Multiplan,Multiplan,,,125.32,,125.32,109.09,125.32,percent of total billed charges,,
NALOXONE 4 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-811-84,NDC,both,0.25,ea,147.44,88.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.09,125.32,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NALTREXONE 25 MG TABLET,J3490,HCPCS,40810-0013-68,NDC,both,1,UN,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Aetna,Commerical,,,2.43,,2.43,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Aetna,Middlesex Employees,,,2.33,,2.33,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Anthem,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Anthem,Indemnity,,,2.36,,2.36,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Anthem,Individual Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Anthem,State Preferred,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Cigna,Cigna,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Connecticare,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Connecticare,Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,Multiplan,Multiplan,,,2.68,,2.68,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0406-1170-01,NDC,both,1,ea,3.15,1.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Aetna,Commerical,,,2.43,,2.43,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Aetna,Middlesex Employees,,,2.33,,2.33,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Anthem,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Anthem,Indemnity,,,2.36,,2.36,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Anthem,Individual Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Anthem,State Preferred,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Cigna,Cigna,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Connecticare,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Connecticare,Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,Multiplan,Multiplan,,,2.68,,2.68,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,0904-7036-04,NDC,both,1,ea,3.15,1.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Aetna,Commerical,,,2.43,,2.43,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Aetna,Middlesex Employees,,,2.33,,2.33,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Anthem,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Anthem,Indemnity,,,2.36,,2.36,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Anthem,Individual Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Anthem,State Preferred,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Cigna,Cigna,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Connecticare,Commerical,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Connecticare,Exchange,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,Multiplan,Multiplan,,,2.68,,2.68,2.33,2.68,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,51224-206-30,NDC,both,1,ea,3.15,1.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.33,2.68,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Aetna,Commerical,,,6.38,,6.38,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Aetna,Middlesex Employees,,,6.12,,6.12,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Anthem,Commerical,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Anthem,Indemnity,,,6.2,,6.2,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Anthem,Individual Exchange,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Anthem,State Preferred,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Cigna,Cigna,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Connecticare,Commerical,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Connecticare,Exchange,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,Multiplan,Multiplan,,,7.03,,7.03,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-11,NDC,both,1,ea,8.27,4.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Aetna,Commerical,,,6.38,,6.38,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Aetna,Middlesex Employees,,,6.12,,6.12,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Anthem,Commerical,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Anthem,Indemnity,,,6.2,,6.2,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Anthem,Individual Exchange,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Anthem,State Preferred,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Cigna,Cigna,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Connecticare,Commerical,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Connecticare,Exchange,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,Multiplan,Multiplan,,,7.03,,7.03,6.12,7.03,percent of total billed charges,,
NALTREXONE 50 MG TABLET,J3490,HCPCS,68084-291-21,NDC,both,1,ea,8.27,4.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.12,7.03,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Aetna,Commerical,,,865.88,,865.88,830.31,953.86,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Aetna,Middlesex Employees,,,830.31,,830.31,830.31,953.86,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Anthem,Commerical,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Anthem,Indemnity,,,840.63,,840.63,830.31,953.86,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Anthem,Individual Exchange,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Anthem,State Preferred,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Cigna,Cigna,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Connecticare,Commerical,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Connecticare,Exchange,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,Multiplan,Multiplan,,,953.86,,953.86,830.31,953.86,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,68134-201-16,NDC,both,1,mL,1122.19,673.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,830.31,953.86,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Aetna,Commerical,,,819.13,,819.13,785.48,902.36,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Aetna,Middlesex Employees,,,785.48,,785.48,785.48,902.36,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Anthem,Commerical,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Anthem,Indemnity,,,795.24,,795.24,785.48,902.36,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Anthem,Individual Exchange,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Anthem,State Preferred,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Cigna,Cigna,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Connecticare,Commerical,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Connecticare,Exchange,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,Multiplan,Multiplan,,,902.36,,902.36,785.48,902.36,percent of total billed charges,,
NAPROXEN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,69238-1730-2,NDC,both,1,mL,1061.6,636.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,785.48,902.36,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,65162-188-10,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
NAPROXEN 250 MG TABLET,J3490,HCPCS,68462-188-01,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,40810-0007-57,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,65162-189-10,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
NAPROXEN 375 MG TABLET,J3490,HCPCS,70010-138-01,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-01,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,60687-491-11,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
NAPROXEN 500 MG TABLET,J3490,HCPCS,63739-403-10,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Aetna,Commerical,,,24260.51,,24260.51,27.2,26725.55,percent of total billed charges,,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Aetna,Middlesex Employees,,,23263.8,,23263.8,27.2,26725.55,percent of total billed charges,,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Anthem,Commerical,,,,,,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Anthem,Indemnity,,,23553.07,,23553.07,27.2,26725.55,percent of total billed charges,,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Anthem,Individual Exchange,,,,,,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Anthem,State Preferred,,,,,,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Cigna,Cigna,,27.2,,,27.2,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Connecticare,Commerical,,36.88,,,36.88,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Connecticare,Exchange,,36.88,,,36.88,27.2,26725.55,Other,Could be inpatient or outpatient,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,Multiplan,Multiplan,,,26725.55,,26725.55,27.2,26725.55,percent of total billed charges,,
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,J2323,HCPCS,64406-008-01,NDC,both,15,mL,31441.82,18865.09,United Healthcare/Oxford,United Healthcare/Oxford,,29.37,,,29.37,27.2,26725.55,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Aetna,Commerical,,,68238.17,,68238.17,743.19,75171.65,percent of total billed charges,,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Aetna,Middlesex Employees,,,65434.71,,65434.71,743.19,75171.65,percent of total billed charges,,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Anthem,Commerical,,,,,,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Anthem,Indemnity,,,66248.33,,66248.33,743.19,75171.65,percent of total billed charges,,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Anthem,Individual Exchange,,,,,,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Anthem,State Preferred,,,,,,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Cigna,Cigna,,858.93,,,858.93,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Connecticare,Commerical,,980.54,,,980.54,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Connecticare,Exchange,,980.54,,,980.54,743.19,75171.65,Other,Could be inpatient or outpatient,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,Multiplan,Multiplan,,,75171.65,,75171.65,743.19,75171.65,percent of total billed charges,,
NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION,J9348,HCPCS,73042-201-01,NDC,both,1,mL,88437.23,53062.34,United Healthcare/Oxford,United Healthcare/Oxford,,743.19,,,743.19,743.19,75171.65,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,0078-0683-61,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-06,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,43598-142-11,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-1,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1726-8,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-1,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,70710-1839-8,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-01,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Aetna,Commerical,,,763.78,,763.78,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Aetna,Middlesex Employees,,,732.4,,732.4,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Commerical,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Indemnity,,,741.51,,741.51,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,Individual Exchange,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Anthem,State Preferred,,,,,,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Cigna,Cigna,,103.38,,,103.38,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Connecticare,Commerical,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Connecticare,Exchange,,110.75,,,110.75,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,Multiplan,Multiplan,,,841.39,,841.39,89.45,841.39,percent of total billed charges,,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,J9261,HCPCS,81927-111-06,NDC,both,10,mL,989.87,593.92,United Healthcare/Oxford,United Healthcare/Oxford,,89.45,,,89.45,89.45,841.39,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Aetna,Commerical,,,11.51,,11.51,11.04,12.68,percent of total billed charges,,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Aetna,Middlesex Employees,,,11.04,,11.04,11.04,12.68,percent of total billed charges,,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Anthem,Commerical,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Anthem,Indemnity,,,11.18,,11.18,11.04,12.68,percent of total billed charges,,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Anthem,Individual Exchange,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Anthem,State Preferred,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Cigna,Cigna,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Connecticare,Commerical,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Connecticare,Exchange,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,Multiplan,Multiplan,,,12.68,,12.68,11.04,12.68,percent of total billed charges,,
NELFINAVIR 250 MG TABLET,J3490,HCPCS,63010-010-30,NDC,both,1,ea,14.92,8.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.04,12.68,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Aetna,Commerical,,,28.78,,28.78,27.6,31.71,percent of total billed charges,,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Aetna,Middlesex Employees,,,27.6,,27.6,27.6,31.71,percent of total billed charges,,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Anthem,Commerical,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Anthem,Indemnity,,,27.94,,27.94,27.6,31.71,percent of total billed charges,,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Anthem,Individual Exchange,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Anthem,State Preferred,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Cigna,Cigna,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Connecticare,Commerical,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Connecticare,Exchange,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,Multiplan,Multiplan,,,31.71,,31.71,27.6,31.71,percent of total billed charges,,
NELFINAVIR 625 MG TABLET,J3490,HCPCS,63010-027-70,NDC,both,1,ea,37.3,22.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.6,31.71,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Aetna,Commerical,,,366.45,,366.45,351.39,403.68,percent of total billed charges,,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Aetna,Middlesex Employees,,,351.39,,351.39,351.39,403.68,percent of total billed charges,,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Anthem,Commerical,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Anthem,Indemnity,,,355.76,,355.76,351.39,403.68,percent of total billed charges,,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Anthem,Individual Exchange,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Anthem,State Preferred,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Cigna,Cigna,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Connecticare,Commerical,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Connecticare,Exchange,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,Multiplan,Multiplan,,,403.68,,403.68,351.39,403.68,percent of total billed charges,,
NEOMYCIN 0.04 MG/ML POLYMIXIN B 200 UNITS/ML IN NS IRRIGATION,J3490,HCPCS,40810-0015-05,NDC,both,1,mL,474.92,284.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.39,403.68,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Aetna,Commerical,,,2.12,,2.12,2.03,2.34,percent of total billed charges,,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.34,percent of total billed charges,,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Anthem,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Anthem,Indemnity,,,2.06,,2.06,2.03,2.34,percent of total billed charges,,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Anthem,Individual Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Anthem,State Preferred,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Cigna,Cigna,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Connecticare,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Connecticare,Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,Multiplan,Multiplan,,,2.34,,2.34,2.03,2.34,percent of total billed charges,,
NEOMYCIN 125 MG ORAL TAB,J3490,HCPCS,40810-0002-26,NDC,both,1,ea,2.75,1.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Aetna,Commerical,,,2.12,,2.12,2.03,2.34,percent of total billed charges,,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Aetna,Middlesex Employees,,,2.03,,2.03,2.03,2.34,percent of total billed charges,,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Anthem,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Anthem,Indemnity,,,2.06,,2.06,2.03,2.34,percent of total billed charges,,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Anthem,Individual Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Anthem,State Preferred,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Cigna,Cigna,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Connecticare,Commerical,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Connecticare,Exchange,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,Multiplan,Multiplan,,,2.34,,2.34,2.03,2.34,percent of total billed charges,,
NEOMYCIN 250 MG ORAL TAB,J3490,HCPCS,40810-0002-27,NDC,both,1,ea,2.75,1.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.03,2.34,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Aetna,Commerical,,,51.21,,51.21,49.11,56.41,percent of total billed charges,,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Aetna,Middlesex Employees,,,49.11,,49.11,49.11,56.41,percent of total billed charges,,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Anthem,Commerical,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Anthem,Indemnity,,,49.72,,49.72,49.11,56.41,percent of total billed charges,,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Anthem,Individual Exchange,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Anthem,State Preferred,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Cigna,Cigna,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Connecticare,Commerical,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Connecticare,Exchange,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,Multiplan,Multiplan,,,56.41,,56.41,49.11,56.41,percent of total billed charges,,
"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",J3490,HCPCS,61314-631-36,NDC,both,3.5,gm,66.37,39.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.11,56.41,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Aetna,Commerical,,,387.37,,387.37,371.45,426.73,percent of total billed charges,,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Aetna,Middlesex Employees,,,371.45,,371.45,371.45,426.73,percent of total billed charges,,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Anthem,Commerical,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Anthem,Indemnity,,,376.07,,376.07,371.45,426.73,percent of total billed charges,,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Anthem,Individual Exchange,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Anthem,State Preferred,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Cigna,Cigna,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Connecticare,Commerical,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Connecticare,Exchange,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,Multiplan,Multiplan,,,426.73,,426.73,371.45,426.73,percent of total billed charges,,
"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",J3490,HCPCS,61314-641-75,NDC,both,7.5,mL,502.03,301.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,371.45,426.73,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Aetna,Commerical,,,31.08,,31.08,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Aetna,Middlesex Employees,,,29.8,,29.8,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Anthem,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Anthem,Indemnity,,,30.17,,30.17,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Anthem,Individual Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Anthem,State Preferred,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Cigna,Cigna,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Connecticare,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Connecticare,Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,Multiplan,Multiplan,,,34.24,,34.24,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-45,NDC,both,1,mL,40.28,24.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Aetna,Commerical,,,31.08,,31.08,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Aetna,Middlesex Employees,,,29.8,,29.8,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Anthem,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Anthem,Indemnity,,,30.17,,30.17,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Anthem,Individual Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Anthem,State Preferred,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Cigna,Cigna,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Connecticare,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Connecticare,Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,Multiplan,Multiplan,,,34.24,,34.24,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,0591-2190-54,NDC,both,1,mL,40.28,24.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Aetna,Commerical,,,31.08,,31.08,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Aetna,Middlesex Employees,,,29.8,,29.8,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Anthem,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Anthem,Indemnity,,,30.17,,30.17,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Anthem,Individual Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Anthem,State Preferred,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Cigna,Cigna,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Connecticare,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Connecticare,Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,Multiplan,Multiplan,,,34.24,,34.24,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-1,NDC,both,1,mL,40.28,24.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Aetna,Commerical,,,31.08,,31.08,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Aetna,Middlesex Employees,,,29.8,,29.8,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Anthem,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Anthem,Indemnity,,,30.17,,30.17,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Anthem,Individual Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Anthem,State Preferred,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Cigna,Cigna,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Connecticare,Commerical,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Connecticare,Exchange,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,Multiplan,Multiplan,,,34.24,,34.24,29.8,34.24,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-2,NDC,both,1,mL,40.28,24.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.8,34.24,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Aetna,Commerical,,,30.38,,30.38,29.13,33.46,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Aetna,Middlesex Employees,,,29.13,,29.13,29.13,33.46,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Anthem,Commerical,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Anthem,Indemnity,,,29.49,,29.49,29.13,33.46,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Anthem,Individual Exchange,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Anthem,State Preferred,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Cigna,Cigna,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Connecticare,Commerical,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Connecticare,Exchange,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,Multiplan,Multiplan,,,33.46,,33.46,29.13,33.46,percent of total billed charges,,
"NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",J3490,HCPCS,39822-1201-5,NDC,both,1,mL,39.37,23.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.13,33.46,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Aetna,Commerical,,,2.15,,2.15,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Aetna,Middlesex Employees,,,2.06,,2.06,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Anthem,Commerical,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Anthem,Indemnity,,,2.09,,2.09,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Anthem,Individual Exchange,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Anthem,State Preferred,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Cigna,Cigna,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Connecticare,Commerical,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Connecticare,Exchange,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,Multiplan,Multiplan,,,2.37,,2.37,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,0093-1177-01,NDC,both,1,ea,2.79,1.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Aetna,Commerical,,,2.15,,2.15,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Aetna,Middlesex Employees,,,2.06,,2.06,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Anthem,Commerical,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Anthem,Indemnity,,,2.09,,2.09,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Anthem,Individual Exchange,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Anthem,State Preferred,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Cigna,Cigna,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Connecticare,Commerical,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Connecticare,Exchange,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,Multiplan,Multiplan,,,2.37,,2.37,2.06,2.37,percent of total billed charges,,
NEOMYCIN 500 MG TABLET,J3490,HCPCS,50383-565-10,NDC,both,1,ea,2.79,1.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.06,2.37,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Aetna,Commerical,,,53.06,,53.06,50.88,58.45,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Aetna,Middlesex Employees,,,50.88,,50.88,50.88,58.45,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Anthem,Commerical,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Anthem,Indemnity,,,51.51,,51.51,50.88,58.45,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Anthem,Individual Exchange,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Anthem,State Preferred,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Cigna,Cigna,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Connecticare,Commerical,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Connecticare,Exchange,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,Multiplan,Multiplan,,,58.45,,58.45,50.88,58.45,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT",J3490,HCPCS,24208-785-55,NDC,both,3.5,gm,68.76,41.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.88,58.45,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Aetna,Commerical,,,56.14,,56.14,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Anthem,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Anthem,Indemnity,,,54.5,,54.5,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Anthem,Individual Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Anthem,State Preferred,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Cigna,Cigna,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Connecticare,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Connecticare,Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,Multiplan,Multiplan,,,61.85,,61.85,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,16571-754-53,NDC,both,1,gm,72.76,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Aetna,Commerical,,,49.13,,49.13,47.11,54.12,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Aetna,Middlesex Employees,,,47.11,,47.11,47.11,54.12,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Anthem,Commerical,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Anthem,Indemnity,,,47.7,,47.7,47.11,54.12,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Anthem,Individual Exchange,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Anthem,State Preferred,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Cigna,Cigna,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Connecticare,Commerical,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Connecticare,Exchange,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,Multiplan,Multiplan,,,54.12,,54.12,47.11,54.12,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,24208-780-55,NDC,both,3.5,gm,63.67,38.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,47.11,54.12,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Aetna,Commerical,,,56.14,,56.14,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Anthem,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Anthem,Indemnity,,,54.5,,54.5,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Anthem,Individual Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Anthem,State Preferred,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Cigna,Cigna,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Connecticare,Commerical,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Connecticare,Exchange,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,Multiplan,Multiplan,,,61.85,,61.85,53.84,61.85,percent of total billed charges,,
"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",J3490,HCPCS,57237-129-53,NDC,both,1,gm,72.76,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.84,61.85,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,0904-0734-31,NDC,both,1,gm,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Aetna,Commerical,,,4.8,,4.8,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Aetna,Middlesex Employees,,,4.6,,4.6,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Anthem,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Anthem,Indemnity,,,4.66,,4.66,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Anthem,Individual Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Anthem,State Preferred,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Cigna,Cigna,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Connecticare,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Connecticare,Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,Multiplan,Multiplan,,,5.29,,5.29,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,45802-143-01,NDC,both,1,gm,6.22,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Aetna,Commerical,,,4.8,,4.8,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Aetna,Middlesex Employees,,,4.6,,4.6,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Anthem,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Anthem,Indemnity,,,4.66,,4.66,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Anthem,Individual Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Anthem,State Preferred,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Cigna,Cigna,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Connecticare,Commerical,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Connecticare,Exchange,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,Multiplan,Multiplan,,,5.29,,5.29,4.6,5.29,percent of total billed charges,,
"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",J3490,HCPCS,61269-179-34,NDC,both,1,gm,6.22,3.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.6,5.29,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Aetna,Commerical,,,38.69,,38.69,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Aetna,Middlesex Employees,,,37.1,,37.1,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Anthem,Commerical,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Anthem,Indemnity,,,37.56,,37.56,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Anthem,Individual Exchange,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Anthem,State Preferred,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Cigna,Cigna,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Connecticare,Commerical,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Connecticare,Exchange,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,Multiplan,Multiplan,,,42.62,,42.62,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,24208-830-60,NDC,both,5,mL,50.14,30.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Aetna,Commerical,,,38.69,,38.69,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Aetna,Middlesex Employees,,,37.1,,37.1,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Anthem,Commerical,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Anthem,Indemnity,,,37.56,,37.56,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Anthem,Individual Exchange,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Anthem,State Preferred,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Cigna,Cigna,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Connecticare,Commerical,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Connecticare,Exchange,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,Multiplan,Multiplan,,,42.62,,42.62,37.1,42.62,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",J3490,HCPCS,61314-630-06,NDC,both,5,mL,50.14,30.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.1,42.62,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Aetna,Commerical,,,130.62,,130.62,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Aetna,Middlesex Employees,,,125.26,,125.26,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Anthem,Commerical,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Anthem,Indemnity,,,126.82,,126.82,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Anthem,Individual Exchange,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Anthem,State Preferred,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Cigna,Cigna,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Connecticare,Commerical,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Connecticare,Exchange,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,Multiplan,Multiplan,,,143.9,,143.9,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,24208-635-62,NDC,both,10,mL,169.29,101.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Aetna,Commerical,,,130.62,,130.62,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Aetna,Middlesex Employees,,,125.26,,125.26,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Anthem,Commerical,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Anthem,Indemnity,,,126.82,,126.82,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Anthem,Individual Exchange,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Anthem,State Preferred,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Cigna,Cigna,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Connecticare,Commerical,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Connecticare,Exchange,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,Multiplan,Multiplan,,,143.9,,143.9,125.26,143.9,percent of total billed charges,,
"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",J3490,HCPCS,61314-645-11,NDC,both,1,mL,169.29,101.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,125.26,143.9,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-01,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6149-10,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,0641-6265-10,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-01,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,70069-806-10,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Cigna,Cigna,,0.93,,,0.93,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Commerical,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Connecticare,Exchange,,,,,,0.93,6.29,Other,Could be inpatient or outpatient,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.93,6.29,percent of total billed charges,,
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,J2710,HCPCS,76014-903-10,NDC,both,0.5,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,2.21,,,2.21,0.93,6.29,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Aetna,Commerical,,,430.52,,430.52,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Aetna,Middlesex Employees,,,412.83,,412.83,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Anthem,Commerical,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Anthem,Indemnity,,,417.97,,417.97,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Anthem,Individual Exchange,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Anthem,State Preferred,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Cigna,Cigna,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Connecticare,Commerical,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Connecticare,Exchange,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,Multiplan,Multiplan,,,474.27,,474.27,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0597-0047-24,NDC,both,1,mL,557.96,334.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Aetna,Commerical,,,430.52,,430.52,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Aetna,Middlesex Employees,,,412.83,,412.83,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Anthem,Commerical,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Anthem,Indemnity,,,417.97,,417.97,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Anthem,Individual Exchange,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Anthem,State Preferred,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Cigna,Cigna,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Connecticare,Commerical,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Connecticare,Exchange,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,Multiplan,Multiplan,,,474.27,,474.27,412.83,474.27,percent of total billed charges,,
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65862-057-24,NDC,both,1,mL,557.96,334.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,412.83,474.27,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,536407601,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
NIACIN 100 MG TABLET,J3490,HCPCS,8068105700,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Aetna,Commerical,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Aetna,Middlesex Employees,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Anthem,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Anthem,Indemnity,,,0.08,,0.08,0.08,0.09,percent of total billed charges,,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Anthem,Individual Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Anthem,State Preferred,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Cigna,Cigna,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Connecticare,Commerical,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Connecticare,Exchange,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,Multiplan,Multiplan,,,0.09,,0.09,0.08,0.09,percent of total billed charges,,
NIACIN 25 MG TABLET,J3490,HCPCS,40810-0013-69,NDC,both,1,ea,0.11,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.08,0.09,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,7985420140,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
NIACIN 250 MG TABLET,J3490,HCPCS,54629-0710-01,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
NIACIN 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-62,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0143-9689-01,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-01,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,0517-0735-10,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-01,NDC,both,1,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-02,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-10,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,55150-183-11,NDC,both,0.4,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Aetna,Commerical,,,33.13,,33.13,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Aetna,Middlesex Employees,,,31.77,,31.77,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Anthem,Commerical,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Anthem,Indemnity,,,32.17,,32.17,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Anthem,Individual Exchange,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Anthem,State Preferred,,,,,,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Cigna,Cigna,,0.11,,,0.11,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Connecticare,Commerical,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Connecticare,Exchange,,0.82,,,0.82,0.11,36.5,Other,Could be inpatient or outpatient,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,Multiplan,Multiplan,,,36.5,,36.5,0.11,36.5,percent of total billed charges,,
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,J2404,HCPCS,67457-224-10,NDC,both,1,mL,42.94,25.76,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.11,36.5,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Aetna,Commerical,,,1.86,,1.86,1.78,2.05,percent of total billed charges,,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Aetna,Middlesex Employees,,,1.78,,1.78,1.78,2.05,percent of total billed charges,,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Anthem,Commerical,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Anthem,Indemnity,,,1.81,,1.81,1.78,2.05,percent of total billed charges,,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Anthem,Individual Exchange,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Anthem,State Preferred,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Cigna,Cigna,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Connecticare,Commerical,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Connecticare,Exchange,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,Multiplan,Multiplan,,,2.05,,2.05,1.78,2.05,percent of total billed charges,,
NICOTINE (POLACRILEX) 2 MG GUM,J3490,HCPCS,0135-0474-08,NDC,both,1,ea,2.41,1.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.78,2.05,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Aetna,Commerical,,,5.68,,5.68,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Aetna,Middlesex Employees,,,5.45,,5.45,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Anthem,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Anthem,Indemnity,,,5.51,,5.51,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Anthem,Individual Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Anthem,State Preferred,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Cigna,Cigna,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Connecticare,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Connecticare,Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,Multiplan,Multiplan,,,6.26,,6.26,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500151,NDC,both,1,ea,7.36,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Aetna,Commerical,,,5.68,,5.68,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Aetna,Middlesex Employees,,,5.45,,5.45,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Anthem,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Anthem,Indemnity,,,5.51,,5.51,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Anthem,Individual Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Anthem,State Preferred,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Cigna,Cigna,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Connecticare,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Connecticare,Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,Multiplan,Multiplan,,,6.26,,6.26,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7062-0,NDC,both,1,ea,7.36,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Aetna,Commerical,,,5.68,,5.68,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Aetna,Middlesex Employees,,,5.45,,5.45,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Anthem,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Anthem,Indemnity,,,5.51,,5.51,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Anthem,Individual Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Anthem,State Preferred,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Cigna,Cigna,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Connecticare,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Connecticare,Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,Multiplan,Multiplan,,,6.26,,6.26,5.45,6.26,percent of total billed charges,,
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7089-0,NDC,both,1,ea,7.36,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,4898500154,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5896-53,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Anthem,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Anthem,Individual Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Anthem,State Preferred,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Cigna,Cigna,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Connecticare,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Connecticare,Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,0536-5894-53,NDC,both,1,ea,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Anthem,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Anthem,Individual Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Anthem,State Preferred,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Cigna,Cigna,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Connecticare,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Connecticare,Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-70,NDC,both,1,ea,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Anthem,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Anthem,Individual Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Anthem,State Preferred,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Cigna,Cigna,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Connecticare,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Connecticare,Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,43598-446-71,NDC,both,1,ea,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Aetna,Commerical,,,4.64,,4.64,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Anthem,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Anthem,Indemnity,,,4.5,,4.5,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Anthem,Individual Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Anthem,State Preferred,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Cigna,Cigna,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Connecticare,Commerical,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Connecticare,Exchange,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,Multiplan,Multiplan,,,5.11,,5.11,4.45,5.11,percent of total billed charges,,
NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,J3490,HCPCS,60505-7061-0,NDC,both,1,ea,6.01,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.45,5.11,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Aetna,Commerical,,,73.88,,73.88,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Aetna,Middlesex Employees,,,70.85,,70.85,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Anthem,Commerical,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Anthem,Indemnity,,,71.73,,71.73,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Anthem,Individual Exchange,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Anthem,State Preferred,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Cigna,Cigna,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Connecticare,Commerical,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Connecticare,Exchange,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,Multiplan,Multiplan,,,81.39,,81.39,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,38779-0280-3,NDC,both,1,gm,95.75,57.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Aetna,Commerical,,,73.88,,73.88,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Aetna,Middlesex Employees,,,70.85,,70.85,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Anthem,Commerical,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Anthem,Indemnity,,,71.73,,71.73,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Anthem,Individual Exchange,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Anthem,State Preferred,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Cigna,Cigna,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Connecticare,Commerical,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Connecticare,Exchange,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,Multiplan,Multiplan,,,81.39,,81.39,70.85,81.39,percent of total billed charges,,
NIFEDIPINE (BULK) POWDER,J3490,HCPCS,51552-0720-2,NDC,both,1,gm,95.75,57.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.85,81.39,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Aetna,Commerical,,,2.53,,2.53,2.43,2.79,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Aetna,Middlesex Employees,,,2.43,,2.43,2.43,2.79,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Anthem,Commerical,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Anthem,Indemnity,,,2.46,,2.46,2.43,2.79,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Anthem,Individual Exchange,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Anthem,State Preferred,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Cigna,Cigna,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Connecticare,Commerical,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Connecticare,Exchange,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,Multiplan,Multiplan,,,2.79,,2.79,2.43,2.79,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,23155-194-01,NDC,both,1,ea,3.28,1.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.43,2.79,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Aetna,Commerical,,,0.88,,0.88,0.84,0.97,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.97,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Anthem,Commerical,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.97,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Anthem,Individual Exchange,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Anthem,State Preferred,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Cigna,Cigna,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Connecticare,Commerical,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Connecticare,Exchange,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,Multiplan,Multiplan,,,0.97,,0.97,0.84,0.97,percent of total billed charges,,
NIFEDIPINE 10 MG CAPSULE,J3490,HCPCS,43386-440-24,NDC,both,1,ea,1.14,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Aetna,Commerical,,,113.49,,113.49,108.82,125.02,percent of total billed charges,,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Aetna,Middlesex Employees,,,108.82,,108.82,108.82,125.02,percent of total billed charges,,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Anthem,Commerical,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Anthem,Indemnity,,,110.18,,110.18,108.82,125.02,percent of total billed charges,,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Anthem,Individual Exchange,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Anthem,State Preferred,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Cigna,Cigna,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Connecticare,Commerical,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Connecticare,Exchange,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,Multiplan,Multiplan,,,125.02,,125.02,108.82,125.02,percent of total billed charges,,
NIFEDIPINE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0019-67,NDC,both,1,mL,147.08,88.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Aetna,Commerical,,,55.32,,55.32,53.05,60.95,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Aetna,Middlesex Employees,,,53.05,,53.05,53.05,60.95,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Anthem,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Anthem,Indemnity,,,53.71,,53.71,53.05,60.95,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Anthem,Individual Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Anthem,State Preferred,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Cigna,Cigna,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Connecticare,Commerical,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Connecticare,Exchange,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,Multiplan,Multiplan,,,60.95,,60.95,53.05,60.95,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-42,NDC,both,2.5,mL,71.7,43.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.05,60.95,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Aetna,Commerical,,,27.66,,27.66,26.53,30.47,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Aetna,Middlesex Employees,,,26.53,,26.53,26.53,30.47,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Anthem,Commerical,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Anthem,Indemnity,,,26.86,,26.86,26.53,30.47,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Anthem,Individual Exchange,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Anthem,State Preferred,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Cigna,Cigna,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Connecticare,Commerical,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Connecticare,Exchange,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,Multiplan,Multiplan,,,30.47,,30.47,26.53,30.47,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-43,NDC,both,2.5,mL,35.85,21.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.53,30.47,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Aetna,Commerical,,,110.65,,110.65,106.1,121.89,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Aetna,Middlesex Employees,,,106.1,,106.1,106.1,121.89,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Anthem,Commerical,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Anthem,Indemnity,,,107.42,,107.42,106.1,121.89,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Anthem,Individual Exchange,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Anthem,State Preferred,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Cigna,Cigna,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Connecticare,Commerical,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Connecticare,Exchange,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,Multiplan,Multiplan,,,121.89,,121.89,106.1,121.89,percent of total billed charges,,
NIFEDIPINE 4 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-44,NDC,both,2.5,mL,143.4,86.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.1,121.89,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-7208-61,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0017-80,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Aetna,Commerical,,,2.41,,2.41,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Aetna,Middlesex Employees,,,2.31,,2.31,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Anthem,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Anthem,Indemnity,,,2.34,,2.34,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Anthem,Individual Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Anthem,State Preferred,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Cigna,Cigna,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Connecticare,Commerical,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Connecticare,Exchange,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,Multiplan,Multiplan,,,2.65,,2.65,2.31,2.65,percent of total billed charges,,
"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,68084-597-01,NDC,both,1,ea,3.12,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.31,2.65,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Aetna,Commerical,,,0.51,,0.51,0.49,0.56,percent of total billed charges,,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Aetna,Middlesex Employees,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Anthem,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Anthem,Indemnity,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Anthem,Individual Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Anthem,State Preferred,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Cigna,Cigna,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Connecticare,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Connecticare,Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,Multiplan,Multiplan,,,0.56,,0.56,0.49,0.56,percent of total billed charges,,
"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50742-261-01,NDC,both,1,ea,0.66,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Aetna,Commerical,,,6.37,,6.37,6.11,7.02,percent of total billed charges,,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Aetna,Middlesex Employees,,,6.11,,6.11,6.11,7.02,percent of total billed charges,,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Anthem,Commerical,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Anthem,Indemnity,,,6.19,,6.19,6.11,7.02,percent of total billed charges,,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Anthem,Individual Exchange,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Anthem,State Preferred,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Cigna,Cigna,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Connecticare,Commerical,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Connecticare,Exchange,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,Multiplan,Multiplan,,,7.02,,7.02,6.11,7.02,percent of total billed charges,,
"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-599-15,NDC,both,1,ea,8.26,4.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.11,7.02,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,14.17,16.28,percent of total billed charges,,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,14.17,16.28,percent of total billed charges,,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Anthem,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,14.17,16.28,percent of total billed charges,,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Anthem,State Preferred,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Cigna,Cigna,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Connecticare,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Connecticare,Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,14.17,16.28,percent of total billed charges,,
NIMODIPINE 30 MG/1ML ORAL SOLUTION,J8499,HCPCS,40810-0205-96,NDC,both,1,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Aetna,Commerical,,,127.55,,127.55,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Aetna,Middlesex Employees,,,122.31,,122.31,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Anthem,Commerical,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Anthem,Indemnity,,,123.83,,123.83,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Anthem,Individual Exchange,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Anthem,State Preferred,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Cigna,Cigna,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Connecticare,Commerical,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Connecticare,Exchange,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,Multiplan,Multiplan,,,140.51,,140.51,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-12,NDC,both,1,mL,165.31,99.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Aetna,Commerical,,,127.55,,127.55,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Aetna,Middlesex Employees,,,122.31,,122.31,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Anthem,Commerical,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Anthem,Indemnity,,,123.83,,123.83,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Anthem,Individual Exchange,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Anthem,State Preferred,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Cigna,Cigna,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Connecticare,Commerical,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Connecticare,Exchange,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,Multiplan,Multiplan,,,140.51,,140.51,122.31,140.51,percent of total billed charges,,
NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),J8499,HCPCS,24338-230-30,NDC,both,1,mL,165.31,99.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.31,140.51,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Aetna,Commerical,,,3953.75,,3953.75,3791.31,4355.48,percent of total billed charges,,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Aetna,Middlesex Employees,,,3791.31,,3791.31,3791.31,4355.48,percent of total billed charges,,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Anthem,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Anthem,Indemnity,,,3838.46,,3838.46,3791.31,4355.48,percent of total billed charges,,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Anthem,Individual Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Anthem,State Preferred,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Cigna,Cigna,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Connecticare,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Connecticare,Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,Multiplan,Multiplan,,,4355.48,,4355.48,3791.31,4355.48,percent of total billed charges,,
NIRMATRELVIR 150 MG-RITONAVIR 100 MG TABLETS IN A DOSE PACK,J8499,HCPCS,0069-5317-20,NDC,both,1,ea,5124.09,3074.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Aetna,Commerical,,,3953.75,,3953.75,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Aetna,Middlesex Employees,,,3791.31,,3791.31,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Indemnity,,,3838.46,,3838.46,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Individual Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Anthem,State Preferred,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Cigna,Cigna,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Connecticare,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Connecticare,Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,Multiplan,Multiplan,,,4355.48,,4355.48,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-1085-30,NDC,both,1,ea,5124.09,3074.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Aetna,Commerical,,,131.8,,131.8,126.38,145.19,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Aetna,Middlesex Employees,,,126.38,,126.38,126.38,145.19,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Anthem,Commerical,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Anthem,Indemnity,,,127.95,,127.95,126.38,145.19,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Anthem,Individual Exchange,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Anthem,State Preferred,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Cigna,Cigna,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Connecticare,Commerical,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Connecticare,Exchange,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,Multiplan,Multiplan,,,145.19,,145.19,126.38,145.19,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-03,NDC,both,1,ea,170.81,102.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,126.38,145.19,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Aetna,Commerical,,,3953.75,,3953.75,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Aetna,Middlesex Employees,,,3791.31,,3791.31,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Indemnity,,,3838.46,,3838.46,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Anthem,Individual Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Anthem,State Preferred,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Cigna,Cigna,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Connecticare,Commerical,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Connecticare,Exchange,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,Multiplan,Multiplan,,,4355.48,,4355.48,3791.31,4355.48,percent of total billed charges,,
"NIRMATRELVIR 300 MG (150 MG X2)-RITONAVIR 100 MG TABLET,DOSE PACK",J8499,HCPCS,0069-5321-30,NDC,both,1,ea,5124.09,3074.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3791.31,4355.48,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Aetna,Commerical,,,101.74,,101.74,97.56,112.07,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Aetna,Middlesex Employees,,,97.56,,97.56,97.56,112.07,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Anthem,Commerical,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Anthem,Indemnity,,,98.77,,98.77,97.56,112.07,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Anthem,Individual Exchange,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Anthem,State Preferred,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Cigna,Cigna,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Connecticare,Commerical,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Connecticare,Exchange,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,Multiplan,Multiplan,,,112.07,,112.07,97.56,112.07,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,40810-0206-10,NDC,both,1,mL,131.85,79.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.56,112.07,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Aetna,Commerical,,,244.17,,244.17,234.13,268.97,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Aetna,Middlesex Employees,,,234.13,,234.13,234.13,268.97,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Anthem,Commerical,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Anthem,Indemnity,,,237.05,,237.05,234.13,268.97,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Anthem,Individual Exchange,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Anthem,State Preferred,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Cigna,Cigna,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Connecticare,Commerical,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Connecticare,Exchange,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,Multiplan,Multiplan,,,268.97,,268.97,234.13,268.97,percent of total billed charges,,
NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,67546-212-21,NDC,both,1,mL,316.44,189.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,234.13,268.97,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Aetna,Commerical,,,296.67,,296.67,284.48,326.82,percent of total billed charges,,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Aetna,Middlesex Employees,,,284.48,,284.48,284.48,326.82,percent of total billed charges,,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Anthem,Commerical,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Anthem,Indemnity,,,288.02,,288.02,284.48,326.82,percent of total billed charges,,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Anthem,Individual Exchange,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Anthem,State Preferred,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Cigna,Cigna,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Connecticare,Commerical,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Connecticare,Exchange,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,Multiplan,Multiplan,,,326.82,,326.82,284.48,326.82,percent of total billed charges,,
NITAZOXANIDE 250 MG TABLET,J3490,HCPCS,40810-0201-98,NDC,both,1,ea,384.49,230.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,284.48,326.82,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-03,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,43386-405-12,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-03,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-21,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,64980-526-60,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Aetna,Commerical,,,63.1,,63.1,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Aetna,Middlesex Employees,,,60.51,,60.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Anthem,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Anthem,Indemnity,,,61.26,,61.26,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Anthem,Individual Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Anthem,State Preferred,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Cigna,Cigna,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Connecticare,Commerical,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Connecticare,Exchange,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,Multiplan,Multiplan,,,69.51,,69.51,60.51,69.51,percent of total billed charges,,
NITAZOXANIDE 500 MG TABLET,J3490,HCPCS,67546-111-12,NDC,both,1,ea,81.78,49.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.51,69.51,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,16571-740-24,NDC,both,1,mL,5266.91,3160.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,65162-689-88,NDC,both,1,mL,5266.91,3160.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70199-006-32,NDC,both,1,mL,5266.91,3160.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Aetna,Commerical,,,4240.64,,4240.64,4066.42,4671.52,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Aetna,Middlesex Employees,,,4066.42,,4066.42,4066.42,4671.52,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Anthem,Commerical,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Anthem,Indemnity,,,4116.98,,4116.98,4066.42,4671.52,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Anthem,Individual Exchange,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Anthem,State Preferred,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Cigna,Cigna,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Connecticare,Commerical,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Connecticare,Exchange,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,Multiplan,Multiplan,,,4671.52,,4671.52,4066.42,4671.52,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70408-239-32,NDC,both,1,mL,5495.9,3297.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4066.42,4671.52,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-496-10,NDC,both,1,mL,5266.91,3160.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,65162-689-88,NDC,both,1,mL,10724.08,6434.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Aetna,Commerical,,,4063.95,,4063.95,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Aetna,Middlesex Employees,,,3896.99,,3896.99,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Anthem,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Anthem,Indemnity,,,3945.44,,3945.44,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Anthem,Individual Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Anthem,State Preferred,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Cigna,Cigna,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Connecticare,Commerical,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Connecticare,Exchange,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,Multiplan,Multiplan,,,4476.87,,4476.87,3896.99,4476.87,percent of total billed charges,,
NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,70199-006-32,NDC,both,1,mL,10724.08,6434.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3896.99,4476.87,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,40810-0017-13,NDC,both,1,ea,7.56,4.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,7.56,4.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,7.56,4.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE,J3490,HCPCS,70756-410-11,NDC,both,1,ea,7.56,4.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,47781-306-01,NDC,both,1,ea,21.61,12.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Aetna,Commerical,,,5.83,,5.83,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Anthem,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Anthem,Indemnity,,,5.66,,5.66,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Anthem,Individual Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Anthem,State Preferred,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Cigna,Cigna,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Connecticare,Commerical,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Connecticare,Exchange,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,Multiplan,Multiplan,,,6.43,,6.43,5.59,6.43,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE FOR PROPHYLAXIS USE,J3490,HCPCS,52427-286-01,NDC,both,1,ea,21.61,12.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.43,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Aetna,Commerical,,,3.89,,3.89,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Aetna,Middlesex Employees,,,3.73,,3.73,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Anthem,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Anthem,Indemnity,,,3.78,,3.78,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Anthem,Individual Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Anthem,State Preferred,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Cigna,Cigna,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Connecticare,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Connecticare,Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,Multiplan,Multiplan,,,4.28,,4.28,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0115-1643-01,NDC,both,1,ea,5.04,3.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Aetna,Commerical,,,3.89,,3.89,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Aetna,Middlesex Employees,,,3.73,,3.73,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Anthem,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Anthem,Indemnity,,,3.78,,3.78,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Anthem,Individual Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Anthem,State Preferred,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Cigna,Cigna,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Connecticare,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Connecticare,Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,Multiplan,Multiplan,,,4.28,,4.28,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,0904-7026-61,NDC,both,1,ea,5.04,3.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Aetna,Commerical,,,3.89,,3.89,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Aetna,Middlesex Employees,,,3.73,,3.73,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Anthem,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Anthem,Indemnity,,,3.78,,3.78,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Anthem,Individual Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Anthem,State Preferred,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Cigna,Cigna,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Connecticare,Commerical,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Connecticare,Exchange,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,Multiplan,Multiplan,,,4.28,,4.28,3.73,4.28,percent of total billed charges,,
NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,J3490,HCPCS,50268-623-11,NDC,both,1,ea,5.04,3.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.73,4.28,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Aetna,Commerical,,,226.52,,226.52,217.21,249.53,percent of total billed charges,,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Aetna,Middlesex Employees,,,217.21,,217.21,217.21,249.53,percent of total billed charges,,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Anthem,Commerical,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Anthem,Indemnity,,,219.91,,219.91,217.21,249.53,percent of total billed charges,,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Anthem,Individual Exchange,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Anthem,State Preferred,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Cigna,Cigna,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Connecticare,Commerical,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Connecticare,Exchange,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,Multiplan,Multiplan,,,249.53,,249.53,217.21,249.53,percent of total billed charges,,
NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-296-03,NDC,both,30,ea,293.57,176.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,217.21,249.53,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Aetna,Commerical,,,146.11,,146.11,140.11,160.96,percent of total billed charges,,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Aetna,Middlesex Employees,,,140.11,,140.11,140.11,160.96,percent of total billed charges,,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Anthem,Commerical,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Anthem,Indemnity,,,141.85,,141.85,140.11,160.96,percent of total billed charges,,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Anthem,Individual Exchange,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Anthem,State Preferred,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Cigna,Cigna,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Connecticare,Commerical,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Connecticare,Exchange,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,Multiplan,Multiplan,,,160.96,,160.96,140.11,160.96,percent of total billed charges,,
NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,49730-111-30,NDC,both,30,ea,189.36,113.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,140.11,160.96,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Aetna,Commerical,,,4.38,,4.38,4.2,4.83,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Aetna,Middlesex Employees,,,4.2,,4.2,4.2,4.83,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Anthem,Commerical,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Anthem,Indemnity,,,4.25,,4.25,4.2,4.83,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Anthem,Individual Exchange,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Anthem,State Preferred,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Cigna,Cigna,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Connecticare,Commerical,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Connecticare,Exchange,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,Multiplan,Multiplan,,,4.83,,4.83,4.2,4.83,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,0071-0418-13,NDC,both,1,ea,5.68,3.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.2,4.83,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Aetna,Commerical,,,1.4,,1.4,1.34,1.54,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Aetna,Middlesex Employees,,,1.34,,1.34,1.34,1.54,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Anthem,Commerical,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Anthem,Indemnity,,,1.36,,1.36,1.34,1.54,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Anthem,Individual Exchange,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Anthem,State Preferred,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Cigna,Cigna,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Connecticare,Commerical,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Connecticare,Exchange,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,Multiplan,Multiplan,,,1.54,,1.54,1.34,1.54,percent of total billed charges,,
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,J3490,HCPCS,59762-3304-3,NDC,both,1,ea,1.81,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.34,1.54,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Aetna,Commerical,,,257.91,,257.91,247.31,284.11,percent of total billed charges,,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Aetna,Middlesex Employees,,,247.31,,247.31,247.31,284.11,percent of total billed charges,,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Anthem,Commerical,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Anthem,Indemnity,,,250.39,,250.39,247.31,284.11,percent of total billed charges,,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Anthem,Individual Exchange,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Anthem,State Preferred,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Cigna,Cigna,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Connecticare,Commerical,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Connecticare,Exchange,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,Multiplan,Multiplan,,,284.11,,284.11,247.31,284.11,percent of total billed charges,,
NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,J3490,HCPCS,47781-298-03,NDC,both,30,ea,334.25,200.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,247.31,284.11,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Anthem,Commerical,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Anthem,State Preferred,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Cigna,Cigna,,1.51,,,1.51,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Connecticare,Commerical,,2.15,,,2.15,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Connecticare,Exchange,,2.15,,,2.15,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0338-1051-02,NDC,both,250,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Anthem,Commerical,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Anthem,State Preferred,,,,,,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Cigna,Cigna,,1.51,,,1.51,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Connecticare,Commerical,,2.15,,,2.15,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Connecticare,Exchange,,2.15,,,2.15,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,1.51,73.25,percent of total billed charges,,
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,J2305,HCPCS,0409-1484-02,NDC,both,2.5,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,73.25,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Aetna,Commerical,,,88.13,,88.13,84.51,97.09,percent of total billed charges,,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Aetna,Middlesex Employees,,,84.51,,84.51,84.51,97.09,percent of total billed charges,,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Anthem,Commerical,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Anthem,Indemnity,,,85.56,,85.56,84.51,97.09,percent of total billed charges,,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Anthem,Individual Exchange,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Anthem,State Preferred,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Cigna,Cigna,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Connecticare,Commerical,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Connecticare,Exchange,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,Multiplan,Multiplan,,,97.09,,97.09,84.51,97.09,percent of total billed charges,,
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,J3490,HCPCS,0281-0326-30,NDC,both,1,gm,114.22,68.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,84.51,97.09,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Aetna,Commerical,,,40.55,,40.55,1.51,44.67,percent of total billed charges,,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Aetna,Middlesex Employees,,,38.88,,38.88,1.51,44.67,percent of total billed charges,,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Anthem,Commerical,,,,,,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Anthem,Indemnity,,,39.37,,39.37,1.51,44.67,percent of total billed charges,,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Anthem,Individual Exchange,,,,,,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Anthem,State Preferred,,,,,,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Cigna,Cigna,,1.51,,,1.51,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Connecticare,Commerical,,2.15,,,2.15,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Connecticare,Exchange,,2.15,,,2.15,1.51,44.67,Other,Could be inpatient or outpatient,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,Multiplan,Multiplan,,,44.67,,44.67,1.51,44.67,percent of total billed charges,,
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,J2305,HCPCS,0517-4810-25,NDC,both,1,mL,52.55,31.53,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,44.67,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Aetna,Commerical,,,9035.82,,9035.82,38.55,9953.93,percent of total billed charges,,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Aetna,Middlesex Employees,,,8664.6,,8664.6,38.55,9953.93,percent of total billed charges,,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Anthem,Commerical,,,,,,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Anthem,Indemnity,,,8772.34,,8772.34,38.55,9953.93,percent of total billed charges,,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Anthem,Individual Exchange,,,,,,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Anthem,State Preferred,,,,,,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Cigna,Cigna,,44.56,,,44.56,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Connecticare,Commerical,,48.48,,,48.48,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Connecticare,Exchange,,48.48,,,48.48,38.55,9953.93,Other,Could be inpatient or outpatient,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,Multiplan,Multiplan,,,9953.93,,9953.93,38.55,9953.93,percent of total billed charges,,
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,J9299,HCPCS,0003-3774-12,NDC,both,0.1,mL,11710.5,7026.3,United Healthcare/Oxford,United Healthcare/Oxford,,38.55,,,38.55,38.55,9953.93,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE 32 MCG/ML CONTINUOUS IV FREQUENCY,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,225.02,135.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3375-04,NDC,both,1,mL,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-17,NDC,both,1,mL,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51991-983-99,NDC,both,1,mL,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-852-00,NDC,both,1,mL,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72078-002-00,NDC,both,1,mL,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,44567-641-10,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,69374-504-25,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,71266-5015-2,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
NOREPINEPHRINE BITATTRATE 8 MG/250 ML (32 MCG/ML) INFUSION (EMERGENT),J3490,HCPCS,76154-475-15,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Aetna,Commerical,,,8.53,,8.53,8.18,9.39,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Aetna,Middlesex Employees,,,8.18,,8.18,8.18,9.39,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Anthem,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Anthem,Indemnity,,,8.28,,8.28,8.18,9.39,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Anthem,Individual Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Anthem,State Preferred,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Cigna,Cigna,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Connecticare,Commerical,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Connecticare,Exchange,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,Multiplan,Multiplan,,,9.39,,9.39,8.18,9.39,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-71,NDC,both,1,ea,11.05,6.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.18,9.39,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,J3490,HCPCS,68180-876-73,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Aetna,Commerical,,,4.57,,4.57,4.38,5.03,percent of total billed charges,,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Aetna,Middlesex Employees,,,4.38,,4.38,4.38,5.03,percent of total billed charges,,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Anthem,Commerical,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Anthem,Indemnity,,,4.43,,4.43,4.38,5.03,percent of total billed charges,,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Anthem,Individual Exchange,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Anthem,State Preferred,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Cigna,Cigna,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Connecticare,Commerical,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Connecticare,Exchange,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,Multiplan,Multiplan,,,5.03,,5.03,4.38,5.03,percent of total billed charges,,
NORETHINDRONE ACETATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-28,NDC,both,1,ea,5.92,3.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.38,5.03,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Aetna,Commerical,,,1.71,,1.71,1.64,1.88,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Aetna,Middlesex Employees,,,1.64,,1.64,1.64,1.88,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Anthem,Commerical,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Anthem,Indemnity,,,1.66,,1.66,1.64,1.88,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Anthem,Individual Exchange,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Anthem,State Preferred,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Cigna,Cigna,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Connecticare,Commerical,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Connecticare,Exchange,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,Multiplan,Multiplan,,,1.88,,1.88,1.64,1.88,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,65162-475-05,NDC,both,1,ea,2.21,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.64,1.88,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Aetna,Commerical,,,5.49,,5.49,5.26,6.04,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Aetna,Middlesex Employees,,,5.26,,5.26,5.26,6.04,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Anthem,Commerical,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Anthem,Indemnity,,,5.33,,5.33,5.26,6.04,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Anthem,Individual Exchange,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Anthem,State Preferred,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Cigna,Cigna,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Connecticare,Commerical,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Connecticare,Exchange,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,Multiplan,Multiplan,,,6.04,,6.04,5.26,6.04,percent of total billed charges,,
NORETHINDRONE ACETATE 5 MG TABLET,J3490,HCPCS,68462-304-50,NDC,both,1,ea,7.11,4.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.26,6.04,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.78,0.9,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.9,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Anthem,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.78,0.9,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Cigna,Cigna,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Connecticare,Commerical,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Connecticare,Exchange,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.78,0.9,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-53,NDC,both,1,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.9,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Aetna,Commerical,,,68.43,,68.43,65.62,75.39,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Aetna,Middlesex Employees,,,65.62,,65.62,65.62,75.39,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Anthem,Commerical,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Anthem,Indemnity,,,66.44,,66.44,65.62,75.39,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Anthem,Individual Exchange,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Anthem,State Preferred,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Cigna,Cigna,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Connecticare,Commerical,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Connecticare,Exchange,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,Multiplan,Multiplan,,,75.39,,75.39,65.62,75.39,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,0378-7297-85,NDC,both,1,ea,88.69,53.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,65.62,75.39,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Aetna,Commerical,,,2.45,,2.45,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Anthem,Commerical,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Anthem,Indemnity,,,2.37,,2.37,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Anthem,Individual Exchange,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Anthem,State Preferred,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Cigna,Cigna,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Connecticare,Commerical,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Connecticare,Exchange,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,Multiplan,Multiplan,,,2.69,,2.69,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-71,NDC,both,1,ea,3.17,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Aetna,Commerical,,,2.45,,2.45,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Aetna,Middlesex Employees,,,2.35,,2.35,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Anthem,Commerical,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Anthem,Indemnity,,,2.37,,2.37,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Anthem,Individual Exchange,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Anthem,State Preferred,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Cigna,Cigna,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Connecticare,Commerical,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Connecticare,Exchange,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,Multiplan,Multiplan,,,2.69,,2.69,2.35,2.69,percent of total billed charges,,
NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLET,J3490,HCPCS,68180-873-73,NDC,both,1,ea,3.17,1.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.35,2.69,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Aetna,Commerical,,,24.3,,24.3,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Aetna,Middlesex Employees,,,23.3,,23.3,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Anthem,Commerical,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Anthem,Indemnity,,,23.59,,23.59,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Anthem,Individual Exchange,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Anthem,State Preferred,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Cigna,Cigna,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Connecticare,Commerical,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Connecticare,Exchange,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,Multiplan,Multiplan,,,26.77,,26.77,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,386000801,NDC,both,30,mL,31.49,18.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Aetna,Commerical,,,48.59,,48.59,46.59,53.52,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Aetna,Middlesex Employees,,,46.59,,46.59,46.59,53.52,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Anthem,Commerical,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Anthem,Indemnity,,,47.17,,47.17,46.59,53.52,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Anthem,Individual Exchange,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Anthem,State Preferred,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Cigna,Cigna,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Connecticare,Commerical,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Connecticare,Exchange,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,Multiplan,Multiplan,,,53.52,,53.52,46.59,53.52,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,5633100624,NDC,both,30,mL,62.97,37.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.59,53.52,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Aetna,Commerical,,,24.3,,24.3,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Aetna,Middlesex Employees,,,23.3,,23.3,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Anthem,Commerical,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Anthem,Indemnity,,,23.59,,23.59,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Anthem,Individual Exchange,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Anthem,State Preferred,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Cigna,Cigna,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Connecticare,Commerical,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Connecticare,Exchange,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,Multiplan,Multiplan,,,26.77,,26.77,23.3,26.77,percent of total billed charges,,
NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,J3490,HCPCS,0386-0008-04,NDC,both,30,mL,31.49,18.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.3,26.77,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.58,percent of total billed charges,,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.58,percent of total billed charges,,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Anthem,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Anthem,Indemnity,,,40.17,,40.17,39.67,45.58,percent of total billed charges,,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Anthem,Individual Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Anthem,State Preferred,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Cigna,Cigna,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Connecticare,Commerical,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Connecticare,Exchange,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,Multiplan,Multiplan,,,45.58,,45.58,39.67,45.58,percent of total billed charges,,
NORGESTREL 0.3 MG-ETHINYL ESTRADIOL 30 MCG TABLET,J3490,HCPCS,0555-9049-58,NDC,both,1,ea,53.62,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.58,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Aetna,Commerical,,142298.96,,,142299,142299,255000,percent of total billed charges,,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Aetna,Middlesex Employees,,142298.96,,,142299,142299,255000,percent of total billed charges,,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Anthem,Commerical,,223880.3,,,22388.3,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Anthem,Indemnity,,,224730,,224730,142299,255000,percent of total billed charges,,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Anthem,Individual Exchange,,179104.24,,,179104.2,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Anthem,State Preferred,,223880.3,,,223880.3,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Cigna,Cigna,,,,,,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Connecticare,Commerical,,,,,,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Connecticare,Exchange,,,,,,142299,255000,Other,Could be inpatient or outpatient,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,Multiplan,Multiplan,,,255000,,255000,142299,255000,percent of total billed charges,,
NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION,J2326,HCPCS,64406-058-01,NDC,both,1,mL,300000,180000,United Healthcare/Oxford,United Healthcare/Oxford,,143288.4,,,143288.4,142299,255000,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/1ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Aetna,Commerical,,,24.21,,24.21,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Aetna,Middlesex Employees,,,23.21,,23.21,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Anthem,Commerical,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Anthem,Indemnity,,,23.5,,23.5,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Anthem,Individual Exchange,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Anthem,State Preferred,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Cigna,Cigna,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Connecticare,Commerical,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Connecticare,Exchange,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,Multiplan,Multiplan,,,26.66,,26.66,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-11,NDC,both,1,gm,31.37,18.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Aetna,Commerical,,,12.11,,12.11,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Aetna,Middlesex Employees,,,11.61,,11.61,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Anthem,Commerical,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Anthem,Indemnity,,,11.75,,11.75,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Anthem,Individual Exchange,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Anthem,State Preferred,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Cigna,Cigna,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Connecticare,Commerical,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Connecticare,Exchange,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,Multiplan,Multiplan,,,13.34,,13.34,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,45802-059-35,NDC,both,1,gm,15.69,9.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Aetna,Commerical,,,12.11,,12.11,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Aetna,Middlesex Employees,,,11.61,,11.61,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Anthem,Commerical,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Anthem,Indemnity,,,11.75,,11.75,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Anthem,Individual Exchange,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Anthem,State Preferred,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Cigna,Cigna,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Connecticare,Commerical,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Connecticare,Exchange,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,Multiplan,Multiplan,,,13.34,,13.34,11.61,13.34,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-1,NDC,both,1,gm,15.69,9.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.61,13.34,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Aetna,Commerical,,,24.21,,24.21,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Aetna,Middlesex Employees,,,23.21,,23.21,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Anthem,Commerical,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Anthem,Indemnity,,,23.5,,23.5,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Anthem,Individual Exchange,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Anthem,State Preferred,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Cigna,Cigna,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Connecticare,Commerical,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Connecticare,Exchange,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,Multiplan,Multiplan,,,26.66,,26.66,23.21,26.66,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",J3490,HCPCS,51672-1289-2,NDC,both,1,gm,31.37,18.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.21,26.66,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Aetna,Commerical,,,8.56,,8.56,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Aetna,Middlesex Employees,,,8.21,,8.21,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Anthem,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Anthem,Indemnity,,,8.31,,8.31,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Anthem,Individual Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Anthem,State Preferred,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Cigna,Cigna,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Connecticare,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Connecticare,Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,Multiplan,Multiplan,,,9.43,,9.43,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0168-0007-15,NDC,both,1,gm,11.09,6.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Aetna,Commerical,,,8.56,,8.56,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Aetna,Middlesex Employees,,,8.21,,8.21,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Anthem,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Anthem,Indemnity,,,8.31,,8.31,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Anthem,Individual Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Anthem,State Preferred,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Cigna,Cigna,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Connecticare,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Connecticare,Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,Multiplan,Multiplan,,,9.43,,9.43,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,0713-0686-15,NDC,both,1,gm,11.09,6.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Aetna,Commerical,,,8.56,,8.56,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Aetna,Middlesex Employees,,,8.21,,8.21,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Anthem,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Anthem,Indemnity,,,8.31,,8.31,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Anthem,Individual Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Anthem,State Preferred,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Cigna,Cigna,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Connecticare,Commerical,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Connecticare,Exchange,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,Multiplan,Multiplan,,,9.43,,9.43,8.21,9.43,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",J3490,HCPCS,45802-048-35,NDC,both,1,gm,11.09,6.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.21,9.43,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Aetna,Commerical,,,82.48,,82.48,79.09,90.86,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Aetna,Middlesex Employees,,,79.09,,79.09,79.09,90.86,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Anthem,Commerical,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Anthem,Indemnity,,,80.07,,80.07,79.09,90.86,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Anthem,Individual Exchange,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Anthem,State Preferred,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Cigna,Cigna,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Connecticare,Commerical,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Connecticare,Exchange,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,Multiplan,Multiplan,,,90.86,,90.86,79.09,90.86,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,0121-0868-16,NDC,both,1,mL,106.89,64.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,79.09,90.86,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Aetna,Commerical,,,83.7,,83.7,80.26,92.2,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Aetna,Middlesex Employees,,,80.26,,80.26,80.26,92.2,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Anthem,Commerical,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Anthem,Indemnity,,,81.25,,81.25,80.26,92.2,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Anthem,Individual Exchange,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Anthem,State Preferred,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Cigna,Cigna,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Connecticare,Commerical,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Connecticare,Exchange,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,Multiplan,Multiplan,,,92.2,,92.2,80.26,92.2,percent of total billed charges,,
"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",J3490,HCPCS,66689-008-16,NDC,both,1,mL,108.47,65.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.26,92.2,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
"NYSTATIN 200,000 UNIT/2 ML ORAL SUSPENSION SYRINGE",J3490,HCPCS,40810-0004-95,NDC,both,2,mL,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Anthem,Commerical,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Anthem,Individual Exchange,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Anthem,State Preferred,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Cigna,Cigna,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Connecticare,Commerical,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Connecticare,Exchange,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,0093-0983-01,NDC,both,1,ea,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Anthem,Commerical,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Anthem,Individual Exchange,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Anthem,State Preferred,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Cigna,Cigna,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Connecticare,Commerical,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Connecticare,Exchange,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,2.74,3.15,percent of total billed charges,,
"NYSTATIN 500,000 UNIT TABLET",J3490,HCPCS,40810-0007-60,NDC,both,1,ea,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.74,3.15,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Aetna,Commerical,,,32.45,,32.45,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Aetna,Middlesex Employees,,,31.12,,31.12,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Anthem,Commerical,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Anthem,Indemnity,,,31.51,,31.51,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Anthem,Individual Exchange,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Anthem,State Preferred,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Cigna,Cigna,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Connecticare,Commerical,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Connecticare,Exchange,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,Multiplan,Multiplan,,,35.75,,35.75,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,45802-880-14,NDC,both,1,gm,42.06,25.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Aetna,Commerical,,,32.45,,32.45,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Aetna,Middlesex Employees,,,31.12,,31.12,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Anthem,Commerical,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Anthem,Indemnity,,,31.51,,31.51,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Anthem,Individual Exchange,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Anthem,State Preferred,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Cigna,Cigna,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Connecticare,Commerical,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Connecticare,Exchange,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,Multiplan,Multiplan,,,35.75,,35.75,31.12,35.75,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",J3490,HCPCS,51672-1263-1,NDC,both,1,gm,42.06,25.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.12,35.75,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Aetna,Commerical,,,12.46,,12.46,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Aetna,Middlesex Employees,,,11.95,,11.95,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Anthem,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Anthem,Indemnity,,,12.1,,12.1,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Anthem,Individual Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Anthem,State Preferred,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Cigna,Cigna,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Connecticare,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Connecticare,Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,Multiplan,Multiplan,,,13.73,,13.73,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,45802-244-14,NDC,both,1,gm,16.15,9.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Aetna,Commerical,,,12.46,,12.46,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Aetna,Middlesex Employees,,,11.95,,11.95,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Anthem,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Anthem,Indemnity,,,12.1,,12.1,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Anthem,Individual Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Anthem,State Preferred,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Cigna,Cigna,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Connecticare,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Connecticare,Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,Multiplan,Multiplan,,,13.73,,13.73,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,52565-042-15,NDC,both,1,gm,16.15,9.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Aetna,Commerical,,,12.46,,12.46,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Aetna,Middlesex Employees,,,11.95,,11.95,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Anthem,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Anthem,Indemnity,,,12.1,,12.1,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Anthem,Individual Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Anthem,State Preferred,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Cigna,Cigna,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Connecticare,Commerical,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Connecticare,Exchange,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,Multiplan,Multiplan,,,13.73,,13.73,11.95,13.73,percent of total billed charges,,
"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT",J3490,HCPCS,62332-585-15,NDC,both,1,gm,16.15,9.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.95,13.73,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Aetna,Commerical,,,304.74,,304.74,1.1,335.71,percent of total billed charges,,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Aetna,Middlesex Employees,,,292.22,,292.22,1.1,335.71,percent of total billed charges,,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Anthem,Commerical,,,,,,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Anthem,Indemnity,,,295.86,,295.86,1.1,335.71,percent of total billed charges,,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Anthem,Individual Exchange,,,,,,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Anthem,State Preferred,,,,,,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Cigna,Cigna,,1.27,,,1.27,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Connecticare,Commerical,,1.32,,,1.32,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Connecticare,Exchange,,1.32,,,1.32,1.1,335.71,Other,Could be inpatient or outpatient,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,Multiplan,Multiplan,,,335.71,,335.71,1.1,335.71,percent of total billed charges,,
"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",J2354,HCPCS,63323-379-05,NDC,both,0.025,mL,394.95,236.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,335.71,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Aetna,Commerical,,,7.15,,7.15,1.1,7.87,percent of total billed charges,,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Aetna,Middlesex Employees,,,6.85,,6.85,1.1,7.87,percent of total billed charges,,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Anthem,Commerical,,,,,,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Anthem,Indemnity,,,6.94,,6.94,1.1,7.87,percent of total billed charges,,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Anthem,Individual Exchange,,,,,,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Anthem,State Preferred,,,,,,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Cigna,Cigna,,1.27,,,1.27,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Connecticare,Commerical,,1.32,,,1.32,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Connecticare,Exchange,,1.32,,,1.32,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,Multiplan,Multiplan,,,7.87,,7.87,1.1,7.87,percent of total billed charges,,
OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-376-01,NDC,both,0.25,mL,9.26,5.56,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,7.87,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Aetna,Commerical,,,6.54,,6.54,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Aetna,Middlesex Employees,,,6.27,,6.27,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Anthem,Commerical,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Anthem,Indemnity,,,6.35,,6.35,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Anthem,Individual Exchange,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Anthem,State Preferred,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Cigna,Cigna,,1.27,,,1.27,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Connecticare,Commerical,,1.32,,,1.32,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Connecticare,Exchange,,1.32,,,1.32,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,Multiplan,Multiplan,,,7.21,,7.21,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6174-10,NDC,both,0.5,mL,8.48,5.09,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Aetna,Commerical,,,6.54,,6.54,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Aetna,Middlesex Employees,,,6.27,,6.27,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Anthem,Commerical,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Anthem,Indemnity,,,6.35,,6.35,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Anthem,Individual Exchange,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Anthem,State Preferred,,,,,,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Cigna,Cigna,,1.27,,,1.27,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Connecticare,Commerical,,1.32,,,1.32,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Connecticare,Exchange,,1.32,,,1.32,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,Multiplan,Multiplan,,,7.21,,7.21,1.1,7.21,percent of total billed charges,,
OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,J2354,HCPCS,62756-348-44,NDC,both,0.5,mL,8.48,5.09,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,7.21,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Aetna,Commerical,,,33.43,,33.43,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Aetna,Middlesex Employees,,,32.05,,32.05,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Commerical,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Indemnity,,,32.45,,32.45,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Individual Exchange,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Anthem,State Preferred,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Cigna,Cigna,,1.27,,,1.27,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Connecticare,Commerical,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Connecticare,Exchange,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,Multiplan,Multiplan,,,36.82,,36.82,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-01,NDC,both,0.05,mL,43.32,25.99,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Aetna,Commerical,,,33.43,,33.43,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Aetna,Middlesex Employees,,,32.05,,32.05,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Anthem,Commerical,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Anthem,Indemnity,,,32.45,,32.45,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Anthem,Individual Exchange,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Anthem,State Preferred,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Cigna,Cigna,,1.27,,,1.27,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Connecticare,Commerical,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Connecticare,Exchange,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,Multiplan,Multiplan,,,36.82,,36.82,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,0641-6176-10,NDC,both,0.05,mL,43.32,25.99,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Aetna,Commerical,,,33.43,,33.43,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Aetna,Middlesex Employees,,,32.05,,32.05,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Commerical,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Indemnity,,,32.45,,32.45,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Anthem,Individual Exchange,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Anthem,State Preferred,,,,,,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Cigna,Cigna,,1.27,,,1.27,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Connecticare,Commerical,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Connecticare,Exchange,,1.32,,,1.32,1.1,36.82,Other,Could be inpatient or outpatient,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,Multiplan,Multiplan,,,36.82,,36.82,1.1,36.82,percent of total billed charges,,
OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,J2354,HCPCS,63323-377-01,NDC,both,0.05,mL,43.32,25.99,United Healthcare/Oxford,United Healthcare/Oxford,,1.1,,,1.1,1.1,36.82,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Aetna,Commerical,,,16662.46,,16662.46,78.03,18355.49,percent of total billed charges,,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Aetna,Middlesex Employees,,,15977.91,,15977.91,78.03,18355.49,percent of total billed charges,,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Anthem,Commerical,,,,,,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Anthem,Indemnity,,,16176.58,,16176.58,78.03,18355.49,percent of total billed charges,,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Anthem,Individual Exchange,,,,,,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Anthem,State Preferred,,,,,,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Cigna,Cigna,,86.77,,,86.77,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Connecticare,Commerical,,97.66,,,97.66,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Connecticare,Exchange,,97.66,,,97.66,78.03,18355.49,Other,Could be inpatient or outpatient,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,Multiplan,Multiplan,,,18355.49,,18355.49,78.03,18355.49,percent of total billed charges,,
"OFATUMUMAB 1,000 MG/50 ML INTRAVENOUS SOLUTION",J9302,HCPCS,0078-0690-61,NDC,both,0.5,mL,21594.69,12956.81,United Healthcare/Oxford,United Healthcare/Oxford,,78.03,,,78.03,78.03,18355.49,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Aetna,Commerical,,,1681.02,,1681.02,78.03,1851.83,percent of total billed charges,,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Aetna,Middlesex Employees,,,1611.96,,1611.96,78.03,1851.83,percent of total billed charges,,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Anthem,Commerical,,,,,,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Anthem,Indemnity,,,1632,,1632,78.03,1851.83,percent of total billed charges,,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Anthem,Individual Exchange,,,,,,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Anthem,State Preferred,,,,,,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Cigna,Cigna,,86.77,,,86.77,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Connecticare,Commerical,,97.66,,,97.66,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Connecticare,Exchange,,97.66,,,97.66,78.03,1851.83,Other,Could be inpatient or outpatient,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,Multiplan,Multiplan,,,1851.83,,1851.83,78.03,1851.83,percent of total billed charges,,
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION,J9302,HCPCS,0078-0669-13,NDC,both,0.5,mL,2178.62,1307.17,United Healthcare/Oxford,United Healthcare/Oxford,,78.03,,,78.03,78.03,1851.83,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Aetna,Commerical,,,360.95,,360.95,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Aetna,Middlesex Employees,,,346.13,,346.13,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Anthem,Commerical,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Anthem,Indemnity,,,350.43,,350.43,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Anthem,Individual Exchange,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Anthem,State Preferred,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Cigna,Cigna,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Connecticare,Commerical,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Connecticare,Exchange,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,Multiplan,Multiplan,,,397.63,,397.63,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,24208-410-05,NDC,both,5,mL,467.8,280.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Aetna,Commerical,,,360.95,,360.95,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Aetna,Middlesex Employees,,,346.13,,346.13,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Anthem,Commerical,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Anthem,Indemnity,,,350.43,,350.43,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Anthem,Individual Exchange,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Anthem,State Preferred,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Cigna,Cigna,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Connecticare,Commerical,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Connecticare,Exchange,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,Multiplan,Multiplan,,,397.63,,397.63,346.13,397.63,percent of total billed charges,,
OFLOXACIN 0.3 % EAR DROPS,J8499,HCPCS,70756-609-15,NDC,both,5,mL,467.8,280.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,346.13,397.63,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Aetna,Commerical,,,21.55,,21.55,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Aetna,Middlesex Employees,,,20.67,,20.67,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Anthem,Commerical,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Anthem,Indemnity,,,20.92,,20.92,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Anthem,Individual Exchange,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Anthem,State Preferred,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Cigna,Cigna,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Connecticare,Commerical,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Connecticare,Exchange,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,Multiplan,Multiplan,,,23.74,,23.74,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,24208-434-05,NDC,both,5,mL,27.93,16.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,60505-0560-0,NDC,both,1,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Aetna,Commerical,,,43.09,,43.09,41.32,47.47,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Aetna,Middlesex Employees,,,41.32,,41.32,41.32,47.47,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Anthem,Commerical,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Anthem,Indemnity,,,41.84,,41.84,41.32,47.47,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Anthem,Individual Exchange,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Anthem,State Preferred,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Cigna,Cigna,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Connecticare,Commerical,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Connecticare,Exchange,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,Multiplan,Multiplan,,,47.47,,47.47,41.32,47.47,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-01,NDC,both,1,mL,55.85,33.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,41.32,47.47,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Aetna,Commerical,,,21.55,,21.55,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Aetna,Middlesex Employees,,,20.67,,20.67,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Anthem,Commerical,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Anthem,Indemnity,,,20.92,,20.92,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Anthem,Individual Exchange,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Anthem,State Preferred,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Cigna,Cigna,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Connecticare,Commerical,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Connecticare,Exchange,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,Multiplan,Multiplan,,,23.74,,23.74,20.67,23.74,percent of total billed charges,,
OFLOXACIN 0.3 % EYE DROPS,J3490,HCPCS,64980-515-05,NDC,both,1,mL,27.93,16.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.67,23.74,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
OLANZAPINE 1.25 MG TABLET,J3490,HCPCS,40810-0013-70,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Aetna,Commerical,,,1.27,,1.27,1.21,1.39,percent of total billed charges,,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Aetna,Middlesex Employees,,,1.21,,1.21,1.21,1.39,percent of total billed charges,,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Anthem,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Anthem,Indemnity,,,1.23,,1.23,1.21,1.39,percent of total billed charges,,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Anthem,Individual Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Anthem,State Preferred,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Cigna,Cigna,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Connecticare,Commerical,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Connecticare,Exchange,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,Multiplan,Multiplan,,,1.39,,1.39,1.21,1.39,percent of total billed charges,,
OLANZAPINE 10 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-084-07,NDC,both,1,ea,1.64,0.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.21,1.39,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Aetna,Commerical,,,37.41,,37.41,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Aetna,Middlesex Employees,,,35.88,,35.88,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Anthem,Commerical,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Anthem,Indemnity,,,36.32,,36.32,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Anthem,Individual Exchange,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Anthem,State Preferred,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Cigna,Cigna,,1.11,,,1.11,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Connecticare,Commerical,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Connecticare,Exchange,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,Multiplan,Multiplan,,,41.22,,41.22,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0002-7597-01,NDC,both,1,ea,48.49,29.09,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Aetna,Commerical,,,97.52,,97.52,1.11,107.43,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Aetna,Middlesex Employees,,,93.52,,93.52,1.11,107.43,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Commerical,,,,,,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Indemnity,,,94.68,,94.68,1.11,107.43,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Anthem,Individual Exchange,,,,,,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Anthem,State Preferred,,,,,,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Cigna,Cigna,,1.11,,,1.11,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Connecticare,Commerical,,1.4,,,1.4,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Connecticare,Exchange,,1.4,,,1.4,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,Multiplan,Multiplan,,,107.43,,107.43,1.11,107.43,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0517-0955-01,NDC,both,0.1,ea,126.39,75.83,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,107.43,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Aetna,Commerical,,,98.12,,98.12,1.11,108.09,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Aetna,Middlesex Employees,,,94.09,,94.09,1.11,108.09,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Anthem,Commerical,,,,,,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Anthem,Indemnity,,,95.26,,95.26,1.11,108.09,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Anthem,Individual Exchange,,,,,,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Anthem,State Preferred,,,,,,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Cigna,Cigna,,1.11,,,1.11,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Connecticare,Commerical,,1.4,,,1.4,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Connecticare,Exchange,,1.4,,,1.4,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,Multiplan,Multiplan,,,108.09,,108.09,1.11,108.09,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,0781-3159-72,NDC,both,1,ea,127.16,76.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,108.09,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Aetna,Commerical,,,37.41,,37.41,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Aetna,Middlesex Employees,,,35.88,,35.88,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Anthem,Commerical,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Anthem,Indemnity,,,36.32,,36.32,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Anthem,Individual Exchange,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Anthem,State Preferred,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Cigna,Cigna,,1.11,,,1.11,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Connecticare,Commerical,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Connecticare,Exchange,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,Multiplan,Multiplan,,,41.22,,41.22,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,31722-308-01,NDC,both,0.1,ea,48.49,29.09,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Aetna,Commerical,,,37.41,,37.41,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Aetna,Middlesex Employees,,,35.88,,35.88,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Anthem,Commerical,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Anthem,Indemnity,,,36.32,,36.32,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Anthem,Individual Exchange,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Anthem,State Preferred,,,,,,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Cigna,Cigna,,1.11,,,1.11,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Connecticare,Commerical,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Connecticare,Exchange,,1.4,,,1.4,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,Multiplan,Multiplan,,,41.22,,41.22,1.11,41.22,percent of total billed charges,,
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,J2359,HCPCS,55150-308-01,NDC,both,1,ea,48.49,29.09,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,41.22,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Aetna,Commerical,,,0.51,,0.51,0.49,0.56,percent of total billed charges,,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Aetna,Middlesex Employees,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Anthem,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Anthem,Indemnity,,,0.49,,0.49,0.49,0.56,percent of total billed charges,,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Anthem,Individual Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Anthem,State Preferred,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Cigna,Cigna,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Connecticare,Commerical,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Connecticare,Exchange,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,Multiplan,Multiplan,,,0.56,,0.56,0.49,0.56,percent of total billed charges,,
OLANZAPINE 10 MG TABLET,J3490,HCPCS,0904-6376-61,NDC,both,1,ea,0.66,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.49,0.56,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Aetna,Commerical,,,101.25,,101.25,97.09,111.54,percent of total billed charges,,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Aetna,Middlesex Employees,,,97.09,,97.09,97.09,111.54,percent of total billed charges,,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Anthem,Commerical,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Anthem,Indemnity,,,98.3,,98.3,97.09,111.54,percent of total billed charges,,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Anthem,Individual Exchange,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Anthem,State Preferred,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Cigna,Cigna,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Connecticare,Commerical,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Connecticare,Exchange,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,Multiplan,Multiplan,,,111.54,,111.54,97.09,111.54,percent of total billed charges,,
OLANZAPINE 15 MG TABLET,J3490,HCPCS,0002-4415-30,NDC,both,1,ea,131.22,78.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,97.09,111.54,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Aetna,Commerical,,,4.17,,4.17,4,4.6,percent of total billed charges,,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Aetna,Middlesex Employees,,,4,,4,4,4.6,percent of total billed charges,,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Anthem,Commerical,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Anthem,Indemnity,,,4.05,,4.05,4,4.6,percent of total billed charges,,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Anthem,Individual Exchange,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Anthem,State Preferred,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Cigna,Cigna,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Connecticare,Commerical,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Connecticare,Exchange,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,Multiplan,Multiplan,,,4.6,,4.6,4,4.6,percent of total billed charges,,
OLANZAPINE 2.5 MG DISINTEGRATING SPLIT TABLET,J3490,HCPCS,40810-0205-25,NDC,both,1,ea,5.41,3.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4,4.6,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
OLANZAPINE 2.5 MG TABLET,J3490,HCPCS,0904-6283-61,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-083-07,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,55111-262-81,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Aetna,Commerical,,,22.31,,22.31,21.39,24.57,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Aetna,Middlesex Employees,,,21.39,,21.39,21.39,24.57,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Anthem,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Anthem,Indemnity,,,21.66,,21.66,21.39,24.57,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Anthem,Individual Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Anthem,State Preferred,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Cigna,Cigna,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Connecticare,Commerical,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Connecticare,Exchange,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,Multiplan,Multiplan,,,24.57,,24.57,21.39,24.57,percent of total billed charges,,
OLANZAPINE 5 MG DISINTEGRATING TABLET,J3490,HCPCS,60505-3275-3,NDC,both,1,ea,28.91,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.39,24.57,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,0904-6377-61,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,43598-164-30,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Anthem,Indemnity,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
OLANZAPINE 5 MG TABLET,J3490,HCPCS,69543-381-30,NDC,both,1,ea,0.63,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Aetna,Commerical,,,3938.44,,3938.44,43.31,4338.61,percent of total billed charges,,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Aetna,Middlesex Employees,,,3776.63,,3776.63,43.31,4338.61,percent of total billed charges,,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Anthem,Commerical,,,,,,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Anthem,Indemnity,,,3823.59,,3823.59,43.31,4338.61,percent of total billed charges,,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Anthem,Individual Exchange,,,,,,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Anthem,State Preferred,,,,,,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Cigna,Cigna,,43.31,,,43.31,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Connecticare,Commerical,,58.47,,,58.47,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Connecticare,Exchange,,58.47,,,58.47,43.31,4338.61,Other,Could be inpatient or outpatient,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,Multiplan,Multiplan,,,4338.61,,4338.61,43.31,4338.61,percent of total billed charges,,
OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,J2357,HCPCS,50242-040-62,NDC,both,0.034,ea,5104.25,3062.55,United Healthcare/Oxford,United Healthcare/Oxford,,46.76,,,46.76,43.31,4338.61,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,42806-552-12,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Aetna,Commerical,,,0.59,,0.59,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Aetna,Middlesex Employees,,,0.57,,0.57,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Anthem,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Anthem,Indemnity,,,0.58,,0.58,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Anthem,Individual Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Anthem,State Preferred,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Cigna,Cigna,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Connecticare,Commerical,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Connecticare,Exchange,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.57,0.65,percent of total billed charges,,
OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,J3490,HCPCS,60505-3170-7,NDC,both,1,ea,0.77,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.57,0.65,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Aetna,Commerical,,,1873.61,,1873.61,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Aetna,Middlesex Employees,,,1796.64,,1796.64,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Commerical,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Indemnity,,,1818.98,,1818.98,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Individual Exchange,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,State Preferred,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Cigna,Cigna,,6.93,,,6.93,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Connecticare,Commerical,,9.78,,,9.78,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Connecticare,Exchange,,9.78,,,9.78,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Multiplan,Multiplan,,,2063.99,,2063.99,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA (BOTOX) 5 UNITS/0.1 ML (50 UNITS/ML) INJECTION FOR OPHTHALMOLOGY/LAGOPHTHAMOS,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,United Healthcare/Oxford,United Healthcare/Oxford,,6.79,,,6.79,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Aetna,Commerical,,,1873.61,,1873.61,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Aetna,Middlesex Employees,,,1796.64,,1796.64,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Commerical,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Indemnity,,,1818.98,,1818.98,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,Individual Exchange,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Anthem,State Preferred,,,,,,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Cigna,Cigna,,6.93,,,6.93,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Connecticare,Commerical,,9.78,,,9.78,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Connecticare,Exchange,,9.78,,,9.78,6.79,2063.99,Other,Could be inpatient or outpatient,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,Multiplan,Multiplan,,,2063.99,,2063.99,6.79,2063.99,percent of total billed charges,,
ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,J0585,HCPCS,0023-1145-01,NDC,both,0.01,ea,2428.22,1456.93,United Healthcare/Oxford,United Healthcare/Oxford,,6.79,,,6.79,6.79,2063.99,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Aetna,Commerical,,2391705.69,,,2391706,1599784.86,4028484.85,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,4028484.85,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Anthem,Commerical,,1999731.08,,,1999731,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Anthem,Indemnity,,,3550280,,3550280,1599784.86,4028484.85,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Anthem,State Preferred,,1999731,,,1999731,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Cigna,Cigna,,,,,,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Connecticare,Commerical,,,,,,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Connecticare,Exchange,,,,,,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,Multiplan,Multiplan,,,4028484.85,,4028484.85,1599784.86,4028484.85,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-120-02,NDC,both,1,mL,4739393.94,2843636.36,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,4028484.85,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Aetna,Commerical,,2391706,,,2391706,1599784.86,4051813.47,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,4051813.47,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Anthem,Commerical,,1999731,,,1999731,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Anthem,Indemnity,,,3570839.38,,3570839.38,1599784.86,4051813.47,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Anthem,State Preferred,,1999731,,,1999731,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Cigna,Cigna,,,,,,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Connecticare,Commerical,,,,,,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Connecticare,Exchange,,,,,,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,Multiplan,Multiplan,,,4051813.47,,4051813.47,1599784.86,4051813.47,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-121-03,NDC,both,1,mL,4766839.38,2860103.63,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,4051813.47,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Aetna,Commerical,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Anthem,Commerical,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Anthem,Indemnity,,,3445860,,3445860,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Cigna,Cigna,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Connecticare,Commerical,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Connecticare,Exchange,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,Multiplan,Multiplan,,,3910000,,3910000,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-122-03,NDC,both,1,mL,4600000,2760000,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Aetna,Commerical,,2391706,,,2391706,1599784.86,3941532.26,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3941532.26,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Anthem,Commerical,,1999731,,,1999731,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Anthem,Indemnity,,,3473649.2,,3473649.2,1599784.86,3941532.26,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Cigna,Cigna,,,,,,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Connecticare,Commerical,,,,,,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Connecticare,Exchange,,,,,,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,Multiplan,Multiplan,,,3941532.26,,3941532.26,1599784.86,3941532.26,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-123-03,NDC,both,1,mL,4637096.78,2782258.07,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3941532.26,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Aetna,Commerical,,2391706,,,2391706,1599784.86,3981090.91,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3981090.91,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Anthem,Commerical,,1999731,,,1999731,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Anthem,Indemnity,,,3508512,,3508512,1599784.86,3981090.91,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Cigna,Cigna,,,,,,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Connecticare,Commerical,,,,,,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Connecticare,Exchange,,,,,,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,Multiplan,Multiplan,,,3981090.91,,3981090.91,1599784.86,3981090.91,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-124-04,NDC,both,1,mL,4683636.37,2810181.82,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3981090.91,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Aetna,Commerical,,2391706,,,2391706,1599784.86,4000330.04,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,4000330.04,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Anthem,Commerical,,1999731,,,1999731,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Anthem,Indemnity,,,3525467.33,,3525467.33,1599784.86,4000330.04,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Anthem,State Preferred,,1999731,,,1999731,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Cigna,Cigna,,,,,,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Connecticare,Commerical,,,,,,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Connecticare,Exchange,,,,,,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,Multiplan,Multiplan,,,4000330.04,,4000330.04,1599784.86,4000330.04,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-125-04,NDC,both,1,mL,4706270.63,2823762.38,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,4000330.04,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Aetna,Commerical,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Anthem,Commerical,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Anthem,Indemnity,,,3445860,,3445860,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Cigna,Cigna,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Connecticare,Commerical,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Connecticare,Exchange,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,Multiplan,Multiplan,,,3910000,,3910000,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-126-04,NDC,both,1,mL,4600000,2760000,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Aetna,Commerical,,2391706,,,2391706,1599784.86,3931843.58,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3931843.58,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Anthem,Commerical,,1999731,,,1999731,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Anthem,Indemnity,,,3465110.62,,3465110.62,1599784.86,3931843.58,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Cigna,Cigna,,,,,,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Connecticare,Commerical,,,,,,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Connecticare,Exchange,,,,,,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,Multiplan,Multiplan,,,3931843.58,,3931843.58,1599784.86,3931843.58,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-127-05,NDC,both,1,mL,4625698.33,2775419,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3931843.58,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Aetna,Commerical,,2391706,,,2391706,1599784.86,3960779.22,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3960779.22,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Anthem,Commerical,,1999731,,,1999731,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Anthem,Indemnity,,,3490611.43,,3490611.43,1599784.86,3960779.22,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Cigna,Cigna,,,,,,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Connecticare,Commerical,,,,,,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Connecticare,Exchange,,,,,,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,Multiplan,Multiplan,,,3960779.22,,3960779.22,1599784.86,3960779.22,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-128-05,NDC,both,1,mL,4659740.26,2795844.16,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3960779.22,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Aetna,Commerical,,2391706,,,2391706,1599784.86,3976271.19,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3976271.19,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Anthem,Commerical,,1999731,,,1999731,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Anthem,Indemnity,,,3504264.41,,3504264.41,1599784.86,3976271.19,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Cigna,Cigna,,,,,,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Connecticare,Commerical,,,,,,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Connecticare,Exchange,,,,,,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,Multiplan,Multiplan,,,3976271.19,,3976271.19,1599784.86,3976271.19,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-129-05,NDC,both,1,mL,4677966.11,2806779.67,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3976271.19,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Aetna,Commerical,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Anthem,Commerical,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Anthem,Indemnity,,,3445860,,3445860,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Cigna,Cigna,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Connecticare,Commerical,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Connecticare,Exchange,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,Multiplan,Multiplan,,,3910000,,3910000,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-130-06,NDC,both,1,mL,4600000,2760000,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Aetna,Commerical,,2391706,,,2391706,1599784.86,3926709.4,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3926709.4,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Anthem,Commerical,,1999731,,,1999731,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Anthem,Indemnity,,,3460585.9,,3460585.9,1599784.86,3926709.4,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Cigna,Cigna,,,,,,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Connecticare,Commerical,,,,,,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Connecticare,Exchange,,,,,,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,Multiplan,Multiplan,,,3926709.4,,3926709.4,1599784.86,3926709.4,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-131-06,NDC,both,1,mL,4619658.12,2771794.87,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3926709.4,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Aetna,Commerical,,2391706,,,2391706,1599784.86,3949494.95,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3949494.95,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Anthem,Commerical,,1999731,,,1999731,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Anthem,Indemnity,,,3480666.67,,3480666.67,1599784.86,3949494.95,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Cigna,Cigna,,,,,,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Connecticare,Commerical,,,,,,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Connecticare,Exchange,,,,,,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,Multiplan,Multiplan,,,3949494.95,,3949494.95,1599784.86,3949494.95,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-132-06,NDC,both,1,mL,4646464.65,2787878.79,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3949494.95,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Aetna,Commerical,,2391706,,,2391706,1599784.86,3962332.7,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3962332.7,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Anthem,Commerical,,1999731,,,1999731,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Anthem,Indemnity,,,3491980.5,,3491980.5,1599784.86,3962332.7,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Cigna,Cigna,,,,,,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Connecticare,Commerical,,,,,,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Connecticare,Exchange,,,,,,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,Multiplan,Multiplan,,,3962332.7,,3962332.7,1599784.86,3962332.7,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-133-07,NDC,both,1,mL,4661567.88,2796940.73,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3962332.7,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Aetna,Commerical,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Anthem,Commerical,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Anthem,Indemnity,,,3445860,,3445860,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Cigna,Cigna,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Connecticare,Commerical,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Connecticare,Exchange,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,Multiplan,Multiplan,,,3910000,,3910000,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-134-07,NDC,both,1,mL,4600000,2760000,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Aetna,Commerical,,2391706,,,2391706,1599784.86,3923529.42,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3923529.42,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Anthem,Commerical,,1999731,,,1999731,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Anthem,Indemnity,,,3457783.39,,3457783.39,1599784.86,3923529.42,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Cigna,Cigna,,,,,,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Connecticare,Commerical,,,,,,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Connecticare,Exchange,,,,,,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,Multiplan,Multiplan,,,3923529.42,,3923529.42,1599784.86,3923529.42,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-135-07,NDC,both,1,mL,4615916.96,2769550.18,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3923529.42,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Aetna,Commerical,,2391706,,,2391706,1599784.86,3942314.05,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3942314.05,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Anthem,Commerical,,1999731,,,1999731,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Anthem,Indemnity,,,3474338.18,,3474338.18,1599784.86,3942314.05,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Cigna,Cigna,,,,,,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Connecticare,Commerical,,,,,,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Connecticare,Exchange,,,,,,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,Multiplan,Multiplan,,,3942314.05,,3942314.05,1599784.86,3942314.05,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-136-08,NDC,both,1,mL,4638016.53,2782809.92,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3942314.05,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Aetna,Commerical,,2391706,,,2391706,1599784.86,3953238.55,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3953238.55,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Anthem,Commerical,,1999731,,,1999731,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Anthem,Indemnity,,,3483965.88,,3483965.88,1599784.86,3953238.55,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Cigna,Cigna,,,,,,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Connecticare,Commerical,,,,,,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Connecticare,Exchange,,,,,,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,Multiplan,Multiplan,,,3953238.55,,3953238.55,1599784.86,3953238.55,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-137-08,NDC,both,1,mL,4650868.88,2790521.33,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3953238.55,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Aetna,Commerical,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Anthem,Commerical,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Anthem,Indemnity,,,3445860,,3445860,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Cigna,Cigna,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Connecticare,Commerical,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Connecticare,Exchange,,,,,,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,Multiplan,Multiplan,,,3910000,,3910000,1599784.86,3910000,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-138-08,NDC,both,1,mL,4600000,2760000,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3910000,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Aetna,Commerical,,2391706,,,2391706,1599784.86,3921366.29,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3921366.29,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Anthem,Commerical,,1999731,,,1999731,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Anthem,Indemnity,,,3455877.04,,3455877.04,1599784.86,3921366.29,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Cigna,Cigna,,,,,,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Connecticare,Commerical,,,,,,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Connecticare,Exchange,,,,,,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,Multiplan,Multiplan,,,3921366.29,,3921366.29,1599784.86,3921366.29,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-139-09,NDC,both,1,mL,4613372.1,2768023.26,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3921366.29,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Aetna,Commerical,,2391706,,,2391706,1599784.86,3937342.66,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3937342.66,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Anthem,Commerical,,1999731,,,1999731,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Anthem,Indemnity,,,3469956.93,,3469956.93,1599784.86,3937342.66,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Cigna,Cigna,,,,,,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Connecticare,Commerical,,,,,,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Connecticare,Exchange,,,,,,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,Multiplan,Multiplan,,,3937342.66,,3937342.66,1599784.86,3937342.66,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-140-09,NDC,both,1,mL,4632167.84,2779300.7,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3937342.66,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Aetna,Commerical,,2391706,,,2391706,1599784.86,3946837.15,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Aetna,Middlesex Employees,,2391706,,,2391706,1599784.86,3946837.15,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Anthem,Commerical,,1999731,,,1999731,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Anthem,Indemnity,,,3478324.36,,3478324.36,1599784.86,3946837.15,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Anthem,Individual Exchange,,1599784.86,,,1599784.86,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Anthem,State Preferred,,1999731,,,1999731,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Cigna,Cigna,,,,,,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Connecticare,Commerical,,,,,,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Connecticare,Exchange,,,,,,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,Multiplan,Multiplan,,,3946837.15,,3946837.15,1599784.86,3946837.15,percent of total billed charges,,
"ONASEMNOGENE ABEPARVOVEC-XIOI 2 X 10EXP13 VG/ML IV SUSPENSION,KIT",J3399,HCPCS,71894-141-09,NDC,both,1,mL,4643337.82,2786002.69,United Healthcare/Oxford,United Healthcare/Oxford,,2392705.69,,,2392705.69,1599784.86,3946837.15,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.01,0.55,percent of total billed charges,,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.01,0.55,percent of total billed charges,,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Anthem,Commerical,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.01,0.55,percent of total billed charges,,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Anthem,Individual Exchange,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Anthem,State Preferred,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Cigna,Cigna,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Connecticare,Commerical,,0.02,,,0.02,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Connecticare,Exchange,,0.02,,,0.02,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.01,0.55,percent of total billed charges,,
ONDANSETRON 2 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0002-32,NDC,both,0.5,ea,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,30.41,,30.41,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,29.16,,29.16,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,29.52,,29.52,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,33.5,,33.5,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0409-4755-18,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Aetna,Commerical,,,30.46,,30.46,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Aetna,Middlesex Employees,,,29.2,,29.2,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Anthem,Commerical,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Anthem,Indemnity,,,29.57,,29.57,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Anthem,Individual Exchange,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Anthem,State Preferred,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Cigna,Cigna,,0.94,,,0.94,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Connecticare,Commerical,,0.14,,,0.14,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Connecticare,Exchange,,0.14,,,0.14,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,Multiplan,Multiplan,,,33.55,,33.55,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-31,NDC,both,0.5,mL,39.47,23.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Aetna,Commerical,,,30.46,,30.46,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Aetna,Middlesex Employees,,,29.2,,29.2,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Anthem,Commerical,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Anthem,Indemnity,,,29.57,,29.57,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Anthem,Individual Exchange,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Anthem,State Preferred,,,,,,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Cigna,Cigna,,0.94,,,0.94,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Connecticare,Commerical,,0.14,,,0.14,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Connecticare,Exchange,,0.14,,,0.14,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,Multiplan,Multiplan,,,33.55,,33.55,0.11,33.55,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-196-43,NDC,both,0.5,mL,39.47,23.68,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,33.55,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Aetna,Commerical,,,30.41,,30.41,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Aetna,Middlesex Employees,,,29.16,,29.16,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Anthem,Commerical,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Anthem,Indemnity,,,29.52,,29.52,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Anthem,Individual Exchange,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Anthem,State Preferred,,,,,,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Cigna,Cigna,,0.94,,,0.94,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Connecticare,Commerical,,0.14,,,0.14,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Connecticare,Exchange,,0.14,,,0.14,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,Multiplan,Multiplan,,,33.5,,33.5,0.11,33.5,percent of total billed charges,,
ONDANSETRON 2 MG/ML INTRAVENOUS SOLUTION UNDILUTED FOR IV FLUID SHORTAGE,J2405,HCPCS,55154-8329-5,NDC,both,0.5,mL,39.41,23.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,33.5,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7732-93,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-06,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5238-64,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,40810-0010-95,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Aetna,Commerical,,,1.86,,1.86,0.01,2.05,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Aetna,Middlesex Employees,,,1.78,,1.78,0.01,2.05,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Anthem,Commerical,,,,,,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Anthem,Indemnity,,,1.81,,1.81,0.01,2.05,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Anthem,Individual Exchange,,,,,,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Anthem,State Preferred,,,,,,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Cigna,Cigna,,0.01,,,0.01,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Connecticare,Commerical,,0.02,,,0.02,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Connecticare,Exchange,,0.02,,,0.02,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,Multiplan,Multiplan,,,2.05,,2.05,0.01,2.05,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-10,NDC,both,0.25,ea,2.41,1.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,2.05,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-077-30,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Aetna,Commerical,,,3.07,,3.07,0.01,3.38,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Aetna,Middlesex Employees,,,2.94,,2.94,0.01,3.38,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Anthem,Commerical,,,,,,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Anthem,Indemnity,,,2.98,,2.98,0.01,3.38,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Anthem,Individual Exchange,,,,,,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Anthem,State Preferred,,,,,,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Cigna,Cigna,,0.01,,,0.01,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Connecticare,Commerical,,0.02,,,0.02,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Connecticare,Exchange,,0.02,,,0.02,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,Multiplan,Multiplan,,,3.38,,3.38,0.01,3.38,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-60,NDC,both,0.25,ea,3.98,2.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.38,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-240-64,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-390-10,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-13,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Anthem,Commerical,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Anthem,Individual Exchange,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Anthem,State Preferred,,,,,,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Cigna,Cigna,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Connecticare,Commerical,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Connecticare,Exchange,,0.02,,,0.02,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,0.01,1.92,percent of total billed charges,,
ONDANSETRON 4 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-157-40,NDC,both,0.25,ea,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.92,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0378-7734-93,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-06,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,0781-5239-64,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Aetna,Commerical,,,2.95,,2.95,0.01,3.25,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Aetna,Middlesex Employees,,,2.83,,2.83,0.01,3.25,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Anthem,Commerical,,,,,,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Anthem,Indemnity,,,2.86,,2.86,0.01,3.25,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Anthem,Individual Exchange,,,,,,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Anthem,State Preferred,,,,,,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Cigna,Cigna,,0.01,,,0.01,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Connecticare,Commerical,,0.02,,,0.02,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Connecticare,Exchange,,0.02,,,0.02,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,Multiplan,Multiplan,,,3.25,,3.25,0.01,3.25,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,57237-078-10,NDC,both,0.125,ea,3.82,2.29,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.25,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,62756-356-64,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,65862-391-10,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-11,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Aetna,Commerical,,,1.67,,1.67,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Aetna,Middlesex Employees,,,1.61,,1.61,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Anthem,Commerical,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Anthem,Indemnity,,,1.63,,1.63,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Anthem,Individual Exchange,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Anthem,State Preferred,,,,,,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Cigna,Cigna,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Connecticare,Commerical,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Connecticare,Exchange,,0.02,,,0.02,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,Multiplan,Multiplan,,,1.84,,1.84,0.01,1.84,percent of total billed charges,,
ONDANSETRON 8 MG DISINTEGRATING TABLET,Q0162,HCPCS,68462-158-13,NDC,both,0.125,ea,2.17,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.84,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-01,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6078-25,NDC,both,1,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-31,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-41,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-547-42,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,23155-548-41,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Aetna,Commerical,,,5.18,,5.18,0.11,5.7,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Aetna,Middlesex Employees,,,4.96,,4.96,0.11,5.7,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Anthem,Commerical,,,,,,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Anthem,Indemnity,,,5.03,,5.03,0.11,5.7,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Anthem,Individual Exchange,,,,,,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Anthem,State Preferred,,,,,,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Cigna,Cigna,,0.94,,,0.94,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Connecticare,Commerical,,0.14,,,0.14,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Connecticare,Exchange,,0.14,,,0.14,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,Multiplan,Multiplan,,,5.7,,5.7,0.11,5.7,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,25021-777-02,NDC,both,0.5,mL,6.71,4.03,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,5.7,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-0,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,60505-6130-5,NDC,both,0.25,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-00,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,J2405,HCPCS,63323-373-02,NDC,both,0.5,mL,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,0.01,1.16,percent of total billed charges,,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,0.01,1.16,percent of total billed charges,,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Anthem,Commerical,,,,,,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,0.01,1.16,percent of total billed charges,,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Anthem,State Preferred,,,,,,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Cigna,Cigna,,0.01,,,0.01,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Connecticare,Commerical,,0.02,,,0.02,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Connecticare,Exchange,,0.02,,,0.02,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,0.01,1.16,percent of total billed charges,,
ONDANSETRON HCL 2 MG ORAL TAB,Q0162,HCPCS,40810-0002-33,NDC,both,0.5,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.16,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Aetna,Commerical,,,23.23,,23.23,0.11,25.59,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Aetna,Middlesex Employees,,,22.28,,22.28,0.11,25.59,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Anthem,Commerical,,,,,,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Anthem,Indemnity,,,22.56,,22.56,0.11,25.59,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Anthem,Individual Exchange,,,,,,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Anthem,State Preferred,,,,,,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Cigna,Cigna,,0.94,,,0.94,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Connecticare,Commerical,,0.14,,,0.14,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Connecticare,Exchange,,0.14,,,0.14,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,Multiplan,Multiplan,,,25.59,,25.59,0.11,25.59,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,0641-6079-01,NDC,both,0.5,mL,30.11,18.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,25.59,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,16729-298-05,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,0.11,16.28,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,0.11,16.28,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Anthem,Commerical,,,,,,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,0.11,16.28,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Anthem,State Preferred,,,,,,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Cigna,Cigna,,0.94,,,0.94,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Connecticare,Commerical,,0.14,,,0.14,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Connecticare,Exchange,,0.14,,,0.14,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,0.11,16.28,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-168-31,NDC,both,0.5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,16.28,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,23155-549-31,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,55390-121-01,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,63323-374-20,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-20,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Aetna,Commerical,,,12.71,,12.71,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Aetna,Middlesex Employees,,,12.19,,12.19,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Anthem,Commerical,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Anthem,Indemnity,,,12.34,,12.34,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Anthem,Individual Exchange,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Anthem,State Preferred,,,,,,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Cigna,Cigna,,0.94,,,0.94,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Connecticare,Commerical,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Connecticare,Exchange,,0.14,,,0.14,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,Multiplan,Multiplan,,,14,,14,0.11,14,percent of total billed charges,,
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,J2405,HCPCS,70860-777-21,NDC,both,0.5,mL,16.47,9.88,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,14,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Anthem,Commerical,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Cigna,Cigna,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Connecticare,Commerical,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Connecticare,Exchange,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,0904-6551-61,NDC,both,0.25,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Anthem,Commerical,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Cigna,Cigna,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Connecticare,Commerical,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Connecticare,Exchange,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-11,NDC,both,0.25,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Anthem,Commerical,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Cigna,Cigna,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Connecticare,Commerical,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Connecticare,Exchange,,0.02,,,0.02,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.01,1,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,50268-621-15,NDC,both,0.25,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,0.01,1.45,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,0.01,1.45,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Anthem,Commerical,,,,,,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,0.01,1.45,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Anthem,Individual Exchange,,,,,,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Anthem,State Preferred,,,,,,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Cigna,Cigna,,0.01,,,0.01,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Connecticare,Commerical,,0.02,,,0.02,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Connecticare,Exchange,,0.02,,,0.02,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,0.01,1.45,percent of total billed charges,,
ONDANSETRON HCL 4 MG TABLET,Q0162,HCPCS,65862-187-30,NDC,both,0.25,ea,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Aetna,Commerical,,,47.88,,47.88,0.01,52.74,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Aetna,Middlesex Employees,,,45.91,,45.91,0.01,52.74,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Anthem,Commerical,,,,,,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Anthem,Indemnity,,,46.48,,46.48,0.01,52.74,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Anthem,Individual Exchange,,,,,,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Anthem,State Preferred,,,,,,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Cigna,Cigna,,0.01,,,0.01,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Connecticare,Commerical,,0.02,,,0.02,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Connecticare,Exchange,,0.02,,,0.02,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,Multiplan,Multiplan,,,52.74,,52.74,0.01,52.74,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,0054-0064-47,NDC,both,1.25,mL,62.05,37.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,52.74,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Aetna,Commerical,,,36.06,,36.06,0.01,39.72,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Aetna,Middlesex Employees,,,34.58,,34.58,0.01,39.72,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Anthem,Commerical,,,,,,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Anthem,Indemnity,,,35.01,,35.01,0.01,39.72,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Anthem,Individual Exchange,,,,,,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Anthem,State Preferred,,,,,,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Cigna,Cigna,,0.01,,,0.01,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Connecticare,Commerical,,0.02,,,0.02,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Connecticare,Exchange,,0.02,,,0.02,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,Multiplan,Multiplan,,,39.72,,39.72,0.01,39.72,percent of total billed charges,,
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,Q0162,HCPCS,65162-691-79,NDC,both,1.25,mL,46.73,28.04,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,39.72,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,0904-6552-61,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,40810-0008-77,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-01,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,51079-525-20,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,55111-154-30,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Anthem,Commerical,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Anthem,State Preferred,,,,,,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Cigna,Cigna,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Connecticare,Commerical,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Connecticare,Exchange,,0.02,,,0.02,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.01,1.41,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,63304-459-30,NDC,both,0.125,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.41,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Aetna,Commerical,,,1.57,,1.57,0.01,1.73,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Aetna,Middlesex Employees,,,1.51,,1.51,0.01,1.73,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Anthem,Commerical,,,,,,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Anthem,Indemnity,,,1.53,,1.53,0.01,1.73,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Anthem,Individual Exchange,,,,,,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Anthem,State Preferred,,,,,,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Cigna,Cigna,,0.01,,,0.01,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Connecticare,Commerical,,0.02,,,0.02,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Connecticare,Exchange,,0.02,,,0.02,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,Multiplan,Multiplan,,,1.73,,1.73,0.01,1.73,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,65862-188-30,NDC,both,0.125,ea,2.04,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.73,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,0.01,3.13,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,0.01,3.13,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Anthem,Commerical,,,,,,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,0.01,3.13,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Anthem,Individual Exchange,,,,,,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Anthem,State Preferred,,,,,,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Cigna,Cigna,,0.01,,,0.01,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Connecticare,Commerical,,0.02,,,0.02,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Connecticare,Exchange,,0.02,,,0.02,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,0.01,3.13,percent of total billed charges,,
ONDANSETRON HCL 8 MG TABLET,Q0162,HCPCS,68084-221-11,NDC,both,0.125,ea,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.13,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN (VIAL ONLY),J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0409-4755-03,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-01,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,0641-6080-25,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,36000-012-25,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Aetna,Commerical,,,1.31,,1.31,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Aetna,Middlesex Employees,,,1.26,,1.26,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Commerical,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Indemnity,,,1.27,,1.27,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,Individual Exchange,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Anthem,State Preferred,,,,,,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Cigna,Cigna,,0.94,,,0.94,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Connecticare,Commerical,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Connecticare,Exchange,,0.14,,,0.14,0.11,1.45,Other,Could be inpatient or outpatient,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,Multiplan,Multiplan,,,1.45,,1.45,0.11,1.45,percent of total billed charges,,
ONDANSETRON IV PRN ED,J2405,HCPCS,55150-125-02,NDC,both,0.5,mL,4.73,2.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,1.45,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Aetna,Commerical,,,50.32,,50.32,48.26,55.44,percent of total billed charges,,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Aetna,Middlesex Employees,,,48.26,,48.26,48.26,55.44,percent of total billed charges,,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Anthem,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Anthem,Indemnity,,,48.86,,48.86,48.26,55.44,percent of total billed charges,,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Anthem,Individual Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Anthem,State Preferred,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Cigna,Cigna,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Connecticare,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Connecticare,Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,Multiplan,Multiplan,,,55.44,,55.44,48.26,55.44,percent of total billed charges,,
ORA-BLEND,J3490,HCPCS,574031116,NDC,both,1,mL,65.22,39.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Aetna,Commerical,,,50.32,,50.32,48.26,55.44,percent of total billed charges,,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Aetna,Middlesex Employees,,,48.26,,48.26,48.26,55.44,percent of total billed charges,,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Anthem,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Anthem,Indemnity,,,48.86,,48.86,48.26,55.44,percent of total billed charges,,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Anthem,Individual Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Anthem,State Preferred,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Cigna,Cigna,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Connecticare,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Connecticare,Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,Multiplan,Multiplan,,,55.44,,55.44,48.26,55.44,percent of total billed charges,,
ORA-BLEND SUGAR FREE,J3490,HCPCS,574031216,NDC,both,1,mL,65.22,39.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Aetna,Commerical,,,50.32,,50.32,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Aetna,Middlesex Employees,,,48.26,,48.26,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Anthem,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Anthem,Indemnity,,,48.86,,48.86,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Anthem,Individual Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Anthem,State Preferred,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Cigna,Cigna,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Connecticare,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Connecticare,Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,Multiplan,Multiplan,,,55.44,,55.44,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,574030316,NDC,both,1,mL,65.22,39.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Aetna,Commerical,,,50.32,,50.32,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Aetna,Middlesex Employees,,,48.26,,48.26,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Anthem,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Anthem,Indemnity,,,48.86,,48.86,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Anthem,Individual Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Anthem,State Preferred,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Cigna,Cigna,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Connecticare,Commerical,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Connecticare,Exchange,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,Multiplan,Multiplan,,,55.44,,55.44,48.26,55.44,percent of total billed charges,,
ORA-PLUS,J3490,HCPCS,3877907438,NDC,both,1,mL,65.22,39.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.26,55.44,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Aetna,Commerical,,,157.95,,157.95,151.46,174,percent of total billed charges,,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Aetna,Middlesex Employees,,,151.46,,151.46,151.46,174,percent of total billed charges,,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Anthem,Commerical,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Anthem,Indemnity,,,153.35,,153.35,151.46,174,percent of total billed charges,,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Anthem,Individual Exchange,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Anthem,State Preferred,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Cigna,Cigna,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Connecticare,Commerical,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Connecticare,Exchange,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,Multiplan,Multiplan,,,174,,174,151.46,174,percent of total billed charges,,
ORA-SWEET,J3490,HCPCS,3877925118,NDC,both,1,mL,204.71,122.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,151.46,174,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Aetna,Commerical,,,48.93,,48.93,46.92,53.9,percent of total billed charges,,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Aetna,Middlesex Employees,,,46.92,,46.92,46.92,53.9,percent of total billed charges,,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Anthem,Commerical,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Anthem,Indemnity,,,47.5,,47.5,46.92,53.9,percent of total billed charges,,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Anthem,Individual Exchange,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Anthem,State Preferred,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Cigna,Cigna,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Connecticare,Commerical,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Connecticare,Exchange,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,Multiplan,Multiplan,,,53.9,,53.9,46.92,53.9,percent of total billed charges,,
ORA-SWEET SUGAR-FREE,J3490,HCPCS,574030216,NDC,both,1,mL,63.41,38.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.92,53.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
OSELTAMIVIR 30 MG CAPSULE,J3490,HCPCS,70710-1008-2,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Aetna,Commerical,,,23.51,,23.51,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Aetna,Middlesex Employees,,,22.54,,22.54,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Anthem,Commerical,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Anthem,Indemnity,,,22.83,,22.83,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Anthem,Individual Exchange,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Anthem,State Preferred,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Cigna,Cigna,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Connecticare,Commerical,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Connecticare,Exchange,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,Multiplan,Multiplan,,,25.9,,25.9,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,0004-0801-85,NDC,both,1,ea,30.47,18.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Aetna,Commerical,,,23.51,,23.51,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Aetna,Middlesex Employees,,,22.54,,22.54,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Anthem,Commerical,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Anthem,Indemnity,,,22.83,,22.83,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Anthem,Individual Exchange,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Anthem,State Preferred,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Cigna,Cigna,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Connecticare,Commerical,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Connecticare,Exchange,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,Multiplan,Multiplan,,,25.9,,25.9,22.54,25.9,percent of total billed charges,,
OSELTAMIVIR 45 MG CAPSULE,J3490,HCPCS,69238-1265-1,NDC,both,1,ea,30.47,18.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.54,25.9,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,0004-0822-05,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,27241-139-09,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,47781-384-26,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,68180-678-01,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,69238-1273-6,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Aetna,Commerical,,,73.41,,73.41,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Aetna,Middlesex Employees,,,70.39,,70.39,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Anthem,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Anthem,Indemnity,,,71.27,,71.27,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Anthem,Individual Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Anthem,State Preferred,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Cigna,Cigna,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Connecticare,Commerical,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Connecticare,Exchange,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,Multiplan,Multiplan,,,80.87,,80.87,70.39,80.87,percent of total billed charges,,
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,J3490,HCPCS,70710-1165-6,NDC,both,1,mL,95.14,57.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.39,80.87,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,0004-0800-85,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,47781-470-13,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,62332-415-10,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,68180-677-11,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Aetna,Commerical,,,3.34,,3.34,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Aetna,Middlesex Employees,,,3.2,,3.2,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Anthem,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Anthem,Indemnity,,,3.24,,3.24,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Anthem,Individual Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Anthem,State Preferred,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Cigna,Cigna,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Connecticare,Commerical,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Connecticare,Exchange,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,Multiplan,Multiplan,,,3.68,,3.68,3.2,3.68,percent of total billed charges,,
OSELTAMIVIR 75 MG CAPSULE,J3490,HCPCS,70710-1010-2,NDC,both,1,ea,4.33,2.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.2,3.68,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Aetna,Commerical,,,25.77,,25.77,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Aetna,Middlesex Employees,,,24.71,,24.71,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Anthem,Commerical,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Anthem,Indemnity,,,25.02,,25.02,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Anthem,Individual Exchange,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Anthem,State Preferred,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Cigna,Cigna,,0.11,,,0.11,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Connecticare,Commerical,,0.09,,,0.09,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Connecticare,Exchange,,0.09,,,0.09,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,Multiplan,Multiplan,,,28.39,,28.39,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,0955-1727-20,NDC,both,0.1,mL,33.4,20.04,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Aetna,Commerical,,,25.77,,25.77,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Aetna,Middlesex Employees,,,24.71,,24.71,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Anthem,Commerical,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Anthem,Indemnity,,,25.02,,25.02,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Anthem,Individual Exchange,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Anthem,State Preferred,,,,,,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Cigna,Cigna,,0.11,,,0.11,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Connecticare,Commerical,,0.09,,,0.09,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Connecticare,Exchange,,0.09,,,0.09,0.09,28.39,Other,Could be inpatient or outpatient,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,Multiplan,Multiplan,,,28.39,,28.39,0.09,28.39,percent of total billed charges,,
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,J9263,HCPCS,60505-6132-7,NDC,both,0.1,mL,33.4,20.04,United Healthcare/Oxford,United Healthcare/Oxford,,0.1,,,0.1,0.09,28.39,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Aetna,Commerical,,,1.27,,1.27,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Aetna,Middlesex Employees,,,1.22,,1.22,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Anthem,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Anthem,Indemnity,,,1.24,,1.24,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Anthem,Individual Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Anthem,State Preferred,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Cigna,Cigna,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Connecticare,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Connecticare,Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,Multiplan,Multiplan,,,1.4,,1.4,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,0904-7262-61,NDC,both,1,ea,1.65,0.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Aetna,Commerical,,,1.61,,1.61,1.55,1.78,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Aetna,Middlesex Employees,,,1.55,,1.55,1.55,1.78,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Anthem,Commerical,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Anthem,Indemnity,,,1.57,,1.57,1.55,1.78,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Anthem,Individual Exchange,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Anthem,State Preferred,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Cigna,Cigna,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Connecticare,Commerical,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Connecticare,Exchange,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,Multiplan,Multiplan,,,1.78,,1.78,1.55,1.78,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,51991-292-01,NDC,both,1,ea,2.09,1.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.55,1.78,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Aetna,Commerical,,,1.27,,1.27,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Aetna,Middlesex Employees,,,1.22,,1.22,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Anthem,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Anthem,Indemnity,,,1.24,,1.24,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Anthem,Individual Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Anthem,State Preferred,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Cigna,Cigna,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Connecticare,Commerical,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Connecticare,Exchange,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,Multiplan,Multiplan,,,1.4,,1.4,1.22,1.4,percent of total billed charges,,
OXCARBAZEPINE 150 MG TABLET,J3490,HCPCS,68084-845-01,NDC,both,1,ea,1.65,0.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.22,1.4,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,0904-7263-61,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Aetna,Commerical,,,7.76,,7.76,7.44,8.55,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Aetna,Middlesex Employees,,,7.44,,7.44,7.44,8.55,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Anthem,Commerical,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Anthem,Indemnity,,,7.54,,7.54,7.44,8.55,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Anthem,Individual Exchange,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Anthem,State Preferred,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Cigna,Cigna,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Connecticare,Commerical,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Connecticare,Exchange,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,Multiplan,Multiplan,,,8.55,,8.55,7.44,8.55,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,51991-293-01,NDC,both,1,ea,10.06,6.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.44,8.55,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Aetna,Commerical,,,1.88,,1.88,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Aetna,Middlesex Employees,,,1.81,,1.81,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Anthem,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Anthem,Indemnity,,,1.83,,1.83,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Anthem,Individual Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Anthem,State Preferred,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Cigna,Cigna,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Connecticare,Commerical,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Connecticare,Exchange,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.81,2.07,percent of total billed charges,,
OXCARBAZEPINE 300 MG TABLET,J3490,HCPCS,68084-853-01,NDC,both,1,ea,2.44,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.81,2.07,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Aetna,Commerical,,,506.83,,506.83,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Aetna,Middlesex Employees,,,486,,486,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Anthem,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Anthem,Indemnity,,,492.05,,492.05,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Anthem,Individual Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Anthem,State Preferred,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Cigna,Cigna,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Connecticare,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Connecticare,Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,Multiplan,Multiplan,,,558.32,,558.32,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,656.85,394.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Aetna,Commerical,,,506.83,,506.83,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Aetna,Middlesex Employees,,,486,,486,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Anthem,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Anthem,Indemnity,,,492.05,,492.05,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Anthem,Individual Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Anthem,State Preferred,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Cigna,Cigna,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Connecticare,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Connecticare,Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,Multiplan,Multiplan,,,558.32,,558.32,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0781-6270-43,NDC,both,1,mL,656.85,394.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Aetna,Commerical,,,506.83,,506.83,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Aetna,Middlesex Employees,,,486,,486,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Anthem,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Anthem,Indemnity,,,492.05,,492.05,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Anthem,Individual Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Anthem,State Preferred,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Cigna,Cigna,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Connecticare,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Connecticare,Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,Multiplan,Multiplan,,,558.32,,558.32,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,656.85,394.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Aetna,Commerical,,,50.69,,50.69,48.6,55.84,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Aetna,Middlesex Employees,,,48.6,,48.6,48.6,55.84,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Anthem,Commerical,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Anthem,Indemnity,,,49.21,,49.21,48.6,55.84,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Anthem,Individual Exchange,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Anthem,State Preferred,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Cigna,Cigna,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Connecticare,Commerical,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Connecticare,Exchange,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,Multiplan,Multiplan,,,55.84,,55.84,48.6,55.84,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML ORAL SOLN FOR KETOGENIC DIET,J3490,HCPCS,40810-0204-04,NDC,both,1,mL,65.69,39.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,48.6,55.84,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Aetna,Commerical,,,506.83,,506.83,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Aetna,Middlesex Employees,,,486,,486,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Anthem,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Anthem,Indemnity,,,492.05,,492.05,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Anthem,Individual Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Anthem,State Preferred,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Cigna,Cigna,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Connecticare,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Connecticare,Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,Multiplan,Multiplan,,,558.32,,558.32,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,0078-0357-52,NDC,both,1,mL,1710.1,1026.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Aetna,Commerical,,,506.83,,506.83,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Aetna,Middlesex Employees,,,486,,486,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Anthem,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Anthem,Indemnity,,,492.05,,492.05,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Anthem,Individual Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Anthem,State Preferred,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Cigna,Cigna,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Connecticare,Commerical,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Connecticare,Exchange,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,Multiplan,Multiplan,,,558.32,,558.32,486,558.32,percent of total billed charges,,
OXCARBAZEPINE 300 MG/5 ML RECTAL SUSPENSION,J3490,HCPCS,65162-649-78,NDC,both,1,mL,1710.1,1026.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,486,558.32,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Aetna,Commerical,,,3.73,,3.73,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Aetna,Middlesex Employees,,,3.58,,3.58,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Anthem,Commerical,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Anthem,Indemnity,,,3.63,,3.63,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Anthem,Individual Exchange,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Anthem,State Preferred,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Cigna,Cigna,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Connecticare,Commerical,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Connecticare,Exchange,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,Multiplan,Multiplan,,,4.11,,4.11,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,0904-7264-61,NDC,both,1,ea,4.84,2.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Aetna,Commerical,,,3.73,,3.73,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Aetna,Middlesex Employees,,,3.58,,3.58,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Anthem,Commerical,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Anthem,Indemnity,,,3.63,,3.63,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Anthem,Individual Exchange,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Anthem,State Preferred,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Cigna,Cigna,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Connecticare,Commerical,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Connecticare,Exchange,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,Multiplan,Multiplan,,,4.11,,4.11,3.58,4.11,percent of total billed charges,,
OXCARBAZEPINE 600 MG TABLET,J3490,HCPCS,68084-867-01,NDC,both,1,ea,4.84,2.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.58,4.11,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Aetna,Commerical,,,0.57,,0.57,0.55,0.63,percent of total billed charges,,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Aetna,Middlesex Employees,,,0.55,,0.55,0.55,0.63,percent of total billed charges,,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Anthem,Commerical,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Anthem,Indemnity,,,0.55,,0.55,0.55,0.63,percent of total billed charges,,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Anthem,Individual Exchange,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Anthem,State Preferred,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Cigna,Cigna,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Connecticare,Commerical,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Connecticare,Exchange,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,Multiplan,Multiplan,,,0.63,,0.63,0.55,0.63,percent of total billed charges,,
OXCARBAZEPINE 75 MG TABLET,J3490,HCPCS,40810-0013-71,NDC,both,1,ea,0.74,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.55,0.63,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-35,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-34,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-00,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0832-0038-89,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG TABLET,J3490,HCPCS,0904-2821-61,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Aetna,Commerical,,,25.16,,25.16,24.13,27.72,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Aetna,Middlesex Employees,,,24.13,,24.13,24.13,27.72,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Anthem,Commerical,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Anthem,Indemnity,,,24.43,,24.43,24.13,27.72,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Anthem,Individual Exchange,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Anthem,State Preferred,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Cigna,Cigna,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Connecticare,Commerical,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Connecticare,Exchange,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,Multiplan,Multiplan,,,27.72,,27.72,24.13,27.72,percent of total billed charges,,
OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,J3490,HCPCS,54838-510-80,NDC,both,1,mL,32.61,19.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.13,27.72,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Aetna,Commerical,,,3.58,,3.58,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Anthem,Indemnity,,,3.48,,3.48,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-06,NDC,both,1,ea,4.64,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Aetna,Commerical,,,3.58,,3.58,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Anthem,Indemnity,,,3.48,,3.48,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6570-61,NDC,both,1,ea,4.64,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Aetna,Commerical,,,3.58,,3.58,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Anthem,Indemnity,,,3.48,,3.48,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,50268-627-15,NDC,both,1,ea,4.64,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Aetna,Commerical,,,3.58,,3.58,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Aetna,Middlesex Employees,,,3.43,,3.43,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Anthem,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Anthem,Indemnity,,,3.48,,3.48,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Anthem,Individual Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Anthem,State Preferred,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Cigna,Cigna,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Connecticare,Commerical,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Connecticare,Exchange,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,Multiplan,Multiplan,,,3.94,,3.94,3.43,3.94,percent of total billed charges,,
"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,51079-722-20,NDC,both,1,ea,4.64,2.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.43,3.94,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-23,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,0406-8515-62,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-184-11,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-01,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Aetna,Commerical,,,2.35,,2.35,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Aetna,Middlesex Employees,,,2.26,,2.26,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Anthem,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Anthem,Indemnity,,,2.28,,2.28,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Anthem,Individual Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Anthem,State Preferred,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Cigna,Cigna,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Connecticare,Commerical,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Connecticare,Exchange,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,Multiplan,Multiplan,,,2.59,,2.59,2.26,2.59,percent of total billed charges,,
OXYCODONE 15 MG TABLET,J3490,HCPCS,68084-975-11,NDC,both,1,ea,3.05,1.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.26,2.59,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.25,percent of total billed charges,,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.22,,0.22,0.21,0.25,percent of total billed charges,,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.25,,0.25,0.21,0.25,percent of total billed charges,,
OXYCODONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-37,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.25,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-01,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-23,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0406-0552-62,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,0904-6966-61,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,10702-018-01,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-01,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
OXYCODONE 5 MG TABLET,J3490,HCPCS,68084-354-11,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-4839-05,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-05,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-92,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Aetna,Commerical,,,11.4,,11.4,10.93,12.55,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Aetna,Middlesex Employees,,,10.93,,10.93,10.93,12.55,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Anthem,Commerical,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Anthem,Indemnity,,,11.06,,11.06,10.93,12.55,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Anthem,Individual Exchange,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Anthem,State Preferred,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Cigna,Cigna,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Connecticare,Commerical,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Connecticare,Exchange,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,Multiplan,Multiplan,,,12.55,,12.55,10.93,12.55,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0904-6828-94,NDC,both,1,mL,14.77,8.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.93,12.55,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-40,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-67,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60687-406-77,NDC,both,1,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Aetna,Commerical,,,11.3,,11.3,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Aetna,Middlesex Employees,,,10.83,,10.83,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Anthem,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Anthem,Indemnity,,,10.97,,10.97,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Anthem,Individual Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Anthem,State Preferred,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Cigna,Cigna,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Connecticare,Commerical,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Connecticare,Exchange,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,Multiplan,Multiplan,,,12.44,,12.44,10.83,12.44,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-401-01,NDC,both,5,mL,14.64,8.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.83,12.44,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Aetna,Commerical,,,1128.9,,1128.9,1082.52,1243.6,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Aetna,Middlesex Employees,,,1082.52,,1082.52,1082.52,1243.6,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Anthem,Commerical,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Anthem,Indemnity,,,1095.98,,1095.98,1082.52,1243.6,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Anthem,Individual Exchange,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Anthem,State Preferred,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Cigna,Cigna,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Connecticare,Commerical,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Connecticare,Exchange,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,Multiplan,Multiplan,,,1243.6,,1243.6,1082.52,1243.6,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION,J3490,HCPCS,66689-403-16,NDC,both,1,mL,1463.06,877.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1082.52,1243.6,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,3.13,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,3.13,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,3.13,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Cigna,Cigna,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Connecticare,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Connecticare,Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,3.13,percent of total billed charges,,
OXYCODONE 5 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0005-13,NDC,both,5,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Aetna,Commerical,,,11.41,,11.41,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Aetna,Middlesex Employees,,,10.94,,10.94,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Anthem,Commerical,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Anthem,Indemnity,,,11.08,,11.08,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Anthem,Individual Exchange,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Anthem,State Preferred,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Cigna,Cigna,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Connecticare,Commerical,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Connecticare,Exchange,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,Multiplan,Multiplan,,,12.57,,12.57,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-10,NDC,both,1,ea,14.79,8.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Aetna,Commerical,,,11.41,,11.41,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Aetna,Middlesex Employees,,,10.94,,10.94,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Anthem,Commerical,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Anthem,Indemnity,,,11.08,,11.08,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Anthem,Individual Exchange,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Anthem,State Preferred,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Cigna,Cigna,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Connecticare,Commerical,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Connecticare,Exchange,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,Multiplan,Multiplan,,,12.57,,12.57,10.94,12.57,percent of total billed charges,,
"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-410-20,NDC,both,1,ea,14.79,8.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.94,12.57,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Aetna,Commerical,,,21.83,,21.83,20.93,24.05,percent of total billed charges,,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Aetna,Middlesex Employees,,,20.93,,20.93,20.93,24.05,percent of total billed charges,,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Anthem,Commerical,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Anthem,Indemnity,,,21.19,,21.19,20.93,24.05,percent of total billed charges,,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Anthem,Individual Exchange,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Anthem,State Preferred,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Cigna,Cigna,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Connecticare,Commerical,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Connecticare,Exchange,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,Multiplan,Multiplan,,,24.05,,24.05,20.93,24.05,percent of total billed charges,,
"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",J3490,HCPCS,59011-420-20,NDC,both,1,ea,28.29,16.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.93,24.05,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-23,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0406-0512-62,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-6437-61,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,0904-7093-61,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-11,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,50268-644-15,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,J8499,HCPCS,68084-355-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081123,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Aetna,Commerical,,,8.7,,8.7,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Aetna,Middlesex Employees,,,8.34,,8.34,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Anthem,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Anthem,Indemnity,,,8.44,,8.44,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Anthem,Individual Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Anthem,State Preferred,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Cigna,Cigna,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Connecticare,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Connecticare,Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,Multiplan,Multiplan,,,9.58,,9.58,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081125,NDC,both,1,mL,11.27,6.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110081127,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Aetna,Commerical,,,12.99,,12.99,12.46,14.31,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Aetna,Middlesex Employees,,,12.46,,12.46,12.46,14.31,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Anthem,Commerical,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Anthem,Indemnity,,,12.61,,12.61,12.46,14.31,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Anthem,Individual Exchange,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Anthem,State Preferred,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Cigna,Cigna,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Connecticare,Commerical,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Connecticare,Exchange,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,Multiplan,Multiplan,,,14.31,,14.31,12.46,14.31,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,4110085457,NDC,both,1,mL,16.84,10.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.46,14.31,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,5002443100,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,6373673005,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Aetna,Commerical,,,9.49,,9.49,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Aetna,Middlesex Employees,,,9.1,,9.1,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Anthem,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Anthem,Indemnity,,,9.21,,9.21,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Anthem,Individual Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Anthem,State Preferred,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Cigna,Cigna,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Connecticare,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Connecticare,Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,Multiplan,Multiplan,,,10.46,,10.46,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770112689,NDC,both,1,mL,12.3,7.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Aetna,Commerical,,,6.92,,6.92,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Aetna,Middlesex Employees,,,6.64,,6.64,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Anthem,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Anthem,Indemnity,,,6.72,,6.72,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Anthem,Individual Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Anthem,State Preferred,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Cigna,Cigna,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Connecticare,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Connecticare,Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,Multiplan,Multiplan,,,7.62,,7.62,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770143595,NDC,both,1,mL,8.97,5.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Aetna,Commerical,,,6.92,,6.92,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Aetna,Middlesex Employees,,,6.64,,6.64,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Anthem,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Anthem,Indemnity,,,6.72,,6.72,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Anthem,Individual Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Anthem,State Preferred,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Cigna,Cigna,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Connecticare,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Connecticare,Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,Multiplan,Multiplan,,,7.62,,7.62,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,8770189900,NDC,both,1,mL,8.97,5.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Aetna,Commerical,,,8.7,,8.7,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Aetna,Middlesex Employees,,,8.34,,8.34,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Anthem,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Anthem,Indemnity,,,8.44,,8.44,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Anthem,Individual Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Anthem,State Preferred,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Cigna,Cigna,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Connecticare,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Connecticare,Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,Multiplan,Multiplan,,,9.58,,9.58,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-6761-30,NDC,both,1,mL,11.27,6.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,0904-7006-35,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Aetna,Commerical,,,6.92,,6.92,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Aetna,Middlesex Employees,,,6.64,,6.64,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Anthem,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Anthem,Indemnity,,,6.72,,6.72,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Anthem,Individual Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Anthem,State Preferred,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Cigna,Cigna,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Connecticare,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Connecticare,Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,Multiplan,Multiplan,,,7.62,,7.62,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-067-10,NDC,both,1,mL,8.97,5.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Aetna,Commerical,,,9.49,,9.49,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Aetna,Middlesex Employees,,,9.1,,9.1,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Anthem,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Anthem,Indemnity,,,9.21,,9.21,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Anthem,Individual Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Anthem,State Preferred,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Cigna,Cigna,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Connecticare,Commerical,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Connecticare,Exchange,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,Multiplan,Multiplan,,,10.46,,10.46,9.1,10.46,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,24385-352-10,NDC,both,1,mL,12.3,7.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.1,10.46,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Aetna,Commerical,,,8.7,,8.7,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Aetna,Middlesex Employees,,,8.34,,8.34,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Anthem,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Anthem,Indemnity,,,8.44,,8.44,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Anthem,Individual Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Anthem,State Preferred,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Cigna,Cigna,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Connecticare,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Connecticare,Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,Multiplan,Multiplan,,,9.58,,9.58,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,30142-303-10,NDC,both,1,mL,11.27,6.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Aetna,Commerical,,,8.7,,8.7,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Aetna,Middlesex Employees,,,8.34,,8.34,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Anthem,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Anthem,Indemnity,,,8.44,,8.44,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Anthem,Individual Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Anthem,State Preferred,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Cigna,Cigna,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Connecticare,Commerical,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Connecticare,Exchange,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,Multiplan,Multiplan,,,9.58,,9.58,8.34,9.58,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,45802-410-59,NDC,both,1,mL,11.27,6.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.34,9.58,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Aetna,Commerical,,,6.92,,6.92,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Aetna,Middlesex Employees,,,6.64,,6.64,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Anthem,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Anthem,Indemnity,,,6.72,,6.72,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Anthem,Individual Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Anthem,State Preferred,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Cigna,Cigna,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Connecticare,Commerical,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Connecticare,Exchange,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,Multiplan,Multiplan,,,7.62,,7.62,6.64,7.62,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,46122-165-10,NDC,both,1,mL,8.97,5.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.64,7.62,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Aetna,Commerical,,,4.35,,4.35,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Aetna,Middlesex Employees,,,4.17,,4.17,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Anthem,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Anthem,Indemnity,,,4.22,,4.22,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Anthem,Individual Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Anthem,State Preferred,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Cigna,Cigna,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Connecticare,Commerical,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Connecticare,Exchange,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,Multiplan,Multiplan,,,4.79,,4.79,4.17,4.79,percent of total billed charges,,
OXYMETAZOLINE 0.05 % NASAL SPRAY,J3490,HCPCS,59390-036-13,NDC,both,1,mL,5.64,3.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.17,4.79,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Aetna,Commerical,,,2.79,,2.79,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Aetna,Middlesex Employees,,,2.68,,2.68,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Anthem,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Anthem,Indemnity,,,2.71,,2.71,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Anthem,Individual Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Anthem,State Preferred,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Cigna,Cigna,,1.62,,,1.62,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Connecticare,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Connecticare,Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,Multiplan,Multiplan,,,3.08,,3.08,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-03,NDC,both,1,mL,3.62,2.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Aetna,Commerical,,,2.79,,2.79,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Aetna,Middlesex Employees,,,2.68,,2.68,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Anthem,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Anthem,Indemnity,,,2.71,,2.71,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Anthem,Individual Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Anthem,State Preferred,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Cigna,Cigna,,1.62,,,1.62,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Connecticare,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Connecticare,Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,Multiplan,Multiplan,,,3.08,,3.08,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-07,NDC,both,1,mL,3.62,2.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Aetna,Commerical,,,2.79,,2.79,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Aetna,Middlesex Employees,,,2.68,,2.68,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Anthem,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Anthem,Indemnity,,,2.71,,2.71,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Anthem,Individual Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Anthem,State Preferred,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Cigna,Cigna,,1.62,,,1.62,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Connecticare,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Connecticare,Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,Multiplan,Multiplan,,,3.08,,3.08,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-11,NDC,both,1,mL,3.62,2.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Aetna,Commerical,,,2.79,,2.79,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Aetna,Middlesex Employees,,,2.68,,2.68,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Anthem,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Anthem,Indemnity,,,2.71,,2.71,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Anthem,Individual Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Anthem,State Preferred,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Cigna,Cigna,,1.62,,,1.62,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Connecticare,Commerical,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Connecticare,Exchange,,,,,,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,Multiplan,Multiplan,,,3.08,,3.08,1.62,3.08,percent of total billed charges,,
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,J2590,HCPCS,63323-012-17,NDC,both,1,mL,3.62,2.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,3.08,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Aetna,Commerical,,,36.94,,36.94,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Aetna,Middlesex Employees,,,35.43,,35.43,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Commerical,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Indemnity,,,35.87,,35.87,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Individual Exchange,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,State Preferred,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Cigna,Cigna,,1.62,,,1.62,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Connecticare,Commerical,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Connecticare,Exchange,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,Multiplan,Multiplan,,,40.7,,40.7,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,71285-6044-1,NDC,both,50,mL,47.88,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Aetna,Commerical,,,36.94,,36.94,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Aetna,Middlesex Employees,,,35.43,,35.43,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Commerical,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Indemnity,,,35.87,,35.87,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,Individual Exchange,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Anthem,State Preferred,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Cigna,Cigna,,1.62,,,1.62,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Connecticare,Commerical,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Connecticare,Exchange,,,,,,1.62,40.7,Other,Could be inpatient or outpatient,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,Multiplan,Multiplan,,,40.7,,40.7,1.62,40.7,percent of total billed charges,,
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,J2590,HCPCS,72196-6044-1,NDC,both,50,mL,47.88,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,2.45,,,2.45,1.62,40.7,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Aetna,Commerical,,,79.46,,79.46,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Aetna,Middlesex Employees,,,76.19,,76.19,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Anthem,Commerical,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Anthem,Indemnity,,,77.14,,77.14,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Anthem,Individual Exchange,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Anthem,State Preferred,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Cigna,Cigna,,0.13,,,0.13,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Connecticare,Commerical,,0.15,,,0.15,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Connecticare,Exchange,,0.15,,,0.15,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,Multiplan,Multiplan,,,87.53,,87.53,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,25021-255-17,NDC,both,0.167,mL,102.98,61.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Aetna,Commerical,,,79.46,,79.46,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Aetna,Middlesex Employees,,,76.19,,76.19,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Anthem,Commerical,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Anthem,Indemnity,,,77.14,,77.14,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Anthem,Individual Exchange,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Anthem,State Preferred,,,,,,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Cigna,Cigna,,0.13,,,0.13,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Connecticare,Commerical,,0.15,,,0.15,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Connecticare,Exchange,,0.15,,,0.15,0.11,87.53,Other,Could be inpatient or outpatient,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,Multiplan,Multiplan,,,87.53,,87.53,0.11,87.53,percent of total billed charges,,
"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",J9267,HCPCS,61703-342-22,NDC,both,0.167,mL,102.98,61.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.11,87.53,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Aetna,Commerical,,,4494.35,,4494.35,16.15,4951,percent of total billed charges,,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Aetna,Middlesex Employees,,,4309.7,,4309.7,16.15,4951,percent of total billed charges,,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Anthem,Commerical,,,,,,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Anthem,Indemnity,,,4363.29,,4363.29,16.15,4951,percent of total billed charges,,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Anthem,Individual Exchange,,,,,,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Anthem,State Preferred,,,,,,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Cigna,Cigna,,18.67,,,18.67,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Connecticare,Commerical,,19.89,,,19.89,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Connecticare,Exchange,,19.89,,,19.89,16.15,4951,Other,Could be inpatient or outpatient,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,Multiplan,Multiplan,,,4951,,4951,16.15,4951,percent of total billed charges,,
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,J9264,HCPCS,68817-134-50,NDC,both,0.01,ea,5824.71,3494.83,United Healthcare/Oxford,United Healthcare/Oxford,,16.15,,,16.15,16.15,4951,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Commerical,,,2249.13,,2249.13,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Middlesex Employees,,,2156.73,,2156.73,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Indemnity,,,2183.54,,2183.54,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Individual Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Anthem,State Preferred,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Cigna,Cigna,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,Multiplan,Multiplan,,,2477.66,,2477.66,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 100 MG CAPSULE,J8999,HCPCS,0069-0188-21,NDC,both,1,ea,2914.89,1748.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Commerical,,,2249.13,,2249.13,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Middlesex Employees,,,2156.73,,2156.73,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Indemnity,,,2183.54,,2183.54,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Individual Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Anthem,State Preferred,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Cigna,Cigna,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,Multiplan,Multiplan,,,2477.66,,2477.66,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 125 MG CAPSULE,J8999,HCPCS,0069-0189-21,NDC,both,1,ea,2914.89,1748.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Commerical,,,2249.13,,2249.13,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Aetna,Middlesex Employees,,,2156.73,,2156.73,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Indemnity,,,2183.54,,2183.54,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Anthem,Individual Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Anthem,State Preferred,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Cigna,Cigna,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Commerical,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Connecticare,Exchange,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,Multiplan,Multiplan,,,2477.66,,2477.66,2156.73,2477.66,percent of total billed charges,,
PALBOCICLIB 75 MG CAPSULE,J8999,HCPCS,0069-0187-21,NDC,both,1,ea,2914.89,1748.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2156.73,2477.66,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,5.91,6.79,percent of total billed charges,,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,5.91,6.79,percent of total billed charges,,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Anthem,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,5.91,6.79,percent of total billed charges,,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Anthem,Individual Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Anthem,State Preferred,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Cigna,Cigna,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Connecticare,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Connecticare,Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,5.91,6.79,percent of total billed charges,,
"PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-280-03,NDC,both,1,ea,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Aetna,Commerical,,,48.33,,48.33,46.35,53.24,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Aetna,Middlesex Employees,,,46.35,,46.35,46.35,53.24,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Anthem,Commerical,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Anthem,Indemnity,,,46.92,,46.92,46.35,53.24,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Anthem,Individual Exchange,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Anthem,State Preferred,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Cigna,Cigna,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Connecticare,Commerical,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Connecticare,Exchange,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,Multiplan,Multiplan,,,53.24,,53.24,46.35,53.24,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0378-3979-93,NDC,both,1,ea,62.64,37.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,46.35,53.24,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Aetna,Commerical,,,4.93,,4.93,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Aetna,Middlesex Employees,,,4.73,,4.73,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Anthem,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Anthem,Indemnity,,,4.79,,4.79,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Anthem,Individual Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Anthem,State Preferred,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Cigna,Cigna,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Connecticare,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Connecticare,Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,Multiplan,Multiplan,,,5.43,,5.43,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,0904-6935-61,NDC,both,1,ea,6.39,3.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Aetna,Commerical,,,4.93,,4.93,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Aetna,Middlesex Employees,,,4.73,,4.73,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Anthem,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Anthem,Indemnity,,,4.79,,4.79,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Anthem,Individual Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Anthem,State Preferred,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Cigna,Cigna,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Connecticare,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Connecticare,Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,Multiplan,Multiplan,,,5.43,,5.43,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,10147-0952-1,NDC,both,1,ea,6.39,3.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Aetna,Commerical,,,4.93,,4.93,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Aetna,Middlesex Employees,,,4.73,,4.73,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Anthem,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Anthem,Indemnity,,,4.79,,4.79,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Anthem,Individual Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Anthem,State Preferred,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Cigna,Cigna,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Connecticare,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Connecticare,Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,Multiplan,Multiplan,,,5.43,,5.43,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-765-83,NDC,both,1,ea,6.39,3.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Aetna,Commerical,,,4.93,,4.93,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Aetna,Middlesex Employees,,,4.73,,4.73,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Anthem,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Anthem,Indemnity,,,4.79,,4.79,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Anthem,Individual Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Anthem,State Preferred,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Cigna,Cigna,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Connecticare,Commerical,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Connecticare,Exchange,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,Multiplan,Multiplan,,,5.43,,5.43,4.73,5.43,percent of total billed charges,,
"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-281-03,NDC,both,1,ea,6.39,3.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.73,5.43,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Aetna,Commerical,,,5.96,,5.96,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Aetna,Middlesex Employees,,,5.71,,5.71,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Anthem,Commerical,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Anthem,Indemnity,,,5.78,,5.78,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Anthem,Individual Exchange,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Anthem,State Preferred,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Cigna,Cigna,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Connecticare,Commerical,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Connecticare,Exchange,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,Multiplan,Multiplan,,,6.56,,6.56,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,47335-766-83,NDC,both,1,ea,7.72,4.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Aetna,Commerical,,,5.96,,5.96,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Aetna,Middlesex Employees,,,5.71,,5.71,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Anthem,Commerical,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Anthem,Indemnity,,,5.78,,5.78,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Anthem,Individual Exchange,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Anthem,State Preferred,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Cigna,Cigna,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Connecticare,Commerical,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Connecticare,Exchange,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,Multiplan,Multiplan,,,6.56,,6.56,5.71,6.56,percent of total billed charges,,
"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",J3490,HCPCS,65162-282-03,NDC,both,1,ea,7.72,4.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.71,6.56,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Aetna,Commerical,,,6349.1,,6349.1,16.57,6994.22,percent of total billed charges,,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Aetna,Middlesex Employees,,,6088.26,,6088.26,16.57,6994.22,percent of total billed charges,,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Anthem,Commerical,,,,,,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Anthem,Indemnity,,,6163.96,,6163.96,16.57,6994.22,percent of total billed charges,,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Anthem,Individual Exchange,,,,,,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Anthem,State Preferred,,,,,,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Cigna,Cigna,,16.57,,,16.57,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Connecticare,Commerical,,22.54,,,22.54,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Connecticare,Exchange,,22.54,,,22.54,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,Multiplan,Multiplan,,,6994.22,,6994.22,16.57,6994.22,percent of total billed charges,,
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-563-03,NDC,both,1,mL,8228.49,4937.09,United Healthcare/Oxford,United Healthcare/Oxford,,17.89,,,17.89,16.57,6994.22,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Aetna,Commerical,,,5567.71,,5567.71,16.57,6133.43,percent of total billed charges,,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Aetna,Middlesex Employees,,,5338.97,,5338.97,16.57,6133.43,percent of total billed charges,,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Anthem,Commerical,,,,,,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Anthem,Indemnity,,,5405.36,,5405.36,16.57,6133.43,percent of total billed charges,,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Anthem,Individual Exchange,,,,,,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Anthem,State Preferred,,,,,,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Cigna,Cigna,,16.57,,,16.57,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Connecticare,Commerical,,22.54,,,22.54,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Connecticare,Exchange,,22.54,,,22.54,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,Multiplan,Multiplan,,,6133.43,,6133.43,16.57,6133.43,percent of total billed charges,,
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,J2426,HCPCS,50458-564-01,NDC,both,0.007,mL,7215.8,4329.48,United Healthcare/Oxford,United Healthcare/Oxford,,17.89,,,17.89,16.57,6133.43,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Aetna,Commerical,,,7124.72,,7124.72,2223.54,7848.64,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Aetna,Middlesex Employees,,,6832.01,,6832.01,2223.54,7848.64,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Anthem,Commerical,,2779.42,,,2779.42,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Anthem,Indemnity,,,6916.96,,6916.96,2223.54,7848.64,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Anthem,Individual Exchange,,2223.54,,,2223.54,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Anthem,State Preferred,,2779.42,,,2779.42,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Cigna,Cigna,,,,,,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Connecticare,Commerical,,,,,,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Connecticare,Exchange,,,,,,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,Multiplan,Multiplan,,,7848.64,,7848.64,2223.54,7848.64,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML IM SOLN SPLIT SYRINGE,90378,HCPCS,60574-4113-1,NDC,both,0.5,mL,9233.69,5540.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2223.54,7848.64,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Aetna,Commerical,,,10159.84,,10159.84,2223.54,11192.15,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Aetna,Middlesex Employees,,,9742.44,,9742.44,2223.54,11192.15,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Anthem,Commerical,,2779.42,,,2779.42,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Anthem,Indemnity,,,9863.58,,9863.58,2223.54,11192.15,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Anthem,Individual Exchange,,2223.54,,,2223.54,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Anthem,State Preferred,,2779.42,,,2779.42,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Cigna,Cigna,,,,,,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Connecticare,Commerical,,,,,,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Connecticare,Exchange,,,,,,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,Multiplan,Multiplan,,,11192.15,,11192.15,2223.54,11192.15,percent of total billed charges,,
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-231-01,NDC,both,0.5,mL,13167.24,7900.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2223.54,11192.15,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Aetna,Commerical,,,5380.47,,5380.47,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Aetna,Middlesex Employees,,,5159.42,,5159.42,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Commerical,,2779.42,,,2779.42,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Indemnity,,,5223.57,,5223.57,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Individual Exchange,,2223.54,,,2223.54,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Anthem,State Preferred,,2779.42,,,2779.42,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Cigna,Cigna,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Connecticare,Commerical,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Connecticare,Exchange,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,Multiplan,Multiplan,,,5927.16,,5927.16,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,60574-4114-1,NDC,both,0.5,mL,6973.13,4183.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Aetna,Commerical,,,5380.47,,5380.47,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Aetna,Middlesex Employees,,,5159.42,,5159.42,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Commerical,,2779.42,,,2779.42,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Indemnity,,,5223.57,,5223.57,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Anthem,Individual Exchange,,2223.54,,,2223.54,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Anthem,State Preferred,,2779.42,,,2779.42,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Cigna,Cigna,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Connecticare,Commerical,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Connecticare,Exchange,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,Multiplan,Multiplan,,,5927.16,,5927.16,2223.54,5927.16,percent of total billed charges,,
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION,90378,HCPCS,66658-230-01,NDC,both,0.5,mL,6973.13,4183.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2223.54,5927.16,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3312-75,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,0781-3415-75,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,55111-694-07,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,67457-317-25,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-01,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Anthem,Commerical,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Anthem,State Preferred,,,,,,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Cigna,Cigna,,1.33,,,1.33,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Connecticare,Commerical,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Connecticare,Exchange,,0.94,,,0.94,0.94,31.36,Other,Could be inpatient or outpatient,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,0.94,31.36,percent of total billed charges,,
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,J2469,HCPCS,69543-371-10,NDC,both,5,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,0.94,31.36,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Aetna,Commerical,,,26.22,,26.22,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Aetna,Middlesex Employees,,,25.14,,25.14,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Anthem,Commerical,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Anthem,Indemnity,,,25.45,,25.45,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Anthem,Individual Exchange,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Anthem,State Preferred,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Cigna,Cigna,,16.45,,,16.45,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Connecticare,Commerical,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Connecticare,Exchange,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,Multiplan,Multiplan,,,28.88,,28.88,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-324-18,NDC,both,10,mL,33.98,20.39,United Healthcare/Oxford,United Healthcare/Oxford,,14.24,,,14.24,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Aetna,Commerical,,,26.22,,26.22,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Aetna,Middlesex Employees,,,25.14,,25.14,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Anthem,Commerical,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Anthem,Indemnity,,,25.45,,25.45,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Anthem,Individual Exchange,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Anthem,State Preferred,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Cigna,Cigna,,16.45,,,16.45,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Connecticare,Commerical,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Connecticare,Exchange,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,Multiplan,Multiplan,,,28.88,,28.88,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,63323-734-10,NDC,both,10,mL,33.98,20.39,United Healthcare/Oxford,United Healthcare/Oxford,,14.24,,,14.24,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Aetna,Commerical,,,26.22,,26.22,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Aetna,Middlesex Employees,,,25.14,,25.14,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Anthem,Commerical,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Anthem,Indemnity,,,25.45,,25.45,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Anthem,Individual Exchange,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Anthem,State Preferred,,,,,,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Cigna,Cigna,,16.45,,,16.45,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Connecticare,Commerical,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Connecticare,Exchange,,19.26,,,19.26,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,Multiplan,Multiplan,,,28.88,,28.88,14.24,28.88,percent of total billed charges,,
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,67457-430-10,NDC,both,10,mL,33.98,20.39,United Healthcare/Oxford,United Healthcare/Oxford,,14.24,,,14.24,14.24,28.88,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Aetna,Commerical,,,86,,86,14.24,94.74,percent of total billed charges,,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Aetna,Middlesex Employees,,,82.47,,82.47,14.24,94.74,percent of total billed charges,,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Anthem,Commerical,,,,,,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Anthem,Indemnity,,,83.49,,83.49,14.24,94.74,percent of total billed charges,,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Anthem,Individual Exchange,,,,,,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Anthem,State Preferred,,,,,,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Cigna,Cigna,,16.45,,,16.45,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Connecticare,Commerical,,19.26,,,19.26,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Connecticare,Exchange,,19.26,,,19.26,14.24,94.74,Other,Could be inpatient or outpatient,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,Multiplan,Multiplan,,,94.74,,94.74,14.24,94.74,percent of total billed charges,,
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,J2430,HCPCS,61703-325-18,NDC,both,5,mL,111.46,66.88,United Healthcare/Oxford,United Healthcare/Oxford,,14.24,,,14.24,14.24,94.74,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Aetna,Commerical,,,3630.01,,3630.01,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Aetna,Middlesex Employees,,,3480.87,,3480.87,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Anthem,Commerical,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Anthem,Indemnity,,,3524.16,,3524.16,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Anthem,Individual Exchange,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Anthem,State Preferred,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Cigna,Cigna,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Connecticare,Commerical,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Connecticare,Exchange,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,Multiplan,Multiplan,,,3998.84,,3998.84,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,0078-0651-06,NDC,both,0.067,ea,4704.52,2822.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Aetna,Commerical,,,3630.01,,3630.01,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Aetna,Middlesex Employees,,,3480.87,,3480.87,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Anthem,Commerical,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Anthem,Indemnity,,,3524.16,,3524.16,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Anthem,Individual Exchange,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Anthem,State Preferred,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Cigna,Cigna,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Connecticare,Commerical,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Connecticare,Exchange,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,Multiplan,Multiplan,,,3998.84,,3998.84,3480.87,3998.84,percent of total billed charges,,
PANOBINOSTAT 15 MG CAPSULE,J8999,HCPCS,40810-0020-27,NDC,both,0.067,UN,4704.52,2822.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3480.87,3998.84,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,0781-3232-95,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,25021-751-10,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,55150-202-00,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,62756-129-40,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,65219-433-01,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-00,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,5.24,,,5.24,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,5.24,11.93,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2470,HCPCS,67850-150-25,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,11.93,,,11.93,5.24,11.93,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Aetna,Commerical,,,7.89,,7.89,7.49,9.52,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Aetna,Middlesex Employees,,,7.57,,7.57,7.49,9.52,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Anthem,Commerical,,,,,,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Anthem,Indemnity,,,7.66,,7.66,7.49,9.52,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Anthem,Individual Exchange,,,,,,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Anthem,State Preferred,,,,,,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Cigna,Cigna,,7.49,,,7.49,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Connecticare,Commerical,,,,,,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Connecticare,Exchange,,,,,,7.49,9.52,Other,Could be inpatient or outpatient,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,Multiplan,Multiplan,,,8.7,,8.7,7.49,9.52,percent of total billed charges,,
PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,J2471,HCPCS,0143-9300-10,NDC,both,1,ea,10.23,6.14,United Healthcare/Oxford,United Healthcare/Oxford,,9.52,,,9.52,7.49,9.52,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Aetna,Commerical,,,41.17,,41.17,39.48,45.36,percent of total billed charges,,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Aetna,Middlesex Employees,,,39.48,,39.48,39.48,45.36,percent of total billed charges,,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Anthem,Commerical,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Anthem,Indemnity,,,39.97,,39.97,39.48,45.36,percent of total billed charges,,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Anthem,Individual Exchange,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Anthem,State Preferred,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Cigna,Cigna,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Connecticare,Commerical,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Connecticare,Exchange,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,Multiplan,Multiplan,,,45.36,,45.36,39.48,45.36,percent of total billed charges,,
"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0008-0841-81,NDC,both,1,ea,53.36,32.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.48,45.36,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Aetna,Commerical,,,48.36,,48.36,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Aetna,Middlesex Employees,,,46.38,,46.38,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Anthem,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Anthem,Indemnity,,,46.95,,46.95,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Anthem,Individual Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Anthem,State Preferred,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Cigna,Cigna,,43.22,,,43.22,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Connecticare,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Connecticare,Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,Multiplan,Multiplan,,,53.28,,53.28,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,0517-4002-25,NDC,both,2,mL,62.68,37.61,United Healthcare/Oxford,United Healthcare/Oxford,,56.05,,,56.05,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Aetna,Commerical,,,48.36,,48.36,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Aetna,Middlesex Employees,,,46.38,,46.38,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Anthem,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Anthem,Indemnity,,,46.95,,46.95,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Anthem,Individual Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Anthem,State Preferred,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Cigna,Cigna,,43.22,,,43.22,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Connecticare,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Connecticare,Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,Multiplan,Multiplan,,,53.28,,53.28,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-01,NDC,both,1,mL,62.68,37.61,United Healthcare/Oxford,United Healthcare/Oxford,,56.05,,,56.05,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Aetna,Commerical,,,48.36,,48.36,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Aetna,Middlesex Employees,,,46.38,,46.38,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Anthem,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Anthem,Indemnity,,,46.95,,46.95,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Anthem,Individual Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Anthem,State Preferred,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Cigna,Cigna,,43.22,,,43.22,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Connecticare,Commerical,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Connecticare,Exchange,,,,,,43.22,56.05,Other,Could be inpatient or outpatient,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,Multiplan,Multiplan,,,53.28,,53.28,43.22,56.05,percent of total billed charges,,
PAPAVERINE 30 MG/ML INJECTION SOLUTION,J2440,HCPCS,54288-142-10,NDC,both,2,mL,62.68,37.61,United Healthcare/Oxford,United Healthcare/Oxford,,56.05,,,56.05,43.22,56.05,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,6.69,7.68,percent of total billed charges,,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,6.69,7.68,percent of total billed charges,,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Anthem,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,6.69,7.68,percent of total billed charges,,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Anthem,Individual Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Anthem,State Preferred,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Cigna,Cigna,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Connecticare,Commerical,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Connecticare,Exchange,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,6.69,7.68,percent of total billed charges,,
PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,J3490,HCPCS,299392140,NDC,both,118,mL,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.69,7.68,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Aetna,Commerical,,,579.22,,579.22,555.43,638.08,percent of total billed charges,,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Aetna,Middlesex Employees,,,555.43,,555.43,555.43,638.08,percent of total billed charges,,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Anthem,Commerical,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Anthem,Indemnity,,,562.33,,562.33,555.43,638.08,percent of total billed charges,,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Anthem,Individual Exchange,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Anthem,State Preferred,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Cigna,Cigna,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Connecticare,Commerical,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Connecticare,Exchange,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,Multiplan,Multiplan,,,638.08,,638.08,555.43,638.08,percent of total billed charges,,
PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,J3490,HCPCS,0338-1130-06,NDC,both,1,mL,750.68,450.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,555.43,638.08,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,22.67,26.04,percent of total billed charges,,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,22.67,26.04,percent of total billed charges,,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Anthem,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,22.67,26.04,percent of total billed charges,,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Anthem,State Preferred,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Cigna,Cigna,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Connecticare,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Connecticare,Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,22.67,26.04,percent of total billed charges,,
PARENTERAL AMINO ACID 15 % COMBINATION NO.2 INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7171-17,NDC,both,1,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,40810-0005-89,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,2.73,3.14,percent of total billed charges,,
PARICALCITOL 1 MCG CAPSULE,J8499,HCPCS,49483-687-03,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.73,3.14,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Aetna,Commerical,,,11.38,,11.38,1.11,12.54,percent of total billed charges,,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Aetna,Middlesex Employees,,,10.91,,10.91,1.11,12.54,percent of total billed charges,,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Anthem,Commerical,,,,,,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Anthem,Indemnity,,,11.05,,11.05,1.11,12.54,percent of total billed charges,,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Anthem,Individual Exchange,,,,,,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Anthem,State Preferred,,,,,,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Cigna,Cigna,,1.11,,,1.11,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Connecticare,Commerical,,1.15,,,1.15,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Connecticare,Exchange,,1.15,,,1.15,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,Multiplan,Multiplan,,,12.54,,12.54,1.11,12.54,percent of total billed charges,,
PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-4637-01,NDC,both,0.5,mL,14.75,8.85,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,12.54,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Aetna,Commerical,,,22.25,,22.25,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Aetna,Middlesex Employees,,,21.33,,21.33,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Anthem,Commerical,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Anthem,Indemnity,,,21.6,,21.6,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Anthem,Individual Exchange,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Anthem,State Preferred,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Cigna,Cigna,,1.11,,,1.11,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Connecticare,Commerical,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Connecticare,Exchange,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,Multiplan,Multiplan,,,24.51,,24.51,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,0074-1658-01,NDC,both,0.2,mL,28.83,17.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Aetna,Commerical,,,22.25,,22.25,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Aetna,Middlesex Employees,,,21.33,,21.33,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Anthem,Commerical,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Anthem,Indemnity,,,21.6,,21.6,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Anthem,Individual Exchange,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Anthem,State Preferred,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Cigna,Cigna,,1.11,,,1.11,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Connecticare,Commerical,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Connecticare,Exchange,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,Multiplan,Multiplan,,,24.51,,24.51,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-08,NDC,both,0.2,mL,28.83,17.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Aetna,Commerical,,,22.25,,22.25,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Aetna,Middlesex Employees,,,21.33,,21.33,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Anthem,Commerical,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Anthem,Indemnity,,,21.6,,21.6,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Anthem,Individual Exchange,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Anthem,State Preferred,,,,,,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Cigna,Cigna,,1.11,,,1.11,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Connecticare,Commerical,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Connecticare,Exchange,,1.15,,,1.15,1.11,24.51,Other,Could be inpatient or outpatient,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,Multiplan,Multiplan,,,24.51,,24.51,1.11,24.51,percent of total billed charges,,
PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION,J2501,HCPCS,16729-311-63,NDC,both,0.2,mL,28.83,17.3,United Healthcare/Oxford,United Healthcare/Oxford,,1.2,,,1.2,1.11,24.51,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Aetna,Commerical,,,16.76,,16.76,16.07,18.46,percent of total billed charges,,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Aetna,Middlesex Employees,,,16.07,,16.07,16.07,18.46,percent of total billed charges,,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Anthem,Commerical,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Anthem,Indemnity,,,16.27,,16.27,16.07,18.46,percent of total billed charges,,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Anthem,Individual Exchange,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Anthem,State Preferred,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Cigna,Cigna,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Connecticare,Commerical,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Connecticare,Exchange,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,Multiplan,Multiplan,,,18.46,,18.46,16.07,18.46,percent of total billed charges,,
PAROMOMYCIN 250 MG CAPSULE,J3490,HCPCS,23155-038-01,NDC,both,1,ea,21.72,13.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.07,18.46,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,2.61,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,2.61,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Anthem,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,2.61,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Anthem,State Preferred,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Cigna,Cigna,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Connecticare,Commerical,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Connecticare,Exchange,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,2.61,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,0904-5676-61,NDC,both,1,ea,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.27,2.61,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Aetna,Commerical,,,1.13,,1.13,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Aetna,Middlesex Employees,,,1.09,,1.09,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Anthem,Commerical,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Anthem,Indemnity,,,1.1,,1.1,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Anthem,Individual Exchange,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Anthem,State Preferred,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Cigna,Cigna,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Connecticare,Commerical,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Connecticare,Exchange,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,Multiplan,Multiplan,,,1.25,,1.25,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-01,NDC,both,1,ea,1.47,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Aetna,Commerical,,,1.13,,1.13,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Aetna,Middlesex Employees,,,1.09,,1.09,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Anthem,Commerical,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Anthem,Indemnity,,,1.1,,1.1,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Anthem,Individual Exchange,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Anthem,State Preferred,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Cigna,Cigna,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Connecticare,Commerical,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Connecticare,Exchange,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,Multiplan,Multiplan,,,1.25,,1.25,1.09,1.25,percent of total billed charges,,
PAROXETINE 10 MG TABLET,J3490,HCPCS,68084-044-11,NDC,both,1,ea,1.47,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.09,1.25,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Aetna,Commerical,,,568.89,,568.89,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Aetna,Middlesex Employees,,,545.51,,545.51,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Anthem,Commerical,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Anthem,Indemnity,,,552.3,,552.3,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Anthem,Individual Exchange,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Anthem,State Preferred,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Cigna,Cigna,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Connecticare,Commerical,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Connecticare,Exchange,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,Multiplan,Multiplan,,,626.69,,626.69,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,60505-0402-5,NDC,both,1,mL,737.28,442.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Aetna,Commerical,,,568.89,,568.89,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Aetna,Middlesex Employees,,,545.51,,545.51,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Anthem,Commerical,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Anthem,Indemnity,,,552.3,,552.3,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Anthem,Individual Exchange,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Anthem,State Preferred,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Cigna,Cigna,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Connecticare,Commerical,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Connecticare,Exchange,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,Multiplan,Multiplan,,,626.69,,626.69,545.51,626.69,percent of total billed charges,,
PAROXETINE 10 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-319-10,NDC,both,1,mL,737.28,442.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,545.51,626.69,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,0904-5677-61,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-01,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
PAROXETINE 20 MG TABLET,J3490,HCPCS,68084-045-11,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Aetna,Commerical,,,8.32,,8.32,7.98,9.16,percent of total billed charges,,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Aetna,Middlesex Employees,,,7.98,,7.98,7.98,9.16,percent of total billed charges,,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Anthem,Commerical,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Anthem,Indemnity,,,8.08,,8.08,7.98,9.16,percent of total billed charges,,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Anthem,Individual Exchange,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Anthem,State Preferred,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Cigna,Cigna,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Connecticare,Commerical,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Connecticare,Exchange,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,Multiplan,Multiplan,,,9.16,,9.16,7.98,9.16,percent of total billed charges,,
PAROXETINE 5 MG TABLET,J3490,HCPCS,40810-0013-72,NDC,both,1,ea,10.78,6.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.98,9.16,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Aetna,Commerical,,,378.21,,378.21,362.67,416.64,percent of total billed charges,,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Aetna,Middlesex Employees,,,362.67,,362.67,362.67,416.64,percent of total billed charges,,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Anthem,Commerical,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Anthem,Indemnity,,,367.18,,367.18,362.67,416.64,percent of total billed charges,,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Anthem,Individual Exchange,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Anthem,State Preferred,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Cigna,Cigna,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Connecticare,Commerical,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Connecticare,Exchange,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,Multiplan,Multiplan,,,416.64,,416.64,362.67,416.64,percent of total billed charges,,
PAZOPANIB 200 MG TABLET,J3490,HCPCS,0078-0670-66,NDC,both,1,ea,490.16,294.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,362.67,416.64,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT NO.93-IRON 3 MG/5.6 GRAM TUBE FEEDING POWDER ADDITIVE,J3490,HCPCS,40810-0201-73,NDC,both,1,UN,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 0.75 MG/1.4 GRAM (0.25 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-87,NDC,both,1,UN,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Aetna,Commerical,,,0.2,,0.2,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Aetna,Middlesex Employees,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Anthem,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Anthem,Indemnity,,,0.19,,0.19,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Anthem,Individual Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Anthem,State Preferred,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Cigna,Cigna,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Connecticare,Commerical,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Connecticare,Exchange,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,Multiplan,Multiplan,,,0.22,,0.22,0.19,0.22,percent of total billed charges,,
PEDI MULTIVIT-IRON 1.5 MG/2.8 GRAM (0.5 SCOOP) T/F POWDER,J3490,HCPCS,40810-0204-00,NDC,both,1,UN,0.26,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.19,0.22,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
PEDI MULTIVIT-IRON 2.25 MG/4.2 GRAM (0.75 SCOOP) T/F POWDER,J3490,HCPCS,40810-0201-72,NDC,both,1,UN,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Aetna,Commerical,,,91.32,,91.32,87.57,100.6,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Aetna,Middlesex Employees,,,87.57,,87.57,87.57,100.6,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Anthem,Commerical,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Anthem,Indemnity,,,88.66,,88.66,87.57,100.6,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Anthem,Individual Exchange,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Anthem,State Preferred,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Cigna,Cigna,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Connecticare,Commerical,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Connecticare,Exchange,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,Multiplan,Multiplan,,,100.6,,100.6,87.57,100.6,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,A9153,HCPCS,6817600010,NDC,both,1,mL,118.35,71.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.57,100.6,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Aetna,Commerical,,,147.92,,147.92,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Aetna,Middlesex Employees,,,141.84,,141.84,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Anthem,Commerical,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Anthem,Indemnity,,,143.6,,143.6,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Anthem,Individual Exchange,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Anthem,State Preferred,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Cigna,Cigna,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Connecticare,Commerical,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Connecticare,Exchange,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,Multiplan,Multiplan,,,162.95,,162.95,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.14-IRON 3.5 MG-FOLIC ACID 75 MCG ORAL POWDER,J3490,HCPCS,5777100113,NDC,both,1,gm,191.7,115.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Aetna,Commerical,,,147.92,,147.92,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Aetna,Middlesex Employees,,,141.84,,141.84,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Anthem,Commerical,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Anthem,Indemnity,,,143.6,,143.6,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Anthem,Individual Exchange,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Anthem,State Preferred,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Cigna,Cigna,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Connecticare,Commerical,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Connecticare,Exchange,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,Multiplan,Multiplan,,,162.95,,162.95,141.84,162.95,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.15-IRON-FOLIC ACID 5 MG-100 MCG ORAL POWDER,J3490,HCPCS,5777100148,NDC,both,1,gm,191.7,115.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,141.84,162.95,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Aetna,Commerical,,,31.47,,31.47,30.18,34.67,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Aetna,Middlesex Employees,,,30.18,,30.18,30.18,34.67,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Anthem,Commerical,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Anthem,Indemnity,,,30.56,,30.56,30.18,34.67,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Anthem,Individual Exchange,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Anthem,State Preferred,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Cigna,Cigna,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Connecticare,Commerical,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Connecticare,Exchange,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,Multiplan,Multiplan,,,34.67,,34.67,30.18,34.67,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,J3490,HCPCS,87040501,NDC,both,1,mL,40.79,24.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.18,34.67,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,1650059918,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,J3490,HCPCS,40810-0208-88,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN NO.48 CHEWABLE TABLET,J3490,HCPCS,1650052426,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,1650008806,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,J3490,HCPCS,40810-0010-64,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
PEDIATRIC MULTIVIT-IRON-MIN ORAL 1/2 CHEW,J3490,HCPCS,40810-0002-31,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-100-01,NDC,both,4000,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,10572-101-01,NDC,both,4000,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-100-01,NDC,both,4000,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,J3490,HCPCS,52268-101-01,NDC,both,4000,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Aetna,Commerical,,,1.57,,1.57,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Aetna,Middlesex Employees,,,1.51,,1.51,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Anthem,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Anthem,Indemnity,,,1.53,,1.53,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Anthem,Individual Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Anthem,State Preferred,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Cigna,Cigna,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Connecticare,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Connecticare,Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,65143205,NDC,both,1,ea,2.04,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Aetna,Commerical,,,1.57,,1.57,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Aetna,Middlesex Employees,,,1.51,,1.51,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Anthem,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Anthem,Indemnity,,,1.53,,1.53,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Anthem,Individual Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Anthem,State Preferred,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Cigna,Cigna,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Connecticare,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Connecticare,Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-05,NDC,both,1,ea,2.04,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Aetna,Commerical,,,1.57,,1.57,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Aetna,Middlesex Employees,,,1.51,,1.51,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Anthem,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Anthem,Indemnity,,,1.53,,1.53,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Anthem,Individual Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Anthem,State Preferred,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Cigna,Cigna,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Connecticare,Commerical,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Connecticare,Exchange,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,Multiplan,Multiplan,,,1.73,,1.73,1.51,1.73,percent of total billed charges,,
PEG 400-PROPYLENE GLYCOL (PF) 0.4 %-0.3 % EYE DROPS IN A DROPPERETTE,J3490,HCPCS,0065-1432-06,NDC,both,1,ea,2.04,1.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.51,1.73,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Aetna,Commerical,,,71877.44,,71877.44,32958.13,79180.7,percent of total billed charges,,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Aetna,Middlesex Employees,,,68924.47,,68924.47,32958.13,79180.7,percent of total billed charges,,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Anthem,Commerical,,,,,,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Anthem,Indemnity,,,69781.48,,69781.48,32958.13,79180.7,percent of total billed charges,,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Anthem,Individual Exchange,,,,,,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Anthem,State Preferred,,,,,,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Cigna,Cigna,,38090.95,,,38090.95,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Connecticare,Commerical,,41336.19,,,41336.19,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Connecticare,Exchange,,41336.19,,,41336.19,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,Multiplan,Multiplan,,,79180.7,,79180.7,32958.13,79180.7,percent of total billed charges,,
PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,J9266,HCPCS,72694-954-01,NDC,both,5,mL,93153.76,55892.26,United Healthcare/Oxford,United Healthcare/Oxford,,32958.13,,,32958.13,32958.13,79180.7,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Aetna,Commerical,,,59.1,,59.1,56.68,65.11,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Aetna,Middlesex Employees,,,56.68,,56.68,56.68,65.11,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Anthem,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Anthem,Indemnity,,,57.38,,57.38,56.68,65.11,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Anthem,Individual Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Anthem,State Preferred,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Cigna,Cigna,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Connecticare,Commerical,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Connecticare,Exchange,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,Multiplan,Multiplan,,,65.11,,65.11,56.68,65.11,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,10572-302-01,NDC,both,1,mL,76.6,45.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.68,65.11,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Aetna,Commerical,,,70.93,,70.93,68.01,78.13,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Aetna,Middlesex Employees,,,68.01,,68.01,68.01,78.13,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Anthem,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Anthem,Indemnity,,,68.86,,68.86,68.01,78.13,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Anthem,Individual Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Anthem,State Preferred,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Cigna,Cigna,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Connecticare,Commerical,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Connecticare,Exchange,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,Multiplan,Multiplan,,,78.13,,78.13,68.01,78.13,percent of total billed charges,,
PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,J3490,HCPCS,52268-400-01,NDC,both,4000,mL,91.92,55.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.01,78.13,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Aetna,Commerical,,,13183.84,,13183.84,47.56,14523.41,percent of total billed charges,,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Aetna,Middlesex Employees,,,12642.2,,12642.2,47.56,14523.41,percent of total billed charges,,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Anthem,Commerical,,,,,,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Anthem,Indemnity,,,12799.39,,12799.39,47.56,14523.41,percent of total billed charges,,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Anthem,Individual Exchange,,,,,,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Anthem,State Preferred,,,,,,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Cigna,Cigna,,77.73,,,77.73,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Connecticare,Commerical,,47.56,,,47.56,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Connecticare,Exchange,,47.56,,,47.56,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,Multiplan,Multiplan,,,14523.41,,14523.41,47.56,14523.41,percent of total billed charges,,
PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,J2506,HCPCS,55513-190-01,NDC,both,0.6,mL,17086.36,10251.82,United Healthcare/Oxford,United Healthcare/Oxford,,67.26,,,67.26,47.56,14523.41,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Aetna,Commerical,,,7951.11,,7951.11,180.27,8759,percent of total billed charges,,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Aetna,Middlesex Employees,,,7624.45,,7624.45,180.27,8759,percent of total billed charges,,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Anthem,Commerical,,,,,,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Anthem,Indemnity,,,7719.25,,7719.25,180.27,8759,percent of total billed charges,,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Anthem,Individual Exchange,,,,,,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Anthem,State Preferred,,,,,,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Cigna,Cigna,,208.34,,,208.34,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Connecticare,Commerical,,216.52,,,216.52,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Connecticare,Exchange,,216.52,,,216.52,180.27,8759,Other,Could be inpatient or outpatient,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,Multiplan,Multiplan,,,8759,,8759,180.27,8759,percent of total billed charges,,
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,Q5108,HCPCS,67457-833-06,NDC,both,0.6,mL,10304.7,6182.82,United Healthcare/Oxford,United Healthcare/Oxford,,180.27,,,180.27,180.27,8759,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Aetna,Commerical,,,16423.75,,16423.75,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Aetna,Middlesex Employees,,,15749,,15749,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Commerical,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Indemnity,,,15944.83,,15944.83,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Individual Exchange,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Anthem,State Preferred,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Cigna,Cigna,,79.89,,,79.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Connecticare,Commerical,,88.89,,,88.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Connecticare,Exchange,,88.89,,,88.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,Multiplan,Multiplan,,,18092.51,,18092.51,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-01,NDC,both,0.04,mL,21285.31,12771.19,United Healthcare/Oxford,United Healthcare/Oxford,,69.13,,,69.13,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Aetna,Commerical,,,16423.75,,16423.75,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Aetna,Middlesex Employees,,,15749,,15749,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Commerical,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Indemnity,,,15944.83,,15944.83,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Anthem,Individual Exchange,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Anthem,State Preferred,,,,,,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Cigna,Cigna,,79.89,,,79.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Connecticare,Commerical,,88.89,,,88.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Connecticare,Exchange,,88.89,,,88.89,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,Multiplan,Multiplan,,,18092.51,,18092.51,69.13,18092.51,percent of total billed charges,,
PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,J9271,HCPCS,0006-3026-02,NDC,both,0.04,mL,21285.31,12771.19,United Healthcare/Oxford,United Healthcare/Oxford,,69.13,,,69.13,69.13,18092.51,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Aetna,Commerical,,,2300,,2300,6.39,2533.7,percent of total billed charges,,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Aetna,Middlesex Employees,,,2205.51,,2205.51,6.39,2533.7,percent of total billed charges,,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Anthem,Commerical,,,,,,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Anthem,Indemnity,,,2232.93,,2232.93,6.39,2533.7,percent of total billed charges,,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Anthem,Individual Exchange,,,,,,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Anthem,State Preferred,,,,,,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Cigna,Cigna,,7.92,,,7.92,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Connecticare,Commerical,,6.39,,,6.39,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Connecticare,Exchange,,6.39,,,6.39,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,Multiplan,Multiplan,,,2533.7,,2533.7,6.39,2533.7,percent of total billed charges,,
PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7640-01,NDC,both,0.1,ea,2980.82,1788.49,United Healthcare/Oxford,United Healthcare/Oxford,,6.86,,,6.86,6.39,2533.7,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Aetna,Commerical,,,11499.95,,11499.95,6.39,12668.43,percent of total billed charges,,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Aetna,Middlesex Employees,,,11027.49,,11027.49,6.39,12668.43,percent of total billed charges,,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Anthem,Commerical,,,,,,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Anthem,Indemnity,,,11164.61,,11164.61,6.39,12668.43,percent of total billed charges,,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Anthem,Individual Exchange,,,,,,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Anthem,State Preferred,,,,,,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Cigna,Cigna,,7.92,,,7.92,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Connecticare,Commerical,,6.39,,,6.39,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Connecticare,Exchange,,6.39,,,6.39,6.39,12668.43,Other,Could be inpatient or outpatient,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,Multiplan,Multiplan,,,12668.43,,12668.43,6.39,12668.43,percent of total billed charges,,
PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,J9305,HCPCS,0002-7623-01,NDC,both,0.02,ea,14904.03,8942.42,United Healthcare/Oxford,United Healthcare/Oxford,,6.86,,,6.86,6.39,12668.43,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Aetna,Commerical,,,85.95,,85.95,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Aetna,Middlesex Employees,,,82.42,,82.42,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Anthem,Commerical,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Anthem,Indemnity,,,83.44,,83.44,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Anthem,Individual Exchange,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Anthem,State Preferred,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Cigna,Cigna,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Connecticare,Commerical,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Connecticare,Exchange,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,Multiplan,Multiplan,,,94.68,,94.68,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,0400-0089-13,NDC,both,1,ea,111.39,66.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Aetna,Commerical,,,85.95,,85.95,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Aetna,Middlesex Employees,,,82.42,,82.42,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Anthem,Commerical,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Anthem,Indemnity,,,83.44,,83.44,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Anthem,Individual Exchange,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Anthem,State Preferred,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Cigna,Cigna,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Connecticare,Commerical,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Connecticare,Exchange,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,Multiplan,Multiplan,,,94.68,,94.68,82.42,94.68,percent of total billed charges,,
PENICILLAMINE 125 MG TABLET,J3490,HCPCS,40810-0002-38,NDC,both,1,ea,111.39,66.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,82.42,94.68,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Aetna,Commerical,,,392.42,,392.42,376.3,432.29,percent of total billed charges,,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Aetna,Middlesex Employees,,,376.3,,376.3,376.3,432.29,percent of total billed charges,,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Anthem,Commerical,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Anthem,Indemnity,,,380.98,,380.98,376.3,432.29,percent of total billed charges,,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Anthem,Individual Exchange,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Anthem,State Preferred,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Cigna,Cigna,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Connecticare,Commerical,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Connecticare,Exchange,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,Multiplan,Multiplan,,,432.29,,432.29,376.3,432.29,percent of total billed charges,,
PENICILLAMINE 250 MG CAPSULE,J3490,HCPCS,25010-705-15,NDC,both,1,ea,508.58,305.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,376.3,432.29,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Aetna,Commerical,,,132.35,,132.35,126.92,145.8,percent of total billed charges,,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Aetna,Middlesex Employees,,,126.92,,126.92,126.92,145.8,percent of total billed charges,,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Anthem,Commerical,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Anthem,Indemnity,,,128.49,,128.49,126.92,145.8,percent of total billed charges,,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Anthem,Individual Exchange,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Anthem,State Preferred,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Cigna,Cigna,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Connecticare,Commerical,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Connecticare,Exchange,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,Multiplan,Multiplan,,,145.8,,145.8,126.92,145.8,percent of total billed charges,,
PENICILLAMINE 250 MG TABLET,J3490,HCPCS,0254-2000-01,NDC,both,1,ea,171.53,102.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,126.92,145.8,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Aetna,Commerical,,,38.1,,38.1,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Aetna,Middlesex Employees,,,36.54,,36.54,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Anthem,Commerical,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Anthem,Indemnity,,,36.99,,36.99,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Anthem,Individual Exchange,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Anthem,State Preferred,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Cigna,Cigna,,1.05,,,1.05,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Connecticare,Commerical,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Connecticare,Exchange,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,Multiplan,Multiplan,,,41.97,,41.97,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D10W NICU",J2540,HCPCS,40810-0004-68,NDC,both,6,mL,49.38,29.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Aetna,Commerical,,,38.1,,38.1,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Aetna,Middlesex Employees,,,36.54,,36.54,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Anthem,Commerical,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Anthem,Indemnity,,,36.99,,36.99,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Anthem,Individual Exchange,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Anthem,State Preferred,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Cigna,Cigna,,1.05,,,1.05,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Connecticare,Commerical,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Connecticare,Exchange,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,Multiplan,Multiplan,,,41.97,,41.97,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN D5W NICU",J2540,HCPCS,40810-0004-69,NDC,both,6,mL,49.38,29.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Aetna,Commerical,,,38.1,,38.1,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Aetna,Middlesex Employees,,,36.54,,36.54,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Anthem,Commerical,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Anthem,Indemnity,,,36.99,,36.99,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Anthem,Individual Exchange,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Anthem,State Preferred,,,,,,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Cigna,Cigna,,1.05,,,1.05,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Connecticare,Commerical,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Connecticare,Exchange,,1.55,,,1.55,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,Multiplan,Multiplan,,,41.97,,41.97,1.05,41.97,percent of total billed charges,,
"PENICILLIN G 100,000 UNITS/ML IN NS NICU",J2540,HCPCS,40810-0004-70,NDC,both,6,mL,49.38,29.63,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,41.97,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Aetna,Commerical,,,716.89,,716.89,27.09,789.73,percent of total billed charges,,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Aetna,Middlesex Employees,,,687.43,,687.43,27.09,789.73,percent of total billed charges,,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Anthem,Commerical,,,,,,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Anthem,Indemnity,,,695.98,,695.98,27.09,789.73,percent of total billed charges,,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Anthem,Individual Exchange,,,,,,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Anthem,State Preferred,,,,,,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Cigna,Cigna,,27.09,,,27.09,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Connecticare,Commerical,,37.21,,,37.21,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Connecticare,Exchange,,37.21,,,37.21,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,Multiplan,Multiplan,,,789.73,,789.73,27.09,789.73,percent of total billed charges,,
"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-701-10,NDC,both,2,mL,929.09,557.45,United Healthcare/Oxford,United Healthcare/Oxford,,29.24,,,29.24,27.09,789.73,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Aetna,Commerical,,,1472.02,,1472.02,27.09,1621.59,percent of total billed charges,,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Aetna,Middlesex Employees,,,1411.54,,1411.54,27.09,1621.59,percent of total billed charges,,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Anthem,Commerical,,,,,,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Anthem,Indemnity,,,1429.1,,1429.1,27.09,1621.59,percent of total billed charges,,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Anthem,Individual Exchange,,,,,,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Anthem,State Preferred,,,,,,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Cigna,Cigna,,27.09,,,27.09,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Connecticare,Commerical,,37.21,,,37.21,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Connecticare,Exchange,,37.21,,,37.21,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,Multiplan,Multiplan,,,1621.59,,1621.59,27.09,1621.59,percent of total billed charges,,
"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-702-10,NDC,both,0.167,mL,1907.75,1144.65,United Healthcare/Oxford,United Healthcare/Oxford,,29.24,,,29.24,27.09,1621.59,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Aetna,Commerical,,,413.89,,413.89,27.09,455.94,percent of total billed charges,,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Aetna,Middlesex Employees,,,396.88,,396.88,27.09,455.94,percent of total billed charges,,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Anthem,Commerical,,,,,,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Anthem,Indemnity,,,401.82,,401.82,27.09,455.94,percent of total billed charges,,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Anthem,Individual Exchange,,,,,,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Anthem,State Preferred,,,,,,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Cigna,Cigna,,27.09,,,27.09,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Connecticare,Commerical,,37.21,,,37.21,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Connecticare,Exchange,,37.21,,,37.21,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,Multiplan,Multiplan,,,455.94,,455.94,27.09,455.94,percent of total billed charges,,
"PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J0561,HCPCS,60793-700-01,NDC,both,1,mL,536.4,321.84,United Healthcare/Oxford,United Healthcare/Oxford,,29.24,,,29.24,27.09,455.94,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Aetna,Commerical,,,11.54,,11.54,11.06,29.81,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Aetna,Middlesex Employees,,,11.06,,11.06,11.06,29.81,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Anthem,Commerical,,,,,,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Anthem,Indemnity,,,11.2,,11.2,11.06,29.81,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Anthem,Individual Exchange,,,,,,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Anthem,State Preferred,,,,,,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Cigna,Cigna,,22.06,,,22.06,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Connecticare,Commerical,,29.81,,,29.81,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Connecticare,Exchange,,29.81,,,29.81,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,Multiplan,Multiplan,,,12.71,,12.71,11.06,29.81,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-02,NDC,both,0.167,mL,14.95,8.97,United Healthcare/Oxford,United Healthcare/Oxford,,23.81,,,23.81,11.06,29.81,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Aetna,Commerical,,,571.45,,571.45,22.06,629.51,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Aetna,Middlesex Employees,,,547.97,,547.97,22.06,629.51,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Anthem,Commerical,,,,,,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Anthem,Indemnity,,,554.78,,554.78,22.06,629.51,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Anthem,Individual Exchange,,,,,,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Anthem,State Preferred,,,,,,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Cigna,Cigna,,22.06,,,22.06,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Connecticare,Commerical,,29.81,,,29.81,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Connecticare,Exchange,,29.81,,,29.81,22.06,629.51,Other,Could be inpatient or outpatient,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,Multiplan,Multiplan,,,629.51,,629.51,22.06,629.51,percent of total billed charges,,
"PENICILLIN G BENZATHINE AND PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE",J0558,HCPCS,60793-600-10,NDC,both,2,mL,740.6,444.36,United Healthcare/Oxford,United Healthcare/Oxford,,23.81,,,23.81,22.06,629.51,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Aetna,Commerical,,,68.58,,68.58,1.05,75.55,percent of total billed charges,,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Aetna,Middlesex Employees,,,65.76,,65.76,1.05,75.55,percent of total billed charges,,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Anthem,Commerical,,,,,,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Anthem,Indemnity,,,66.58,,66.58,1.05,75.55,percent of total billed charges,,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Anthem,Individual Exchange,,,,,,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Anthem,State Preferred,,,,,,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Cigna,Cigna,,1.05,,,1.05,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Connecticare,Commerical,,1.55,,,1.55,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Connecticare,Exchange,,1.55,,,1.55,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,Multiplan,Multiplan,,,75.55,,75.55,1.05,75.55,percent of total billed charges,,
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0530-28,NDC,both,0.03,ea,88.88,53.33,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,75.55,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,1.05,35.16,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,1.05,35.16,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Anthem,Commerical,,,,,,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,1.05,35.16,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Anthem,Individual Exchange,,,,,,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Anthem,State Preferred,,,,,,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Cigna,Cigna,,1.05,,,1.05,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Connecticare,Commerical,,1.55,,,1.55,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Connecticare,Exchange,,1.55,,,1.55,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,1.05,35.16,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-22,NDC,both,0.12,ea,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,35.16,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Aetna,Commerical,,,13.61,,13.61,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Aetna,Middlesex Employees,,,13.05,,13.05,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Anthem,Commerical,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Anthem,Indemnity,,,13.21,,13.21,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Anthem,Individual Exchange,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Anthem,State Preferred,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Cigna,Cigna,,1.05,,,1.05,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Connecticare,Commerical,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Connecticare,Exchange,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,Multiplan,Multiplan,,,14.99,,14.99,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-23,NDC,both,0.12,ea,17.64,10.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Aetna,Commerical,,,12.61,,12.61,1.05,13.89,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Aetna,Middlesex Employees,,,12.09,,12.09,1.05,13.89,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Anthem,Commerical,,,,,,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Anthem,Indemnity,,,12.24,,12.24,1.05,13.89,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Anthem,Individual Exchange,,,,,,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Anthem,State Preferred,,,,,,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Cigna,Cigna,,1.05,,,1.05,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Connecticare,Commerical,,1.55,,,1.55,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Connecticare,Exchange,,1.55,,,1.55,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,Multiplan,Multiplan,,,13.89,,13.89,1.05,13.89,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-83,NDC,both,1,ea,16.34,9.8,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,13.89,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Aetna,Commerical,,,13.61,,13.61,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Aetna,Middlesex Employees,,,13.05,,13.05,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Anthem,Commerical,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Anthem,Indemnity,,,13.21,,13.21,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Anthem,Individual Exchange,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Anthem,State Preferred,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Cigna,Cigna,,1.05,,,1.05,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Connecticare,Commerical,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Connecticare,Exchange,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,Multiplan,Multiplan,,,14.99,,14.99,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,0049-0520-84,NDC,both,0.12,ea,17.64,10.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Aetna,Commerical,,,13.61,,13.61,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Aetna,Middlesex Employees,,,13.05,,13.05,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Anthem,Commerical,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Anthem,Indemnity,,,13.21,,13.21,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Anthem,Individual Exchange,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Anthem,State Preferred,,,,,,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Cigna,Cigna,,1.05,,,1.05,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Connecticare,Commerical,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Connecticare,Exchange,,1.55,,,1.55,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,Multiplan,Multiplan,,,14.99,,14.99,1.05,14.99,percent of total billed charges,,
PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,J2540,HCPCS,44567-311-10,NDC,both,0.12,ea,17.64,10.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,1.05,14.99,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Aetna,Commerical,,,228.29,,228.29,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Aetna,Middlesex Employees,,,218.91,,218.91,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Anthem,Commerical,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Anthem,Indemnity,,,221.63,,221.63,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Anthem,Individual Exchange,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Anthem,State Preferred,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Cigna,Cigna,,52.96,,,52.96,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Connecticare,Commerical,,66.23,,,66.23,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Connecticare,Exchange,,66.23,,,66.23,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,Multiplan,Multiplan,,,251.48,,251.48,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-01,NDC,both,1,mL,295.86,177.52,United Healthcare/Oxford,United Healthcare/Oxford,,49.95,,,49.95,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Aetna,Commerical,,,228.29,,228.29,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Aetna,Middlesex Employees,,,218.91,,218.91,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Anthem,Commerical,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Anthem,Indemnity,,,221.63,,221.63,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Anthem,Individual Exchange,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Anthem,State Preferred,,,,,,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Cigna,Cigna,,52.96,,,52.96,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Connecticare,Commerical,,66.23,,,66.23,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Connecticare,Exchange,,66.23,,,66.23,49.95,251.48,Other,Could be inpatient or outpatient,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,Multiplan,Multiplan,,,251.48,,251.48,49.95,251.48,percent of total billed charges,,
PENICILLIN G PROCAINE 1.2 MILLION UNIT/2 ML INTRAMUSCULAR SYRINGE,J2510,HCPCS,60793-131-10,NDC,both,2,mL,295.86,177.52,United Healthcare/Oxford,United Healthcare/Oxford,,49.95,,,49.95,49.95,251.48,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Aetna,Commerical,,,135.8,,135.8,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Aetna,Middlesex Employees,,,130.22,,130.22,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Anthem,Commerical,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Anthem,Indemnity,,,131.84,,131.84,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Anthem,Individual Exchange,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Anthem,State Preferred,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Cigna,Cigna,,52.96,,,52.96,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Connecticare,Commerical,,66.23,,,66.23,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Connecticare,Exchange,,66.23,,,66.23,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,Multiplan,Multiplan,,,149.6,,149.6,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-01,NDC,both,1,mL,176,105.6,United Healthcare/Oxford,United Healthcare/Oxford,,49.95,,,49.95,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Aetna,Commerical,,,135.8,,135.8,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Aetna,Middlesex Employees,,,130.22,,130.22,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Anthem,Commerical,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Anthem,Indemnity,,,131.84,,131.84,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Anthem,Individual Exchange,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Anthem,State Preferred,,,,,,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Cigna,Cigna,,52.96,,,52.96,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Connecticare,Commerical,,66.23,,,66.23,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Connecticare,Exchange,,66.23,,,66.23,49.95,149.6,Other,Could be inpatient or outpatient,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,Multiplan,Multiplan,,,149.6,,149.6,49.95,149.6,percent of total billed charges,,
"PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",J2510,HCPCS,60793-130-10,NDC,both,1,mL,176,105.6,United Healthcare/Oxford,United Healthcare/Oxford,,49.95,,,49.95,49.95,149.6,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
PENICILLIN V POTASSIUM 125 MG ORAL TAB,J3490,HCPCS,40810-0002-39,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,0143-9837-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET,J3490,HCPCS,65862-175-01,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,57237-040-01,NDC,both,1,ea,0.29,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Aetna,Commerical,,,10.05,,10.05,9.64,11.08,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Aetna,Middlesex Employees,,,9.64,,9.64,9.64,11.08,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Anthem,Commerical,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Anthem,Indemnity,,,9.76,,9.76,9.64,11.08,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Anthem,Individual Exchange,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Anthem,State Preferred,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Cigna,Cigna,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Connecticare,Commerical,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Connecticare,Exchange,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,Multiplan,Multiplan,,,11.08,,11.08,9.64,11.08,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-73,NDC,both,1,mL,13.03,7.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.64,11.08,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Aetna,Commerical,,,27.19,,27.19,26.07,29.95,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Aetna,Middlesex Employees,,,26.07,,26.07,26.07,29.95,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Anthem,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Anthem,Indemnity,,,26.4,,26.4,26.07,29.95,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Anthem,Individual Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Anthem,State Preferred,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Cigna,Cigna,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Connecticare,Commerical,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Connecticare,Exchange,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,Multiplan,Multiplan,,,29.95,,29.95,26.07,29.95,percent of total billed charges,,
PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0093-4127-74,NDC,both,1,mL,35.24,21.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.07,29.95,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,40810-0017-18,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
PENICILLIN V POTASSIUM 500 MG TABLET,J3490,HCPCS,65862-176-01,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Aetna,Commerical,,,287.64,,287.64,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Aetna,Middlesex Employees,,,275.82,,275.82,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Anthem,Commerical,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Anthem,Indemnity,,,279.25,,279.25,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Anthem,Individual Exchange,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Anthem,State Preferred,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Cigna,Cigna,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Connecticare,Commerical,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Connecticare,Exchange,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,Multiplan,Multiplan,,,316.86,,316.86,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,13925-522-01,NDC,both,1,ea,372.78,223.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Aetna,Commerical,,,287.64,,287.64,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Aetna,Middlesex Employees,,,275.82,,275.82,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Anthem,Commerical,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Anthem,Indemnity,,,279.25,,279.25,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Anthem,Individual Exchange,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Anthem,State Preferred,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Cigna,Cigna,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Connecticare,Commerical,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Connecticare,Exchange,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,Multiplan,Multiplan,,,316.86,,316.86,275.82,316.86,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INHALATION,J7676,HCPCS,63323-877-15,NDC,both,1,ea,372.78,223.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,275.82,316.86,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,112.6,,,112.6,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,23155-748-31,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,112.6,,,112.6,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-1,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,112.6,,,112.6,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,39822-3050-2,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Aetna,Commerical,,,139.38,,139.38,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Aetna,Middlesex Employees,,,133.66,,133.66,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Anthem,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Anthem,Indemnity,,,135.32,,135.32,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Anthem,Individual Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Anthem,State Preferred,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Cigna,Cigna,,112.6,,,112.6,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Connecticare,Commerical,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Connecticare,Exchange,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,Multiplan,Multiplan,,,153.54,,153.54,112.6,153.54,percent of total billed charges,,
PENTAMIDINE 300 MG SOLUTION FOR INJECTION,S0080,HCPCS,63323-113-10,NDC,both,1,ea,180.64,108.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.6,153.54,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Aetna,Commerical,,,2444.98,,2444.98,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Aetna,Middlesex Employees,,,2344.54,,2344.54,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Commerical,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Indemnity,,,2373.69,,2373.69,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Individual Exchange,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Anthem,State Preferred,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Cigna,Cigna,,60.88,,,60.88,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Connecticare,Commerical,,34.51,,,34.51,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Connecticare,Exchange,,34.51,,,34.51,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,Multiplan,Multiplan,,,2693.41,,2693.41,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-20,NDC,both,1,mL,3168.72,1901.23,United Healthcare/Oxford,United Healthcare/Oxford,,82.37,,,82.37,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Aetna,Commerical,,,6112.45,,6112.45,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Aetna,Middlesex Employees,,,5861.33,,5861.33,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Commerical,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Indemnity,,,5934.21,,5934.21,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Individual Exchange,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Anthem,State Preferred,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Cigna,Cigna,,60.88,,,60.88,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Connecticare,Commerical,,34.51,,,34.51,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Connecticare,Exchange,,34.51,,,34.51,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,Multiplan,Multiplan,,,6733.52,,6733.52,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,24201-010-50,NDC,both,1,mL,7921.79,4753.07,United Healthcare/Oxford,United Healthcare/Oxford,,82.37,,,82.37,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Aetna,Commerical,,,2444.98,,2444.98,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Aetna,Middlesex Employees,,,2344.54,,2344.54,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Commerical,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Indemnity,,,2373.69,,2373.69,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Anthem,Individual Exchange,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Anthem,State Preferred,,,,,,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Cigna,Cigna,,60.88,,,60.88,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Connecticare,Commerical,,34.51,,,34.51,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Connecticare,Exchange,,34.51,,,34.51,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,Multiplan,Multiplan,,,2693.41,,2693.41,34.51,2693.41,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-20,NDC,both,1,mL,3168.72,1901.23,United Healthcare/Oxford,United Healthcare/Oxford,,82.37,,,82.37,34.51,2693.41,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Aetna,Commerical,,,6112.45,,6112.45,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Aetna,Middlesex Employees,,,5861.33,,5861.33,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Commerical,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Indemnity,,,5934.21,,5934.21,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Anthem,Individual Exchange,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Anthem,State Preferred,,,,,,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Cigna,Cigna,,60.88,,,60.88,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Connecticare,Commerical,,34.51,,,34.51,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Connecticare,Exchange,,34.51,,,34.51,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,Multiplan,Multiplan,,,6733.52,,6733.52,34.51,6733.52,percent of total billed charges,,
PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,J2515,HCPCS,76478-501-50,NDC,both,1,mL,7921.79,4753.07,United Healthcare/Oxford,United Healthcare/Oxford,,82.37,,,82.37,34.51,6733.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Aetna,Commerical,,,6574.5,,6574.5,3095.23,7242.52,percent of total billed charges,,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Aetna,Middlesex Employees,,,6304.4,,6304.4,3095.23,7242.52,percent of total billed charges,,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Anthem,Commerical,,,,,,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Anthem,Indemnity,,,6382.79,,6382.79,3095.23,7242.52,percent of total billed charges,,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Anthem,Individual Exchange,,,,,,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Anthem,State Preferred,,,,,,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Cigna,Cigna,,3577.27,,,3577.27,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Connecticare,Commerical,,3881.24,,,3881.24,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Connecticare,Exchange,,3881.24,,,3881.24,3095.23,7242.52,Other,Could be inpatient or outpatient,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,Multiplan,Multiplan,,,7242.52,,7242.52,3095.23,7242.52,percent of total billed charges,,
PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,J9268,HCPCS,0409-0801-01,NDC,both,1,ea,8520.61,5112.37,United Healthcare/Oxford,United Healthcare/Oxford,,3095.23,,,3095.23,3095.23,7242.52,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-5448-61,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,60505-0033-6,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68682-101-10,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,70954-668-10,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Aetna,Commerical,,,46.81,,46.81,44.89,51.57,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Aetna,Middlesex Employees,,,44.89,,44.89,44.89,51.57,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Anthem,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Anthem,Indemnity,,,45.45,,45.45,44.89,51.57,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Anthem,Individual Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Anthem,State Preferred,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Cigna,Cigna,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Connecticare,Commerical,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Connecticare,Exchange,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,Multiplan,Multiplan,,,51.57,,51.57,44.89,51.57,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,395201591,NDC,both,1,mL,60.67,36.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.89,51.57,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Aetna,Commerical,,,19.68,,19.68,18.87,21.68,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Aetna,Middlesex Employees,,,18.87,,18.87,18.87,21.68,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Anthem,Commerical,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Anthem,Indemnity,,,19.11,,19.11,18.87,21.68,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Anthem,Individual Exchange,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Anthem,State Preferred,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Cigna,Cigna,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Connecticare,Commerical,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Connecticare,Exchange,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,Multiplan,Multiplan,,,21.68,,21.68,18.87,21.68,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,2353507005,NDC,both,1,mL,25.51,15.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.87,21.68,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Aetna,Commerical,,,9.85,,9.85,9.44,10.85,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Aetna,Middlesex Employees,,,9.44,,9.44,9.44,10.85,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Anthem,Commerical,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Anthem,Indemnity,,,9.56,,9.56,9.44,10.85,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Anthem,Individual Exchange,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Anthem,State Preferred,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Cigna,Cigna,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Connecticare,Commerical,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Connecticare,Exchange,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,Multiplan,Multiplan,,,10.85,,10.85,9.44,10.85,percent of total billed charges,,
PEPPERMINT OIL,J3490,HCPCS,40093-0101-00,NDC,both,1,mL,12.76,7.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.44,10.85,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Aetna,Commerical,,,20.75,,20.75,19.9,22.86,percent of total billed charges,,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Aetna,Middlesex Employees,,,19.9,,19.9,19.9,22.86,percent of total billed charges,,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Anthem,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Anthem,Indemnity,,,20.14,,20.14,19.9,22.86,percent of total billed charges,,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Anthem,Individual Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Anthem,State Preferred,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Cigna,Cigna,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Connecticare,Commerical,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Connecticare,Exchange,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,Multiplan,Multiplan,,,22.86,,22.86,19.9,22.86,percent of total billed charges,,
PEPPERMINT SPIRIT ORAL,J3490,HCPCS,395224391,NDC,both,30,mL,26.89,16.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.9,22.86,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Aetna,Commerical,,,935.8,,935.8,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Aetna,Middlesex Employees,,,897.36,,897.36,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Indemnity,,,908.52,,908.52,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Individual Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,State Preferred,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Cigna,Cigna,,1.83,,,1.83,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,Multiplan,Multiplan,,,1030.89,,1030.89,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-01,NDC,both,0.1,mL,1212.81,727.69,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Aetna,Commerical,,,935.8,,935.8,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Aetna,Middlesex Employees,,,897.36,,897.36,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Indemnity,,,908.52,,908.52,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Individual Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,State Preferred,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Cigna,Cigna,,1.83,,,1.83,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,Multiplan,Multiplan,,,1030.89,,1030.89,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,61364-181-03,NDC,both,0.1,mL,1212.81,727.69,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Aetna,Commerical,,,935.8,,935.8,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Aetna,Middlesex Employees,,,897.36,,897.36,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Indemnity,,,908.52,,908.52,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,Individual Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Anthem,State Preferred,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Cigna,Cigna,,1.83,,,1.83,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,Multiplan,Multiplan,,,1030.89,,1030.89,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-01,NDC,both,0.1,mL,1212.81,727.69,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Aetna,Commerical,,,935.8,,935.8,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Aetna,Middlesex Employees,,,897.36,,897.36,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Indemnity,,,908.52,,908.52,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,Individual Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Anthem,State Preferred,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Cigna,Cigna,,1.83,,,1.83,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Commerical,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Connecticare,Exchange,,,,,,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,Multiplan,Multiplan,,,1030.89,,1030.89,1.83,1030.89,percent of total billed charges,,
PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,J2547,HCPCS,72769-181-03,NDC,both,0.1,mL,1212.81,727.69,United Healthcare/Oxford,United Healthcare/Oxford,,2.05,,,2.05,1.83,1030.89,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Aetna,Commerical,,,55.56,,55.56,53.28,61.21,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Aetna,Middlesex Employees,,,53.28,,53.28,53.28,61.21,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Anthem,Commerical,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Anthem,Indemnity,,,53.94,,53.94,53.28,61.21,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Anthem,Individual Exchange,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Anthem,State Preferred,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Cigna,Cigna,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Connecticare,Commerical,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Connecticare,Exchange,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,Multiplan,Multiplan,,,61.21,,61.21,53.28,61.21,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,40810-0015-26,NDC,both,1,UN,72.01,43.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.28,61.21,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Aetna,Commerical,,,27.22,,27.22,26.1,29.99,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Aetna,Middlesex Employees,,,26.1,,26.1,26.1,29.99,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Anthem,Commerical,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Anthem,Indemnity,,,26.43,,26.43,26.1,29.99,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Anthem,Individual Exchange,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Anthem,State Preferred,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Cigna,Cigna,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Connecticare,Commerical,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Connecticare,Exchange,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,Multiplan,Multiplan,,,29.99,,29.99,26.1,29.99,percent of total billed charges,,
PERAMPANEL 2 MG TABLET,J3490,HCPCS,62856-272-30,NDC,both,1,ea,35.28,21.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.1,29.99,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Aetna,Commerical,,,33.48,,33.48,32.1,36.88,percent of total billed charges,,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Aetna,Middlesex Employees,,,32.1,,32.1,32.1,36.88,percent of total billed charges,,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Anthem,Commerical,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Anthem,Indemnity,,,32.5,,32.5,32.1,36.88,percent of total billed charges,,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Anthem,Individual Exchange,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Anthem,State Preferred,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Cigna,Cigna,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Connecticare,Commerical,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Connecticare,Exchange,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,Multiplan,Multiplan,,,36.88,,36.88,32.1,36.88,percent of total billed charges,,
PERMETHRIN 1 % TOPICAL LIQUID,J3490,HCPCS,6373612002,NDC,both,1,mL,43.39,26.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.1,36.88,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Aetna,Commerical,,,52.67,,52.67,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Aetna,Middlesex Employees,,,50.51,,50.51,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Anthem,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Anthem,Indemnity,,,51.13,,51.13,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Anthem,Individual Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Anthem,State Preferred,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Cigna,Cigna,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Connecticare,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Connecticare,Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,Multiplan,Multiplan,,,58.02,,58.02,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,0472-0242-60,NDC,both,60,gm,68.26,40.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Aetna,Commerical,,,52.67,,52.67,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Aetna,Middlesex Employees,,,50.51,,50.51,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Anthem,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Anthem,Indemnity,,,51.13,,51.13,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Anthem,Individual Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Anthem,State Preferred,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Cigna,Cigna,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Connecticare,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Connecticare,Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,Multiplan,Multiplan,,,58.02,,58.02,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,21922-021-07,NDC,both,60,gm,68.26,40.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Aetna,Commerical,,,52.67,,52.67,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Aetna,Middlesex Employees,,,50.51,,50.51,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Anthem,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Anthem,Indemnity,,,51.13,,51.13,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Anthem,Individual Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Anthem,State Preferred,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Cigna,Cigna,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Connecticare,Commerical,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Connecticare,Exchange,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,Multiplan,Multiplan,,,58.02,,58.02,50.51,58.02,percent of total billed charges,,
PERMETHRIN 5 % TOPICAL CREAM,J3490,HCPCS,45802-269-37,NDC,both,60,gm,68.26,40.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.51,58.02,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Aetna,Commerical,,,7.89,,7.89,0.62,8.69,percent of total billed charges,,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Aetna,Middlesex Employees,,,7.56,,7.56,0.62,8.69,percent of total billed charges,,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Anthem,Commerical,,,,,,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Anthem,Indemnity,,,7.66,,7.66,0.62,8.69,percent of total billed charges,,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Anthem,Individual Exchange,,,,,,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Anthem,State Preferred,,,,,,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Cigna,Cigna,,0.62,,,0.62,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Connecticare,Commerical,,,,,,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Connecticare,Exchange,,,,,,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,Multiplan,Multiplan,,,8.69,,8.69,0.62,8.69,percent of total billed charges,,
PERPHENAZINE 1 MG TABLET,Q0175,HCPCS,40810-0017-57,NDC,both,4,ea,10.22,6.13,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,8.69,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Aetna,Commerical,,,5.51,,5.51,0.62,6.07,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Aetna,Middlesex Employees,,,5.28,,5.28,0.62,6.07,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Anthem,Commerical,,,,,,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Anthem,Indemnity,,,5.35,,5.35,0.62,6.07,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Anthem,Individual Exchange,,,,,,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Anthem,State Preferred,,,,,,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Cigna,Cigna,,0.62,,,0.62,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Connecticare,Commerical,,,,,,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Connecticare,Exchange,,,,,,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,Multiplan,Multiplan,,,6.07,,6.07,0.62,6.07,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0603-5060-21,NDC,both,2,ea,7.14,4.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,6.07,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Anthem,Commerical,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Anthem,State Preferred,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Cigna,Cigna,,0.62,,,0.62,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Connecticare,Commerical,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Connecticare,Exchange,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,0781-1046-13,NDC,both,2,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Aetna,Commerical,,,1.28,,1.28,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Aetna,Middlesex Employees,,,1.23,,1.23,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Anthem,Commerical,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Anthem,Indemnity,,,1.24,,1.24,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Anthem,Individual Exchange,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Anthem,State Preferred,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Cigna,Cigna,,0.62,,,0.62,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Connecticare,Commerical,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Connecticare,Exchange,,,,,,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,Multiplan,Multiplan,,,1.41,,1.41,0.62,1.41,percent of total billed charges,,
PERPHENAZINE 2 MG TABLET,Q0175,HCPCS,52536-162-01,NDC,both,2,ea,1.66,1,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,1.41,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Aetna,Commerical,,,3.77,,3.77,0.62,4.15,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Aetna,Middlesex Employees,,,3.61,,3.61,0.62,4.15,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Anthem,Commerical,,,,,,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Anthem,Indemnity,,,3.66,,3.66,0.62,4.15,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Anthem,Individual Exchange,,,,,,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Anthem,State Preferred,,,,,,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Cigna,Cigna,,0.62,,,0.62,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Connecticare,Commerical,,,,,,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Connecticare,Exchange,,,,,,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,Multiplan,Multiplan,,,4.15,,4.15,0.62,4.15,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0603-5061-21,NDC,both,1,ea,4.88,2.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,4.15,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,0.62,,,0.62,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0781-1047-13,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,0.62,,,0.62,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,0904-6600-61,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,0.62,,,0.62,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,52536-164-01,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,0.62,,,0.62,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-01,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Aetna,Commerical,,,2.85,,2.85,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Aetna,Middlesex Employees,,,2.73,,2.73,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Anthem,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Anthem,Indemnity,,,2.76,,2.76,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Anthem,Individual Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Anthem,State Preferred,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Cigna,Cigna,,0.62,,,0.62,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Connecticare,Commerical,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Connecticare,Exchange,,,,,,0.62,3.14,Other,Could be inpatient or outpatient,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,Multiplan,Multiplan,,,3.14,,3.14,0.62,3.14,percent of total billed charges,,
PERPHENAZINE 4 MG TABLET,Q0175,HCPCS,68084-602-11,NDC,both,1,ea,3.69,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.62,3.14,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Aetna,Commerical,,,15.46,,15.46,14.82,17.03,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Aetna,Middlesex Employees,,,14.82,,14.82,14.82,17.03,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Anthem,Commerical,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Anthem,Indemnity,,,15,,15,14.82,17.03,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Anthem,Individual Exchange,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Anthem,State Preferred,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Cigna,Cigna,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Connecticare,Commerical,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Connecticare,Exchange,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,Multiplan,Multiplan,,,17.03,,17.03,14.82,17.03,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-01,NDC,both,1,ea,20.03,12.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.82,17.03,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Aetna,Commerical,,,9.43,,9.43,9.04,10.39,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Aetna,Middlesex Employees,,,9.04,,9.04,9.04,10.39,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Anthem,Commerical,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Anthem,Indemnity,,,9.15,,9.15,9.04,10.39,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Anthem,Individual Exchange,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Anthem,State Preferred,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Cigna,Cigna,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Connecticare,Commerical,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Connecticare,Exchange,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,Multiplan,Multiplan,,,10.39,,10.39,9.04,10.39,percent of total billed charges,,
"PERTZYE 16,000-57,500-60,500 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,59767-016-02,NDC,both,1,ea,12.22,7.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.04,10.39,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Aetna,Commerical,,,4.44,,4.44,4.26,4.9,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Aetna,Middlesex Employees,,,4.26,,4.26,4.26,4.9,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Anthem,Commerical,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Anthem,Indemnity,,,4.31,,4.31,4.26,4.9,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Anthem,Individual Exchange,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Anthem,State Preferred,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Cigna,Cigna,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Connecticare,Commerical,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Connecticare,Exchange,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,Multiplan,Multiplan,,,4.9,,4.9,4.26,4.9,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,40810-0202-59,NDC,both,1,ea,5.76,3.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.26,4.9,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Aetna,Commerical,,,5.19,,5.19,4.97,5.71,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Aetna,Middlesex Employees,,,4.97,,4.97,4.97,5.71,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Anthem,Commerical,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Anthem,Indemnity,,,5.03,,5.03,4.97,5.71,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Anthem,Individual Exchange,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Anthem,State Preferred,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Cigna,Cigna,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Connecticare,Commerical,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Connecticare,Exchange,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,Multiplan,Multiplan,,,5.71,,5.71,4.97,5.71,percent of total billed charges,,
"PERTZYE 4,000-14,375-15,125 UNIT CAPSULE,DELAYED REL",J3490,HCPCS,59767-004-01,NDC,both,1,ea,6.72,4.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.97,5.71,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Aetna,Commerical,,,23.41,,23.41,22.45,25.79,percent of total billed charges,,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Aetna,Middlesex Employees,,,22.45,,22.45,22.45,25.79,percent of total billed charges,,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Anthem,Commerical,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Anthem,Indemnity,,,22.73,,22.73,22.45,25.79,percent of total billed charges,,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Anthem,Individual Exchange,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Anthem,State Preferred,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Cigna,Cigna,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Connecticare,Commerical,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Connecticare,Exchange,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,Multiplan,Multiplan,,,25.79,,25.79,22.45,25.79,percent of total billed charges,,
PHENAZOPYRIDINE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-41,NDC,both,1,mL,30.34,18.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.45,25.79,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,40810-0007-66,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,51293-810-01,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,65162-681-10,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
PHENAZOPYRIDINE 100 MG TABLET,J3490,HCPCS,75826-114-10,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,65162-682-10,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Aetna,Commerical,,,1.12,,1.12,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Aetna,Middlesex Employees,,,1.07,,1.07,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Anthem,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Anthem,Indemnity,,,1.09,,1.09,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Anthem,Individual Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Anthem,State Preferred,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Cigna,Cigna,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Connecticare,Commerical,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Connecticare,Exchange,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,Multiplan,Multiplan,,,1.23,,1.23,1.07,1.23,percent of total billed charges,,
PHENAZOPYRIDINE 200 MG TABLET,J3490,HCPCS,75826-115-10,NDC,both,1,ea,1.45,0.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.07,1.23,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
PHENAZOPYRIDINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-40,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
PHENAZOPYRIDINE 95 MG TABLET,J3490,HCPCS,2351370001,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Aetna,Commerical,,,217.04,,217.04,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Aetna,Middlesex Employees,,,208.12,,208.12,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Anthem,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Anthem,Indemnity,,,210.71,,210.71,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Anthem,Individual Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Anthem,State Preferred,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Cigna,Cigna,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Connecticare,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Connecticare,Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,Multiplan,Multiplan,,,239.09,,239.09,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,50742-665-04,NDC,both,1,mL,281.28,168.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Aetna,Commerical,,,217.04,,217.04,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Aetna,Middlesex Employees,,,208.12,,208.12,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Anthem,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Anthem,Indemnity,,,210.71,,210.71,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Anthem,Individual Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Anthem,State Preferred,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Cigna,Cigna,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Connecticare,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Connecticare,Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,Multiplan,Multiplan,,,239.09,,239.09,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,59212-422-04,NDC,both,1,mL,281.28,168.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Aetna,Commerical,,,217.04,,217.04,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Aetna,Middlesex Employees,,,208.12,,208.12,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Anthem,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Anthem,Indemnity,,,210.71,,210.71,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Anthem,Individual Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Anthem,State Preferred,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Cigna,Cigna,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Connecticare,Commerical,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Connecticare,Exchange,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,Multiplan,Multiplan,,,239.09,,239.09,208.12,239.09,percent of total billed charges,,
PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG/5 ML ELIXIR,J3490,HCPCS,75826-127-04,NDC,both,1,mL,281.28,168.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,208.12,239.09,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Aetna,Commerical,,,0.86,,0.86,0.82,0.94,percent of total billed charges,,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Aetna,Middlesex Employees,,,0.82,,0.82,0.82,0.94,percent of total billed charges,,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Anthem,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Anthem,Indemnity,,,0.83,,0.83,0.82,0.94,percent of total billed charges,,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Anthem,Individual Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Anthem,State Preferred,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Cigna,Cigna,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Connecticare,Commerical,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Connecticare,Exchange,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,Multiplan,Multiplan,,,0.94,,0.94,0.82,0.94,percent of total billed charges,,
PHENOBARBITAL 100 MG TABLET,J3490,HCPCS,0143-1458-05,NDC,both,1,ea,1.11,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.82,0.94,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1445-05,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
PHENOBARBITAL 15 MG TABLET,J3490,HCPCS,0143-1495-01,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,6.76,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Aetna,Commerical,,,493.44,,493.44,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Aetna,Middlesex Employees,,,473.17,,473.17,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Anthem,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Anthem,Indemnity,,,479.05,,479.05,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Anthem,Individual Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Anthem,State Preferred,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Cigna,Cigna,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Connecticare,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Connecticare,Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,Multiplan,Multiplan,,,543.58,,543.58,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,639.5,383.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,6.76,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Aetna,Commerical,,,493.44,,493.44,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Aetna,Middlesex Employees,,,473.17,,473.17,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Anthem,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Anthem,Indemnity,,,479.05,,479.05,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Anthem,Individual Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Anthem,State Preferred,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Cigna,Cigna,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Connecticare,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Connecticare,Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,Multiplan,Multiplan,,,543.58,,543.58,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,13517-107-16,NDC,both,1,mL,639.5,383.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Aetna,Commerical,,,493.44,,493.44,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Aetna,Middlesex Employees,,,473.17,,473.17,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Anthem,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Anthem,Indemnity,,,479.05,,479.05,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Anthem,Individual Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Anthem,State Preferred,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Cigna,Cigna,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Connecticare,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Connecticare,Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,Multiplan,Multiplan,,,543.58,,543.58,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,16571-675-16,NDC,both,1,mL,639.5,383.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,6.76,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-40,NDC,both,5,mL,6.76,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,J3490,HCPCS,60687-448-67,NDC,both,5,mL,6.76,4.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-05,NDC,both,1,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Aetna,Commerical,,,493.44,,493.44,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Aetna,Middlesex Employees,,,473.17,,473.17,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Anthem,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Anthem,Indemnity,,,479.05,,479.05,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Anthem,Individual Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Anthem,State Preferred,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Cigna,Cigna,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Connecticare,Commerical,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Connecticare,Exchange,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,Multiplan,Multiplan,,,543.58,,543.58,473.17,543.58,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-16,NDC,both,1,mL,105.08,63.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,473.17,543.58,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,0121-0942-50,NDC,both,1,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,40810-0013-33,NDC,both,5,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-40,NDC,both,5,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-46,NDC,both,5,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Aetna,Commerical,,,5.22,,5.22,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Aetna,Middlesex Employees,,,5,,5,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Anthem,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Anthem,Indemnity,,,5.06,,5.06,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Anthem,Individual Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Anthem,State Preferred,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Cigna,Cigna,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Connecticare,Commerical,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Connecticare,Exchange,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,Multiplan,Multiplan,,,5.75,,5.75,5,5.75,percent of total billed charges,,
PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR SYRINGE,J3490,HCPCS,60687-448-67,NDC,both,5,mL,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5,5.75,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1450-05,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Aetna,Commerical,,,0.6,,0.6,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Anthem,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Anthem,Indemnity,,,0.58,,0.58,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Anthem,Individual Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Anthem,State Preferred,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Cigna,Cigna,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Connecticare,Commerical,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Connecticare,Exchange,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,Multiplan,Multiplan,,,0.66,,0.66,0.58,0.66,percent of total billed charges,,
PHENOBARBITAL 30 MG TABLET,J3490,HCPCS,0143-1500-01,NDC,both,1,ea,0.78,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.66,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
PHENOBARBITAL 50 MG ORAL TAB,J3490,HCPCS,40810-0002-42,NDC,both,1,ea,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
PHENOBARBITAL 7.5 MG ORAL TAB,J3490,HCPCS,40810-0002-43,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Aetna,Commerical,,,71.22,,71.22,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Aetna,Middlesex Employees,,,68.29,,68.29,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Anthem,Commerical,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Anthem,Indemnity,,,69.14,,69.14,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Anthem,Individual Exchange,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Anthem,State Preferred,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Cigna,Cigna,,37.03,,,37.03,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Connecticare,Commerical,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Connecticare,Exchange,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,Multiplan,Multiplan,,,78.46,,78.46,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-21,NDC,both,1,mL,92.3,55.38,United Healthcare/Oxford,United Healthcare/Oxford,,39.98,,,39.98,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Aetna,Commerical,,,71.22,,71.22,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Aetna,Middlesex Employees,,,68.29,,68.29,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Anthem,Commerical,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Anthem,Indemnity,,,69.14,,69.14,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Anthem,Individual Exchange,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Anthem,State Preferred,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Cigna,Cigna,,37.03,,,37.03,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Connecticare,Commerical,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Connecticare,Exchange,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,Multiplan,Multiplan,,,78.46,,78.46,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,0641-0476-25,NDC,both,1,mL,92.3,55.38,United Healthcare/Oxford,United Healthcare/Oxford,,39.98,,,39.98,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Aetna,Commerical,,,71.22,,71.22,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Aetna,Middlesex Employees,,,68.29,,68.29,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Anthem,Commerical,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Anthem,Indemnity,,,69.14,,69.14,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Anthem,Individual Exchange,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Anthem,State Preferred,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Cigna,Cigna,,37.03,,,37.03,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Connecticare,Commerical,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Connecticare,Exchange,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,Multiplan,Multiplan,,,78.46,,78.46,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-01,NDC,both,1,mL,92.3,55.38,United Healthcare/Oxford,United Healthcare/Oxford,,39.98,,,39.98,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Aetna,Commerical,,,71.22,,71.22,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Aetna,Middlesex Employees,,,68.29,,68.29,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Anthem,Commerical,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Anthem,Indemnity,,,69.14,,69.14,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Anthem,Individual Exchange,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Anthem,State Preferred,,,,,,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Cigna,Cigna,,37.03,,,37.03,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Connecticare,Commerical,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Connecticare,Exchange,,47.91,,,47.91,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,Multiplan,Multiplan,,,78.46,,78.46,37.03,78.46,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-415-25,NDC,both,1,mL,92.3,55.38,United Healthcare/Oxford,United Healthcare/Oxford,,39.98,,,39.98,37.03,78.46,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Aetna,Commerical,,,131.53,,131.53,37.03,144.9,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Aetna,Middlesex Employees,,,126.13,,126.13,37.03,144.9,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Anthem,Commerical,,,,,,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Anthem,Indemnity,,,127.7,,127.7,37.03,144.9,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Anthem,Individual Exchange,,,,,,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Anthem,State Preferred,,,,,,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Cigna,Cigna,,37.03,,,37.03,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Connecticare,Commerical,,47.91,,,47.91,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Connecticare,Exchange,,47.91,,,47.91,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,Multiplan,Multiplan,,,144.9,,144.9,37.03,144.9,percent of total billed charges,,
PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,J2560,HCPCS,42494-441-01,NDC,both,1.847,mL,170.47,102.28,United Healthcare/Oxford,United Healthcare/Oxford,,39.98,,,39.98,37.03,144.9,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Aetna,Commerical,,,5.23,,5.23,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Aetna,Middlesex Employees,,,5.02,,5.02,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Anthem,Commerical,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Anthem,Indemnity,,,5.08,,5.08,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Anthem,Individual Exchange,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Anthem,State Preferred,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Cigna,Cigna,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Connecticare,Commerical,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Connecticare,Exchange,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,Multiplan,Multiplan,,,5.76,,5.76,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201103,NDC,both,177,mL,6.78,4.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Aetna,Commerical,,,10.99,,10.99,10.54,12.1,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Aetna,Middlesex Employees,,,10.54,,10.54,10.54,12.1,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Anthem,Commerical,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Anthem,Indemnity,,,10.67,,10.67,10.54,12.1,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Anthem,Individual Exchange,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Anthem,State Preferred,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Cigna,Cigna,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Connecticare,Commerical,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Connecticare,Exchange,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,Multiplan,Multiplan,,,12.1,,12.1,10.54,12.1,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,7811201104,NDC,both,177,mL,14.24,8.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.54,12.1,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Aetna,Commerical,,,5.23,,5.23,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Aetna,Middlesex Employees,,,5.02,,5.02,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Anthem,Commerical,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Anthem,Indemnity,,,5.08,,5.08,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Anthem,Individual Exchange,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Anthem,State Preferred,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Cigna,Cigna,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Connecticare,Commerical,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Connecticare,Exchange,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,Multiplan,Multiplan,,,5.76,,5.76,5.02,5.76,percent of total billed charges,,
PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,J3490,HCPCS,70000-0458-1,NDC,both,177,mL,6.78,4.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.02,5.76,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Aetna,Commerical,,,58.43,,58.43,56.03,64.36,percent of total billed charges,,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Aetna,Middlesex Employees,,,56.03,,56.03,56.03,64.36,percent of total billed charges,,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Anthem,Commerical,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Anthem,Indemnity,,,56.72,,56.72,56.03,64.36,percent of total billed charges,,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Anthem,Individual Exchange,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Anthem,State Preferred,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Cigna,Cigna,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Connecticare,Commerical,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Connecticare,Exchange,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,Multiplan,Multiplan,,,64.36,,64.36,56.03,64.36,percent of total billed charges,,
PHENOL 1.5 % TOPICAL LIQUID,J3490,HCPCS,54633-612-01,NDC,both,1,mL,75.72,45.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.03,64.36,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Aetna,Commerical,,,170.67,,170.67,163.66,188.01,percent of total billed charges,,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Aetna,Middlesex Employees,,,163.66,,163.66,163.66,188.01,percent of total billed charges,,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Anthem,Commerical,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Anthem,Indemnity,,,165.69,,165.69,163.66,188.01,percent of total billed charges,,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Anthem,Individual Exchange,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Anthem,State Preferred,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Cigna,Cigna,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Connecticare,Commerical,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Connecticare,Exchange,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,Multiplan,Multiplan,,,188.01,,188.01,163.66,188.01,percent of total billed charges,,
PHENOL 6% INJECTION,J3490,HCPCS,88888-0006-36,NDC,both,5,mL,221.19,132.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,163.66,188.01,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Aetna,Commerical,,,17.48,,17.48,16.76,19.25,percent of total billed charges,,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Aetna,Middlesex Employees,,,16.76,,16.76,16.76,19.25,percent of total billed charges,,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Anthem,Commerical,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Anthem,Indemnity,,,16.97,,16.97,16.76,19.25,percent of total billed charges,,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Anthem,Individual Exchange,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Anthem,State Preferred,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Cigna,Cigna,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Connecticare,Commerical,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Connecticare,Exchange,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,Multiplan,Multiplan,,,19.25,,19.25,16.76,19.25,percent of total billed charges,,
PHENOL 89 % TOPICAL SWAB,J3490,HCPCS,884629730,NDC,both,1,ea,22.65,13.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.76,19.25,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Aetna,Commerical,,,27.2,,27.2,26.08,29.96,percent of total billed charges,,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Aetna,Middlesex Employees,,,26.08,,26.08,26.08,29.96,percent of total billed charges,,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Anthem,Commerical,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Anthem,Indemnity,,,26.41,,26.41,26.08,29.96,percent of total billed charges,,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Anthem,Individual Exchange,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Anthem,State Preferred,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Cigna,Cigna,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Connecticare,Commerical,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Connecticare,Exchange,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,Multiplan,Multiplan,,,29.96,,29.96,26.08,29.96,percent of total billed charges,,
PHENOXYBENZAMINE 10 MG CAPSULE,J3490,HCPCS,40810-0005-37,NDC,both,1,ea,35.25,21.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.08,29.96,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.25 MG/ML INJECTION ,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 0.5 MG/ML INJECTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION FOR HYPERTENSION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1715.88,1029.53,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-01,NDC,both,1,ea,1175.97,705.58,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,0143-9564-10,NDC,both,1,ea,1175.97,705.58,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,51224-012-20,NDC,both,1,ea,1175.97,705.58,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Aetna,Commerical,,,907.38,,907.38,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Aetna,Middlesex Employees,,,870.1,,870.1,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Anthem,Commerical,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Anthem,Indemnity,,,880.92,,880.92,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Anthem,Individual Exchange,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Anthem,State Preferred,,,,,,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Cigna,Cigna,,451.24,,,451.24,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Connecticare,Commerical,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Connecticare,Exchange,,560.59,,,560.59,451.24,999.57,Other,Could be inpatient or outpatient,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,Multiplan,Multiplan,,,999.57,,999.57,451.24,999.57,percent of total billed charges,,
PHENTOLAMINE 5 MG INJECTION SOLUTION,J2760,HCPCS,68094-101-20,NDC,both,1,ea,1175.97,705.58,United Healthcare/Oxford,United Healthcare/Oxford,,487.18,,,487.18,451.24,999.57,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Aetna,Commerical,,,12.28,,12.28,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Aetna,Middlesex Employees,,,11.78,,11.78,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Anthem,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Anthem,Indemnity,,,11.93,,11.93,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Anthem,Individual Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Anthem,State Preferred,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Cigna,Cigna,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Connecticare,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Connecticare,Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,Multiplan,Multiplan,,,13.53,,13.53,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0024-1348-03,NDC,both,1,mL,15.92,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Aetna,Commerical,,,12.28,,12.28,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Aetna,Middlesex Employees,,,11.78,,11.78,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Anthem,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Anthem,Indemnity,,,11.93,,11.93,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Anthem,Individual Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Anthem,State Preferred,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Cigna,Cigna,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Connecticare,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Connecticare,Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,Multiplan,Multiplan,,,13.53,,13.53,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,0225-0800-47,NDC,both,1,mL,15.92,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Aetna,Commerical,,,12.28,,12.28,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Aetna,Middlesex Employees,,,11.78,,11.78,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Anthem,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Anthem,Indemnity,,,11.93,,11.93,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Anthem,Individual Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Anthem,State Preferred,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Cigna,Cigna,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Connecticare,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Connecticare,Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,Multiplan,Multiplan,,,13.53,,13.53,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.25 % NASAL SPRAY,J3490,HCPCS,69536-025-15,NDC,both,1,mL,15.92,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Aetna,Commerical,,,12.28,,12.28,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Aetna,Middlesex Employees,,,11.78,,11.78,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Anthem,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Anthem,Indemnity,,,11.93,,11.93,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Anthem,Individual Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Anthem,State Preferred,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Cigna,Cigna,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Connecticare,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Connecticare,Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,Multiplan,Multiplan,,,13.53,,13.53,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0024-1353-01,NDC,both,1,mL,15.92,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Aetna,Commerical,,,12.28,,12.28,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Aetna,Middlesex Employees,,,11.78,,11.78,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Anthem,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Anthem,Indemnity,,,11.93,,11.93,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Anthem,Individual Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Anthem,State Preferred,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Cigna,Cigna,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Connecticare,Commerical,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Connecticare,Exchange,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,Multiplan,Multiplan,,,13.53,,13.53,11.78,13.53,percent of total billed charges,,
PHENYLEPHRINE 0.5 % NASAL SPRAY,J3490,HCPCS,0225-0805-47,NDC,both,1,mL,15.92,9.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.78,13.53,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Aetna,Commerical,,,13.74,,13.74,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Aetna,Middlesex Employees,,,13.18,,13.18,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Anthem,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Anthem,Indemnity,,,13.34,,13.34,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Anthem,Individual Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Anthem,State Preferred,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Cigna,Cigna,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Connecticare,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Connecticare,Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,Multiplan,Multiplan,,,15.14,,15.14,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,0225-0810-47,NDC,both,1,mL,17.81,10.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Aetna,Commerical,,,13.74,,13.74,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Aetna,Middlesex Employees,,,13.18,,13.18,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Anthem,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Anthem,Indemnity,,,13.34,,13.34,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Anthem,Individual Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Anthem,State Preferred,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Cigna,Cigna,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Connecticare,Commerical,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Connecticare,Exchange,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,Multiplan,Multiplan,,,15.14,,15.14,13.18,15.14,percent of total billed charges,,
PHENYLEPHRINE 1 % NASAL SPRAY,J3490,HCPCS,69536-100-15,NDC,both,1,mL,17.81,10.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.18,15.14,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Aetna,Commerical,,,15.22,,15.22,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Aetna,Middlesex Employees,,,14.6,,14.6,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Anthem,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Anthem,Indemnity,,,14.78,,14.78,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Anthem,Individual Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Anthem,State Preferred,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Cigna,Cigna,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Connecticare,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Connecticare,Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,Multiplan,Multiplan,,,16.77,,16.77,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,69374-957-10,NDC,both,10,mL,19.73,11.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Aetna,Commerical,,,15.22,,15.22,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Aetna,Middlesex Employees,,,14.6,,14.6,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Anthem,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Anthem,Indemnity,,,14.78,,14.78,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Anthem,Individual Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Anthem,State Preferred,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Cigna,Cigna,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Connecticare,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Connecticare,Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,Multiplan,Multiplan,,,16.77,,16.77,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,70004-810-12,NDC,both,0.2,mL,19.73,11.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Aetna,Commerical,,,15.22,,15.22,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Aetna,Middlesex Employees,,,14.6,,14.6,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Indemnity,,,14.78,,14.78,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Individual Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Anthem,State Preferred,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Cigna,Cigna,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Connecticare,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Connecticare,Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,Multiplan,Multiplan,,,16.77,,16.77,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9010-1,NDC,both,0.2,mL,19.73,11.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Aetna,Commerical,,,15.22,,15.22,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Aetna,Middlesex Employees,,,14.6,,14.6,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Indemnity,,,14.78,,14.78,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Anthem,Individual Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Anthem,State Preferred,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Cigna,Cigna,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Connecticare,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Connecticare,Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,Multiplan,Multiplan,,,16.77,,16.77,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,71266-9011-1,NDC,both,0.2,mL,19.73,11.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Aetna,Commerical,,,15.22,,15.22,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Aetna,Middlesex Employees,,,14.6,,14.6,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Anthem,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Anthem,Indemnity,,,14.78,,14.78,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Anthem,Individual Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Anthem,State Preferred,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Cigna,Cigna,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Connecticare,Commerical,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Connecticare,Exchange,,,,,,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,Multiplan,Multiplan,,,16.77,,16.77,0.01,16.77,percent of total billed charges,,
PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,J2371,HCPCS,73177-108-03,NDC,both,0.2,mL,19.73,11.84,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,16.77,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Aetna,Commerical,,,113.78,,113.78,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Aetna,Middlesex Employees,,,109.11,,109.11,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Anthem,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Anthem,Indemnity,,,110.46,,110.46,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Anthem,Individual Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Anthem,State Preferred,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Cigna,Cigna,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Connecticare,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Connecticare,Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,Multiplan,Multiplan,,,125.34,,125.34,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,17478-206-05,NDC,both,1,mL,147.46,88.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Aetna,Commerical,,,113.78,,113.78,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Aetna,Middlesex Employees,,,109.11,,109.11,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Anthem,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Anthem,Indemnity,,,110.46,,110.46,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Anthem,Individual Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Anthem,State Preferred,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Cigna,Cigna,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Connecticare,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Connecticare,Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,Multiplan,Multiplan,,,125.34,,125.34,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,42702-103-05,NDC,both,5,mL,147.46,88.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Aetna,Commerical,,,113.78,,113.78,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Aetna,Middlesex Employees,,,109.11,,109.11,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Anthem,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Anthem,Indemnity,,,110.46,,110.46,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Anthem,Individual Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Anthem,State Preferred,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Cigna,Cigna,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Connecticare,Commerical,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Connecticare,Exchange,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,Multiplan,Multiplan,,,125.34,,125.34,109.11,125.34,percent of total billed charges,,
PHENYLEPHRINE 10 % EYE DROPS,J3490,HCPCS,70756-614-30,NDC,both,1,mL,147.46,88.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.11,125.34,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0641-6142-25,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,0781-3458-75,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-01,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,55150-301-10,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,63323-751-00,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-01,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,70069-802-10,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-01,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,71288-807-02,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-01,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Aetna,Commerical,,,21.17,,21.17,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Aetna,Middlesex Employees,,,20.3,,20.3,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Anthem,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Anthem,Indemnity,,,20.56,,20.56,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Anthem,Individual Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Anthem,State Preferred,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Cigna,Cigna,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Connecticare,Commerical,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Connecticare,Exchange,,,,,,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,Multiplan,Multiplan,,,23.32,,23.32,0.01,23.32,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,72485-505-10,NDC,both,2,mL,27.44,16.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,23.32,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-25,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Aetna,Commerical,,,3.53,,3.53,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Aetna,Middlesex Employees,,,3.39,,3.39,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Anthem,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Anthem,Indemnity,,,3.43,,3.43,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Anthem,Individual Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Anthem,State Preferred,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Cigna,Cigna,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Connecticare,Commerical,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Connecticare,Exchange,,,,,,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,Multiplan,Multiplan,,,3.89,,3.89,0.01,3.89,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,76014-004-30,NDC,both,1,mL,4.58,2.75,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,3.89,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Aetna,Commerical,,,7.06,,7.06,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Aetna,Middlesex Employees,,,6.77,,6.77,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Anthem,Commerical,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Anthem,Indemnity,,,6.85,,6.85,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Anthem,Individual Exchange,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Anthem,State Preferred,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Cigna,Cigna,,0.01,,,0.01,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Connecticare,Commerical,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Connecticare,Exchange,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,Multiplan,Multiplan,,,7.78,,7.78,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-00,NDC,both,2,mL,9.15,5.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Aetna,Commerical,,,7.06,,7.06,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Aetna,Middlesex Employees,,,6.77,,6.77,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Anthem,Commerical,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Anthem,Indemnity,,,6.85,,6.85,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Anthem,Individual Exchange,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Anthem,State Preferred,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Cigna,Cigna,,0.01,,,0.01,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Connecticare,Commerical,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Connecticare,Exchange,,,,,,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,Multiplan,Multiplan,,,7.78,,7.78,0.01,7.78,percent of total billed charges,,
PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,J2371,HCPCS,81284-211-25,NDC,both,2,mL,9.15,5.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,7.78,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Aetna,Commerical,,,73.23,,73.23,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Aetna,Middlesex Employees,,,70.22,,70.22,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Anthem,Commerical,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Anthem,Indemnity,,,71.1,,71.1,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Anthem,Individual Exchange,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Anthem,State Preferred,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Cigna,Cigna,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Connecticare,Commerical,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Connecticare,Exchange,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,Multiplan,Multiplan,,,80.67,,80.67,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,69315-323-08,NDC,both,1,mL,94.91,56.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Aetna,Commerical,,,73.23,,73.23,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Aetna,Middlesex Employees,,,70.22,,70.22,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Anthem,Commerical,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Anthem,Indemnity,,,71.1,,71.1,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Anthem,Individual Exchange,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Anthem,State Preferred,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Cigna,Cigna,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Connecticare,Commerical,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Connecticare,Exchange,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,Multiplan,Multiplan,,,80.67,,80.67,70.22,80.67,percent of total billed charges,,
PHENYLEPHRINE 2.5 % EYE DROPS,J3490,HCPCS,70756-629-25,NDC,both,1,mL,94.91,56.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,70.22,80.67,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Aetna,Commerical,,,33.63,,33.63,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Aetna,Middlesex Employees,,,32.24,,32.24,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Anthem,Commerical,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Anthem,Indemnity,,,32.65,,32.65,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Anthem,Individual Exchange,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Anthem,State Preferred,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Cigna,Cigna,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Connecticare,Commerical,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Connecticare,Exchange,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,Multiplan,Multiplan,,,37.04,,37.04,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0071-2214-20,NDC,both,1,mL,43.58,26.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Aetna,Commerical,,,33.63,,33.63,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Aetna,Middlesex Employees,,,32.24,,32.24,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Anthem,Commerical,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Anthem,Indemnity,,,32.65,,32.65,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Anthem,Individual Exchange,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Anthem,State Preferred,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Cigna,Cigna,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Connecticare,Commerical,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Connecticare,Exchange,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,Multiplan,Multiplan,,,37.04,,37.04,32.24,37.04,percent of total billed charges,,
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,51672-4069-1,NDC,both,1,mL,43.58,26.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.24,37.04,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Aetna,Commerical,,,1.38,,1.38,1.32,1.52,percent of total billed charges,,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.52,percent of total billed charges,,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Anthem,Commerical,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Anthem,Indemnity,,,1.34,,1.34,1.32,1.52,percent of total billed charges,,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Anthem,Individual Exchange,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Anthem,State Preferred,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Cigna,Cigna,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Connecticare,Commerical,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Connecticare,Exchange,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,Multiplan,Multiplan,,,1.52,,1.52,1.32,1.52,percent of total billed charges,,
PHENYTOIN 25 MG ORAL CHEW,J3490,HCPCS,40810-0002-45,NDC,both,1,ea,1.79,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.52,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-24,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0071-0007-40,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0378-3850-01,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,0904-7199-07,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Aetna,Commerical,,,1.25,,1.25,1.2,1.38,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Aetna,Middlesex Employees,,,1.2,,1.2,1.2,1.38,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Anthem,Commerical,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Anthem,Indemnity,,,1.21,,1.21,1.2,1.38,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Anthem,Individual Exchange,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Anthem,State Preferred,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Cigna,Cigna,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Connecticare,Commerical,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Connecticare,Exchange,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,Multiplan,Multiplan,,,1.38,,1.38,1.2,1.38,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,51672-4146-1,NDC,both,1,ea,1.62,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.2,1.38,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-25,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
PHENYTOIN 50 MG CHEWABLE TABLET,J3490,HCPCS,60687-156-95,NDC,both,1,ea,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Aetna,Commerical,,,1.86,,1.86,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Aetna,Middlesex Employees,,,1.78,,1.78,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Anthem,Commerical,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Anthem,Indemnity,,,1.81,,1.81,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Anthem,Individual Exchange,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Anthem,State Preferred,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Cigna,Cigna,,0.57,,,0.57,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Connecticare,Commerical,,0.68,,,0.68,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Connecticare,Exchange,,0.68,,,0.68,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,Multiplan,Multiplan,,,2.05,,2.05,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-21,NDC,both,1,mL,2.41,1.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Aetna,Commerical,,,1.86,,1.86,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Aetna,Middlesex Employees,,,1.78,,1.78,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Anthem,Commerical,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Anthem,Indemnity,,,1.81,,1.81,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Anthem,Individual Exchange,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Anthem,State Preferred,,,,,,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Cigna,Cigna,,0.57,,,0.57,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Connecticare,Commerical,,0.68,,,0.68,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Connecticare,Exchange,,0.68,,,0.68,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,Multiplan,Multiplan,,,2.05,,2.05,0.57,2.05,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-0493-25,NDC,both,1,mL,2.41,1.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,2.05,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Aetna,Commerical,,,4.65,,4.65,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Anthem,Commerical,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Anthem,Indemnity,,,4.51,,4.51,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Anthem,Individual Exchange,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Anthem,State Preferred,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Cigna,Cigna,,0.57,,,0.57,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Connecticare,Commerical,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Connecticare,Exchange,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,Multiplan,Multiplan,,,5.12,,5.12,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-10,NDC,both,1,mL,6.02,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Aetna,Commerical,,,4.65,,4.65,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Anthem,Commerical,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Anthem,Indemnity,,,4.51,,4.51,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Anthem,Individual Exchange,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Anthem,State Preferred,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Cigna,Cigna,,0.57,,,0.57,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Connecticare,Commerical,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Connecticare,Exchange,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,Multiplan,Multiplan,,,5.12,,5.12,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-41,NDC,both,1,mL,6.02,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Aetna,Commerical,,,4.65,,4.65,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Anthem,Commerical,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Anthem,Indemnity,,,4.51,,4.51,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Anthem,Individual Exchange,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Anthem,State Preferred,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Cigna,Cigna,,0.57,,,0.57,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Connecticare,Commerical,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Connecticare,Exchange,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,Multiplan,Multiplan,,,5.12,,5.12,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,0641-2555-45,NDC,both,1,mL,6.02,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Aetna,Commerical,,,4.65,,4.65,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Anthem,Commerical,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Anthem,Indemnity,,,4.51,,4.51,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Anthem,Individual Exchange,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Anthem,State Preferred,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Cigna,Cigna,,0.57,,,0.57,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Connecticare,Commerical,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Connecticare,Exchange,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,Multiplan,Multiplan,,,5.12,,5.12,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-05,NDC,both,1,mL,6.02,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Aetna,Commerical,,,4.65,,4.65,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Aetna,Middlesex Employees,,,4.45,,4.45,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Anthem,Commerical,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Anthem,Indemnity,,,4.51,,4.51,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Anthem,Individual Exchange,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Anthem,State Preferred,,,,,,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Cigna,Cigna,,0.57,,,0.57,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Connecticare,Commerical,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Connecticare,Exchange,,0.68,,,0.68,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,Multiplan,Multiplan,,,5.12,,5.12,0.57,5.12,percent of total billed charges,,
PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,J1165,HCPCS,42192-614-30,NDC,both,1,mL,6.02,3.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.61,,,0.61,0.57,5.12,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Aetna,Commerical,,,1.23,,1.23,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Anthem,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Anthem,Indemnity,,,1.2,,1.2,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Anthem,Individual Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Anthem,State Preferred,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Cigna,Cigna,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Connecticare,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Connecticare,Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,Multiplan,Multiplan,,,1.36,,1.36,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,0904-6187-61,NDC,both,1,ea,1.6,0.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Aetna,Commerical,,,1.23,,1.23,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Anthem,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Anthem,Indemnity,,,1.2,,1.2,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Anthem,Individual Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Anthem,State Preferred,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Cigna,Cigna,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Connecticare,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Connecticare,Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,Multiplan,Multiplan,,,1.36,,1.36,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,51079-905-20,NDC,both,1,ea,1.6,0.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Aetna,Commerical,,,1.23,,1.23,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Anthem,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Anthem,Indemnity,,,1.2,,1.2,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Anthem,Individual Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Anthem,State Preferred,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Cigna,Cigna,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Connecticare,Commerical,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Connecticare,Exchange,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,Multiplan,Multiplan,,,1.36,,1.36,1.18,1.36,percent of total billed charges,,
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,J3490,HCPCS,68084-376-01,NDC,both,1,ea,1.6,0.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.36,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Aetna,Commerical,,,1.2,,1.2,1.15,1.33,percent of total billed charges,,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Aetna,Middlesex Employees,,,1.15,,1.15,1.15,1.33,percent of total billed charges,,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Anthem,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Anthem,Indemnity,,,1.17,,1.17,1.15,1.33,percent of total billed charges,,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Anthem,Individual Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Anthem,State Preferred,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Cigna,Cigna,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Connecticare,Commerical,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Connecticare,Exchange,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,Multiplan,Multiplan,,,1.33,,1.33,1.15,1.33,percent of total billed charges,,
PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION,J3490,HCPCS,17478-510-02,NDC,both,1,mL,1.56,0.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.15,1.33,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Anthem,Commerical,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Anthem,Individual Exchange,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Anthem,State Preferred,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Cigna,Cigna,,3.22,,,3.22,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Connecticare,Commerical,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Connecticare,Exchange,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-01,NDC,both,0.5,mL,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Aetna,Commerical,,,10.59,,10.59,3.22,11.67,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Aetna,Middlesex Employees,,,10.16,,10.16,3.22,11.67,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Anthem,Commerical,,,,,,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Anthem,Indemnity,,,10.29,,10.29,3.22,11.67,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Anthem,Individual Exchange,,,,,,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Anthem,State Preferred,,,,,,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Cigna,Cigna,,3.22,,,3.22,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Connecticare,Commerical,,3.83,,,3.83,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Connecticare,Exchange,,3.83,,,3.83,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,Multiplan,Multiplan,,,11.67,,11.67,3.22,11.67,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-31,NDC,both,0.5,mL,13.73,8.24,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,11.67,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Anthem,Commerical,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Anthem,Individual Exchange,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Anthem,State Preferred,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Cigna,Cigna,,3.22,,,3.22,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Connecticare,Commerical,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Connecticare,Exchange,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,0409-9157-50,NDC,both,0.5,mL,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Anthem,Commerical,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Anthem,Individual Exchange,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Anthem,State Preferred,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Cigna,Cigna,,3.22,,,3.22,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Connecticare,Commerical,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Connecticare,Exchange,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-30,NDC,both,0.5,mL,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Aetna,Commerical,,,11.52,,11.52,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Aetna,Middlesex Employees,,,11.05,,11.05,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Anthem,Commerical,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Anthem,Indemnity,,,11.18,,11.18,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Anthem,Individual Exchange,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Anthem,State Preferred,,,,,,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Cigna,Cigna,,3.22,,,3.22,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Connecticare,Commerical,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Connecticare,Exchange,,3.83,,,3.83,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,Multiplan,Multiplan,,,12.69,,12.69,3.22,12.69,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,J3430,HCPCS,69097-709-96,NDC,both,0.5,mL,14.93,8.96,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,12.69,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Aetna,Commerical,,,68.07,,68.07,3.22,74.99,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Aetna,Middlesex Employees,,,65.27,,65.27,3.22,74.99,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Anthem,Commerical,,,,,,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Anthem,Indemnity,,,66.09,,66.09,3.22,74.99,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Anthem,Individual Exchange,,,,,,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Anthem,State Preferred,,,,,,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Cigna,Cigna,,3.22,,,3.22,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Connecticare,Commerical,,3.83,,,3.83,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Connecticare,Exchange,,3.83,,,3.83,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,Multiplan,Multiplan,,,74.99,,74.99,3.22,74.99,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,J3430,HCPCS,76329-1240-1,NDC,both,0.5,mL,88.22,52.93,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,74.99,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Anthem,Commerical,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Anthem,State Preferred,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Cigna,Cigna,,3.22,,,3.22,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Connecticare,Commerical,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Connecticare,Exchange,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-01,NDC,both,0.1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Commerical,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Anthem,State Preferred,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Cigna,Cigna,,3.22,,,3.22,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Connecticare,Commerical,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Connecticare,Exchange,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-11,NDC,both,0.1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Anthem,Commerical,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Anthem,State Preferred,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Cigna,Cigna,,3.22,,,3.22,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Connecticare,Commerical,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Connecticare,Exchange,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,0409-9158-55,NDC,both,0.1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Commerical,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Anthem,State Preferred,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Cigna,Cigna,,3.22,,,3.22,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Connecticare,Commerical,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Connecticare,Exchange,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-11,NDC,both,0.1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Aetna,Commerical,,,72.85,,72.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Aetna,Middlesex Employees,,,69.85,,69.85,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Anthem,Commerical,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Anthem,Indemnity,,,70.72,,70.72,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Anthem,Individual Exchange,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Anthem,State Preferred,,,,,,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Cigna,Cigna,,3.22,,,3.22,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Connecticare,Commerical,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Connecticare,Exchange,,3.83,,,3.83,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,Multiplan,Multiplan,,,80.25,,80.25,3.22,80.25,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,J3430,HCPCS,43598-405-16,NDC,both,0.1,mL,94.41,56.65,United Healthcare/Oxford,United Healthcare/Oxford,,3.48,,,3.48,3.22,80.25,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Aetna,Commerical,,,110.63,,110.63,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Aetna,Middlesex Employees,,,106.09,,106.09,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Anthem,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Anthem,Indemnity,,,107.41,,107.41,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Anthem,Individual Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Anthem,State Preferred,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Cigna,Cigna,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Connecticare,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Connecticare,Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,Multiplan,Multiplan,,,121.87,,121.87,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,0187-1704-05,NDC,both,1,ea,143.38,86.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Aetna,Commerical,,,110.63,,110.63,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Aetna,Middlesex Employees,,,106.09,,106.09,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Anthem,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Anthem,Indemnity,,,107.41,,107.41,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Anthem,Individual Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Anthem,State Preferred,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Cigna,Cigna,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Connecticare,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Connecticare,Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,Multiplan,Multiplan,,,121.87,,121.87,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,40810-0008-81,NDC,both,1,ea,143.38,86.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Aetna,Commerical,,,110.63,,110.63,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Aetna,Middlesex Employees,,,106.09,,106.09,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Anthem,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Anthem,Indemnity,,,107.41,,107.41,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Anthem,Individual Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Anthem,State Preferred,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Cigna,Cigna,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Connecticare,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Connecticare,Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,Multiplan,Multiplan,,,121.87,,121.87,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,69238-1051-3,NDC,both,1,ea,143.38,86.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Aetna,Commerical,,,110.63,,110.63,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Aetna,Middlesex Employees,,,106.09,,106.09,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Anthem,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Anthem,Indemnity,,,107.41,,107.41,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Anthem,Individual Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Anthem,State Preferred,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Cigna,Cigna,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Connecticare,Commerical,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Connecticare,Exchange,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,Multiplan,Multiplan,,,121.87,,121.87,106.09,121.87,percent of total billed charges,,
PHYTONADIONE (VITAMIN K1) 5 MG TABLET,J3490,HCPCS,70710-1014-1,NDC,both,1,ea,143.38,86.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.09,121.87,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Aetna,Commerical,,,919.08,,919.08,881.32,1012.46,percent of total billed charges,,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Aetna,Middlesex Employees,,,881.32,,881.32,881.32,1012.46,percent of total billed charges,,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Anthem,Commerical,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Anthem,Indemnity,,,892.28,,892.28,881.32,1012.46,percent of total billed charges,,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Anthem,Individual Exchange,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Anthem,State Preferred,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Cigna,Cigna,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Connecticare,Commerical,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Connecticare,Exchange,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,Multiplan,Multiplan,,,1012.46,,1012.46,881.32,1012.46,percent of total billed charges,,
PHYTONADIONE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-92,NDC,both,1,mL,1191.13,714.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,881.32,1012.46,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Aetna,Commerical,,,23.09,,23.09,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Aetna,Middlesex Employees,,,22.15,,22.15,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Anthem,Commerical,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Anthem,Indemnity,,,22.42,,22.42,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Anthem,Individual Exchange,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Anthem,State Preferred,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Cigna,Cigna,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Connecticare,Commerical,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Connecticare,Exchange,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,Multiplan,Multiplan,,,25.44,,25.44,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 1.25 MG ORAL TAB,J3490,HCPCS,40810-0002-47,NDC,both,1,ea,29.93,17.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Aetna,Commerical,,,23.09,,23.09,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Aetna,Middlesex Employees,,,22.15,,22.15,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Anthem,Commerical,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Anthem,Indemnity,,,22.42,,22.42,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Anthem,Individual Exchange,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Anthem,State Preferred,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Cigna,Cigna,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Connecticare,Commerical,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Connecticare,Exchange,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,Multiplan,Multiplan,,,25.44,,25.44,22.15,25.44,percent of total billed charges,,
PHYTONADIONE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-46,NDC,both,1,ea,29.93,17.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.15,25.44,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Aetna,Commerical,,,117.43,,117.43,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Aetna,Middlesex Employees,,,112.61,,112.61,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Anthem,Commerical,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Anthem,Indemnity,,,114.01,,114.01,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Anthem,Individual Exchange,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Anthem,State Preferred,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Cigna,Cigna,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Connecticare,Commerical,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Connecticare,Exchange,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,Multiplan,Multiplan,,,129.36,,129.36,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,0998-0203-15,NDC,both,1,mL,152.19,91.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Aetna,Commerical,,,117.43,,117.43,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Aetna,Middlesex Employees,,,112.61,,112.61,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Anthem,Commerical,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Anthem,Indemnity,,,114.01,,114.01,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Anthem,Individual Exchange,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Anthem,State Preferred,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Cigna,Cigna,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Connecticare,Commerical,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Connecticare,Exchange,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,Multiplan,Multiplan,,,129.36,,129.36,112.61,129.36,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,17478-223-12,NDC,both,1,mL,152.19,91.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,112.61,129.36,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Aetna,Commerical,,,219.88,,219.88,210.84,242.22,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Aetna,Middlesex Employees,,,210.84,,210.84,210.84,242.22,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Anthem,Commerical,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Anthem,Indemnity,,,213.46,,213.46,210.84,242.22,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Anthem,Individual Exchange,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Anthem,State Preferred,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Cigna,Cigna,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Connecticare,Commerical,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Connecticare,Exchange,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,Multiplan,Multiplan,,,242.22,,242.22,210.84,242.22,percent of total billed charges,,
PILOCARPINE 1 % EYE DROPS,J3490,HCPCS,61314-203-15,NDC,both,1,mL,284.96,170.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,210.84,242.22,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Aetna,Commerical,,,130.55,,130.55,125.19,143.82,percent of total billed charges,,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Aetna,Middlesex Employees,,,125.19,,125.19,125.19,143.82,percent of total billed charges,,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Anthem,Commerical,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Anthem,Indemnity,,,126.75,,126.75,125.19,143.82,percent of total billed charges,,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Anthem,Individual Exchange,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Anthem,State Preferred,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Cigna,Cigna,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Connecticare,Commerical,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Connecticare,Exchange,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,Multiplan,Multiplan,,,143.82,,143.82,125.19,143.82,percent of total billed charges,,
PILOCARPINE 4 % EYE DROPS,J3490,HCPCS,61314-206-15,NDC,both,15,mL,169.2,101.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,125.19,143.82,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Aetna,Commerical,,,850.67,,850.67,815.72,937.1,percent of total billed charges,,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Aetna,Middlesex Employees,,,815.72,,815.72,815.72,937.1,percent of total billed charges,,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Anthem,Commerical,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Anthem,Indemnity,,,825.86,,825.86,815.72,937.1,percent of total billed charges,,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Anthem,Individual Exchange,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Anthem,State Preferred,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Cigna,Cigna,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Connecticare,Commerical,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Connecticare,Exchange,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,Multiplan,Multiplan,,,937.1,,937.1,815.72,937.1,percent of total billed charges,,
PIMECROLIMUS 1 % TOPICAL CREAM,J3490,HCPCS,0187-5100-01,NDC,both,30,gm,1102.47,661.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,815.72,937.1,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Aetna,Commerical,,,36.84,,36.84,35.33,40.59,percent of total billed charges,,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Aetna,Middlesex Employees,,,35.33,,35.33,35.33,40.59,percent of total billed charges,,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Anthem,Commerical,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Anthem,Indemnity,,,35.77,,35.77,35.33,40.59,percent of total billed charges,,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Anthem,Individual Exchange,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Anthem,State Preferred,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Cigna,Cigna,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Connecticare,Commerical,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Connecticare,Exchange,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,Multiplan,Multiplan,,,40.59,,40.59,35.33,40.59,percent of total billed charges,,
PIOGLITAZONE 15 MG TABLET,J3490,HCPCS,64764-151-04,NDC,both,1,ea,47.75,28.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.33,40.59,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Commerical,,,7.52,,7.52,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Middlesex Employees,,,7.21,,7.21,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Commerical,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Indemnity,,,7.3,,7.3,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Individual Exchange,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Anthem,State Preferred,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Cigna,Cigna,,1.33,,,1.33,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Commerical,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Exchange,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,Multiplan,Multiplan,,,8.28,,8.28,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3110-95,NDC,both,0.5,ea,9.74,5.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Commerical,,,7.52,,7.52,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Middlesex Employees,,,7.21,,7.21,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Commerical,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Indemnity,,,7.3,,7.3,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Individual Exchange,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Anthem,State Preferred,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Cigna,Cigna,,1.33,,,1.33,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Commerical,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Exchange,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,Multiplan,Multiplan,,,8.28,,8.28,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3344-95,NDC,both,0.5,ea,9.74,5.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Aetna,Commerical,,,7.52,,7.52,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Aetna,Middlesex Employees,,,7.21,,7.21,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Anthem,Commerical,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Anthem,Indemnity,,,7.3,,7.3,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Anthem,Individual Exchange,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Anthem,State Preferred,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Cigna,Cigna,,1.33,,,1.33,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Connecticare,Commerical,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Connecticare,Exchange,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,Multiplan,Multiplan,,,8.28,,8.28,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-90,NDC,both,0.5,ea,9.74,5.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Commerical,,,7.52,,7.52,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Aetna,Middlesex Employees,,,7.21,,7.21,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Commerical,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Indemnity,,,7.3,,7.3,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Anthem,Individual Exchange,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Anthem,State Preferred,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Cigna,Cigna,,1.33,,,1.33,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Commerical,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Connecticare,Exchange,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,Multiplan,Multiplan,,,8.28,,8.28,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-9210-95,NDC,both,0.5,ea,9.74,5.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Aetna,Commerical,,,7.52,,7.52,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Aetna,Middlesex Employees,,,7.21,,7.21,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Anthem,Commerical,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Anthem,Indemnity,,,7.3,,7.3,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Anthem,Individual Exchange,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Anthem,State Preferred,,,,,,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Cigna,Cigna,,1.33,,,1.33,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Connecticare,Commerical,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Connecticare,Exchange,,1.68,,,1.68,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,Multiplan,Multiplan,,,8.28,,8.28,1.33,8.28,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-164-30,NDC,both,0.5,ea,9.74,5.84,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,8.28,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Aetna,Commerical,,,21.78,,21.78,1.33,24,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Aetna,Middlesex Employees,,,20.89,,20.89,1.33,24,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Anthem,Commerical,,,,,,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Anthem,Indemnity,,,21.15,,21.15,1.33,24,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Anthem,Individual Exchange,,,,,,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Anthem,State Preferred,,,,,,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Cigna,Cigna,,1.33,,,1.33,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Connecticare,Commerical,,1.68,,,1.68,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Connecticare,Exchange,,1.68,,,1.68,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,Multiplan,Multiplan,,,24,,24,1.33,24,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,55150-119-30,NDC,both,0.5,ea,28.23,16.94,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,24,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Anthem,Commerical,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Anthem,Individual Exchange,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Anthem,State Preferred,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Cigna,Cigna,,1.33,,,1.33,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Connecticare,Commerical,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Connecticare,Exchange,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3113-95,NDC,both,0.334,ea,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Anthem,Commerical,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Anthem,Individual Exchange,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Anthem,State Preferred,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Cigna,Cigna,,1.33,,,1.33,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Connecticare,Commerical,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Connecticare,Exchange,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-01,NDC,both,0.334,ea,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Aetna,Commerical,,,8.96,,8.96,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Aetna,Middlesex Employees,,,8.59,,8.59,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Anthem,Commerical,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Anthem,Indemnity,,,8.7,,8.7,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Anthem,Individual Exchange,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Anthem,State Preferred,,,,,,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Cigna,Cigna,,1.33,,,1.33,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Connecticare,Commerical,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Connecticare,Exchange,,1.68,,,1.68,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,Multiplan,Multiplan,,,9.87,,9.87,1.33,9.87,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,70594-079-02,NDC,both,0.334,ea,11.61,6.97,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,9.87,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3114-95,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-166-48,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-177-50,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-0,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6159-4,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-1,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0130-2,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-05,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-259-45,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-50,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Aetna,Commerical,,,13.26,,13.26,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Aetna,Middlesex Employees,,,12.71,,12.71,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Anthem,Commerical,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Anthem,Indemnity,,,12.87,,12.87,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Anthem,Individual Exchange,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Anthem,State Preferred,,,,,,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Cigna,Cigna,,1.33,,,1.33,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Connecticare,Commerical,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Connecticare,Exchange,,1.68,,,1.68,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,Multiplan,Multiplan,,,14.6,,14.6,1.33,14.6,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,71288-004-51,NDC,both,0.25,ea,17.18,10.31,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,14.6,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,0781-3180-94,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,25021-181-99,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,60505-6262-0,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,61990-0150-1,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-01,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,64679-679-02,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-00,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-24,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Aetna,Commerical,,,126.99,,126.99,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Aetna,Middlesex Employees,,,121.77,,121.77,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Anthem,Commerical,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Anthem,Indemnity,,,123.29,,123.29,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Anthem,Individual Exchange,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Anthem,State Preferred,,,,,,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Cigna,Cigna,,1.33,,,1.33,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Connecticare,Commerical,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Connecticare,Exchange,,1.68,,,1.68,1.33,139.89,Other,Could be inpatient or outpatient,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,Multiplan,Multiplan,,,139.89,,139.89,1.33,139.89,percent of total billed charges,,
PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,J2543,HCPCS,65219-256-28,NDC,both,0.028,ea,164.58,98.75,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,139.89,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Aetna,Commerical,,,584.28,,584.28,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Aetna,Middlesex Employees,,,560.27,,560.27,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Anthem,Commerical,,387.08,,,387.08,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Anthem,Indemnity,,,567.24,,567.24,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Anthem,Individual Exchange,,309.67,,,309.67,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Anthem,State Preferred,,387.08,,,387.08,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Cigna,Cigna,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Connecticare,Commerical,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Connecticare,Exchange,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,Multiplan,Multiplan,,,643.65,,643.65,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-02,NDC,both,0.5,mL,757.23,454.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Aetna,Commerical,,,584.28,,584.28,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Aetna,Middlesex Employees,,,560.27,,560.27,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Anthem,Commerical,,387.08,,,387.08,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Anthem,Indemnity,,,567.24,,567.24,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Anthem,Individual Exchange,,309.67,,,309.67,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Anthem,State Preferred,,387.08,,,387.08,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Cigna,Cigna,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Connecticare,Commerical,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Connecticare,Exchange,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,Multiplan,Multiplan,,,643.65,,643.65,309.67,643.65,percent of total billed charges,,
PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90671,HCPCS,0006-4329-03,NDC,both,0.5,mL,757.23,454.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,309.67,643.65,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Aetna,Commerical,,,737.66,,737.66,363.99,812.61,percent of total billed charges,,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Aetna,Middlesex Employees,,,707.35,,707.35,363.99,812.61,percent of total billed charges,,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Anthem,Commerical,,454.99,,,454.99,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Anthem,Indemnity,,,716.15,,716.15,363.99,812.61,percent of total billed charges,,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Anthem,Individual Exchange,,363.99,,,363.99,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Anthem,State Preferred,,454.99,,,454.99,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Cigna,Cigna,,,,,,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Connecticare,Commerical,,,,,,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Connecticare,Exchange,,,,,,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,Multiplan,Multiplan,,,812.61,,812.61,363.99,812.61,percent of total billed charges,,
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,90677,HCPCS,0005-2000-01,NDC,both,0.5,mL,956.01,573.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,363.99,812.61,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Aetna,Commerical,,,17.18,,17.18,16.48,203.76,percent of total billed charges,,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Aetna,Middlesex Employees,,,16.48,,16.48,16.48,203.76,percent of total billed charges,,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Anthem,Commerical,,203.76,,,203.76,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Anthem,Indemnity,,,16.68,,16.68,16.48,203.76,percent of total billed charges,,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Anthem,Individual Exchange,,163,,,163,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Anthem,State Preferred,,203.76,,,203.76,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Cigna,Cigna,,,,,,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Connecticare,Commerical,,,,,,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Connecticare,Exchange,,,,,,16.48,203.76,Other,Could be inpatient or outpatient,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,Multiplan,Multiplan,,,18.93,,18.93,16.48,203.76,percent of total billed charges,,
PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION,90732,HCPCS,0006-4943-00,NDC,both,0.5,mL,22.27,13.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.48,203.76,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Aetna,Commerical,,,278.74,,278.74,267.29,307.06,percent of total billed charges,,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Aetna,Middlesex Employees,,,267.29,,267.29,267.29,307.06,percent of total billed charges,,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Anthem,Commerical,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Anthem,Indemnity,,,270.61,,270.61,267.29,307.06,percent of total billed charges,,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Anthem,Individual Exchange,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Anthem,State Preferred,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Cigna,Cigna,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Connecticare,Commerical,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Connecticare,Exchange,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,Multiplan,Multiplan,,,307.06,,307.06,267.29,307.06,percent of total billed charges,,
PODOPHYLLUM RESIN 25 % TOPICAL LIQUID,J3490,HCPCS,0574-0601-15,NDC,both,15,mL,361.25,216.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,267.29,307.06,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Aetna,Commerical,,,1127.79,,1127.79,52.08,1242.38,percent of total billed charges,,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Aetna,Middlesex Employees,,,1081.45,,1081.45,52.08,1242.38,percent of total billed charges,,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Anthem,Commerical,,65.09,,,65.09,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Anthem,Indemnity,,,1094.9,,1094.9,52.08,1242.38,percent of total billed charges,,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Anthem,Individual Exchange,,52.08,,,52.08,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Anthem,State Preferred,,65.09,,,65.09,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Cigna,Cigna,,,,,,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Connecticare,Commerical,,,,,,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Connecticare,Exchange,,,,,,52.08,1242.38,Other,Could be inpatient or outpatient,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,Multiplan,Multiplan,,,1242.38,,1242.38,52.08,1242.38,percent of total billed charges,,
POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION,90713,HCPCS,49281-860-10,NDC,both,0.5,mL,1461.62,876.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,52.08,1242.38,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-26,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-76,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-81,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,0904-6931-86,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-00,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Aetna,Commerical,,,4.14,,4.14,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Aetna,Middlesex Employees,,,3.97,,3.97,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Anthem,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Anthem,Indemnity,,,4.02,,4.02,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Anthem,Individual Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Anthem,State Preferred,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Cigna,Cigna,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Connecticare,Commerical,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Connecticare,Exchange,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,Multiplan,Multiplan,,,4.56,,4.56,3.97,4.56,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,J3490,HCPCS,45802-868-66,NDC,both,1,ea,5.37,3.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.97,4.56,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Aetna,Commerical,,,26.03,,26.03,24.96,28.67,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Aetna,Middlesex Employees,,,24.96,,24.96,24.96,28.67,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Anthem,Commerical,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Anthem,Indemnity,,,25.27,,25.27,24.96,28.67,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Anthem,Individual Exchange,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Anthem,State Preferred,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Cigna,Cigna,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Connecticare,Commerical,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Connecticare,Exchange,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,Multiplan,Multiplan,,,28.67,,28.67,24.96,28.67,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,4110082073,NDC,both,1,gm,33.73,20.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.96,28.67,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Aetna,Commerical,,,20.4,,20.4,19.56,22.47,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Aetna,Middlesex Employees,,,19.56,,19.56,19.56,22.47,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Anthem,Commerical,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Anthem,Indemnity,,,19.81,,19.81,19.56,22.47,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Anthem,Individual Exchange,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Anthem,State Preferred,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Cigna,Cigna,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Connecticare,Commerical,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Connecticare,Exchange,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,Multiplan,Multiplan,,,22.47,,22.47,19.56,22.47,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,0536-1052-24,NDC,both,1,gm,26.44,15.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.56,22.47,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Aetna,Commerical,,,16.18,,16.18,15.52,17.82,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Aetna,Middlesex Employees,,,15.52,,15.52,15.52,17.82,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Anthem,Commerical,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Anthem,Indemnity,,,15.71,,15.71,15.52,17.82,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Anthem,Individual Exchange,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Anthem,State Preferred,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Cigna,Cigna,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Connecticare,Commerical,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Connecticare,Exchange,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,Multiplan,Multiplan,,,17.82,,17.82,15.52,17.82,percent of total billed charges,,
POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,J3490,HCPCS,57896-489-14,NDC,both,17,gm,20.97,12.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.52,17.82,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Aetna,Commerical,,,18.36,,18.36,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Aetna,Middlesex Employees,,,17.6,,17.6,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Anthem,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Anthem,Indemnity,,,17.82,,17.82,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Anthem,Individual Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Anthem,State Preferred,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Cigna,Cigna,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Connecticare,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Connecticare,Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,Multiplan,Multiplan,,,20.22,,20.22,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,0023-7824-10,NDC,both,1,mL,23.79,14.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Aetna,Commerical,,,18.36,,18.36,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Aetna,Middlesex Employees,,,17.6,,17.6,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Anthem,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Anthem,Indemnity,,,17.82,,17.82,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Anthem,Individual Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Anthem,State Preferred,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Cigna,Cigna,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Connecticare,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Connecticare,Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,Multiplan,Multiplan,,,20.22,,20.22,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,17478-703-11,NDC,both,10,mL,23.79,14.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Aetna,Commerical,,,18.36,,18.36,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Aetna,Middlesex Employees,,,17.6,,17.6,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Anthem,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Anthem,Indemnity,,,17.82,,17.82,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Anthem,Individual Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Anthem,State Preferred,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Cigna,Cigna,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Connecticare,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Connecticare,Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,Multiplan,Multiplan,,,20.22,,20.22,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,24208-315-10,NDC,both,1,mL,23.79,14.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Aetna,Commerical,,,18.36,,18.36,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Aetna,Middlesex Employees,,,17.6,,17.6,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Anthem,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Anthem,Indemnity,,,17.82,,17.82,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Anthem,Individual Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Anthem,State Preferred,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Cigna,Cigna,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Connecticare,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Connecticare,Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,Multiplan,Multiplan,,,20.22,,20.22,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,60758-908-10,NDC,both,1,mL,23.79,14.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Aetna,Commerical,,,18.36,,18.36,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Aetna,Middlesex Employees,,,17.6,,17.6,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Anthem,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Anthem,Indemnity,,,17.82,,17.82,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Anthem,Individual Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Anthem,State Preferred,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Cigna,Cigna,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Connecticare,Commerical,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Connecticare,Exchange,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,Multiplan,Multiplan,,,20.22,,20.22,17.6,20.22,percent of total billed charges,,
"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",J3490,HCPCS,61314-628-10,NDC,both,1,mL,23.79,14.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.6,20.22,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Aetna,Commerical,,,32.01,,32.01,30.69,35.26,percent of total billed charges,,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Aetna,Middlesex Employees,,,30.69,,30.69,30.69,35.26,percent of total billed charges,,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Anthem,Commerical,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Anthem,Indemnity,,,31.07,,31.07,30.69,35.26,percent of total billed charges,,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Anthem,Individual Exchange,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Anthem,State Preferred,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Cigna,Cigna,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Connecticare,Commerical,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Connecticare,Exchange,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,Multiplan,Multiplan,,,35.26,,35.26,30.69,35.26,percent of total billed charges,,
"POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION",J3490,HCPCS,70594-049-01,NDC,both,1,ea,41.48,24.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.69,35.26,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120311,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,J3490,HCPCS,5199120399,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Aetna,Commerical,,,1925,,1925,1845.91,2120.59,percent of total billed charges,,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Aetna,Middlesex Employees,,,1845.91,,1845.91,1845.91,2120.59,percent of total billed charges,,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Anthem,Commerical,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Anthem,Indemnity,,,1868.86,,1868.86,1845.91,2120.59,percent of total billed charges,,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Anthem,Individual Exchange,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Anthem,State Preferred,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Cigna,Cigna,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Connecticare,Commerical,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Connecticare,Exchange,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,Multiplan,Multiplan,,,2120.59,,2120.59,1845.91,2120.59,percent of total billed charges,,
PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,J3490,HCPCS,10122-510-01,NDC,both,1,mL,2494.81,1496.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1845.91,2120.59,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
POSACONAZOLE 100 MG TABLET FOR SUSPENSION PREP,J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,0085-4324-02,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET, DELAYED RELEASE FIRST ORDER",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,0254-2045-02,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,40810-0019-10,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Commerical,,,21.33,,21.33,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Aetna,Middlesex Employees,,,20.46,,20.46,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Indemnity,,,20.71,,20.71,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,Individual Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Anthem,State Preferred,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Cigna,Cigna,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Commerical,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Connecticare,Exchange,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,Multiplan,Multiplan,,,23.5,,23.5,20.46,23.5,percent of total billed charges,,
"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",J3490,HCPCS,70748-258-07,NDC,both,1,ea,27.65,16.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.46,23.5,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Aetna,Commerical,,,1535.75,,1535.75,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Aetna,Middlesex Employees,,,1472.66,,1472.66,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Indemnity,,,1490.97,,1490.97,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Individual Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Anthem,State Preferred,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Cigna,Cigna,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Connecticare,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Connecticare,Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,Multiplan,Multiplan,,,1691.8,,1691.8,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0085-4331-01,NDC,both,1,mL,1990.35,1194.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Aetna,Commerical,,,1535.75,,1535.75,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Aetna,Middlesex Employees,,,1472.66,,1472.66,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Indemnity,,,1490.97,,1490.97,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Anthem,Individual Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Anthem,State Preferred,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Cigna,Cigna,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Connecticare,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Connecticare,Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,Multiplan,Multiplan,,,1691.8,,1691.8,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,42023-195-01,NDC,both,1,mL,1990.35,1194.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Aetna,Commerical,,,1535.75,,1535.75,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Aetna,Middlesex Employees,,,1472.66,,1472.66,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Anthem,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Anthem,Indemnity,,,1490.97,,1490.97,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Anthem,Individual Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Anthem,State Preferred,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Cigna,Cigna,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Connecticare,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Connecticare,Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,Multiplan,Multiplan,,,1691.8,,1691.8,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-685-17,NDC,both,1,mL,1990.35,1194.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Aetna,Commerical,,,1535.75,,1535.75,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Aetna,Middlesex Employees,,,1472.66,,1472.66,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Anthem,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Anthem,Indemnity,,,1490.97,,1490.97,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Anthem,Individual Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Anthem,State Preferred,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Cigna,Cigna,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Connecticare,Commerical,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Connecticare,Exchange,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,Multiplan,Multiplan,,,1691.8,,1691.8,1472.66,1691.8,percent of total billed charges,,
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-665-20,NDC,both,1,mL,1990.35,1194.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1472.66,1691.8,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Aetna,Commerical,,,32.15,,32.15,30.83,35.42,percent of total billed charges,,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Aetna,Middlesex Employees,,,30.83,,30.83,30.83,35.42,percent of total billed charges,,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Anthem,Commerical,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Anthem,Indemnity,,,31.21,,31.21,30.83,35.42,percent of total billed charges,,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Anthem,Individual Exchange,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Anthem,State Preferred,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Cigna,Cigna,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Connecticare,Commerical,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Connecticare,Exchange,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,Multiplan,Multiplan,,,35.42,,35.42,30.83,35.42,percent of total billed charges,,
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,J3490,HCPCS,121067716,NDC,both,1,mL,41.67,25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.83,35.42,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Aetna,Commerical,,,21.43,,21.43,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Aetna,Middlesex Employees,,,20.55,,20.55,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Anthem,Commerical,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Anthem,Indemnity,,,20.8,,20.8,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Anthem,Individual Exchange,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Anthem,State Preferred,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Cigna,Cigna,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Connecticare,Commerical,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Connecticare,Exchange,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,Multiplan,Multiplan,,,23.6,,23.6,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-15,NDC,both,1,mL,27.77,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Aetna,Commerical,,,28.97,,28.97,27.78,31.91,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Aetna,Middlesex Employees,,,27.78,,27.78,27.78,31.91,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Anthem,Commerical,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Anthem,Indemnity,,,28.12,,28.12,27.78,31.91,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Anthem,Individual Exchange,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Anthem,State Preferred,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Cigna,Cigna,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Connecticare,Commerical,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Connecticare,Exchange,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,Multiplan,Multiplan,,,31.91,,31.91,27.78,31.91,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-25,NDC,both,1,mL,37.54,22.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.78,31.91,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-51,NDC,both,1,mL,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Aetna,Commerical,,,21.43,,21.43,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Aetna,Middlesex Employees,,,20.55,,20.55,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Anthem,Commerical,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Anthem,Indemnity,,,20.8,,20.8,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Anthem,Individual Exchange,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Anthem,State Preferred,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Cigna,Cigna,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Connecticare,Commerical,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Connecticare,Exchange,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,Multiplan,Multiplan,,,23.6,,23.6,20.55,23.6,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3294-61,NDC,both,1,mL,27.77,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.55,23.6,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Aetna,Commerical,,,8.57,,8.57,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Aetna,Middlesex Employees,,,8.22,,8.22,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Indemnity,,,8.32,,8.32,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Individual Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,State Preferred,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Cigna,Cigna,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Connecticare,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Connecticare,Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Multiplan,Multiplan,,,9.44,,9.44,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Aetna,Commerical,,,8.57,,8.57,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Aetna,Middlesex Employees,,,8.22,,8.22,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Anthem,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Anthem,Indemnity,,,8.32,,8.32,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Anthem,Individual Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Anthem,State Preferred,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Cigna,Cigna,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Connecticare,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Connecticare,Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,Multiplan,Multiplan,,,9.44,,9.44,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-8183-15,NDC,both,1,mL,11.11,6.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Aetna,Commerical,,,8.57,,8.57,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Aetna,Middlesex Employees,,,8.22,,8.22,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Indemnity,,,8.32,,8.32,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Individual Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,State Preferred,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Cigna,Cigna,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Connecticare,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Connecticare,Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Multiplan,Multiplan,,,9.44,,9.44,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Aetna,Commerical,,,8.57,,8.57,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Aetna,Middlesex Employees,,,8.22,,8.22,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Indemnity,,,8.32,,8.32,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,Individual Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Anthem,State Preferred,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Cigna,Cigna,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Connecticare,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Connecticare,Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,Multiplan,Multiplan,,,9.44,,9.44,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-8183-01,NDC,both,1,mL,11.11,6.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Aetna,Commerical,,,8.57,,8.57,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Aetna,Middlesex Employees,,,8.22,,8.22,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Indemnity,,,8.32,,8.32,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,Individual Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Anthem,State Preferred,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Cigna,Cigna,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Connecticare,Commerical,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Connecticare,Exchange,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,Multiplan,Multiplan,,,9.44,,9.44,8.22,9.44,percent of total billed charges,,
POTASSIUM ACETATE 2 MEQ/ML ORAL SOLN,J3490,HCPCS,51754-2001-4,NDC,both,1,mL,11.11,6.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.22,9.44,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) GRANULES,J3490,HCPCS,5155203245,NDC,both,1,gm,103.41,62.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Aetna,Commerical,,,39.9,,39.9,38.26,43.95,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Aetna,Middlesex Employees,,,38.26,,38.26,38.26,43.95,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Anthem,Commerical,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Anthem,Indemnity,,,38.74,,38.74,38.26,43.95,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Anthem,Individual Exchange,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Anthem,State Preferred,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Cigna,Cigna,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Connecticare,Commerical,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Connecticare,Exchange,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,Multiplan,Multiplan,,,43.95,,43.95,38.26,43.95,percent of total billed charges,,
POTASSIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0587-8,NDC,both,1,gm,51.71,31.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Anthem,Commerical,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Cigna,Cigna,,0.12,,,0.12,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Connecticare,Commerical,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Connecticare,Exchange,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7993-09,NDC,both,200,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Anthem,Commerical,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Cigna,Cigna,,0.12,,,0.12,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Connecticare,Commerical,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Connecticare,Exchange,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,65219-142-02,NDC,both,200,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Aetna,Commerical,,,8.72,,8.72,8.36,9.61,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Aetna,Middlesex Employees,,,8.36,,8.36,8.36,9.61,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Anthem,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Anthem,Indemnity,,,8.46,,8.46,8.36,9.61,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Anthem,Individual Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Anthem,State Preferred,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Cigna,Cigna,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Connecticare,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Connecticare,Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,Multiplan,Multiplan,,,9.61,,9.61,8.36,9.61,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6651-06,NDC,both,1,mL,11.3,6.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Aetna,Commerical,,,17.44,,17.44,16.72,19.21,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Aetna,Middlesex Employees,,,16.72,,16.72,16.72,19.21,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Anthem,Commerical,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Anthem,Indemnity,,,16.93,,16.93,16.72,19.21,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Anthem,Individual Exchange,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Anthem,State Preferred,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Cigna,Cigna,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Connecticare,Commerical,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Connecticare,Exchange,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,Multiplan,Multiplan,,,19.21,,19.21,16.72,19.21,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML FOR ORAL USE,J3490,HCPCS,0409-6653-05,NDC,both,1,mL,22.6,13.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.72,19.21,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Anthem,Commerical,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Cigna,Cigna,,0.12,,,0.12,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Connecticare,Commerical,,0.16,,,0.16,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Connecticare,Exchange,,0.16,,,0.16,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6635-01,NDC,both,1,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Anthem,Commerical,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Cigna,Cigna,,0.12,,,0.12,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Connecticare,Commerical,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Connecticare,Exchange,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6651-06,NDC,both,1,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Aetna,Commerical,,,11.41,,11.41,0.12,12.57,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Aetna,Middlesex Employees,,,10.94,,10.94,0.12,12.57,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Anthem,Commerical,,,,,,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Anthem,Indemnity,,,11.08,,11.08,0.12,12.57,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Anthem,Individual Exchange,,,,,,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Anthem,State Preferred,,,,,,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Cigna,Cigna,,0.12,,,0.12,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Connecticare,Commerical,,0.16,,,0.16,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Connecticare,Exchange,,0.16,,,0.16,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,Multiplan,Multiplan,,,12.57,,12.57,0.12,12.57,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,0409-6653-05,NDC,both,1,mL,14.79,8.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,12.57,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Aetna,Commerical,,,2.85,,2.85,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Aetna,Middlesex Employees,,,2.74,,2.74,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Anthem,Commerical,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Anthem,Indemnity,,,2.77,,2.77,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Anthem,Individual Exchange,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Anthem,State Preferred,,,,,,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Cigna,Cigna,,0.12,,,0.12,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Connecticare,Commerical,,0.16,,,0.16,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Connecticare,Exchange,,0.16,,,0.16,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,Multiplan,Multiplan,,,3.15,,3.15,0.12,3.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-01,NDC,both,1,mL,3.7,2.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Anthem,Commerical,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Cigna,Cigna,,0.12,,,0.12,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Connecticare,Commerical,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Connecticare,Exchange,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-03,NDC,both,1,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Aetna,Commerical,,,3.76,,3.76,0.12,4.14,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Aetna,Middlesex Employees,,,3.6,,3.6,0.12,4.14,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Anthem,Commerical,,,,,,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Anthem,Indemnity,,,3.65,,3.65,0.12,4.14,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Anthem,Individual Exchange,,,,,,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Anthem,State Preferred,,,,,,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Cigna,Cigna,,0.12,,,0.12,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Connecticare,Commerical,,0.16,,,0.16,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Connecticare,Exchange,,0.16,,,0.16,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,Multiplan,Multiplan,,,4.14,,4.14,0.12,4.14,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-05,NDC,both,1,mL,4.87,2.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,4.14,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Aetna,Commerical,,,5.71,,5.71,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Aetna,Middlesex Employees,,,5.48,,5.48,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Anthem,Commerical,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Anthem,Indemnity,,,5.54,,5.54,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Anthem,Individual Exchange,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Anthem,State Preferred,,,,,,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Cigna,Cigna,,0.12,,,0.12,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Connecticare,Commerical,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Connecticare,Exchange,,0.16,,,0.16,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,Multiplan,Multiplan,,,6.29,,6.29,0.12,6.29,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-10,NDC,both,1,mL,7.4,4.44,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.29,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Aetna,Commerical,,,4.68,,4.68,0.12,5.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Aetna,Middlesex Employees,,,4.48,,4.48,0.12,5.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Anthem,Commerical,,,,,,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Anthem,Indemnity,,,4.54,,4.54,0.12,5.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Anthem,Individual Exchange,,,,,,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Anthem,State Preferred,,,,,,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Cigna,Cigna,,0.12,,,0.12,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Connecticare,Commerical,,0.16,,,0.16,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Connecticare,Exchange,,0.16,,,0.16,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,Multiplan,Multiplan,,,5.15,,5.15,0.12,5.15,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-965-20,NDC,both,1,mL,6.06,3.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,5.15,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Aetna,Commerical,,,17.11,,17.11,0.12,18.85,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Aetna,Middlesex Employees,,,16.41,,16.41,0.12,18.85,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Anthem,Commerical,,,,,,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Anthem,Indemnity,,,16.62,,16.62,0.12,18.85,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Anthem,Individual Exchange,,,,,,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Anthem,State Preferred,,,,,,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Cigna,Cigna,,0.12,,,0.12,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Connecticare,Commerical,,0.16,,,0.16,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Connecticare,Exchange,,0.16,,,0.16,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,Multiplan,Multiplan,,,18.85,,18.85,0.12,18.85,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,J3480,HCPCS,63323-967-30,NDC,both,1,mL,22.18,13.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,18.85,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.12,0.39,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.12,0.39,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Anthem,Commerical,,,,,,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.12,0.39,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Anthem,Individual Exchange,,,,,,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Anthem,State Preferred,,,,,,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Cigna,Cigna,,0.12,,,0.12,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Connecticare,Commerical,,0.16,,,0.16,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Connecticare,Exchange,,0.16,,,0.16,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.12,0.39,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0011-91,NDC,both,1,mL,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,0.39,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Anthem,Commerical,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Cigna,Cigna,,0.12,,,0.12,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Connecticare,Commerical,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Connecticare,Exchange,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN FOR FEEDS,J3480,HCPCS,40810-0201-69,NDC,both,1,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,0.12,1.31,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,0.12,1.31,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Anthem,Commerical,,,,,,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,0.12,1.31,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Anthem,State Preferred,,,,,,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Cigna,Cigna,,0.12,,,0.12,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Connecticare,Commerical,,0.16,,,0.16,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Connecticare,Exchange,,0.16,,,0.16,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,0.12,1.31,percent of total billed charges,,
POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLN-NICU,J3480,HCPCS,40810-0019-40,NDC,both,1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,1.31,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-30,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0245-0360-89,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,0603-1554-16,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,54288-125-30,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-1,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,60219-1617-3,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-1,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69238-1617-3,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Aetna,Commerical,,,2.56,,2.56,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Aetna,Middlesex Employees,,,2.46,,2.46,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Anthem,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Anthem,Indemnity,,,2.49,,2.49,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Anthem,Individual Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Anthem,State Preferred,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Cigna,Cigna,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Connecticare,Commerical,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Connecticare,Exchange,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,Multiplan,Multiplan,,,2.82,,2.82,2.46,2.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,J3490,HCPCS,69543-451-01,NDC,both,1,ea,3.32,1.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.46,2.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0338-0705-48,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,0990-7075-26,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-10,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,14789-108-16,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-00,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Anthem,Commerical,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Cigna,Cigna,,0.12,,,0.12,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Connecticare,Commerical,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Connecticare,Exchange,,0.16,,,0.16,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.12,7.82,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,J3480,HCPCS,65219-006-01,NDC,both,10,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,7.82,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Aetna,Commerical,,,90.86,,90.86,87.13,100.1,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Aetna,Middlesex Employees,,,87.13,,87.13,87.13,100.1,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Anthem,Commerical,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Anthem,Indemnity,,,88.21,,88.21,87.13,100.1,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Anthem,Individual Exchange,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Anthem,State Preferred,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Cigna,Cigna,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Connecticare,Commerical,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Connecticare,Exchange,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,Multiplan,Multiplan,,,100.1,,100.1,87.13,100.1,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,J3490,HCPCS,0603-1542-58,NDC,both,1,mL,117.76,70.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.13,100.1,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Aetna,Commerical,,,20.69,,20.69,0.12,22.79,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Aetna,Middlesex Employees,,,19.84,,19.84,0.12,22.79,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Anthem,Commerical,,,,,,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Anthem,Indemnity,,,20.08,,20.08,0.12,22.79,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Anthem,Individual Exchange,,,,,,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Anthem,State Preferred,,,,,,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Cigna,Cigna,,0.12,,,0.12,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Connecticare,Commerical,,0.16,,,0.16,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Connecticare,Exchange,,0.16,,,0.16,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,Multiplan,Multiplan,,,22.79,,22.79,0.12,22.79,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,J3480,HCPCS,0338-0704-34,NDC,both,100,mL,26.81,16.09,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,22.79,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Anthem,Commerical,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Anthem,State Preferred,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Cigna,Cigna,,0.12,,,0.12,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Connecticare,Commerical,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Connecticare,Exchange,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0264-7652-00,NDC,both,100,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Anthem,Commerical,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Anthem,State Preferred,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Cigna,Cigna,,0.12,,,0.12,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Connecticare,Commerical,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Connecticare,Exchange,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0338-0803-04,NDC,both,100,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Anthem,Commerical,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Anthem,State Preferred,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Cigna,Cigna,,0.12,,,0.12,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Connecticare,Commerical,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Connecticare,Exchange,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,J3480,HCPCS,0990-7107-09,NDC,both,100,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Anthem,Commerical,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Cigna,Cigna,,0.12,,,0.12,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Connecticare,Commerical,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Connecticare,Exchange,,0.16,,,0.16,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,0.12,3.26,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,J3480,HCPCS,0409-7901-09,NDC,both,100,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,3.26,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Anthem,Commerical,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Anthem,State Preferred,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Cigna,Cigna,,0.12,,,0.12,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Connecticare,Commerical,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Connecticare,Exchange,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0264-7635-00,NDC,both,100,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Anthem,Commerical,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Anthem,State Preferred,,,,,,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Cigna,Cigna,,0.12,,,0.12,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Connecticare,Commerical,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Connecticare,Exchange,,0.16,,,0.16,0.12,6.51,Other,Could be inpatient or outpatient,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,0.12,6.51,percent of total billed charges,,
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,J3480,HCPCS,0990-7902-09,NDC,both,100,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,0.13,,,0.13,0.12,6.51,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Aetna,Commerical,,,0.7,,0.7,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Anthem,Indemnity,,,0.68,,0.68,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0574-0275-11,NDC,both,1,ea,0.91,0.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Aetna,Commerical,,,0.7,,0.7,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Anthem,Indemnity,,,0.68,,0.68,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",J3490,HCPCS,0904-7216-61,NDC,both,1,ea,0.91,0.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5317-01,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7085-61,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0904-7292-61,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-446-10,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-170-13,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Aetna,Commerical,,,1.05,,1.05,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Anthem,Indemnity,,,1.02,,1.02,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-632-11,NDC,both,1,ea,1.36,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0245-5319-11,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,0832-5325-11,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,63739-447-10,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,66758-190-06,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-09,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Aetna,Commerical,,,1.76,,1.76,1.69,1.94,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Aetna,Middlesex Employees,,,1.69,,1.69,1.69,1.94,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Anthem,Commerical,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Anthem,Indemnity,,,1.71,,1.71,1.69,1.94,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Anthem,Individual Exchange,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Anthem,State Preferred,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Cigna,Cigna,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Connecticare,Commerical,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Connecticare,Exchange,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,Multiplan,Multiplan,,,1.94,,1.94,1.69,1.94,percent of total billed charges,,
"POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",J3490,HCPCS,68084-360-11,NDC,both,1,ea,2.28,1.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.69,1.94,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,0591-2729-01,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,42543-407-01,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68084-850-33,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Aetna,Commerical,,,4.16,,4.16,3.99,4.58,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Aetna,Middlesex Employees,,,3.99,,3.99,3.99,4.58,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Anthem,Commerical,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Anthem,Indemnity,,,4.04,,4.04,3.99,4.58,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Anthem,Individual Exchange,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Anthem,State Preferred,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Cigna,Cigna,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Connecticare,Commerical,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Connecticare,Exchange,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,Multiplan,Multiplan,,,4.58,,4.58,3.99,4.58,percent of total billed charges,,
"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",J3490,HCPCS,68382-537-01,NDC,both,1,ea,5.39,3.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.99,4.58,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,121067616,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,5865731216,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Aetna,Commerical,,,18.18,,18.18,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Aetna,Middlesex Employees,,,17.43,,17.43,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Anthem,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Anthem,Indemnity,,,17.65,,17.65,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Anthem,Individual Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Anthem,State Preferred,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Cigna,Cigna,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Connecticare,Commerical,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Connecticare,Exchange,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,Multiplan,Multiplan,,,20.03,,20.03,17.43,20.03,percent of total billed charges,,
"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",J3490,HCPCS,6025800316,NDC,both,1,mL,23.56,14.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.43,20.03,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Aetna,Commerical,,,850.84,,850.84,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Aetna,Middlesex Employees,,,815.89,,815.89,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Anthem,Commerical,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Anthem,Indemnity,,,826.03,,826.03,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Anthem,Individual Exchange,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Anthem,State Preferred,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Cigna,Cigna,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Connecticare,Commerical,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Connecticare,Exchange,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,Multiplan,Multiplan,,,937.3,,937.3,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,71740-112-30,NDC,both,1,mL,1102.7,661.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Aetna,Commerical,,,850.84,,850.84,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Aetna,Middlesex Employees,,,815.89,,815.89,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Anthem,Commerical,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Anthem,Indemnity,,,826.03,,826.03,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Anthem,Individual Exchange,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Anthem,State Preferred,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Cigna,Cigna,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Connecticare,Commerical,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Connecticare,Exchange,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,Multiplan,Multiplan,,,937.3,,937.3,815.89,937.3,percent of total billed charges,,
POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,J3490,HCPCS,75834-280-30,NDC,both,1,mL,1102.7,661.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,815.89,937.3,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Aetna,Commerical,,,400.32,,400.32,383.87,441,percent of total billed charges,,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Aetna,Middlesex Employees,,,383.87,,383.87,383.87,441,percent of total billed charges,,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Anthem,Commerical,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Anthem,Indemnity,,,388.65,,388.65,383.87,441,percent of total billed charges,,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Anthem,Individual Exchange,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Anthem,State Preferred,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Cigna,Cigna,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Connecticare,Commerical,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Connecticare,Exchange,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,Multiplan,Multiplan,,,441,,441,383.87,441,percent of total billed charges,,
POTASSIUM IODIDE 1000 MCG/ML ORAL SOLUTION,J3490,HCPCS,40810-0206-24,NDC,both,1,mL,518.82,311.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,383.87,441,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Aetna,Commerical,,,55.42,,55.42,53.14,61.05,percent of total billed charges,,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Aetna,Middlesex Employees,,,53.14,,53.14,53.14,61.05,percent of total billed charges,,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Anthem,Commerical,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Anthem,Indemnity,,,53.8,,53.8,53.14,61.05,percent of total billed charges,,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Anthem,Individual Exchange,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Anthem,State Preferred,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Cigna,Cigna,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Connecticare,Commerical,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Connecticare,Exchange,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,Multiplan,Multiplan,,,61.05,,61.05,53.14,61.05,percent of total billed charges,,
POTASSIUM IODIDE 65 MG/ML ORAL DROPS,J3490,HCPCS,0178-0314-30,NDC,both,1,mL,71.82,43.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.14,61.05,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-08,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Aetna,Commerical,,,45.47,,45.47,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Aetna,Middlesex Employees,,,43.6,,43.6,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Indemnity,,,44.14,,44.14,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Individual Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,State Preferred,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Cigna,Cigna,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Connecticare,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Connecticare,Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Multiplan,Multiplan,,,50.09,,50.09,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Aetna,Commerical,,,45.47,,45.47,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Aetna,Middlesex Employees,,,43.6,,43.6,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Indemnity,,,44.14,,44.14,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Individual Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,State Preferred,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Cigna,Cigna,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Connecticare,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Connecticare,Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Multiplan,Multiplan,,,50.09,,50.09,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,1.45,1.67,percent of total billed charges,,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,1.45,1.67,percent of total billed charges,,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Anthem,Commerical,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,1.45,1.67,percent of total billed charges,,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Anthem,Individual Exchange,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Anthem,State Preferred,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Cigna,Cigna,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Connecticare,Commerical,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Connecticare,Exchange,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,1.45,1.67,percent of total billed charges,,
"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",J3490,HCPCS,0486-1111-01,NDC,both,1,ea,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.45,1.67,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-086-15,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Aetna,Commerical,,,45.47,,45.47,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Aetna,Middlesex Employees,,,43.6,,43.6,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Indemnity,,,44.14,,44.14,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,Individual Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Anthem,State Preferred,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Cigna,Cigna,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Connecticare,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Connecticare,Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,Multiplan,Multiplan,,,50.09,,50.09,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-09,NDC,both,1,mL,58.93,35.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Aetna,Commerical,,,45.47,,45.47,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Aetna,Middlesex Employees,,,43.6,,43.6,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Indemnity,,,44.14,,44.14,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,Individual Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Anthem,State Preferred,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Cigna,Cigna,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Connecticare,Commerical,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Connecticare,Exchange,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,Multiplan,Multiplan,,,50.09,,50.09,43.6,50.09,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-052-29,NDC,both,1,mL,58.93,35.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.6,50.09,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-09,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Aetna,Commerical,,,136.4,,136.4,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Aetna,Middlesex Employees,,,130.8,,130.8,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Indemnity,,,132.43,,132.43,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,Individual Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Anthem,State Preferred,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Cigna,Cigna,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Connecticare,Commerical,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Connecticare,Exchange,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,Multiplan,Multiplan,,,150.26,,150.26,130.8,150.26,percent of total billed charges,,
POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,65219-054-29,NDC,both,1,mL,176.78,106.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.8,150.26,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,6025800601,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101001,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101012,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,7135101099,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Aetna,Commerical,,,1.06,,1.06,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Aetna,Middlesex Employees,,,1.01,,1.01,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Anthem,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Anthem,Indemnity,,,1.03,,1.03,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Anthem,Individual Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Anthem,State Preferred,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Cigna,Cigna,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Connecticare,Commerical,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Connecticare,Exchange,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,Multiplan,Multiplan,,,1.16,,1.16,1.01,1.16,percent of total billed charges,,
"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",J3490,HCPCS,8068117200,NDC,both,1,ea,1.37,0.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.01,1.16,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Aetna,Commerical,,,300.55,,300.55,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Aetna,Middlesex Employees,,,288.21,,288.21,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Anthem,Commerical,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Anthem,Indemnity,,,291.79,,291.79,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Anthem,Individual Exchange,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Anthem,State Preferred,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Cigna,Cigna,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Connecticare,Commerical,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Connecticare,Exchange,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,Multiplan,Multiplan,,,331.09,,331.09,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,6299130932,NDC,both,1,gm,389.52,233.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Aetna,Commerical,,,300.55,,300.55,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Aetna,Middlesex Employees,,,288.21,,288.21,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Anthem,Commerical,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Anthem,Indemnity,,,291.79,,291.79,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Anthem,Individual Exchange,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Anthem,State Preferred,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Cigna,Cigna,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Connecticare,Commerical,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Connecticare,Exchange,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,Multiplan,Multiplan,,,331.09,,331.09,288.21,331.09,percent of total billed charges,,
POVIDONE (BULK) K-30 POWDER,J3490,HCPCS,51552-1323-5,NDC,both,1,gm,389.52,233.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,288.21,331.09,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Aetna,Commerical,,,27.75,,27.75,26.61,30.57,percent of total billed charges,,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Aetna,Middlesex Employees,,,26.61,,26.61,26.61,30.57,percent of total billed charges,,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Anthem,Commerical,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Anthem,Indemnity,,,26.95,,26.95,26.61,30.57,percent of total billed charges,,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Anthem,Individual Exchange,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Anthem,State Preferred,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Cigna,Cigna,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Connecticare,Commerical,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Connecticare,Exchange,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,Multiplan,Multiplan,,,30.57,,30.57,26.61,30.57,percent of total billed charges,,
POVIDONE-IODINE 5 % EYE SOLUTION,J3490,HCPCS,0065-0411-30,NDC,both,30,mL,35.97,21.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.61,30.57,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Aetna,Commerical,,,246.61,,246.61,99.93,271.67,percent of total billed charges,,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Aetna,Middlesex Employees,,,236.48,,236.48,99.93,271.67,percent of total billed charges,,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Anthem,Commerical,,,,,,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Anthem,Indemnity,,,239.42,,239.42,99.93,271.67,percent of total billed charges,,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Anthem,Individual Exchange,,,,,,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Anthem,State Preferred,,,,,,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Cigna,Cigna,,99.93,,,99.93,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Connecticare,Commerical,,140.33,,,140.33,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Connecticare,Exchange,,140.33,,,140.33,99.93,271.67,Other,Could be inpatient or outpatient,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,Multiplan,Multiplan,,,271.67,,271.67,99.93,271.67,percent of total billed charges,,
PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,J2730,HCPCS,60977-141-01,NDC,both,1,ea,319.61,191.77,United Healthcare/Oxford,United Healthcare/Oxford,,126.93,,,126.93,99.93,271.67,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Aetna,Commerical,,,18.49,,18.49,17.73,20.37,percent of total billed charges,,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Aetna,Middlesex Employees,,,17.73,,17.73,17.73,20.37,percent of total billed charges,,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Anthem,Commerical,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Anthem,Indemnity,,,17.95,,17.95,17.73,20.37,percent of total billed charges,,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Anthem,Individual Exchange,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Anthem,State Preferred,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Cigna,Cigna,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Connecticare,Commerical,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Connecticare,Exchange,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,Multiplan,Multiplan,,,20.37,,20.37,17.73,20.37,percent of total billed charges,,
PRAMOXINE-CALAMINE 1 %-3 % LOTION,J3490,HCPCS,8137003690,NDC,both,118,mL,23.96,14.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.73,20.37,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Aetna,Commerical,,,45.22,,45.22,43.36,49.81,percent of total billed charges,,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Aetna,Middlesex Employees,,,43.36,,43.36,43.36,49.81,percent of total billed charges,,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Anthem,Commerical,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Anthem,Indemnity,,,43.9,,43.9,43.36,49.81,percent of total billed charges,,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Anthem,Individual Exchange,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Anthem,State Preferred,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Cigna,Cigna,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Connecticare,Commerical,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Connecticare,Exchange,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,Multiplan,Multiplan,,,49.81,,49.81,43.36,49.81,percent of total billed charges,,
PRASUGREL 10 MG TABLET,J3490,HCPCS,0002-5123-01,NDC,both,1,ea,58.6,35.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.36,49.81,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Aetna,Commerical,,,1.43,,1.43,1.37,1.57,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Aetna,Middlesex Employees,,,1.37,,1.37,1.37,1.57,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Anthem,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Anthem,Indemnity,,,1.39,,1.39,1.37,1.57,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Anthem,Individual Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Anthem,State Preferred,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Cigna,Cigna,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Connecticare,Commerical,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Connecticare,Exchange,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,Multiplan,Multiplan,,,1.57,,1.57,1.37,1.57,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,0093-0771-98,NDC,both,1,ea,1.85,1.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.37,1.57,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
PRAVASTATIN 10 MG TABLET,J3490,HCPCS,68462-195-90,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Aetna,Commerical,,,1.39,,1.39,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Aetna,Middlesex Employees,,,1.33,,1.33,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Anthem,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Anthem,Indemnity,,,1.35,,1.35,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Anthem,Individual Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Anthem,State Preferred,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Cigna,Cigna,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Connecticare,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Connecticare,Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,Multiplan,Multiplan,,,1.53,,1.53,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,0904-5892-61,NDC,both,1,ea,1.8,1.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Aetna,Commerical,,,1.39,,1.39,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Aetna,Middlesex Employees,,,1.33,,1.33,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Anthem,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Anthem,Indemnity,,,1.35,,1.35,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Anthem,Individual Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Anthem,State Preferred,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Cigna,Cigna,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Connecticare,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Connecticare,Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,Multiplan,Multiplan,,,1.53,,1.53,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-01,NDC,both,1,ea,1.8,1.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Aetna,Commerical,,,1.39,,1.39,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Aetna,Middlesex Employees,,,1.33,,1.33,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Anthem,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Anthem,Indemnity,,,1.35,,1.35,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Anthem,Individual Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Anthem,State Preferred,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Cigna,Cigna,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Connecticare,Commerical,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Connecticare,Exchange,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,Multiplan,Multiplan,,,1.53,,1.53,1.33,1.53,percent of total billed charges,,
PRAVASTATIN 20 MG TABLET,J3490,HCPCS,51079-458-20,NDC,both,1,ea,1.8,1.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.33,1.53,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Aetna,Commerical,,,14.1,,14.1,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Aetna,Middlesex Employees,,,13.53,,13.53,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Anthem,Commerical,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Anthem,Indemnity,,,13.69,,13.69,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Anthem,Individual Exchange,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Anthem,State Preferred,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Cigna,Cigna,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Connecticare,Commerical,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Connecticare,Exchange,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,Multiplan,Multiplan,,,15.54,,15.54,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-01,NDC,both,1,ea,18.28,10.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Aetna,Commerical,,,14.1,,14.1,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Aetna,Middlesex Employees,,,13.53,,13.53,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Anthem,Commerical,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Anthem,Indemnity,,,13.69,,13.69,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Anthem,Individual Exchange,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Anthem,State Preferred,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Cigna,Cigna,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Connecticare,Commerical,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Connecticare,Exchange,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,Multiplan,Multiplan,,,15.54,,15.54,13.53,15.54,percent of total billed charges,,
PRAVASTATIN 40 MG TABLET,J3490,HCPCS,51079-782-20,NDC,both,1,ea,18.28,10.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.53,15.54,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Aetna,Commerical,,,2.9,,2.9,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Aetna,Middlesex Employees,,,2.78,,2.78,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Anthem,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Anthem,Indemnity,,,2.82,,2.82,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Anthem,Individual Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Anthem,State Preferred,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Cigna,Cigna,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Connecticare,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Connecticare,Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0378-1101-01,NDC,both,1,ea,3.76,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Aetna,Commerical,,,2.9,,2.9,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Aetna,Middlesex Employees,,,2.78,,2.78,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Anthem,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Anthem,Indemnity,,,2.82,,2.82,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Anthem,Individual Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Anthem,State Preferred,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Cigna,Cigna,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Connecticare,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Connecticare,Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,0904-7020-61,NDC,both,1,ea,3.76,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Aetna,Commerical,,,2.9,,2.9,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Aetna,Middlesex Employees,,,2.78,,2.78,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Anthem,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Anthem,Indemnity,,,2.82,,2.82,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Anthem,Individual Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Anthem,State Preferred,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Cigna,Cigna,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Connecticare,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Connecticare,Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,40810-0011-13,NDC,both,1,ea,3.76,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Aetna,Commerical,,,2.9,,2.9,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Aetna,Middlesex Employees,,,2.78,,2.78,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Anthem,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Anthem,Indemnity,,,2.82,,2.82,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Anthem,Individual Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Anthem,State Preferred,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Cigna,Cigna,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Connecticare,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Connecticare,Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-630-20,NDC,both,1,ea,3.76,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Aetna,Commerical,,,2.9,,2.9,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Aetna,Middlesex Employees,,,2.78,,2.78,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Anthem,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Anthem,Indemnity,,,2.82,,2.82,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Anthem,Individual Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Anthem,State Preferred,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Cigna,Cigna,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Connecticare,Commerical,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Connecticare,Exchange,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.78,3.2,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-01,NDC,both,1,ea,3.76,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.78,3.2,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Aetna,Commerical,,,4.1,,4.1,3.93,4.51,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Aetna,Middlesex Employees,,,3.93,,3.93,3.93,4.51,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Anthem,Commerical,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Anthem,Indemnity,,,3.98,,3.98,3.93,4.51,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Anthem,Individual Exchange,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Anthem,State Preferred,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Cigna,Cigna,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Connecticare,Commerical,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Connecticare,Exchange,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,Multiplan,Multiplan,,,4.51,,4.51,3.93,4.51,percent of total billed charges,,
PRAZOSIN 1 MG CAPSULE,J3490,HCPCS,68084-996-11,NDC,both,1,ea,5.31,3.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.93,4.51,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Aetna,Commerical,,,369.56,,369.56,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Aetna,Middlesex Employees,,,354.38,,354.38,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Anthem,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Anthem,Indemnity,,,358.78,,358.78,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Anthem,Individual Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Anthem,State Preferred,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Cigna,Cigna,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Connecticare,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Connecticare,Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,Multiplan,Multiplan,,,407.11,,407.11,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,60758-119-05,NDC,both,1,mL,114.25,68.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Aetna,Commerical,,,369.56,,369.56,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Aetna,Middlesex Employees,,,354.38,,354.38,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Anthem,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Anthem,Indemnity,,,358.78,,358.78,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Anthem,Individual Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Anthem,State Preferred,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Cigna,Cigna,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Connecticare,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Connecticare,Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,Multiplan,Multiplan,,,407.11,,407.11,354.38,407.11,percent of total billed charges,,
PREDNISOLONE ACETATE 1 % EYE DROP SUSP FOR NASAL ADMIN,J3490,HCPCS,61314-637-05,NDC,both,1,mL,114.25,68.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Aetna,Commerical,,,369.56,,369.56,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Aetna,Middlesex Employees,,,354.38,,354.38,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Anthem,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Anthem,Indemnity,,,358.78,,358.78,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Anthem,Individual Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Anthem,State Preferred,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Cigna,Cigna,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Connecticare,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Connecticare,Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,Multiplan,Multiplan,,,407.11,,407.11,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-180-05,NDC,both,1,mL,478.95,287.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Aetna,Commerical,,,369.56,,369.56,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Aetna,Middlesex Employees,,,354.38,,354.38,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Anthem,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Anthem,Indemnity,,,358.78,,358.78,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Anthem,Individual Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Anthem,State Preferred,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Cigna,Cigna,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Connecticare,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Connecticare,Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,Multiplan,Multiplan,,,407.11,,407.11,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,60758-119-05,NDC,both,1,mL,478.95,287.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Aetna,Commerical,,,369.56,,369.56,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Aetna,Middlesex Employees,,,354.38,,354.38,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Anthem,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Anthem,Indemnity,,,358.78,,358.78,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Anthem,Individual Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Anthem,State Preferred,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Cigna,Cigna,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Connecticare,Commerical,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Connecticare,Exchange,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,Multiplan,Multiplan,,,407.11,,407.11,354.38,407.11,percent of total billed charges,,
"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",J3490,HCPCS,61314-637-05,NDC,both,1,mL,478.95,287.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.38,407.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Aetna,Commerical,,,0.51,,0.51,0.27,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Aetna,Middlesex Employees,,,0.49,,0.49,0.27,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Anthem,Commerical,,,,,,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Anthem,Indemnity,,,0.49,,0.49,0.27,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Anthem,Individual Exchange,,,,,,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Anthem,State Preferred,,,,,,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Cigna,Cigna,,0.27,,,0.27,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Connecticare,Commerical,,0.59,,,0.59,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Connecticare,Exchange,,0.59,,,0.59,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,Multiplan,Multiplan,,,0.56,,0.56,0.27,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 10 MG/3.35ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-98,NDC,both,3.35,mL,0.66,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Commerical,,,101.45,,101.45,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Middlesex Employees,,,97.28,,97.28,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Commerical,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Indemnity,,,98.49,,98.49,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Individual Exchange,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,State Preferred,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Cigna,Cigna,,0.27,,,0.27,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Commerical,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Exchange,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Multiplan,Multiplan,,,111.76,,111.76,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Commerical,,,101.45,,101.45,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Middlesex Employees,,,97.28,,97.28,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Commerical,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Indemnity,,,98.49,,98.49,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Individual Exchange,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Anthem,State Preferred,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Cigna,Cigna,,0.27,,,0.27,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Commerical,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Exchange,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,Multiplan,Multiplan,,,111.76,,111.76,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,J7510,HCPCS,60432-212-08,NDC,both,1.667,mL,131.48,78.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Aetna,Commerical,,,0.76,,0.76,0.27,0.83,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.27,0.83,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Anthem,Commerical,,,,,,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Anthem,Indemnity,,,0.73,,0.73,0.27,0.83,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Anthem,Individual Exchange,,,,,,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Anthem,State Preferred,,,,,,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Cigna,Cigna,,0.27,,,0.27,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Connecticare,Commerical,,0.59,,,0.59,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Connecticare,Exchange,,0.59,,,0.59,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,Multiplan,Multiplan,,,0.83,,0.83,0.27,0.83,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-99,NDC,both,5,mL,0.98,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.83,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Commerical,,,101.45,,101.45,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Aetna,Middlesex Employees,,,97.28,,97.28,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Commerical,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Indemnity,,,98.49,,98.49,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,Individual Exchange,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Anthem,State Preferred,,,,,,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Cigna,Cigna,,0.27,,,0.27,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Commerical,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Connecticare,Exchange,,0.59,,,0.59,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,Multiplan,Multiplan,,,111.76,,111.76,0.27,111.76,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML ORAL SOLUTION CHEMO,J7510,HCPCS,0121-0759-08,NDC,both,1.667,mL,131.48,78.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,111.76,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.27,1.11,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.27,1.11,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Anthem,Commerical,,,,,,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.27,1.11,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Anthem,Individual Exchange,,,,,,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Anthem,State Preferred,,,,,,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Cigna,Cigna,,0.27,,,0.27,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Connecticare,Commerical,,0.59,,,0.59,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Connecticare,Exchange,,0.59,,,0.59,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.27,1.11,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 20 MG/6.66 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0005-01,NDC,both,6.66,mL,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,1.11,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Aetna,Commerical,,,1.51,,1.51,0.27,1.67,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Aetna,Middlesex Employees,,,1.45,,1.45,0.27,1.67,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Anthem,Commerical,,,,,,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Anthem,Indemnity,,,1.47,,1.47,0.27,1.67,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Anthem,Individual Exchange,,,,,,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Anthem,State Preferred,,,,,,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Cigna,Cigna,,0.27,,,0.27,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Connecticare,Commerical,,0.59,,,0.59,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Connecticare,Exchange,,0.59,,,0.59,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,Multiplan,Multiplan,,,1.67,,1.67,0.27,1.67,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 30 MG/10 ML ORAL SOLUTION SYRINGE ,J7510,HCPCS,40810-0005-02,NDC,both,10,mL,1.96,1.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,1.67,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Cigna,Cigna,,0.27,,,0.27,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Connecticare,Commerical,,0.59,,,0.59,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Connecticare,Exchange,,0.59,,,0.59,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.59,percent of total billed charges,,
PREDNISOLONE SODIUM PHOSPHATE 5 MG/1.67 ML ORAL SOLUTION SYRINGE,J7510,HCPCS,40810-0004-97,NDC,both,1.67,mL,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.24,0.59,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Commerical,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Cigna,Cigna,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Connecticare,Commerical,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Connecticare,Exchange,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Commerical,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Cigna,Cigna,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Connecticare,Commerical,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Connecticare,Exchange,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.01,0.87,percent of total billed charges,,
PREDNISONE 0.5 MG ORAL TAB CHEMO,J7512,HCPCS,40810-0002-51,NDC,both,2,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.87,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59651-484-01,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Aetna,Commerical,,,1.5,,1.5,0.01,1.65,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Aetna,Middlesex Employees,,,1.44,,1.44,0.01,1.65,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Anthem,Commerical,,,,,,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Anthem,Indemnity,,,1.45,,1.45,0.01,1.65,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Anthem,Individual Exchange,,,,,,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Anthem,State Preferred,,,,,,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Cigna,Cigna,,0.01,,,0.01,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Connecticare,Commerical,,0.01,,,0.01,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Connecticare,Exchange,,0.01,,,0.01,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,Multiplan,Multiplan,,,1.65,,1.65,0.01,1.65,percent of total billed charges,,
PREDNISONE 1 MG TABLET,J7512,HCPCS,59746-171-06,NDC,both,1,ea,1.94,1.16,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.65,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET CHEMO,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8739-25,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.63,,0.63,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.61,,0.61,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.7,,0.7,0.01,0.7,percent of total billed charges,,
PREDNISONE 1 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5335-21,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.7,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Anthem,Commerical,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Cigna,Cigna,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Connecticare,Commerical,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Connecticare,Exchange,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET,J7512,HCPCS,40810-0013-73,NDC,both,0.8,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Anthem,Commerical,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Cigna,Cigna,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Connecticare,Commerical,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Connecticare,Exchange,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.01,0.3,percent of total billed charges,,
PREDNISONE 1.25 MG TABLET CHEMO,J7512,HCPCS,40810-0013-74,NDC,both,0.8,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.3,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Aetna,Commerical,,,0.58,,0.58,0.01,0.64,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Aetna,Middlesex Employees,,,0.55,,0.55,0.01,0.64,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Anthem,Commerical,,,,,,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Anthem,Indemnity,,,0.56,,0.56,0.01,0.64,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Anthem,Individual Exchange,,,,,,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Anthem,State Preferred,,,,,,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Cigna,Cigna,,0.01,,,0.01,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Connecticare,Commerical,,0.01,,,0.01,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Connecticare,Exchange,,0.01,,,0.01,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,Multiplan,Multiplan,,,0.64,,0.64,0.01,0.64,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,59746-173-06,NDC,both,0.1,ea,0.75,0.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.64,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-01,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,60687-134-11,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,0904-6923-61,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET CHEMO,J7512,HCPCS,63739-519-10,NDC,both,0.1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Aetna,Commerical,,,0.35,,0.35,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Anthem,Indemnity,,,0.34,,0.34,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Cigna,Cigna,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Connecticare,Commerical,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Connecticare,Exchange,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,Multiplan,Multiplan,,,0.39,,0.39,0.01,0.39,percent of total billed charges,,
PREDNISONE 10 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0017-20,NDC,both,0.1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.39,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Commerical,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Individual Exchange,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,State Preferred,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Cigna,Cigna,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Commerical,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Exchange,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.01,0.65,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.01,0.65,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Anthem,Commerical,,,,,,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.01,0.65,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Cigna,Cigna,,0.01,,,0.01,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Connecticare,Commerical,,0.01,,,0.01,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Connecticare,Exchange,,0.01,,,0.01,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.01,0.65,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET,J7512,HCPCS,0603-5336-21,NDC,both,0.4,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.65,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Commerical,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Individual Exchange,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,State Preferred,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Cigna,Cigna,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Commerical,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Exchange,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET CHEMO,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Commerical,,,0.5,,0.5,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Aetna,Middlesex Employees,,,0.48,,0.48,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Commerical,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Indemnity,,,0.49,,0.49,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,Individual Exchange,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Anthem,State Preferred,,,,,,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Cigna,Cigna,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Commerical,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Connecticare,Exchange,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,Multiplan,Multiplan,,,0.55,,0.55,0.01,0.55,percent of total billed charges,,
PREDNISONE 2.5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8740-25,NDC,both,0.4,ea,0.65,0.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.55,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,0904-7127-61,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,60687-145-01,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET,J7512,HCPCS,63739-588-10,NDC,both,0.05,ea,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET CHEMO,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-20,NDC,both,0.05,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0018-25,NDC,both,0.05,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Aetna,Commerical,,,0.41,,0.41,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.39,,0.39,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Anthem,Commerical,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Anthem,Indemnity,,,0.4,,0.4,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Cigna,Cigna,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Connecticare,Commerical,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Connecticare,Exchange,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,Multiplan,Multiplan,,,0.45,,0.45,0.01,0.45,percent of total billed charges,,
PREDNISONE 20 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0603-5339-21,NDC,both,0.05,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.45,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET CHEMO,J7512,HCPCS,63739-518-10,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-8724-25,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Commerical,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Cigna,Cigna,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Commerical,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Connecticare,Exchange,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.01,0.53,percent of total billed charges,,
PREDNISONE 5 MG TABLET FOR TOPICAL USE,J7512,HCPCS,60687-122-01,NDC,both,0.2,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,0.53,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Aetna,Commerical,,,882.14,,882.14,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Aetna,Middlesex Employees,,,845.9,,845.9,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Commerical,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Indemnity,,,856.42,,856.42,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Individual Exchange,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,State Preferred,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Cigna,Cigna,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Connecticare,Commerical,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Connecticare,Exchange,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Multiplan,Multiplan,,,971.77,,971.77,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLN CHEMO,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Aetna,Commerical,,,66.32,,66.32,0.01,73.06,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Aetna,Middlesex Employees,,,63.59,,63.59,0.01,73.06,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Anthem,Commerical,,,,,,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Anthem,Indemnity,,,64.39,,64.39,0.01,73.06,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Anthem,Individual Exchange,,,,,,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Anthem,State Preferred,,,,,,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Cigna,Cigna,,0.01,,,0.01,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Connecticare,Commerical,,0.01,,,0.01,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Connecticare,Exchange,,0.01,,,0.01,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,Multiplan,Multiplan,,,73.06,,73.06,0.01,73.06,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-50,NDC,both,5,mL,85.95,51.57,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,73.06,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Aetna,Commerical,,,882.14,,882.14,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Aetna,Middlesex Employees,,,845.9,,845.9,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Commerical,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Indemnity,,,856.42,,856.42,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,Individual Exchange,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Anthem,State Preferred,,,,,,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Cigna,Cigna,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Connecticare,Commerical,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Connecticare,Exchange,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,Multiplan,Multiplan,,,971.77,,971.77,0.01,971.77,percent of total billed charges,,
PREDNISONE 5 MG/5 ML ORAL SOLUTION,J7512,HCPCS,0054-3722-63,NDC,both,5,mL,1143.26,685.96,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,971.77,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Commerical,,,0.96,,0.96,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Middlesex Employees,,,0.92,,0.92,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Commerical,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Indemnity,,,0.93,,0.93,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Individual Exchange,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,State Preferred,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Cigna,Cigna,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Commerical,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Exchange,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Aetna,Commerical,,,0.96,,0.96,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Aetna,Middlesex Employees,,,0.92,,0.92,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Anthem,Commerical,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Anthem,Indemnity,,,0.93,,0.93,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Anthem,Individual Exchange,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Anthem,State Preferred,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Cigna,Cigna,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Connecticare,Commerical,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Connecticare,Exchange,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET,J7512,HCPCS,64380-949-06,NDC,both,0.02,ea,1.24,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Commerical,,,0.96,,0.96,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Middlesex Employees,,,0.92,,0.92,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Commerical,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Indemnity,,,0.93,,0.93,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Individual Exchange,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,State Preferred,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Cigna,Cigna,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Commerical,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Exchange,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET CHEMO,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Commerical,,,0.96,,0.96,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Aetna,Middlesex Employees,,,0.92,,0.92,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Commerical,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Indemnity,,,0.93,,0.93,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,Individual Exchange,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Anthem,State Preferred,,,,,,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Cigna,Cigna,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Commerical,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Connecticare,Exchange,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.01,1.05,percent of total billed charges,,
PREDNISONE 50 MG TABLET FOR TOPICAL USE,J7512,HCPCS,0054-0019-20,NDC,both,0.02,ea,1.24,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.01,,,0.01,0.01,1.05,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Aetna,Commerical,,,21.99,,21.99,21.09,24.23,percent of total billed charges,,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Aetna,Middlesex Employees,,,21.09,,21.09,21.09,24.23,percent of total billed charges,,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Anthem,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Anthem,Indemnity,,,21.35,,21.35,21.09,24.23,percent of total billed charges,,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Anthem,Individual Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Anthem,State Preferred,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Cigna,Cigna,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Connecticare,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Connecticare,Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,Multiplan,Multiplan,,,24.23,,24.23,21.09,24.23,percent of total billed charges,,
PREGABALIN 100 MG/5 ML ORAL SOLUTION SYRINGE,J3490,HCPCS,40810-0020-47,NDC,both,1,mL,28.5,17.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Aetna,Commerical,,,1.45,,1.45,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Aetna,Middlesex Employees,,,1.39,,1.39,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Anthem,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Anthem,Indemnity,,,1.41,,1.41,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Anthem,Individual Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Anthem,State Preferred,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Cigna,Cigna,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Connecticare,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Connecticare,Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,Multiplan,Multiplan,,,1.6,,1.6,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0071-1016-41,NDC,both,1,ea,1.88,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Aetna,Commerical,,,1.45,,1.45,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Aetna,Middlesex Employees,,,1.39,,1.39,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Anthem,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Anthem,Indemnity,,,1.41,,1.41,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Anthem,Individual Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Anthem,State Preferred,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Cigna,Cigna,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Connecticare,Commerical,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Connecticare,Exchange,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,Multiplan,Multiplan,,,1.6,,1.6,1.39,1.6,percent of total billed charges,,
PREGABALIN 150 MG CAPSULE,J3490,HCPCS,0904-7002-61,NDC,both,1,ea,1.88,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.39,1.6,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Aetna,Commerical,,,3454.02,,3454.02,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Aetna,Middlesex Employees,,,3312.12,,3312.12,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Anthem,Commerical,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Anthem,Indemnity,,,3353.3,,3353.3,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Anthem,Individual Exchange,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Anthem,State Preferred,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Cigna,Cigna,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Connecticare,Commerical,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Connecticare,Exchange,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,Multiplan,Multiplan,,,3804.97,,3804.97,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,0071-1020-01,NDC,both,1,mL,4476.44,2685.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Aetna,Commerical,,,3454.02,,3454.02,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Aetna,Middlesex Employees,,,3312.12,,3312.12,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Anthem,Commerical,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Anthem,Indemnity,,,3353.3,,3353.3,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Anthem,Individual Exchange,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Anthem,State Preferred,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Cigna,Cigna,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Connecticare,Commerical,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Connecticare,Exchange,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,Multiplan,Multiplan,,,3804.97,,3804.97,3312.12,3804.97,percent of total billed charges,,
PREGABALIN 20 MG/ML ORAL SOLUTION,J3490,HCPCS,67877-457-47,NDC,both,1,mL,4476.44,2685.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3312.12,3804.97,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Aetna,Commerical,,,30.15,,30.15,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Aetna,Middlesex Employees,,,28.92,,28.92,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Anthem,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Anthem,Indemnity,,,29.27,,29.27,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Anthem,Individual Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Anthem,State Preferred,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Cigna,Cigna,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Connecticare,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Connecticare,Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,Multiplan,Multiplan,,,33.22,,33.22,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0071-1013-41,NDC,both,1,ea,39.08,23.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Aetna,Commerical,,,30.15,,30.15,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Aetna,Middlesex Employees,,,28.92,,28.92,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Anthem,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Anthem,Indemnity,,,29.27,,29.27,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Anthem,Individual Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Anthem,State Preferred,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Cigna,Cigna,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Connecticare,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Connecticare,Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,Multiplan,Multiplan,,,33.22,,33.22,28.92,33.22,percent of total billed charges,,
PREGABALIN 50 MG CAPSULE,J3490,HCPCS,0904-6992-61,NDC,both,1,ea,39.08,23.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Aetna,Commerical,,,30.15,,30.15,28.92,33.22,percent of total billed charges,,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Aetna,Middlesex Employees,,,28.92,,28.92,28.92,33.22,percent of total billed charges,,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Anthem,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Anthem,Indemnity,,,29.27,,29.27,28.92,33.22,percent of total billed charges,,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Anthem,Individual Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Anthem,State Preferred,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Cigna,Cigna,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Connecticare,Commerical,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Connecticare,Exchange,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,Multiplan,Multiplan,,,33.22,,33.22,28.92,33.22,percent of total billed charges,,
PREGABALIN 75 MG CAPSULE,J3490,HCPCS,0071-1014-41,NDC,both,1,ea,39.08,23.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.92,33.22,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,1650055817,NDC,both,1,ea,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Aetna,Commerical,,,1.72,,1.72,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Aetna,Middlesex Employees,,,1.65,,1.65,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Anthem,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Anthem,Indemnity,,,1.67,,1.67,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Anthem,Individual Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Anthem,State Preferred,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Cigna,Cigna,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Connecticare,Commerical,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Connecticare,Exchange,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.65,1.9,percent of total billed charges,,
PRENATAL VIT 168-IRON 27 MG-FOLIC ACID 800 MCG-OMEGA3 235 MG CAPSULE,J3490,HCPCS,40810-0208-34,NDC,both,1,ea,2.23,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.65,1.9,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Aetna,Commerical,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.28,percent of total billed charges,,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Anthem,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Anthem,Indemnity,,,0.25,,0.25,0.24,0.28,percent of total billed charges,,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Anthem,Individual Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Anthem,State Preferred,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Cigna,Cigna,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Connecticare,Commerical,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Connecticare,Exchange,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,Multiplan,Multiplan,,,0.28,,0.28,0.24,0.28,percent of total billed charges,,
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,J3490,HCPCS,761010418,NDC,both,1,ea,0.33,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.28,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Aetna,Commerical,,,4.27,,4.27,4.09,4.7,percent of total billed charges,,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Aetna,Middlesex Employees,,,4.09,,4.09,4.09,4.7,percent of total billed charges,,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Anthem,Commerical,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Anthem,Indemnity,,,4.14,,4.14,4.09,4.7,percent of total billed charges,,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Anthem,Individual Exchange,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Anthem,State Preferred,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Cigna,Cigna,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Connecticare,Commerical,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Connecticare,Exchange,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,Multiplan,Multiplan,,,4.7,,4.7,4.09,4.7,percent of total billed charges,,
PRIMAQUINE 13.15 MG (7.5 MG BASE) TABLET,J3490,HCPCS,40810-0018-18,NDC,both,1,ea,5.53,3.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.09,4.7,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Aetna,Commerical,,,5.83,,5.83,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Anthem,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Anthem,Indemnity,,,5.66,,5.66,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Anthem,Individual Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Anthem,State Preferred,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Cigna,Cigna,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Connecticare,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Connecticare,Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,Multiplan,Multiplan,,,6.42,,6.42,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,0024-1596-01,NDC,both,1,ea,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Aetna,Commerical,,,5.83,,5.83,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Aetna,Middlesex Employees,,,5.59,,5.59,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Anthem,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Anthem,Indemnity,,,5.66,,5.66,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Anthem,Individual Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Anthem,State Preferred,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Cigna,Cigna,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Connecticare,Commerical,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Connecticare,Exchange,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,Multiplan,Multiplan,,,6.42,,6.42,5.59,6.42,percent of total billed charges,,
PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,J3490,HCPCS,40810-0007-77,NDC,both,1,ea,7.55,4.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.59,6.42,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
PRIMIDONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-53,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
PRIMIDONE 25 MG ORAL TAB,J3490,HCPCS,40810-0002-52,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Aetna,Commerical,,,2.01,,2.01,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Anthem,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Anthem,Indemnity,,,1.95,,1.95,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Anthem,Individual Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Anthem,State Preferred,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Cigna,Cigna,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Connecticare,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Connecticare,Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,Multiplan,Multiplan,,,2.21,,2.21,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-01,NDC,both,1,ea,2.6,1.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Aetna,Commerical,,,2.01,,2.01,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Anthem,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Anthem,Indemnity,,,1.95,,1.95,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Anthem,Individual Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Anthem,State Preferred,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Cigna,Cigna,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Connecticare,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Connecticare,Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,Multiplan,Multiplan,,,2.21,,2.21,1.92,2.21,percent of total billed charges,,
PRIMIDONE 250 MG TABLET,J3490,HCPCS,68084-203-11,NDC,both,1,ea,2.6,1.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Aetna,Commerical,,,1.98,,1.98,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Aetna,Middlesex Employees,,,1.9,,1.9,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Anthem,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Anthem,Indemnity,,,1.93,,1.93,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Anthem,Individual Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Anthem,State Preferred,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Cigna,Cigna,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Connecticare,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Connecticare,Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-01,NDC,both,1,ea,2.57,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Aetna,Commerical,,,1.98,,1.98,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Aetna,Middlesex Employees,,,1.9,,1.9,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Anthem,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Anthem,Indemnity,,,1.93,,1.93,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Anthem,Individual Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Anthem,State Preferred,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Cigna,Cigna,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Connecticare,Commerical,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Connecticare,Exchange,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.9,2.18,percent of total billed charges,,
PRIMIDONE 50 MG TABLET,J3490,HCPCS,68084-202-11,NDC,both,1,ea,2.57,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.9,2.18,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Aetna,Commerical,,,2.01,,2.01,1.92,2.21,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.21,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Indemnity,,,1.95,,1.95,1.92,2.21,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Individual Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,State Preferred,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Cigna,Cigna,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Connecticare,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Connecticare,Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Multiplan,Multiplan,,,2.21,,2.21,1.92,2.21,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Aetna,Commerical,,,1.46,,1.46,1.4,1.61,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Aetna,Middlesex Employees,,,1.4,,1.4,1.4,1.61,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Anthem,Commerical,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Anthem,Indemnity,,,1.42,,1.42,1.4,1.61,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Anthem,Individual Exchange,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Anthem,State Preferred,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Cigna,Cigna,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Connecticare,Commerical,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Connecticare,Exchange,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,Multiplan,Multiplan,,,1.61,,1.61,1.4,1.61,percent of total billed charges,,
PROBENECID 250 MG SPLIT TABLET,J3490,HCPCS,40810-0207-51,NDC,both,1,ea,1.89,1.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.4,1.61,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0378-0156-01,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Aetna,Commerical,,,2.01,,2.01,1.92,2.21,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.21,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Indemnity,,,1.95,,1.95,1.92,2.21,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,Individual Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Anthem,State Preferred,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Cigna,Cigna,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Connecticare,Commerical,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Connecticare,Exchange,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,Multiplan,Multiplan,,,2.21,,2.21,1.92,2.21,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,0527-1367-01,NDC,both,1,ea,2.6,1.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.21,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Anthem,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Anthem,Individual Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Anthem,State Preferred,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Cigna,Cigna,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Connecticare,Commerical,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Connecticare,Exchange,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,2.79,3.2,percent of total billed charges,,
PROBENECID 500 MG TABLET,J3490,HCPCS,40810-0207-52,NDC,both,1,UN,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.79,3.2,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Anthem,Commerical,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Anthem,State Preferred,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Cigna,Cigna,,466.4,,,466.4,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Connecticare,Commerical,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Connecticare,Exchange,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-01,NDC,both,10,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Anthem,Commerical,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Anthem,State Preferred,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Cigna,Cigna,,466.4,,,466.4,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Connecticare,Commerical,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Connecticare,Exchange,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1902-11,NDC,both,1,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Aetna,Commerical,,,156.46,,156.46,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Aetna,Middlesex Employees,,,150.03,,150.03,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Anthem,Commerical,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Anthem,Indemnity,,,151.9,,151.9,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Anthem,Individual Exchange,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Anthem,State Preferred,,,,,,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Cigna,Cigna,,466.4,,,466.4,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Connecticare,Commerical,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Connecticare,Exchange,,833.83,,,833.83,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,Multiplan,Multiplan,,,172.35,,172.35,150.03,833.83,percent of total billed charges,,
PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-901-07,NDC,both,10,mL,202.77,121.66,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,150.03,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Aetna,Commerical,,,215.03,,215.03,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Aetna,Middlesex Employees,,,206.2,,206.2,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Anthem,Commerical,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Anthem,Indemnity,,,208.76,,208.76,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Anthem,Individual Exchange,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Anthem,State Preferred,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Cigna,Cigna,,466.4,,,466.4,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Connecticare,Commerical,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Connecticare,Exchange,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,Multiplan,Multiplan,,,236.88,,236.88,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-01,NDC,both,2,mL,278.68,167.21,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Aetna,Commerical,,,215.03,,215.03,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Aetna,Middlesex Employees,,,206.2,,206.2,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Anthem,Commerical,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Anthem,Indemnity,,,208.76,,208.76,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Anthem,Individual Exchange,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Anthem,State Preferred,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Cigna,Cigna,,466.4,,,466.4,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Connecticare,Commerical,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Connecticare,Exchange,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,Multiplan,Multiplan,,,236.88,,236.88,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,0409-1903-41,NDC,both,1,mL,278.68,167.21,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Aetna,Commerical,,,215.03,,215.03,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Aetna,Middlesex Employees,,,206.2,,206.2,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Anthem,Commerical,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Anthem,Indemnity,,,208.76,,208.76,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Anthem,Individual Exchange,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Anthem,State Preferred,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Cigna,Cigna,,466.4,,,466.4,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Connecticare,Commerical,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Connecticare,Exchange,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,Multiplan,Multiplan,,,236.88,,236.88,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-02,NDC,both,2,mL,278.68,167.21,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Aetna,Commerical,,,215.03,,215.03,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Aetna,Middlesex Employees,,,206.2,,206.2,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Anthem,Commerical,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Anthem,Indemnity,,,208.76,,208.76,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Anthem,Individual Exchange,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Anthem,State Preferred,,,,,,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Cigna,Cigna,,466.4,,,466.4,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Connecticare,Commerical,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Connecticare,Exchange,,833.83,,,833.83,206.2,833.83,Other,Could be inpatient or outpatient,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,Multiplan,Multiplan,,,236.88,,236.88,206.2,833.83,percent of total billed charges,,
PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,J2690,HCPCS,14789-900-07,NDC,both,2,mL,278.68,167.21,United Healthcare/Oxford,United Healthcare/Oxford,,503.54,,,503.54,206.2,833.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Aetna,Commerical,,,382.01,,382.01,366.32,420.83,percent of total billed charges,,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Aetna,Middlesex Employees,,,366.32,,366.32,366.32,420.83,percent of total billed charges,,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Anthem,Commerical,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Anthem,Indemnity,,,370.87,,370.87,366.32,420.83,percent of total billed charges,,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Anthem,Individual Exchange,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Anthem,State Preferred,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Cigna,Cigna,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Connecticare,Commerical,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Connecticare,Exchange,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,Multiplan,Multiplan,,,420.83,,420.83,366.32,420.83,percent of total billed charges,,
PROCARBAZINE 50 MG CAPSULE,J8999,HCPCS,54482-054-01,NDC,both,1,ea,495.09,297.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,366.32,420.83,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Aetna,Commerical,,,30.9,,30.9,29.63,34.04,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Aetna,Middlesex Employees,,,29.63,,29.63,29.63,34.04,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Anthem,Commerical,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Anthem,Indemnity,,,30,,30,29.63,34.04,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Anthem,Individual Exchange,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Anthem,State Preferred,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Cigna,Cigna,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Connecticare,Commerical,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Connecticare,Exchange,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,Multiplan,Multiplan,,,34.04,,34.04,29.63,34.04,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0574-7226-12,NDC,both,0.4,ea,40.05,24.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.63,34.04,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Aetna,Commerical,,,29.75,,29.75,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Aetna,Middlesex Employees,,,28.52,,28.52,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Anthem,Commerical,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Anthem,Indemnity,,,28.88,,28.88,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Anthem,Individual Exchange,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Anthem,State Preferred,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Cigna,Cigna,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Connecticare,Commerical,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Connecticare,Exchange,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,Multiplan,Multiplan,,,32.77,,32.77,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-06,NDC,both,0.4,ea,38.55,23.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Aetna,Commerical,,,29.75,,29.75,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Aetna,Middlesex Employees,,,28.52,,28.52,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Anthem,Commerical,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Anthem,Indemnity,,,28.88,,28.88,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Anthem,Individual Exchange,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Anthem,State Preferred,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Cigna,Cigna,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Connecticare,Commerical,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Connecticare,Exchange,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,Multiplan,Multiplan,,,32.77,,32.77,28.52,32.77,percent of total billed charges,,
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,Q0165,HCPCS,0713-0135-12,NDC,both,0.4,ea,38.55,23.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.52,32.77,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-02,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,0713-0351-09,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-02,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,14789-700-07,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-294-42,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,23155-497-31,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-02,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,25021-790-03,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-01,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55150-360-25,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,55390-077-10,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-00,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,67457-640-99,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-02,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Aetna,Commerical,,,20.43,,20.43,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Aetna,Middlesex Employees,,,19.59,,19.59,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Anthem,Commerical,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Anthem,Indemnity,,,19.84,,19.84,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Anthem,Individual Exchange,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Anthem,State Preferred,,,,,,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Cigna,Cigna,,4.11,,,4.11,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Connecticare,Commerical,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Connecticare,Exchange,,5.59,,,5.59,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,Multiplan,Multiplan,,,22.51,,22.51,4.11,22.51,percent of total billed charges,,
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,J0780,HCPCS,70860-778-41,NDC,both,2,mL,26.48,15.89,United Healthcare/Oxford,United Healthcare/Oxford,,4.44,,,4.44,4.11,22.51,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-54,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,0.41,,,0.41,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,50268-684-15,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,0.41,,,0.41,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-01,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Aetna,Commerical,,,2.91,,2.91,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Aetna,Middlesex Employees,,,2.79,,2.79,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Anthem,Commerical,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Anthem,Indemnity,,,2.82,,2.82,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Anthem,Individual Exchange,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Anthem,State Preferred,,,,,,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Cigna,Cigna,,0.41,,,0.41,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Connecticare,Commerical,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Connecticare,Exchange,,0.67,,,0.67,0.41,3.2,Other,Could be inpatient or outpatient,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,Multiplan,Multiplan,,,3.2,,3.2,0.41,3.2,percent of total billed charges,,
PROCHLORPERAZINE MALEATE 5 MG TABLET,Q0164,HCPCS,51079-541-20,NDC,both,1,ea,3.77,2.26,United Healthcare/Oxford,United Healthcare/Oxford,,0.99,,,0.99,0.41,3.2,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Aetna,Commerical,,,87.1,,87.1,0.82,95.95,percent of total billed charges,,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Aetna,Middlesex Employees,,,83.52,,83.52,0.82,95.95,percent of total billed charges,,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Anthem,Commerical,,,,,,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Anthem,Indemnity,,,84.56,,84.56,0.82,95.95,percent of total billed charges,,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Anthem,Individual Exchange,,,,,,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Anthem,State Preferred,,,,,,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Cigna,Cigna,,0.82,,,0.82,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Connecticare,Commerical,,1.11,,,1.11,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Connecticare,Exchange,,1.11,,,1.11,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,Multiplan,Multiplan,,,95.95,,95.95,0.82,95.95,percent of total billed charges,,
PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,J2675,HCPCS,0143-9725-01,NDC,both,1,mL,112.88,67.73,United Healthcare/Oxford,United Healthcare/Oxford,,0.89,,,0.89,0.82,95.95,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,59651-153-01,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
PROGESTERONE MICRONIZED 200 MG CAPSULE,J3490,HCPCS,69452-234-20,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.06,0.34,percent of total billed charges,,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.06,0.34,percent of total billed charges,,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Anthem,Commerical,,,,,,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.06,0.34,percent of total billed charges,,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Anthem,Individual Exchange,,,,,,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Anthem,State Preferred,,,,,,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Cigna,Cigna,,0.1,,,0.1,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Connecticare,Commerical,,0.06,,,0.06,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Connecticare,Exchange,,0.06,,,0.06,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.06,0.34,percent of total billed charges,,
PROMETHAZINE 12.5 MG ORAL TAB,Q0169,HCPCS,40810-0002-56,NDC,both,1,ea,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,0.34,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Aetna,Commerical,,,12.47,,12.47,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Aetna,Middlesex Employees,,,11.96,,11.96,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Anthem,Commerical,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Anthem,Indemnity,,,12.11,,12.11,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Anthem,Individual Exchange,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Anthem,State Preferred,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Cigna,Cigna,,0.1,,,0.1,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Connecticare,Commerical,,0.06,,,0.06,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Connecticare,Exchange,,0.06,,,0.06,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,Multiplan,Multiplan,,,13.74,,13.74,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-06,NDC,both,1,ea,16.16,9.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Aetna,Commerical,,,12.47,,12.47,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Aetna,Middlesex Employees,,,11.96,,11.96,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Anthem,Commerical,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Anthem,Indemnity,,,12.11,,12.11,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Anthem,Individual Exchange,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Anthem,State Preferred,,,,,,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Cigna,Cigna,,0.1,,,0.1,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Connecticare,Commerical,,0.06,,,0.06,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Connecticare,Exchange,,0.06,,,0.06,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,Multiplan,Multiplan,,,13.74,,13.74,0.06,13.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0536-12,NDC,both,1,ea,16.16,9.7,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,13.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Aetna,Commerical,,,28.81,,28.81,0.06,31.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Aetna,Middlesex Employees,,,27.63,,27.63,0.06,31.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Anthem,Commerical,,,,,,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Anthem,Indemnity,,,27.97,,27.97,0.06,31.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Anthem,Individual Exchange,,,,,,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Anthem,State Preferred,,,,,,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Cigna,Cigna,,0.1,,,0.1,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Connecticare,Commerical,,0.06,,,0.06,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Connecticare,Exchange,,0.06,,,0.06,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,Multiplan,Multiplan,,,31.74,,31.74,0.06,31.74,percent of total billed charges,,
PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,Q0169,HCPCS,45802-758-00,NDC,both,1,ea,37.34,22.4,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,31.74,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Aetna,Commerical,,,10.61,,10.61,0.06,11.69,percent of total billed charges,,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Aetna,Middlesex Employees,,,10.17,,10.17,0.06,11.69,percent of total billed charges,,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Anthem,Commerical,,,,,,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Anthem,Indemnity,,,10.3,,10.3,0.06,11.69,percent of total billed charges,,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Anthem,Individual Exchange,,,,,,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Anthem,State Preferred,,,,,,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Cigna,Cigna,,0.1,,,0.1,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Connecticare,Commerical,,0.06,,,0.06,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Connecticare,Exchange,,0.06,,,0.06,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,Multiplan,Multiplan,,,11.69,,11.69,0.06,11.69,percent of total billed charges,,
PROMETHAZINE 25 MG RECTAL SUPPOSITORY,Q0169,HCPCS,0713-0526-12,NDC,both,0.5,ea,13.75,8.25,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,11.69,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Commerical,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Cigna,Cigna,,0.1,,,0.1,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Connecticare,Commerical,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Connecticare,Exchange,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-6461-61,NDC,both,0.5,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Commerical,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Cigna,Cigna,,0.1,,,0.1,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Connecticare,Commerical,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Connecticare,Exchange,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,0904-7304-61,NDC,both,0.5,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Anthem,Commerical,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Cigna,Cigna,,0.1,,,0.1,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Connecticare,Commerical,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Connecticare,Exchange,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-01,NDC,both,0.5,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Anthem,Commerical,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Cigna,Cigna,,0.1,,,0.1,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Connecticare,Commerical,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Connecticare,Exchange,,0.06,,,0.06,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.06,0.48,percent of total billed charges,,
PROMETHAZINE 25 MG TABLET,Q0169,HCPCS,68084-155-11,NDC,both,0.5,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,0.48,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Aetna,Commerical,,,1.68,,1.68,0.06,1.85,percent of total billed charges,,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Aetna,Middlesex Employees,,,1.61,,1.61,0.06,1.85,percent of total billed charges,,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Anthem,Commerical,,,,,,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Anthem,Indemnity,,,1.63,,1.63,0.06,1.85,percent of total billed charges,,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Anthem,Individual Exchange,,,,,,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Anthem,State Preferred,,,,,,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Cigna,Cigna,,0.1,,,0.1,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Connecticare,Commerical,,0.06,,,0.06,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Connecticare,Exchange,,0.06,,,0.06,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,Multiplan,Multiplan,,,1.85,,1.85,0.06,1.85,percent of total billed charges,,
PROMETHAZINE 6.25 MG RECT SUPP,Q0169,HCPCS,40810-0002-55,NDC,both,1,ea,2.18,1.31,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,1.85,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Anthem,Commerical,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Connecticare,Commerical,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Connecticare,Exchange,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,0121-0927-16,NDC,both,10,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Anthem,Commerical,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Connecticare,Commerical,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Connecticare,Exchange,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,50383-801-16,NDC,both,10,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Anthem,Commerical,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Connecticare,Commerical,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Connecticare,Exchange,,0.06,,,0.06,0.06,39.07,Other,Could be inpatient or outpatient,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.06,39.07,percent of total billed charges,,
PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,Q0169,HCPCS,70408-146-34,NDC,both,10,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.34,,,0.34,0.06,39.07,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Aetna,Commerical,,,84.36,,84.36,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Aetna,Middlesex Employees,,,80.89,,80.89,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Anthem,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Anthem,Indemnity,,,81.9,,81.9,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Anthem,Individual Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Anthem,State Preferred,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Cigna,Cigna,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Connecticare,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Connecticare,Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,Multiplan,Multiplan,,,92.93,,92.93,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,17478-263-12,NDC,both,1,mL,109.33,65.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Aetna,Commerical,,,84.36,,84.36,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Aetna,Middlesex Employees,,,80.89,,80.89,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Anthem,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Anthem,Indemnity,,,81.9,,81.9,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Anthem,Individual Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Anthem,State Preferred,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Cigna,Cigna,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Connecticare,Commerical,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Connecticare,Exchange,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,Multiplan,Multiplan,,,92.93,,92.93,80.89,92.93,percent of total billed charges,,
PROPARACAINE 0.5 % EYE DROPS,J3490,HCPCS,61314-016-01,NDC,both,1,mL,109.33,65.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,80.89,92.93,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-01,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0234-20,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0069-0248-01,NDC,both,1,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-01,NDC,both,1,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,0641-6194-10,NDC,both,1,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Aetna,Commerical,,,86.3,,86.3,0.1,95.06,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Aetna,Middlesex Employees,,,82.75,,82.75,0.1,95.06,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Anthem,Commerical,,,,,,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Anthem,Indemnity,,,83.78,,83.78,0.1,95.06,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Anthem,Individual Exchange,,,,,,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Anthem,State Preferred,,,,,,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Cigna,Cigna,,0.1,,,0.1,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Connecticare,Commerical,,0.14,,,0.14,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Connecticare,Exchange,,0.14,,,0.14,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,Multiplan,Multiplan,,,95.06,,95.06,0.1,95.06,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,25021-608-51,NDC,both,1,mL,111.84,67.1,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,95.06,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-21,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,0.1,19.53,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,43598-548-50,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,19.53,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,0.1,9.77,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,0.1,9.77,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,0.1,9.77,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,0.1,,,0.1,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,0.14,,,0.14,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,0.14,,,0.14,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,0.1,9.77,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-10,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,9.77,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-37,NDC,both,20,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,0.1,35.81,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,0.1,35.81,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,0.1,35.81,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,0.1,,,0.1,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,0.14,,,0.14,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,0.14,,,0.14,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,0.1,35.81,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-65,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.81,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-67,NDC,both,100,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-69,NDC,both,1,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,0.1,39.07,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-78,NDC,both,100,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,39.07,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-269-94,NDC,both,20,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-01,NDC,both,20,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Aetna,Commerical,,,7.1,,7.1,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Aetna,Middlesex Employees,,,6.81,,6.81,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Anthem,Commerical,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Anthem,Indemnity,,,6.89,,6.89,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Anthem,Individual Exchange,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Anthem,State Preferred,,,,,,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Cigna,Cigna,,0.1,,,0.1,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Connecticare,Commerical,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Connecticare,Exchange,,0.14,,,0.14,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,Multiplan,Multiplan,,,7.82,,7.82,0.1,7.82,percent of total billed charges,,
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,J2704,HCPCS,65219-800-10,NDC,both,20,mL,9.2,5.52,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.82,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.58,5.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Aetna,Commerical,,,6.62,,6.62,0.1,7.29,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Aetna,Middlesex Employees,,,6.35,,6.35,0.1,7.29,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Anthem,Commerical,,,,,,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Anthem,Indemnity,,,6.43,,6.43,0.1,7.29,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Anthem,Individual Exchange,,,,,,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Anthem,State Preferred,,,,,,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Cigna,Cigna,,0.1,,,0.1,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Connecticare,Commerical,,0.14,,,0.14,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Connecticare,Exchange,,0.14,,,0.14,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,Multiplan,Multiplan,,,7.29,,7.29,0.1,7.29,percent of total billed charges,,
PROPOFOL 10 MG/ML IV ED/PICU SEDATION,J2704,HCPCS,0409-4699-61,NDC,both,1,mL,8.58,5.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.29,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,33.33,20,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,16.67,10,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-269-29,NDC,both,20,mL,6.67,4,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-50,NDC,both,50,mL,16.67,10,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML,J2704,HCPCS,63323-270-65,NDC,both,100,mL,33.33,20,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-24,NDC,both,100,mL,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-30,NDC,both,1,mL,8.28,4.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,0409-4699-33,NDC,both,50,mL,20.69,12.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Aetna,Commerical,,,6.39,,6.39,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Aetna,Middlesex Employees,,,6.13,,6.13,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Anthem,Commerical,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Anthem,Indemnity,,,6.2,,6.2,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Anthem,Individual Exchange,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Anthem,State Preferred,,,,,,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Cigna,Cigna,,0.1,,,0.1,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Connecticare,Commerical,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Connecticare,Exchange,,0.14,,,0.14,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,Multiplan,Multiplan,,,7.04,,7.04,0.1,7.04,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-269-29,NDC,both,20,mL,8.28,4.97,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,7.04,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Aetna,Commerical,,,15.96,,15.96,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Aetna,Middlesex Employees,,,15.31,,15.31,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Anthem,Commerical,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Anthem,Indemnity,,,15.5,,15.5,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Anthem,Individual Exchange,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Anthem,State Preferred,,,,,,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Cigna,Cigna,,0.1,,,0.1,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Connecticare,Commerical,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Connecticare,Exchange,,0.14,,,0.14,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,Multiplan,Multiplan,,,17.59,,17.59,0.1,17.59,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-50,NDC,both,50,mL,20.69,12.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,17.59,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Anthem,Commerical,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Anthem,Individual Exchange,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Anthem,State Preferred,,,,,,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Cigna,Cigna,,0.1,,,0.1,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Connecticare,Commerical,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Connecticare,Exchange,,0.14,,,0.14,0.1,35.16,Other,Could be inpatient or outpatient,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,0.1,35.16,percent of total billed charges,,
PROPOFOL INFUSION 10 MG/ML SEDATION,J2704,HCPCS,63323-270-65,NDC,both,100,mL,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.11,,,0.11,0.1,35.16,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Aetna,Commerical,,,34.24,,34.24,5.07,37.71,percent of total billed charges,,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Aetna,Middlesex Employees,,,32.83,,32.83,5.07,37.71,percent of total billed charges,,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Anthem,Commerical,,,,,,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Anthem,Indemnity,,,33.24,,33.24,5.07,37.71,percent of total billed charges,,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Anthem,Individual Exchange,,,,,,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Anthem,State Preferred,,,,,,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Cigna,Cigna,,11.23,,,11.23,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Connecticare,Commerical,,5.07,,,5.07,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Connecticare,Exchange,,5.07,,,5.07,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,Multiplan,Multiplan,,,37.71,,37.71,5.07,37.71,percent of total billed charges,,
PROPRANOLOL 0.1 MG/ML IN NS NICU,J1800,HCPCS,40810-0004-72,NDC,both,10,mL,44.37,26.62,United Healthcare/Oxford,United Healthcare/Oxford,,12.32,,,12.32,5.07,37.71,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Aetna,Commerical,,,13.66,,13.66,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Aetna,Middlesex Employees,,,13.1,,13.1,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Anthem,Commerical,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Anthem,Indemnity,,,13.26,,13.26,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Anthem,Individual Exchange,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Anthem,State Preferred,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Cigna,Cigna,,11.23,,,11.23,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Connecticare,Commerical,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Connecticare,Exchange,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,Multiplan,Multiplan,,,15.05,,15.05,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,0143-9872-01,NDC,both,1,mL,17.7,10.62,United Healthcare/Oxford,United Healthcare/Oxford,,12.32,,,12.32,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Aetna,Commerical,,,13.66,,13.66,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Aetna,Middlesex Employees,,,13.1,,13.1,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Anthem,Commerical,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Anthem,Indemnity,,,13.26,,13.26,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Anthem,Individual Exchange,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Anthem,State Preferred,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Cigna,Cigna,,11.23,,,11.23,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Connecticare,Commerical,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Connecticare,Exchange,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,Multiplan,Multiplan,,,15.05,,15.05,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,55390-003-10,NDC,both,1,mL,17.7,10.62,United Healthcare/Oxford,United Healthcare/Oxford,,12.32,,,12.32,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Aetna,Commerical,,,13.66,,13.66,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Aetna,Middlesex Employees,,,13.1,,13.1,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Anthem,Commerical,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Anthem,Indemnity,,,13.26,,13.26,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Anthem,Individual Exchange,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Anthem,State Preferred,,,,,,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Cigna,Cigna,,11.23,,,11.23,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Connecticare,Commerical,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Connecticare,Exchange,,5.07,,,5.07,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,Multiplan,Multiplan,,,15.05,,15.05,5.07,15.05,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-00,NDC,both,1,mL,17.7,10.62,United Healthcare/Oxford,United Healthcare/Oxford,,12.32,,,12.32,5.07,15.05,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Aetna,Commerical,,,22.31,,22.31,5.07,24.58,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Aetna,Middlesex Employees,,,21.4,,21.4,5.07,24.58,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Anthem,Commerical,,,,,,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Anthem,Indemnity,,,21.66,,21.66,5.07,24.58,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Anthem,Individual Exchange,,,,,,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Anthem,State Preferred,,,,,,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Cigna,Cigna,,11.23,,,11.23,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Connecticare,Commerical,,5.07,,,5.07,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Connecticare,Exchange,,5.07,,,5.07,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,Multiplan,Multiplan,,,24.58,,24.58,5.07,24.58,percent of total billed charges,,
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,J1800,HCPCS,63323-604-01,NDC,both,1,mL,28.92,17.35,United Healthcare/Oxford,United Healthcare/Oxford,,12.32,,,12.32,5.07,24.58,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0115-1659-01,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,0904-6550-61,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
PROPRANOLOL 10 MG TABLET,J3490,HCPCS,69238-2077-1,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
PROPRANOLOL 2.5 MG ORAL TAB,J3490,HCPCS,40810-0002-58,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0115-1660-01,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0603-5483-21,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,0904-6705-61,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Aetna,Commerical,,,0.39,,0.39,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Aetna,Middlesex Employees,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Anthem,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Anthem,Indemnity,,,0.37,,0.37,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Anthem,Individual Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Anthem,State Preferred,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Cigna,Cigna,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Connecticare,Commerical,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Connecticare,Exchange,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,Multiplan,Multiplan,,,0.43,,0.43,0.37,0.43,percent of total billed charges,,
PROPRANOLOL 20 MG TABLET,J3490,HCPCS,69238-2078-1,NDC,both,1,ea,0.5,0.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.37,0.43,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Aetna,Commerical,,,135.94,,135.94,130.36,149.75,percent of total billed charges,,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Aetna,Middlesex Employees,,,130.36,,130.36,130.36,149.75,percent of total billed charges,,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Anthem,Commerical,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Anthem,Indemnity,,,131.98,,131.98,130.36,149.75,percent of total billed charges,,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Anthem,Individual Exchange,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Anthem,State Preferred,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Cigna,Cigna,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Connecticare,Commerical,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Connecticare,Exchange,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,Multiplan,Multiplan,,,149.75,,149.75,130.36,149.75,percent of total billed charges,,
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,J3490,HCPCS,0054-3727-63,NDC,both,1,mL,176.18,105.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.36,149.75,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
PROPRANOLOL 5 MG ORAL TAB,J3490,HCPCS,40810-0002-57,NDC,both,1,ea,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,0527-4118-37,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0006-30,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,43478-902-88,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
"PROPRANOLOL ER 120 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-819-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Aetna,Commerical,,,5.31,,5.31,5.09,5.85,percent of total billed charges,,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Aetna,Middlesex Employees,,,5.09,,5.09,5.09,5.85,percent of total billed charges,,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Anthem,Commerical,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Anthem,Indemnity,,,5.15,,5.15,5.09,5.85,percent of total billed charges,,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Anthem,Individual Exchange,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Anthem,State Preferred,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Cigna,Cigna,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Connecticare,Commerical,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Connecticare,Exchange,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,Multiplan,Multiplan,,,5.85,,5.85,5.09,5.85,percent of total billed charges,,
"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,40810-0205-59,NDC,both,1,UN,6.88,4.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.09,5.85,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Aetna,Commerical,,,5.81,,5.81,5.57,6.4,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Aetna,Middlesex Employees,,,5.57,,5.57,5.57,6.4,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Anthem,Commerical,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Anthem,Indemnity,,,5.64,,5.64,5.57,6.4,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Anthem,Individual Exchange,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Anthem,State Preferred,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Cigna,Cigna,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Connecticare,Commerical,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Connecticare,Exchange,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,Multiplan,Multiplan,,,6.4,,6.4,5.57,6.4,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,51991-818-01,NDC,both,1,ea,7.53,4.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.57,6.4,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",J3490,HCPCS,62559-531-01,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Aetna,Commerical,,,21.99,,21.99,21.09,24.23,percent of total billed charges,,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Aetna,Middlesex Employees,,,21.09,,21.09,21.09,24.23,percent of total billed charges,,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Anthem,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Anthem,Indemnity,,,21.35,,21.35,21.09,24.23,percent of total billed charges,,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Anthem,Individual Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Anthem,State Preferred,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Cigna,Cigna,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Connecticare,Commerical,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Connecticare,Exchange,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,Multiplan,Multiplan,,,24.23,,24.23,21.09,24.23,percent of total billed charges,,
PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-45,NDC,both,1,mL,28.5,17.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.09,24.23,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Aetna,Commerical,,,31,,31,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Aetna,Middlesex Employees,,,29.73,,29.73,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Anthem,Commerical,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Anthem,Indemnity,,,30.1,,30.1,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Anthem,Individual Exchange,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Anthem,State Preferred,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Cigna,Cigna,,1.01,,,1.01,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Connecticare,Commerical,,1.64,,,1.64,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Connecticare,Exchange,,1.64,,,1.64,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,Multiplan,Multiplan,,,34.15,,34.15,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-05,NDC,both,1,mL,40.18,24.11,United Healthcare/Oxford,United Healthcare/Oxford,,1.09,,,1.09,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Aetna,Commerical,,,31,,31,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Aetna,Middlesex Employees,,,29.73,,29.73,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Anthem,Commerical,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Anthem,Indemnity,,,30.1,,30.1,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Anthem,Individual Exchange,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Anthem,State Preferred,,,,,,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Cigna,Cigna,,1.01,,,1.01,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Connecticare,Commerical,,1.64,,,1.64,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Connecticare,Exchange,,1.64,,,1.64,1.01,34.15,Other,Could be inpatient or outpatient,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,Multiplan,Multiplan,,,34.15,,34.15,1.01,34.15,percent of total billed charges,,
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,J2720,HCPCS,63323-229-15,NDC,both,1,mL,40.18,24.11,United Healthcare/Oxford,United Healthcare/Oxford,,1.09,,,1.09,1.01,34.15,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Aetna,Commerical,,,6.91,,6.91,6.62,7.61,percent of total billed charges,,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Aetna,Middlesex Employees,,,6.62,,6.62,6.62,7.61,percent of total billed charges,,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Anthem,Commerical,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Anthem,Indemnity,,,6.7,,6.7,6.62,7.61,percent of total billed charges,,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Anthem,Individual Exchange,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Anthem,State Preferred,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Cigna,Cigna,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Connecticare,Commerical,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Connecticare,Exchange,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,Multiplan,Multiplan,,,7.61,,7.61,6.62,7.61,percent of total billed charges,,
PRUCALOPRIDE 0.25 MG SPLIT TABLET,J3490,HCPCS,40810-0207-43,NDC,both,1,ea,8.95,5.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.62,7.61,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Aetna,Commerical,,,13.8,,13.8,13.24,15.21,percent of total billed charges,,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Aetna,Middlesex Employees,,,13.24,,13.24,13.24,15.21,percent of total billed charges,,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Anthem,Commerical,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Anthem,Indemnity,,,13.4,,13.4,13.24,15.21,percent of total billed charges,,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Anthem,Individual Exchange,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Anthem,State Preferred,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Cigna,Cigna,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Connecticare,Commerical,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Connecticare,Exchange,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,Multiplan,Multiplan,,,15.21,,15.21,13.24,15.21,percent of total billed charges,,
PRUCALOPRIDE 0.5 MG SPLIT TABLET,J3490,HCPCS,40810-0207-42,NDC,both,1,ea,17.89,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.24,15.21,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Aetna,Commerical,,,41.32,,41.32,39.62,45.52,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Aetna,Middlesex Employees,,,39.62,,39.62,39.62,45.52,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Anthem,Commerical,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Anthem,Indemnity,,,40.11,,40.11,39.62,45.52,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Anthem,Individual Exchange,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Anthem,State Preferred,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Cigna,Cigna,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Connecticare,Commerical,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Connecticare,Exchange,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,Multiplan,Multiplan,,,45.52,,45.52,39.62,45.52,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,40810-0205-12,NDC,both,1,ea,53.55,32.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.62,45.52,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Aetna,Commerical,,,47.92,,47.92,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Aetna,Middlesex Employees,,,45.96,,45.96,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Anthem,Commerical,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Anthem,Indemnity,,,46.53,,46.53,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Anthem,Individual Exchange,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Anthem,State Preferred,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Cigna,Cigna,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Connecticare,Commerical,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Connecticare,Exchange,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,Multiplan,Multiplan,,,52.79,,52.79,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 1 MG TABLET,J3490,HCPCS,54092-546-01,NDC,both,1,ea,62.11,37.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Aetna,Commerical,,,259.36,,259.36,248.7,285.71,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Aetna,Middlesex Employees,,,248.7,,248.7,248.7,285.71,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Anthem,Commerical,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Anthem,Indemnity,,,251.79,,251.79,248.7,285.71,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Anthem,Individual Exchange,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Anthem,State Preferred,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Cigna,Cigna,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Connecticare,Commerical,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Connecticare,Exchange,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,Multiplan,Multiplan,,,285.71,,285.71,248.7,285.71,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-42,NDC,both,1,mL,336.13,201.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,248.7,285.71,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Aetna,Commerical,,,778.06,,778.06,746.09,857.11,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Aetna,Middlesex Employees,,,746.09,,746.09,746.09,857.11,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Anthem,Commerical,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Anthem,Indemnity,,,755.37,,755.37,746.09,857.11,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Anthem,Individual Exchange,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Anthem,State Preferred,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Cigna,Cigna,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Connecticare,Commerical,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Connecticare,Exchange,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,Multiplan,Multiplan,,,857.11,,857.11,746.09,857.11,percent of total billed charges,,
PRUCALOPRIDE 1 MG/ML ORAL SUSP,J3490,HCPCS,40810-0208-43,NDC,both,1,mL,1008.37,605.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,746.09,857.11,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Aetna,Commerical,,,47.92,,47.92,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Aetna,Middlesex Employees,,,45.96,,45.96,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Anthem,Commerical,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Anthem,Indemnity,,,46.53,,46.53,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Anthem,Individual Exchange,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Anthem,State Preferred,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Cigna,Cigna,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Connecticare,Commerical,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Connecticare,Exchange,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,Multiplan,Multiplan,,,52.79,,52.79,45.96,52.79,percent of total billed charges,,
PRUCALOPRIDE 2 MG TABLET,J3490,HCPCS,54092-547-01,NDC,both,1,ea,62.11,37.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,45.96,52.79,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Aetna,Commerical,,,19.53,,19.53,18.73,21.51,percent of total billed charges,,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Aetna,Middlesex Employees,,,18.73,,18.73,18.73,21.51,percent of total billed charges,,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Anthem,Commerical,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Anthem,Indemnity,,,18.96,,18.96,18.73,21.51,percent of total billed charges,,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Anthem,Individual Exchange,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Anthem,State Preferred,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Cigna,Cigna,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Connecticare,Commerical,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Connecticare,Exchange,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,Multiplan,Multiplan,,,21.51,,21.51,18.73,21.51,percent of total billed charges,,
PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,J3490,HCPCS,50580-536-04,NDC,both,1,mL,25.31,15.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.73,21.51,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-5053-59,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,0904-6337-24,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,40810-0007-84,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,45802-432-62,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
PSEUDOEPHEDRINE 30 MG TABLET,J3490,HCPCS,70000-0135-1,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-5125-59,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Aetna,Commerical,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Anthem,Commerical,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Anthem,Individual Exchange,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Anthem,State Preferred,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Cigna,Cigna,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Connecticare,Commerical,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Connecticare,Exchange,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,Multiplan,Multiplan,,,0.01,,0.01,0.01,0.01,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6728-52,NDC,both,1,ea,0.01,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.01,0.01,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,0904-6907-06,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
PSEUDOEPHEDRINE 60 MG TABLET,J3490,HCPCS,40810-0015-64,NDC,both,1,UN,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
PSEUDOEPHEDRINE HCL 15 MG ORAL TAB,J3490,HCPCS,40810-0002-59,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Aetna,Commerical,,,1.73,,1.73,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Aetna,Middlesex Employees,,,1.66,,1.66,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Anthem,Commerical,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Anthem,Indemnity,,,1.68,,1.68,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Anthem,Individual Exchange,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Anthem,State Preferred,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Cigna,Cigna,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Connecticare,Commerical,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Connecticare,Exchange,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-04,NDC,both,1,ea,2.24,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Aetna,Commerical,,,1.73,,1.73,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Aetna,Middlesex Employees,,,1.66,,1.66,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Anthem,Commerical,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Anthem,Indemnity,,,1.68,,1.68,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Anthem,Individual Exchange,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Anthem,State Preferred,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Cigna,Cigna,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Connecticare,Commerical,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Connecticare,Exchange,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,Multiplan,Multiplan,,,1.9,,1.9,1.66,1.9,percent of total billed charges,,
PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-024-10,NDC,both,1,ea,2.24,1.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.66,1.9,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL POWDER PACKET,J3490,HCPCS,37000-023-04,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Aetna,Commerical,,,35.82,,35.82,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Aetna,Middlesex Employees,,,34.35,,34.35,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Anthem,Commerical,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Anthem,Indemnity,,,34.77,,34.77,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Anthem,Individual Exchange,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Anthem,State Preferred,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Cigna,Cigna,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Connecticare,Commerical,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Connecticare,Exchange,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,Multiplan,Multiplan,,,39.46,,39.46,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,10956-618-21,NDC,both,1,mL,46.42,27.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Aetna,Commerical,,,35.82,,35.82,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Aetna,Middlesex Employees,,,34.35,,34.35,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Anthem,Commerical,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Anthem,Indemnity,,,34.77,,34.77,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Anthem,Individual Exchange,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Anthem,State Preferred,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Cigna,Cigna,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Connecticare,Commerical,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Connecticare,Exchange,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,Multiplan,Multiplan,,,39.46,,39.46,34.35,39.46,percent of total billed charges,,
PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION,J3490,HCPCS,70309-080-02,NDC,both,1,mL,46.42,27.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.35,39.46,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Aetna,Commerical,,,182.99,,182.99,175.47,201.59,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Aetna,Middlesex Employees,,,175.47,,175.47,175.47,201.59,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Anthem,Commerical,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Anthem,Indemnity,,,177.66,,177.66,175.47,201.59,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Anthem,Individual Exchange,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Anthem,State Preferred,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Cigna,Cigna,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Connecticare,Commerical,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Connecticare,Exchange,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,Multiplan,Multiplan,,,201.59,,201.59,175.47,201.59,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-61,NDC,both,1,mL,237.16,142.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.47,201.59,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Aetna,Commerical,,,91.5,,91.5,87.74,100.79,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Aetna,Middlesex Employees,,,87.74,,87.74,87.74,100.79,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Anthem,Commerical,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Anthem,Indemnity,,,88.83,,88.83,87.74,100.79,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Anthem,Individual Exchange,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Anthem,State Preferred,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Cigna,Cigna,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Connecticare,Commerical,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Connecticare,Exchange,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,Multiplan,Multiplan,,,100.79,,100.79,87.74,100.79,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-46,NDC,both,1,mL,118.58,71.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Aetna,Commerical,,,45.75,,45.75,43.87,50.4,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Aetna,Middlesex Employees,,,43.87,,43.87,43.87,50.4,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Anthem,Commerical,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Anthem,Indemnity,,,44.41,,44.41,43.87,50.4,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Anthem,Individual Exchange,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Anthem,State Preferred,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Cigna,Cigna,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Connecticare,Commerical,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Connecticare,Exchange,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,Multiplan,Multiplan,,,50.4,,50.4,43.87,50.4,percent of total billed charges,,
PYRAZINAMIDE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-47,NDC,both,1,mL,59.29,35.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Aetna,Commerical,,,1.53,,1.53,1.47,1.68,percent of total billed charges,,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Aetna,Middlesex Employees,,,1.47,,1.47,1.47,1.68,percent of total billed charges,,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Anthem,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Anthem,Indemnity,,,1.48,,1.48,1.47,1.68,percent of total billed charges,,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Anthem,Individual Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Anthem,State Preferred,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Cigna,Cigna,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Connecticare,Commerical,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Connecticare,Exchange,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,Multiplan,Multiplan,,,1.68,,1.68,1.47,1.68,percent of total billed charges,,
PYRAZINAMIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-60,NDC,both,1,ea,1.98,1.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.47,1.68,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Aetna,Commerical,,,11.57,,11.57,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Aetna,Middlesex Employees,,,11.1,,11.1,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Anthem,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Anthem,Indemnity,,,11.24,,11.24,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Anthem,Individual Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Anthem,State Preferred,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Cigna,Cigna,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Connecticare,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Connecticare,Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,Multiplan,Multiplan,,,12.75,,12.75,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-09,NDC,both,1,ea,15,9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Aetna,Commerical,,,11.57,,11.57,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Aetna,Middlesex Employees,,,11.1,,11.1,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Anthem,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Anthem,Indemnity,,,11.24,,11.24,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Anthem,Individual Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Anthem,State Preferred,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Cigna,Cigna,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Connecticare,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Connecticare,Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,Multiplan,Multiplan,,,12.75,,12.75,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,61748-012-11,NDC,both,1,ea,15,9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Aetna,Commerical,,,11.57,,11.57,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Aetna,Middlesex Employees,,,11.1,,11.1,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Anthem,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Anthem,Indemnity,,,11.24,,11.24,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Anthem,Individual Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Anthem,State Preferred,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Cigna,Cigna,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Connecticare,Commerical,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Connecticare,Exchange,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,Multiplan,Multiplan,,,12.75,,12.75,11.1,12.75,percent of total billed charges,,
PYRAZINAMIDE 500 MG TABLET,J3490,HCPCS,70954-484-10,NDC,both,1,ea,15,9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.1,12.75,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Aetna,Commerical,,,9.46,,9.46,9.07,10.42,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Aetna,Middlesex Employees,,,9.07,,9.07,9.07,10.42,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Anthem,Commerical,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Anthem,Indemnity,,,9.18,,9.18,9.07,10.42,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Anthem,Individual Exchange,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Anthem,State Preferred,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Cigna,Cigna,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Connecticare,Commerical,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Connecticare,Exchange,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,Multiplan,Multiplan,,,10.42,,10.42,9.07,10.42,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 15 MG TABLET,J3490,HCPCS,40810-0020-03,NDC,both,1,ea,12.26,7.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.07,10.42,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Aetna,Commerical,,,18.92,,18.92,18.14,20.84,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Aetna,Middlesex Employees,,,18.14,,18.14,18.14,20.84,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Anthem,Commerical,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Anthem,Indemnity,,,18.37,,18.37,18.14,20.84,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Anthem,Individual Exchange,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Anthem,State Preferred,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Cigna,Cigna,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Connecticare,Commerical,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Connecticare,Exchange,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,Multiplan,Multiplan,,,20.84,,20.84,18.14,20.84,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 30 MG TABLET,J3490,HCPCS,40810-0020-02,NDC,both,1,ea,24.52,14.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.14,20.84,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Aetna,Commerical,,,85.63,,85.63,82.11,94.33,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Aetna,Middlesex Employees,,,82.11,,82.11,82.11,94.33,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Anthem,Commerical,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Anthem,Indemnity,,,83.14,,83.14,82.11,94.33,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Anthem,Individual Exchange,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Anthem,State Preferred,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Cigna,Cigna,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Connecticare,Commerical,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Connecticare,Exchange,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,Multiplan,Multiplan,,,94.33,,94.33,82.11,94.33,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,J3490,HCPCS,0781-3040-95,NDC,both,2,mL,110.98,66.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,82.11,94.33,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Aetna,Commerical,,,2.69,,2.69,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Aetna,Middlesex Employees,,,2.58,,2.58,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Anthem,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Anthem,Indemnity,,,2.61,,2.61,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Anthem,Individual Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Anthem,State Preferred,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Cigna,Cigna,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Connecticare,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Connecticare,Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,Multiplan,Multiplan,,,2.97,,2.97,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0187-3010-30,NDC,both,1,ea,3.49,2.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Aetna,Commerical,,,2.69,,2.69,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Aetna,Middlesex Employees,,,2.58,,2.58,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Anthem,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Anthem,Indemnity,,,2.61,,2.61,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Anthem,Individual Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Anthem,State Preferred,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Cigna,Cigna,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Connecticare,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Connecticare,Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,Multiplan,Multiplan,,,2.97,,2.97,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,0904-6622-61,NDC,both,1,ea,3.49,2.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Aetna,Commerical,,,2.69,,2.69,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Aetna,Middlesex Employees,,,2.58,,2.58,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Anthem,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Anthem,Indemnity,,,2.61,,2.61,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Anthem,Individual Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Anthem,State Preferred,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Cigna,Cigna,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Connecticare,Commerical,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Connecticare,Exchange,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,Multiplan,Multiplan,,,2.97,,2.97,2.58,2.97,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG TABLET,J3490,HCPCS,40810-0019-89,NDC,both,1,UN,3.49,2.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.58,2.97,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Aetna,Commerical,,,1706.75,,1706.75,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Aetna,Middlesex Employees,,,1636.63,,1636.63,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Anthem,Commerical,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Anthem,Indemnity,,,1656.98,,1656.98,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Anthem,Individual Exchange,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Anthem,State Preferred,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Cigna,Cigna,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Connecticare,Commerical,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Connecticare,Exchange,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,Multiplan,Multiplan,,,1880.17,,1880.17,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,0187-3012-20,NDC,both,1,mL,2211.96,1327.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Aetna,Commerical,,,1706.75,,1706.75,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Aetna,Middlesex Employees,,,1636.63,,1636.63,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Anthem,Commerical,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Anthem,Indemnity,,,1656.98,,1656.98,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Anthem,Individual Exchange,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Anthem,State Preferred,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Cigna,Cigna,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Connecticare,Commerical,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Connecticare,Exchange,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,Multiplan,Multiplan,,,1880.17,,1880.17,1636.63,1880.17,percent of total billed charges,,
PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,J3490,HCPCS,70954-148-10,NDC,both,1,mL,2211.96,1327.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1636.63,1880.17,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG TABLET,J3490,HCPCS,5789685401,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Aetna,Commerical,,,54.22,,54.22,11.4,59.73,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Aetna,Middlesex Employees,,,51.99,,51.99,11.4,59.73,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Commerical,,,,,,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Indemnity,,,52.64,,52.64,11.4,59.73,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Individual Exchange,,,,,,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,State Preferred,,,,,,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Cigna,Cigna,,11.4,,,11.4,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Connecticare,Commerical,,26.94,,,26.94,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Connecticare,Exchange,,26.94,,,26.94,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Multiplan,Multiplan,,,59.73,,59.73,11.4,59.73,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,J3415,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,United Healthcare/Oxford,United Healthcare/Oxford,,12.31,,,12.31,11.4,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Aetna,Commerical,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Aetna,Middlesex Employees,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Anthem,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Anthem,Indemnity,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Anthem,Individual Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Anthem,State Preferred,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Cigna,Cigna,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Connecticare,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Connecticare,Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 12.5 MG SPLIT TABLET,J3490,HCPCS,40810-0205-09,NDC,both,1,ea,0.04,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 25 MG TABLET,J3490,HCPCS,536440601,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
PYRIDOXINE (VITAMIN B6) 50 MG TABLET,J3490,HCPCS,7733394010,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Aetna,Commerical,,,54.22,,54.22,51.99,59.73,percent of total billed charges,,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Aetna,Middlesex Employees,,,51.99,,51.99,51.99,59.73,percent of total billed charges,,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Commerical,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Indemnity,,,52.64,,52.64,51.99,59.73,percent of total billed charges,,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,Individual Exchange,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Anthem,State Preferred,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Cigna,Cigna,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Connecticare,Commerical,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Connecticare,Exchange,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,Multiplan,Multiplan,,,59.73,,59.73,51.99,59.73,percent of total billed charges,,
PYRIDOXINE 100 MG/ML ORAL LIQUID,J3490,HCPCS,63323-180-01,NDC,both,1,mL,70.27,42.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.99,59.73,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,0904-6640-61,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-11,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,50268-632-15,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-01,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,60687-349-11,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
QUETIAPINE 100 MG TABLET,J8499,HCPCS,63739-665-10,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Aetna,Commerical,,,1.47,,1.47,1.41,1.62,percent of total billed charges,,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Aetna,Middlesex Employees,,,1.41,,1.41,1.41,1.62,percent of total billed charges,,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Anthem,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Anthem,Indemnity,,,1.42,,1.42,1.41,1.62,percent of total billed charges,,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Anthem,Individual Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Anthem,State Preferred,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Cigna,Cigna,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Connecticare,Commerical,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Connecticare,Exchange,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,Multiplan,Multiplan,,,1.62,,1.62,1.41,1.62,percent of total billed charges,,
QUETIAPINE 12.5 MG ORAL TAB,J8499,HCPCS,40810-0002-64,NDC,both,2,ea,1.9,1.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.41,1.62,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Aetna,Commerical,,,69.51,,69.51,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Aetna,Middlesex Employees,,,66.66,,66.66,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Commerical,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Indemnity,,,67.49,,67.49,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Individual Exchange,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,State Preferred,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Cigna,Cigna,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Connecticare,Commerical,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Connecticare,Exchange,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Multiplan,Multiplan,,,76.58,,76.58,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Aetna,Commerical,,,139.02,,139.02,133.31,153.14,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Aetna,Middlesex Employees,,,133.31,,133.31,133.31,153.14,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Anthem,Commerical,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Anthem,Indemnity,,,134.97,,134.97,133.31,153.14,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Anthem,Individual Exchange,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Anthem,State Preferred,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Cigna,Cigna,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Connecticare,Commerical,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Connecticare,Exchange,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,Multiplan,Multiplan,,,153.14,,153.14,133.31,153.14,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0201-71,NDC,both,1,mL,180.17,108.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,133.31,153.14,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Aetna,Commerical,,,46.34,,46.34,44.44,51.05,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Aetna,Middlesex Employees,,,44.44,,44.44,44.44,51.05,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Anthem,Commerical,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Anthem,Indemnity,,,44.99,,44.99,44.44,51.05,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Anthem,Individual Exchange,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Anthem,State Preferred,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Cigna,Cigna,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Connecticare,Commerical,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Connecticare,Exchange,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,Multiplan,Multiplan,,,51.05,,51.05,44.44,51.05,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-46,NDC,both,1,mL,60.06,36.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.44,51.05,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Aetna,Commerical,,,185.35,,185.35,177.74,204.19,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Aetna,Middlesex Employees,,,177.74,,177.74,177.74,204.19,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Anthem,Commerical,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Anthem,Indemnity,,,179.95,,179.95,177.74,204.19,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Anthem,Individual Exchange,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Anthem,State Preferred,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Cigna,Cigna,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Connecticare,Commerical,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Connecticare,Exchange,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,Multiplan,Multiplan,,,204.19,,204.19,177.74,204.19,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0202-48,NDC,both,1,mL,240.22,144.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,177.74,204.19,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Aetna,Commerical,,,92.68,,92.68,88.87,102.09,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Aetna,Middlesex Employees,,,88.87,,88.87,88.87,102.09,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Anthem,Commerical,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Anthem,Indemnity,,,89.97,,89.97,88.87,102.09,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Anthem,Individual Exchange,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Anthem,State Preferred,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Cigna,Cigna,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Connecticare,Commerical,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Connecticare,Exchange,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,Multiplan,Multiplan,,,102.09,,102.09,88.87,102.09,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION,J8499,HCPCS,40810-0207-77,NDC,both,1,mL,120.11,72.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,88.87,102.09,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Aetna,Commerical,,,69.51,,69.51,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Aetna,Middlesex Employees,,,66.66,,66.66,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Commerical,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Indemnity,,,67.49,,67.49,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,Individual Exchange,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Anthem,State Preferred,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Cigna,Cigna,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Connecticare,Commerical,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Connecticare,Exchange,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,Multiplan,Multiplan,,,76.58,,76.58,66.66,76.58,percent of total billed charges,,
QUETIAPINE 2.5 MG/ML SOLUTION FOR DELIRIUM,J8499,HCPCS,40810-0201-44,NDC,both,1,mL,90.09,54.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,66.66,76.58,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
QUETIAPINE 200 MG TABLET,J8499,HCPCS,0904-6641-61,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,0904-6638-61,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,40810-0009-45,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
QUETIAPINE 25 MG TABLET,J8499,HCPCS,67877-242-01,NDC,both,1,ea,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,0904-6639-61,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-01,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Aetna,Commerical,,,0.63,,0.63,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Aetna,Middlesex Employees,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Anthem,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Anthem,Indemnity,,,0.61,,0.61,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Anthem,Individual Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Anthem,State Preferred,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Cigna,Cigna,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Connecticare,Commerical,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Connecticare,Exchange,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,Multiplan,Multiplan,,,0.7,,0.7,0.61,0.7,percent of total billed charges,,
QUETIAPINE 50 MG TABLET,J8499,HCPCS,60687-338-11,NDC,both,1,ea,0.82,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.61,0.7,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Aetna,Commerical,,,2.93,,2.93,2.81,3.23,percent of total billed charges,,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Aetna,Middlesex Employees,,,2.81,,2.81,2.81,3.23,percent of total billed charges,,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Anthem,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Anthem,Indemnity,,,2.85,,2.85,2.81,3.23,percent of total billed charges,,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Anthem,Individual Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Anthem,State Preferred,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Cigna,Cigna,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Connecticare,Commerical,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Connecticare,Exchange,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,Multiplan,Multiplan,,,3.23,,3.23,2.81,3.23,percent of total billed charges,,
QUETIAPINE 6.25 MG ORAL TAB,J8499,HCPCS,40810-0002-65,NDC,both,4,ea,3.8,2.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.81,3.23,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6803-61,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
"QUETIAPINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-614-07,NDC,both,1,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-6801-61,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,16729-132-12,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Aetna,Commerical,,,0.31,,0.31,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Anthem,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Anthem,Indemnity,,,0.3,,0.3,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Anthem,Individual Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Anthem,State Preferred,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Cigna,Cigna,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Connecticare,Commerical,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Connecticare,Exchange,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,Multiplan,Multiplan,,,0.34,,0.34,0.3,0.34,percent of total billed charges,,
"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",J8499,HCPCS,68180-612-07,NDC,both,1,ea,0.4,0.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.34,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,10.2,11.72,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,10.2,11.72,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Anthem,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,10.2,11.72,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Anthem,Individual Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Anthem,State Preferred,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Cigna,Cigna,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Connecticare,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Connecticare,Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,10.2,11.72,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-48,NDC,both,1,mL,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-49,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
QUINIDINE SULFATE 10 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-50,NDC,both,1,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Aetna,Commerical,,,36.19,,36.19,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Aetna,Middlesex Employees,,,34.7,,34.7,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Anthem,Commerical,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Anthem,Indemnity,,,35.13,,35.13,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Anthem,Individual Exchange,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Anthem,State Preferred,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Cigna,Cigna,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Connecticare,Commerical,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Connecticare,Exchange,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,Multiplan,Multiplan,,,39.87,,39.87,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,0185-1047-01,NDC,both,1,ea,46.9,28.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Aetna,Commerical,,,36.19,,36.19,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Aetna,Middlesex Employees,,,34.7,,34.7,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Anthem,Commerical,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Anthem,Indemnity,,,35.13,,35.13,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Anthem,Individual Exchange,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Anthem,State Preferred,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Cigna,Cigna,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Connecticare,Commerical,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Connecticare,Exchange,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,Multiplan,Multiplan,,,39.87,,39.87,34.7,39.87,percent of total billed charges,,
QUINIDINE SULFATE 300 MG TABLET,J3490,HCPCS,42806-512-30,NDC,both,1,ea,46.9,28.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.7,39.87,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Aetna,Commerical,,,4.46,,4.46,4.28,4.91,percent of total billed charges,,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Aetna,Middlesex Employees,,,4.28,,4.28,4.28,4.91,percent of total billed charges,,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Anthem,Commerical,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Anthem,Indemnity,,,4.33,,4.33,4.28,4.91,percent of total billed charges,,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Anthem,Individual Exchange,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Anthem,State Preferred,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Cigna,Cigna,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Connecticare,Commerical,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Connecticare,Exchange,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,Multiplan,Multiplan,,,4.91,,4.91,4.28,4.91,percent of total billed charges,,
QUININE 324 MG CAPSULE,J3490,HCPCS,68180-560-06,NDC,both,1,ea,5.78,3.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.28,4.91,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Aetna,Commerical,,,6.71,,6.71,6.43,7.39,percent of total billed charges,,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Aetna,Middlesex Employees,,,6.43,,6.43,6.43,7.39,percent of total billed charges,,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Anthem,Commerical,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Anthem,Indemnity,,,6.51,,6.51,6.43,7.39,percent of total billed charges,,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Anthem,Individual Exchange,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Anthem,State Preferred,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Cigna,Cigna,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Connecticare,Commerical,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Connecticare,Exchange,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,Multiplan,Multiplan,,,7.39,,7.39,6.43,7.39,percent of total billed charges,,
QUININE SULFATE ORAL SUSPENSION 6 MG/ML,J3490,HCPCS,40810-0018-38,NDC,both,1,mL,8.69,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.43,7.39,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Aetna,Commerical,,,1693.05,,1693.05,351.37,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Aetna,Middlesex Employees,,,1623.5,,1623.5,351.37,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Anthem,Commerical,,439.22,,,439.22,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Anthem,Indemnity,,,1643.68,,1643.68,351.37,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Anthem,Individual Exchange,,351.37,,,351.37,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Anthem,State Preferred,,439.22,,,439.22,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Cigna,Cigna,,,,,,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Connecticare,Commerical,,,,,,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Connecticare,Exchange,,,,,,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,Multiplan,Multiplan,,,1865.08,,1865.08,351.37,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-02,NDC,both,2,mL,2194.21,1316.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.37,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Aetna,Commerical,,,716.78,,716.78,351.37,789.61,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Aetna,Middlesex Employees,,,687.33,,687.33,351.37,789.61,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Anthem,Commerical,,439.22,,,439.22,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Anthem,Indemnity,,,695.88,,695.88,351.37,789.61,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Anthem,Individual Exchange,,351.37,,,351.37,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Anthem,State Preferred,,439.22,,,439.22,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Cigna,Cigna,,,,,,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Connecticare,Commerical,,,,,,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Connecticare,Exchange,,,,,,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,Multiplan,Multiplan,,,789.61,,789.61,351.37,789.61,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-618-10,NDC,both,2,mL,928.95,557.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.37,789.61,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Aetna,Commerical,,,1693.05,,1693.05,552.71,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Aetna,Middlesex Employees,,,1623.5,,1623.5,552.71,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Anthem,Commerical,,690.89,,,690.89,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Anthem,Indemnity,,,1643.68,,1643.68,552.71,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Anthem,Individual Exchange,,552.71,,,552.71,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Anthem,State Preferred,,690.89,,,690.89,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Cigna,Cigna,,,,,,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Connecticare,Commerical,,,,,,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Connecticare,Exchange,,,,,,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,Multiplan,Multiplan,,,1865.08,,1865.08,552.71,1865.08,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,90376,HCPCS,49281-190-20,NDC,both,2,mL,2194.21,1316.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,552.71,1865.08,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Aetna,Commerical,,,9488.86,,9488.86,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Aetna,Middlesex Employees,,,9099.02,,9099.02,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Commerical,,439.22,,,439.22,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Indemnity,,,9212.16,,9212.16,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Individual Exchange,,351.37,,,351.37,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Anthem,State Preferred,,439.22,,,439.22,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Cigna,Cigna,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Connecticare,Commerical,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Connecticare,Exchange,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,Multiplan,Multiplan,,,10452.99,,10452.99,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-05,NDC,both,0.5,mL,12297.64,7378.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Aetna,Commerical,,,9488.86,,9488.86,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Aetna,Middlesex Employees,,,9099.02,,9099.02,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Commerical,,439.22,,,439.22,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Indemnity,,,9212.16,,9212.16,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Anthem,Individual Exchange,,351.37,,,351.37,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Anthem,State Preferred,,439.22,,,439.22,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Cigna,Cigna,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Connecticare,Commerical,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Connecticare,Exchange,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,Multiplan,Multiplan,,,10452.99,,10452.99,351.37,10452.99,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML 5 ML,90375,HCPCS,13533-318-50,NDC,both,0.5,mL,12297.64,7378.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.37,10452.99,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Aetna,Commerical,,,1897.77,,1897.77,351.37,2090.59,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Aetna,Middlesex Employees,,,1819.8,,1819.8,351.37,2090.59,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Anthem,Commerical,,439.22,,,439.22,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Anthem,Indemnity,,,1842.43,,1842.43,351.37,2090.59,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Anthem,Individual Exchange,,351.37,,,351.37,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Anthem,State Preferred,,439.22,,,439.22,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Cigna,Cigna,,,,,,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Connecticare,Commerical,,,,,,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Connecticare,Exchange,,,,,,351.37,2090.59,Other,Could be inpatient or outpatient,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,Multiplan,Multiplan,,,2090.59,,2090.59,351.37,2090.59,percent of total billed charges,,
RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,90375,HCPCS,13533-318-01,NDC,both,0.5,mL,2459.52,1475.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,351.37,2090.59,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Aetna,Commerical,,,1223.2,,1223.2,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Aetna,Middlesex Employees,,,1172.95,,1172.95,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Anthem,Commerical,,534.52,,,534.52,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Anthem,Indemnity,,,1187.53,,1187.53,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Anthem,Individual Exchange,,427.62,,,427.62,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Anthem,State Preferred,,534.52,,,534.52,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Cigna,Cigna,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Connecticare,Commerical,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Connecticare,Exchange,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,Multiplan,Multiplan,,,1347.49,,1347.49,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,50632-010-01,NDC,both,1,ea,1585.28,951.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Aetna,Commerical,,,1223.2,,1223.2,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Aetna,Middlesex Employees,,,1172.95,,1172.95,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Anthem,Commerical,,534.52,,,534.52,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Anthem,Indemnity,,,1187.53,,1187.53,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Anthem,Individual Exchange,,427.62,,,427.62,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Anthem,State Preferred,,534.52,,,534.52,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Cigna,Cigna,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Connecticare,Commerical,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Connecticare,Exchange,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,Multiplan,Multiplan,,,1347.49,,1347.49,427.62,1347.49,percent of total billed charges,,
"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",90675,HCPCS,58160-964-12,NDC,both,1,ea,1585.28,951.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,427.62,1347.49,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Aetna,Commerical,,,615.55,,615.55,427.62,678.1,percent of total billed charges,,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Aetna,Middlesex Employees,,,590.26,,590.26,427.62,678.1,percent of total billed charges,,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Anthem,Commerical,,534.52,,,534.52,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Anthem,Indemnity,,,597.6,,597.6,427.62,678.1,percent of total billed charges,,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Anthem,Individual Exchange,,427.62,,,427.62,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Anthem,State Preferred,,534.52,,,534.52,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Cigna,Cigna,,,,,,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Connecticare,Commerical,,,,,,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Connecticare,Exchange,,,,,,427.62,678.1,Other,Could be inpatient or outpatient,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,Multiplan,Multiplan,,,678.1,,678.1,427.62,678.1,percent of total billed charges,,
"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION",90675,HCPCS,49281-250-51,NDC,both,1,ea,797.76,478.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,427.62,678.1,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Aetna,Commerical,,,3.31,,3.31,3.17,3.65,percent of total billed charges,,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Aetna,Middlesex Employees,,,3.17,,3.17,3.17,3.65,percent of total billed charges,,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Anthem,Commerical,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Anthem,Indemnity,,,3.21,,3.21,3.17,3.65,percent of total billed charges,,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Anthem,Individual Exchange,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Anthem,State Preferred,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Cigna,Cigna,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Connecticare,Commerical,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Connecticare,Exchange,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,Multiplan,Multiplan,,,3.65,,3.65,3.17,3.65,percent of total billed charges,,
RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,J3490,HCPCS,0487-5901-99,NDC,both,1,ea,4.29,2.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.17,3.65,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Aetna,Commerical,,,22.65,,22.65,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Aetna,Middlesex Employees,,,21.72,,21.72,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Anthem,Commerical,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Anthem,Indemnity,,,21.99,,21.99,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Anthem,Individual Exchange,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Anthem,State Preferred,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Cigna,Cigna,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Connecticare,Commerical,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Connecticare,Exchange,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,Multiplan,Multiplan,,,24.95,,24.95,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG CHEWABLE TABLET,J8499,HCPCS,0006-0477-61,NDC,both,1,ea,29.35,17.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Aetna,Commerical,,,22.65,,22.65,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Aetna,Middlesex Employees,,,21.72,,21.72,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Anthem,Commerical,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Anthem,Indemnity,,,21.99,,21.99,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Anthem,Individual Exchange,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Anthem,State Preferred,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Cigna,Cigna,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Connecticare,Commerical,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Connecticare,Exchange,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,Multiplan,Multiplan,,,24.95,,24.95,21.72,24.95,percent of total billed charges,,
RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,J8499,HCPCS,0006-3603-61,NDC,both,1,ea,29.35,17.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.72,24.95,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Aetna,Commerical,,,5.66,,5.66,5.43,6.24,percent of total billed charges,,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Aetna,Middlesex Employees,,,5.43,,5.43,5.43,6.24,percent of total billed charges,,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Anthem,Commerical,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Anthem,Indemnity,,,5.5,,5.5,5.43,6.24,percent of total billed charges,,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Anthem,Individual Exchange,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Anthem,State Preferred,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Cigna,Cigna,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Connecticare,Commerical,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Connecticare,Exchange,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,Multiplan,Multiplan,,,6.24,,6.24,5.43,6.24,percent of total billed charges,,
RALTEGRAVIR 25 MG CHEWABLE TABLET,J3490,HCPCS,0006-0473-61,NDC,both,1,ea,7.34,4.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.43,6.24,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Aetna,Commerical,,,90.57,,90.57,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Aetna,Middlesex Employees,,,86.85,,86.85,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Anthem,Commerical,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Anthem,Indemnity,,,87.93,,87.93,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Anthem,Individual Exchange,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Anthem,State Preferred,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Cigna,Cigna,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Connecticare,Commerical,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Connecticare,Exchange,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,Multiplan,Multiplan,,,99.77,,99.77,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,0006-0227-61,NDC,both,1,ea,117.38,70.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Aetna,Commerical,,,90.57,,90.57,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Aetna,Middlesex Employees,,,86.85,,86.85,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Anthem,Commerical,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Anthem,Indemnity,,,87.93,,87.93,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Anthem,Individual Exchange,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Anthem,State Preferred,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Cigna,Cigna,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Connecticare,Commerical,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Connecticare,Exchange,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,Multiplan,Multiplan,,,99.77,,99.77,86.85,99.77,percent of total billed charges,,
RALTEGRAVIR 400 MG TABLET,J3490,HCPCS,40810-0010-09,NDC,both,1,ea,117.38,70.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.85,99.77,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Aetna,Commerical,,,3144,,3144,452.5,3463.45,percent of total billed charges,,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Aetna,Middlesex Employees,,,3014.83,,3014.83,452.5,3463.45,percent of total billed charges,,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Anthem,Commerical,,,,,,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Anthem,Indemnity,,,3052.32,,3052.32,452.5,3463.45,percent of total billed charges,,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Anthem,Individual Exchange,,,,,,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Anthem,State Preferred,,,,,,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Cigna,Cigna,,522.97,,,522.97,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Connecticare,Commerical,,566.96,,,566.96,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Connecticare,Exchange,,566.96,,,566.96,452.5,3463.45,Other,Could be inpatient or outpatient,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,Multiplan,Multiplan,,,3463.45,,3463.45,452.5,3463.45,percent of total billed charges,,
RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,J2783,HCPCS,0024-5150-10,NDC,both,1,ea,4074.65,2444.79,United Healthcare/Oxford,United Healthcare/Oxford,,452.5,,,452.5,452.5,3463.45,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
RASPBERRY ORAL SYRUP,J3490,HCPCS,395266416,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Aetna,Commerical,,,98826.68,,98826.68,249.97,108868.17,percent of total billed charges,,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Aetna,Middlesex Employees,,,94766.54,,94766.54,249.97,108868.17,percent of total billed charges,,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Anthem,Commerical,,,,,,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Anthem,Indemnity,,,95944.88,,95944.88,249.97,108868.17,percent of total billed charges,,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Anthem,Individual Exchange,,,,,,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Anthem,State Preferred,,,,,,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Cigna,Cigna,,249.97,,,249.97,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Connecticare,Commerical,,337.08,,,337.08,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Connecticare,Exchange,,337.08,,,337.08,249.97,108868.17,Other,Could be inpatient or outpatient,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,Multiplan,Multiplan,,,108868.17,,108868.17,249.97,108868.17,percent of total billed charges,,
RAVULIZUMAB-CWVZ 10 MG/ML INTRAVENOUS SOLUTION,J1303,HCPCS,25682-022-01,NDC,both,1,mL,128080.2,76848.12,United Healthcare/Oxford,United Healthcare/Oxford,,269.88,,,269.88,249.97,108868.17,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Aetna,Commerical,,,118.72,,118.72,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Aetna,Middlesex Employees,,,113.84,,113.84,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Anthem,Commerical,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Anthem,Indemnity,,,115.26,,115.26,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Anthem,Individual Exchange,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Anthem,State Preferred,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Cigna,Cigna,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Connecticare,Commerical,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Connecticare,Exchange,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,Multiplan,Multiplan,,,130.78,,130.78,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,40810-0209-18,NDC,both,1,ea,153.86,92.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Aetna,Commerical,,,118.72,,118.72,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Aetna,Middlesex Employees,,,113.84,,113.84,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Anthem,Commerical,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Anthem,Indemnity,,,115.26,,115.26,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Anthem,Individual Exchange,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Anthem,State Preferred,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Cigna,Cigna,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Connecticare,Commerical,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Connecticare,Exchange,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,Multiplan,Multiplan,,,130.78,,130.78,113.84,130.78,percent of total billed charges,,
RELUGOLIX 40 MG-ESTRADIOL 1 MG-NORETHINDRONE ACETATE 0.5 MG TABLET,J3490,HCPCS,72974-415-01,NDC,both,1,ea,153.86,92.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,113.84,130.78,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Aetna,Commerical,,,1688.85,,1688.85,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Aetna,Middlesex Employees,,,1619.47,,1619.47,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Anthem,Commerical,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Anthem,Indemnity,,,1639.61,,1639.61,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Anthem,Individual Exchange,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Anthem,State Preferred,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Cigna,Cigna,,7.18,,,7.18,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Connecticare,Commerical,,9.7,,,9.7,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Connecticare,Exchange,,9.7,,,9.7,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,Multiplan,Multiplan,,,1860.45,,1860.45,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-1,NDC,both,0.01,ea,2188.77,1313.26,United Healthcare/Oxford,United Healthcare/Oxford,,7.75,,,7.75,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Aetna,Commerical,,,1688.85,,1688.85,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Aetna,Middlesex Employees,,,1619.47,,1619.47,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Anthem,Commerical,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Anthem,Indemnity,,,1639.61,,1639.61,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Anthem,Individual Exchange,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Anthem,State Preferred,,,,,,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Cigna,Cigna,,7.18,,,7.18,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Connecticare,Commerical,,9.7,,,9.7,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Connecticare,Exchange,,9.7,,,9.7,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,Multiplan,Multiplan,,,1860.45,,1860.45,7.18,1860.45,percent of total billed charges,,
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,J0248,HCPCS,61958-2901-2,NDC,both,1,ea,2188.77,1313.26,United Healthcare/Oxford,United Healthcare/Oxford,,7.75,,,7.75,7.18,1860.45,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Aetna,Commerical,,,1536.72,,1536.72,1473.58,1692.86,percent of total billed charges,,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Aetna,Middlesex Employees,,,1473.58,,1473.58,1473.58,1692.86,percent of total billed charges,,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Anthem,Commerical,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Anthem,Indemnity,,,1491.91,,1491.91,1473.58,1692.86,percent of total billed charges,,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Anthem,Individual Exchange,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Anthem,State Preferred,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Cigna,Cigna,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Connecticare,Commerical,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Connecticare,Exchange,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,Multiplan,Multiplan,,,1692.86,,1692.86,1473.58,1692.86,percent of total billed charges,,
REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),J3490,HCPCS,61958-2902-1,NDC,both,1,mL,1991.6,1194.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1473.58,1692.86,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Aetna,Commerical,,,113.49,,113.49,108.83,125.03,percent of total billed charges,,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Aetna,Middlesex Employees,,,108.83,,108.83,108.83,125.03,percent of total billed charges,,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Anthem,Commerical,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Anthem,Indemnity,,,110.19,,110.19,108.83,125.03,percent of total billed charges,,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Anthem,Individual Exchange,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Anthem,State Preferred,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Cigna,Cigna,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Connecticare,Commerical,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Connecticare,Exchange,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,Multiplan,Multiplan,,,125.03,,125.03,108.83,125.03,percent of total billed charges,,
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9391-10,NDC,both,1,ea,147.09,88.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.83,125.03,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-01,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-724-05,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-05,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Aetna,Commerical,,,285.29,,285.29,273.57,314.28,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Aetna,Middlesex Employees,,,273.57,,273.57,273.57,314.28,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Anthem,Commerical,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Anthem,Indemnity,,,276.97,,276.97,273.57,314.28,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Anthem,Individual Exchange,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Anthem,State Preferred,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Cigna,Cigna,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Connecticare,Commerical,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Connecticare,Exchange,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,Multiplan,Multiplan,,,314.28,,314.28,273.57,314.28,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-99,NDC,both,0.5,ea,369.74,221.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,273.57,314.28,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-00,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-913-02,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Aetna,Commerical,,,273.86,,273.86,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Aetna,Middlesex Employees,,,262.61,,262.61,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Indemnity,,,265.88,,265.88,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Anthem,Individual Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Anthem,State Preferred,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Cigna,Cigna,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Connecticare,Commerical,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Connecticare,Exchange,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,Multiplan,Multiplan,,,301.69,,301.69,262.61,301.69,percent of total billed charges,,
REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,J3490,HCPCS,72078-035-00,NDC,both,0.5,ea,354.93,212.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,262.61,301.69,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Aetna,Commerical,,,458.01,,458.01,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Aetna,Middlesex Employees,,,439.2,,439.2,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Anthem,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Anthem,Indemnity,,,444.66,,444.66,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Anthem,Individual Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Anthem,State Preferred,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Cigna,Cigna,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Connecticare,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Connecticare,Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,Multiplan,Multiplan,,,504.55,,504.55,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-198-98,NDC,both,0.2,ea,593.59,356.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Aetna,Commerical,,,458.01,,458.01,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Aetna,Middlesex Employees,,,439.2,,439.2,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Anthem,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Anthem,Indemnity,,,444.66,,444.66,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Anthem,Individual Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Anthem,State Preferred,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Cigna,Cigna,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Connecticare,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Connecticare,Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,Multiplan,Multiplan,,,504.55,,504.55,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-00,NDC,both,0.2,ea,593.59,356.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Aetna,Commerical,,,458.01,,458.01,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Aetna,Middlesex Employees,,,439.2,,439.2,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Anthem,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Anthem,Indemnity,,,444.66,,444.66,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Anthem,Individual Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Anthem,State Preferred,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Cigna,Cigna,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Connecticare,Commerical,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Connecticare,Exchange,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,Multiplan,Multiplan,,,504.55,,504.55,439.2,504.55,percent of total billed charges,,
REMIFENTANIL 5 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-914-05,NDC,both,0.2,ea,593.59,356.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,439.2,504.55,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Aetna,Commerical,,,237.84,,237.84,87.37,262,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Aetna,Middlesex Employees,,,228.07,,228.07,87.37,262,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Anthem,Commerical,,,,,,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Anthem,Indemnity,,,230.9,,230.9,87.37,262,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Anthem,Individual Exchange,,,,,,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Anthem,State Preferred,,,,,,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Cigna,Cigna,,87.37,,,87.37,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Connecticare,Commerical,,122.37,,,122.37,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Connecticare,Exchange,,122.37,,,122.37,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,Multiplan,Multiplan,,,262,,262,87.37,262,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE",J2790,HCPCS,0562-7805-01,NDC,both,1,ea,308.24,184.94,United Healthcare/Oxford,United Healthcare/Oxford,,94.33,,,94.33,87.37,262,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Aetna,Commerical,,,4273.51,,4273.51,38.1,4707.73,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Aetna,Middlesex Employees,,,4097.94,,4097.94,38.1,4707.73,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Anthem,Commerical,,,,,,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Anthem,Indemnity,,,4148.89,,4148.89,38.1,4707.73,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Anthem,Individual Exchange,,,,,,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Anthem,State Preferred,,,,,,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Cigna,Cigna,,38.1,,,38.1,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Connecticare,Commerical,,52.43,,,52.43,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Connecticare,Exchange,,52.43,,,52.43,38.1,4707.73,Other,Could be inpatient or outpatient,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,Multiplan,Multiplan,,,4707.73,,4707.73,38.1,4707.73,percent of total billed charges,,
"RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT (1,000 MCG)/4.4 ML INJ. SOLN",J2792,HCPCS,70257-310-51,NDC,both,0.088,mL,5538.5,3323.1,United Healthcare/Oxford,United Healthcare/Oxford,,41.14,,,41.14,38.1,4707.73,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184507141,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,1184571401,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Aetna,Commerical,,,0.21,,0.21,0.2,0.23,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Aetna,Middlesex Employees,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Anthem,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Anthem,Indemnity,,,0.2,,0.2,0.2,0.23,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Anthem,Individual Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Anthem,State Preferred,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Cigna,Cigna,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Connecticare,Commerical,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Connecticare,Exchange,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,Multiplan,Multiplan,,,0.23,,0.23,0.2,0.23,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,7431200640,NDC,both,1,ea,0.27,0.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.2,0.23,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,J3490,HCPCS,40810-0008-87,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 25 MG ORAL TAB,J3490,HCPCS,40810-0002-69,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
RIBOFLAVIN 50 MG ORAL TAB,J3490,HCPCS,40810-0002-68,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Aetna,Commerical,,,41.37,,41.37,39.67,45.57,percent of total billed charges,,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Aetna,Middlesex Employees,,,39.67,,39.67,39.67,45.57,percent of total billed charges,,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Anthem,Commerical,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Anthem,Indemnity,,,40.16,,40.16,39.67,45.57,percent of total billed charges,,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Anthem,Individual Exchange,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Anthem,State Preferred,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Cigna,Cigna,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Connecticare,Commerical,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Connecticare,Exchange,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,Multiplan,Multiplan,,,45.57,,45.57,39.67,45.57,percent of total billed charges,,
RIFABUTIN 150 MG CAPSULE,J3490,HCPCS,59762-1350-1,NDC,both,1,ea,53.61,32.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.67,45.57,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Aetna,Commerical,,,294.34,,294.34,282.25,324.25,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Aetna,Middlesex Employees,,,282.25,,282.25,282.25,324.25,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Anthem,Commerical,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Anthem,Indemnity,,,285.76,,285.76,282.25,324.25,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Anthem,Individual Exchange,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Anthem,State Preferred,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Cigna,Cigna,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Connecticare,Commerical,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Connecticare,Exchange,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,Multiplan,Multiplan,,,324.25,,324.25,282.25,324.25,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-78,NDC,both,1,mL,381.47,228.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,282.25,324.25,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Aetna,Commerical,,,588.68,,588.68,564.5,648.5,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Aetna,Middlesex Employees,,,564.5,,564.5,564.5,648.5,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Anthem,Commerical,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Anthem,Indemnity,,,571.52,,571.52,564.5,648.5,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Anthem,Individual Exchange,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Anthem,State Preferred,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Cigna,Cigna,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Connecticare,Commerical,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Connecticare,Exchange,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,Multiplan,Multiplan,,,648.5,,648.5,564.5,648.5,percent of total billed charges,,
RIFABUTIN 20 MG/ML ORAL SUSP,J3490,HCPCS,40810-0201-79,NDC,both,1,mL,762.94,457.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,564.5,648.5,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Aetna,Commerical,,,7.67,,7.67,7.35,8.45,percent of total billed charges,,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Aetna,Middlesex Employees,,,7.35,,7.35,7.35,8.45,percent of total billed charges,,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Anthem,Commerical,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Anthem,Indemnity,,,7.45,,7.45,7.35,8.45,percent of total billed charges,,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Anthem,Individual Exchange,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Anthem,State Preferred,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Cigna,Cigna,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Connecticare,Commerical,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Connecticare,Exchange,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,Multiplan,Multiplan,,,8.45,,8.45,7.35,8.45,percent of total billed charges,,
RIFAMPIN 150 MG CAPSULE,J3490,HCPCS,68180-658-06,NDC,both,1,ea,9.94,5.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.35,8.45,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Aetna,Commerical,,,187.95,,187.95,180.23,207.05,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Aetna,Middlesex Employees,,,180.23,,180.23,180.23,207.05,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Anthem,Commerical,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Anthem,Indemnity,,,182.47,,182.47,180.23,207.05,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Anthem,Individual Exchange,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Anthem,State Preferred,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Cigna,Cigna,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Connecticare,Commerical,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Connecticare,Exchange,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,Multiplan,Multiplan,,,207.05,,207.05,180.23,207.05,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-70,NDC,both,1,mL,243.59,146.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,180.23,207.05,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Aetna,Commerical,,,93.98,,93.98,90.12,103.53,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Aetna,Middlesex Employees,,,90.12,,90.12,90.12,103.53,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Anthem,Commerical,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Anthem,Indemnity,,,91.24,,91.24,90.12,103.53,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Anthem,Individual Exchange,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Anthem,State Preferred,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Cigna,Cigna,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Connecticare,Commerical,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Connecticare,Exchange,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,Multiplan,Multiplan,,,103.53,,103.53,90.12,103.53,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-82,NDC,both,1,mL,121.8,73.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,90.12,103.53,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Aetna,Commerical,,,375.91,,375.91,360.46,414.1,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Aetna,Middlesex Employees,,,360.46,,360.46,360.46,414.1,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Anthem,Commerical,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Anthem,Indemnity,,,364.95,,364.95,360.46,414.1,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Anthem,Individual Exchange,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Anthem,State Preferred,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Cigna,Cigna,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Connecticare,Commerical,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Connecticare,Exchange,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,Multiplan,Multiplan,,,414.1,,414.1,360.46,414.1,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-83,NDC,both,1,mL,487.18,292.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,360.46,414.1,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Aetna,Commerical,,,469.88,,469.88,450.58,517.62,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Aetna,Middlesex Employees,,,450.58,,450.58,450.58,517.62,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Anthem,Commerical,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Anthem,Indemnity,,,456.18,,456.18,450.58,517.62,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Anthem,Individual Exchange,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Anthem,State Preferred,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Cigna,Cigna,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Connecticare,Commerical,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Connecticare,Exchange,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,Multiplan,Multiplan,,,517.62,,517.62,450.58,517.62,percent of total billed charges,,
RIFAMPIN 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-84,NDC,both,1,mL,608.97,365.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,450.58,517.62,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Aetna,Commerical,,,8.09,,8.09,7.75,8.91,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Aetna,Middlesex Employees,,,7.75,,7.75,7.75,8.91,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Anthem,Commerical,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Anthem,Indemnity,,,7.85,,7.85,7.75,8.91,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Anthem,Individual Exchange,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Anthem,State Preferred,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Cigna,Cigna,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Connecticare,Commerical,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Connecticare,Exchange,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,Multiplan,Multiplan,,,8.91,,8.91,7.75,8.91,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,0904-5282-61,NDC,both,1,ea,10.48,6.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.75,8.91,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Aetna,Commerical,,,1.37,,1.37,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Anthem,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Anthem,Indemnity,,,1.33,,1.33,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Anthem,Individual Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Anthem,State Preferred,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Cigna,Cigna,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Connecticare,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Connecticare,Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,Multiplan,Multiplan,,,1.51,,1.51,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,61748-018-01,NDC,both,1,ea,1.78,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Aetna,Commerical,,,1.37,,1.37,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Anthem,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Anthem,Indemnity,,,1.33,,1.33,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Anthem,Individual Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Anthem,State Preferred,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Cigna,Cigna,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Connecticare,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Connecticare,Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,Multiplan,Multiplan,,,1.51,,1.51,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,63739-415-10,NDC,both,1,ea,1.78,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Aetna,Commerical,,,1.37,,1.37,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Anthem,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Anthem,Indemnity,,,1.33,,1.33,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Anthem,Individual Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Anthem,State Preferred,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Cigna,Cigna,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Connecticare,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Connecticare,Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,Multiplan,Multiplan,,,1.51,,1.51,1.32,1.51,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68084-358-11,NDC,both,1,ea,1.78,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Aetna,Commerical,,,10.86,,10.86,10.41,11.96,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Aetna,Middlesex Employees,,,10.41,,10.41,10.41,11.96,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Anthem,Commerical,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Anthem,Indemnity,,,10.54,,10.54,10.41,11.96,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Anthem,Individual Exchange,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Anthem,State Preferred,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Cigna,Cigna,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Connecticare,Commerical,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Connecticare,Exchange,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,Multiplan,Multiplan,,,11.96,,11.96,10.41,11.96,percent of total billed charges,,
RIFAMPIN 300 MG CAPSULE,J3490,HCPCS,68180-659-06,NDC,both,1,ea,14.07,8.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.41,11.96,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Aetna,Commerical,,,301.15,,301.15,288.78,331.75,percent of total billed charges,,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Aetna,Middlesex Employees,,,288.78,,288.78,288.78,331.75,percent of total billed charges,,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Anthem,Commerical,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Anthem,Indemnity,,,292.37,,292.37,288.78,331.75,percent of total billed charges,,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Anthem,Individual Exchange,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Anthem,State Preferred,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Cigna,Cigna,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Connecticare,Commerical,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Connecticare,Exchange,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,Multiplan,Multiplan,,,331.75,,331.75,288.78,331.75,percent of total billed charges,,
RIFAMPIN 6 MG/ML IN NS NICU,J3490,HCPCS,40810-0004-74,NDC,both,1,mL,390.29,234.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,288.78,331.75,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Aetna,Commerical,,,507.89,,507.89,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Aetna,Middlesex Employees,,,487.02,,487.02,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Anthem,Commerical,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Anthem,Indemnity,,,493.08,,493.08,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Anthem,Individual Exchange,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Anthem,State Preferred,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Cigna,Cigna,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Connecticare,Commerical,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Connecticare,Exchange,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,Multiplan,Multiplan,,,559.5,,559.5,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0597-01,NDC,both,1,ea,658.23,394.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Aetna,Commerical,,,507.89,,507.89,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Aetna,Middlesex Employees,,,487.02,,487.02,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Anthem,Commerical,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Anthem,Indemnity,,,493.08,,493.08,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Anthem,Individual Exchange,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Anthem,State Preferred,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Cigna,Cigna,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Connecticare,Commerical,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Connecticare,Exchange,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,Multiplan,Multiplan,,,559.5,,559.5,487.02,559.5,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0068-0599-01,NDC,both,1,ea,658.23,394.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,487.02,559.5,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Aetna,Commerical,,,455.41,,455.41,436.7,501.68,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Aetna,Middlesex Employees,,,436.7,,436.7,436.7,501.68,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Anthem,Commerical,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Anthem,Indemnity,,,442.13,,442.13,436.7,501.68,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Anthem,Individual Exchange,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Anthem,State Preferred,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Cigna,Cigna,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Connecticare,Commerical,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Connecticare,Exchange,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,Multiplan,Multiplan,,,501.68,,501.68,436.7,501.68,percent of total billed charges,,
RIFAMPIN 600 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-445-60,NDC,both,1,ea,590.21,354.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,436.7,501.68,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Aetna,Commerical,,,31.59,,31.59,30.29,34.8,percent of total billed charges,,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Aetna,Middlesex Employees,,,30.29,,30.29,30.29,34.8,percent of total billed charges,,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Anthem,Commerical,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Anthem,Indemnity,,,30.67,,30.67,30.29,34.8,percent of total billed charges,,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Anthem,Individual Exchange,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Anthem,State Preferred,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Cigna,Cigna,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Connecticare,Commerical,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Connecticare,Exchange,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,Multiplan,Multiplan,,,34.8,,34.8,30.29,34.8,percent of total billed charges,,
RIFAXIMIN 100 MG ORAL TAB,J3490,HCPCS,40810-0002-73,NDC,both,1,ea,40.94,24.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.29,34.8,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Aetna,Commerical,,,117.03,,117.03,1.86,128.92,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Aetna,Middlesex Employees,,,112.22,,112.22,1.86,128.92,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Anthem,Commerical,,,,,,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Anthem,Indemnity,,,113.62,,113.62,1.86,128.92,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Anthem,Individual Exchange,,,,,,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Anthem,State Preferred,,,,,,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Cigna,Cigna,,1.86,,,1.86,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Connecticare,Commerical,,2.52,,,2.52,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Connecticare,Exchange,,2.52,,,2.52,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,Multiplan,Multiplan,,,128.92,,128.92,1.86,128.92,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0002-71,NDC,both,1,mL,151.67,91,United Healthcare/Oxford,United Healthcare/Oxford,,2.01,,,2.01,1.86,128.92,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Aetna,Commerical,,,234.06,,234.06,1.86,257.84,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Aetna,Middlesex Employees,,,224.44,,224.44,1.86,257.84,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Anthem,Commerical,,,,,,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Anthem,Indemnity,,,227.23,,227.23,1.86,257.84,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Anthem,Individual Exchange,,,,,,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Anthem,State Preferred,,,,,,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Cigna,Cigna,,1.86,,,1.86,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Connecticare,Commerical,,2.52,,,2.52,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Connecticare,Exchange,,2.52,,,2.52,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,Multiplan,Multiplan,,,257.84,,257.84,1.86,257.84,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0018-02,NDC,both,1,mL,303.34,182,United Healthcare/Oxford,United Healthcare/Oxford,,2.01,,,2.01,1.86,257.84,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Aetna,Commerical,,,536.38,,536.38,1.86,590.88,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Aetna,Middlesex Employees,,,514.34,,514.34,1.86,590.88,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Anthem,Commerical,,,,,,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Anthem,Indemnity,,,520.74,,520.74,1.86,590.88,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Anthem,Individual Exchange,,,,,,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Anthem,State Preferred,,,,,,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Cigna,Cigna,,1.86,,,1.86,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Connecticare,Commerical,,2.52,,,2.52,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Connecticare,Exchange,,2.52,,,2.52,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,Multiplan,Multiplan,,,590.88,,590.88,1.86,590.88,percent of total billed charges,,
RIFAXIMIN 20 MG/ML ORAL SUSP,J7194,HCPCS,40810-0205-98,NDC,both,1,mL,695.15,417.09,United Healthcare/Oxford,United Healthcare/Oxford,,2.01,,,2.01,1.86,590.88,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Aetna,Commerical,,,29.14,,29.14,27.94,32.1,percent of total billed charges,,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Aetna,Middlesex Employees,,,27.94,,27.94,27.94,32.1,percent of total billed charges,,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Anthem,Commerical,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Anthem,Indemnity,,,28.29,,28.29,27.94,32.1,percent of total billed charges,,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Anthem,Individual Exchange,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Anthem,State Preferred,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Cigna,Cigna,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Connecticare,Commerical,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Connecticare,Exchange,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,Multiplan,Multiplan,,,32.1,,32.1,27.94,32.1,percent of total billed charges,,
RIFAXIMIN 200 MG TABLET,J3490,HCPCS,65649-301-03,NDC,both,1,ea,37.76,22.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,27.94,32.1,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Aetna,Commerical,,,149.8,,149.8,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Aetna,Middlesex Employees,,,143.64,,143.64,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Anthem,Commerical,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Anthem,Indemnity,,,145.43,,145.43,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Anthem,Individual Exchange,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Anthem,State Preferred,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Cigna,Cigna,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Connecticare,Commerical,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Connecticare,Exchange,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,Multiplan,Multiplan,,,165.02,,165.02,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,40810-0206-00,NDC,both,1,UN,194.14,116.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Aetna,Commerical,,,149.8,,149.8,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Aetna,Middlesex Employees,,,143.64,,143.64,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Anthem,Commerical,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Anthem,Indemnity,,,145.43,,145.43,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Anthem,Individual Exchange,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Anthem,State Preferred,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Cigna,Cigna,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Connecticare,Commerical,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Connecticare,Exchange,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,Multiplan,Multiplan,,,165.02,,165.02,143.64,165.02,percent of total billed charges,,
RIFAXIMIN 550 MG TABLET,J3490,HCPCS,65649-303-02,NDC,both,1,ea,194.14,116.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,143.64,165.02,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Aetna,Commerical,,,6333.4,,6333.4,6073.2,6976.92,percent of total billed charges,,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Aetna,Middlesex Employees,,,6073.2,,6073.2,6073.2,6976.92,percent of total billed charges,,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Anthem,Commerical,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Anthem,Indemnity,,,6148.72,,6148.72,6073.2,6976.92,percent of total billed charges,,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Anthem,Individual Exchange,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Anthem,State Preferred,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Cigna,Cigna,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Connecticare,Commerical,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Connecticare,Exchange,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,Multiplan,Multiplan,,,6976.92,,6976.92,6073.2,6976.92,percent of total billed charges,,
"RILPIVIRINE ER 600 MG/2 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-249-02,NDC,both,2,mL,8208.14,4924.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6073.2,6976.92,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Aetna,Commerical,,,9500.09,,9500.09,9109.79,10465.36,percent of total billed charges,,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Aetna,Middlesex Employees,,,9109.79,,9109.79,9109.79,10465.36,percent of total billed charges,,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Anthem,Commerical,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Anthem,Indemnity,,,9223.06,,9223.06,9109.79,10465.36,percent of total billed charges,,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Anthem,Individual Exchange,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Anthem,State Preferred,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Cigna,Cigna,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Connecticare,Commerical,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Connecticare,Exchange,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,Multiplan,Multiplan,,,10465.36,,10465.36,9109.79,10465.36,percent of total billed charges,,
"RILPIVIRINE ER 900 MG/3 ML (300 MG/ML) IM SUSPENSION, EXTENDED RELEASE",J3490,HCPCS,49702-243-02,NDC,both,3,mL,12312.19,7387.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9109.79,10465.36,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Aetna,Commerical,,,6.47,,6.47,6.21,7.13,percent of total billed charges,,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Aetna,Middlesex Employees,,,6.21,,6.21,6.21,7.13,percent of total billed charges,,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Anthem,Commerical,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Anthem,Indemnity,,,6.28,,6.28,6.21,7.13,percent of total billed charges,,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Anthem,Individual Exchange,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Anthem,State Preferred,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Cigna,Cigna,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Connecticare,Commerical,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Connecticare,Exchange,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,Multiplan,Multiplan,,,7.13,,7.13,6.21,7.13,percent of total billed charges,,
RIMANTADINE 100 MG TABLET,J3490,HCPCS,0115-1911-01,NDC,both,1,ea,8.39,5.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.21,7.13,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Aetna,Commerical,,,6.2,,6.2,5.94,6.83,percent of total billed charges,,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Aetna,Middlesex Employees,,,5.94,,5.94,5.94,6.83,percent of total billed charges,,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Anthem,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Anthem,Indemnity,,,6.02,,6.02,5.94,6.83,percent of total billed charges,,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Anthem,Individual Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Anthem,State Preferred,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Cigna,Cigna,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Connecticare,Commerical,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Connecticare,Exchange,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,Multiplan,Multiplan,,,6.83,,6.83,5.94,6.83,percent of total billed charges,,
RIMANTADINE 50 MG ORAL TAB,J3490,HCPCS,40810-0002-72,NDC,both,1,ea,8.03,4.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.94,6.83,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Aetna,Commerical,,,27000.15,,27000.15,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Aetna,Commerical,,,27000.15,,27000.15,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Aetna,Middlesex Employees,,,25890.89,,25890.89,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Aetna,Middlesex Employees,,,25890.89,,25890.89,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Commerical,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Commerical,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Indemnity,,,26212.82,,26212.82,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Indemnity,,,26212.82,,26212.82,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Individual Exchange,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,Individual Exchange,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,State Preferred,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Anthem,State Preferred,,,,,,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Cigna,Cigna,,16.94,,,16.94,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Cigna,Cigna,,16.94,,,16.94,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Connecticare,Commerical,,22.34,,,22.34,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Connecticare,Commerical,,22.34,,,22.34,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Connecticare,Exchange,,22.34,,,22.34,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Connecticare,Exchange,,22.34,,,22.34,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Multiplan,Multiplan,,,29743.56,,29743.56,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,Multiplan,Multiplan,,,29743.56,,29743.56,16.94,29743.56,percent of total billed charges,,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,United Healthcare/Oxford,United Healthcare/Oxford,,18.29,,,18.29,16.94,29743.56,Other,Could be inpatient or outpatient,
RISANKIZUMAB 600 MG/10 ML INJECTION,J2327,HCPCS,0074-5015-01,NDC,both,1,mL,34992.42,20995.45,United Healthcare/Oxford,United Healthcare/Oxford,,18.29,,,18.29,16.94,29743.56,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
RISPERIDONE 0.125 MG ORAL TAB,J3490,HCPCS,40810-0002-74,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-6357-61,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,0904-7360-61,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,40810-0009-64,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Aetna,Commerical,,,0.59,,0.59,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Aetna,Middlesex Employees,,,0.56,,0.56,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Anthem,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Anthem,Indemnity,,,0.57,,0.57,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Anthem,Individual Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Anthem,State Preferred,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Cigna,Cigna,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Connecticare,Commerical,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Connecticare,Exchange,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,Multiplan,Multiplan,,,0.65,,0.65,0.56,0.65,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68084-270-11,NDC,both,1,ea,0.76,0.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.56,0.65,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Aetna,Commerical,,,0.65,,0.65,0.62,0.71,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Aetna,Middlesex Employees,,,0.62,,0.62,0.62,0.71,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Anthem,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Anthem,Indemnity,,,0.63,,0.63,0.62,0.71,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Anthem,Individual Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Anthem,State Preferred,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Cigna,Cigna,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Connecticare,Commerical,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Connecticare,Exchange,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,Multiplan,Multiplan,,,0.71,,0.71,0.62,0.71,percent of total billed charges,,
RISPERIDONE 0.25 MG TABLET,J3490,HCPCS,68382-112-14,NDC,both,1,ea,0.84,0.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.62,0.71,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-6358-61,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Aetna,Commerical,,,0.73,,0.73,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Anthem,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Anthem,Indemnity,,,0.71,,0.71,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Anthem,Individual Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Anthem,State Preferred,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Cigna,Cigna,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Connecticare,Commerical,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Connecticare,Exchange,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,Multiplan,Multiplan,,,0.81,,0.81,0.7,0.81,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,0904-7361-61,NDC,both,1,ea,0.95,0.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.81,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Aetna,Commerical,,,2,,2,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Anthem,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Anthem,Individual Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Anthem,State Preferred,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Cigna,Cigna,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Connecticare,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Connecticare,Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-01,NDC,both,1,ea,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Aetna,Commerical,,,2,,2,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Aetna,Middlesex Employees,,,1.92,,1.92,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Anthem,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Anthem,Indemnity,,,1.94,,1.94,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Anthem,Individual Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Anthem,State Preferred,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Cigna,Cigna,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Connecticare,Commerical,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Connecticare,Exchange,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,Multiplan,Multiplan,,,2.2,,2.2,1.92,2.2,percent of total billed charges,,
RISPERIDONE 0.5 MG TABLET,J3490,HCPCS,68084-271-11,NDC,both,1,ea,2.59,1.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.92,2.2,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Aetna,Commerical,,,13.46,,13.46,12.9,14.82,percent of total billed charges,,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Aetna,Middlesex Employees,,,12.9,,12.9,12.9,14.82,percent of total billed charges,,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Anthem,Commerical,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Anthem,Indemnity,,,13.06,,13.06,12.9,14.82,percent of total billed charges,,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Anthem,Individual Exchange,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Anthem,State Preferred,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Cigna,Cigna,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Connecticare,Commerical,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Connecticare,Exchange,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,Multiplan,Multiplan,,,14.82,,14.82,12.9,14.82,percent of total billed charges,,
RISPERIDONE 1 MG DISINTEGRATING TABLET,J3490,HCPCS,59746-020-22,NDC,both,1,ea,17.44,10.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.9,14.82,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-6359-61,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,0904-7362-61,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,50458-300-01,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
RISPERIDONE 1 MG TABLET,J3490,HCPCS,68084-272-01,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Aetna,Commerical,,,29.88,,29.88,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Aetna,Middlesex Employees,,,28.66,,28.66,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Anthem,Commerical,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Anthem,Indemnity,,,29.01,,29.01,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Anthem,Individual Exchange,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Anthem,State Preferred,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Cigna,Cigna,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Connecticare,Commerical,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Connecticare,Exchange,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,Multiplan,Multiplan,,,32.92,,32.92,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,27808-002-01,NDC,both,1,mL,38.73,23.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Aetna,Commerical,,,29.88,,29.88,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Aetna,Middlesex Employees,,,28.66,,28.66,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Anthem,Commerical,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Anthem,Indemnity,,,29.01,,29.01,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Anthem,Individual Exchange,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Anthem,State Preferred,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Cigna,Cigna,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Connecticare,Commerical,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Connecticare,Exchange,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,Multiplan,Multiplan,,,32.92,,32.92,28.66,32.92,percent of total billed charges,,
RISPERIDONE 1 MG/ML ORAL SOLUTION,J3490,HCPCS,65162-673-84,NDC,both,1,mL,38.73,23.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.66,32.92,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-6360-61,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,0904-7363-61,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Aetna,Commerical,,,1.23,,1.23,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Aetna,Middlesex Employees,,,1.18,,1.18,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Anthem,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Anthem,Indemnity,,,1.19,,1.19,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Anthem,Individual Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Anthem,State Preferred,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Cigna,Cigna,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Connecticare,Commerical,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Connecticare,Exchange,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,Multiplan,Multiplan,,,1.35,,1.35,1.18,1.35,percent of total billed charges,,
RISPERIDONE 2 MG TABLET,J3490,HCPCS,51079-463-20,NDC,both,1,ea,1.59,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.18,1.35,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Aetna,Commerical,,,24.39,,24.39,23.39,26.87,percent of total billed charges,,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Aetna,Middlesex Employees,,,23.39,,23.39,23.39,26.87,percent of total billed charges,,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Anthem,Commerical,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Anthem,Indemnity,,,23.68,,23.68,23.39,26.87,percent of total billed charges,,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Anthem,Individual Exchange,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Anthem,State Preferred,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Cigna,Cigna,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Connecticare,Commerical,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Connecticare,Exchange,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,Multiplan,Multiplan,,,26.87,,26.87,23.39,26.87,percent of total billed charges,,
RITONAVIR 100 MG ORAL POWDER PACKET,J3490,HCPCS,0074-3399-30,NDC,both,1,ea,31.61,18.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.39,26.87,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Aetna,Commerical,,,7.49,,7.49,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Aetna,Middlesex Employees,,,7.18,,7.18,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Anthem,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Anthem,Indemnity,,,7.27,,7.27,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Anthem,Individual Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Anthem,State Preferred,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Cigna,Cigna,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Connecticare,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Connecticare,Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,Multiplan,Multiplan,,,8.25,,8.25,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0054-0407-13,NDC,both,1,ea,9.71,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Aetna,Commerical,,,7.49,,7.49,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Aetna,Middlesex Employees,,,7.18,,7.18,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Anthem,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Anthem,Indemnity,,,7.27,,7.27,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Anthem,Individual Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Anthem,State Preferred,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Cigna,Cigna,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Connecticare,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Connecticare,Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,Multiplan,Multiplan,,,8.25,,8.25,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,0074-2340-30,NDC,both,1,ea,9.71,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Aetna,Commerical,,,7.48,,7.48,7.17,8.24,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Aetna,Middlesex Employees,,,7.17,,7.17,7.17,8.24,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Anthem,Commerical,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Anthem,Indemnity,,,7.26,,7.26,7.17,8.24,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Anthem,Individual Exchange,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Anthem,State Preferred,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Cigna,Cigna,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Connecticare,Commerical,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Connecticare,Exchange,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,Multiplan,Multiplan,,,8.24,,8.24,7.17,8.24,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,31722-597-30,NDC,both,1,ea,9.69,5.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.17,8.24,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Aetna,Commerical,,,7.49,,7.49,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Aetna,Middlesex Employees,,,7.18,,7.18,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Anthem,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Anthem,Indemnity,,,7.27,,7.27,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Anthem,Individual Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Anthem,State Preferred,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Cigna,Cigna,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Connecticare,Commerical,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Connecticare,Exchange,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,Multiplan,Multiplan,,,8.25,,8.25,7.18,8.25,percent of total billed charges,,
RITONAVIR 100 MG TABLET,J3490,HCPCS,65862-687-30,NDC,both,1,ea,9.71,5.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.18,8.25,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Aetna,Commerical,,,4117.94,,4117.94,3948.76,4536.35,percent of total billed charges,,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Aetna,Middlesex Employees,,,3948.76,,3948.76,3948.76,4536.35,percent of total billed charges,,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Anthem,Commerical,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Anthem,Indemnity,,,3997.86,,3997.86,3948.76,4536.35,percent of total billed charges,,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Anthem,Individual Exchange,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Anthem,State Preferred,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Cigna,Cigna,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Connecticare,Commerical,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Connecticare,Exchange,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,Multiplan,Multiplan,,,4536.35,,4536.35,3948.76,4536.35,percent of total billed charges,,
RITONAVIR 80 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-1940-63,NDC,both,1,mL,5336.88,3202.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3948.76,4536.35,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Aetna,Commerical,,,2776.5,,2776.5,94.77,3058.61,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Aetna,Middlesex Employees,,,2662.43,,2662.43,94.77,3058.61,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Anthem,Commerical,,,,,,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Anthem,Indemnity,,,2695.54,,2695.54,94.77,3058.61,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Anthem,Individual Exchange,,,,,,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Anthem,State Preferred,,,,,,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Cigna,Cigna,,109.53,,,109.53,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Connecticare,Commerical,,118.06,,,118.06,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Connecticare,Exchange,,118.06,,,118.06,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,Multiplan,Multiplan,,,3058.61,,3058.61,94.77,3058.61,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-051-21,NDC,both,1,mL,3598.37,2159.02,United Healthcare/Oxford,United Healthcare/Oxford,,94.77,,,94.77,94.77,3058.61,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Aetna,Commerical,,,13882.48,,13882.48,94.77,15293.04,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Aetna,Middlesex Employees,,,13312.14,,13312.14,94.77,15293.04,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Anthem,Commerical,,,,,,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Anthem,Indemnity,,,13477.66,,13477.66,94.77,15293.04,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Anthem,Individual Exchange,,,,,,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Anthem,State Preferred,,,,,,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Cigna,Cigna,,109.53,,,109.53,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Connecticare,Commerical,,118.06,,,118.06,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Connecticare,Exchange,,118.06,,,118.06,94.77,15293.04,Other,Could be inpatient or outpatient,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,Multiplan,Multiplan,,,15293.04,,15293.04,94.77,15293.04,percent of total billed charges,,
"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",J9312,HCPCS,50242-053-06,NDC,both,1,mL,17991.81,10795.09,United Healthcare/Oxford,United Healthcare/Oxford,,94.77,,,94.77,94.77,15293.04,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Aetna,Commerical,,,1731.68,,1731.68,41.11,1907.63,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Aetna,Middlesex Employees,,,1660.54,,1660.54,41.11,1907.63,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Anthem,Commerical,,,,,,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Anthem,Indemnity,,,1681.18,,1681.18,41.11,1907.63,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Anthem,Individual Exchange,,,,,,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Anthem,State Preferred,,,,,,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Cigna,Cigna,,47.52,,,47.52,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Connecticare,Commerical,,44.93,,,44.93,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Connecticare,Exchange,,44.93,,,44.93,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,Multiplan,Multiplan,,,1907.63,,1907.63,41.11,1907.63,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-103-10,NDC,both,1,mL,2244.27,1346.56,United Healthcare/Oxford,United Healthcare/Oxford,,41.11,,,41.11,41.11,1907.63,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Aetna,Commerical,,,8658.38,,8658.38,41.11,9538.13,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Aetna,Middlesex Employees,,,8302.66,,8302.66,41.11,9538.13,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Anthem,Commerical,,,,,,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Anthem,Indemnity,,,8405.9,,8405.9,41.11,9538.13,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Anthem,Individual Exchange,,,,,,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Anthem,State Preferred,,,,,,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Cigna,Cigna,,47.52,,,47.52,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Connecticare,Commerical,,44.93,,,44.93,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Connecticare,Exchange,,44.93,,,44.93,41.11,9538.13,Other,Could be inpatient or outpatient,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,Multiplan,Multiplan,,,9538.13,,9538.13,41.11,9538.13,percent of total billed charges,,
RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,Q5115,HCPCS,63459-104-50,NDC,both,1,mL,11221.33,6732.8,United Healthcare/Oxford,United Healthcare/Oxford,,41.11,,,41.11,41.11,9538.13,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Aetna,Commerical,,,1202.42,,1202.42,1153.02,1324.59,percent of total billed charges,,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Aetna,Middlesex Employees,,,1153.02,,1153.02,1153.02,1324.59,percent of total billed charges,,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Anthem,Commerical,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Anthem,Indemnity,,,1167.35,,1167.35,1153.02,1324.59,percent of total billed charges,,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Anthem,Individual Exchange,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Anthem,State Preferred,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Cigna,Cigna,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Connecticare,Commerical,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Connecticare,Exchange,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,Multiplan,Multiplan,,,1324.59,,1324.59,1153.02,1324.59,percent of total billed charges,,
RIVAROXABAN 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,50458-575-01,NDC,both,1,mL,1558.34,935,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1153.02,1324.59,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Aetna,Commerical,,,38.58,,38.58,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Aetna,Middlesex Employees,,,37,,37,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Anthem,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Anthem,Indemnity,,,37.46,,37.46,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Anthem,Individual Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Anthem,State Preferred,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Cigna,Cigna,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Connecticare,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Connecticare,Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,Multiplan,Multiplan,,,42.5,,42.5,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,40810-0203-74,NDC,both,1,ea,50,30,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Aetna,Commerical,,,38.58,,38.58,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Aetna,Middlesex Employees,,,37,,37,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Anthem,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Anthem,Indemnity,,,37.46,,37.46,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Anthem,Individual Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Anthem,State Preferred,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Cigna,Cigna,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Connecticare,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Connecticare,Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,Multiplan,Multiplan,,,42.5,,42.5,37,42.5,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-10,NDC,both,1,ea,50,30,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Aetna,Commerical,,,31,,31,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Aetna,Middlesex Employees,,,29.73,,29.73,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Anthem,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Anthem,Indemnity,,,30.1,,30.1,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Anthem,Individual Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Anthem,State Preferred,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Cigna,Cigna,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Connecticare,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Connecticare,Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,Multiplan,Multiplan,,,34.15,,34.15,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 15 MG TABLET,J3490,HCPCS,50458-578-30,NDC,both,1,ea,40.18,24.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Aetna,Commerical,,,38.58,,38.58,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Aetna,Middlesex Employees,,,37,,37,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Anthem,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Anthem,Indemnity,,,37.46,,37.46,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Anthem,Individual Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Anthem,State Preferred,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Cigna,Cigna,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Connecticare,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Connecticare,Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,Multiplan,Multiplan,,,42.5,,42.5,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,40810-0203-75,NDC,both,1,ea,50,30,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Aetna,Commerical,,,38.58,,38.58,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Aetna,Middlesex Employees,,,37,,37,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Anthem,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Anthem,Indemnity,,,37.46,,37.46,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Anthem,Individual Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Anthem,State Preferred,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Cigna,Cigna,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Connecticare,Commerical,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Connecticare,Exchange,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,Multiplan,Multiplan,,,42.5,,42.5,37,42.5,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-10,NDC,both,1,ea,50,30,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37,42.5,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Aetna,Commerical,,,31,,31,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Aetna,Middlesex Employees,,,29.73,,29.73,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Anthem,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Anthem,Indemnity,,,30.1,,30.1,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Anthem,Individual Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Anthem,State Preferred,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Cigna,Cigna,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Connecticare,Commerical,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Connecticare,Exchange,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,Multiplan,Multiplan,,,34.15,,34.15,29.73,34.15,percent of total billed charges,,
RIVAROXABAN 20 MG TABLET,J3490,HCPCS,50458-579-30,NDC,both,1,ea,40.18,24.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.73,34.15,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Aetna,Commerical,,,2.31,,2.31,2.22,2.55,percent of total billed charges,,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Aetna,Middlesex Employees,,,2.22,,2.22,2.22,2.55,percent of total billed charges,,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Anthem,Commerical,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Anthem,Indemnity,,,2.25,,2.25,2.22,2.55,percent of total billed charges,,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Anthem,Individual Exchange,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Anthem,State Preferred,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Cigna,Cigna,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Connecticare,Commerical,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Connecticare,Exchange,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,Multiplan,Multiplan,,,2.55,,2.55,2.22,2.55,percent of total billed charges,,
RIZATRIPTAN 5 MG DISINTEGRATING TABLET,J3490,HCPCS,33342-093-41,NDC,both,1,ea,3,1.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.22,2.55,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9250-01,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1403-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3189-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Aetna,Commerical,,,10.88,,10.88,10.43,11.99,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Aetna,Middlesex Employees,,,10.43,,10.43,10.43,11.99,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Anthem,Commerical,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Anthem,Indemnity,,,10.56,,10.56,10.43,11.99,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Anthem,Individual Exchange,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Anthem,State Preferred,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Cigna,Cigna,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Connecticare,Commerical,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Connecticare,Exchange,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,Multiplan,Multiplan,,,11.99,,11.99,10.43,11.99,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-05,NDC,both,1,mL,14.1,8.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.43,11.99,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-11,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Aetna,Commerical,,,10.79,,10.79,10.34,11.88,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Aetna,Middlesex Employees,,,10.34,,10.34,10.34,11.88,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Anthem,Commerical,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Anthem,Indemnity,,,10.47,,10.47,10.34,11.88,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Anthem,Individual Exchange,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Anthem,State Preferred,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Cigna,Cigna,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Connecticare,Commerical,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Connecticare,Exchange,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,Multiplan,Multiplan,,,11.88,,11.88,10.34,11.88,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-49,NDC,both,1,mL,13.98,8.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.34,11.88,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-9558-50,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0781-3220-95,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-662-05,NDC,both,1,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-1,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Aetna,Commerical,,,8.4,,8.4,8.06,9.26,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Aetna,Middlesex Employees,,,8.06,,8.06,8.06,9.26,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Anthem,Commerical,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Anthem,Indemnity,,,8.16,,8.16,8.06,9.26,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Anthem,Individual Exchange,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Anthem,State Preferred,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Cigna,Cigna,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Connecticare,Commerical,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Connecticare,Exchange,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,Multiplan,Multiplan,,,9.26,,9.26,8.06,9.26,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,39822-4200-2,NDC,both,1,mL,10.89,6.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.06,9.26,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43066-007-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-01,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43547-530-10,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-426-10,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-00,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Aetna,Commerical,,,9.91,,9.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Aetna,Middlesex Employees,,,9.5,,9.5,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Indemnity,,,9.62,,9.62,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,Individual Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Anthem,State Preferred,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Cigna,Cigna,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Connecticare,Commerical,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Connecticare,Exchange,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,Multiplan,Multiplan,,,10.91,,10.91,9.5,10.91,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-228-10,NDC,both,1,mL,12.84,7.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.5,10.91,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69374-924-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70860-651-41,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-05,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Aetna,Commerical,,,4.95,,4.95,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Aetna,Middlesex Employees,,,4.75,,4.75,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Indemnity,,,4.81,,4.81,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,Individual Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Anthem,State Preferred,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Cigna,Cigna,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Connecticare,Commerical,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Connecticare,Exchange,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,Multiplan,Multiplan,,,5.46,,5.46,4.75,5.46,percent of total billed charges,,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,71288-700-06,NDC,both,1,mL,6.42,3.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.75,5.46,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Aetna,Commerical,,,5233.57,,5233.57,122.99,5765.34,percent of total billed charges,,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Aetna,Middlesex Employees,,,5018.56,,5018.56,122.99,5765.34,percent of total billed charges,,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Anthem,Commerical,,,,,,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Anthem,Indemnity,,,5080.96,,5080.96,122.99,5765.34,percent of total billed charges,,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Anthem,Individual Exchange,,,,,,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Anthem,State Preferred,,,,,,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Cigna,Cigna,,142.14,,,142.14,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Connecticare,Commerical,,154.3,,,154.3,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Connecticare,Exchange,,154.3,,,154.3,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,Multiplan,Multiplan,,,5765.34,,5765.34,122.99,5765.34,percent of total billed charges,,
ROMIPLOSTIM 125 MCG/ML DILUTION,J2796,HCPCS,40810-0203-59,NDC,both,0.08,mL,6782.75,4069.65,United Healthcare/Oxford,United Healthcare/Oxford,,122.99,,,122.99,122.99,5765.34,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Aetna,Commerical,,,7076.51,,7076.51,122.99,7795.54,percent of total billed charges,,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Aetna,Middlesex Employees,,,6785.79,,6785.79,122.99,7795.54,percent of total billed charges,,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Anthem,Commerical,,,,,,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Anthem,Indemnity,,,6870.16,,6870.16,122.99,7795.54,percent of total billed charges,,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Anthem,Individual Exchange,,,,,,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Anthem,State Preferred,,,,,,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Cigna,Cigna,,142.14,,,142.14,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Connecticare,Commerical,,154.3,,,154.3,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Connecticare,Exchange,,154.3,,,154.3,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,Multiplan,Multiplan,,,7795.54,,7795.54,122.99,7795.54,percent of total billed charges,,
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-221-01,NDC,both,0.04,ea,9171.22,5502.73,United Healthcare/Oxford,United Healthcare/Oxford,,122.99,,,122.99,122.99,7795.54,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Aetna,Commerical,,,14123.91,,14123.91,122.99,15559,percent of total billed charges,,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Aetna,Middlesex Employees,,,13543.65,,13543.65,122.99,15559,percent of total billed charges,,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Anthem,Commerical,,,,,,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Anthem,Indemnity,,,13712.05,,13712.05,122.99,15559,percent of total billed charges,,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Anthem,Individual Exchange,,,,,,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Anthem,State Preferred,,,,,,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Cigna,Cigna,,142.14,,,142.14,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Connecticare,Commerical,,154.3,,,154.3,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Connecticare,Exchange,,154.3,,,154.3,122.99,15559,Other,Could be inpatient or outpatient,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,Multiplan,Multiplan,,,15559,,15559,122.99,15559,percent of total billed charges,,
ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,J2796,HCPCS,55513-222-01,NDC,both,0.02,ea,18304.7,10982.82,United Healthcare/Oxford,United Healthcare/Oxford,,122.99,,,122.99,122.99,15559,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Aetna,Commerical,,,59.99,,59.99,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Aetna,Middlesex Employees,,,57.53,,57.53,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Anthem,Commerical,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Anthem,Indemnity,,,58.24,,58.24,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Anthem,Individual Exchange,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Anthem,State Preferred,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Cigna,Cigna,,0.08,,,0.08,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Connecticare,Commerical,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Connecticare,Exchange,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,Multiplan,Multiplan,,,66.09,,66.09,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-66,NDC,both,0.05,mL,77.75,46.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Aetna,Commerical,,,119.98,,119.98,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Aetna,Middlesex Employees,,,115.05,,115.05,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Anthem,Commerical,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Anthem,Indemnity,,,116.49,,116.49,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Anthem,Individual Exchange,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Anthem,State Preferred,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Cigna,Cigna,,0.08,,,0.08,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Connecticare,Commerical,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Connecticare,Exchange,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,Multiplan,Multiplan,,,132.18,,132.18,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,25021-671-67,NDC,both,0.5,mL,155.5,93.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Aetna,Commerical,,,59.99,,59.99,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Aetna,Middlesex Employees,,,57.53,,57.53,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Anthem,Commerical,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Anthem,Indemnity,,,58.24,,58.24,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Anthem,Individual Exchange,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Anthem,State Preferred,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Cigna,Cigna,,0.08,,,0.08,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Connecticare,Commerical,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Connecticare,Exchange,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,Multiplan,Multiplan,,,66.09,,66.09,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-02,NDC,both,0.5,mL,77.75,46.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Aetna,Commerical,,,12,,12,0.08,13.22,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Aetna,Middlesex Employees,,,11.51,,11.51,0.08,13.22,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Anthem,Commerical,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Anthem,Indemnity,,,11.65,,11.65,0.08,13.22,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Anthem,Individual Exchange,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Anthem,State Preferred,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Cigna,Cigna,,0.08,,,0.08,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Connecticare,Commerical,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Connecticare,Exchange,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,Multiplan,Multiplan,,,13.22,,13.22,0.08,13.22,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,15.55,9.33,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Aetna,Commerical,,,59.99,,59.99,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Aetna,Middlesex Employees,,,57.53,,57.53,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Anthem,Commerical,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Anthem,Indemnity,,,58.24,,58.24,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Anthem,Individual Exchange,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Anthem,State Preferred,,,,,,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Cigna,Cigna,,0.08,,,0.08,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Connecticare,Commerical,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Connecticare,Exchange,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,Multiplan,Multiplan,,,66.09,,66.09,0.08,66.09,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-61,NDC,both,0.5,mL,77.75,46.65,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,66.09,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Aetna,Commerical,,,119.98,,119.98,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Aetna,Middlesex Employees,,,115.05,,115.05,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Anthem,Commerical,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Anthem,Indemnity,,,116.49,,116.49,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Anthem,Individual Exchange,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Anthem,State Preferred,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Cigna,Cigna,,0.08,,,0.08,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Connecticare,Commerical,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Connecticare,Exchange,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,Multiplan,Multiplan,,,132.18,,132.18,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-63,NDC,both,200,mL,155.5,93.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Aetna,Commerical,,,119.98,,119.98,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Aetna,Middlesex Employees,,,115.05,,115.05,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Anthem,Commerical,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Anthem,Indemnity,,,116.49,,116.49,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Anthem,Individual Exchange,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Anthem,State Preferred,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Cigna,Cigna,,0.08,,,0.08,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Connecticare,Commerical,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Connecticare,Exchange,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,Multiplan,Multiplan,,,132.18,,132.18,0.08,132.18,percent of total billed charges,,
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,J2795,HCPCS,63323-285-64,NDC,both,200,mL,155.5,93.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Aetna,Commerical,,,10.52,,10.52,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Aetna,Middlesex Employees,,,10.09,,10.09,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Anthem,Commerical,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Anthem,Indemnity,,,10.22,,10.22,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Anthem,Individual Exchange,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Anthem,State Preferred,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Cigna,Cigna,,0.08,,,0.08,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Connecticare,Commerical,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Connecticare,Exchange,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,Multiplan,Multiplan,,,11.59,,11.59,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-01,NDC,both,0.2,mL,13.64,8.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Aetna,Commerical,,,10.52,,10.52,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Aetna,Middlesex Employees,,,10.09,,10.09,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Anthem,Commerical,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Anthem,Indemnity,,,10.22,,10.22,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Anthem,Individual Exchange,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Anthem,State Preferred,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Cigna,Cigna,,0.08,,,0.08,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Connecticare,Commerical,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Connecticare,Exchange,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,Multiplan,Multiplan,,,11.59,,11.59,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,43066-019-10,NDC,both,0.2,mL,13.64,8.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Aetna,Commerical,,,10.52,,10.52,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Aetna,Middlesex Employees,,,10.09,,10.09,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Anthem,Commerical,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Anthem,Indemnity,,,10.22,,10.22,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Anthem,Individual Exchange,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Anthem,State Preferred,,,,,,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Cigna,Cigna,,0.08,,,0.08,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Connecticare,Commerical,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Connecticare,Exchange,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,Multiplan,Multiplan,,,11.59,,11.59,0.08,11.59,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-23,NDC,both,0.2,mL,13.64,8.18,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,11.59,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-01,NDC,both,0.2,mL,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,J2795,HCPCS,70069-064-10,NDC,both,0.2,mL,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Aetna,Commerical,,,14.32,,14.32,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Aetna,Middlesex Employees,,,13.73,,13.73,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Anthem,Commerical,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Anthem,Indemnity,,,13.9,,13.9,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Anthem,Individual Exchange,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Anthem,State Preferred,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Cigna,Cigna,,0.08,,,0.08,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Connecticare,Commerical,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Connecticare,Exchange,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,Multiplan,Multiplan,,,15.78,,15.78,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-01,NDC,both,0.134,mL,18.56,11.14,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Aetna,Commerical,,,52.65,,52.65,0.08,58,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Aetna,Middlesex Employees,,,50.48,,50.48,0.08,58,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Anthem,Commerical,,,,,,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Anthem,Indemnity,,,51.11,,51.11,0.08,58,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Anthem,Individual Exchange,,,,,,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Anthem,State Preferred,,,,,,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Cigna,Cigna,,0.08,,,0.08,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Connecticare,Commerical,,0.09,,,0.09,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Connecticare,Exchange,,0.09,,,0.09,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,Multiplan,Multiplan,,,58,,58,0.08,58,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-20,NDC,both,0.133,mL,68.23,40.94,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,58,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Aetna,Commerical,,,14.32,,14.32,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Aetna,Middlesex Employees,,,13.73,,13.73,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Anthem,Commerical,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Anthem,Indemnity,,,13.9,,13.9,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Anthem,Individual Exchange,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Anthem,State Preferred,,,,,,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Cigna,Cigna,,0.08,,,0.08,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Connecticare,Commerical,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Connecticare,Exchange,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,Multiplan,Multiplan,,,15.78,,15.78,0.08,15.78,percent of total billed charges,,
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,J2795,HCPCS,63323-287-21,NDC,both,0.134,mL,18.56,11.14,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,15.78,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Aetna,Commerical,,,1072.75,,1072.75,0.08,1181.75,percent of total billed charges,,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Aetna,Middlesex Employees,,,1028.68,,1028.68,0.08,1181.75,percent of total billed charges,,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Anthem,Commerical,,,,,,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Anthem,Indemnity,,,1041.47,,1041.47,0.08,1181.75,percent of total billed charges,,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Anthem,Individual Exchange,,,,,,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Anthem,State Preferred,,,,,,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Cigna,Cigna,,0.08,,,0.08,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Connecticare,Commerical,,0.09,,,0.09,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Connecticare,Exchange,,0.09,,,0.09,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,Multiplan,Multiplan,,,1181.75,,1181.75,0.08,1181.75,percent of total billed charges,,
ROPIVACAINE 0.2% ON Q PUMP,J2795,HCPCS,40810-0013-02,NDC,both,750,mL,1390.29,834.17,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,1181.75,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,17478-081-30,NDC,both,0.2,mL,80.09,48.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Aetna,Commerical,,,41.2,,41.2,0.08,45.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Aetna,Middlesex Employees,,,39.51,,39.51,0.08,45.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Anthem,Commerical,,,,,,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Anthem,Indemnity,,,40,,40,0.08,45.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Anthem,Individual Exchange,,,,,,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Anthem,State Preferred,,,,,,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Cigna,Cigna,,0.08,,,0.08,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Connecticare,Commerical,,0.09,,,0.09,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Connecticare,Exchange,,0.09,,,0.09,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,Multiplan,Multiplan,,,45.39,,45.39,0.08,45.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-20,NDC,both,0.2,mL,53.4,32.04,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,45.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Aetna,Commerical,,,15.79,,15.79,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Aetna,Middlesex Employees,,,15.14,,15.14,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Commerical,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Indemnity,,,15.33,,15.33,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Anthem,Individual Exchange,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Anthem,State Preferred,,,,,,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Cigna,Cigna,,0.08,,,0.08,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Connecticare,Commerical,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Connecticare,Exchange,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,Multiplan,Multiplan,,,17.39,,17.39,0.08,17.39,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-30,NDC,both,0.2,mL,80.09,48.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,17.39,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Aetna,Commerical,,,61.8,,61.8,0.08,68.08,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Aetna,Middlesex Employees,,,59.26,,59.26,0.08,68.08,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Anthem,Commerical,,,,,,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Anthem,Indemnity,,,60,,60,0.08,68.08,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Anthem,Individual Exchange,,,,,,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Anthem,State Preferred,,,,,,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Cigna,Cigna,,0.08,,,0.08,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Connecticare,Commerical,,0.09,,,0.09,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Connecticare,Exchange,,0.09,,,0.09,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,Multiplan,Multiplan,,,68.08,,68.08,0.08,68.08,percent of total billed charges,,
ROPIVACAINE 5 MG/ML INJECTION SOLUTION,J2795,HCPCS,63323-286-95,NDC,both,0.2,mL,80.09,48.05,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,68.08,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Aetna,Commerical,,,56.15,,56.15,0.08,61.85,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Aetna,Middlesex Employees,,,53.84,,53.84,0.08,61.85,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Anthem,Commerical,,,,,,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Anthem,Indemnity,,,54.51,,54.51,0.08,61.85,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Anthem,Individual Exchange,,,,,,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Anthem,State Preferred,,,,,,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Cigna,Cigna,,0.08,,,0.08,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Connecticare,Commerical,,0.09,,,0.09,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Connecticare,Exchange,,0.09,,,0.09,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,Multiplan,Multiplan,,,61.85,,61.85,0.08,61.85,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,25021-671-82,NDC,both,0.5,mL,72.77,43.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,61.85,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Aetna,Commerical,,,5.62,,5.62,0.08,6.19,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Aetna,Middlesex Employees,,,5.39,,5.39,0.08,6.19,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Anthem,Commerical,,,,,,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Anthem,Indemnity,,,5.45,,5.45,0.08,6.19,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Anthem,Individual Exchange,,,,,,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Anthem,State Preferred,,,,,,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Cigna,Cigna,,0.08,,,0.08,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Connecticare,Commerical,,0.09,,,0.09,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Connecticare,Exchange,,0.09,,,0.09,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,Multiplan,Multiplan,,,6.19,,6.19,0.08,6.19,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-10,NDC,both,0.5,mL,7.28,4.37,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,6.19,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Aetna,Commerical,,,12,,12,0.08,13.22,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Aetna,Middlesex Employees,,,11.51,,11.51,0.08,13.22,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Anthem,Commerical,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Anthem,Indemnity,,,11.65,,11.65,0.08,13.22,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Anthem,Individual Exchange,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Anthem,State Preferred,,,,,,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Cigna,Cigna,,0.08,,,0.08,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Connecticare,Commerical,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Connecticare,Exchange,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,Multiplan,Multiplan,,,13.22,,13.22,0.08,13.22,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-23,NDC,both,0.5,mL,14.56,8.74,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,13.22,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Aetna,Commerical,,,119.98,,119.98,0.08,132.18,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Aetna,Middlesex Employees,,,115.05,,115.05,0.08,132.18,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Anthem,Commerical,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Anthem,Indemnity,,,116.49,,116.49,0.08,132.18,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Anthem,Individual Exchange,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Anthem,State Preferred,,,,,,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Cigna,Cigna,,0.08,,,0.08,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Connecticare,Commerical,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Connecticare,Exchange,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,Multiplan,Multiplan,,,132.18,,132.18,0.08,132.18,percent of total billed charges,,
ROPIVACAINE INFUSION VIA SCIATIC NERVE,J2795,HCPCS,63323-285-64,NDC,both,200,mL,145.54,87.32,United Healthcare/Oxford,United Healthcare/Oxford,,0.09,,,0.09,0.08,132.18,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Aetna,Commerical,,,220.03,,220.03,120.69,242.39,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Aetna,Middlesex Employees,,,210.99,,210.99,120.69,242.39,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Anthem,Commerical,,150.86,,,150.86,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Anthem,Indemnity,,,213.61,,213.61,120.69,242.39,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Anthem,Individual Exchange,,120.69,,,120.69,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Anthem,State Preferred,,150.86,,,150.86,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Cigna,Cigna,,,,,,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Connecticare,Commerical,,,,,,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Connecticare,Exchange,,,,,,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,Multiplan,Multiplan,,,242.39,,242.39,120.69,242.39,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-01,NDC,both,1,mL,285.16,171.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,120.69,242.39,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Aetna,Commerical,,,243.25,,243.25,120.69,267.97,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Aetna,Middlesex Employees,,,233.26,,233.26,120.69,267.97,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Anthem,Commerical,,150.86,,,150.86,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Anthem,Indemnity,,,236.16,,236.16,120.69,267.97,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Anthem,Individual Exchange,,120.69,,,120.69,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Anthem,State Preferred,,150.86,,,150.86,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Cigna,Cigna,,,,,,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Connecticare,Commerical,,,,,,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Connecticare,Exchange,,,,,,120.69,267.97,Other,Could be inpatient or outpatient,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,Multiplan,Multiplan,,,267.97,,267.97,120.69,267.97,percent of total billed charges,,
"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",90680,HCPCS,0006-4047-41,NDC,both,2,mL,315.26,189.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,120.69,267.97,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Aetna,Commerical,,,24.31,,24.31,23.31,26.78,percent of total billed charges,,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Aetna,Middlesex Employees,,,23.31,,23.31,23.31,26.78,percent of total billed charges,,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Anthem,Commerical,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Anthem,Indemnity,,,23.6,,23.6,23.31,26.78,percent of total billed charges,,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Anthem,Individual Exchange,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Anthem,State Preferred,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Cigna,Cigna,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Connecticare,Commerical,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Connecticare,Exchange,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,Multiplan,Multiplan,,,26.78,,26.78,23.31,26.78,percent of total billed charges,,
RUFINAMIDE 100 MG ORAL TAB,J8499,HCPCS,40810-0002-75,NDC,both,2,ea,31.5,18.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.31,26.78,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Aetna,Commerical,,,6.54,,6.54,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Aetna,Middlesex Employees,,,6.27,,6.27,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Anthem,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Anthem,Indemnity,,,6.34,,6.34,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Anthem,Individual Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Anthem,State Preferred,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Cigna,Cigna,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Connecticare,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Connecticare,Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,Multiplan,Multiplan,,,7.2,,7.2,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,0054-0425-23,NDC,both,1,ea,8.47,5.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Aetna,Commerical,,,6.54,,6.54,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Aetna,Middlesex Employees,,,6.27,,6.27,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Anthem,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Anthem,Indemnity,,,6.34,,6.34,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Anthem,Individual Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Anthem,State Preferred,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Cigna,Cigna,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Connecticare,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Connecticare,Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,Multiplan,Multiplan,,,7.2,,7.2,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,40810-0010-12,NDC,both,1,ea,8.47,5.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Aetna,Commerical,,,6.54,,6.54,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Aetna,Middlesex Employees,,,6.27,,6.27,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Anthem,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Anthem,Indemnity,,,6.34,,6.34,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Anthem,Individual Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Anthem,State Preferred,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Cigna,Cigna,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Connecticare,Commerical,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Connecticare,Exchange,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,Multiplan,Multiplan,,,7.2,,7.2,6.27,7.2,percent of total billed charges,,
RUFINAMIDE 200 MG TABLET,J8499,HCPCS,62856-582-52,NDC,both,1,ea,8.47,5.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.27,7.2,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Aetna,Commerical,,,1824.32,,1824.32,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Aetna,Middlesex Employees,,,1749.38,,1749.38,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Anthem,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Anthem,Indemnity,,,1771.13,,1771.13,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Anthem,Individual Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Anthem,State Preferred,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Cigna,Cigna,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Connecticare,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Connecticare,Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,Multiplan,Multiplan,,,2009.69,,2009.69,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,0054-0528-63,NDC,both,5,mL,2364.34,1418.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Aetna,Commerical,,,475.92,,475.92,456.36,524.27,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Aetna,Middlesex Employees,,,456.36,,456.36,456.36,524.27,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Anthem,Commerical,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Anthem,Indemnity,,,462.04,,462.04,456.36,524.27,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Anthem,Individual Exchange,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Anthem,State Preferred,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Cigna,Cigna,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Connecticare,Commerical,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Connecticare,Exchange,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,Multiplan,Multiplan,,,524.27,,524.27,456.36,524.27,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0015-00,NDC,both,5,mL,616.79,370.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,456.36,524.27,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Aetna,Commerical,,,1824.32,,1824.32,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Aetna,Middlesex Employees,,,1749.38,,1749.38,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Anthem,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Anthem,Indemnity,,,1771.13,,1771.13,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Anthem,Individual Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Anthem,State Preferred,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Cigna,Cigna,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Connecticare,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Connecticare,Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,Multiplan,Multiplan,,,2009.69,,2009.69,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,62856-584-46,NDC,both,5,mL,2364.34,1418.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Aetna,Commerical,,,1824.32,,1824.32,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Aetna,Middlesex Employees,,,1749.38,,1749.38,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Anthem,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Anthem,Indemnity,,,1771.13,,1771.13,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Anthem,Individual Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Anthem,State Preferred,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Cigna,Cigna,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Connecticare,Commerical,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Connecticare,Exchange,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,Multiplan,Multiplan,,,2009.69,,2009.69,1749.38,2009.69,percent of total billed charges,,
RUFINAMIDE 40 MG/ML ORAL SUSPENSION,J3490,HCPCS,67877-673-62,NDC,both,5,mL,2364.34,1418.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1749.38,2009.69,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Aetna,Commerical,,,11.04,,11.04,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Aetna,Middlesex Employees,,,10.59,,10.59,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Anthem,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Anthem,Indemnity,,,10.72,,10.72,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Anthem,Individual Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Anthem,State Preferred,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Cigna,Cigna,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Connecticare,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Connecticare,Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,Multiplan,Multiplan,,,12.16,,12.16,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,0054-0426-23,NDC,both,1,ea,14.31,8.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Aetna,Commerical,,,11.04,,11.04,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Aetna,Middlesex Employees,,,10.59,,10.59,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Anthem,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Anthem,Indemnity,,,10.72,,10.72,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Anthem,Individual Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Anthem,State Preferred,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Cigna,Cigna,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Connecticare,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Connecticare,Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,Multiplan,Multiplan,,,12.16,,12.16,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,59651-617-08,NDC,both,1,ea,14.31,8.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Aetna,Commerical,,,11.04,,11.04,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Aetna,Middlesex Employees,,,10.59,,10.59,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Anthem,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Anthem,Indemnity,,,10.72,,10.72,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Anthem,Individual Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Anthem,State Preferred,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Cigna,Cigna,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Connecticare,Commerical,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Connecticare,Exchange,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,Multiplan,Multiplan,,,12.16,,12.16,10.59,12.16,percent of total billed charges,,
RUFINAMIDE 400 MG TABLET,J8499,HCPCS,62856-583-52,NDC,both,1,ea,14.31,8.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.59,12.16,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Aetna,Commerical,,,29.52,,29.52,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Aetna,Middlesex Employees,,,28.31,,28.31,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Anthem,Commerical,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Anthem,Indemnity,,,28.66,,28.66,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Anthem,Individual Exchange,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Anthem,State Preferred,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Cigna,Cigna,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Connecticare,Commerical,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Connecticare,Exchange,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,Multiplan,Multiplan,,,32.52,,32.52,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,0078-0659-20,NDC,both,1,ea,38.26,22.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Aetna,Commerical,,,29.52,,29.52,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Aetna,Middlesex Employees,,,28.31,,28.31,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Anthem,Commerical,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Anthem,Indemnity,,,28.66,,28.66,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Anthem,Individual Exchange,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Anthem,State Preferred,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Cigna,Cigna,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Connecticare,Commerical,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Connecticare,Exchange,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,Multiplan,Multiplan,,,32.52,,32.52,28.31,32.52,percent of total billed charges,,
SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,J3490,HCPCS,40810-0206-21,NDC,both,1,ea,38.26,22.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.31,32.52,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Aetna,Commerical,,,31.35,,31.35,30.06,34.54,percent of total billed charges,,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Aetna,Middlesex Employees,,,30.06,,30.06,30.06,34.54,percent of total billed charges,,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Anthem,Commerical,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Anthem,Indemnity,,,30.44,,30.44,30.06,34.54,percent of total billed charges,,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Anthem,Individual Exchange,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Anthem,State Preferred,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Cigna,Cigna,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Connecticare,Commerical,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Connecticare,Exchange,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,Multiplan,Multiplan,,,34.54,,34.54,30.06,34.54,percent of total billed charges,,
SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,J3490,HCPCS,0078-0777-20,NDC,both,1,ea,40.63,24.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.06,34.54,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Aetna,Commerical,,,28.08,,28.08,26.92,30.93,percent of total billed charges,,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Aetna,Middlesex Employees,,,26.92,,26.92,26.92,30.93,percent of total billed charges,,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Anthem,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Anthem,Indemnity,,,27.26,,27.26,26.92,30.93,percent of total billed charges,,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Anthem,Individual Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Anthem,State Preferred,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Cigna,Cigna,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Connecticare,Commerical,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Connecticare,Exchange,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,Multiplan,Multiplan,,,30.93,,30.93,26.92,30.93,percent of total billed charges,,
SAFFLOWER OIL (BULK),J3490,HCPCS,5155206266,NDC,both,1,mL,36.39,21.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.92,30.93,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Aetna,Commerical,,,605.24,,605.24,580.37,666.73,percent of total billed charges,,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Aetna,Middlesex Employees,,,580.37,,580.37,580.37,666.73,percent of total billed charges,,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Anthem,Commerical,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Anthem,Indemnity,,,587.59,,587.59,580.37,666.73,percent of total billed charges,,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Anthem,Individual Exchange,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Anthem,State Preferred,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Cigna,Cigna,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Connecticare,Commerical,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Connecticare,Exchange,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,Multiplan,Multiplan,,,666.73,,666.73,580.37,666.73,percent of total billed charges,,
SALICYLIC ACID 6 % TOPICAL GEL,J3490,HCPCS,42192-134-40,NDC,both,1,gm,784.39,470.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,580.37,666.73,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Aetna,Commerical,,,7.41,,7.41,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Aetna,Middlesex Employees,,,7.1,,7.1,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Anthem,Commerical,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Anthem,Indemnity,,,7.19,,7.19,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Anthem,Individual Exchange,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Anthem,State Preferred,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Cigna,Cigna,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Connecticare,Commerical,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Connecticare,Exchange,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,Multiplan,Multiplan,,,8.16,,8.16,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,6014629312,NDC,both,1,mL,9.6,5.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Aetna,Commerical,,,18.53,,18.53,17.77,20.42,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Aetna,Middlesex Employees,,,17.77,,17.77,17.77,20.42,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Anthem,Commerical,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Anthem,Indemnity,,,17.99,,17.99,17.77,20.42,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Anthem,Individual Exchange,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Anthem,State Preferred,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Cigna,Cigna,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Connecticare,Commerical,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Connecticare,Exchange,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,Multiplan,Multiplan,,,20.42,,20.42,17.77,20.42,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,8489800001,NDC,both,1,mL,24.02,14.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.77,20.42,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Aetna,Commerical,,,7.41,,7.41,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Aetna,Middlesex Employees,,,7.1,,7.1,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Anthem,Commerical,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Anthem,Indemnity,,,7.19,,7.19,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Anthem,Individual Exchange,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Anthem,State Preferred,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Cigna,Cigna,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Connecticare,Commerical,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Connecticare,Exchange,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,Multiplan,Multiplan,,,8.16,,8.16,7.1,8.16,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.2,J3490,HCPCS,7309-8000-03,NDC,both,1,mL,9.6,5.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.1,8.16,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Aetna,Commerical,,,12.61,,12.61,12.09,13.89,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Aetna,Middlesex Employees,,,12.09,,12.09,12.09,13.89,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Anthem,Commerical,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Anthem,Indemnity,,,12.24,,12.24,12.09,13.89,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Anthem,Individual Exchange,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Anthem,State Preferred,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Cigna,Cigna,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Connecticare,Commerical,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Connecticare,Exchange,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,Multiplan,Multiplan,,,13.89,,13.89,12.09,13.89,percent of total billed charges,,
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,J3490,HCPCS,4858280220,NDC,both,237,mL,16.34,9.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.09,13.89,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Aetna,Commerical,,,859.83,,859.83,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Aetna,Middlesex Employees,,,824.51,,824.51,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Anthem,Commerical,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Anthem,Indemnity,,,834.76,,834.76,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Anthem,Individual Exchange,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Anthem,State Preferred,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Cigna,Cigna,,84.6,,,84.6,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Connecticare,Commerical,,92.04,,,92.04,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Connecticare,Exchange,,92.04,,,92.04,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,Multiplan,Multiplan,,,947.2,,947.2,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-1,NDC,both,0.2,ea,1114.35,668.61,United Healthcare/Oxford,United Healthcare/Oxford,,73.2,,,73.2,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Aetna,Commerical,,,859.83,,859.83,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Aetna,Middlesex Employees,,,824.51,,824.51,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Anthem,Commerical,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Anthem,Indemnity,,,834.76,,834.76,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Anthem,Individual Exchange,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Anthem,State Preferred,,,,,,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Cigna,Cigna,,84.6,,,84.6,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Connecticare,Commerical,,92.04,,,92.04,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Connecticare,Exchange,,92.04,,,92.04,73.2,947.2,Other,Could be inpatient or outpatient,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,Multiplan,Multiplan,,,947.2,,947.2,73.2,947.2,percent of total billed charges,,
SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION,J2820,HCPCS,71837-5843-5,NDC,both,0.2,ea,1114.35,668.61,United Healthcare/Oxford,United Healthcare/Oxford,,73.2,,,73.2,73.2,947.2,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-16,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,0378-6470-99,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,10019-553-04,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,45802-580-01,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-01,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Aetna,Commerical,,,52.28,,52.28,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Aetna,Middlesex Employees,,,50.14,,50.14,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Anthem,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Anthem,Indemnity,,,50.76,,50.76,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Anthem,Individual Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Anthem,State Preferred,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Cigna,Cigna,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Connecticare,Commerical,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Connecticare,Exchange,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,Multiplan,Multiplan,,,57.6,,57.6,50.14,57.6,percent of total billed charges,,
SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,J3490,HCPCS,50742-505-24,NDC,both,1,ea,67.76,40.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.14,57.6,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Aetna,Commerical,,,1876.69,,1876.69,37.82,2067.38,percent of total billed charges,,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Aetna,Middlesex Employees,,,1799.59,,1799.59,37.82,2067.38,percent of total billed charges,,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Anthem,Commerical,,,,,,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Anthem,Indemnity,,,1821.97,,1821.97,37.82,2067.38,percent of total billed charges,,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Anthem,Individual Exchange,,,,,,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Anthem,State Preferred,,,,,,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Cigna,Cigna,,37.82,,,37.82,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Connecticare,Commerical,,53.11,,,53.11,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Connecticare,Exchange,,53.11,,,53.11,37.82,2067.38,Other,Could be inpatient or outpatient,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,Multiplan,Multiplan,,,2067.38,,2067.38,37.82,2067.38,percent of total billed charges,,
SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,J2850,HCPCS,67066-005-01,NDC,both,0.063,ea,2432.21,1459.33,United Healthcare/Oxford,United Healthcare/Oxford,,51.94,,,51.94,37.82,2067.38,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Aetna,Commerical,,,5985.85,,5985.85,19.84,6594.05,percent of total billed charges,,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Aetna,Middlesex Employees,,,5739.93,,5739.93,19.84,6594.05,percent of total billed charges,,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Anthem,Commerical,,,,,,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Anthem,Indemnity,,,5811.3,,5811.3,19.84,6594.05,percent of total billed charges,,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Anthem,Individual Exchange,,,,,,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Anthem,State Preferred,,,,,,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Cigna,Cigna,,19.84,,,19.84,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Connecticare,Commerical,,26.78,,,26.78,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Connecticare,Exchange,,26.78,,,26.78,19.84,6594.05,Other,Could be inpatient or outpatient,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,Multiplan,Multiplan,,,6594.05,,6594.05,19.84,6594.05,percent of total billed charges,,
SECUKINUMAB 25 MG/ML INTRAVENOUS SOLUTION,J3247,HCPCS,0078-1168-61,NDC,both,0.04,mL,7757.71,4654.63,United Healthcare/Oxford,United Healthcare/Oxford,,21.42,,,21.42,19.84,6594.05,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
SELENIUM 25 MCG TABLET,J3490,HCPCS,40810-0203-95,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6510-25,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
SELENIUM 50 MCG TABLET,J3490,HCPCS,07610-02120,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Aetna,Commerical,,,7.96,,7.96,7.63,8.76,percent of total billed charges,,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Aetna,Middlesex Employees,,,7.63,,7.63,7.63,8.76,percent of total billed charges,,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Anthem,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Anthem,Indemnity,,,7.72,,7.72,7.63,8.76,percent of total billed charges,,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Anthem,Individual Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Anthem,State Preferred,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Cigna,Cigna,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Connecticare,Commerical,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Connecticare,Exchange,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,Multiplan,Multiplan,,,8.76,,8.76,7.63,8.76,percent of total billed charges,,
SELENIUM SULFIDE 1 % SHAMPOO,J3490,HCPCS,0536-1995-53,NDC,both,207,mL,10.31,6.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.63,8.76,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Aetna,Commerical,,,20.57,,20.57,19.73,22.66,percent of total billed charges,,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Aetna,Middlesex Employees,,,19.73,,19.73,19.73,22.66,percent of total billed charges,,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Anthem,Commerical,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Anthem,Indemnity,,,19.97,,19.97,19.73,22.66,percent of total billed charges,,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Anthem,Individual Exchange,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Anthem,State Preferred,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Cigna,Cigna,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Connecticare,Commerical,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Connecticare,Exchange,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,Multiplan,Multiplan,,,22.66,,22.66,19.73,22.66,percent of total billed charges,,
SELENIUM SULFIDE 2.5 % LOTION,J3490,HCPCS,45802-040-64,NDC,both,120,mL,26.66,16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.73,22.66,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Aetna,Commerical,,,0.24,,0.24,0.23,0.26,percent of total billed charges,,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Aetna,Middlesex Employees,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Anthem,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Anthem,Indemnity,,,0.23,,0.23,0.23,0.26,percent of total billed charges,,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Anthem,Individual Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Anthem,State Preferred,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Cigna,Cigna,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Connecticare,Commerical,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Connecticare,Exchange,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,Multiplan,Multiplan,,,0.26,,0.26,0.23,0.26,percent of total billed charges,,
SENNOSIDES 4.4 MG/2.5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-45,NDC,both,2.5,mL,0.31,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.23,0.26,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6522-61,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-6725-59,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,0904-7252-61,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Aetna,Commerical,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Aetna,Middlesex Employees,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Anthem,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Anthem,Indemnity,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Anthem,Individual Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Anthem,State Preferred,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Cigna,Cigna,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Connecticare,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Connecticare,Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,49483-080-01,NDC,both,1,ea,0.04,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Aetna,Commerical,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Aetna,Middlesex Employees,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Anthem,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Anthem,Indemnity,,,0.05,,0.05,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Anthem,Individual Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Anthem,State Preferred,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Cigna,Cigna,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Connecticare,Commerical,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Connecticare,Exchange,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,Multiplan,Multiplan,,,0.06,,0.06,0.05,0.06,percent of total billed charges,,
SENNOSIDES 8.6 MG TABLET,J3490,HCPCS,70000-0447-2,NDC,both,1,ea,0.07,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.05,0.06,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,3786485099,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,57896-458-01,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,J3490,HCPCS,70000-0526-1,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Aetna,Commerical,,,25.22,,25.22,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Aetna,Middlesex Employees,,,24.18,,24.18,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Anthem,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Anthem,Indemnity,,,24.48,,24.48,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Anthem,Individual Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Anthem,State Preferred,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Cigna,Cigna,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Connecticare,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Connecticare,Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,Multiplan,Multiplan,,,27.78,,27.78,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,0536-1266-59,NDC,both,1,mL,32.68,19.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Aetna,Commerical,,,25.22,,25.22,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Aetna,Middlesex Employees,,,24.18,,24.18,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Anthem,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Anthem,Indemnity,,,24.48,,24.48,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Anthem,Individual Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Anthem,State Preferred,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Cigna,Cigna,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Connecticare,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Connecticare,Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,Multiplan,Multiplan,,,27.78,,27.78,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,39328-020-08,NDC,both,1,mL,32.68,19.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Aetna,Commerical,,,25.22,,25.22,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Aetna,Middlesex Employees,,,24.18,,24.18,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Anthem,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Anthem,Indemnity,,,24.48,,24.48,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Anthem,Individual Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Anthem,State Preferred,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Cigna,Cigna,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Connecticare,Commerical,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Connecticare,Exchange,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,Multiplan,Multiplan,,,27.78,,27.78,24.18,27.78,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,J3490,HCPCS,57896-462-08,NDC,both,1,mL,32.68,19.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.18,27.78,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.46,0.53,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Anthem,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Anthem,Individual Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Anthem,State Preferred,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Cigna,Cigna,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Connecticare,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Connecticare,Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.46,0.53,percent of total billed charges,,
SENNOSIDES 8.8 MG/5 ML SYRUP SYRINGE,J3490,HCPCS,40810-0013-44,NDC,both,5,mL,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Aetna,Commerical,,,18.52,,18.52,17.76,20.4,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Aetna,Middlesex Employees,,,17.76,,17.76,17.76,20.4,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Anthem,Commerical,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Anthem,Indemnity,,,17.98,,17.98,17.76,20.4,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Anthem,Individual Exchange,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Anthem,State Preferred,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Cigna,Cigna,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Connecticare,Commerical,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Connecticare,Exchange,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,Multiplan,Multiplan,,,20.4,,20.4,17.76,20.4,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0049-4910-30,NDC,both,1,ea,24,14.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.76,20.4,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,0904-6926-61,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-01,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,60687-253-11,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Aetna,Commerical,,,0.69,,0.69,0.67,0.77,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Anthem,Indemnity,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-06,NDC,both,1,ea,0.9,0.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SERTRALINE 100 MG TABLET,J3490,HCPCS,68180-353-09,NDC,both,1,ea,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
SERTRALINE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-77,NDC,both,1,ea,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Aetna,Commerical,,,135.82,,135.82,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Aetna,Middlesex Employees,,,130.24,,130.24,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Anthem,Commerical,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Anthem,Indemnity,,,131.86,,131.86,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Anthem,Individual Exchange,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Anthem,State Preferred,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Cigna,Cigna,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Connecticare,Commerical,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Connecticare,Exchange,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,Multiplan,Multiplan,,,149.63,,149.63,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,59762-0067-1,NDC,both,1,mL,176.03,105.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Aetna,Commerical,,,135.82,,135.82,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Aetna,Middlesex Employees,,,130.24,,130.24,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Anthem,Commerical,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Anthem,Indemnity,,,131.86,,131.86,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Anthem,Individual Exchange,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Anthem,State Preferred,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Cigna,Cigna,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Connecticare,Commerical,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Connecticare,Exchange,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,Multiplan,Multiplan,,,149.63,,149.63,130.24,149.63,percent of total billed charges,,
SERTRALINE 20 MG/ML ORAL CONCENTRATE,J3490,HCPCS,64980-409-06,NDC,both,1,mL,176.03,105.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,130.24,149.63,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,0904-6924-61,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Aetna,Commerical,,,0.76,,0.76,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Aetna,Middlesex Employees,,,0.73,,0.73,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Anthem,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Anthem,Indemnity,,,0.74,,0.74,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Anthem,Individual Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Anthem,State Preferred,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Cigna,Cigna,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Connecticare,Commerical,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Connecticare,Exchange,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,Multiplan,Multiplan,,,0.84,,0.84,0.73,0.84,percent of total billed charges,,
SERTRALINE 25 MG TABLET,J3490,HCPCS,60687-231-01,NDC,both,1,ea,0.99,0.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.73,0.84,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Aetna,Commerical,,,0.93,,0.93,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Aetna,Middlesex Employees,,,0.89,,0.89,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Anthem,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Anthem,Indemnity,,,0.9,,0.9,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Anthem,Individual Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Anthem,State Preferred,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Cigna,Cigna,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Connecticare,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Connecticare,Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,Multiplan,Multiplan,,,1.02,,1.02,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,0904-6925-61,NDC,both,1,ea,1.2,0.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Aetna,Commerical,,,0.93,,0.93,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Aetna,Middlesex Employees,,,0.89,,0.89,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Anthem,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Anthem,Indemnity,,,0.9,,0.9,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Anthem,Individual Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Anthem,State Preferred,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Cigna,Cigna,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Connecticare,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Connecticare,Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,Multiplan,Multiplan,,,1.02,,1.02,0.89,1.02,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,60687-242-01,NDC,both,1,ea,1.2,0.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Aetna,Commerical,,,0.54,,0.54,0.52,0.6,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Aetna,Middlesex Employees,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Anthem,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Anthem,Indemnity,,,0.52,,0.52,0.52,0.6,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Anthem,Individual Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Anthem,State Preferred,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Cigna,Cigna,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Connecticare,Commerical,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Connecticare,Exchange,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,Multiplan,Multiplan,,,0.6,,0.6,0.52,0.6,percent of total billed charges,,
SERTRALINE 50 MG TABLET,J3490,HCPCS,68180-352-09,NDC,both,1,ea,0.7,0.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.52,0.6,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Aetna,Commerical,,,22.55,,22.55,21.63,24.85,percent of total billed charges,,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Aetna,Middlesex Employees,,,21.63,,21.63,21.63,24.85,percent of total billed charges,,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Anthem,Commerical,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Anthem,Indemnity,,,21.9,,21.9,21.63,24.85,percent of total billed charges,,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Anthem,Individual Exchange,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Anthem,State Preferred,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Cigna,Cigna,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Connecticare,Commerical,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Connecticare,Exchange,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,Multiplan,Multiplan,,,24.85,,24.85,21.63,24.85,percent of total billed charges,,
SEVELAMER CARBONATE 0.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0204-71,NDC,both,1,ea,29.23,17.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.63,24.85,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Aetna,Commerical,,,22.53,,22.53,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Aetna,Middlesex Employees,,,21.61,,21.61,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Anthem,Commerical,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Anthem,Indemnity,,,21.87,,21.87,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Anthem,Individual Exchange,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Anthem,State Preferred,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Cigna,Cigna,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Connecticare,Commerical,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Connecticare,Exchange,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,Multiplan,Multiplan,,,24.82,,24.82,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 0.6 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-45,NDC,both,1,ea,29.2,17.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Aetna,Commerical,,,5.59,,5.59,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Anthem,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Anthem,Indemnity,,,5.42,,5.42,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Anthem,Individual Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Anthem,State Preferred,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Cigna,Cigna,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Connecticare,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Connecticare,Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-01,NDC,both,1,ea,7.24,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Aetna,Commerical,,,5.59,,5.59,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Anthem,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Anthem,Indemnity,,,5.42,,5.42,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Anthem,Individual Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Anthem,State Preferred,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Cigna,Cigna,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Connecticare,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Connecticare,Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,43598-478-90,NDC,both,1,ea,7.24,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Aetna,Commerical,,,5.59,,5.59,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Anthem,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Anthem,Indemnity,,,5.42,,5.42,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Anthem,Individual Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Anthem,State Preferred,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Cigna,Cigna,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Connecticare,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Connecticare,Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0132-2,NDC,both,1,ea,7.24,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Aetna,Commerical,,,5.59,,5.59,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Anthem,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Anthem,Indemnity,,,5.42,,5.42,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Anthem,Individual Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Anthem,State Preferred,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Cigna,Cigna,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Connecticare,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Connecticare,Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-08,NDC,both,1,ea,7.24,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Aetna,Commerical,,,5.59,,5.59,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Aetna,Middlesex Employees,,,5.36,,5.36,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Anthem,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Anthem,Indemnity,,,5.42,,5.42,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Anthem,Individual Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Anthem,State Preferred,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Cigna,Cigna,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Connecticare,Commerical,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Connecticare,Exchange,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,Multiplan,Multiplan,,,6.15,,6.15,5.36,6.15,percent of total billed charges,,
SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,J8499,HCPCS,65862-930-90,NDC,both,1,ea,7.24,4.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.36,6.15,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Aetna,Commerical,,,22.53,,22.53,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Aetna,Middlesex Employees,,,21.61,,21.61,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Anthem,Commerical,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Anthem,Indemnity,,,21.87,,21.87,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Anthem,Individual Exchange,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Anthem,State Preferred,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Cigna,Cigna,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Connecticare,Commerical,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Connecticare,Exchange,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,Multiplan,Multiplan,,,24.82,,24.82,21.61,24.82,percent of total billed charges,,
SEVELAMER CARBONATE 1.2 GRAM ORAL POWDER PACKET,J8499,HCPCS,40810-0011-44,NDC,both,1,ea,29.2,17.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.61,24.82,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Aetna,Commerical,,,4569.11,,4569.11,4381.4,5033.37,percent of total billed charges,,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Aetna,Middlesex Employees,,,4381.4,,4381.4,4381.4,5033.37,percent of total billed charges,,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Anthem,Commerical,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Anthem,Indemnity,,,4435.88,,4435.88,4381.4,5033.37,percent of total billed charges,,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Anthem,Individual Exchange,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Anthem,State Preferred,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Cigna,Cigna,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Connecticare,Commerical,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Connecticare,Exchange,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,Multiplan,Multiplan,,,5033.37,,5033.37,4381.4,5033.37,percent of total billed charges,,
SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,J8499,HCPCS,58468-0131-2,NDC,both,90,ea,5921.61,3552.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4381.4,5033.37,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-29,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG POWDER PACKET FOR DECANTING,J8499,HCPCS,0115-1365-30,NDC,both,1,ea,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Aetna,Commerical,,,1.08,,1.08,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Aetna,Middlesex Employees,,,1.04,,1.04,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Anthem,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Anthem,Indemnity,,,1.05,,1.05,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Anthem,Individual Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Anthem,State Preferred,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Cigna,Cigna,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Connecticare,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Connecticare,Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,Multiplan,Multiplan,,,1.19,,1.19,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,0955-1050-27,NDC,both,1,ea,1.4,0.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Aetna,Commerical,,,1.08,,1.08,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Aetna,Middlesex Employees,,,1.04,,1.04,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Anthem,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Anthem,Indemnity,,,1.05,,1.05,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Anthem,Individual Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Anthem,State Preferred,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Cigna,Cigna,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Connecticare,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Connecticare,Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,Multiplan,Multiplan,,,1.19,,1.19,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,40810-0010-10,NDC,both,1,ea,1.4,0.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Aetna,Commerical,,,1.08,,1.08,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Aetna,Middlesex Employees,,,1.04,,1.04,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Anthem,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Anthem,Indemnity,,,1.05,,1.05,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Anthem,Individual Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Anthem,State Preferred,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Cigna,Cigna,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Connecticare,Commerical,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Connecticare,Exchange,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,Multiplan,Multiplan,,,1.19,,1.19,1.04,1.19,percent of total billed charges,,
SEVELAMER CARBONATE 800 MG TABLET,J8499,HCPCS,58468-0130-1,NDC,both,1,ea,1.4,0.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.04,1.19,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Aetna,Commerical,,,9.39,,9.39,9,10.34,percent of total billed charges,,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Aetna,Middlesex Employees,,,9,,9,9,10.34,percent of total billed charges,,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Anthem,Commerical,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Anthem,Indemnity,,,9.12,,9.12,9,10.34,percent of total billed charges,,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Anthem,Individual Exchange,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Anthem,State Preferred,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Cigna,Cigna,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Connecticare,Commerical,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Connecticare,Exchange,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,Multiplan,Multiplan,,,10.34,,10.34,9,10.34,percent of total billed charges,,
SEVELAMER HCL 800 MG TABLET,J8499,HCPCS,58468-0021-1,NDC,both,1,ea,12.17,7.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9,10.34,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Aetna,Commerical,,,187.66,,187.66,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Aetna,Middlesex Employees,,,179.95,,179.95,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Anthem,Commerical,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Anthem,Indemnity,,,182.19,,182.19,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Anthem,Individual Exchange,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Anthem,State Preferred,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Cigna,Cigna,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Connecticare,Commerical,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Connecticare,Exchange,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,Multiplan,Multiplan,,,206.73,,206.73,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,0074-4456-04,NDC,both,250,mL,243.21,145.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Aetna,Commerical,,,187.66,,187.66,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Aetna,Middlesex Employees,,,179.95,,179.95,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Anthem,Commerical,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Anthem,Indemnity,,,182.19,,182.19,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Anthem,Individual Exchange,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Anthem,State Preferred,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Cigna,Cigna,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Connecticare,Commerical,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Connecticare,Exchange,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,Multiplan,Multiplan,,,206.73,,206.73,179.95,206.73,percent of total billed charges,,
SEVOFLURANE INHALATION LIQUID,J3490,HCPCS,10019-651-64,NDC,both,1,mL,243.21,145.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,179.95,206.73,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Aetna,Commerical,,,344.88,,344.88,330.71,379.92,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Aetna,Middlesex Employees,,,330.71,,330.71,330.71,379.92,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Anthem,Commerical,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Anthem,Indemnity,,,334.83,,334.83,330.71,379.92,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Anthem,Individual Exchange,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Anthem,State Preferred,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Cigna,Cigna,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Connecticare,Commerical,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Connecticare,Exchange,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,Multiplan,Multiplan,,,379.92,,379.92,330.71,379.92,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,55150-166-13,NDC,both,12.5,mL,446.97,268.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,330.71,379.92,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,31722-136-31,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,51672-4231-8,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,68180-283-01,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69238-1574-1,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,69543-419-72,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Aetna,Commerical,,,886.72,,886.72,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Aetna,Middlesex Employees,,,850.29,,850.29,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Anthem,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Anthem,Indemnity,,,860.86,,860.86,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Anthem,Individual Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Anthem,State Preferred,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Cigna,Cigna,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Connecticare,Commerical,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Connecticare,Exchange,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,Multiplan,Multiplan,,,976.81,,976.81,850.29,976.81,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,J3490,HCPCS,70954-168-10,NDC,both,1,mL,1149.19,689.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,850.29,976.81,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Aetna,Commerical,,,101.08,,101.08,96.93,111.35,percent of total billed charges,,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Aetna,Middlesex Employees,,,96.93,,96.93,96.93,111.35,percent of total billed charges,,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Anthem,Commerical,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Anthem,Indemnity,,,98.13,,98.13,96.93,111.35,percent of total billed charges,,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Anthem,Individual Exchange,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Anthem,State Preferred,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Cigna,Cigna,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Connecticare,Commerical,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Connecticare,Exchange,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,Multiplan,Multiplan,,,111.35,,111.35,96.93,111.35,percent of total billed charges,,
SILDENAFIL 0.5 MG/ML IV DILUTION,J3490,HCPCS,40810-0018-89,NDC,both,2,mL,131,78.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,96.93,111.35,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,13668-188-30,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Aetna,Commerical,,,0.66,,0.66,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Aetna,Middlesex Employees,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Anthem,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Anthem,Indemnity,,,0.64,,0.64,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Anthem,Individual Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Anthem,State Preferred,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Cigna,Cigna,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Connecticare,Commerical,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Connecticare,Exchange,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,Multiplan,Multiplan,,,0.73,,0.73,0.64,0.73,percent of total billed charges,,
SILDENAFIL 100 MG TABLET,J3490,HCPCS,60219-1753-3,NDC,both,1,ea,0.86,0.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.64,0.73,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Aetna,Commerical,,,228.74,,228.74,219.34,251.98,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Aetna,Middlesex Employees,,,219.34,,219.34,219.34,251.98,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Anthem,Commerical,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Anthem,Indemnity,,,222.07,,222.07,219.34,251.98,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Anthem,Individual Exchange,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Anthem,State Preferred,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Cigna,Cigna,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Connecticare,Commerical,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Connecticare,Exchange,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,Multiplan,Multiplan,,,251.98,,251.98,219.34,251.98,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-78,NDC,both,1,mL,296.45,177.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,219.34,251.98,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Aetna,Commerical,,,114.37,,114.37,109.68,126,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Aetna,Middlesex Employees,,,109.68,,109.68,109.68,126,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Anthem,Commerical,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Anthem,Indemnity,,,111.04,,111.04,109.68,126,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Anthem,Individual Exchange,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Anthem,State Preferred,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Cigna,Cigna,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Connecticare,Commerical,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Connecticare,Exchange,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,Multiplan,Multiplan,,,126,,126,109.68,126,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-51,NDC,both,1,mL,148.23,88.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,109.68,126,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Aetna,Commerical,,,457.47,,457.47,438.68,503.96,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Aetna,Middlesex Employees,,,438.68,,438.68,438.68,503.96,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Anthem,Commerical,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Anthem,Indemnity,,,444.13,,444.13,438.68,503.96,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Anthem,Individual Exchange,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Anthem,State Preferred,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Cigna,Cigna,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Connecticare,Commerical,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Connecticare,Exchange,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,Multiplan,Multiplan,,,503.96,,503.96,438.68,503.96,percent of total billed charges,,
SILDENAFIL 2.5 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-52,NDC,both,1,mL,592.89,355.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,438.68,503.96,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Aetna,Commerical,,,1.3,,1.3,1.24,1.43,percent of total billed charges,,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Aetna,Middlesex Employees,,,1.24,,1.24,1.24,1.43,percent of total billed charges,,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Indemnity,,,1.26,,1.26,1.24,1.43,percent of total billed charges,,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,Individual Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Anthem,State Preferred,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Cigna,Cigna,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Connecticare,Commerical,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Connecticare,Exchange,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,Multiplan,Multiplan,,,1.43,,1.43,1.24,1.43,percent of total billed charges,,
SILDENAFIL 20 MG TABLET (CUSTOM FOR IMS),J3490,HCPCS,0904-6671-04,NDC,both,1,ea,1.68,1.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.24,1.43,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Aetna,Commerical,,,76.26,,76.26,73.12,84.01,percent of total billed charges,,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Aetna,Middlesex Employees,,,73.12,,73.12,73.12,84.01,percent of total billed charges,,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Anthem,Commerical,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Anthem,Indemnity,,,74.03,,74.03,73.12,84.01,percent of total billed charges,,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Anthem,Individual Exchange,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Anthem,State Preferred,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Cigna,Cigna,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Connecticare,Commerical,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Connecticare,Exchange,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,Multiplan,Multiplan,,,84.01,,84.01,73.12,84.01,percent of total billed charges,,
SILDENAFIL 25 MG (SPLIT TABLET),J3490,HCPCS,40810-0013-83,NDC,both,1,ea,98.83,59.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,73.12,84.01,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Aetna,Commerical,,,236.84,,236.84,227.11,260.91,percent of total billed charges,,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Aetna,Middlesex Employees,,,227.11,,227.11,227.11,260.91,percent of total billed charges,,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Anthem,Commerical,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Anthem,Indemnity,,,229.94,,229.94,227.11,260.91,percent of total billed charges,,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Anthem,Individual Exchange,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Anthem,State Preferred,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Cigna,Cigna,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Connecticare,Commerical,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Connecticare,Exchange,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,Multiplan,Multiplan,,,260.91,,260.91,227.11,260.91,percent of total billed charges,,
SILDENAFIL 50 MG TABLET,J3490,HCPCS,0069-4210-30,NDC,both,1,ea,306.95,184.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,227.11,260.91,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Aetna,Commerical,,,90.28,,90.28,86.57,99.45,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Aetna,Middlesex Employees,,,86.57,,86.57,86.57,99.45,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Anthem,Commerical,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Anthem,Indemnity,,,87.64,,87.64,86.57,99.45,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Anthem,Individual Exchange,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Anthem,State Preferred,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Cigna,Cigna,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Connecticare,Commerical,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Connecticare,Exchange,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,Multiplan,Multiplan,,,99.45,,99.45,86.57,99.45,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8019629660,NDC,both,44.4,gm,117,70.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,86.57,99.45,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Aetna,Commerical,,,91.5,,91.5,87.74,100.79,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Aetna,Middlesex Employees,,,87.74,,87.74,87.74,100.79,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Anthem,Commerical,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Anthem,Indemnity,,,88.83,,88.83,87.74,100.79,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Anthem,Individual Exchange,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Anthem,State Preferred,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Cigna,Cigna,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Connecticare,Commerical,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Connecticare,Exchange,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,Multiplan,Multiplan,,,100.79,,100.79,87.74,100.79,percent of total billed charges,,
"SILVER ER TOPICAL GEL,EXTENDED RELEASE",J3490,HCPCS,8327030909,NDC,both,1,mL,118.58,71.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,87.74,100.79,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Aetna,Commerical,,,164.55,,164.55,157.79,181.27,percent of total billed charges,,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Aetna,Middlesex Employees,,,157.79,,157.79,157.79,181.27,percent of total billed charges,,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Anthem,Commerical,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Anthem,Indemnity,,,159.75,,159.75,157.79,181.27,percent of total billed charges,,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Anthem,Individual Exchange,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Anthem,State Preferred,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Cigna,Cigna,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Connecticare,Commerical,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Connecticare,Exchange,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,Multiplan,Multiplan,,,181.27,,181.27,157.79,181.27,percent of total billed charges,,
SILVER NITRATE 0.5 % TOPICAL SOLUTION,J3490,HCPCS,0093-9614-13,NDC,both,1,mL,213.26,127.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,157.79,181.27,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Aetna,Commerical,,,195.64,,195.64,187.6,215.52,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Aetna,Middlesex Employees,,,187.6,,187.6,187.6,215.52,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Anthem,Commerical,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Anthem,Indemnity,,,189.93,,189.93,187.6,215.52,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Anthem,Individual Exchange,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Anthem,State Preferred,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Cigna,Cigna,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Connecticare,Commerical,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Connecticare,Exchange,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,Multiplan,Multiplan,,,215.52,,215.52,187.6,215.52,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12165-100-03,NDC,both,1,ea,253.55,152.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,187.6,215.52,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Aetna,Commerical,,,113.49,,113.49,108.82,125.02,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Aetna,Middlesex Employees,,,108.82,,108.82,108.82,125.02,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Anthem,Commerical,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Anthem,Indemnity,,,110.18,,110.18,108.82,125.02,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Anthem,Individual Exchange,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Anthem,State Preferred,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Cigna,Cigna,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Connecticare,Commerical,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Connecticare,Exchange,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,Multiplan,Multiplan,,,125.02,,125.02,108.82,125.02,percent of total billed charges,,
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,J3490,HCPCS,12870-0001-1,NDC,both,1,ea,147.08,88.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,108.82,125.02,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Aetna,Commerical,,,8.65,,8.65,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Aetna,Middlesex Employees,,,8.29,,8.29,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Anthem,Commerical,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Anthem,Indemnity,,,8.4,,8.4,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Anthem,Individual Exchange,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Anthem,State Preferred,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Cigna,Cigna,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Connecticare,Commerical,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Connecticare,Exchange,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,Multiplan,Multiplan,,,9.53,,9.53,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-25,NDC,both,1,gm,11.21,6.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Aetna,Commerical,,,138.31,,138.31,132.63,152.36,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Aetna,Middlesex Employees,,,132.63,,132.63,132.63,152.36,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Anthem,Commerical,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Anthem,Indemnity,,,134.28,,134.28,132.63,152.36,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Anthem,Individual Exchange,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Anthem,State Preferred,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Cigna,Cigna,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Connecticare,Commerical,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Connecticare,Exchange,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,Multiplan,Multiplan,,,152.36,,152.36,132.63,152.36,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-40,NDC,both,1,gm,179.25,107.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,132.63,152.36,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Aetna,Commerical,,,17.29,,17.29,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Aetna,Middlesex Employees,,,16.58,,16.58,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Anthem,Commerical,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Anthem,Indemnity,,,16.79,,16.79,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Anthem,Individual Exchange,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Anthem,State Preferred,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Cigna,Cigna,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Connecticare,Commerical,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Connecticare,Exchange,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,Multiplan,Multiplan,,,19.05,,19.05,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,43598-210-55,NDC,both,1,gm,22.41,13.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Aetna,Commerical,,,8.65,,8.65,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Aetna,Middlesex Employees,,,8.29,,8.29,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Anthem,Commerical,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Anthem,Indemnity,,,8.4,,8.4,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Anthem,Individual Exchange,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Anthem,State Preferred,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Cigna,Cigna,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Connecticare,Commerical,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Connecticare,Exchange,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,Multiplan,Multiplan,,,9.53,,9.53,8.29,9.53,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-25,NDC,both,1,gm,11.21,6.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.29,9.53,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Aetna,Commerical,,,17.29,,17.29,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Aetna,Middlesex Employees,,,16.58,,16.58,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Anthem,Commerical,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Anthem,Indemnity,,,16.79,,16.79,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Anthem,Individual Exchange,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Anthem,State Preferred,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Cigna,Cigna,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Connecticare,Commerical,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Connecticare,Exchange,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,Multiplan,Multiplan,,,19.05,,19.05,16.58,19.05,percent of total billed charges,,
SILVER SULFADIAZINE 1 % TOPICAL CREAM,J3490,HCPCS,67877-124-50,NDC,both,1,gm,22.41,13.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.58,19.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Aetna,Commerical,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Anthem,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Anthem,Indemnity,,,0.04,,0.04,0.04,0.05,percent of total billed charges,,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Anthem,Individual Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Anthem,State Preferred,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Cigna,Cigna,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Connecticare,Commerical,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Connecticare,Exchange,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,Multiplan,Multiplan,,,0.05,,0.05,0.04,0.05,percent of total billed charges,,
SIMETHICONE 40 MG ORAL CHEW,J3490,HCPCS,40810-0002-79,NDC,both,1,ea,0.06,0.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.05,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301020,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301021,NDC,both,1,mL,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301022,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,1990301023,NDC,both,1,mL,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,5618412041,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0536-1303-75,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,0904-5894-30,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Aetna,Commerical,,,3.11,,3.11,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Aetna,Middlesex Employees,,,2.98,,2.98,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Anthem,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Anthem,Indemnity,,,3.02,,3.02,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Anthem,Individual Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Anthem,State Preferred,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Cigna,Cigna,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Connecticare,Commerical,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Connecticare,Exchange,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,Multiplan,Multiplan,,,3.43,,3.43,2.98,3.43,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,62372-630-15,NDC,both,1,mL,4.03,2.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.98,3.43,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,69618-059-51,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0051-1,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,70000-0423-1,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Aetna,Commerical,,,6.21,,6.21,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Aetna,Middlesex Employees,,,5.96,,5.96,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Anthem,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Anthem,Indemnity,,,6.03,,6.03,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Anthem,Individual Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Anthem,State Preferred,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Cigna,Cigna,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Connecticare,Commerical,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Connecticare,Exchange,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,Multiplan,Multiplan,,,6.84,,6.84,5.96,6.84,percent of total billed charges,,
"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",J3490,HCPCS,71399-0041-1,NDC,both,1,mL,8.05,4.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.96,6.84,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,3786486001,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,0904-5068-60,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,51645-860-01,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,63739-225-10,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,70000-0434-1,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-10,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
SIMETHICONE 80 MG CHEWABLE TABLET,J3490,HCPCS,77333-812-25,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Aetna,Commerical,,,36.48,,36.48,34.98,40.19,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Aetna,Middlesex Employees,,,34.98,,34.98,34.98,40.19,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Anthem,Commerical,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Anthem,Indemnity,,,35.42,,35.42,34.98,40.19,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Anthem,Individual Exchange,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Anthem,State Preferred,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Cigna,Cigna,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Connecticare,Commerical,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Connecticare,Exchange,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,Multiplan,Multiplan,,,40.19,,40.19,34.98,40.19,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-0202-30,NDC,both,1,mL,47.28,28.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.98,40.19,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Aetna,Commerical,,,43.87,,43.87,42.06,48.32,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Aetna,Middlesex Employees,,,42.06,,42.06,42.06,48.32,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Anthem,Commerical,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Anthem,Indemnity,,,42.59,,42.59,42.06,48.32,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Anthem,Individual Exchange,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Anthem,State Preferred,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Cigna,Cigna,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Connecticare,Commerical,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Connecticare,Exchange,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,Multiplan,Multiplan,,,48.32,,48.32,42.06,48.32,percent of total billed charges,,
SIMPLE D12.5,J3490,HCPCS,40810-208-70,NDC,both,1,mL,56.85,34.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.06,48.32,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Aetna,Commerical,,,40.91,,40.91,39.23,45.07,percent of total billed charges,,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Aetna,Middlesex Employees,,,39.23,,39.23,39.23,45.07,percent of total billed charges,,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Anthem,Commerical,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Anthem,Indemnity,,,39.72,,39.72,39.23,45.07,percent of total billed charges,,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Anthem,Individual Exchange,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Anthem,State Preferred,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Cigna,Cigna,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Connecticare,Commerical,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Connecticare,Exchange,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,Multiplan,Multiplan,,,45.07,,45.07,39.23,45.07,percent of total billed charges,,
SIMPLE D15,J3490,HCPCS,40810-0202-31,NDC,both,1,mL,53.02,31.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,39.23,45.07,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Aetna,Commerical,,,42.39,,42.39,40.65,46.7,percent of total billed charges,,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Aetna,Middlesex Employees,,,40.65,,40.65,40.65,46.7,percent of total billed charges,,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Anthem,Commerical,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Anthem,Indemnity,,,41.16,,41.16,40.65,46.7,percent of total billed charges,,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Anthem,Individual Exchange,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Anthem,State Preferred,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Cigna,Cigna,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Connecticare,Commerical,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Connecticare,Exchange,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,Multiplan,Multiplan,,,46.7,,46.7,40.65,46.7,percent of total billed charges,,
SIMPLE D17.5,J3490,HCPCS,40810-0202-32,NDC,both,1,mL,54.94,32.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.65,46.7,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Aetna,Commerical,,,46.82,,46.82,44.9,51.58,percent of total billed charges,,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Aetna,Middlesex Employees,,,44.9,,44.9,44.9,51.58,percent of total billed charges,,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Anthem,Commerical,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Anthem,Indemnity,,,45.46,,45.46,44.9,51.58,percent of total billed charges,,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Anthem,Individual Exchange,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Anthem,State Preferred,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Cigna,Cigna,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Connecticare,Commerical,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Connecticare,Exchange,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,Multiplan,Multiplan,,,51.58,,51.58,44.9,51.58,percent of total billed charges,,
SIMPLE D20,J3490,HCPCS,40810-0202-33,NDC,both,1,mL,60.68,36.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,44.9,51.58,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Aetna,Commerical,,,54.21,,54.21,51.99,59.72,percent of total billed charges,,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Aetna,Middlesex Employees,,,51.99,,51.99,51.99,59.72,percent of total billed charges,,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Anthem,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Anthem,Indemnity,,,52.63,,52.63,51.99,59.72,percent of total billed charges,,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Anthem,Individual Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Anthem,State Preferred,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Cigna,Cigna,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Connecticare,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Connecticare,Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,Multiplan,Multiplan,,,59.72,,59.72,51.99,59.72,percent of total billed charges,,
SIMPLE D22.5,j3490,HCPCS,40810-0202-42,NDC,both,1,mL,70.26,42.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Aetna,Commerical,,,52.73,,52.73,50.56,58.09,percent of total billed charges,,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Aetna,Middlesex Employees,,,50.56,,50.56,50.56,58.09,percent of total billed charges,,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Anthem,Commerical,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Anthem,Indemnity,,,51.19,,51.19,50.56,58.09,percent of total billed charges,,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Anthem,Individual Exchange,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Anthem,State Preferred,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Cigna,Cigna,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Connecticare,Commerical,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Connecticare,Exchange,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,Multiplan,Multiplan,,,58.09,,58.09,50.56,58.09,percent of total billed charges,,
SIMPLE D25,J3490,HCPCS,40810-0202-34,NDC,both,1,mL,68.34,41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.56,58.09,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Aetna,Commerical,,,58.64,,58.64,56.23,64.6,percent of total billed charges,,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Aetna,Middlesex Employees,,,56.23,,56.23,56.23,64.6,percent of total billed charges,,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Anthem,Commerical,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Anthem,Indemnity,,,56.93,,56.93,56.23,64.6,percent of total billed charges,,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Anthem,Individual Exchange,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Anthem,State Preferred,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Cigna,Cigna,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Connecticare,Commerical,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Connecticare,Exchange,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,Multiplan,Multiplan,,,64.6,,64.6,56.23,64.6,percent of total billed charges,,
SIMPLE D30,J3490,HCPCS,40810-0202-35,NDC,both,1,mL,76,45.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Aetna,Commerical,,,58.64,,58.64,56.23,64.6,percent of total billed charges,,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Aetna,Middlesex Employees,,,56.23,,56.23,56.23,64.6,percent of total billed charges,,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Anthem,Commerical,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Anthem,Indemnity,,,56.93,,56.93,56.23,64.6,percent of total billed charges,,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Anthem,Individual Exchange,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Anthem,State Preferred,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Cigna,Cigna,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Connecticare,Commerical,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Connecticare,Exchange,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,Multiplan,Multiplan,,,64.6,,64.6,56.23,64.6,percent of total billed charges,,
SIMPLE D40,J3490,HCPCS,40810-0206-16,NDC,both,1,mL,76,45.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.23,64.6,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Aetna,Commerical,,,30.57,,30.57,29.31,33.68,percent of total billed charges,,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Aetna,Middlesex Employees,,,29.31,,29.31,29.31,33.68,percent of total billed charges,,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Anthem,Commerical,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Anthem,Indemnity,,,29.68,,29.68,29.31,33.68,percent of total billed charges,,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Anthem,Individual Exchange,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Anthem,State Preferred,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Cigna,Cigna,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Connecticare,Commerical,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Connecticare,Exchange,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,Multiplan,Multiplan,,,33.68,,33.68,29.31,33.68,percent of total billed charges,,
SIMPLE D5LR,J3490,HCPCS,40810-0202-36,NDC,both,1,mL,39.62,23.77,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.31,33.68,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Aetna,Commerical,,,54.21,,54.21,51.99,59.72,percent of total billed charges,,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Aetna,Middlesex Employees,,,51.99,,51.99,51.99,59.72,percent of total billed charges,,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Anthem,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Anthem,Indemnity,,,52.63,,52.63,51.99,59.72,percent of total billed charges,,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Anthem,Individual Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Anthem,State Preferred,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Cigna,Cigna,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Connecticare,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Connecticare,Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,Multiplan,Multiplan,,,59.72,,59.72,51.99,59.72,percent of total billed charges,,
SIMPLE D7,j3490,HCPCS,40810-0202-40,NDC,both,1,mL,70.26,42.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Aetna,Commerical,,,54.21,,54.21,51.99,59.72,percent of total billed charges,,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Aetna,Middlesex Employees,,,51.99,,51.99,51.99,59.72,percent of total billed charges,,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Anthem,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Anthem,Indemnity,,,52.63,,52.63,51.99,59.72,percent of total billed charges,,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Anthem,Individual Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Anthem,State Preferred,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Cigna,Cigna,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Connecticare,Commerical,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Connecticare,Exchange,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,Multiplan,Multiplan,,,59.72,,59.72,51.99,59.72,percent of total billed charges,,
SIMPLE D7.5,J3490,HCPCS,40810-0202-27,NDC,both,1,mL,70.26,42.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.99,59.72,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Aetna,Commerical,,,280.28,,280.28,268.77,308.76,percent of total billed charges,,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Aetna,Middlesex Employees,,,268.77,,268.77,268.77,308.76,percent of total billed charges,,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Anthem,Commerical,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Anthem,Indemnity,,,272.11,,272.11,268.77,308.76,percent of total billed charges,,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Anthem,Individual Exchange,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Anthem,State Preferred,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Cigna,Cigna,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Connecticare,Commerical,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Connecticare,Exchange,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,Multiplan,Multiplan,,,308.76,,308.76,268.77,308.76,percent of total billed charges,,
SIMPLE D8,J3490,HCPCS,40810-0202-41,NDC,both,1,mL,363.25,217.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,268.77,308.76,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Aetna,Commerical,,,33.55,,33.55,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Aetna,Middlesex Employees,,,32.17,,32.17,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Anthem,Commerical,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Anthem,Indemnity,,,32.57,,32.57,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Anthem,Individual Exchange,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Anthem,State Preferred,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Cigna,Cigna,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Connecticare,Commerical,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Connecticare,Exchange,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,Multiplan,Multiplan,,,36.96,,36.96,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,395266116,NDC,both,1,mL,43.48,26.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Aetna,Commerical,,,33.55,,33.55,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Aetna,Middlesex Employees,,,32.17,,32.17,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Anthem,Commerical,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Anthem,Indemnity,,,32.57,,32.57,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Anthem,Individual Exchange,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Anthem,State Preferred,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Cigna,Cigna,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Connecticare,Commerical,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Connecticare,Exchange,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,Multiplan,Multiplan,,,36.96,,36.96,32.17,36.96,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3172293747,NDC,both,1,mL,43.48,26.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.17,36.96,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Aetna,Commerical,,,26.6,,26.6,25.5,29.3,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Aetna,Middlesex Employees,,,25.5,,25.5,25.5,29.3,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Anthem,Commerical,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Anthem,Indemnity,,,25.82,,25.82,25.5,29.3,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Anthem,Individual Exchange,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Anthem,State Preferred,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Cigna,Cigna,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Connecticare,Commerical,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Connecticare,Exchange,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,Multiplan,Multiplan,,,29.3,,29.3,25.5,29.3,percent of total billed charges,,
SIMPLE SYRUP,J3490,HCPCS,3877917798,NDC,both,1,mL,34.47,20.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.5,29.3,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Aetna,Commerical,,,360.28,,360.28,161.05,396.89,percent of total billed charges,,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Aetna,Middlesex Employees,,,345.48,,345.48,161.05,396.89,percent of total billed charges,,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Anthem,Commerical,,,,,,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Anthem,Indemnity,,,349.78,,349.78,161.05,396.89,percent of total billed charges,,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Anthem,Individual Exchange,,,,,,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Anthem,State Preferred,,,,,,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Cigna,Cigna,,161.05,,,161.05,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Connecticare,Commerical,,188.76,,,188.76,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Connecticare,Exchange,,188.76,,,188.76,161.05,396.89,Other,Could be inpatient or outpatient,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,Multiplan,Multiplan,,,396.89,,396.89,161.05,396.89,percent of total billed charges,,
SINCALIDE 5 MCG SOLUTION FOR INJECTION,J2805,HCPCS,0270-0556-15,NDC,both,1,ea,466.93,280.16,United Healthcare/Oxford,United Healthcare/Oxford,,173.87,,,173.87,161.05,396.89,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Aetna,Commerical,,,101.6,,101.6,1.51,111.92,percent of total billed charges,,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Aetna,Middlesex Employees,,,97.42,,97.42,1.51,111.92,percent of total billed charges,,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Anthem,Commerical,,,,,,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Anthem,Indemnity,,,98.63,,98.63,1.51,111.92,percent of total billed charges,,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Anthem,Individual Exchange,,,,,,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Anthem,State Preferred,,,,,,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Cigna,Cigna,,1.51,,,1.51,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Connecticare,Commerical,,2.03,,,2.03,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Connecticare,Exchange,,2.03,,,2.03,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,Multiplan,Multiplan,,,111.92,,111.92,1.51,111.92,percent of total billed charges,,
SIROLIMUS 0.5 MG TABLET CHEMO,J7520,HCPCS,0008-1040-10,NDC,both,2,ea,131.67,79,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,111.92,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Aetna,Commerical,,,97.78,,97.78,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Aetna,Middlesex Employees,,,93.76,,93.76,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Commerical,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Indemnity,,,94.93,,94.93,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Individual Exchange,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,State Preferred,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Cigna,Cigna,,1.51,,,1.51,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Connecticare,Commerical,,2.03,,,2.03,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Connecticare,Exchange,,2.03,,,2.03,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Multiplan,Multiplan,,,107.71,,107.71,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Aetna,Commerical,,,97.78,,97.78,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Aetna,Middlesex Employees,,,93.76,,93.76,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Commerical,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Indemnity,,,94.93,,94.93,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,Individual Exchange,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Anthem,State Preferred,,,,,,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Cigna,Cigna,,1.51,,,1.51,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Connecticare,Commerical,,2.03,,,2.03,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Connecticare,Exchange,,2.03,,,2.03,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,Multiplan,Multiplan,,,107.71,,107.71,1.51,107.71,percent of total billed charges,,
SIROLIMUS 1 MG TABLET CHEMO,J7520,HCPCS,0008-1041-10,NDC,both,1,ea,126.72,76.03,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,107.71,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Aetna,Commerical,,,5587.16,,5587.16,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Aetna,Middlesex Employees,,,5357.62,,5357.62,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Commerical,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Indemnity,,,5424.23,,5424.23,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Individual Exchange,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,State Preferred,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Cigna,Cigna,,1.51,,,1.51,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Connecticare,Commerical,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Connecticare,Exchange,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Multiplan,Multiplan,,,6154.85,,6154.85,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Aetna,Commerical,,,5587.16,,5587.16,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Aetna,Middlesex Employees,,,5357.62,,5357.62,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Commerical,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Indemnity,,,5424.23,,5424.23,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Individual Exchange,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,State Preferred,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Cigna,Cigna,,1.51,,,1.51,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Connecticare,Commerical,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Connecticare,Exchange,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Multiplan,Multiplan,,,6154.85,,6154.85,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Aetna,Commerical,,,5587.16,,5587.16,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Aetna,Middlesex Employees,,,5357.62,,5357.62,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Commerical,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Indemnity,,,5424.23,,5424.23,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,Individual Exchange,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Anthem,State Preferred,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Cigna,Cigna,,1.51,,,1.51,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Connecticare,Commerical,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Connecticare,Exchange,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,Multiplan,Multiplan,,,6154.85,,6154.85,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-04,NDC,both,1,mL,7241,4344.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Aetna,Commerical,,,5587.16,,5587.16,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Aetna,Middlesex Employees,,,5357.62,,5357.62,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Commerical,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Indemnity,,,5424.23,,5424.23,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,Individual Exchange,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Anthem,State Preferred,,,,,,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Cigna,Cigna,,1.51,,,1.51,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Connecticare,Commerical,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Connecticare,Exchange,,2.03,,,2.03,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,Multiplan,Multiplan,,,6154.85,,6154.85,1.51,6154.85,percent of total billed charges,,
SIROLIMUS 1 MG/ML ORAL SOLUTION CHEMO,J7520,HCPCS,0008-1030-06,NDC,both,1,mL,7241,4344.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,6154.85,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Aetna,Commerical,,,195.55,,195.55,1.51,215.42,percent of total billed charges,,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Aetna,Middlesex Employees,,,187.51,,187.51,1.51,215.42,percent of total billed charges,,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Anthem,Commerical,,,,,,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Anthem,Indemnity,,,189.84,,189.84,1.51,215.42,percent of total billed charges,,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Anthem,Individual Exchange,,,,,,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Anthem,State Preferred,,,,,,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Cigna,Cigna,,1.51,,,1.51,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Connecticare,Commerical,,2.03,,,2.03,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Connecticare,Exchange,,2.03,,,2.03,1.51,215.42,Other,Could be inpatient or outpatient,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,Multiplan,Multiplan,,,215.42,,215.42,1.51,215.42,percent of total billed charges,,
SIROLIMUS 2 MG TABLET CHEMO,J7520,HCPCS,0008-1042-05,NDC,both,0.5,ea,253.43,152.06,United Healthcare/Oxford,United Healthcare/Oxford,,1.63,,,1.63,1.51,215.42,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Aetna,Commerical,,,51.88,,51.88,49.75,57.15,percent of total billed charges,,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Aetna,Middlesex Employees,,,49.75,,49.75,49.75,57.15,percent of total billed charges,,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Anthem,Commerical,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Anthem,Indemnity,,,50.37,,50.37,49.75,57.15,percent of total billed charges,,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Anthem,Individual Exchange,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Anthem,State Preferred,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Cigna,Cigna,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Connecticare,Commerical,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Connecticare,Exchange,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,Multiplan,Multiplan,,,57.15,,57.15,49.75,57.15,percent of total billed charges,,
SITAGLIPTIN PHOSPHATE 100 MG TABLET,J3490,HCPCS,0006-0277-28,NDC,both,1,ea,67.24,40.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.75,57.15,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-06,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-3299-46,NDC,both,1,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Aetna,Commerical,,,8.52,,8.52,8.17,9.38,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Aetna,Middlesex Employees,,,8.17,,8.17,8.17,9.38,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Anthem,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Anthem,Indemnity,,,8.27,,8.27,8.17,9.38,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Anthem,Individual Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Anthem,State Preferred,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Cigna,Cigna,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Connecticare,Commerical,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Connecticare,Exchange,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,Multiplan,Multiplan,,,9.38,,9.38,8.17,9.38,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7299-73,NDC,both,1,mL,11.04,6.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.17,9.38,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-10,NDC,both,1,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Aetna,Commerical,,,21.28,,21.28,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Aetna,Middlesex Employees,,,20.41,,20.41,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Anthem,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Anthem,Indemnity,,,20.66,,20.66,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Anthem,Individual Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Anthem,State Preferred,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Cigna,Cigna,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Connecticare,Commerical,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Connecticare,Exchange,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,Multiplan,Multiplan,,,23.44,,23.44,20.41,23.44,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-230-20,NDC,both,1,mL,27.58,16.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.41,23.44,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Aetna,Commerical,,,42.56,,42.56,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Aetna,Middlesex Employees,,,40.81,,40.81,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Anthem,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Anthem,Indemnity,,,41.32,,41.32,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Anthem,Individual Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Anthem,State Preferred,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Cigna,Cigna,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Connecticare,Commerical,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Connecticare,Exchange,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,Multiplan,Multiplan,,,46.89,,46.89,40.81,46.89,percent of total billed charges,,
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,69784-231-20,NDC,both,1,mL,55.16,33.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.81,46.89,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Aetna,Commerical,,,11986.4,,11986.4,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Aetna,Middlesex Employees,,,11493.96,,11493.96,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Anthem,Commerical,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Anthem,Indemnity,,,11636.88,,11636.88,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Anthem,Individual Exchange,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Anthem,State Preferred,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Cigna,Cigna,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Connecticare,Commerical,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Connecticare,Exchange,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,Multiplan,Multiplan,,,13204.31,,13204.31,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,0187-0010-50,NDC,both,1,mL,15534.48,9320.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Aetna,Commerical,,,11986.4,,11986.4,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Aetna,Middlesex Employees,,,11493.96,,11493.96,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Anthem,Commerical,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Anthem,Indemnity,,,11636.88,,11636.88,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Anthem,Individual Exchange,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Anthem,State Preferred,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Cigna,Cigna,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Connecticare,Commerical,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Connecticare,Exchange,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,Multiplan,Multiplan,,,13204.31,,13204.31,11493.96,13204.31,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,68382-396-01,NDC,both,1,mL,15534.48,9320.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11493.96,13204.31,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Aetna,Commerical,,,4794.57,,4794.57,4597.59,5281.73,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Aetna,Middlesex Employees,,,4597.59,,4597.59,4597.59,5281.73,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Anthem,Commerical,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Anthem,Indemnity,,,4654.76,,4654.76,4597.59,5281.73,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Anthem,Individual Exchange,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Anthem,State Preferred,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Cigna,Cigna,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Connecticare,Commerical,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Connecticare,Exchange,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,Multiplan,Multiplan,,,5281.73,,5281.73,4597.59,5281.73,percent of total billed charges,,
SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,J3490,HCPCS,72266-236-01,NDC,both,1,mL,6213.8,3728.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4597.59,5281.73,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-14,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-22,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-30,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6625-35,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-089-50,NDC,both,50,mL,31.6,18.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE 1 MEQ/ML ORAL SOLN,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Aetna,Commerical,,,51.75,,51.75,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Aetna,Middlesex Employees,,,49.63,,49.63,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Anthem,Commerical,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Anthem,Indemnity,,,50.24,,50.24,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Anthem,Individual Exchange,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Anthem,State Preferred,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Cigna,Cigna,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Connecticare,Commerical,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Connecticare,Exchange,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,Multiplan,Multiplan,,,57.01,,57.01,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-14,NDC,both,1,mL,67.07,40.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Aetna,Commerical,,,51.75,,51.75,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Aetna,Middlesex Employees,,,49.63,,49.63,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Anthem,Commerical,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Anthem,Indemnity,,,50.24,,50.24,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Anthem,Individual Exchange,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Anthem,State Preferred,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Cigna,Cigna,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Connecticare,Commerical,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Connecticare,Exchange,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,Multiplan,Multiplan,,,57.01,,57.01,49.63,57.01,percent of total billed charges,,
SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-4900-34,NDC,both,10,mL,67.07,40.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.63,57.01,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Aetna,Commerical,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Aetna,Middlesex Employees,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Anthem,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Anthem,Indemnity,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Anthem,Individual Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Anthem,State Preferred,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Cigna,Cigna,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Connecticare,Commerical,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Connecticare,Exchange,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.03,0.03,percent of total billed charges,,
SODIUM BICARBONATE 325 MG ORAL TAB,J3490,HCPCS,40810-0002-81,NDC,both,1,ea,0.04,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.03,0.03,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-5534-34,NDC,both,10,mL,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Aetna,Commerical,,,7.54,,7.54,7.23,8.3,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Aetna,Middlesex Employees,,,7.23,,7.23,7.23,8.3,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Anthem,Commerical,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Anthem,Indemnity,,,7.32,,7.32,7.23,8.3,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Anthem,Individual Exchange,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Anthem,State Preferred,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Cigna,Cigna,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Connecticare,Commerical,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Connecticare,Exchange,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,Multiplan,Multiplan,,,8.3,,8.3,7.23,8.3,percent of total billed charges,,
SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,J3490,HCPCS,63323-026-05,NDC,both,1,mL,9.77,5.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.23,8.3,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0223-1721-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,0904-7261-61,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,40810-0007-88,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
SODIUM BICARBONATE 650 MG TABLET,J3490,HCPCS,66553-008-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Aetna,Commerical,,,37.24,,37.24,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Aetna,Middlesex Employees,,,35.71,,35.71,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Anthem,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Anthem,Indemnity,,,36.15,,36.15,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Anthem,Individual Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Anthem,State Preferred,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Cigna,Cigna,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Connecticare,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Connecticare,Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,Multiplan,Multiplan,,,41.02,,41.02,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-14,NDC,both,1,mL,48.26,28.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Aetna,Commerical,,,37.24,,37.24,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Aetna,Middlesex Employees,,,35.71,,35.71,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Anthem,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Anthem,Indemnity,,,36.15,,36.15,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Anthem,Individual Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Anthem,State Preferred,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Cigna,Cigna,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Connecticare,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Connecticare,Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,Multiplan,Multiplan,,,41.02,,41.02,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-24,NDC,both,1,mL,48.26,28.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Aetna,Commerical,,,37.24,,37.24,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Aetna,Middlesex Employees,,,35.71,,35.71,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Anthem,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Anthem,Indemnity,,,36.15,,36.15,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Anthem,Individual Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Anthem,State Preferred,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Cigna,Cigna,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Connecticare,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Connecticare,Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,Multiplan,Multiplan,,,41.02,,41.02,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,0409-6637-34,NDC,both,1,mL,48.26,28.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Aetna,Commerical,,,29.55,,29.55,28.34,32.56,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Aetna,Middlesex Employees,,,28.34,,28.34,28.34,32.56,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Anthem,Commerical,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Anthem,Indemnity,,,28.69,,28.69,28.34,32.56,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Anthem,Individual Exchange,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Anthem,State Preferred,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Cigna,Cigna,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Connecticare,Commerical,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Connecticare,Exchange,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,Multiplan,Multiplan,,,32.56,,32.56,28.34,32.56,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,69374-914-50,NDC,both,1,mL,38.3,22.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.34,32.56,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Aetna,Commerical,,,37.24,,37.24,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Aetna,Middlesex Employees,,,35.71,,35.71,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Anthem,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Anthem,Indemnity,,,36.15,,36.15,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Anthem,Individual Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Anthem,State Preferred,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Cigna,Cigna,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Connecticare,Commerical,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Connecticare,Exchange,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,Multiplan,Multiplan,,,41.02,,41.02,35.71,41.02,percent of total billed charges,,
SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE,J3490,HCPCS,76329-3352-1,NDC,both,1,mL,48.26,28.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.71,41.02,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Aetna,Commerical,,,24.38,,24.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Aetna,Middlesex Employees,,,23.38,,23.38,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Indemnity,,,23.67,,23.67,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,Individual Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Anthem,State Preferred,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Cigna,Cigna,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Connecticare,Commerical,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Connecticare,Exchange,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,Multiplan,Multiplan,,,26.86,,26.86,23.38,26.86,percent of total billed charges,,
SODIUM BICARBONATE IV BOLUS 1 MEQ/ML - CHILD,J3490,HCPCS,0409-6625-02,NDC,both,50,mL,29.3,17.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,23.38,26.86,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Aetna,Commerical,,,8.72,,8.72,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Aetna,Middlesex Employees,,,8.36,,8.36,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Anthem,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Anthem,Indemnity,,,8.46,,8.46,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Anthem,Individual Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Anthem,State Preferred,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Cigna,Cigna,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Connecticare,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Connecticare,Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,Multiplan,Multiplan,,,9.61,,9.61,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,1011900252,NDC,both,118,mL,11.3,6.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Aetna,Commerical,,,8.72,,8.72,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Aetna,Middlesex Employees,,,8.36,,8.36,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Anthem,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Anthem,Indemnity,,,8.46,,8.46,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Anthem,Individual Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Anthem,State Preferred,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Cigna,Cigna,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Connecticare,Commerical,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Connecticare,Exchange,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,Multiplan,Multiplan,,,9.61,,9.61,8.36,9.61,percent of total billed charges,,
SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,J3490,HCPCS,0536-1224-97,NDC,both,1,mL,11.3,6.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.36,9.61,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Aetna,Commerical,,,478.75,,478.75,459.08,527.39,percent of total billed charges,,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Aetna,Middlesex Employees,,,459.08,,459.08,459.08,527.39,percent of total billed charges,,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Anthem,Commerical,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Anthem,Indemnity,,,464.79,,464.79,459.08,527.39,percent of total billed charges,,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Anthem,Individual Exchange,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Anthem,State Preferred,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Cigna,Cigna,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Connecticare,Commerical,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Connecticare,Exchange,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,Multiplan,Multiplan,,,527.39,,527.39,459.08,527.39,percent of total billed charges,,
SODIUM CHLORIDE (BULK) POWDER,J3490,HCPCS,38779-0629-9,NDC,both,1,gm,620.46,372.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,459.08,527.39,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Aetna,Commerical,,,10.35,,10.35,9.92,11.4,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Aetna,Middlesex Employees,,,9.92,,9.92,9.92,11.4,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Anthem,Commerical,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Anthem,Indemnity,,,10.05,,10.05,9.92,11.4,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Anthem,Individual Exchange,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Anthem,State Preferred,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Cigna,Cigna,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Connecticare,Commerical,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Connecticare,Exchange,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,Multiplan,Multiplan,,,11.4,,11.4,9.92,11.4,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-03,NDC,both,500,mL,13.41,8.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.92,11.4,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Aetna,Commerical,,,20.69,,20.69,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Aetna,Middlesex Employees,,,19.84,,19.84,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Indemnity,,,20.08,,20.08,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Individual Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,State Preferred,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Cigna,Cigna,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Connecticare,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Connecticare,Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,Multiplan,Multiplan,,,22.79,,22.79,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7985-09,NDC,both,1,mL,26.81,16.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Aetna,Commerical,,,20.69,,20.69,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Aetna,Middlesex Employees,,,19.84,,19.84,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Indemnity,,,20.08,,20.08,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,Individual Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Anthem,State Preferred,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Cigna,Cigna,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Connecticare,Commerical,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Connecticare,Exchange,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,Multiplan,Multiplan,,,22.79,,22.79,19.84,22.79,percent of total billed charges,,
SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,J3490,HCPCS,0990-7985-09,NDC,both,1,mL,26.81,16.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,19.84,22.79,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.45% FLUSH 10ML,J3490,HCPCS,40810-0020-12,NDC,both,1,mL,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Aetna,Commerical,,,2.61,,2.61,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Aetna,Middlesex Employees,,,2.5,,2.5,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Indemnity,,,2.53,,2.53,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Individual Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,State Preferred,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Cigna,Cigna,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Connecticare,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Connecticare,Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Multiplan,Multiplan,,,2.87,,2.87,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Aetna,Commerical,,,4.3,,4.3,4.12,4.73,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Aetna,Middlesex Employees,,,4.12,,4.12,4.12,4.73,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Anthem,Commerical,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Anthem,Indemnity,,,4.17,,4.17,4.12,4.73,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Anthem,Individual Exchange,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Anthem,State Preferred,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Cigna,Cigna,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Connecticare,Commerical,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Connecticare,Exchange,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,Multiplan,Multiplan,,,4.73,,4.73,4.12,4.73,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0536-2506-76,NDC,both,1,mL,5.57,3.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.12,4.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Aetna,Commerical,,,2.61,,2.61,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Aetna,Middlesex Employees,,,2.5,,2.5,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Indemnity,,,2.53,,2.53,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Individual Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,State Preferred,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Cigna,Cigna,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Connecticare,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Connecticare,Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Multiplan,Multiplan,,,2.87,,2.87,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL DROPS,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Aetna,Commerical,,,2.61,,2.61,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Aetna,Middlesex Employees,,,2.5,,2.5,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Indemnity,,,2.53,,2.53,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,Individual Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Anthem,State Preferred,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Cigna,Cigna,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Connecticare,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Connecticare,Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,Multiplan,Multiplan,,,2.87,,2.87,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,9629513160,NDC,both,1,mL,3.38,2.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Aetna,Commerical,,,2.61,,2.61,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Aetna,Middlesex Employees,,,2.5,,2.5,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Indemnity,,,2.53,,2.53,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,Individual Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Anthem,State Preferred,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Cigna,Cigna,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Connecticare,Commerical,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Connecticare,Exchange,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,Multiplan,Multiplan,,,2.87,,2.87,2.5,2.87,percent of total billed charges,,
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,J3490,HCPCS,0904-3865-75,NDC,both,44,mL,3.38,2.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.5,2.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Aetna,Commerical,,,1.74,,1.74,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Aetna,Middlesex Employees,,,1.66,,1.66,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Commerical,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Indemnity,,,1.69,,1.69,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Individual Exchange,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,State Preferred,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Cigna,Cigna,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Connecticare,Commerical,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Connecticare,Exchange,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Multiplan,Multiplan,,,1.91,,1.91,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Aetna,Commerical,,,1.19,,1.19,1.14,1.31,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Aetna,Middlesex Employees,,,1.14,,1.14,1.14,1.31,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Anthem,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Anthem,Indemnity,,,1.15,,1.15,1.14,1.31,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Anthem,Individual Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Anthem,State Preferred,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Cigna,Cigna,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Connecticare,Commerical,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Connecticare,Exchange,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,Multiplan,Multiplan,,,1.31,,1.31,1.14,1.31,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6380710055,NDC,both,1,mL,1.54,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.14,1.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Cigna,Cigna,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Connecticare,Commerical,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Connecticare,Exchange,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,6425311135,NDC,both,1,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.83,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Anthem,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Anthem,Individual Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Anthem,State Preferred,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Cigna,Cigna,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Connecticare,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Connecticare,Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8881570125,NDC,both,1,mL,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Aetna,Commerical,,,1.74,,1.74,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Aetna,Middlesex Employees,,,1.67,,1.67,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Anthem,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Anthem,Indemnity,,,1.69,,1.69,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Anthem,Individual Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Anthem,State Preferred,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Cigna,Cigna,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Connecticare,Commerical,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Connecticare,Exchange,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,Multiplan,Multiplan,,,1.92,,1.92,1.67,1.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,J3490,HCPCS,8882-776758,NDC,both,1,mL,2.26,1.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.67,1.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Aetna,Commerical,,,0.3,,0.3,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Aetna,Middlesex Employees,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Anthem,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Anthem,Indemnity,,,0.29,,0.29,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Anthem,Individual Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Anthem,State Preferred,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Cigna,Cigna,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Connecticare,Commerical,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Connecticare,Exchange,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,Multiplan,Multiplan,,,0.33,,0.33,0.29,0.33,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J3490,HCPCS,0338-0049-11,NDC,both,50,mL,0.39,0.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.29,0.33,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,0.76,35.81,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,0.76,35.81,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Anthem,Commerical,,,,,,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,0.76,35.81,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Anthem,State Preferred,,,,,,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Cigna,Cigna,,0.76,,,0.76,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Connecticare,Commerical,,0.98,,,0.98,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Connecticare,Exchange,,0.98,,,0.98,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,0.76,35.81,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FLUSH 25 ML,J7050,HCPCS,0409-7984-06,NDC,both,250,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,35.81,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Aetna,Commerical,,,1.74,,1.74,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Aetna,Middlesex Employees,,,1.66,,1.66,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Commerical,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Indemnity,,,1.69,,1.69,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,Individual Exchange,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Anthem,State Preferred,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Cigna,Cigna,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Connecticare,Commerical,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Connecticare,Exchange,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,Multiplan,Multiplan,,,1.91,,1.91,1.66,1.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,6380710051,NDC,both,1,mL,2.25,1.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.66,1.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % FOR INHALATION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Aetna,Commerical,,,1.01,,1.01,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Aetna,Middlesex Employees,,,0.97,,0.97,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Indemnity,,,0.98,,0.98,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,Individual Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Anthem,State Preferred,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Cigna,Cigna,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Connecticare,Commerical,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Connecticare,Exchange,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,Multiplan,Multiplan,,,1.11,,1.11,0.97,1.11,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-02,NDC,both,10,mL,1.31,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.97,1.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-03,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Aetna,Commerical,,,2.84,,2.84,2.72,3.13,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Aetna,Middlesex Employees,,,2.72,,2.72,2.72,3.13,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Anthem,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Anthem,Indemnity,,,2.76,,2.76,2.72,3.13,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Anthem,Individual Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Anthem,State Preferred,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Cigna,Cigna,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Connecticare,Commerical,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Connecticare,Exchange,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,Multiplan,Multiplan,,,3.13,,3.13,2.72,3.13,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,0409-4888-20,NDC,both,1,mL,3.68,2.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.72,3.13,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-05,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-133-07,NDC,both,1,mL,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-05,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,14789-134-07,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Aetna,Commerical,,,2.4,,2.4,2.3,2.64,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Aetna,Middlesex Employees,,,2.3,,2.3,2.3,2.64,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Anthem,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Anthem,Indemnity,,,2.33,,2.33,2.3,2.64,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Anthem,Individual Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Anthem,State Preferred,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Cigna,Cigna,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Connecticare,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Connecticare,Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,Multiplan,Multiplan,,,2.64,,2.64,2.3,2.64,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-01,NDC,both,1,mL,3.11,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION FOR PROLO THERAPY,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Aetna,Commerical,,,14.63,,14.63,14.03,16.12,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Aetna,Middlesex Employees,,,14.03,,14.03,14.03,16.12,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Anthem,Commerical,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Anthem,Indemnity,,,14.2,,14.2,14.03,16.12,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Anthem,Individual Exchange,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Anthem,State Preferred,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Cigna,Cigna,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Connecticare,Commerical,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Connecticare,Exchange,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,Multiplan,Multiplan,,,16.12,,16.12,14.03,16.12,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,J3490,HCPCS,0338-0553-11,NDC,both,1,mL,18.96,11.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.03,16.12,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-02,NDC,both,500,mL,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Aetna,Commerical,,,0.02,,0.02,0.01,0.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Aetna,Middlesex Employees,,,0.01,,0.01,0.01,0.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Anthem,Commerical,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Anthem,Indemnity,,,0.01,,0.01,0.01,0.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Anthem,Individual Exchange,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Anthem,State Preferred,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Cigna,Cigna,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Connecticare,Commerical,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Connecticare,Exchange,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,Multiplan,Multiplan,,,0.02,,0.02,0.01,0.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-41,NDC,both,1000,mL,0.02,0.01,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.01,0.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,14.17,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,14.17,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Anthem,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,14.17,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Anthem,State Preferred,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Cigna,Cigna,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Connecticare,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Connecticare,Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,14.17,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,76297-001-42,NDC,both,1000,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J3490,HCPCS,79672-613-04,NDC,both,500,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Aetna,Commerical,,,62.06,,62.06,3.04,68.37,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Aetna,Middlesex Employees,,,59.51,,59.51,3.04,68.37,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Anthem,Commerical,,,,,,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Anthem,Indemnity,,,60.25,,60.25,3.04,68.37,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Anthem,Individual Exchange,,,,,,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Anthem,State Preferred,,,,,,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Cigna,Cigna,,3.04,,,3.04,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Connecticare,Commerical,,3.92,,,3.92,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Connecticare,Exchange,,3.92,,,3.92,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,Multiplan,Multiplan,,,68.37,,68.37,3.04,68.37,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0338-9543-02,NDC,both,1000,mL,80.43,48.26,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,68.37,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,3.04,,,3.04,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,1.53,6.51,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,1.53,6.51,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Commerical,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,1.53,6.51,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Anthem,State Preferred,,,,,,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Cigna,Cigna,,1.53,,,1.53,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Connecticare,Commerical,,1.96,,,1.96,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Connecticare,Exchange,,1.96,,,1.96,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,1.53,6.51,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0338-0049-04,NDC,both,500,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,1.65,,,1.65,1.53,6.51,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Commerical,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,State Preferred,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Cigna,Cigna,,1.53,,,1.53,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Commerical,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Exchange,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.65,,,1.65,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Commerical,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,State Preferred,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Cigna,Cigna,,0.76,,,0.76,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Connecticare,Commerical,,0.98,,,0.98,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Connecticare,Exchange,,0.98,,,0.98,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Aetna,Commerical,,,4.44,,4.44,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Aetna,Middlesex Employees,,,4.25,,4.25,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Commerical,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Indemnity,,,4.31,,4.31,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Individual Exchange,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,State Preferred,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Cigna,Cigna,,0.76,,,0.76,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Connecticare,Commerical,,0.98,,,0.98,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Connecticare,Exchange,,0.98,,,0.98,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Multiplan,Multiplan,,,4.89,,4.89,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Aetna,Commerical,,,15.52,,15.52,0.76,17.09,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Aetna,Middlesex Employees,,,14.88,,14.88,0.76,17.09,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Anthem,Commerical,,,,,,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Anthem,Indemnity,,,15.06,,15.06,0.76,17.09,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Anthem,Individual Exchange,,,,,,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Anthem,State Preferred,,,,,,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Cigna,Cigna,,0.76,,,0.76,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Connecticare,Commerical,,0.98,,,0.98,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Connecticare,Exchange,,0.98,,,0.98,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,Multiplan,Multiplan,,,17.09,,17.09,0.76,17.09,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0409-7983-53,NDC,both,250,mL,20.11,12.07,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,17.09,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Commerical,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,State Preferred,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Cigna,Cigna,,0.76,,,0.76,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Connecticare,Commerical,,0.98,,,0.98,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Connecticare,Exchange,,0.98,,,0.98,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Aetna,Commerical,,,36.2,,36.2,0.76,39.88,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Aetna,Middlesex Employees,,,34.72,,34.72,0.76,39.88,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Anthem,Commerical,,,,,,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Anthem,Indemnity,,,35.15,,35.15,0.76,39.88,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Anthem,Individual Exchange,,,,,,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Anthem,State Preferred,,,,,,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Cigna,Cigna,,0.76,,,0.76,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Connecticare,Commerical,,0.98,,,0.98,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Connecticare,Exchange,,0.98,,,0.98,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,Multiplan,Multiplan,,,39.88,,39.88,0.76,39.88,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-13,NDC,both,250,mL,46.92,28.15,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,39.88,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Aetna,Commerical,,,17,,17,0.76,18.73,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Aetna,Middlesex Employees,,,16.3,,16.3,0.76,18.73,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Anthem,Commerical,,,,,,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Anthem,Indemnity,,,16.5,,16.5,0.76,18.73,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Anthem,Individual Exchange,,,,,,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Anthem,State Preferred,,,,,,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Cigna,Cigna,,0.76,,,0.76,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Connecticare,Commerical,,0.98,,,0.98,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Connecticare,Exchange,,0.98,,,0.98,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,Multiplan,Multiplan,,,18.73,,18.73,0.76,18.73,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-23,NDC,both,250,mL,22.03,13.22,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,18.73,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Aetna,Commerical,,,21.43,,21.43,0.76,23.6,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Aetna,Middlesex Employees,,,20.55,,20.55,0.76,23.6,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Anthem,Commerical,,,,,,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Anthem,Indemnity,,,20.8,,20.8,0.76,23.6,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Anthem,Individual Exchange,,,,,,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Anthem,State Preferred,,,,,,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Cigna,Cigna,,0.76,,,0.76,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Connecticare,Commerical,,0.98,,,0.98,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Connecticare,Exchange,,0.98,,,0.98,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,Multiplan,Multiplan,,,23.6,,23.6,0.76,23.6,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-36,NDC,both,250,mL,27.77,16.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,23.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Aetna,Commerical,,,14.04,,14.04,0.76,15.47,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Aetna,Middlesex Employees,,,13.47,,13.47,0.76,15.47,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Anthem,Commerical,,,,,,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Anthem,Indemnity,,,13.63,,13.63,0.76,15.47,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Anthem,Individual Exchange,,,,,,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Anthem,State Preferred,,,,,,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Cigna,Cigna,,0.76,,,0.76,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Connecticare,Commerical,,0.98,,,0.98,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Connecticare,Exchange,,0.98,,,0.98,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,Multiplan,Multiplan,,,15.47,,15.47,0.76,15.47,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,J7050,HCPCS,0990-7984-37,NDC,both,250,mL,18.2,10.92,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,15.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,J3490,HCPCS,0990-7972-05,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Commerical,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Anthem,State Preferred,,,,,,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Cigna,Cigna,,3.04,,,3.04,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Commerical,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Connecticare,Exchange,,3.92,,,3.92,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,2.83,3.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-02,NDC,both,1000,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,2.83,3.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,3.04,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,3.04,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Commerical,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,3.04,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Anthem,State Preferred,,,,,,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Cigna,Cigna,,3.04,,,3.04,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Connecticare,Commerical,,3.92,,,3.92,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Connecticare,Exchange,,3.92,,,3.92,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,3.04,13.02,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7030,HCPCS,0990-7983-03,NDC,both,1000,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,13.02,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Commerical,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Anthem,State Preferred,,,,,,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Cigna,Cigna,,1.53,,,1.53,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Commerical,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Connecticare,Exchange,,1.96,,,1.96,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,1.53,16.28,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7040,HCPCS,0990-7983-09,NDC,both,500,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.65,,,1.65,1.53,16.28,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.98,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.98,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.98,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Cigna,Cigna,,0.76,,,0.76,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Connecticare,Commerical,,0.98,,,0.98,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Connecticare,Exchange,,0.98,,,0.98,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.98,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0487-4301-10,NDC,both,250,mL,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.15,0.98,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Commerical,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Anthem,State Preferred,,,,,,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Cigna,Cigna,,0.76,,,0.76,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Connecticare,Commerical,,0.98,,,0.98,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Connecticare,Exchange,,0.98,,,0.98,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,0.76,17.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV BOLUS,J7050,HCPCS,0990-7983-61,NDC,both,250,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,17.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-31,NDC,both,50,mL,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Aetna,Commerical,,,3.55,,3.55,3.4,3.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Aetna,Middlesex Employees,,,3.4,,3.4,3.4,3.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Anthem,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Anthem,Indemnity,,,3.45,,3.45,3.4,3.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Anthem,Individual Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Anthem,State Preferred,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Cigna,Cigna,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Connecticare,Commerical,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Connecticare,Exchange,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,Multiplan,Multiplan,,,3.91,,3.91,3.4,3.91,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J3490,HCPCS,0264-1800-32,NDC,both,100,mL,4.6,2.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.4,3.91,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,3.04,19.53,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,3.04,19.53,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Anthem,Commerical,,,,,,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,3.04,19.53,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Anthem,State Preferred,,,,,,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Cigna,Cigna,,3.04,,,3.04,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Connecticare,Commerical,,3.92,,,3.92,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Connecticare,Exchange,,3.92,,,3.92,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,3.04,19.53,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-02,NDC,both,1000,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,19.53,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,3.04,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,3.04,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Anthem,Commerical,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,3.04,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Anthem,State Preferred,,,,,,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Cigna,Cigna,,3.04,,,3.04,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Connecticare,Commerical,,3.92,,,3.92,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Connecticare,Exchange,,3.92,,,3.92,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,3.04,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7030,HCPCS,0338-0049-03,NDC,both,1000,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,3.28,,,3.28,3.04,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Aetna,Commerical,,,91.61,,91.61,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Aetna,Middlesex Employees,,,87.85,,87.85,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Anthem,Commerical,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Anthem,Indemnity,,,88.94,,88.94,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Anthem,Individual Exchange,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Anthem,State Preferred,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Cigna,Cigna,,0.76,,,0.76,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Connecticare,Commerical,,0.98,,,0.98,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Connecticare,Exchange,,0.98,,,0.98,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,Multiplan,Multiplan,,,100.92,,100.92,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,118.73,71.24,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Aetna,Commerical,,,45.81,,45.81,0.76,50.46,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Aetna,Middlesex Employees,,,43.93,,43.93,0.76,50.46,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Anthem,Commerical,,,,,,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Anthem,Indemnity,,,44.47,,44.47,0.76,50.46,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Anthem,Individual Exchange,,,,,,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Anthem,State Preferred,,,,,,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Cigna,Cigna,,0.76,,,0.76,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Connecticare,Commerical,,0.98,,,0.98,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Connecticare,Exchange,,0.98,,,0.98,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,Multiplan,Multiplan,,,50.46,,50.46,0.76,50.46,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-5802-10,NDC,both,250,mL,59.37,35.62,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,50.46,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Aetna,Commerical,,,2.96,,2.96,0.76,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Aetna,Middlesex Employees,,,2.83,,2.83,0.76,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Anthem,Commerical,,,,,,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Anthem,Indemnity,,,2.87,,2.87,0.76,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Anthem,Individual Exchange,,,,,,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Anthem,State Preferred,,,,,,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Cigna,Cigna,,0.76,,,0.76,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Connecticare,Commerical,,0.98,,,0.98,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Connecticare,Exchange,,0.98,,,0.98,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,Multiplan,Multiplan,,,3.26,,3.26,0.76,3.26,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-00,NDC,both,250,mL,3.83,2.3,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,3.26,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Commerical,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Anthem,State Preferred,,,,,,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Cigna,Cigna,,0.76,,,0.76,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Connecticare,Commerical,,0.98,,,0.98,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Connecticare,Exchange,,0.98,,,0.98,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,0.76,9.77,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-09,NDC,both,250,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Aetna,Commerical,,,4.44,,4.44,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Aetna,Middlesex Employees,,,4.25,,4.25,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Commerical,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Indemnity,,,4.31,,4.31,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,Individual Exchange,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Anthem,State Preferred,,,,,,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Cigna,Cigna,,0.76,,,0.76,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Connecticare,Commerical,,0.98,,,0.98,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Connecticare,Exchange,,0.98,,,0.98,0.76,4.89,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,Multiplan,Multiplan,,,4.89,,4.89,0.76,4.89,percent of total billed charges,,
SODIUM CHLORIDE 0.9 % IV FOR RECTAL,J7050,HCPCS,0264-7800-10,NDC,both,250,mL,5.75,3.45,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,4.89,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-02,NDC,both,30,mL,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Aetna,Commerical,,,2.31,,2.31,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Aetna,Middlesex Employees,,,2.21,,2.21,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Anthem,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Anthem,Indemnity,,,2.24,,2.24,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Anthem,Individual Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Anthem,State Preferred,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Cigna,Cigna,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Connecticare,Commerical,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Connecticare,Exchange,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,Multiplan,Multiplan,,,2.54,,2.54,2.21,2.54,percent of total billed charges,,
"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-1966-07,NDC,both,30,mL,2.99,1.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.21,2.54,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,0409-4888-10,NDC,both,1,mL,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-10,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Commerical,,,5.32,,5.32,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Aetna,Middlesex Employees,,,5.11,,5.11,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Indemnity,,,5.17,,5.17,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,Individual Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Anthem,State Preferred,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Cigna,Cigna,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Commerical,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Connecticare,Exchange,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,Multiplan,Multiplan,,,5.87,,5.87,5.11,5.87,percent of total billed charges,,
SODIUM CHLORIDE 0.9% INJECTION,J3490,HCPCS,63323-186-20,NDC,both,1,mL,6.9,4.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.11,5.87,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Aetna,Commerical,,,91.61,,91.61,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Aetna,Middlesex Employees,,,87.85,,87.85,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Anthem,Commerical,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Anthem,Indemnity,,,88.94,,88.94,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Anthem,State Preferred,,,,,,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Cigna,Cigna,,0.76,,,0.76,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Connecticare,Commerical,,0.98,,,0.98,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Connecticare,Exchange,,0.98,,,0.98,0.76,100.92,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,Multiplan,Multiplan,,,100.92,,100.92,0.76,100.92,percent of total billed charges,,
SODIUM CHLORIDE 0.9% IV FOR INTRA-AMNIOTIC,J7050,HCPCS,0264-5802-00,NDC,both,250,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,0.82,,,0.82,0.76,100.92,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",J3490,HCPCS,536134201,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Aetna,Commerical,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Aetna,Middlesex Employees,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Anthem,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Anthem,Indemnity,,,0.06,,0.06,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Anthem,Individual Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Anthem,State Preferred,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Cigna,Cigna,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Connecticare,Commerical,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Connecticare,Exchange,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,Multiplan,Multiplan,,,0.07,,0.07,0.06,0.07,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6657-73,NDC,both,1,mL,0.08,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.06,0.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Aetna,Commerical,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Aetna,Middlesex Employees,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Anthem,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Anthem,Indemnity,,,0.12,,0.12,0.12,0.14,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Anthem,Individual Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Anthem,State Preferred,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Cigna,Cigna,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Connecticare,Commerical,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Connecticare,Exchange,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.12,0.14,percent of total billed charges,,
SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-6660-75,NDC,both,1,mL,0.16,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.12,0.14,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,21.26,24.42,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,21.26,24.42,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,21.26,24.42,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,21.26,24.42,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1130-02,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Aetna,Commerical,,,7.69,,7.69,7.37,8.47,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Aetna,Middlesex Employees,,,7.37,,7.37,7.37,8.47,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Anthem,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Anthem,Indemnity,,,7.46,,7.46,7.37,8.47,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Anthem,Individual Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Anthem,State Preferred,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Cigna,Cigna,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Connecticare,Commerical,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Connecticare,Exchange,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,Multiplan,Multiplan,,,8.47,,8.47,7.37,8.47,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-02,NDC,both,1,mL,9.96,5.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.37,8.47,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,0409-1141-12,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,2.66,,2.66,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,2.55,,2.55,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,2.58,,2.58,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,2.93,,2.93,2.55,2.93,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-01,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.55,2.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Aetna,Commerical,,,19.07,,19.07,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Aetna,Middlesex Employees,,,18.28,,18.28,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Anthem,Commerical,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Anthem,Indemnity,,,18.51,,18.51,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Anthem,Individual Exchange,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Anthem,State Preferred,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Cigna,Cigna,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Connecticare,Commerical,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Connecticare,Exchange,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,Multiplan,Multiplan,,,21,,21,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-093-30,NDC,both,1,mL,3.45,2.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Anthem,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Anthem,State Preferred,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Cigna,Cigna,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Connecticare,Commerical,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Connecticare,Exchange,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,8.5,9.77,percent of total billed charges,,
SODIUM CHLORIDE 23.4% (4 MEQ/ML) IV BOLUS,J3490,HCPCS,63323-095-02,NDC,both,1,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.5,9.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Aetna,Commerical,,,164.94,,164.94,158.17,181.7,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Aetna,Middlesex Employees,,,158.17,,158.17,158.17,181.7,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Anthem,Commerical,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Anthem,Indemnity,,,160.14,,160.14,158.17,181.7,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Anthem,Individual Exchange,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Anthem,State Preferred,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Cigna,Cigna,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Connecticare,Commerical,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Connecticare,Exchange,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,Multiplan,Multiplan,,,181.7,,181.7,158.17,181.7,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,536137785,NDC,both,1,mL,213.77,128.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,158.17,181.7,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Aetna,Commerical,,,178.93,,178.93,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Aetna,Middlesex Employees,,,171.58,,171.58,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Anthem,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Anthem,Indemnity,,,173.71,,173.71,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Anthem,Individual Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Anthem,State Preferred,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Cigna,Cigna,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Connecticare,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Connecticare,Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,Multiplan,Multiplan,,,197.11,,197.11,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,J3490,HCPCS,4843321501,NDC,both,1,mL,213.77,128.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 250 MG ORAL TAB,J3490,HCPCS,40810-0018-86,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900330,NDC,both,1,mL,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Aetna,Commerical,,,0.73,,0.73,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Aetna,Middlesex Employees,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Anthem,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Anthem,Indemnity,,,0.7,,0.7,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Anthem,Individual Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Anthem,State Preferred,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Cigna,Cigna,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Connecticare,Commerical,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Connecticare,Exchange,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,Multiplan,Multiplan,,,0.8,,0.8,0.7,0.8,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,487900360,NDC,both,1,mL,0.94,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.7,0.8,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Aetna,Commerical,,,1.87,,1.87,1.8,2.07,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Aetna,Middlesex Employees,,,1.8,,1.8,1.8,2.07,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Anthem,Commerical,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Anthem,Indemnity,,,1.82,,1.82,1.8,2.07,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Anthem,Individual Exchange,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Anthem,State Preferred,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Cigna,Cigna,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Connecticare,Commerical,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Connecticare,Exchange,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,Multiplan,Multiplan,,,2.07,,2.07,1.8,2.07,percent of total billed charges,,
SODIUM CHLORIDE 3 % FOR NEBULIZATION,J7699,HCPCS,5019014263,NDC,both,1,mL,2.43,1.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.8,2.07,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS HYPONATREMIA AND SEIZURE,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0264-7805-10,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Commerical,,,19.21,,19.21,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Aetna,Middlesex Employees,,,18.42,,18.42,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Indemnity,,,18.65,,18.65,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,Individual Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Anthem,State Preferred,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Cigna,Cigna,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Commerical,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Connecticare,Exchange,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,Multiplan,Multiplan,,,21.17,,21.17,18.42,21.17,percent of total billed charges,,
SODIUM CHLORIDE 3% IV BOLUS INCREASED ICP,J3490,HCPCS,0338-0054-03,NDC,both,500,mL,24.9,14.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.42,21.17,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Aetna,Commerical,,,19.07,,19.07,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Aetna,Middlesex Employees,,,18.28,,18.28,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Anthem,Commerical,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Anthem,Indemnity,,,18.51,,18.51,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Anthem,Individual Exchange,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Anthem,State Preferred,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Cigna,Cigna,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Connecticare,Commerical,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Connecticare,Exchange,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,Multiplan,Multiplan,,,21,,21,18.28,21,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-093-30,NDC,both,1,mL,24.71,14.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.28,21,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Commerical,,,178.93,,178.93,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Middlesex Employees,,,171.58,,171.58,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Indemnity,,,173.71,,173.71,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Individual Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,State Preferred,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Cigna,Cigna,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Multiplan,Multiplan,,,197.11,,197.11,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Commerical,,,178.93,,178.93,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Middlesex Employees,,,171.58,,171.58,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Indemnity,,,173.71,,173.71,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Individual Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,State Preferred,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Cigna,Cigna,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Multiplan,Multiplan,,,197.11,,197.11,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN FOR FEEDS,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Commerical,,,178.93,,178.93,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Aetna,Middlesex Employees,,,171.58,,171.58,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Indemnity,,,173.71,,173.71,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,Individual Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Anthem,State Preferred,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Cigna,Cigna,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Commerical,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Connecticare,Exchange,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,Multiplan,Multiplan,,,197.11,,197.11,171.58,197.11,percent of total billed charges,,
SODIUM CHLORIDE 4 MEQ/ML ORAL SOLN-NICU,J3490,HCPCS,4843321501,NDC,both,1,mL,231.89,139.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,171.58,197.11,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
SODIUM CHLORIDE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-82,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900730,NDC,both,4,mL,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,487900760,NDC,both,4,mL,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Aetna,Commerical,,,1.98,,1.98,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Aetna,Middlesex Employees,,,1.89,,1.89,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Anthem,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Anthem,Indemnity,,,1.92,,1.92,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Anthem,Individual Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Anthem,State Preferred,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Cigna,Cigna,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Connecticare,Commerical,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Connecticare,Exchange,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,Multiplan,Multiplan,,,2.18,,2.18,1.89,2.18,percent of total billed charges,,
SODIUM CHLORIDE 7 % FOR NEBULIZATION,J7699,HCPCS,5019014123,NDC,both,4,mL,2.56,1.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.89,2.18,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Aetna,Commerical,,,53.19,,53.19,51.01,58.6,percent of total billed charges,,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Aetna,Middlesex Employees,,,51.01,,51.01,51.01,58.6,percent of total billed charges,,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Anthem,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Anthem,Indemnity,,,51.64,,51.64,51.01,58.6,percent of total billed charges,,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Anthem,Individual Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Anthem,State Preferred,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Cigna,Cigna,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Connecticare,Commerical,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Connecticare,Exchange,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,Multiplan,Multiplan,,,58.6,,58.6,51.01,58.6,percent of total billed charges,,
SODIUM CHLORIDE 7.5% IV BOLUS,J3490,HCPCS,40810-0019-94,NDC,both,1,mL,68.94,41.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.01,58.6,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Aetna,Commerical,,,9.92,,9.92,9.52,10.93,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Aetna,Middlesex Employees,,,9.52,,9.52,9.52,10.93,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Anthem,Commerical,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Anthem,Indemnity,,,9.63,,9.63,9.52,10.93,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Anthem,Individual Exchange,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Anthem,State Preferred,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Cigna,Cigna,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Connecticare,Commerical,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Connecticare,Exchange,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,Multiplan,Multiplan,,,10.93,,10.93,9.52,10.93,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL GEL,J3490,HCPCS,225052547,NDC,both,14.1,gm,12.86,7.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.52,10.93,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Aetna,Commerical,,,17.04,,17.04,16.34,18.77,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Aetna,Middlesex Employees,,,16.34,,16.34,16.34,18.77,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Anthem,Commerical,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Anthem,Indemnity,,,16.54,,16.54,16.34,18.77,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Anthem,Individual Exchange,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Anthem,State Preferred,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Cigna,Cigna,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Connecticare,Commerical,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Connecticare,Exchange,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,Multiplan,Multiplan,,,18.77,,18.77,16.34,18.77,percent of total billed charges,,
SODIUM CHLORIDE-ALOE VERA NASAL SPRAY,J3490,HCPCS,225052848,NDC,both,1,mL,22.08,13.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.34,18.77,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Aetna,Commerical,,,14.78,,14.78,14.17,16.28,percent of total billed charges,,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Aetna,Middlesex Employees,,,14.17,,14.17,14.17,16.28,percent of total billed charges,,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Anthem,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Anthem,Indemnity,,,14.35,,14.35,14.17,16.28,percent of total billed charges,,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Anthem,Individual Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Anthem,State Preferred,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Cigna,Cigna,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Connecticare,Commerical,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Connecticare,Exchange,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,Multiplan,Multiplan,,,16.28,,16.28,14.17,16.28,percent of total billed charges,,
SODIUM CITRATE 4 % (5 ML) INTRA-CATHETER INJECTION SYRINGE,J3490,HCPCS,69374-906-05,NDC,both,5,mL,19.15,11.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.17,16.28,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Aetna,Commerical,,,39.14,,39.14,37.54,43.12,percent of total billed charges,,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Aetna,Middlesex Employees,,,37.54,,37.54,37.54,43.12,percent of total billed charges,,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Anthem,Commerical,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Anthem,Indemnity,,,38,,38,37.54,43.12,percent of total billed charges,,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Anthem,Individual Exchange,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Anthem,State Preferred,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Cigna,Cigna,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Connecticare,Commerical,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Connecticare,Exchange,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,Multiplan,Multiplan,,,43.12,,43.12,37.54,43.12,percent of total billed charges,,
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,J3490,HCPCS,121059516,NDC,both,1,mL,50.73,30.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,37.54,43.12,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,6498010401,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Aetna,Commerical,,,0.75,,0.75,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Aetna,Middlesex Employees,,,0.72,,0.72,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Anthem,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Anthem,Indemnity,,,0.73,,0.73,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Anthem,Individual Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Anthem,State Preferred,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Cigna,Cigna,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Connecticare,Commerical,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Connecticare,Exchange,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,Multiplan,Multiplan,,,0.82,,0.82,0.72,0.82,percent of total billed charges,,
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,J3490,HCPCS,40810-0015-43,NDC,both,1,ea,0.97,0.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.72,0.82,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Aetna,Commerical,,,22.48,,22.48,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Aetna,Middlesex Employees,,,21.55,,21.55,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Anthem,Commerical,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Anthem,Indemnity,,,21.82,,21.82,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Anthem,Individual Exchange,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Anthem,State Preferred,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Cigna,Cigna,,2.42,,,2.42,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Connecticare,Commerical,,3.34,,,3.34,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Connecticare,Exchange,,3.34,,,3.34,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,Multiplan,Multiplan,,,24.76,,24.76,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-01,NDC,both,0.2,mL,29.13,17.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.61,,,2.61,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Aetna,Commerical,,,38.75,,38.75,2.42,42.69,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Aetna,Middlesex Employees,,,37.16,,37.16,2.42,42.69,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Anthem,Commerical,,,,,,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Anthem,Indemnity,,,37.62,,37.62,2.42,42.69,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Anthem,Individual Exchange,,,,,,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Anthem,State Preferred,,,,,,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Cigna,Cigna,,2.42,,,2.42,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Connecticare,Commerical,,3.34,,,3.34,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Connecticare,Exchange,,3.34,,,3.34,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,Multiplan,Multiplan,,,42.69,,42.69,2.42,42.69,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0024-2792-10,NDC,both,0.2,mL,50.22,30.13,United Healthcare/Oxford,United Healthcare/Oxford,,2.61,,,2.61,2.42,42.69,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Aetna,Commerical,,,22.49,,22.49,2.42,24.78,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Aetna,Middlesex Employees,,,21.57,,21.57,2.42,24.78,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Anthem,Commerical,,,,,,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Anthem,Indemnity,,,21.84,,21.84,2.42,24.78,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Anthem,Individual Exchange,,,,,,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Anthem,State Preferred,,,,,,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Cigna,Cigna,,2.42,,,2.42,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Connecticare,Commerical,,3.34,,,3.34,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Connecticare,Exchange,,3.34,,,3.34,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,Multiplan,Multiplan,,,24.78,,24.78,2.42,24.78,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-01,NDC,both,0.2,mL,29.15,17.49,United Healthcare/Oxford,United Healthcare/Oxford,,2.61,,,2.61,2.42,24.78,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Aetna,Commerical,,,22.48,,22.48,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Aetna,Middlesex Employees,,,21.55,,21.55,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Anthem,Commerical,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Anthem,Indemnity,,,21.82,,21.82,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Anthem,Individual Exchange,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Anthem,State Preferred,,,,,,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Cigna,Cigna,,2.42,,,2.42,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Connecticare,Commerical,,3.34,,,3.34,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Connecticare,Exchange,,3.34,,,3.34,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,Multiplan,Multiplan,,,24.76,,24.76,2.42,24.76,percent of total billed charges,,
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,J2916,HCPCS,0143-9570-10,NDC,both,0.2,mL,29.13,17.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.61,,,2.61,2.42,24.76,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Aetna,Commerical,,,561.49,,561.49,85.29,618.55,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Aetna,Middlesex Employees,,,538.43,,538.43,85.29,618.55,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Anthem,Commerical,,,,,,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Anthem,Indemnity,,,545.12,,545.12,85.29,618.55,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Anthem,Individual Exchange,,,,,,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Anthem,State Preferred,,,,,,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Cigna,Cigna,,85.29,,,85.29,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Connecticare,Commerical,,111.81,,,111.81,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Connecticare,Exchange,,111.81,,,111.81,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,Multiplan,Multiplan,,,618.55,,618.55,85.29,618.55,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION,J7321,HCPCS,89122-0724-12,NDC,both,1,mL,727.7,436.62,United Healthcare/Oxford,United Healthcare/Oxford,,92.09,,,92.09,85.29,618.55,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Aetna,Commerical,,,476.8,,476.8,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Aetna,Middlesex Employees,,,457.21,,457.21,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Anthem,Commerical,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Anthem,Indemnity,,,462.9,,462.9,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Anthem,Individual Exchange,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Anthem,State Preferred,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Cigna,Cigna,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Connecticare,Commerical,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Connecticare,Exchange,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,Multiplan,Multiplan,,,525.25,,525.25,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,8544636981,NDC,both,1,mL,617.94,370.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Aetna,Commerical,,,476.8,,476.8,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Aetna,Middlesex Employees,,,457.21,,457.21,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Anthem,Commerical,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Anthem,Indemnity,,,462.9,,462.9,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Anthem,Individual Exchange,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Anthem,State Preferred,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Cigna,Cigna,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Connecticare,Commerical,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Connecticare,Exchange,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,Multiplan,Multiplan,,,525.25,,525.25,457.21,525.25,percent of total billed charges,,
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE,J3490,HCPCS,59354-4000-00,NDC,both,1,mL,617.94,370.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,457.21,525.25,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Aetna,Commerical,,,1359.64,,1359.64,135.37,1497.79,percent of total billed charges,,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Aetna,Middlesex Employees,,,1303.79,,1303.79,135.37,1497.79,percent of total billed charges,,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Anthem,Commerical,,,,,,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Anthem,Indemnity,,,1320,,1320,135.37,1497.79,percent of total billed charges,,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Anthem,Individual Exchange,,,,,,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Anthem,State Preferred,,,,,,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Cigna,Cigna,,135.37,,,135.37,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Connecticare,Commerical,,187.69,,,187.69,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Connecticare,Exchange,,187.69,,,187.69,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,Multiplan,Multiplan,,,1497.79,,1497.79,135.37,1497.79,percent of total billed charges,,
SODIUM HYALURONATE 30 MG/2 ML INTRA-ARTICULAR SYRINGE,J7324,HCPCS,5967636001,NDC,both,2,mL,1762.11,1057.27,United Healthcare/Oxford,United Healthcare/Oxford,,146.16,,,146.16,135.37,1497.79,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Aetna,Commerical,,,53.12,,53.12,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Aetna,Middlesex Employees,,,50.94,,50.94,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Anthem,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Anthem,Indemnity,,,51.58,,51.58,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Anthem,Individual Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Anthem,State Preferred,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Cigna,Cigna,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Connecticare,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Connecticare,Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,Multiplan,Multiplan,,,58.52,,58.52,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.125 % SOLUTION,J3490,HCPCS,0436-0672-16,NDC,both,1,mL,68.85,41.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Aetna,Commerical,,,53.12,,53.12,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Aetna,Middlesex Employees,,,50.94,,50.94,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Anthem,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Anthem,Indemnity,,,51.58,,51.58,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Anthem,Individual Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Anthem,State Preferred,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Cigna,Cigna,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Connecticare,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Connecticare,Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,Multiplan,Multiplan,,,58.52,,58.52,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,0436-0936-16,NDC,both,473,mL,68.85,41.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Aetna,Commerical,,,53.12,,53.12,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Aetna,Middlesex Employees,,,50.94,,50.94,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Anthem,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Anthem,Indemnity,,,51.58,,51.58,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Anthem,Individual Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Anthem,State Preferred,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Cigna,Cigna,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Connecticare,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Connecticare,Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,Multiplan,Multiplan,,,58.52,,58.52,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.25 % SOLUTION,J3490,HCPCS,39328-063-25,NDC,both,1,mL,68.85,41.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Aetna,Commerical,,,53.12,,53.12,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Aetna,Middlesex Employees,,,50.94,,50.94,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Anthem,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Anthem,Indemnity,,,51.58,,51.58,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Anthem,Individual Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Anthem,State Preferred,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Cigna,Cigna,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Connecticare,Commerical,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Connecticare,Exchange,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,Multiplan,Multiplan,,,58.52,,58.52,50.94,58.52,percent of total billed charges,,
SODIUM HYPOCHLORITE 0.5 % SOLUTION,J3490,HCPCS,0436-0946-16,NDC,both,473,mL,68.85,41.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.94,58.52,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-02,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25021-310-66,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,25208-003-05,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,43598-587-23,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,67457-839-02,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70436-028-80,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70700-126-92,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-105-01,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Aetna,Commerical,,,60.59,,60.59,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Aetna,Middlesex Employees,,,58.1,,58.1,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Anthem,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Anthem,Indemnity,,,58.82,,58.82,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Anthem,Individual Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Anthem,State Preferred,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Cigna,Cigna,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Connecticare,Commerical,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Connecticare,Exchange,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,Multiplan,Multiplan,,,66.74,,66.74,58.1,66.74,percent of total billed charges,,
SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-305-01,NDC,both,1,mL,78.52,47.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.1,66.74,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Aetna,Commerical,,,44.31,,44.31,42.49,48.82,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Aetna,Middlesex Employees,,,42.49,,42.49,42.49,48.82,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Anthem,Commerical,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Anthem,Indemnity,,,43.02,,43.02,42.49,48.82,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Anthem,Individual Exchange,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Anthem,State Preferred,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Cigna,Cigna,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Connecticare,Commerical,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Connecticare,Exchange,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,Multiplan,Multiplan,,,48.82,,48.82,42.49,48.82,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,40810-0019-59,NDC,both,1,gm,57.43,34.46,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.49,48.82,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Aetna,Commerical,,,11786.65,,11786.65,11302.41,12984.25,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Aetna,Middlesex Employees,,,11302.41,,11302.41,11302.41,12984.25,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Anthem,Commerical,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Anthem,Indemnity,,,11442.94,,11442.94,11302.41,12984.25,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Anthem,Individual Exchange,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Anthem,State Preferred,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Cigna,Cigna,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Connecticare,Commerical,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Connecticare,Exchange,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,Multiplan,Multiplan,,,12984.25,,12984.25,11302.41,12984.25,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 1 GRAM ORAL POWDER,J3490,HCPCS,49884-006-04,NDC,both,1,gm,15275.59,9165.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11302.41,12984.25,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Aetna,Commerical,,,159.5,,159.5,152.94,175.7,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Aetna,Middlesex Employees,,,152.94,,152.94,152.94,175.7,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Anthem,Commerical,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Anthem,Indemnity,,,154.85,,154.85,152.94,175.7,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Anthem,Individual Exchange,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Anthem,State Preferred,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Cigna,Cigna,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Connecticare,Commerical,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Connecticare,Exchange,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,Multiplan,Multiplan,,,175.7,,175.7,152.94,175.7,percent of total billed charges,,
SODIUM PHENYLBUTYRATE 3 GRAM ORAL POWDER,J3490,HCPCS,40810-0014-08,NDC,both,3,gm,206.71,124.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,152.94,175.7,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Aetna,Commerical,,,3189.88,,3189.88,3058.83,3513.99,percent of total billed charges,,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Aetna,Middlesex Employees,,,3058.83,,3058.83,3058.83,3513.99,percent of total billed charges,,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Anthem,Commerical,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Anthem,Indemnity,,,3096.86,,3096.86,3058.83,3513.99,percent of total billed charges,,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Anthem,Individual Exchange,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Anthem,State Preferred,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Cigna,Cigna,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Connecticare,Commerical,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Connecticare,Exchange,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,Multiplan,Multiplan,,,3513.99,,3513.99,3058.83,3513.99,percent of total billed charges,,
SODIUM PHENYLBUTYRATE ORAL SUSPENSION,J3490,HCPCS,40810-0201-87,NDC,both,5,mL,4134.11,2480.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3058.83,3513.99,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-170-15,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,0409-7391-72,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,40810-0201-01,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-01,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
SODIUM PHOSPHATE 3 MMOLE/ML ORAL SOLN,J3490,HCPCS,63323-881-16,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Aetna,Commerical,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Aetna,Middlesex Employees,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Anthem,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Anthem,Indemnity,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Anthem,Individual Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Anthem,State Preferred,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Cigna,Cigna,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Connecticare,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Connecticare,Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,0132-0119-46,NDC,both,1,UN,0.03,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Aetna,Commerical,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Aetna,Middlesex Employees,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Anthem,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Anthem,Indemnity,,,0.02,,0.02,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Anthem,Individual Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Anthem,State Preferred,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Cigna,Cigna,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Connecticare,Commerical,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Connecticare,Exchange,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,Multiplan,Multiplan,,,0.03,,0.03,0.02,0.03,percent of total billed charges,,
SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,J3490,HCPCS,35135-0150-32,NDC,both,1,UN,0.03,0.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.02,0.03,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Aetna,Commerical,,,4.68,,4.68,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Aetna,Commerical,,,4.68,,4.68,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Aetna,Middlesex Employees,,,4.49,,4.49,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Aetna,Middlesex Employees,,,4.49,,4.49,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Commerical,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Commerical,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Indemnity,,,4.55,,4.55,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Indemnity,,,4.55,,4.55,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Individual Exchange,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,Individual Exchange,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,State Preferred,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Anthem,State Preferred,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Cigna,Cigna,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Cigna,Cigna,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Connecticare,Commerical,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Connecticare,Commerical,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Connecticare,Exchange,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Connecticare,Exchange,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Multiplan,Multiplan,,,5.16,,5.16,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,Multiplan,Multiplan,,,5.16,,5.16,4.49,5.16,percent of total billed charges,,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,J3490,HCPCS,0132-0202-20,NDC,both,66,mL,6.07,3.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.49,5.16,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Aetna,Commerical,,,2.38,,2.38,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Aetna,Middlesex Employees,,,2.28,,2.28,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Anthem,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Anthem,Indemnity,,,2.31,,2.31,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Anthem,Individual Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Anthem,State Preferred,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Cigna,Cigna,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Connecticare,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Connecticare,Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,Multiplan,Multiplan,,,2.62,,2.62,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE 1 GRAM POWDER PACKET,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,3.08,1.85,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Aetna,Commerical,,,35.12,,35.12,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Aetna,Middlesex Employees,,,33.67,,33.67,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Anthem,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Anthem,Indemnity,,,34.09,,34.09,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Anthem,Individual Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Anthem,State Preferred,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Cigna,Cigna,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Connecticare,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Connecticare,Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,Multiplan,Multiplan,,,38.68,,38.68,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE ORAL POWDER,J3490,HCPCS,10702-036-15,NDC,both,1,gm,45.51,27.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Aetna,Commerical,,,35.12,,35.12,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Aetna,Middlesex Employees,,,33.67,,33.67,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Anthem,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Anthem,Indemnity,,,34.09,,34.09,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Anthem,Individual Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Anthem,State Preferred,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Cigna,Cigna,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Connecticare,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Connecticare,Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,Multiplan,Multiplan,,,38.68,,38.68,33.67,38.68,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,10702-036-15,NDC,both,1,gm,33.15,19.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Aetna,Commerical,,,25.58,,25.58,24.53,28.18,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Aetna,Middlesex Employees,,,24.53,,24.53,24.53,28.18,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Anthem,Commerical,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Anthem,Indemnity,,,24.83,,24.83,24.53,28.18,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Anthem,Individual Exchange,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Anthem,State Preferred,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Cigna,Cigna,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Connecticare,Commerical,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Connecticare,Exchange,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,Multiplan,Multiplan,,,28.18,,28.18,24.53,28.18,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,11534-166-16,NDC,both,1,gm,33.15,19.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.53,28.18,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Aetna,Commerical,,,2.38,,2.38,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Aetna,Middlesex Employees,,,2.28,,2.28,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Anthem,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Anthem,Indemnity,,,2.31,,2.31,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Anthem,Individual Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Anthem,State Preferred,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Cigna,Cigna,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Connecticare,Commerical,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Connecticare,Exchange,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,Multiplan,Multiplan,,,2.62,,2.62,2.28,2.62,percent of total billed charges,,
SODIUM POLYSTYRENE SULFONATE POWDER FOR ORAL SUSP,J3490,HCPCS,40810-0202-54,NDC,both,1,gm,2.21,1.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.28,2.62,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Aetna,Commerical,,,199.12,,199.12,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Aetna,Middlesex Employees,,,190.94,,190.94,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Anthem,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Anthem,Indemnity,,,193.31,,193.31,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Anthem,Individual Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Anthem,State Preferred,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Cigna,Cigna,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Connecticare,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Connecticare,Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,Multiplan,Multiplan,,,219.35,,219.35,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-01,NDC,both,1,mL,258.06,154.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Aetna,Commerical,,,199.12,,199.12,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Aetna,Middlesex Employees,,,190.94,,190.94,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Anthem,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Anthem,Indemnity,,,193.31,,193.31,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Anthem,Individual Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Anthem,State Preferred,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Cigna,Cigna,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Connecticare,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Connecticare,Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,Multiplan,Multiplan,,,219.35,,219.35,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,24201-201-05,NDC,both,1,mL,258.06,154.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Aetna,Commerical,,,199.12,,199.12,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Aetna,Middlesex Employees,,,190.94,,190.94,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Anthem,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Anthem,Indemnity,,,193.31,,193.31,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Anthem,Individual Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Anthem,State Preferred,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Cigna,Cigna,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Connecticare,Commerical,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Connecticare,Exchange,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,Multiplan,Multiplan,,,219.35,,219.35,190.94,219.35,percent of total billed charges,,
SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,67457-163-02,NDC,both,1,mL,258.06,154.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,190.94,219.35,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Aetna,Commerical,,,287.25,,287.25,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Aetna,Middlesex Employees,,,275.45,,275.45,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Commerical,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Indemnity,,,278.87,,278.87,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Individual Exchange,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,State Preferred,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Cigna,Cigna,,0.89,,,0.89,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Connecticare,Commerical,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Connecticare,Exchange,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Multiplan,Multiplan,,,316.44,,316.44,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Aetna,Commerical,,,287.25,,287.25,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Aetna,Middlesex Employees,,,275.45,,275.45,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Commerical,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Indemnity,,,278.87,,278.87,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,Individual Exchange,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Anthem,State Preferred,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Cigna,Cigna,,0.89,,,0.89,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Connecticare,Commerical,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Connecticare,Exchange,,,,,,0.89,316.44,Other,Could be inpatient or outpatient,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,Multiplan,Multiplan,,,316.44,,316.44,0.89,316.44,percent of total billed charges,,
SODIUM THIOSULFATE 12.5 GRAM/50 ML CHEMO IV,J0209,HCPCS,60267-705-50,NDC,both,0.4,mL,372.28,223.37,United Healthcare/Oxford,United Healthcare/Oxford,,1.13,,,1.13,0.89,316.44,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Aetna,Commerical,,,942.04,,942.04,174.97,1037.76,percent of total billed charges,,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Aetna,Middlesex Employees,,,903.34,,903.34,174.97,1037.76,percent of total billed charges,,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Anthem,Commerical,,,,,,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Anthem,Indemnity,,,914.57,,914.57,174.97,1037.76,percent of total billed charges,,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Anthem,Individual Exchange,,,,,,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Anthem,State Preferred,,,,,,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Cigna,Cigna,,174.97,,,174.97,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Connecticare,Commerical,,,,,,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Connecticare,Exchange,,,,,,174.97,1037.76,Other,Could be inpatient or outpatient,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,Multiplan,Multiplan,,,1037.76,,1037.76,174.97,1037.76,percent of total billed charges,,
SOMATROPIN 5 MG/1.5 ML (3.3 MG/ML) SUBCUTANEOUS CARTRIDGE,J2941,HCPCS,0781-3001-07,NDC,both,0.3,mL,1220.89,732.53,United Healthcare/Oxford,United Healthcare/Oxford,,199.53,,,199.53,174.97,1037.76,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Aetna,Commerical,,,592.77,,592.77,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Aetna,Middlesex Employees,,,568.41,,568.41,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Anthem,Commerical,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Anthem,Indemnity,,,575.48,,575.48,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Anthem,Individual Exchange,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Anthem,State Preferred,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Cigna,Cigna,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Connecticare,Commerical,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Connecticare,Exchange,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,Multiplan,Multiplan,,,653,,653,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,40810-0015-51,NDC,both,1,ea,768.23,460.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Aetna,Commerical,,,592.77,,592.77,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Aetna,Middlesex Employees,,,568.41,,568.41,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Anthem,Commerical,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Anthem,Indemnity,,,575.48,,575.48,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Anthem,Individual Exchange,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Anthem,State Preferred,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Cigna,Cigna,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Connecticare,Commerical,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Connecticare,Exchange,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,Multiplan,Multiplan,,,653,,653,568.41,653,percent of total billed charges,,
SORAFENIB 200 MG TABLET,J8999,HCPCS,50419-488-58,NDC,both,1,ea,768.23,460.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,568.41,653,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Aetna,Commerical,,,11.19,,11.19,10.73,12.33,percent of total billed charges,,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Aetna,Middlesex Employees,,,10.73,,10.73,10.73,12.33,percent of total billed charges,,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Anthem,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Anthem,Indemnity,,,10.86,,10.86,10.73,12.33,percent of total billed charges,,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Anthem,Individual Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Anthem,State Preferred,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Cigna,Cigna,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Connecticare,Commerical,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Connecticare,Exchange,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,Multiplan,Multiplan,,,12.33,,12.33,10.73,12.33,percent of total billed charges,,
SORBITOL 70 % SOLUTION,J3490,HCPCS,0121-0659-16,NDC,both,1,mL,14.5,8.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.73,12.33,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,0245-0013-01,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,40810-0015-84,NDC,both,1,UN,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
SOTALOL 120 MG TABLET,J3490,HCPCS,60505-0159-0,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Aetna,Commerical,,,8862.73,,8862.73,25.32,9763.24,percent of total billed charges,,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Aetna,Middlesex Employees,,,8498.62,,8498.62,25.32,9763.24,percent of total billed charges,,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Anthem,Commerical,,,,,,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Anthem,Indemnity,,,8604.29,,8604.29,25.32,9763.24,percent of total billed charges,,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Anthem,Individual Exchange,,,,,,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Anthem,State Preferred,,,,,,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Cigna,Cigna,,25.32,,,25.32,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Connecticare,Commerical,,,,,,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Connecticare,Exchange,,,,,,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,Multiplan,Multiplan,,,9763.24,,9763.24,25.32,9763.24,percent of total billed charges,,
SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,C9482,HCPCS,69724-112-10,NDC,both,0.05,mL,11486.17,6891.7,United Healthcare/Oxford,United Healthcare/Oxford,,27.8,,,27.8,25.32,9763.24,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Aetna,Commerical,,,1,,1,0.96,1.11,percent of total billed charges,,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Aetna,Middlesex Employees,,,0.96,,0.96,0.96,1.11,percent of total billed charges,,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Anthem,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Anthem,Indemnity,,,0.97,,0.97,0.96,1.11,percent of total billed charges,,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Anthem,Individual Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Anthem,State Preferred,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Cigna,Cigna,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Connecticare,Commerical,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Connecticare,Exchange,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,Multiplan,Multiplan,,,1.11,,1.11,0.96,1.11,percent of total billed charges,,
SOTALOL 40 MG ORAL TAB,J3490,HCPCS,40810-0002-86,NDC,both,1,ea,1.3,0.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.96,1.11,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Aetna,Commerical,,,1367.54,,1367.54,1311.35,1506.49,percent of total billed charges,,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Aetna,Middlesex Employees,,,1311.35,,1311.35,1311.35,1506.49,percent of total billed charges,,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Anthem,Commerical,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Anthem,Indemnity,,,1327.66,,1327.66,1311.35,1506.49,percent of total billed charges,,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Anthem,Individual Exchange,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Anthem,State Preferred,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Cigna,Cigna,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Connecticare,Commerical,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Connecticare,Exchange,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,Multiplan,Multiplan,,,1506.49,,1506.49,1311.35,1506.49,percent of total billed charges,,
SOTALOL 5 MG/ML ORAL SOLUTION,J3490,HCPCS,24338-530-25,NDC,both,1,mL,1772.34,1063.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1311.35,1506.49,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
SOTALOL 80 MG TABLET,J3490,HCPCS,0093-1061-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 10 MG/1 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0003-74,NDC,both,1,mL,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Aetna,Commerical,,,52.01,,52.01,49.88,57.3,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Aetna,Middlesex Employees,,,49.88,,49.88,49.88,57.3,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Anthem,Commerical,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Anthem,Indemnity,,,50.5,,50.5,49.88,57.3,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Anthem,Individual Exchange,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Anthem,State Preferred,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Cigna,Cigna,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Connecticare,Commerical,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Connecticare,Exchange,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,Multiplan,Multiplan,,,57.3,,57.3,49.88,57.3,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-75,NDC,both,1,mL,67.41,40.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.88,57.3,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Aetna,Commerical,,,26.01,,26.01,24.94,28.65,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Aetna,Middlesex Employees,,,24.94,,24.94,24.94,28.65,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Anthem,Commerical,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Anthem,Indemnity,,,25.25,,25.25,24.94,28.65,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Anthem,Individual Exchange,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Anthem,State Preferred,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Cigna,Cigna,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Connecticare,Commerical,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Connecticare,Exchange,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,Multiplan,Multiplan,,,28.65,,28.65,24.94,28.65,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-55,NDC,both,1,mL,33.71,20.23,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.94,28.65,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Aetna,Commerical,,,31.21,,31.21,29.93,34.38,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Aetna,Middlesex Employees,,,29.93,,29.93,29.93,34.38,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Anthem,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Anthem,Indemnity,,,30.3,,30.3,29.93,34.38,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Anthem,Individual Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Anthem,State Preferred,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Cigna,Cigna,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Connecticare,Commerical,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Connecticare,Exchange,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,Multiplan,Multiplan,,,34.38,,34.38,29.93,34.38,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-43,NDC,both,1,mL,40.45,24.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,29.93,34.38,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Aetna,Commerical,,,62.41,,62.41,59.85,68.76,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Aetna,Middlesex Employees,,,59.85,,59.85,59.85,68.76,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Anthem,Commerical,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Anthem,Indemnity,,,60.59,,60.59,59.85,68.76,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Anthem,Individual Exchange,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Anthem,State Preferred,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Cigna,Cigna,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Connecticare,Commerical,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Connecticare,Exchange,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,Multiplan,Multiplan,,,68.76,,68.76,59.85,68.76,percent of total billed charges,,
SPIRONOLACTONE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0020-46,NDC,both,1,mL,80.89,48.53,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,59.85,68.76,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0002-89,NDC,both,1,ea,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,0904-6927-61,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,16729-225-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,40810-0007-90,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,53489-143-05,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-01,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,60687-465-11,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,63739-544-10,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Aetna,Commerical,,,0.33,,0.33,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Aetna,Middlesex Employees,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Anthem,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Anthem,Indemnity,,,0.32,,0.32,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Anthem,Individual Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Anthem,State Preferred,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Cigna,Cigna,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Connecticare,Commerical,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Connecticare,Exchange,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,Multiplan,Multiplan,,,0.37,,0.37,0.32,0.37,percent of total billed charges,,
SPIRONOLACTONE 25 MG TABLET,J3490,HCPCS,65162-511-10,NDC,both,1,ea,0.43,0.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.32,0.37,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Aetna,Commerical,,,4112.4,,4112.4,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Aetna,Middlesex Employees,,,3943.45,,3943.45,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Anthem,Commerical,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Anthem,Indemnity,,,3992.48,,3992.48,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Anthem,Individual Exchange,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Anthem,State Preferred,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Cigna,Cigna,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Connecticare,Commerical,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Connecticare,Exchange,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,Multiplan,Multiplan,,,4530.25,,4530.25,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0574-1133-16,NDC,both,1,mL,5329.7,3197.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Aetna,Commerical,,,4112.4,,4112.4,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Aetna,Middlesex Employees,,,3943.45,,3943.45,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Anthem,Commerical,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Anthem,Indemnity,,,3992.48,,3992.48,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Anthem,Individual Exchange,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Anthem,State Preferred,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Cigna,Cigna,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Connecticare,Commerical,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Connecticare,Exchange,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,Multiplan,Multiplan,,,4530.25,,4530.25,3943.45,4530.25,percent of total billed charges,,
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,46287-020-01,NDC,both,1,mL,5329.7,3197.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3943.45,4530.25,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
SPIRONOLACTONE 5 MG/0.5 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0002-91,NDC,both,0.5,mL,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Aetna,Commerical,,,0.26,,0.26,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Aetna,Middlesex Employees,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Anthem,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Anthem,Indemnity,,,0.25,,0.25,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Anthem,Individual Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Anthem,State Preferred,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Cigna,Cigna,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Connecticare,Commerical,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Connecticare,Exchange,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,Multiplan,Multiplan,,,0.29,,0.29,0.25,0.29,percent of total billed charges,,
SPIRONOLACTONE 6.25 MG ORAL TAB,J3490,HCPCS,40810-0002-90,NDC,both,1,ea,0.34,0.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.25,0.29,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Aetna,Commerical,,,36.17,,36.17,34.69,39.85,percent of total billed charges,,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Aetna,Middlesex Employees,,,34.69,,34.69,34.69,39.85,percent of total billed charges,,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Anthem,Commerical,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Anthem,Indemnity,,,35.12,,35.12,34.69,39.85,percent of total billed charges,,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Anthem,Individual Exchange,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Anthem,State Preferred,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Cigna,Cigna,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Connecticare,Commerical,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Connecticare,Exchange,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,Multiplan,Multiplan,,,39.85,,39.85,34.69,39.85,percent of total billed charges,,
STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,J3490,HCPCS,63256-100-30,NDC,both,30,gm,46.88,28.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.69,39.85,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Aetna,Commerical,,,118.43,,118.43,36.14,130.46,percent of total billed charges,,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Aetna,Middlesex Employees,,,113.56,,113.56,36.14,130.46,percent of total billed charges,,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Anthem,Commerical,,,,,,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Anthem,Indemnity,,,114.97,,114.97,36.14,130.46,percent of total billed charges,,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Anthem,Individual Exchange,,,,,,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Anthem,State Preferred,,,,,,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Cigna,Cigna,,36.14,,,36.14,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Connecticare,Commerical,,50,,,50,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Connecticare,Exchange,,50,,,50,36.14,130.46,Other,Could be inpatient or outpatient,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,Multiplan,Multiplan,,,130.46,,130.46,36.14,130.46,percent of total billed charges,,
STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,J3000,HCPCS,39822-0706-2,NDC,both,1,ea,153.48,92.09,United Healthcare/Oxford,United Healthcare/Oxford,,39.02,,,39.02,36.14,130.46,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Aetna,Commerical,,,71.05,,71.05,68.13,78.27,percent of total billed charges,,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Aetna,Middlesex Employees,,,68.13,,68.13,68.13,78.27,percent of total billed charges,,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Anthem,Commerical,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Anthem,Indemnity,,,68.98,,68.98,68.13,78.27,percent of total billed charges,,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Anthem,Individual Exchange,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Anthem,State Preferred,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Cigna,Cigna,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Connecticare,Commerical,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Connecticare,Exchange,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,Multiplan,Multiplan,,,78.27,,78.27,68.13,78.27,percent of total billed charges,,
SUCCIMER 100 MG CAPSULE,J3490,HCPCS,55292-201-11,NDC,both,1,ea,92.08,55.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,68.13,78.27,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Aetna,Commerical,,,76.84,,76.84,0.93,84.64,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Aetna,Middlesex Employees,,,73.68,,73.68,0.93,84.64,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Anthem,Commerical,,,,,,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Anthem,Indemnity,,,74.6,,74.6,0.93,84.64,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Anthem,Individual Exchange,,,,,,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Anthem,State Preferred,,,,,,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Cigna,Cigna,,0.93,,,0.93,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Connecticare,Commerical,,,,,,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Connecticare,Exchange,,,,,,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,Multiplan,Multiplan,,,84.64,,84.64,0.93,84.64,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,0409-6629-02,NDC,both,1,mL,99.58,59.75,United Healthcare/Oxford,United Healthcare/Oxford,,2.06,,,2.06,0.93,84.64,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Anthem,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Anthem,State Preferred,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Cigna,Cigna,,0.93,,,0.93,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Connecticare,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Connecticare,Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,40810-0018-55,NDC,both,1,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,2.06,,,2.06,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Aetna,Commerical,,,36.94,,36.94,0.93,40.7,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Aetna,Middlesex Employees,,,35.43,,35.43,0.93,40.7,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Anthem,Commerical,,,,,,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Anthem,Indemnity,,,35.87,,35.87,0.93,40.7,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Anthem,Individual Exchange,,,,,,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Anthem,State Preferred,,,,,,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Cigna,Cigna,,0.93,,,0.93,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Connecticare,Commerical,,,,,,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Connecticare,Exchange,,,,,,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,Multiplan,Multiplan,,,40.7,,40.7,0.93,40.7,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,69374-920-05,NDC,both,1,mL,47.88,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,2.06,,,2.06,0.93,40.7,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Anthem,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Anthem,State Preferred,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Cigna,Cigna,,0.93,,,0.93,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Connecticare,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Connecticare,Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,71266-2001-1,NDC,both,1,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,2.06,,,2.06,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Aetna,Commerical,,,38.42,,38.42,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Aetna,Middlesex Employees,,,36.84,,36.84,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Anthem,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Anthem,Indemnity,,,37.3,,37.3,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Anthem,Individual Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Anthem,State Preferred,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Cigna,Cigna,,0.93,,,0.93,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Connecticare,Commerical,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Connecticare,Exchange,,,,,,0.93,42.32,Other,Could be inpatient or outpatient,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,Multiplan,Multiplan,,,42.32,,42.32,0.93,42.32,percent of total billed charges,,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,J0330,HCPCS,73177-116-02,NDC,both,1,mL,49.79,29.87,United Healthcare/Oxford,United Healthcare/Oxford,,2.06,,,2.06,0.93,42.32,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,0093-2210-01,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,51079-753-20,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Aetna,Commerical,,,0.77,,0.77,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Aetna,Middlesex Employees,,,0.74,,0.74,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Anthem,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Anthem,Indemnity,,,0.75,,0.75,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Anthem,Individual Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Anthem,State Preferred,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Cigna,Cigna,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Connecticare,Commerical,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Connecticare,Exchange,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,Multiplan,Multiplan,,,0.85,,0.85,0.74,0.85,percent of total billed charges,,
SUCRALFATE 1 GRAM TABLET,J3490,HCPCS,63739-943-10,NDC,both,1,ea,1,0.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.74,0.85,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Aetna,Commerical,,,17.23,,17.23,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Aetna,Middlesex Employees,,,16.52,,16.52,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Anthem,Commerical,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Anthem,Indemnity,,,16.73,,16.73,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Anthem,Individual Exchange,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Anthem,State Preferred,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Cigna,Cigna,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Connecticare,Commerical,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Connecticare,Exchange,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,Multiplan,Multiplan,,,18.98,,18.98,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0747-40,NDC,both,1,mL,22.33,13.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Aetna,Commerical,,,17.23,,17.23,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Aetna,Middlesex Employees,,,16.52,,16.52,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Anthem,Commerical,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Anthem,Indemnity,,,16.73,,16.73,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Anthem,Individual Exchange,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Anthem,State Preferred,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Cigna,Cigna,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Connecticare,Commerical,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Connecticare,Exchange,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,Multiplan,Multiplan,,,18.98,,18.98,16.52,18.98,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,0121-0974-10,NDC,both,1,mL,22.33,13.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,16.52,18.98,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Aetna,Commerical,,,723.62,,723.62,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Aetna,Middlesex Employees,,,693.89,,693.89,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Anthem,Commerical,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Anthem,Indemnity,,,702.52,,702.52,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Anthem,Individual Exchange,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Anthem,State Preferred,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Cigna,Cigna,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Connecticare,Commerical,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Connecticare,Exchange,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,Multiplan,Multiplan,,,797.15,,797.15,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,58914-170-14,NDC,both,1,mL,937.82,562.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Aetna,Commerical,,,723.62,,723.62,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Aetna,Middlesex Employees,,,693.89,,693.89,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Anthem,Commerical,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Anthem,Indemnity,,,702.52,,702.52,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Anthem,Individual Exchange,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Anthem,State Preferred,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Cigna,Cigna,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Connecticare,Commerical,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Connecticare,Exchange,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,Multiplan,Multiplan,,,797.15,,797.15,693.89,797.15,percent of total billed charges,,
SUCRALFATE 100 MG/ML ORAL SUSPENSION,J3490,HCPCS,65162-062-05,NDC,both,1,mL,937.82,562.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,693.89,797.15,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Aetna,Commerical,,,0.8,,0.8,0.77,0.88,percent of total billed charges,,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Aetna,Middlesex Employees,,,0.77,,0.77,0.77,0.88,percent of total billed charges,,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Anthem,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Anthem,Indemnity,,,0.78,,0.78,0.77,0.88,percent of total billed charges,,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Anthem,Individual Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Anthem,State Preferred,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Cigna,Cigna,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Connecticare,Commerical,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Connecticare,Exchange,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.77,0.88,percent of total billed charges,,
SUCRALFATE 500 MG ORAL TAB,J3490,HCPCS,40810-0002-92,NDC,both,0.5,ea,1.04,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.77,0.88,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
SUCRALFATE TOPICAL - 500 MG TABLET,J3490,HCPCS,40810-0003-15,NDC,both,0.5,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Aetna,Commerical,,,44.33,,44.33,42.51,48.83,percent of total billed charges,,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Aetna,Middlesex Employees,,,42.51,,42.51,42.51,48.83,percent of total billed charges,,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Anthem,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Anthem,Indemnity,,,43.04,,43.04,42.51,48.83,percent of total billed charges,,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Anthem,Individual Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Anthem,State Preferred,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Cigna,Cigna,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Connecticare,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Connecticare,Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,Multiplan,Multiplan,,,48.83,,48.83,42.51,48.83,percent of total billed charges,,
SUCROSE (BULK) CRYSTALS,J3490,HCPCS,5155205025,NDC,both,1,gm,57.45,34.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800612,NDC,both,1,mL,1.33,0.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800613,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800614,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,5475800615,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL DROPS,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.65,1.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800612,NDC,both,1,mL,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800613,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800614,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,5475800615,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,00906-9904-41,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,40810-0205-19,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Aetna,Commerical,,,2.25,,2.25,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Aetna,Middlesex Employees,,,2.16,,2.16,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Anthem,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Anthem,Indemnity,,,2.19,,2.19,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Anthem,Individual Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Anthem,State Preferred,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Cigna,Cigna,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Connecticare,Commerical,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Connecticare,Exchange,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,Multiplan,Multiplan,,,2.48,,2.48,2.16,2.48,percent of total billed charges,,
SUCROSE 24 % ORAL SOLUTION,J3490,HCPCS,89805-637-45,NDC,both,2,mL,2.92,1.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.16,2.48,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Aetna,Commerical,,,351.27,,351.27,336.84,386.96,percent of total billed charges,,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Aetna,Middlesex Employees,,,336.84,,336.84,336.84,386.96,percent of total billed charges,,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Anthem,Commerical,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Anthem,Indemnity,,,341.03,,341.03,336.84,386.96,percent of total billed charges,,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Anthem,Individual Exchange,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Anthem,State Preferred,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Cigna,Cigna,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Connecticare,Commerical,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Connecticare,Exchange,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,Multiplan,Multiplan,,,386.96,,386.96,336.84,386.96,percent of total billed charges,,
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0006-5423-12,NDC,both,1,mL,455.25,273.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,336.84,386.96,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Aetna,Commerical,,,263.02,,263.02,252.21,289.74,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Aetna,Middlesex Employees,,,252.21,,252.21,252.21,289.74,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Anthem,Commerical,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Anthem,Indemnity,,,255.35,,255.35,252.21,289.74,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Anthem,Individual Exchange,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Anthem,State Preferred,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Cigna,Cigna,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Connecticare,Commerical,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Connecticare,Exchange,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,Multiplan,Multiplan,,,289.74,,289.74,252.21,289.74,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-05,NDC,both,1,mL,340.87,204.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,252.21,289.74,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Aetna,Commerical,,,526.03,,526.03,504.42,579.48,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Aetna,Middlesex Employees,,,504.42,,504.42,504.42,579.48,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Anthem,Commerical,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Anthem,Indemnity,,,510.69,,510.69,504.42,579.48,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Anthem,Individual Exchange,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Anthem,State Preferred,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Cigna,Cigna,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Connecticare,Commerical,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Connecticare,Exchange,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,Multiplan,Multiplan,,,579.48,,579.48,504.42,579.48,percent of total billed charges,,
"SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION",J3490,HCPCS,11980-022-10,NDC,both,1,mL,681.74,409.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,504.42,579.48,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Aetna,Commerical,,,144.07,,144.07,138.15,158.71,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Aetna,Middlesex Employees,,,138.15,,138.15,138.15,158.71,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Anthem,Commerical,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Anthem,Indemnity,,,139.87,,139.87,138.15,158.71,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Anthem,Individual Exchange,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Anthem,State Preferred,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Cigna,Cigna,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Connecticare,Commerical,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Connecticare,Exchange,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,Multiplan,Multiplan,,,158.71,,158.71,138.15,158.71,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,24208-670-04,NDC,both,1,mL,186.72,112.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.15,158.71,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Aetna,Commerical,,,127.8,,127.8,122.55,140.79,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Aetna,Middlesex Employees,,,122.55,,122.55,122.55,140.79,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Anthem,Commerical,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Anthem,Indemnity,,,124.07,,124.07,122.55,140.79,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Anthem,Individual Exchange,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Anthem,State Preferred,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Cigna,Cigna,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Connecticare,Commerical,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Connecticare,Exchange,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,Multiplan,Multiplan,,,140.79,,140.79,122.55,140.79,percent of total billed charges,,
SULFACETAMIDE SODIUM 10 % EYE DROPS,J3490,HCPCS,61314-701-01,NDC,both,1,mL,165.63,99.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.55,140.79,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Aetna,Commerical,,,44.33,,44.33,42.51,48.83,percent of total billed charges,,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Aetna,Middlesex Employees,,,42.51,,42.51,42.51,48.83,percent of total billed charges,,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Anthem,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Anthem,Indemnity,,,43.04,,43.04,42.51,48.83,percent of total billed charges,,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Anthem,Individual Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Anthem,State Preferred,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Cigna,Cigna,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Connecticare,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Connecticare,Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,Multiplan,Multiplan,,,48.83,,48.83,42.51,48.83,percent of total billed charges,,
SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,J3490,HCPCS,24208-317-05,NDC,both,1,mL,57.45,34.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Aetna,Commerical,,,44.21,,44.21,42.4,48.71,percent of total billed charges,,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Aetna,Middlesex Employees,,,42.4,,42.4,42.4,48.71,percent of total billed charges,,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Anthem,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Anthem,Indemnity,,,42.92,,42.92,42.4,48.71,percent of total billed charges,,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Anthem,Individual Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Anthem,State Preferred,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Cigna,Cigna,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Connecticare,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Connecticare,Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,Multiplan,Multiplan,,,48.71,,48.71,42.4,48.71,percent of total billed charges,,
SULFADIAZINE 200 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-82,NDC,both,2.5,mL,57.3,34.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Aetna,Commerical,,,45.59,,45.59,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Aetna,Middlesex Employees,,,43.72,,43.72,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Anthem,Commerical,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Anthem,Indemnity,,,44.26,,44.26,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Anthem,Individual Exchange,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Anthem,State Preferred,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Cigna,Cigna,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Connecticare,Commerical,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Connecticare,Exchange,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,Multiplan,Multiplan,,,50.23,,50.23,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,0185-0757-01,NDC,both,1,ea,59.09,35.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Aetna,Commerical,,,10.54,,10.54,10.11,11.61,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Aetna,Middlesex Employees,,,10.11,,10.11,10.11,11.61,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Anthem,Commerical,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Anthem,Indemnity,,,10.23,,10.23,10.11,11.61,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Anthem,Individual Exchange,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Anthem,State Preferred,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Cigna,Cigna,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Connecticare,Commerical,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Connecticare,Exchange,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,Multiplan,Multiplan,,,11.61,,11.61,10.11,11.61,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,40810-0017-87,NDC,both,1,ea,13.66,8.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.11,11.61,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Aetna,Commerical,,,45.59,,45.59,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Aetna,Middlesex Employees,,,43.72,,43.72,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Anthem,Commerical,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Anthem,Indemnity,,,44.26,,44.26,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Anthem,Individual Exchange,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Anthem,State Preferred,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Cigna,Cigna,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Connecticare,Commerical,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Connecticare,Exchange,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,Multiplan,Multiplan,,,50.23,,50.23,43.72,50.23,percent of total billed charges,,
SULFADIAZINE 500 MG TABLET,J3490,HCPCS,42806-757-60,NDC,both,1,ea,59.09,35.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.72,50.23,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Aetna,Commerical,,,99.25,,99.25,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Aetna,Middlesex Employees,,,95.17,,95.17,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Anthem,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Anthem,Indemnity,,,96.36,,96.36,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Anthem,Individual Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Anthem,State Preferred,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Cigna,Cigna,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Connecticare,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Connecticare,Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,Multiplan,Multiplan,,,109.34,,109.34,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,0121-0854-16,NDC,both,1,mL,128.63,77.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Aetna,Commerical,,,99.25,,99.25,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Aetna,Middlesex Employees,,,95.17,,95.17,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Anthem,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Anthem,Indemnity,,,96.36,,96.36,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Anthem,Individual Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Anthem,State Preferred,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Cigna,Cigna,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Connecticare,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Connecticare,Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,Multiplan,Multiplan,,,109.34,,109.34,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,50383-824-16,NDC,both,1,mL,128.63,77.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Aetna,Commerical,,,99.25,,99.25,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Aetna,Middlesex Employees,,,95.17,,95.17,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Anthem,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Anthem,Indemnity,,,96.36,,96.36,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Anthem,Individual Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Anthem,State Preferred,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Cigna,Cigna,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Connecticare,Commerical,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Connecticare,Exchange,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,Multiplan,Multiplan,,,109.34,,109.34,95.17,109.34,percent of total billed charges,,
SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,70954-258-10,NDC,both,1,mL,128.63,77.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,95.17,109.34,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,40810-0007-92,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,J3490,HCPCS,65162-271-10,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Aetna,Commerical,,,19.04,,19.04,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Aetna,Middlesex Employees,,,18.25,,18.25,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Anthem,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Anthem,Indemnity,,,18.48,,18.48,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Anthem,Individual Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Anthem,State Preferred,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Cigna,Cigna,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Connecticare,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Connecticare,Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,Multiplan,Multiplan,,,20.97,,20.97,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-91,NDC,both,1,mL,24.67,14.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Aetna,Commerical,,,19.04,,19.04,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Aetna,Middlesex Employees,,,18.25,,18.25,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Anthem,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Anthem,Indemnity,,,18.48,,18.48,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Anthem,Individual Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Anthem,State Preferred,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Cigna,Cigna,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Connecticare,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Connecticare,Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,Multiplan,Multiplan,,,20.97,,20.97,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,0703-9514-93,NDC,both,1,mL,24.67,14.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Aetna,Commerical,,,19.04,,19.04,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Aetna,Middlesex Employees,,,18.25,,18.25,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Anthem,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Anthem,Indemnity,,,18.48,,18.48,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Anthem,Individual Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Anthem,State Preferred,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Cigna,Cigna,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Connecticare,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Connecticare,Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,Multiplan,Multiplan,,,20.97,,20.97,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-01,NDC,both,1,mL,24.67,14.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Aetna,Commerical,,,19.04,,19.04,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Aetna,Middlesex Employees,,,18.25,,18.25,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Anthem,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Anthem,Indemnity,,,18.48,,18.48,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Anthem,Individual Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Anthem,State Preferred,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Cigna,Cigna,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Connecticare,Commerical,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Connecticare,Exchange,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,Multiplan,Multiplan,,,20.97,,20.97,18.25,20.97,percent of total billed charges,,
SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-362-10,NDC,both,1,mL,24.67,14.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.25,20.97,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,0904-2725-61,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,J3490,HCPCS,13310-146-01,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Aetna,Commerical,,,0.25,,0.25,0.24,0.27,percent of total billed charges,,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Aetna,Middlesex Employees,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Anthem,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Anthem,Indemnity,,,0.24,,0.24,0.24,0.27,percent of total billed charges,,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Anthem,Individual Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Anthem,State Preferred,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Cigna,Cigna,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Connecticare,Commerical,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Connecticare,Exchange,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,Multiplan,Multiplan,,,0.27,,0.27,0.24,0.27,percent of total billed charges,,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG ORAL TAB,J3490,HCPCS,40810-0002-12,NDC,both,1,ea,0.32,0.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.24,0.27,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Aetna,Commerical,,,44.33,,44.33,42.51,48.83,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Aetna,Middlesex Employees,,,42.51,,42.51,42.51,48.83,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Anthem,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Anthem,Indemnity,,,43.04,,43.04,42.51,48.83,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Anthem,Individual Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Anthem,State Preferred,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Cigna,Cigna,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Connecticare,Commerical,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Connecticare,Exchange,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,Multiplan,Multiplan,,,48.83,,48.83,42.51,48.83,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0002-94,NDC,both,1,mL,57.45,34.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.51,48.83,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Aetna,Commerical,,,22.17,,22.17,21.26,24.42,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Aetna,Middlesex Employees,,,21.26,,21.26,21.26,24.42,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Anthem,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Anthem,Indemnity,,,21.52,,21.52,21.26,24.42,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Anthem,Individual Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Anthem,State Preferred,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Cigna,Cigna,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Connecticare,Commerical,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Connecticare,Exchange,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,Multiplan,Multiplan,,,24.42,,24.42,21.26,24.42,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-58,NDC,both,1,mL,28.73,17.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.26,24.42,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Aetna,Commerical,,,88.66,,88.66,85.01,97.67,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Aetna,Middlesex Employees,,,85.01,,85.01,85.01,97.67,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Anthem,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Anthem,Indemnity,,,86.07,,86.07,85.01,97.67,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Anthem,Individual Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Anthem,State Preferred,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Cigna,Cigna,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Connecticare,Commerical,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Connecticare,Exchange,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,Multiplan,Multiplan,,,97.67,,97.67,85.01,97.67,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-59,NDC,both,1,mL,114.9,68.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,85.01,97.67,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Aetna,Commerical,,,132.99,,132.99,127.52,146.5,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Aetna,Middlesex Employees,,,127.52,,127.52,127.52,146.5,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Anthem,Commerical,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Anthem,Indemnity,,,129.11,,129.11,127.52,146.5,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Anthem,Individual Exchange,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Anthem,State Preferred,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Cigna,Cigna,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Connecticare,Commerical,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Connecticare,Exchange,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,Multiplan,Multiplan,,,146.5,,146.5,127.52,146.5,percent of total billed charges,,
SULFASALAZINE 100 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-60,NDC,both,1,mL,172.35,103.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,127.52,146.5,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Aetna,Commerical,,,0.37,,0.37,0.36,0.41,percent of total billed charges,,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Anthem,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Anthem,Indemnity,,,0.36,,0.36,0.36,0.41,percent of total billed charges,,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Anthem,Individual Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Anthem,State Preferred,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Cigna,Cigna,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Connecticare,Commerical,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Connecticare,Exchange,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,Multiplan,Multiplan,,,0.41,,0.41,0.36,0.41,percent of total billed charges,,
SULFASALAZINE 250 MG ORAL TAB,J3490,HCPCS,40810-0002-93,NDC,both,1,ea,0.48,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.41,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
SULFASALAZINE 500 MG TABLET,J3490,HCPCS,59762-5000-5,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Aetna,Commerical,,,360.07,,360.07,21.52,396.66,percent of total billed charges,,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Aetna,Middlesex Employees,,,345.28,,345.28,21.52,396.66,percent of total billed charges,,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Anthem,Commerical,,,,,,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Anthem,Indemnity,,,349.58,,349.58,21.52,396.66,percent of total billed charges,,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Anthem,Individual Exchange,,,,,,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Anthem,State Preferred,,,,,,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Cigna,Cigna,,21.52,,,21.52,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Connecticare,Commerical,,28.48,,,28.48,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Connecticare,Exchange,,28.48,,,28.48,21.52,396.66,Other,Could be inpatient or outpatient,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,Multiplan,Multiplan,,,396.66,,396.66,21.52,396.66,percent of total billed charges,,
SULFUR HEXAFLUORIDE MICROSPHERES 25 MG INTRAVENOUS SUSPENSION,Q9950,HCPCS,0270-7099-16,NDC,both,0.2,ea,466.66,280,United Healthcare/Oxford,United Healthcare/Oxford,,23.23,,,23.23,21.52,396.66,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Aetna,Commerical,,,51.66,,51.66,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Aetna,Middlesex Employees,,,49.54,,49.54,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Anthem,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Anthem,Indemnity,,,50.15,,50.15,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Anthem,Individual Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Anthem,State Preferred,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Cigna,Cigna,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Connecticare,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Connecticare,Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,Multiplan,Multiplan,,,56.91,,56.91,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0527-1859-43,NDC,both,1,ea,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Aetna,Commerical,,,51.66,,51.66,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Aetna,Middlesex Employees,,,49.54,,49.54,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Anthem,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Anthem,Indemnity,,,50.15,,50.15,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Anthem,Individual Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Anthem,State Preferred,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Cigna,Cigna,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Connecticare,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Connecticare,Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,Multiplan,Multiplan,,,56.91,,56.91,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-082-69,NDC,both,1,ea,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Aetna,Commerical,,,51.66,,51.66,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Aetna,Middlesex Employees,,,49.54,,49.54,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Anthem,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Anthem,Indemnity,,,50.15,,50.15,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Anthem,Individual Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Anthem,State Preferred,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Cigna,Cigna,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Connecticare,Commerical,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Connecticare,Exchange,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,Multiplan,Multiplan,,,56.91,,56.91,49.54,56.91,percent of total billed charges,,
SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,71921-170-61,NDC,both,1,ea,66.95,40.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.54,56.91,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Aetna,Commerical,,,5.05,,5.05,4.84,5.56,percent of total billed charges,,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Aetna,Middlesex Employees,,,4.84,,4.84,4.84,5.56,percent of total billed charges,,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Anthem,Commerical,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Anthem,Indemnity,,,4.9,,4.9,4.84,5.56,percent of total billed charges,,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Anthem,Individual Exchange,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Anthem,State Preferred,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Cigna,Cigna,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Connecticare,Commerical,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Connecticare,Exchange,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,Multiplan,Multiplan,,,5.56,,5.56,4.84,5.56,percent of total billed charges,,
SUMATRIPTAN 25 MG TABLET,J3490,HCPCS,62756-520-69,NDC,both,1,ea,6.54,3.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.84,5.56,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Aetna,Commerical,,,116.44,,116.44,111.66,128.27,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Aetna,Middlesex Employees,,,111.66,,111.66,111.66,128.27,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Anthem,Commerical,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Anthem,Indemnity,,,113.05,,113.05,111.66,128.27,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Anthem,Individual Exchange,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Anthem,State Preferred,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Cigna,Cigna,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Connecticare,Commerical,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Connecticare,Exchange,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,Multiplan,Multiplan,,,128.27,,128.27,111.66,128.27,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-06,NDC,both,1,ea,150.91,90.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,111.66,128.27,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Aetna,Commerical,,,56.63,,56.63,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Aetna,Middlesex Employees,,,54.3,,54.3,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Anthem,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Anthem,Indemnity,,,54.98,,54.98,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Anthem,Individual Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Anthem,State Preferred,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Cigna,Cigna,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Connecticare,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Connecticare,Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,Multiplan,Multiplan,,,62.38,,62.38,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,0781-6524-86,NDC,both,1,ea,73.39,44.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Aetna,Commerical,,,56.63,,56.63,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Aetna,Middlesex Employees,,,54.3,,54.3,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Anthem,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Anthem,Indemnity,,,54.98,,54.98,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Anthem,Individual Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Anthem,State Preferred,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Cigna,Cigna,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Connecticare,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Connecticare,Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,Multiplan,Multiplan,,,62.38,,62.38,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-00,NDC,both,1,ea,73.39,44.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Aetna,Commerical,,,56.63,,56.63,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Aetna,Middlesex Employees,,,54.3,,54.3,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Anthem,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Anthem,Indemnity,,,54.98,,54.98,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Anthem,Individual Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Anthem,State Preferred,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Cigna,Cigna,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Connecticare,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Connecticare,Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,Multiplan,Multiplan,,,62.38,,62.38,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,45802-619-06,NDC,both,1,ea,73.39,44.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Aetna,Commerical,,,56.63,,56.63,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Aetna,Middlesex Employees,,,54.3,,54.3,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Anthem,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Anthem,Indemnity,,,54.98,,54.98,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Anthem,Individual Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Anthem,State Preferred,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Cigna,Cigna,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Connecticare,Commerical,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Connecticare,Exchange,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,Multiplan,Multiplan,,,62.38,,62.38,54.3,62.38,percent of total billed charges,,
SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY,J3490,HCPCS,66993-081-69,NDC,both,1,ea,73.39,44.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,54.3,62.38,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Aetna,Commerical,,,1.02,,1.02,0.98,1.12,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Aetna,Middlesex Employees,,,0.98,,0.98,0.98,1.12,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Anthem,Commerical,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Anthem,Indemnity,,,0.99,,0.99,0.98,1.12,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Anthem,Individual Exchange,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Anthem,State Preferred,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Cigna,Cigna,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Connecticare,Commerical,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Connecticare,Exchange,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,Multiplan,Multiplan,,,1.12,,1.12,0.98,1.12,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,62756-521-69,NDC,both,1,ea,1.32,0.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.98,1.12,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Aetna,Commerical,,,5.24,,5.24,5.02,5.77,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Aetna,Middlesex Employees,,,5.02,,5.02,5.02,5.77,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Anthem,Commerical,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Anthem,Indemnity,,,5.09,,5.09,5.02,5.77,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Anthem,Individual Exchange,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Anthem,State Preferred,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Cigna,Cigna,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Connecticare,Commerical,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Connecticare,Exchange,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,Multiplan,Multiplan,,,5.77,,5.77,5.02,5.77,percent of total billed charges,,
SUMATRIPTAN 50 MG TABLET,J3490,HCPCS,65862-147-36,NDC,both,1,ea,6.79,4.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.02,5.77,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Aetna,Commerical,,,10.9,,10.9,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Aetna,Middlesex Employees,,,10.45,,10.45,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Anthem,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Anthem,Indemnity,,,10.58,,10.58,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Anthem,Individual Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Anthem,State Preferred,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Cigna,Cigna,,72.33,,,72.33,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Connecticare,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Connecticare,Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,Multiplan,Multiplan,,,12.01,,12.01,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,0173-0449-02,NDC,both,0.5,mL,14.13,8.48,United Healthcare/Oxford,United Healthcare/Oxford,,201.04,,,201.04,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Aetna,Commerical,,,10.9,,10.9,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Aetna,Middlesex Employees,,,10.45,,10.45,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Indemnity,,,10.58,,10.58,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Individual Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Anthem,State Preferred,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Cigna,Cigna,,72.33,,,72.33,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Connecticare,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Connecticare,Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,Multiplan,Multiplan,,,12.01,,12.01,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-01,NDC,both,0.5,mL,14.13,8.48,United Healthcare/Oxford,United Healthcare/Oxford,,201.04,,,201.04,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Aetna,Commerical,,,10.9,,10.9,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Aetna,Middlesex Employees,,,10.45,,10.45,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Anthem,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Anthem,Indemnity,,,10.58,,10.58,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Anthem,Individual Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Anthem,State Preferred,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Cigna,Cigna,,72.33,,,72.33,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Connecticare,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Connecticare,Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,Multiplan,Multiplan,,,12.01,,12.01,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,55150-173-05,NDC,both,0.5,mL,14.13,8.48,United Healthcare/Oxford,United Healthcare/Oxford,,201.04,,,201.04,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Aetna,Commerical,,,10.9,,10.9,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Aetna,Middlesex Employees,,,10.45,,10.45,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Indemnity,,,10.58,,10.58,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Anthem,Individual Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Anthem,State Preferred,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Cigna,Cigna,,72.33,,,72.33,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Connecticare,Commerical,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Connecticare,Exchange,,,,,,10.45,201.04,Other,Could be inpatient or outpatient,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,Multiplan,Multiplan,,,12.01,,12.01,10.45,201.04,percent of total billed charges,,
SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,J3030,HCPCS,63323-273-01,NDC,both,0.5,mL,14.13,8.48,United Healthcare/Oxford,United Healthcare/Oxford,,201.04,,,201.04,10.45,201.04,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Aetna,Commerical,,,274.84,,274.84,263.54,302.76,percent of total billed charges,,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Aetna,Middlesex Employees,,,263.54,,263.54,263.54,302.76,percent of total billed charges,,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Anthem,Commerical,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Anthem,Indemnity,,,266.82,,266.82,263.54,302.76,percent of total billed charges,,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Anthem,Individual Exchange,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Anthem,State Preferred,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Cigna,Cigna,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Connecticare,Commerical,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Connecticare,Exchange,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,Multiplan,Multiplan,,,302.76,,302.76,263.54,302.76,percent of total billed charges,,
TACROLIMUS 0.1 % TOPICAL OINTMENT,J3490,HCPCS,16729-422-10,NDC,both,1,gm,356.19,213.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,263.54,302.76,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Anthem,Commerical,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Cigna,Cigna,,0.27,,,0.27,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Connecticare,Commerical,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Connecticare,Exchange,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0607-73,NDC,both,2,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Anthem,Commerical,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Cigna,Cigna,,0.27,,,0.27,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Connecticare,Commerical,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Connecticare,Exchange,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2102-01,NDC,both,2,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Anthem,Commerical,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Cigna,Cigna,,0.27,,,0.27,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Connecticare,Commerical,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Connecticare,Exchange,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,40810-0005-66,NDC,both,2,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Aetna,Commerical,,,0.82,,0.82,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Aetna,Middlesex Employees,,,0.78,,0.78,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Anthem,Commerical,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Anthem,Indemnity,,,0.79,,0.79,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Anthem,Individual Exchange,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Anthem,State Preferred,,,,,,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Cigna,Cigna,,0.27,,,0.27,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Connecticare,Commerical,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Connecticare,Exchange,,0.39,,,0.39,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,Multiplan,Multiplan,,,0.9,,0.9,0.27,0.9,percent of total billed charges,,
"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-014-11,NDC,both,2,ea,1.06,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,0.9,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0469-0617-73,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-01,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,51079-818-20,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,54288-135-01,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-450-01,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Aetna,Commerical,,,16.55,,16.55,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Aetna,Middlesex Employees,,,15.87,,15.87,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Anthem,Commerical,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Anthem,Indemnity,,,16.07,,16.07,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Anthem,Individual Exchange,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Anthem,State Preferred,,,,,,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Cigna,Cigna,,0.27,,,0.27,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Connecticare,Commerical,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Connecticare,Exchange,,0.39,,,0.39,0.27,18.23,Other,Could be inpatient or outpatient,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,Multiplan,Multiplan,,,18.23,,18.23,0.27,18.23,percent of total billed charges,,
"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-015-11,NDC,both,1,ea,21.45,12.87,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,18.23,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Aetna,Commerical,,,680,,680,0.27,749.1,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Aetna,Middlesex Employees,,,652.07,,652.07,0.27,749.1,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Anthem,Commerical,,,,,,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Anthem,Indemnity,,,660.17,,660.17,0.27,749.1,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Anthem,Individual Exchange,,,,,,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Anthem,State Preferred,,,,,,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Cigna,Cigna,,0.27,,,0.27,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Connecticare,Commerical,,0.39,,,0.39,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Connecticare,Exchange,,0.39,,,0.39,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,Multiplan,Multiplan,,,749.1,,749.1,0.27,749.1,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0002-95,NDC,both,1,mL,881.29,528.77,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,749.1,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Aetna,Commerical,,,340.01,,340.01,0.27,374.55,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Aetna,Middlesex Employees,,,326.04,,326.04,0.27,374.55,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Anthem,Commerical,,,,,,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Anthem,Indemnity,,,330.09,,330.09,0.27,374.55,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Anthem,Individual Exchange,,,,,,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Anthem,State Preferred,,,,,,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Cigna,Cigna,,0.27,,,0.27,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Connecticare,Commerical,,0.39,,,0.39,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Connecticare,Exchange,,0.39,,,0.39,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,Multiplan,Multiplan,,,374.55,,374.55,0.27,374.55,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-61,NDC,both,1,mL,440.65,264.39,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,374.55,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Aetna,Commerical,,,1360,,1360,0.27,1498.18,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Aetna,Middlesex Employees,,,1304.13,,1304.13,0.27,1498.18,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Anthem,Commerical,,,,,,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Anthem,Indemnity,,,1320.34,,1320.34,0.27,1498.18,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Anthem,Individual Exchange,,,,,,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Anthem,State Preferred,,,,,,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Cigna,Cigna,,0.27,,,0.27,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Connecticare,Commerical,,0.39,,,0.39,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Connecticare,Exchange,,0.39,,,0.39,0.27,1498.18,Other,Could be inpatient or outpatient,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,Multiplan,Multiplan,,,1498.18,,1498.18,0.27,1498.18,percent of total billed charges,,
TACROLIMUS 1 MG/ML ORAL SUSP,J7507,HCPCS,40810-0012-62,NDC,both,1,mL,1762.57,1057.54,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,1498.18,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Commerical,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Anthem,State Preferred,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Cigna,Cigna,,0.27,,,0.27,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Connecticare,Commerical,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Connecticare,Exchange,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0781-2104-01,NDC,both,0.2,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Anthem,Commerical,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Anthem,State Preferred,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Cigna,Cigna,,0.27,,,0.27,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Connecticare,Commerical,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Connecticare,Exchange,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,0904-6624-61,NDC,both,0.2,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Commerical,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Anthem,State Preferred,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Cigna,Cigna,,0.27,,,0.27,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Connecticare,Commerical,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Connecticare,Exchange,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-01,NDC,both,0.2,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Commerical,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Anthem,State Preferred,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Cigna,Cigna,,0.27,,,0.27,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Connecticare,Commerical,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Connecticare,Exchange,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,68084-451-11,NDC,both,0.2,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Aetna,Commerical,,,3.42,,3.42,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Aetna,Middlesex Employees,,,3.28,,3.28,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Commerical,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Indemnity,,,3.32,,3.32,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Anthem,Individual Exchange,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Anthem,State Preferred,,,,,,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Cigna,Cigna,,0.27,,,0.27,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Connecticare,Commerical,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Connecticare,Exchange,,0.39,,,0.39,0.27,3.77,Other,Could be inpatient or outpatient,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,Multiplan,Multiplan,,,3.77,,3.77,0.27,3.77,percent of total billed charges,,
"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",J7507,HCPCS,70377-016-11,NDC,both,0.2,ea,4.43,2.66,United Healthcare/Oxford,United Healthcare/Oxford,,0.29,,,0.29,0.27,3.77,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Aetna,Commerical,,,683.77,,683.77,286.58,753.24,percent of total billed charges,,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Aetna,Middlesex Employees,,,655.68,,655.68,286.58,753.24,percent of total billed charges,,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Anthem,Commerical,,,,,,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Anthem,Indemnity,,,663.83,,663.83,286.58,753.24,percent of total billed charges,,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Anthem,Individual Exchange,,,,,,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Anthem,State Preferred,,,,,,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Cigna,Cigna,,286.58,,,286.58,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Connecticare,Commerical,,389.04,,,389.04,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Connecticare,Exchange,,389.04,,,389.04,286.58,753.24,Other,Could be inpatient or outpatient,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,Multiplan,Multiplan,,,753.24,,753.24,286.58,753.24,percent of total billed charges,,
TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,J7525,HCPCS,0469-3016-01,NDC,both,1,mL,886.17,531.7,United Healthcare/Oxford,United Healthcare/Oxford,,309.4,,,309.4,286.58,753.24,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,0093-3018-56,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,29300-288-13,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,66993-702-30,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Aetna,Commerical,,,2.72,,2.72,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Aetna,Middlesex Employees,,,2.6,,2.6,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Anthem,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Anthem,Indemnity,,,2.64,,2.64,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Anthem,Individual Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Anthem,State Preferred,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Cigna,Cigna,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Connecticare,Commerical,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Connecticare,Exchange,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,Multiplan,Multiplan,,,2.99,,2.99,2.6,2.99,percent of total billed charges,,
TADALAFIL 10 MG TABLET,J3490,HCPCS,68382-898-06,NDC,both,1,ea,3.52,2.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.6,2.99,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,27241-111-03,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,29300-286-13,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Aetna,Commerical,,,0.38,,0.38,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Aetna,Middlesex Employees,,,0.36,,0.36,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Anthem,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Anthem,Indemnity,,,0.37,,0.37,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Anthem,Individual Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Anthem,State Preferred,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Cigna,Cigna,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Connecticare,Commerical,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Connecticare,Exchange,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,Multiplan,Multiplan,,,0.42,,0.42,0.36,0.42,percent of total billed charges,,
TADALAFIL 2.5 MG TABLET,J3490,HCPCS,68382-896-06,NDC,both,1,ea,0.49,0.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.36,0.42,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Aetna,Commerical,,,2.24,,2.24,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Aetna,Middlesex Employees,,,2.15,,2.15,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Anthem,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Anthem,Indemnity,,,2.17,,2.17,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Anthem,Individual Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Anthem,State Preferred,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Cigna,Cigna,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Connecticare,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Connecticare,Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,Multiplan,Multiplan,,,2.47,,2.47,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,40810-0203-54,NDC,both,1,UN,2.9,1.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Aetna,Commerical,,,2.24,,2.24,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Aetna,Middlesex Employees,,,2.15,,2.15,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Anthem,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Anthem,Indemnity,,,2.17,,2.17,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Anthem,Individual Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Anthem,State Preferred,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Cigna,Cigna,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Connecticare,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Connecticare,Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,Multiplan,Multiplan,,,2.47,,2.47,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,65862-880-60,NDC,both,1,ea,2.9,1.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Aetna,Commerical,,,2.24,,2.24,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Aetna,Middlesex Employees,,,2.15,,2.15,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Anthem,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Anthem,Indemnity,,,2.17,,2.17,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Anthem,Individual Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Anthem,State Preferred,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Cigna,Cigna,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Connecticare,Commerical,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Connecticare,Exchange,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,Multiplan,Multiplan,,,2.47,,2.47,2.15,2.47,percent of total billed charges,,
TADALAFIL 20 MG TABLET,J3490,HCPCS,68382-899-06,NDC,both,1,ea,2.9,1.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.15,2.47,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Aetna,Commerical,,,36.88,,36.88,35.37,40.63,percent of total billed charges,,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Aetna,Middlesex Employees,,,35.37,,35.37,35.37,40.63,percent of total billed charges,,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Anthem,Commerical,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Anthem,Indemnity,,,35.81,,35.81,35.37,40.63,percent of total billed charges,,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Anthem,Individual Exchange,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Anthem,State Preferred,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Cigna,Cigna,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Connecticare,Commerical,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Connecticare,Exchange,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,Multiplan,Multiplan,,,40.63,,40.63,35.37,40.63,percent of total billed charges,,
TADALAFIL 5 MG/ML SUSPENSION,J3490,HCPCS,40810-0203-55,NDC,both,1,mL,47.8,28.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.37,40.63,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Aetna,Commerical,,,47704.45,,47704.45,398.37,52551.56,percent of total billed charges,,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Aetna,Middlesex Employees,,,45744.58,,45744.58,398.37,52551.56,percent of total billed charges,,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Anthem,Commerical,,,,,,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Anthem,Indemnity,,,46313.38,,46313.38,398.37,52551.56,percent of total billed charges,,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Anthem,Individual Exchange,,,,,,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Anthem,State Preferred,,,,,,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Cigna,Cigna,,460.41,,,460.41,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Connecticare,Commerical,,517.7,,,517.7,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Connecticare,Exchange,,517.7,,,517.7,398.37,52551.56,Other,Could be inpatient or outpatient,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,Multiplan,Multiplan,,,52551.56,,52551.56,398.37,52551.56,percent of total billed charges,,
"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",J9269,HCPCS,72187-0401-1,NDC,both,0.01,mL,61825.36,37095.22,United Healthcare/Oxford,United Healthcare/Oxford,,398.37,,,398.37,398.37,52551.56,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Anthem,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Cigna,Cigna,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Connecticare,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Connecticare,Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,0904-6401-61,NDC,both,1,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Anthem,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Cigna,Cigna,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Connecticare,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Connecticare,Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,40810-0006-20,NDC,both,1,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,65862-598-01,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Aetna,Commerical,,,0.79,,0.79,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Aetna,Middlesex Employees,,,0.75,,0.75,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Anthem,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Anthem,Indemnity,,,0.76,,0.76,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Anthem,Individual Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Anthem,State Preferred,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Cigna,Cigna,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Connecticare,Commerical,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Connecticare,Exchange,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,Multiplan,Multiplan,,,0.87,,0.87,0.75,0.87,percent of total billed charges,,
TAMSULOSIN 0.4 MG CAPSULE,J3490,HCPCS,68382-132-01,NDC,both,1,ea,1.02,0.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.75,0.87,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Aetna,Commerical,,,7074.82,,7074.82,0.28,7793.67,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Aetna,Middlesex Employees,,,6784.16,,6784.16,0.28,7793.67,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Anthem,Commerical,,,,,,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Anthem,Indemnity,,,6868.51,,6868.51,0.28,7793.67,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Anthem,Individual Exchange,,,,,,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Anthem,State Preferred,,,,,,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Cigna,Cigna,,0.32,,,0.32,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Connecticare,Commerical,,0.4,,,0.4,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Connecticare,Exchange,,0.4,,,0.4,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,Multiplan,Multiplan,,,7793.67,,7793.67,0.28,7793.67,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-63,NDC,both,0.5,mL,9169.02,5501.41,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7793.67,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Aetna,Commerical,,,3537.41,,3537.41,0.28,3896.83,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Aetna,Middlesex Employees,,,3392.08,,3392.08,0.28,3896.83,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Anthem,Commerical,,,,,,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Anthem,Indemnity,,,3434.26,,3434.26,0.28,3896.83,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Anthem,Individual Exchange,,,,,,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Anthem,State Preferred,,,,,,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Cigna,Cigna,,0.32,,,0.32,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Connecticare,Commerical,,0.4,,,0.4,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Connecticare,Exchange,,0.4,,,0.4,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,Multiplan,Multiplan,,,3896.83,,3896.83,0.28,3896.83,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-64,NDC,both,0.5,mL,4584.51,2750.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,3896.83,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Aetna,Commerical,,,14149.63,,14149.63,0.28,15587.33,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Aetna,Middlesex Employees,,,13568.32,,13568.32,0.28,15587.33,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Anthem,Commerical,,,,,,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Anthem,Indemnity,,,13737.03,,13737.03,0.28,15587.33,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Anthem,Individual Exchange,,,,,,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Anthem,State Preferred,,,,,,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Cigna,Cigna,,0.32,,,0.32,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Connecticare,Commerical,,0.4,,,0.4,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Connecticare,Exchange,,0.4,,,0.4,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,Multiplan,Multiplan,,,15587.33,,15587.33,0.28,15587.33,percent of total billed charges,,
TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION CHEMO,J8700,HCPCS,40810-0012-65,NDC,both,0.5,mL,18338.04,11002.82,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,15587.33,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Aetna,Commerical,,,334.26,,334.26,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Aetna,Middlesex Employees,,,320.53,,320.53,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Anthem,Commerical,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Anthem,Indemnity,,,324.52,,324.52,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Anthem,Individual Exchange,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Anthem,State Preferred,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Cigna,Cigna,,0.32,,,0.32,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Connecticare,Commerical,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Connecticare,Exchange,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,Multiplan,Multiplan,,,368.23,,368.23,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,16729-050-54,NDC,both,0.05,ea,433.21,259.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Aetna,Commerical,,,71.08,,71.08,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Aetna,Middlesex Employees,,,68.16,,68.16,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Anthem,Commerical,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Anthem,Indemnity,,,69.01,,69.01,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Anthem,Individual Exchange,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Anthem,State Preferred,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Cigna,Cigna,,0.32,,,0.32,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Connecticare,Commerical,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Connecticare,Exchange,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,Multiplan,Multiplan,,,78.3,,78.3,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-60,NDC,both,0.05,ea,92.12,55.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Aetna,Commerical,,,71.08,,71.08,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Aetna,Middlesex Employees,,,68.16,,68.16,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Anthem,Commerical,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Anthem,Indemnity,,,69.01,,69.01,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Anthem,Individual Exchange,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Anthem,State Preferred,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Cigna,Cigna,,0.32,,,0.32,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Connecticare,Commerical,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Connecticare,Exchange,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,Multiplan,Multiplan,,,78.3,,78.3,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-72,NDC,both,0.05,ea,92.12,55.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Aetna,Commerical,,,71.08,,71.08,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Aetna,Middlesex Employees,,,68.16,,68.16,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Anthem,Commerical,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Anthem,Indemnity,,,69.01,,69.01,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Anthem,Individual Exchange,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Anthem,State Preferred,,,,,,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Cigna,Cigna,,0.32,,,0.32,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Connecticare,Commerical,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Connecticare,Exchange,,0.4,,,0.4,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,Multiplan,Multiplan,,,78.3,,78.3,0.28,78.3,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,47335-892-74,NDC,both,0.05,ea,92.12,55.27,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,78.3,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Aetna,Commerical,,,334.26,,334.26,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Aetna,Middlesex Employees,,,320.53,,320.53,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Commerical,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Indemnity,,,324.52,,324.52,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Individual Exchange,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Anthem,State Preferred,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Cigna,Cigna,,0.32,,,0.32,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Connecticare,Commerical,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Connecticare,Exchange,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,Multiplan,Multiplan,,,368.23,,368.23,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,64980-335-14,NDC,both,0.05,ea,433.21,259.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Aetna,Commerical,,,334.26,,334.26,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Aetna,Middlesex Employees,,,320.53,,320.53,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Commerical,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Indemnity,,,324.52,,324.52,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Anthem,Individual Exchange,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Anthem,State Preferred,,,,,,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Cigna,Cigna,,0.32,,,0.32,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Connecticare,Commerical,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Connecticare,Exchange,,0.4,,,0.4,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,Multiplan,Multiplan,,,368.23,,368.23,0.28,368.23,percent of total billed charges,,
TEMOZOLOMIDE 100 MG CAPSULE,J8700,HCPCS,67877-539-14,NDC,both,0.05,ea,433.21,259.93,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,368.23,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Aetna,Commerical,,,1738.72,,1738.72,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Aetna,Middlesex Employees,,,1667.28,,1667.28,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Commerical,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Indemnity,,,1688.01,,1688.01,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Individual Exchange,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,State Preferred,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Cigna,Cigna,,14.66,,,14.66,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Connecticare,Commerical,,15.88,,,15.88,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Connecticare,Exchange,,15.88,,,15.88,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Multiplan,Multiplan,,,1915.38,,1915.38,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,United Healthcare/Oxford,United Healthcare/Oxford,,12.69,,,12.69,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,0781-2694-44,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,16729-129-54,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-60,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,47335-929-74,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,59923-710-14,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,65162-804-51,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Aetna,Commerical,,,103.8,,103.8,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Aetna,Middlesex Employees,,,99.53,,99.53,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Commerical,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Indemnity,,,100.77,,100.77,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Anthem,Individual Exchange,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Anthem,State Preferred,,,,,,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Cigna,Cigna,,0.32,,,0.32,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Connecticare,Commerical,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Connecticare,Exchange,,0.4,,,0.4,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,Multiplan,Multiplan,,,114.34,,114.34,0.28,114.34,percent of total billed charges,,
TEMOZOLOMIDE 140 MG CAPSULE,J8700,HCPCS,67877-540-14,NDC,both,0.036,ea,134.52,80.71,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,114.34,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Aetna,Commerical,,,67.7,,67.7,0.28,74.58,percent of total billed charges,,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Aetna,Middlesex Employees,,,64.92,,64.92,0.28,74.58,percent of total billed charges,,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Anthem,Commerical,,,,,,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Anthem,Indemnity,,,65.73,,65.73,0.28,74.58,percent of total billed charges,,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Anthem,Individual Exchange,,,,,,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Anthem,State Preferred,,,,,,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Cigna,Cigna,,0.32,,,0.32,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Connecticare,Commerical,,0.4,,,0.4,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Connecticare,Exchange,,0.4,,,0.4,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,Multiplan,Multiplan,,,74.58,,74.58,0.28,74.58,percent of total billed charges,,
TEMOZOLOMIDE 180 MG CAPSULE,J8700,HCPCS,65162-805-51,NDC,both,0.028,ea,87.74,52.64,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,74.58,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-60,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-72,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,47335-891-74,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-14,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,65162-802-51,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Aetna,Commerical,,,17.01,,17.01,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Aetna,Middlesex Employees,,,16.31,,16.31,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Commerical,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Indemnity,,,16.52,,16.52,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Anthem,Individual Exchange,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Anthem,State Preferred,,,,,,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Cigna,Cigna,,0.32,,,0.32,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Connecticare,Commerical,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Connecticare,Exchange,,0.4,,,0.4,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,Multiplan,Multiplan,,,18.74,,18.74,0.28,18.74,percent of total billed charges,,
TEMOZOLOMIDE 20 MG CAPSULE,J8700,HCPCS,67877-538-14,NDC,both,0.25,ea,22.05,13.23,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,18.74,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Aetna,Commerical,,,3366,,3366,0.28,3708.01,percent of total billed charges,,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Aetna,Middlesex Employees,,,3227.72,,3227.72,0.28,3708.01,percent of total billed charges,,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Anthem,Commerical,,,,,,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Anthem,Indemnity,,,3267.85,,3267.85,0.28,3708.01,percent of total billed charges,,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Anthem,Individual Exchange,,,,,,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Anthem,State Preferred,,,,,,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Cigna,Cigna,,0.32,,,0.32,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Connecticare,Commerical,,0.4,,,0.4,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Connecticare,Exchange,,0.4,,,0.4,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,Multiplan,Multiplan,,,3708.01,,3708.01,0.28,3708.01,percent of total billed charges,,
TEMOZOLOMIDE 250 MG CAPSULE,J8700,HCPCS,0085-1417-02,NDC,both,0.02,ea,4362.37,2617.42,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,3708.01,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,0781-2691-44,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,16729-048-54,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,40810-0005-68,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,47335-890-72,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-07,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Aetna,Commerical,,,6.7,,6.7,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Aetna,Middlesex Employees,,,6.42,,6.42,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Anthem,Commerical,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Anthem,Indemnity,,,6.5,,6.5,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Anthem,Individual Exchange,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Anthem,State Preferred,,,,,,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Cigna,Cigna,,0.32,,,0.32,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Connecticare,Commerical,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Connecticare,Exchange,,0.4,,,0.4,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,Multiplan,Multiplan,,,7.38,,7.38,0.28,7.38,percent of total billed charges,,
TEMOZOLOMIDE 5 MG CAPSULE,J8700,HCPCS,67877-537-14,NDC,both,1,ea,8.68,5.21,United Healthcare/Oxford,United Healthcare/Oxford,,0.28,,,0.28,0.28,7.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Aetna,Commerical,,,1738.72,,1738.72,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Aetna,Middlesex Employees,,,1667.28,,1667.28,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Commerical,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Indemnity,,,1688.01,,1688.01,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,Individual Exchange,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Anthem,State Preferred,,,,,,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Cigna,Cigna,,14.66,,,14.66,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Connecticare,Commerical,,15.88,,,15.88,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Connecticare,Exchange,,15.88,,,15.88,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,Multiplan,Multiplan,,,1915.38,,1915.38,12.69,1915.38,percent of total billed charges,,
TEMOZOLOMIDE IV CHEMO,J9328,HCPCS,0085-1381-01,NDC,both,0.01,ea,2253.39,1352.03,United Healthcare/Oxford,United Healthcare/Oxford,,12.69,,,12.69,12.69,1915.38,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Commerical,,,4235.44,,4235.44,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Middlesex Employees,,,4061.43,,4061.43,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Commerical,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Indemnity,,,4111.93,,4111.93,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Individual Exchange,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Anthem,State Preferred,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Cigna,Cigna,,43.36,,,43.36,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Commerical,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Exchange,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,Multiplan,Multiplan,,,4665.79,,4665.79,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,0008-1179-01,NDC,both,0.1,mL,5489.16,3293.5,United Healthcare/Oxford,United Healthcare/Oxford,,37.52,,,37.52,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Commerical,,,4235.44,,4235.44,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Middlesex Employees,,,4061.43,,4061.43,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Commerical,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Indemnity,,,4111.93,,4111.93,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Individual Exchange,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Anthem,State Preferred,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Cigna,Cigna,,43.36,,,43.36,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Commerical,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Exchange,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,Multiplan,Multiplan,,,4665.79,,4665.79,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,16729-223-61,NDC,both,0.1,mL,5489.16,3293.5,United Healthcare/Oxford,United Healthcare/Oxford,,37.52,,,37.52,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Commerical,,,4235.44,,4235.44,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Aetna,Middlesex Employees,,,4061.43,,4061.43,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Commerical,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Indemnity,,,4111.93,,4111.93,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Anthem,Individual Exchange,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Anthem,State Preferred,,,,,,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Cigna,Cigna,,43.36,,,43.36,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Commerical,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Connecticare,Exchange,,49.18,,,49.18,37.52,4665.79,Other,Could be inpatient or outpatient,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,Multiplan,Multiplan,,,4665.79,,4665.79,37.52,4665.79,percent of total billed charges,,
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,J9330,HCPCS,65219-200-05,NDC,both,0.1,mL,5489.16,3293.5,United Healthcare/Oxford,United Healthcare/Oxford,,37.52,,,37.52,37.52,4665.79,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,33342-096-07,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,40810-0009-82,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,42385-901-03,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,J3490,HCPCS,61958-0401-1,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Aetna,Commerical,,,1944.07,,1944.07,1864.2,2141.6,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Aetna,Middlesex Employees,,,1864.2,,1864.2,1864.2,2141.6,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Anthem,Commerical,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Anthem,Indemnity,,,1887.38,,1887.38,1864.2,2141.6,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Anthem,Individual Exchange,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Anthem,State Preferred,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Cigna,Cigna,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Connecticare,Commerical,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Connecticare,Exchange,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,Multiplan,Multiplan,,,2141.6,,2141.6,1864.2,2141.6,percent of total billed charges,,
TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWDER,J3490,HCPCS,61958-0403-1,NDC,both,1,gm,2519.53,1511.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1864.2,2141.6,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Aetna,Commerical,,,47048.12,,47048.12,379.84,51828.54,percent of total billed charges,,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Aetna,Middlesex Employees,,,45115.22,,45115.22,379.84,51828.54,percent of total billed charges,,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Anthem,Commerical,,,,,,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Anthem,Indemnity,,,45676.19,,45676.19,379.84,51828.54,percent of total billed charges,,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Anthem,Individual Exchange,,,,,,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Anthem,State Preferred,,,,,,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Cigna,Cigna,,379.84,,,379.84,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Connecticare,Commerical,,525.11,,,525.11,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Connecticare,Exchange,,525.11,,,525.11,379.84,51828.54,Other,Could be inpatient or outpatient,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,Multiplan,Multiplan,,,51828.54,,51828.54,379.84,51828.54,percent of total billed charges,,
TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,J3241,HCPCS,75987-130-15,NDC,both,0.1,ea,60974.75,36584.85,United Healthcare/Oxford,United Healthcare/Oxford,,410.09,,,410.09,379.84,51828.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,51079-936-20,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Aetna,Commerical,,,0.29,,0.29,0.27,0.31,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Aetna,Middlesex Employees,,,0.27,,0.27,0.27,0.31,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Anthem,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Anthem,Indemnity,,,0.28,,0.28,0.27,0.31,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Anthem,Individual Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Anthem,State Preferred,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Cigna,Cigna,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Connecticare,Commerical,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Connecticare,Exchange,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,Multiplan,Multiplan,,,0.31,,0.31,0.27,0.31,percent of total billed charges,,
TERAZOSIN 1 MG CAPSULE,J3490,HCPCS,59746-383-06,NDC,both,1,ea,0.37,0.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.27,0.31,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,23155-738-01,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Aetna,Commerical,,,0.52,,0.52,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Aetna,Middlesex Employees,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Anthem,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Anthem,Indemnity,,,0.5,,0.5,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Anthem,Individual Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Anthem,State Preferred,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Cigna,Cigna,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Connecticare,Commerical,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Connecticare,Exchange,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,Multiplan,Multiplan,,,0.57,,0.57,0.5,0.57,percent of total billed charges,,
TERAZOSIN 10 MG CAPSULE,J3490,HCPCS,59746-386-06,NDC,both,1,ea,0.67,0.4,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.5,0.57,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,40810-0205-80,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Aetna,Commerical,,,0.49,,0.49,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Aetna,Middlesex Employees,,,0.47,,0.47,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Anthem,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Anthem,Indemnity,,,0.48,,0.48,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Anthem,Individual Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Anthem,State Preferred,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Cigna,Cigna,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Connecticare,Commerical,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Connecticare,Exchange,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,Multiplan,Multiplan,,,0.54,,0.54,0.47,0.54,percent of total billed charges,,
TERAZOSIN 5 MG CAPSULE,J3490,HCPCS,59746-385-06,NDC,both,1,ea,0.64,0.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.47,0.54,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Anthem,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Anthem,Individual Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Anthem,State Preferred,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Cigna,Cigna,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Connecticare,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Connecticare,Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,51672-2080-1,NDC,both,15,gm,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Aetna,Commerical,,,15.79,,15.79,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Aetna,Middlesex Employees,,,15.14,,15.14,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Anthem,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Anthem,Indemnity,,,15.33,,15.33,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Anthem,Individual Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Anthem,State Preferred,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Cigna,Cigna,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Connecticare,Commerical,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Connecticare,Exchange,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,Multiplan,Multiplan,,,17.39,,17.39,15.14,17.39,percent of total billed charges,,
TERBINAFINE HCL 1 % TOPICAL CREAM,J3490,HCPCS,70000-0338-1,NDC,both,1,gm,20.46,12.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.14,17.39,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
TERBINAFINE HCL 250 MG TABLET,J8499,HCPCS,40810-0020-96,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Aetna,Commerical,,,3.64,,3.64,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.49,,3.49,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Commerical,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Indemnity,,,3.54,,3.54,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,State Preferred,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Cigna,Cigna,,4.14,,,4.14,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Connecticare,Commerical,,3.46,,,3.46,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Connecticare,Exchange,,3.46,,,3.46,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Multiplan,Multiplan,,,4.01,,4.01,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML INJECTION FOR TOCOLYSIS,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Aetna,Commerical,,,3.25,,3.25,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.11,,3.11,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Anthem,Commerical,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Anthem,Indemnity,,,3.15,,3.15,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Anthem,State Preferred,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Cigna,Cigna,,4.14,,,4.14,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Connecticare,Commerical,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Connecticare,Exchange,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,Multiplan,Multiplan,,,3.58,,3.58,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Aetna,Commerical,,,3.25,,3.25,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.11,,3.11,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Anthem,Commerical,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Anthem,Indemnity,,,3.15,,3.15,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Anthem,State Preferred,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Cigna,Cigna,,4.14,,,4.14,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Connecticare,Commerical,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Connecticare,Exchange,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,Multiplan,Multiplan,,,3.58,,3.58,3.11,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Aetna,Commerical,,,3.64,,3.64,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Aetna,Middlesex Employees,,,3.49,,3.49,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Commerical,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Indemnity,,,3.54,,3.54,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,Individual Exchange,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Anthem,State Preferred,,,,,,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Cigna,Cigna,,4.14,,,4.14,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Connecticare,Commerical,,3.46,,,3.46,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Connecticare,Exchange,,3.46,,,3.46,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,Multiplan,Multiplan,,,4.01,,4.01,3.46,4.47,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,0143-9746-10,NDC,both,1,mL,4.72,2.83,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Aetna,Commerical,,,4.54,,4.54,3.46,5,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Aetna,Middlesex Employees,,,4.35,,4.35,3.46,5,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Commerical,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Indemnity,,,4.4,,4.4,3.46,5,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Individual Exchange,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,State Preferred,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Cigna,Cigna,,4.14,,,4.14,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Connecticare,Commerical,,3.46,,,3.46,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Connecticare,Exchange,,3.46,,,3.46,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Multiplan,Multiplan,,,5,,5,3.46,5,percent of total billed charges,,
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Aetna,Commerical,,,3.25,,3.25,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Aetna,Middlesex Employees,,,3.11,,3.11,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Anthem,Commerical,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Anthem,Indemnity,,,3.15,,3.15,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Anthem,Individual Exchange,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Anthem,State Preferred,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Cigna,Cigna,,4.14,,,4.14,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Connecticare,Commerical,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Connecticare,Exchange,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,Multiplan,Multiplan,,,3.58,,3.58,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-01,NDC,both,1,mL,4.21,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Aetna,Commerical,,,3.25,,3.25,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Aetna,Middlesex Employees,,,3.11,,3.11,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Anthem,Commerical,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Anthem,Indemnity,,,3.15,,3.15,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Anthem,Individual Exchange,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Anthem,State Preferred,,,,,,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Cigna,Cigna,,4.14,,,4.14,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Connecticare,Commerical,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Connecticare,Exchange,,3.46,,,3.46,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,Multiplan,Multiplan,,,3.58,,3.58,3.11,4.47,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,0143-9375-10,NDC,both,1,mL,4.21,2.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.11,4.47,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Aetna,Commerical,,,162.1,,162.1,3.46,178.57,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Aetna,Middlesex Employees,,,155.44,,155.44,3.46,178.57,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Anthem,Commerical,,,,,,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Anthem,Indemnity,,,157.37,,157.37,3.46,178.57,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Anthem,Individual Exchange,,,,,,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Anthem,State Preferred,,,,,,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Cigna,Cigna,,4.14,,,4.14,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Connecticare,Commerical,,3.46,,,3.46,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Connecticare,Exchange,,3.46,,,3.46,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,Multiplan,Multiplan,,,178.57,,178.57,3.46,178.57,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-53,NDC,both,1,mL,210.08,126.05,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,178.57,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Aetna,Commerical,,,324.2,,324.2,3.46,357.14,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Aetna,Middlesex Employees,,,310.88,,310.88,3.46,357.14,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Anthem,Commerical,,,,,,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Anthem,Indemnity,,,314.74,,314.74,3.46,357.14,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Anthem,Individual Exchange,,,,,,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Anthem,State Preferred,,,,,,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Cigna,Cigna,,4.14,,,4.14,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Connecticare,Commerical,,3.46,,,3.46,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Connecticare,Exchange,,3.46,,,3.46,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,Multiplan,Multiplan,,,357.14,,357.14,3.46,357.14,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0011-54,NDC,both,1,mL,420.16,252.1,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,357.14,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Aetna,Commerical,,,81.05,,81.05,3.46,89.28,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Aetna,Middlesex Employees,,,77.72,,77.72,3.46,89.28,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Anthem,Commerical,,,,,,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Anthem,Indemnity,,,78.69,,78.69,3.46,89.28,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Anthem,Individual Exchange,,,,,,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Anthem,State Preferred,,,,,,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Cigna,Cigna,,4.14,,,4.14,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Connecticare,Commerical,,3.46,,,3.46,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Connecticare,Exchange,,3.46,,,3.46,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,Multiplan,Multiplan,,,89.28,,89.28,3.46,89.28,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,40810-0205-91,NDC,both,1,mL,105.04,63.02,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,89.28,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Aetna,Commerical,,,4.54,,4.54,3.46,5,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Aetna,Middlesex Employees,,,4.35,,4.35,3.46,5,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Commerical,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Indemnity,,,4.4,,4.4,3.46,5,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,Individual Exchange,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Anthem,State Preferred,,,,,,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Cigna,Cigna,,4.14,,,4.14,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Connecticare,Commerical,,3.46,,,3.46,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Connecticare,Exchange,,3.46,,,3.46,3.46,5,Other,Could be inpatient or outpatient,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,Multiplan,Multiplan,,,5,,5,3.46,5,percent of total billed charges,,
TERBUTALINE INFUSION,J3105,HCPCS,63323-665-01,NDC,both,1,mL,5.88,3.53,United Healthcare/Oxford,United Healthcare/Oxford,,4.47,,,4.47,3.46,5,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Aetna,Commerical,,,1.13,,1.13,1.08,1.24,percent of total billed charges,,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Aetna,Middlesex Employees,,,1.08,,1.08,1.08,1.24,percent of total billed charges,,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Anthem,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Anthem,Indemnity,,,1.09,,1.09,1.08,1.24,percent of total billed charges,,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Anthem,Individual Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Anthem,State Preferred,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Cigna,Cigna,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Connecticare,Commerical,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Connecticare,Exchange,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,Multiplan,Multiplan,,,1.24,,1.24,1.08,1.24,percent of total billed charges,,
TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,J3490,HCPCS,0051-8425-30,NDC,both,2.5,gm,1.46,0.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.08,1.24,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Aetna,Commerical,,,133.68,,133.68,0.03,147.26,percent of total billed charges,,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Aetna,Middlesex Employees,,,128.19,,128.19,0.03,147.26,percent of total billed charges,,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Anthem,Commerical,,,,,,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Anthem,Indemnity,,,129.78,,129.78,0.03,147.26,percent of total billed charges,,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Anthem,Individual Exchange,,,,,,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Anthem,State Preferred,,,,,,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Cigna,Cigna,,0.03,,,0.03,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Connecticare,Commerical,,0.05,,,0.05,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Connecticare,Exchange,,0.05,,,0.05,0.03,147.26,Other,Could be inpatient or outpatient,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,Multiplan,Multiplan,,,147.26,,147.26,0.03,147.26,percent of total billed charges,,
TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,J1071,HCPCS,0009-0347-02,NDC,both,0.01,mL,173.25,103.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.04,,,0.04,0.03,147.26,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Aetna,Commerical,,,100.86,,100.86,53.32,111.1,percent of total billed charges,,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Aetna,Middlesex Employees,,,96.71,,96.71,53.32,111.1,percent of total billed charges,,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Anthem,Commerical,,66.65,,,66.65,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Anthem,Indemnity,,,97.91,,97.91,53.32,111.1,percent of total billed charges,,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Anthem,Individual Exchange,,53.32,,,53.32,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Anthem,State Preferred,,66.65,,,66.65,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Cigna,Cigna,,,,,,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Connecticare,Commerical,,,,,,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Connecticare,Exchange,,,,,,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,Multiplan,Multiplan,,,111.1,,111.1,53.32,111.1,percent of total billed charges,,
TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,90714,HCPCS,49281-215-58,NDC,both,0.5,mL,130.71,78.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.32,111.1,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Aetna,Commerical,,,1574.08,,1574.08,638.36,1734.02,percent of total billed charges,,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Aetna,Middlesex Employees,,,1509.41,,1509.41,638.36,1734.02,percent of total billed charges,,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Anthem,Commerical,,,,,,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Anthem,Indemnity,,,1528.18,,1528.18,638.36,1734.02,percent of total billed charges,,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Anthem,Individual Exchange,,,,,,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Anthem,State Preferred,,,,,,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Cigna,Cigna,,638.36,,,638.36,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Connecticare,Commerical,,888.36,,,888.36,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Connecticare,Exchange,,888.36,,,888.36,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,Multiplan,Multiplan,,,1734.02,,1734.02,638.36,1734.02,percent of total billed charges,,
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,J1670,HCPCS,13533-634-02,NDC,both,1,mL,2040.02,1224.01,United Healthcare/Oxford,United Healthcare/Oxford,,689.2,,,689.2,638.36,1734.02,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Aetna,Commerical,,,67.24,,67.24,53.32,74.07,percent of total billed charges,,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Aetna,Middlesex Employees,,,64.47,,64.47,53.32,74.07,percent of total billed charges,,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Anthem,Commerical,,66.65,,,66.65,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Anthem,Indemnity,,,65.28,,65.28,53.32,74.07,percent of total billed charges,,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Anthem,Individual Exchange,,53.32,,,53.32,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Anthem,State Preferred,,66.65,,,66.65,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Cigna,Cigna,,,,,,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Connecticare,Commerical,,,,,,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Connecticare,Exchange,,,,,,53.32,74.07,Other,Could be inpatient or outpatient,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,Multiplan,Multiplan,,,74.07,,74.07,53.32,74.07,percent of total billed charges,,
TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION,90714,HCPCS,13533-131-01,NDC,both,0.5,mL,87.14,52.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.32,74.07,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,40810-0209-27,NDC,both,1,ea,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 12.5 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,7.08,4.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Aetna,Commerical,,,2.73,,2.73,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Aetna,Middlesex Employees,,,2.62,,2.62,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Anthem,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Anthem,Indemnity,,,2.65,,2.65,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Anthem,Individual Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Anthem,State Preferred,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Cigna,Cigna,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Connecticare,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Connecticare,Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,Multiplan,Multiplan,,,3.01,,3.01,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,40810-0209-28,NDC,both,1,ea,3.54,2.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Aetna,Commerical,,,5.46,,5.46,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Aetna,Middlesex Employees,,,5.24,,5.24,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Anthem,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Anthem,Indemnity,,,5.3,,5.3,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Anthem,Individual Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Anthem,State Preferred,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Cigna,Cigna,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Connecticare,Commerical,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Connecticare,Exchange,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,Multiplan,Multiplan,,,6.02,,6.02,5.24,6.02,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,43598-394-67,NDC,both,1,ea,3.54,2.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.24,6.02,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Aetna,Commerical,,,2.73,,2.73,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Aetna,Middlesex Employees,,,2.62,,2.62,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Anthem,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Anthem,Indemnity,,,2.65,,2.65,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Anthem,Individual Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Anthem,State Preferred,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Cigna,Cigna,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Connecticare,Commerical,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Connecticare,Exchange,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,Multiplan,Multiplan,,,3.01,,3.01,2.62,3.01,percent of total billed charges,,
TETRABENAZINE 6.25 MG TABLET,J8499,HCPCS,47335-277-23,NDC,both,1,ea,3.54,2.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.62,3.01,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Aetna,Commerical,,,31.84,,31.84,30.53,35.07,percent of total billed charges,,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Aetna,Middlesex Employees,,,30.53,,30.53,30.53,35.07,percent of total billed charges,,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Anthem,Commerical,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Anthem,Indemnity,,,30.91,,30.91,30.53,35.07,percent of total billed charges,,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Anthem,Individual Exchange,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Anthem,State Preferred,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Cigna,Cigna,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Connecticare,Commerical,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Connecticare,Exchange,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,Multiplan,Multiplan,,,35.07,,35.07,30.53,35.07,percent of total billed charges,,
TETRACAINE HCL (PF) 0.5 % EYE DROPS,J3490,HCPCS,0065-0741-14,NDC,both,1,mL,41.26,24.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.53,35.07,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Aetna,Commerical,,,0.41,,0.41,0.39,0.45,percent of total billed charges,,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Aetna,Middlesex Employees,,,0.39,,0.39,0.39,0.45,percent of total billed charges,,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Anthem,Commerical,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Anthem,Indemnity,,,0.4,,0.4,0.39,0.45,percent of total billed charges,,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Anthem,Individual Exchange,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Anthem,State Preferred,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Cigna,Cigna,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Connecticare,Commerical,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Connecticare,Exchange,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,Multiplan,Multiplan,,,0.45,,0.45,0.39,0.45,percent of total billed charges,,
TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,J3490,HCPCS,17478-045-32,NDC,both,1,mL,0.53,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.39,0.45,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Aetna,Commerical,,,819.81,,819.81,786.13,903.11,percent of total billed charges,,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Aetna,Middlesex Employees,,,786.13,,786.13,786.13,903.11,percent of total billed charges,,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Anthem,Commerical,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Anthem,Indemnity,,,795.9,,795.9,786.13,903.11,percent of total billed charges,,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Anthem,Individual Exchange,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Anthem,State Preferred,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Cigna,Cigna,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Connecticare,Commerical,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Connecticare,Exchange,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,Multiplan,Multiplan,,,903.11,,903.11,786.13,903.11,percent of total billed charges,,
THALIDOMIDE 100 MG CAPSULE,J3490,HCPCS,59572-210-15,NDC,both,1,ea,1062.48,637.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,786.13,903.11,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Aetna,Commerical,,,876.58,,876.58,840.56,965.64,percent of total billed charges,,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Aetna,Middlesex Employees,,,840.56,,840.56,840.56,965.64,percent of total billed charges,,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Anthem,Commerical,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Anthem,Indemnity,,,851.02,,851.02,840.56,965.64,percent of total billed charges,,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Anthem,Individual Exchange,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Anthem,State Preferred,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Cigna,Cigna,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Connecticare,Commerical,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Connecticare,Exchange,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,Multiplan,Multiplan,,,965.64,,965.64,840.56,965.64,percent of total billed charges,,
THALIDOMIDE 150 MG CAPSULE,J3490,HCPCS,59572-215-13,NDC,both,1,ea,1136.05,681.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,840.56,965.64,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Aetna,Commerical,,,933.38,,933.38,895.03,1028.22,percent of total billed charges,,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Aetna,Middlesex Employees,,,895.03,,895.03,895.03,1028.22,percent of total billed charges,,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Anthem,Commerical,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Anthem,Indemnity,,,906.16,,906.16,895.03,1028.22,percent of total billed charges,,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Anthem,Individual Exchange,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Anthem,State Preferred,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Cigna,Cigna,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Connecticare,Commerical,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Connecticare,Exchange,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,Multiplan,Multiplan,,,1028.22,,1028.22,895.03,1028.22,percent of total billed charges,,
THALIDOMIDE 200 MG CAPSULE,J3490,HCPCS,59572-220-16,NDC,both,1,ea,1209.67,725.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,895.03,1028.22,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Aetna,Commerical,,,505.06,,505.06,484.31,556.38,percent of total billed charges,,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Aetna,Middlesex Employees,,,484.31,,484.31,484.31,556.38,percent of total billed charges,,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Anthem,Commerical,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Anthem,Indemnity,,,490.33,,490.33,484.31,556.38,percent of total billed charges,,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Anthem,Individual Exchange,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Anthem,State Preferred,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Cigna,Cigna,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Connecticare,Commerical,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Connecticare,Exchange,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,Multiplan,Multiplan,,,556.38,,556.38,484.31,556.38,percent of total billed charges,,
THALIDOMIDE 50 MG CAPSULE,J3490,HCPCS,59572-205-14,NDC,both,1,ea,654.56,392.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,484.31,556.38,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Aetna,Commerical,,,109.03,,109.03,104.56,120.11,percent of total billed charges,,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Aetna,Middlesex Employees,,,104.56,,104.56,104.56,120.11,percent of total billed charges,,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Anthem,Commerical,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Anthem,Indemnity,,,105.86,,105.86,104.56,120.11,percent of total billed charges,,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Anthem,Individual Exchange,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Anthem,State Preferred,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Cigna,Cigna,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Connecticare,Commerical,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Connecticare,Exchange,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,Multiplan,Multiplan,,,120.11,,120.11,104.56,120.11,percent of total billed charges,,
THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,J3490,HCPCS,27808-033-01,NDC,both,1,mL,141.31,84.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,104.56,120.11,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Aetna,Commerical,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Aetna,Middlesex Employees,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Anthem,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Anthem,Indemnity,,,0.09,,0.09,0.09,0.1,percent of total billed charges,,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Anthem,Individual Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Anthem,State Preferred,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Cigna,Cigna,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Connecticare,Commerical,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Connecticare,Exchange,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,Multiplan,Multiplan,,,0.1,,0.1,0.09,0.1,percent of total billed charges,,
THERAPEUTIC MULTIVITAMIN TABLET,J3490,HCPCS,40810-0007-94,NDC,both,1,ea,0.12,0.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.09,0.1,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Aetna,Commerical,,,14.1,,14.1,13.52,15.53,percent of total billed charges,,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Aetna,Middlesex Employees,,,13.52,,13.52,13.52,15.53,percent of total billed charges,,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Anthem,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Anthem,Indemnity,,,13.69,,13.69,13.52,15.53,percent of total billed charges,,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Anthem,Individual Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Anthem,State Preferred,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Cigna,Cigna,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Connecticare,Commerical,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Connecticare,Exchange,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,Multiplan,Multiplan,,,15.53,,15.53,13.52,15.53,percent of total billed charges,,
THIAMINE (VITAMIN B1) 100 MG/ML SUSPENSION,J3490,HCPCS,40810-0205-58,NDC,both,1,mL,18.27,10.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.52,15.53,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Aetna,Commerical,,,0.15,,0.15,0.14,0.16,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Aetna,Middlesex Employees,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Anthem,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Anthem,Indemnity,,,0.14,,0.14,0.14,0.16,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Anthem,Individual Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Anthem,State Preferred,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Cigna,Cigna,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Connecticare,Commerical,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Connecticare,Exchange,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,Multiplan,Multiplan,,,0.16,,0.16,0.14,0.16,percent of total billed charges,,
THIAMINE 50 MG SPLIT TABLET,J3490,HCPCS,40810-0020-16,NDC,both,2,UN,0.19,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.14,0.16,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,8068109800,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,37864-905-99,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,77333-934-10,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Aetna,Commerical,,,11.7,,11.7,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Aetna,Middlesex Employees,,,11.22,,11.22,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Anthem,Commerical,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Anthem,Indemnity,,,11.36,,11.36,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Anthem,Individual Exchange,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Anthem,State Preferred,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Cigna,Cigna,,2.19,,,2.19,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Connecticare,Commerical,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Connecticare,Exchange,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,Multiplan,Multiplan,,,12.89,,12.89,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-11,NDC,both,1,mL,15.16,9.1,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Aetna,Commerical,,,11.7,,11.7,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Aetna,Middlesex Employees,,,11.22,,11.22,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Anthem,Commerical,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Anthem,Indemnity,,,11.36,,11.36,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Anthem,Individual Exchange,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Anthem,State Preferred,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Cigna,Cigna,,2.19,,,2.19,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Connecticare,Commerical,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Connecticare,Exchange,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,Multiplan,Multiplan,,,12.89,,12.89,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,43598-050-25,NDC,both,1,mL,15.16,9.1,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Aetna,Commerical,,,11.7,,11.7,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Aetna,Middlesex Employees,,,11.22,,11.22,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Anthem,Commerical,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Anthem,Indemnity,,,11.36,,11.36,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Anthem,Individual Exchange,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Anthem,State Preferred,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Cigna,Cigna,,2.19,,,2.19,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Connecticare,Commerical,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Connecticare,Exchange,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,Multiplan,Multiplan,,,12.89,,12.89,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-02,NDC,both,1,mL,15.16,9.1,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Aetna,Commerical,,,20.46,,20.46,2.19,22.53,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Aetna,Middlesex Employees,,,19.61,,19.61,2.19,22.53,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Anthem,Commerical,,,,,,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Anthem,Indemnity,,,19.86,,19.86,2.19,22.53,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Anthem,Individual Exchange,,,,,,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Anthem,State Preferred,,,,,,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Cigna,Cigna,,2.19,,,2.19,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Connecticare,Commerical,,2.73,,,2.73,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Connecticare,Exchange,,2.73,,,2.73,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,Multiplan,Multiplan,,,22.53,,22.53,2.19,22.53,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-09,NDC,both,1,mL,26.51,15.91,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,22.53,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Aetna,Commerical,,,11.7,,11.7,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Aetna,Middlesex Employees,,,11.22,,11.22,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Anthem,Commerical,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Anthem,Indemnity,,,11.36,,11.36,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Anthem,Individual Exchange,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Anthem,State Preferred,,,,,,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Cigna,Cigna,,2.19,,,2.19,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Connecticare,Commerical,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Connecticare,Exchange,,2.73,,,2.73,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,Multiplan,Multiplan,,,12.89,,12.89,2.19,12.89,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,J3411,HCPCS,63323-013-21,NDC,both,1,mL,15.16,9.1,United Healthcare/Oxford,United Healthcare/Oxford,,2.37,,,2.37,2.19,12.89,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,1000673019,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
THIAMINE HCL (VITAMIN B1) 50 MG TABLET,J3490,HCPCS,8068109700,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Aetna,Commerical,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Aetna,Middlesex Employees,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Anthem,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Anthem,Indemnity,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Anthem,Individual Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Anthem,State Preferred,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Cigna,Cigna,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Connecticare,Commerical,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Connecticare,Exchange,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,Multiplan,Multiplan,,,0.04,,0.04,0.04,0.04,percent of total billed charges,,
THIAMINE HCL 25 MG ORAL TAB,J3490,HCPCS,40810-0002-96,NDC,both,1,ea,0.05,0.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.04,0.04,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,5026885111,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411659,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Aetna,Commerical,,,0.47,,0.47,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Aetna,Middlesex Employees,,,0.45,,0.45,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Anthem,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Anthem,Indemnity,,,0.46,,0.46,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Anthem,Individual Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Anthem,State Preferred,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Cigna,Cigna,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Connecticare,Commerical,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Connecticare,Exchange,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,Multiplan,Multiplan,,,0.52,,0.52,0.45,0.52,percent of total billed charges,,
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,J3490,HCPCS,6809411661,NDC,both,1,ea,0.61,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.45,0.52,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Aetna,Commerical,,,35.56,,35.56,34.09,39.17,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Aetna,Middlesex Employees,,,34.09,,34.09,34.09,39.17,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Anthem,Commerical,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Anthem,Indemnity,,,34.52,,34.52,34.09,39.17,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Anthem,Individual Exchange,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Anthem,State Preferred,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Cigna,Cigna,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Connecticare,Commerical,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Connecticare,Exchange,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,Multiplan,Multiplan,,,39.17,,39.17,34.09,39.17,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,40810-0013-75,NDC,both,1,ea,46.08,27.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.09,39.17,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Aetna,Commerical,,,1478.64,,1478.64,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Aetna,Middlesex Employees,,,1417.89,,1417.89,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Anthem,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Anthem,Indemnity,,,1435.52,,1435.52,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Anthem,Individual Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Anthem,State Preferred,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Cigna,Cigna,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Connecticare,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Connecticare,Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,Multiplan,Multiplan,,,1628.88,,1628.88,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 20 MG TABLET CHEMO,J8999,HCPCS,69784-630-25,NDC,both,1,ea,46.08,27.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Aetna,Commerical,,,9723.71,,9723.71,9324.23,10711.71,percent of total billed charges,,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Aetna,Middlesex Employees,,,9324.23,,9324.23,9324.23,10711.71,percent of total billed charges,,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Anthem,Commerical,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Anthem,Indemnity,,,9440.17,,9440.17,9324.23,10711.71,percent of total billed charges,,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Anthem,Individual Exchange,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Anthem,State Preferred,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Cigna,Cigna,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Connecticare,Commerical,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Connecticare,Exchange,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,Multiplan,Multiplan,,,10711.71,,10711.71,9324.23,10711.71,percent of total billed charges,,
THIOGUANINE 20 MG/ML SUSPENSION CHEMO,J3490,HCPCS,40810-208-73,NDC,both,1,mL,12602.01,7561.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9324.23,10711.71,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Aetna,Commerical,,,1478.64,,1478.64,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Aetna,Middlesex Employees,,,1417.89,,1417.89,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Anthem,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Anthem,Indemnity,,,1435.52,,1435.52,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Anthem,Individual Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Anthem,State Preferred,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Cigna,Cigna,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Connecticare,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Connecticare,Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,Multiplan,Multiplan,,,1628.88,,1628.88,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,40810-0015-34,NDC,both,1,ea,1916.33,1149.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Commerical,,,1478.64,,1478.64,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Middlesex Employees,,,1417.89,,1417.89,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Indemnity,,,1435.52,,1435.52,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Individual Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,State Preferred,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Cigna,Cigna,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,Multiplan,Multiplan,,,1628.88,,1628.88,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,69784-630-25,NDC,both,1,ea,1916.33,1149.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Commerical,,,1478.64,,1478.64,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Middlesex Employees,,,1417.89,,1417.89,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Indemnity,,,1435.52,,1435.52,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Individual Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Anthem,State Preferred,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Cigna,Cigna,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,Multiplan,Multiplan,,,1628.88,,1628.88,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,76388-880-25,NDC,both,1,ea,1916.33,1149.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Commerical,,,1478.64,,1478.64,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Aetna,Middlesex Employees,,,1417.89,,1417.89,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Indemnity,,,1435.52,,1435.52,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,Individual Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Anthem,State Preferred,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Cigna,Cigna,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Commerical,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Connecticare,Exchange,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,Multiplan,Multiplan,,,1628.88,,1628.88,1417.89,1628.88,percent of total billed charges,,
THIOGUANINE 40 MG TABLET,J8999,HCPCS,80725-630-25,NDC,both,1,ea,1916.33,1149.8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1417.89,1628.88,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Aetna,Commerical,,,2659.71,,2659.71,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Aetna,Middlesex Employees,,,2550.44,,2550.44,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Anthem,Commerical,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Anthem,Indemnity,,,2582.15,,2582.15,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Anthem,Individual Exchange,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Anthem,State Preferred,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Cigna,Cigna,,320.44,,,320.44,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Connecticare,Commerical,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Connecticare,Exchange,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,Multiplan,Multiplan,,,2929.95,,2929.95,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,0143-9565-01,NDC,both,1,ea,3447,2068.2,United Healthcare/Oxford,United Healthcare/Oxford,,277.26,,,277.26,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Aetna,Commerical,,,2659.71,,2659.71,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Aetna,Middlesex Employees,,,2550.44,,2550.44,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Anthem,Commerical,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Anthem,Indemnity,,,2582.15,,2582.15,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Anthem,Individual Exchange,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Anthem,State Preferred,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Cigna,Cigna,,320.44,,,320.44,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Connecticare,Commerical,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Connecticare,Exchange,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,Multiplan,Multiplan,,,2929.95,,2929.95,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,25021-246-02,NDC,both,1,ea,3447,2068.2,United Healthcare/Oxford,United Healthcare/Oxford,,277.26,,,277.26,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Aetna,Commerical,,,2659.71,,2659.71,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Aetna,Middlesex Employees,,,2550.44,,2550.44,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Anthem,Commerical,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Anthem,Indemnity,,,2582.15,,2582.15,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Anthem,Individual Exchange,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Anthem,State Preferred,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Cigna,Cigna,,320.44,,,320.44,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Connecticare,Commerical,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Connecticare,Exchange,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,Multiplan,Multiplan,,,2929.95,,2929.95,277.26,2929.95,percent of total billed charges,,
THIOTEPA 15 MG SOLUTION FOR INJECTION,J9340,HCPCS,70121-1630-1,NDC,both,1,ea,3447,2068.2,United Healthcare/Oxford,United Healthcare/Oxford,,277.26,,,277.26,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Aetna,Commerical,,,2659.71,,2659.71,277.26,2929.95,percent of total billed charges,,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Aetna,Middlesex Employees,,,2550.44,,2550.44,277.26,2929.95,percent of total billed charges,,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Anthem,Commerical,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Anthem,Indemnity,,,2582.15,,2582.15,277.26,2929.95,percent of total billed charges,,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Anthem,Individual Exchange,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Anthem,State Preferred,,,,,,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Cigna,Cigna,,320.44,,,320.44,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Connecticare,Commerical,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Connecticare,Exchange,,319.16,,,319.16,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,Multiplan,Multiplan,,,2929.95,,2929.95,277.26,2929.95,percent of total billed charges,,
THIOTEPA UNDILUTED 10 MG/ML FOR IT CHEMO,J9340,HCPCS,25021-246-02,NDC,both,1,ea,706.37,423.82,United Healthcare/Oxford,United Healthcare/Oxford,,277.26,,,277.26,277.26,2929.95,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Anthem,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Anthem,Individual Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Anthem,State Preferred,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Cigna,Cigna,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Connecticare,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Connecticare,Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-01,NDC,both,1,ea,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Aetna,Commerical,,,1.4,,1.4,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Aetna,Middlesex Employees,,,1.35,,1.35,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Anthem,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Anthem,Indemnity,,,1.36,,1.36,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Anthem,Individual Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Anthem,State Preferred,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Cigna,Cigna,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Connecticare,Commerical,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Connecticare,Exchange,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,Multiplan,Multiplan,,,1.55,,1.55,1.35,1.55,percent of total billed charges,,
THIOTHIXENE 5 MG CAPSULE,J3490,HCPCS,51079-588-20,NDC,both,1,ea,1.82,1.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.35,1.55,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Aetna,Commerical,,,631.12,,631.12,605.19,695.25,percent of total billed charges,,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Aetna,Middlesex Employees,,,605.19,,605.19,605.19,695.25,percent of total billed charges,,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Anthem,Commerical,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Anthem,Indemnity,,,612.72,,612.72,605.19,695.25,percent of total billed charges,,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Anthem,Individual Exchange,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Anthem,State Preferred,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Cigna,Cigna,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Connecticare,Commerical,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Connecticare,Exchange,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,Multiplan,Multiplan,,,695.25,,695.25,605.19,695.25,percent of total billed charges,,
"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-217-20,NDC,both,1,ea,817.94,490.76,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,605.19,695.25,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Aetna,Commerical,,,160.03,,160.03,153.46,176.29,percent of total billed charges,,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Aetna,Middlesex Employees,,,153.46,,153.46,153.46,176.29,percent of total billed charges,,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Anthem,Commerical,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Anthem,Indemnity,,,155.36,,155.36,153.46,176.29,percent of total billed charges,,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Anthem,Individual Exchange,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Anthem,State Preferred,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Cigna,Cigna,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Connecticare,Commerical,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Connecticare,Exchange,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,Multiplan,Multiplan,,,176.29,,176.29,153.46,176.29,percent of total billed charges,,
"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,60793-215-05,NDC,both,1,ea,207.4,124.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.46,176.29,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Aetna,Commerical,,,587.09,,587.09,562.97,646.74,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Aetna,Middlesex Employees,,,562.97,,562.97,562.97,646.74,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Anthem,Commerical,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Anthem,Indemnity,,,569.97,,569.97,562.97,646.74,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Anthem,Individual Exchange,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Anthem,State Preferred,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Cigna,Cigna,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Connecticare,Commerical,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Connecticare,Exchange,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,Multiplan,Multiplan,,,646.74,,646.74,562.97,646.74,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-707-41,NDC,both,1,ea,760.87,456.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,562.97,646.74,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Aetna,Commerical,,,183.46,,183.46,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Aetna,Middlesex Employees,,,175.93,,175.93,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Anthem,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Anthem,Indemnity,,,178.11,,178.11,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Anthem,Individual Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Anthem,State Preferred,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Cigna,Cigna,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Connecticare,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Connecticare,Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,Multiplan,Multiplan,,,202.1,,202.1,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0322-01,NDC,both,1,ea,237.77,142.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Aetna,Commerical,,,183.46,,183.46,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Aetna,Middlesex Employees,,,175.93,,175.93,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Anthem,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Anthem,Indemnity,,,178.11,,178.11,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Anthem,Individual Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Anthem,State Preferred,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Cigna,Cigna,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Connecticare,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Connecticare,Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,Multiplan,Multiplan,,,202.1,,202.1,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,0338-0324-01,NDC,both,1,ea,237.77,142.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Aetna,Commerical,,,183.46,,183.46,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Aetna,Middlesex Employees,,,175.93,,175.93,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Anthem,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Anthem,Indemnity,,,178.11,,178.11,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Anthem,Individual Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Anthem,State Preferred,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Cigna,Cigna,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Connecticare,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Connecticare,Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,Multiplan,Multiplan,,,202.1,,202.1,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-006-41,NDC,both,1,ea,237.77,142.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Aetna,Commerical,,,183.46,,183.46,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Aetna,Middlesex Employees,,,175.93,,175.93,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Anthem,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Anthem,Indemnity,,,178.11,,178.11,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Anthem,Individual Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Anthem,State Preferred,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Cigna,Cigna,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Connecticare,Commerical,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Connecticare,Exchange,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,Multiplan,Multiplan,,,202.1,,202.1,175.93,202.1,percent of total billed charges,,
"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",J3490,HCPCS,43825-606-41,NDC,both,1,ea,237.77,142.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.93,202.1,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
TIAGABINE 1 MG ORAL TAB,J3490,HCPCS,40810-0002-98,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Aetna,Commerical,,,127.31,,127.31,122.08,140.25,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Aetna,Middlesex Employees,,,122.08,,122.08,122.08,140.25,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Anthem,Commerical,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Anthem,Indemnity,,,123.6,,123.6,122.08,140.25,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Anthem,Individual Exchange,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Anthem,State Preferred,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Cigna,Cigna,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Connecticare,Commerical,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Connecticare,Exchange,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,Multiplan,Multiplan,,,140.25,,140.25,122.08,140.25,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-98,NDC,both,2,mL,165,99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,122.08,140.25,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Aetna,Commerical,,,63.66,,63.66,61.04,70.13,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Aetna,Middlesex Employees,,,61.04,,61.04,61.04,70.13,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Anthem,Commerical,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Anthem,Indemnity,,,61.8,,61.8,61.04,70.13,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Anthem,Individual Exchange,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Anthem,State Preferred,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Cigna,Cigna,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Connecticare,Commerical,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Connecticare,Exchange,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,Multiplan,Multiplan,,,70.13,,70.13,61.04,70.13,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0011-99,NDC,both,2,mL,82.5,49.5,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,61.04,70.13,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Aetna,Commerical,,,254.63,,254.63,244.17,280.5,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Aetna,Middlesex Employees,,,244.17,,244.17,244.17,280.5,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Anthem,Commerical,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Anthem,Indemnity,,,247.2,,247.2,244.17,280.5,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Anthem,Individual Exchange,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Anthem,State Preferred,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Cigna,Cigna,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Connecticare,Commerical,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Connecticare,Exchange,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,Multiplan,Multiplan,,,280.5,,280.5,244.17,280.5,percent of total billed charges,,
TIAGABINE 1 MG/ML ORAL SUSPENSION,J3490,HCPCS,40810-0012-00,NDC,both,2,mL,330,198,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,244.17,280.5,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Aetna,Commerical,,,9.86,,9.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Aetna,Middlesex Employees,,,9.46,,9.46,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Anthem,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Anthem,Indemnity,,,9.57,,9.57,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Anthem,Individual Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Anthem,State Preferred,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Cigna,Cigna,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Connecticare,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Connecticare,Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,Multiplan,Multiplan,,,10.86,,10.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,0093-5030-56,NDC,both,1,ea,12.78,7.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Aetna,Commerical,,,9.86,,9.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Aetna,Middlesex Employees,,,9.46,,9.46,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Anthem,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Anthem,Indemnity,,,9.57,,9.57,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Anthem,Individual Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Anthem,State Preferred,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Cigna,Cigna,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Connecticare,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Connecticare,Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,Multiplan,Multiplan,,,10.86,,10.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,40810-0019-55,NDC,both,1,ea,12.78,7.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Aetna,Commerical,,,9.86,,9.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Aetna,Middlesex Employees,,,9.46,,9.46,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Anthem,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Anthem,Indemnity,,,9.57,,9.57,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Anthem,Individual Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Anthem,State Preferred,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Cigna,Cigna,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Connecticare,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Connecticare,Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,Multiplan,Multiplan,,,10.86,,10.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,63459-402-30,NDC,both,1,ea,12.78,7.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Aetna,Commerical,,,9.86,,9.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Aetna,Middlesex Employees,,,9.46,,9.46,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Anthem,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Anthem,Indemnity,,,9.57,,9.57,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Anthem,Individual Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Anthem,State Preferred,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Cigna,Cigna,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Connecticare,Commerical,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Connecticare,Exchange,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,Multiplan,Multiplan,,,10.86,,10.86,9.46,10.86,percent of total billed charges,,
TIAGABINE 2 MG TABLET,J3490,HCPCS,72205-084-30,NDC,both,1,ea,12.78,7.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.46,10.86,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,62756-224-83,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
TIAGABINE 4 MG TABLET,J3490,HCPCS,63459-404-30,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Aetna,Commerical,,,6.74,,6.74,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Aetna,Middlesex Employees,,,6.47,,6.47,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Anthem,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Anthem,Indemnity,,,6.55,,6.55,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Anthem,Individual Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Anthem,State Preferred,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Cigna,Cigna,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Connecticare,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Connecticare,Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,Multiplan,Multiplan,,,7.43,,7.43,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,60758-802-05,NDC,both,1,mL,8.74,5.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Aetna,Commerical,,,6.74,,6.74,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Aetna,Middlesex Employees,,,6.47,,6.47,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Anthem,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Anthem,Indemnity,,,6.55,,6.55,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Anthem,Individual Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Anthem,State Preferred,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Cigna,Cigna,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Connecticare,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Connecticare,Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,Multiplan,Multiplan,,,7.43,,7.43,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,61314-226-05,NDC,both,1,mL,8.74,5.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Aetna,Commerical,,,6.74,,6.74,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Aetna,Middlesex Employees,,,6.47,,6.47,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Anthem,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Anthem,Indemnity,,,6.55,,6.55,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Anthem,Individual Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Anthem,State Preferred,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Cigna,Cigna,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Connecticare,Commerical,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Connecticare,Exchange,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,Multiplan,Multiplan,,,7.43,,7.43,6.47,7.43,percent of total billed charges,,
TIMOLOL MALEATE 0.25 % EYE DROPS,J3490,HCPCS,64980-513-05,NDC,both,1,mL,8.74,5.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.47,7.43,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Aetna,Commerical,,,14.27,,14.27,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Aetna,Middlesex Employees,,,13.69,,13.69,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Indemnity,,,13.86,,13.86,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Individual Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,State Preferred,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Cigna,Cigna,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Connecticare,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Connecticare,Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Multiplan,Multiplan,,,15.73,,15.73,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Anthem,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Anthem,State Preferred,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Cigna,Cigna,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Connecticare,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Connecticare,Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,61314-227-05,NDC,both,1,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Anthem,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Anthem,State Preferred,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Cigna,Cigna,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Connecticare,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Connecticare,Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,64980-514-05,NDC,both,1,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Aetna,Commerical,,,26.66,,26.66,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Anthem,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Anthem,Indemnity,,,25.88,,25.88,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Anthem,Individual Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Anthem,State Preferred,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Cigna,Cigna,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Connecticare,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Connecticare,Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,Multiplan,Multiplan,,,29.37,,29.37,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS,J3490,HCPCS,68682-813-05,NDC,both,1,mL,34.55,20.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Aetna,Commerical,,,14.27,,14.27,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Aetna,Middlesex Employees,,,13.69,,13.69,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Indemnity,,,13.86,,13.86,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,Individual Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Anthem,State Preferred,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Cigna,Cigna,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Connecticare,Commerical,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Connecticare,Exchange,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,Multiplan,Multiplan,,,15.73,,15.73,13.69,15.73,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,17478-288-10,NDC,both,1,mL,18.5,11.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.69,15.73,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Aetna,Commerical,,,26.66,,26.66,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Aetna,Middlesex Employees,,,25.56,,25.56,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Anthem,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Anthem,Indemnity,,,25.88,,25.88,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Anthem,Individual Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Anthem,State Preferred,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Cigna,Cigna,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Connecticare,Commerical,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Connecticare,Exchange,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,Multiplan,Multiplan,,,29.37,,29.37,25.56,29.37,percent of total billed charges,,
TIMOLOL MALEATE 0.5 % EYE DROPS FOR TOPICAL USE,J3490,HCPCS,64980-514-05,NDC,both,1,mL,18.58,11.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.56,29.37,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Aetna,Commerical,,,1060.39,,1060.39,1016.82,1168.13,percent of total billed charges,,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Aetna,Middlesex Employees,,,1016.82,,1016.82,1016.82,1168.13,percent of total billed charges,,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Anthem,Commerical,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Anthem,Indemnity,,,1029.47,,1029.47,1016.82,1168.13,percent of total billed charges,,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Anthem,Individual Exchange,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Anthem,State Preferred,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Cigna,Cigna,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Connecticare,Commerical,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Connecticare,Exchange,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,Multiplan,Multiplan,,,1168.13,,1168.13,1016.82,1168.13,percent of total billed charges,,
TIPRANAVIR-VITAMIN E TPGS 100 MG/ML ORAL SOLUTION,J3490,HCPCS,0597-0002-01,NDC,both,1,mL,1374.27,824.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1016.82,1168.13,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Aetna,Commerical,,,0.56,,0.56,0.54,0.62,percent of total billed charges,,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Aetna,Middlesex Employees,,,0.54,,0.54,0.54,0.62,percent of total billed charges,,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Anthem,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Anthem,Indemnity,,,0.55,,0.55,0.54,0.62,percent of total billed charges,,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Anthem,Individual Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Anthem,State Preferred,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Cigna,Cigna,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Connecticare,Commerical,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Connecticare,Exchange,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,Multiplan,Multiplan,,,0.62,,0.62,0.54,0.62,percent of total billed charges,,
TIZANIDINE 1 MG TABLET,J3490,HCPCS,40810-0013-76,NDC,both,1,ea,0.73,0.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.54,0.62,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Aetna,Commerical,,,2.19,,2.19,2.1,2.41,percent of total billed charges,,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Aetna,Middlesex Employees,,,2.1,,2.1,2.1,2.41,percent of total billed charges,,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Anthem,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Anthem,Indemnity,,,2.13,,2.13,2.1,2.41,percent of total billed charges,,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Anthem,Individual Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Anthem,State Preferred,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Cigna,Cigna,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Connecticare,Commerical,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Connecticare,Exchange,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,Multiplan,Multiplan,,,2.41,,2.41,2.1,2.41,percent of total billed charges,,
TIZANIDINE 1 MG/ML SUSPENSION,J3490,HCPCS,40810-0207-41,NDC,both,1,mL,2.84,1.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.1,2.41,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,40810-0009-10,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-10,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Aetna,Commerical,,,0.23,,0.23,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Aetna,Middlesex Employees,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Anthem,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Anthem,Indemnity,,,0.22,,0.22,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Anthem,Individual Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Anthem,State Preferred,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Cigna,Cigna,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Connecticare,Commerical,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Connecticare,Exchange,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,Multiplan,Multiplan,,,0.26,,0.26,0.22,0.26,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,55111-179-15,NDC,both,1,ea,0.3,0.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.22,0.26,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Aetna,Commerical,,,0.81,,0.81,0.78,0.89,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Aetna,Middlesex Employees,,,0.78,,0.78,0.78,0.89,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Anthem,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Anthem,Indemnity,,,0.79,,0.79,0.78,0.89,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Anthem,Individual Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Anthem,State Preferred,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Cigna,Cigna,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Connecticare,Commerical,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Connecticare,Exchange,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,Multiplan,Multiplan,,,0.89,,0.89,0.78,0.89,percent of total billed charges,,
TIZANIDINE 2 MG TABLET,J3490,HCPCS,57664-502-89,NDC,both,1,ea,1.05,0.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.78,0.89,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Aetna,Commerical,,,1.67,,1.67,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Aetna,Middlesex Employees,,,1.6,,1.6,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Anthem,Commerical,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Anthem,Indemnity,,,1.62,,1.62,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Anthem,Individual Exchange,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Anthem,State Preferred,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Cigna,Cigna,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Connecticare,Commerical,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Connecticare,Exchange,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,Multiplan,Multiplan,,,1.84,,1.84,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,51079-998-01,NDC,both,1,ea,2.16,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Aetna,Commerical,,,1.67,,1.67,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Aetna,Middlesex Employees,,,1.6,,1.6,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Anthem,Commerical,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Anthem,Indemnity,,,1.62,,1.62,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Anthem,Individual Exchange,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Anthem,State Preferred,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Cigna,Cigna,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Connecticare,Commerical,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Connecticare,Exchange,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,Multiplan,Multiplan,,,1.84,,1.84,1.6,1.84,percent of total billed charges,,
TIZANIDINE 4 MG TABLET,J3490,HCPCS,68084-645-11,NDC,both,1,ea,2.16,1.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.6,1.84,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Aetna,Commerical,,,5.21,,5.21,4.99,5.74,percent of total billed charges,,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Aetna,Middlesex Employees,,,4.99,,4.99,4.99,5.74,percent of total billed charges,,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Anthem,Commerical,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Anthem,Indemnity,,,5.06,,5.06,4.99,5.74,percent of total billed charges,,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Anthem,Individual Exchange,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Anthem,State Preferred,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Cigna,Cigna,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Connecticare,Commerical,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Connecticare,Exchange,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,Multiplan,Multiplan,,,5.74,,5.74,4.99,5.74,percent of total billed charges,,
TMP/SMZ 0.4 MG/2 MG/1 ML SUSP DESENSITIZATION,J3490,HCPCS,40810-0017-95,NDC,both,40,mL,6.75,4.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.99,5.74,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Anthem,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Anthem,Individual Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Anthem,State Preferred,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Cigna,Cigna,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Connecticare,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Connecticare,Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,17478-290-10,NDC,both,1,mL,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Anthem,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Anthem,Individual Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Anthem,State Preferred,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Cigna,Cigna,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Connecticare,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Connecticare,Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,24208-290-05,NDC,both,1,mL,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Anthem,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Anthem,Individual Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Anthem,State Preferred,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Cigna,Cigna,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Connecticare,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Connecticare,Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,61314-643-05,NDC,both,1,mL,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Anthem,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Anthem,Individual Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Anthem,State Preferred,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Cigna,Cigna,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Connecticare,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Connecticare,Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,62332-518-05,NDC,both,1,mL,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Aetna,Commerical,,,21.13,,21.13,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Aetna,Middlesex Employees,,,20.27,,20.27,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Anthem,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Anthem,Indemnity,,,20.52,,20.52,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Anthem,Individual Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Anthem,State Preferred,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Cigna,Cigna,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Connecticare,Commerical,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Connecticare,Exchange,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,Multiplan,Multiplan,,,23.28,,23.28,20.27,23.28,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE DROPS,J3490,HCPCS,70069-131-01,NDC,both,1,mL,27.39,16.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.27,23.28,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Aetna,Commerical,,,703.58,,703.58,674.68,775.07,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Aetna,Middlesex Employees,,,674.68,,674.68,674.68,775.07,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Anthem,Commerical,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Anthem,Indemnity,,,683.07,,683.07,674.68,775.07,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Anthem,Individual Exchange,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Anthem,State Preferred,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Cigna,Cigna,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Connecticare,Commerical,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Connecticare,Exchange,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,Multiplan,Multiplan,,,775.07,,775.07,674.68,775.07,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0065-0644-35,NDC,both,3.5,gm,911.85,547.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,674.68,775.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Aetna,Commerical,,,804.1,,804.1,771.06,885.8,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Aetna,Middlesex Employees,,,771.06,,771.06,771.06,885.8,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Anthem,Commerical,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Anthem,Indemnity,,,780.65,,780.65,771.06,885.8,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Anthem,Individual Exchange,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Anthem,State Preferred,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Cigna,Cigna,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Connecticare,Commerical,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Connecticare,Exchange,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,Multiplan,Multiplan,,,885.8,,885.8,771.06,885.8,percent of total billed charges,,
TOBRAMYCIN 0.3 % EYE OINTMENT,J3490,HCPCS,0078-0813-01,NDC,both,1,gm,1042.12,625.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,771.06,885.8,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Aetna,Commerical,,,80.54,,80.54,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Aetna,Middlesex Employees,,,77.23,,77.23,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Anthem,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Anthem,Indemnity,,,78.19,,78.19,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Anthem,Individual Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Anthem,State Preferred,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Cigna,Cigna,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Connecticare,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Connecticare,Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,Multiplan,Multiplan,,,88.72,,88.72,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0065-0647-25,NDC,both,1,mL,104.38,62.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Aetna,Commerical,,,80.54,,80.54,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Aetna,Middlesex Employees,,,77.23,,77.23,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Anthem,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Anthem,Indemnity,,,78.19,,78.19,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Anthem,Individual Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Anthem,State Preferred,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Cigna,Cigna,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Connecticare,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Connecticare,Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,Multiplan,Multiplan,,,88.72,,88.72,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,0574-4031-25,NDC,both,1,mL,104.38,62.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Aetna,Commerical,,,80.54,,80.54,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Aetna,Middlesex Employees,,,77.23,,77.23,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Anthem,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Anthem,Indemnity,,,78.19,,78.19,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Anthem,Individual Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Anthem,State Preferred,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Cigna,Cigna,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Connecticare,Commerical,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Connecticare,Exchange,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,Multiplan,Multiplan,,,88.72,,88.72,77.23,88.72,percent of total billed charges,,
"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",J3490,HCPCS,24208-295-25,NDC,both,1,mL,104.38,62.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,77.23,88.72,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Aetna,Commerical,,,160.08,,160.08,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Aetna,Middlesex Employees,,,153.51,,153.51,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Commerical,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Indemnity,,,155.42,,155.42,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Individual Exchange,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,State Preferred,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Cigna,Cigna,,2.7,,,2.7,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Connecticare,Commerical,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Connecticare,Exchange,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Multiplan,Multiplan,,,176.35,,176.35,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,2.7,,,2.7,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,3.47,,,3.47,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,3.47,,,3.47,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Aetna,Commerical,,,160.08,,160.08,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Aetna,Middlesex Employees,,,153.51,,153.51,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Anthem,Commerical,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Anthem,Indemnity,,,155.42,,155.42,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Anthem,Individual Exchange,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Anthem,State Preferred,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Cigna,Cigna,,2.7,,,2.7,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Connecticare,Commerical,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Connecticare,Exchange,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,Multiplan,Multiplan,,,176.35,,176.35,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-01,NDC,both,0.067,ea,207.47,124.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Aetna,Commerical,,,160.08,,160.08,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Aetna,Middlesex Employees,,,153.51,,153.51,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Anthem,Commerical,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Anthem,Indemnity,,,155.42,,155.42,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Anthem,Individual Exchange,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Anthem,State Preferred,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Cigna,Cigna,,2.7,,,2.7,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Connecticare,Commerical,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Connecticare,Exchange,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,Multiplan,Multiplan,,,176.35,,176.35,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,J3260,HCPCS,72266-163-06,NDC,both,0.067,ea,207.47,124.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-1,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-01,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,152.74,175.47,percent of total billed charges,,
TOBRAMYCIN 1.2 GRAM TOPICAL FOR OSM,J3490,HCPCS,72266-163-06,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,152.74,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Aetna,Commerical,,,34.14,,34.14,32.73,37.6,percent of total billed charges,,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Aetna,Middlesex Employees,,,32.73,,32.73,32.73,37.6,percent of total billed charges,,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Anthem,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Anthem,Indemnity,,,33.14,,33.14,32.73,37.6,percent of total billed charges,,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Anthem,Individual Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Anthem,State Preferred,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Cigna,Cigna,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Connecticare,Commerical,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Connecticare,Exchange,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,Multiplan,Multiplan,,,37.6,,37.6,32.73,37.6,percent of total billed charges,,
TOBRAMYCIN 14 MG/ML FORTIFIED OPHTHALMIC DROPS,J3490,HCPCS,40810-0204-65,NDC,both,1,mL,44.24,26.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,32.73,37.6,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Aetna,Commerical,,,30.15,,30.15,2.7,33.22,percent of total billed charges,,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Aetna,Middlesex Employees,,,28.92,,28.92,2.7,33.22,percent of total billed charges,,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Anthem,Commerical,,,,,,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Anthem,Indemnity,,,29.27,,29.27,2.7,33.22,percent of total billed charges,,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Anthem,Individual Exchange,,,,,,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Anthem,State Preferred,,,,,,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Cigna,Cigna,,2.7,,,2.7,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Connecticare,Commerical,,3.47,,,3.47,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Connecticare,Exchange,,3.47,,,3.47,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,Multiplan,Multiplan,,,33.22,,33.22,2.7,33.22,percent of total billed charges,,
TOBRAMYCIN 2 MG/ML IN D10W NICU,J3260,HCPCS,40810-0004-75,NDC,both,40,mL,39.08,23.45,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,33.22,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Aetna,Commerical,,,46.62,,46.62,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Aetna,Middlesex Employees,,,44.7,,44.7,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Anthem,Commerical,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Anthem,Indemnity,,,45.26,,45.26,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Anthem,Individual Exchange,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Anthem,State Preferred,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Cigna,Cigna,,19.26,,,19.26,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Connecticare,Commerical,,24.36,,,24.36,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Connecticare,Exchange,,24.36,,,24.36,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,Multiplan,Multiplan,,,51.36,,51.36,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,0078-0494-71,NDC,both,5,mL,60.42,36.25,United Healthcare/Oxford,United Healthcare/Oxford,,20.79,,,20.79,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Aetna,Commerical,,,46.62,,46.62,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Aetna,Middlesex Employees,,,44.7,,44.7,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Anthem,Commerical,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Anthem,Indemnity,,,45.26,,45.26,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Anthem,Individual Exchange,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Anthem,State Preferred,,,,,,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Cigna,Cigna,,19.26,,,19.26,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Connecticare,Commerical,,24.36,,,24.36,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Connecticare,Exchange,,24.36,,,24.36,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,Multiplan,Multiplan,,,51.36,,51.36,19.26,51.36,percent of total billed charges,,
TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,J7682,HCPCS,65162-914-46,NDC,both,5,mL,60.42,36.25,United Healthcare/Oxford,United Healthcare/Oxford,,20.79,,,20.79,19.26,51.36,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Anthem,Commerical,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Anthem,State Preferred,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Cigna,Cigna,,2.7,,,2.7,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Connecticare,Commerical,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Connecticare,Exchange,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,0409-3578-01,NDC,both,2,mL,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Anthem,Commerical,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Anthem,State Preferred,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Cigna,Cigna,,2.7,,,2.7,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Connecticare,Commerical,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Connecticare,Exchange,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-01,NDC,both,2,mL,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Anthem,Commerical,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Anthem,State Preferred,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Cigna,Cigna,,2.7,,,2.7,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Connecticare,Commerical,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Connecticare,Exchange,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,36000-244-25,NDC,both,2,mL,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Anthem,Commerical,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Anthem,State Preferred,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Cigna,Cigna,,2.7,,,2.7,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Connecticare,Commerical,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Connecticare,Exchange,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-01,NDC,both,2,mL,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Aetna,Commerical,,,2.37,,2.37,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Aetna,Middlesex Employees,,,2.27,,2.27,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Anthem,Commerical,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Anthem,Indemnity,,,2.3,,2.3,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Anthem,Individual Exchange,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Anthem,State Preferred,,,,,,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Cigna,Cigna,,2.7,,,2.7,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Connecticare,Commerical,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Connecticare,Exchange,,3.47,,,3.47,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,Multiplan,Multiplan,,,2.61,,2.61,2.27,3.47,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-02,NDC,both,2,mL,3.07,1.84,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.27,3.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Anthem,Commerical,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Anthem,State Preferred,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Cigna,Cigna,,2.7,,,2.7,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Connecticare,Commerical,,3.47,,,3.47,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Connecticare,Exchange,,3.47,,,3.47,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,63323-306-30,NDC,both,2,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Aetna,Commerical,,,35.46,,35.46,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Aetna,Middlesex Employees,,,34.01,,34.01,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Anthem,Commerical,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Anthem,Indemnity,,,34.43,,34.43,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Anthem,Individual Exchange,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Anthem,State Preferred,,,,,,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Cigna,Cigna,,2.7,,,2.7,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Connecticare,Commerical,,3.47,,,3.47,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Connecticare,Exchange,,3.47,,,3.47,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,Multiplan,Multiplan,,,39.07,,39.07,2.7,39.07,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-428-30,NDC,both,2,mL,45.96,27.58,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,39.07,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Aetna,Commerical,,,5.86,,5.86,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Aetna,Middlesex Employees,,,5.62,,5.62,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Anthem,Commerical,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Anthem,Indemnity,,,5.69,,5.69,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Anthem,Individual Exchange,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Anthem,State Preferred,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Cigna,Cigna,,2.7,,,2.7,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Connecticare,Commerical,,3.47,,,3.47,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Connecticare,Exchange,,3.47,,,3.47,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,Multiplan,Multiplan,,,6.45,,6.45,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-00,NDC,both,2,mL,7.59,4.55,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Aetna,Commerical,,,5.86,,5.86,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Aetna,Middlesex Employees,,,5.62,,5.62,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Anthem,Commerical,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Anthem,Indemnity,,,5.69,,5.69,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Anthem,Individual Exchange,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Anthem,State Preferred,,,,,,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Cigna,Cigna,,2.7,,,2.7,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Connecticare,Commerical,,3.47,,,3.47,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Connecticare,Exchange,,3.47,,,3.47,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,Multiplan,Multiplan,,,6.45,,6.45,2.7,6.45,percent of total billed charges,,
TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,J3260,HCPCS,67457-473-22,NDC,both,2,mL,7.59,4.55,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,6.45,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Aetna,Commerical,,,160.08,,160.08,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Aetna,Middlesex Employees,,,153.51,,153.51,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Commerical,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Indemnity,,,155.42,,155.42,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,Individual Exchange,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Anthem,State Preferred,,,,,,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Cigna,Cigna,,2.7,,,2.7,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Connecticare,Commerical,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Connecticare,Exchange,,3.47,,,3.47,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,Multiplan,Multiplan,,,176.35,,176.35,2.7,176.35,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-1,NDC,both,0.067,ea,207.47,124.48,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,176.35,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Commerical,,,159.29,,159.29,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Aetna,Middlesex Employees,,,152.74,,152.74,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Commerical,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Indemnity,,,154.64,,154.64,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,Individual Exchange,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Anthem,State Preferred,,,,,,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Cigna,Cigna,,2.7,,,2.7,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Commerical,,3.47,,,3.47,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Connecticare,Exchange,,3.47,,,3.47,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,Multiplan,Multiplan,,,175.47,,175.47,2.7,175.47,percent of total billed charges,,
TOBRAMYCIN SULFATE 1.2 G INTRA-ARTICULAR,J3260,HCPCS,39822-0412-6,NDC,both,1,ea,206.44,123.86,United Healthcare/Oxford,United Healthcare/Oxford,,2.92,,,2.92,2.7,175.47,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Aetna,Commerical,,,35.12,,35.12,19.26,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Aetna,Middlesex Employees,,,33.67,,33.67,19.26,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Anthem,Commerical,,,,,,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Anthem,Indemnity,,,34.09,,34.09,19.26,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Anthem,Individual Exchange,,,,,,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Anthem,State Preferred,,,,,,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Cigna,Cigna,,19.26,,,19.26,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Connecticare,Commerical,,24.36,,,24.36,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Connecticare,Exchange,,24.36,,,24.36,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,Multiplan,Multiplan,,,38.68,,38.68,19.26,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML FOR INHALATION,J7682,HCPCS,63323-306-30,NDC,both,7.5,mL,45.51,27.31,United Healthcare/Oxford,United Healthcare/Oxford,,20.79,,,20.79,19.26,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Aetna,Commerical,,,35.12,,35.12,33.67,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Aetna,Middlesex Employees,,,33.67,,33.67,33.67,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Anthem,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Anthem,Indemnity,,,34.09,,34.09,33.67,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Anthem,Individual Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Anthem,State Preferred,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Cigna,Cigna,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Connecticare,Commerical,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Connecticare,Exchange,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,Multiplan,Multiplan,,,38.68,,38.68,33.67,38.68,percent of total billed charges,,
TOBRAMYCIN SULFATE 40 MG/ML ORAL SOLN,J3490,HCPCS,63323-306-30,NDC,both,1,mL,45.51,27.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,33.67,38.68,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Aetna,Commerical,,,749.03,,749.03,718.26,825.14,percent of total billed charges,,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Aetna,Middlesex Employees,,,718.26,,718.26,718.26,825.14,percent of total billed charges,,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Anthem,Commerical,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Anthem,Indemnity,,,727.19,,727.19,718.26,825.14,percent of total billed charges,,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Anthem,Individual Exchange,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Anthem,State Preferred,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Cigna,Cigna,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Connecticare,Commerical,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Connecticare,Exchange,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,Multiplan,Multiplan,,,825.14,,825.14,718.26,825.14,percent of total billed charges,,
TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,J3490,HCPCS,0078-0876-01,NDC,both,3.5,gm,970.75,582.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,718.26,825.14,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Aetna,Commerical,,,2154.69,,2154.69,7.26,2373.63,percent of total billed charges,,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Aetna,Middlesex Employees,,,2066.17,,2066.17,7.26,2373.63,percent of total billed charges,,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Anthem,Commerical,,,,,,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Anthem,Indemnity,,,2091.86,,2091.86,7.26,2373.63,percent of total billed charges,,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Anthem,Individual Exchange,,,,,,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Anthem,State Preferred,,,,,,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Cigna,Cigna,,8.39,,,8.39,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Connecticare,Commerical,,9.1,,,9.1,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Connecticare,Exchange,,9.1,,,9.1,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,Multiplan,Multiplan,,,2373.63,,2373.63,7.26,2373.63,percent of total billed charges,,
TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-136-01,NDC,both,0.05,mL,2792.5,1675.5,United Healthcare/Oxford,United Healthcare/Oxford,,7.26,,,7.26,7.26,2373.63,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Aetna,Commerical,,,861.87,,861.87,7.26,949.44,percent of total billed charges,,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Aetna,Middlesex Employees,,,826.46,,826.46,7.26,949.44,percent of total billed charges,,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Anthem,Commerical,,,,,,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Anthem,Indemnity,,,836.74,,836.74,7.26,949.44,percent of total billed charges,,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Anthem,Individual Exchange,,,,,,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Anthem,State Preferred,,,,,,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Cigna,Cigna,,8.39,,,8.39,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Connecticare,Commerical,,9.1,,,9.1,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Connecticare,Exchange,,9.1,,,9.1,7.26,949.44,Other,Could be inpatient or outpatient,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,Multiplan,Multiplan,,,949.44,,949.44,7.26,949.44,percent of total billed charges,,
TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,J3262,HCPCS,50242-135-01,NDC,both,0.05,mL,1116.99,670.19,United Healthcare/Oxford,United Healthcare/Oxford,,7.26,,,7.26,7.26,949.44,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Aetna,Commerical,,,12546.72,,12546.72,12031.25,13821.55,percent of total billed charges,,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Aetna,Middlesex Employees,,,12031.25,,12031.25,12031.25,13821.55,percent of total billed charges,,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Anthem,Commerical,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Anthem,Indemnity,,,12180.85,,12180.85,12031.25,13821.55,percent of total billed charges,,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Anthem,Individual Exchange,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Anthem,State Preferred,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Cigna,Cigna,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Connecticare,Commerical,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Connecticare,Exchange,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,Multiplan,Multiplan,,,13821.55,,13821.55,12031.25,13821.55,percent of total billed charges,,
TOFACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0069-1029-02,NDC,both,1,mL,16260.65,9756.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12031.25,13821.55,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Aetna,Commerical,,,261.39,,261.39,250.66,287.95,percent of total billed charges,,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Aetna,Middlesex Employees,,,250.66,,250.66,250.66,287.95,percent of total billed charges,,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Anthem,Commerical,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Anthem,Indemnity,,,253.77,,253.77,250.66,287.95,percent of total billed charges,,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Anthem,Individual Exchange,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Anthem,State Preferred,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Cigna,Cigna,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Connecticare,Commerical,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Connecticare,Exchange,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,Multiplan,Multiplan,,,287.95,,287.95,250.66,287.95,percent of total billed charges,,
TOFACITINIB 5 MG TABLET,J8499,HCPCS,0069-1001-01,NDC,both,1,ea,338.77,203.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,250.66,287.95,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Aetna,Commerical,,,177.31,,177.31,170.03,195.33,percent of total billed charges,,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Aetna,Middlesex Employees,,,170.03,,170.03,170.03,195.33,percent of total billed charges,,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Anthem,Commerical,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Anthem,Indemnity,,,172.14,,172.14,170.03,195.33,percent of total billed charges,,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Anthem,Individual Exchange,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Anthem,State Preferred,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Cigna,Cigna,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Connecticare,Commerical,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Connecticare,Exchange,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,Multiplan,Multiplan,,,195.33,,195.33,170.03,195.33,percent of total billed charges,,
TOFACTINIB 2.5 MG TABLET,J8499,HCPCS,40810-0020-79,NDC,both,1,ea,229.8,137.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.03,195.33,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Aetna,Commerical,,,1.24,,1.24,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Aetna,Middlesex Employees,,,1.19,,1.19,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Anthem,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Anthem,Indemnity,,,1.21,,1.21,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Anthem,Individual Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Anthem,State Preferred,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Cigna,Cigna,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Connecticare,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Connecticare,Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,Multiplan,Multiplan,,,1.37,,1.37,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-01,NDC,both,1,ea,1.61,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Aetna,Commerical,,,1.24,,1.24,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Aetna,Middlesex Employees,,,1.19,,1.19,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Anthem,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Anthem,Indemnity,,,1.21,,1.21,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Anthem,Individual Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Anthem,State Preferred,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Cigna,Cigna,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Connecticare,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Connecticare,Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,Multiplan,Multiplan,,,1.37,,1.37,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68084-344-11,NDC,both,1,ea,1.61,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Aetna,Commerical,,,1.24,,1.24,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Aetna,Middlesex Employees,,,1.19,,1.19,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Anthem,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Anthem,Indemnity,,,1.21,,1.21,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Anthem,Individual Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Anthem,State Preferred,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Cigna,Cigna,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Connecticare,Commerical,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Connecticare,Exchange,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,Multiplan,Multiplan,,,1.37,,1.37,1.19,1.37,percent of total billed charges,,
TOPIRAMATE 100 MG TABLET,J3490,HCPCS,68382-140-14,NDC,both,1,ea,1.61,0.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.19,1.37,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Aetna,Commerical,,,0.32,,0.32,0.3,0.35,percent of total billed charges,,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Aetna,Middlesex Employees,,,0.3,,0.3,0.3,0.35,percent of total billed charges,,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Anthem,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Anthem,Indemnity,,,0.31,,0.31,0.3,0.35,percent of total billed charges,,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Anthem,Individual Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Anthem,State Preferred,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Cigna,Cigna,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Connecticare,Commerical,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Connecticare,Exchange,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,Multiplan,Multiplan,,,0.35,,0.35,0.3,0.35,percent of total billed charges,,
TOPIRAMATE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-02,NDC,both,1,ea,0.41,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.3,0.35,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-26,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Aetna,Commerical,,,1.48,,1.48,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Aetna,Middlesex Employees,,,1.42,,1.42,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Anthem,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Anthem,Indemnity,,,1.44,,1.44,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Anthem,Individual Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Anthem,State Preferred,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Cigna,Cigna,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Connecticare,Commerical,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Connecticare,Exchange,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,Multiplan,Multiplan,,,1.63,,1.63,1.42,1.63,percent of total billed charges,,
TOPIRAMATE 15 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-004-14,NDC,both,1,ea,1.92,1.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.42,1.63,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-11,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68084-345-21,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
TOPIRAMATE 200 MG TABLET,J3490,HCPCS,68382-141-14,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,0093-7336-06,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,40810-0006-27,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,50458-645-65,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,59651-453-60,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Aetna,Commerical,,,1.16,,1.16,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Aetna,Middlesex Employees,,,1.11,,1.11,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Anthem,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Anthem,Indemnity,,,1.12,,1.12,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Anthem,Individual Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Anthem,State Preferred,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Cigna,Cigna,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Connecticare,Commerical,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Connecticare,Exchange,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,Multiplan,Multiplan,,,1.28,,1.28,1.11,1.28,percent of total billed charges,,
TOPIRAMATE 25 MG SPRINKLE CAPSULE,J3490,HCPCS,68382-005-14,NDC,both,1,ea,1.5,0.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.11,1.28,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,0904-6928-61,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Aetna,Commerical,,,0.62,,0.62,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Aetna,Middlesex Employees,,,0.59,,0.59,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Anthem,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Anthem,Indemnity,,,0.6,,0.6,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Anthem,Individual Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Anthem,State Preferred,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Cigna,Cigna,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Connecticare,Commerical,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Connecticare,Exchange,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,Multiplan,Multiplan,,,0.68,,0.68,0.59,0.68,percent of total billed charges,,
TOPIRAMATE 25 MG TABLET,J3490,HCPCS,68084-342-11,NDC,both,1,ea,0.8,0.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.59,0.68,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Aetna,Commerical,,,1873.09,,1873.09,1796.14,2063.41,percent of total billed charges,,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Aetna,Middlesex Employees,,,1796.14,,1796.14,1796.14,2063.41,percent of total billed charges,,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Anthem,Commerical,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Anthem,Indemnity,,,1818.47,,1818.47,1796.14,2063.41,percent of total billed charges,,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Anthem,Individual Exchange,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Anthem,State Preferred,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Cigna,Cigna,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Connecticare,Commerical,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Connecticare,Exchange,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,Multiplan,Multiplan,,,2063.41,,2063.41,1796.14,2063.41,percent of total billed charges,,
TOPIRAMATE 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52652-9001-1,NDC,both,1,mL,2427.54,1456.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1796.14,2063.41,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Aetna,Commerical,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Anthem,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.11,percent of total billed charges,,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Anthem,Individual Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Anthem,State Preferred,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Cigna,Cigna,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Connecticare,Commerical,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Connecticare,Exchange,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,Multiplan,Multiplan,,,0.11,,0.11,0.1,0.11,percent of total billed charges,,
TOPIRAMATE 50 MG TABLET,J3490,HCPCS,68382-139-14,NDC,both,1,ea,0.13,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.11,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Aetna,Commerical,,,55.86,,55.86,53.56,61.53,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Aetna,Middlesex Employees,,,53.56,,53.56,53.56,61.53,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Anthem,Commerical,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Anthem,Indemnity,,,54.23,,54.23,53.56,61.53,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Anthem,Individual Exchange,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Anthem,State Preferred,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Cigna,Cigna,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Connecticare,Commerical,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Connecticare,Exchange,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,Multiplan,Multiplan,,,61.53,,61.53,53.56,61.53,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-03,NDC,both,1,mL,72.39,43.43,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,53.56,61.53,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Aetna,Commerical,,,27.93,,27.93,26.78,30.77,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Aetna,Middlesex Employees,,,26.78,,26.78,26.78,30.77,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Anthem,Commerical,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Anthem,Indemnity,,,27.12,,27.12,26.78,30.77,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Anthem,Individual Exchange,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Anthem,State Preferred,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Cigna,Cigna,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Connecticare,Commerical,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Connecticare,Exchange,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,Multiplan,Multiplan,,,30.77,,30.77,26.78,30.77,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-69,NDC,both,1,mL,36.2,21.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.78,30.77,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Aetna,Commerical,,,111.71,,111.71,107.12,123.06,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Aetna,Middlesex Employees,,,107.12,,107.12,107.12,123.06,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Anthem,Commerical,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Anthem,Indemnity,,,108.45,,108.45,107.12,123.06,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Anthem,Individual Exchange,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Anthem,State Preferred,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Cigna,Cigna,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Connecticare,Commerical,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Connecticare,Exchange,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,Multiplan,Multiplan,,,123.06,,123.06,107.12,123.06,percent of total billed charges,,
TOPIRAMATE 6 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-70,NDC,both,1,mL,144.78,86.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,107.12,123.06,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Commerical,,,64.25,,64.25,1.15,70.78,percent of total billed charges,,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Middlesex Employees,,,61.61,,61.61,1.15,70.78,percent of total billed charges,,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Commerical,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Indemnity,,,62.38,,62.38,1.15,70.78,percent of total billed charges,,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Individual Exchange,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,State Preferred,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Cigna,Cigna,,1.33,,,1.33,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Commerical,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Exchange,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Multiplan,Multiplan,,,70.78,,70.78,1.15,70.78,percent of total billed charges,,
TOPOTECAN 1 MG/ML ORAL SOLUTION CHEMO,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Aetna,Commerical,,,676.75,,676.75,1.15,745.51,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Aetna,Middlesex Employees,,,648.94,,648.94,1.15,745.51,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Anthem,Commerical,,,,,,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Anthem,Indemnity,,,657.01,,657.01,1.15,745.51,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Anthem,Individual Exchange,,,,,,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Anthem,State Preferred,,,,,,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Cigna,Cigna,,1.33,,,1.33,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Connecticare,Commerical,,2.47,,,2.47,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Connecticare,Exchange,,2.47,,,2.47,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,Multiplan,Multiplan,,,745.51,,745.51,1.15,745.51,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,16729-151-31,NDC,both,0.25,ea,877.07,526.24,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,745.51,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Aetna,Commerical,,,413.73,,413.73,1.15,455.77,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Aetna,Middlesex Employees,,,396.73,,396.73,1.15,455.77,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Anthem,Commerical,,,,,,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Anthem,Indemnity,,,401.67,,401.67,1.15,455.77,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Anthem,Individual Exchange,,,,,,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Anthem,State Preferred,,,,,,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Cigna,Cigna,,1.33,,,1.33,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Connecticare,Commerical,,2.47,,,2.47,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Connecticare,Exchange,,2.47,,,2.47,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,Multiplan,Multiplan,,,455.77,,455.77,1.15,455.77,percent of total billed charges,,
TOPOTECAN 4 MG INTRAVENOUS SOLUTION,J9351,HCPCS,50742-404-01,NDC,both,0.25,ea,536.2,321.72,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,455.77,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Commerical,,,64.25,,64.25,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Middlesex Employees,,,61.61,,61.61,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Commerical,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Indemnity,,,62.38,,62.38,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Individual Exchange,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Anthem,State Preferred,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Cigna,Cigna,,1.33,,,1.33,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Commerical,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Exchange,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,Multiplan,Multiplan,,,70.78,,70.78,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0409-0302-01,NDC,both,0.1,mL,83.27,49.96,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Commerical,,,64.25,,64.25,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Aetna,Middlesex Employees,,,61.61,,61.61,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Commerical,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Indemnity,,,62.38,,62.38,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Anthem,Individual Exchange,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Anthem,State Preferred,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Cigna,Cigna,,1.33,,,1.33,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Commerical,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Connecticare,Exchange,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,Multiplan,Multiplan,,,70.78,,70.78,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,0703-4714-01,NDC,both,0.1,mL,83.27,49.96,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Aetna,Commerical,,,64.25,,64.25,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Aetna,Middlesex Employees,,,61.61,,61.61,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Anthem,Commerical,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Anthem,Indemnity,,,62.38,,62.38,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Anthem,Individual Exchange,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Anthem,State Preferred,,,,,,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Cigna,Cigna,,1.33,,,1.33,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Connecticare,Commerical,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Connecticare,Exchange,,2.47,,,2.47,1.15,70.78,Other,Could be inpatient or outpatient,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,Multiplan,Multiplan,,,70.78,,70.78,1.15,70.78,percent of total billed charges,,
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,J9351,HCPCS,16729-243-31,NDC,both,0.1,mL,83.27,49.96,United Healthcare/Oxford,United Healthcare/Oxford,,1.15,,,1.15,1.15,70.78,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
TORSEMIDE 100 MG TABLET,J3490,HCPCS,31722-532-01,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Aetna,Commerical,,,0.9,,0.9,0.87,0.99,percent of total billed charges,,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,0.99,percent of total billed charges,,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Anthem,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Anthem,Indemnity,,,0.88,,0.88,0.87,0.99,percent of total billed charges,,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Anthem,Individual Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Anthem,State Preferred,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Cigna,Cigna,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Connecticare,Commerical,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Connecticare,Exchange,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,Multiplan,Multiplan,,,0.99,,0.99,0.87,0.99,percent of total billed charges,,
TORSEMIDE 20 MG TABLET,J3490,HCPCS,50268-756-11,NDC,both,1,ea,1.17,0.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,0.99,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Aetna,Commerical,,,0.69,,0.69,0.67,0.77,percent of total billed charges,,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Aetna,Middlesex Employees,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Anthem,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Anthem,Indemnity,,,0.67,,0.67,0.67,0.77,percent of total billed charges,,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Anthem,Individual Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Anthem,State Preferred,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Cigna,Cigna,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Connecticare,Commerical,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Connecticare,Exchange,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,Multiplan,Multiplan,,,0.77,,0.77,0.67,0.77,percent of total billed charges,,
TORSEMIDE 50 MG (SPLIT TABLET),J3490,HCPCS,40810-0018-51,NDC,both,1,ea,0.9,0.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.67,0.77,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Aetna,Commerical,,,9522.96,,9522.96,433.54,10490.56,percent of total billed charges,,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Aetna,Middlesex Employees,,,9131.73,,9131.73,433.54,10490.56,percent of total billed charges,,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Anthem,Commerical,,,,,,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Anthem,Indemnity,,,9245.27,,9245.27,433.54,10490.56,percent of total billed charges,,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Anthem,Individual Exchange,,,,,,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Anthem,State Preferred,,,,,,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Cigna,Cigna,,501.06,,,501.06,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Connecticare,Commerical,,554.03,,,554.03,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Connecticare,Exchange,,554.03,,,554.03,433.54,10490.56,Other,Could be inpatient or outpatient,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,Multiplan,Multiplan,,,10490.56,,10490.56,433.54,10490.56,percent of total billed charges,,
TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,J9352,HCPCS,59676-610-01,NDC,both,0.1,ea,12341.84,7405.1,United Healthcare/Oxford,United Healthcare/Oxford,,433.54,,,433.54,433.54,10490.56,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Aetna,Commerical,,,36.94,,36.94,35.43,40.7,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Aetna,Middlesex Employees,,,35.43,,35.43,35.43,40.7,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Anthem,Commerical,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Anthem,Indemnity,,,35.87,,35.87,35.43,40.7,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Anthem,Individual Exchange,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Anthem,State Preferred,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Cigna,Cigna,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Connecticare,Commerical,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Connecticare,Exchange,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,Multiplan,Multiplan,,,40.7,,40.7,35.43,40.7,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8201-25,NDC,both,1,mL,47.88,28.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,35.43,40.7,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Aetna,Commerical,,,369.4,,369.4,354.23,406.94,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Aetna,Middlesex Employees,,,354.23,,354.23,354.23,406.94,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Anthem,Commerical,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Anthem,Indemnity,,,358.63,,358.63,354.23,406.94,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Anthem,Individual Exchange,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Anthem,State Preferred,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Cigna,Cigna,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Connecticare,Commerical,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Connecticare,Exchange,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,Multiplan,Multiplan,,,406.94,,406.94,354.23,406.94,percent of total billed charges,,
TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60 MCG-5MG/ML IV SOLN,J3490,HCPCS,0517-8210-25,NDC,both,1,mL,478.75,287.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.23,406.94,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Aetna,Commerical,,,60.43,,60.43,57.95,66.57,percent of total billed charges,,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Aetna,Middlesex Employees,,,57.95,,57.95,57.95,66.57,percent of total billed charges,,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Anthem,Commerical,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Anthem,Indemnity,,,58.67,,58.67,57.95,66.57,percent of total billed charges,,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Anthem,Individual Exchange,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Anthem,State Preferred,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Cigna,Cigna,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Connecticare,Commerical,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Connecticare,Exchange,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,Multiplan,Multiplan,,,66.57,,66.57,57.95,66.57,percent of total billed charges,,
TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,J3490,HCPCS,0517-9305-25,NDC,both,1,mL,78.32,46.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.95,66.57,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Aetna,Commerical,,,0.17,,0.17,0.16,0.19,percent of total billed charges,,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Aetna,Middlesex Employees,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Anthem,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Anthem,Indemnity,,,0.16,,0.16,0.16,0.19,percent of total billed charges,,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Anthem,Individual Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Anthem,State Preferred,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Cigna,Cigna,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Connecticare,Commerical,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Connecticare,Exchange,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,Multiplan,Multiplan,,,0.19,,0.19,0.16,0.19,percent of total billed charges,,
TRAMADOL 25 MG ORAL TAB,J3490,HCPCS,40810-0003-04,NDC,both,1,ea,0.22,0.13,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.16,0.19,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,15.59,17.91,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,15.59,17.91,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Anthem,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,15.59,17.91,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Anthem,State Preferred,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Cigna,Cigna,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Connecticare,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Connecticare,Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,15.59,17.91,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-05,NDC,both,1,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Aetna,Commerical,,,8.13,,8.13,7.8,8.96,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Aetna,Middlesex Employees,,,7.8,,7.8,7.8,8.96,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Anthem,Commerical,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Anthem,Indemnity,,,7.9,,7.9,7.8,8.96,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Anthem,Individual Exchange,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Anthem,State Preferred,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Cigna,Cigna,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Connecticare,Commerical,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Connecticare,Exchange,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,Multiplan,Multiplan,,,8.96,,8.96,7.8,8.96,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-71,NDC,both,1,mL,10.54,6.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.8,8.96,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
TRAMADOL 5 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-72,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-6365-61,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
TRAMADOL 50 MG TABLET,J3490,HCPCS,0904-7179-61,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Aetna,Commerical,,,1.63,,1.63,1.56,1.79,percent of total billed charges,,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Aetna,Middlesex Employees,,,1.56,,1.56,1.56,1.79,percent of total billed charges,,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Anthem,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Anthem,Indemnity,,,1.58,,1.58,1.56,1.79,percent of total billed charges,,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Anthem,Individual Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Anthem,State Preferred,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Cigna,Cigna,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Connecticare,Commerical,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Connecticare,Exchange,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,Multiplan,Multiplan,,,1.79,,1.79,1.56,1.79,percent of total billed charges,,
TRAMADOL 50 MG/10 ML ORAL SUSP SYRINGE,J3490,HCPCS,40810-0018-11,NDC,both,10,mL,2.11,1.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.56,1.79,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Aetna,Commerical,,,392.46,,392.46,376.34,432.34,percent of total billed charges,,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Aetna,Middlesex Employees,,,376.34,,376.34,376.34,432.34,percent of total billed charges,,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Anthem,Commerical,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Anthem,Indemnity,,,381.01,,381.01,376.34,432.34,percent of total billed charges,,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Anthem,Individual Exchange,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Anthem,State Preferred,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Cigna,Cigna,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Connecticare,Commerical,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Connecticare,Exchange,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,Multiplan,Multiplan,,,432.34,,432.34,376.34,432.34,percent of total billed charges,,
TRAMETINIB 0.5 MG TABLET,J3490,HCPCS,0078-0666-15,NDC,both,1,ea,508.63,305.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,376.34,432.34,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Aetna,Commerical,,,1335.74,,1335.74,1280.86,1471.46,percent of total billed charges,,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Aetna,Middlesex Employees,,,1280.86,,1280.86,1280.86,1471.46,percent of total billed charges,,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Anthem,Commerical,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Anthem,Indemnity,,,1296.79,,1296.79,1280.86,1471.46,percent of total billed charges,,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Anthem,Individual Exchange,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Anthem,State Preferred,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Cigna,Cigna,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Connecticare,Commerical,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Connecticare,Exchange,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,Multiplan,Multiplan,,,1471.46,,1471.46,1280.86,1471.46,percent of total billed charges,,
TRAMETINIB 2 MG TABLET,J3490,HCPCS,0078-0668-15,NDC,both,1,ea,1731.13,1038.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1280.86,1471.46,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) FOR NEBULIZATION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRANASAL SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-31,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,23155-166-41,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,39822-1000-1,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,40810-0011-94,NDC,both,50,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,47781-601-91,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,55150-188-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,63323-563-97,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,67850-041-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-611-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-00,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",J3490,HCPCS,81284-612-10,NDC,both,1,mL,8.43,5.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Aetna,Commerical,,,25.72,,25.72,24.66,28.33,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Aetna,Middlesex Employees,,,24.66,,24.66,24.66,28.33,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Anthem,Commerical,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Anthem,Indemnity,,,24.97,,24.97,24.66,28.33,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Anthem,Individual Exchange,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Anthem,State Preferred,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Cigna,Cigna,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Connecticare,Commerical,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Connecticare,Exchange,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,Multiplan,Multiplan,,,28.33,,28.33,24.66,28.33,percent of total billed charges,,
"TRANEXAMIC ACID 1,000 MG/100 ML (10 MG/ML) IN SODIUM CHLORIDE FOR POSTPARTUM HEMMORRHAGE",J3490,HCPCS,51754-0108-3,NDC,both,1,mL,33.33,20,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,24.66,28.33,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,63323-563-97,NDC,both,1,mL,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-00,NDC,both,1,mL,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-611-10,NDC,both,1,mL,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-00,NDC,both,1,mL,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Aetna,Commerical,,,6.5,,6.5,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Aetna,Middlesex Employees,,,6.24,,6.24,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Anthem,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Anthem,Indemnity,,,6.31,,6.31,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Anthem,Individual Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Anthem,State Preferred,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Cigna,Cigna,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Connecticare,Commerical,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Connecticare,Exchange,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,Multiplan,Multiplan,,,7.17,,7.17,6.24,7.17,percent of total billed charges,,
TRANEXAMIC ACID 100 MG/ML BOLUS,J3490,HCPCS,81284-612-10,NDC,both,1,mL,46.13,27.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.24,7.17,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Aetna,Commerical,,,66.5,,66.5,63.76,73.25,percent of total billed charges,,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Aetna,Middlesex Employees,,,63.76,,63.76,63.76,73.25,percent of total billed charges,,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Anthem,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Anthem,Indemnity,,,64.56,,64.56,63.76,73.25,percent of total billed charges,,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Anthem,Individual Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Anthem,State Preferred,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Cigna,Cigna,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Connecticare,Commerical,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Connecticare,Exchange,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,Multiplan,Multiplan,,,73.25,,73.25,63.76,73.25,percent of total billed charges,,
TRANEXAMIC ACID 50 MG/ML (5 %) FOR ORAL TOPICAL USE SOLUTION,J3490,HCPCS,40810-208-68,NDC,both,1,mL,86.18,51.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,63.76,73.25,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,0904-6869-61,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
TRAZODONE 100 MG TABLET,J3490,HCPCS,60687-454-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
TRAZODONE 12.5 MG ORAL TAB,J3490,HCPCS,40810-0003-07,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
TRAZODONE 25 MG ORAL TAB,J3490,HCPCS,40810-0003-06,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,0904-6868-61,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,50111-560-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
TRAZODONE 50 MG TABLET,J3490,HCPCS,60687-443-01,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Aetna,Commerical,,,4562.58,,4562.58,62.69,5026.17,percent of total billed charges,,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Aetna,Middlesex Employees,,,4375.13,,4375.13,62.69,5026.17,percent of total billed charges,,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Anthem,Commerical,,,,,,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Anthem,Indemnity,,,4429.53,,4429.53,62.69,5026.17,percent of total billed charges,,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Anthem,Individual Exchange,,,,,,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Anthem,State Preferred,,,,,,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Cigna,Cigna,,62.69,,,62.69,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Connecticare,Commerical,,85.23,,,85.23,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Connecticare,Exchange,,85.23,,,85.23,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,Multiplan,Multiplan,,,5026.17,,5026.17,62.69,5026.17,percent of total billed charges,,
TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-101-01,NDC,both,1,mL,5913.14,3547.88,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,5026.17,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Aetna,Commerical,,,45625.77,,45625.77,62.69,50261.66,percent of total billed charges,,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Aetna,Middlesex Employees,,,43751.3,,43751.3,62.69,50261.66,percent of total billed charges,,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Anthem,Commerical,,,,,,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Anthem,Indemnity,,,44295.31,,44295.31,62.69,50261.66,percent of total billed charges,,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Anthem,Individual Exchange,,,,,,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Anthem,State Preferred,,,,,,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Cigna,Cigna,,62.69,,,62.69,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Connecticare,Commerical,,85.23,,,85.23,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Connecticare,Exchange,,85.23,,,85.23,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,Multiplan,Multiplan,,,50261.66,,50261.66,62.69,50261.66,percent of total billed charges,,
TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-110-01,NDC,both,0.1,mL,59131.37,35478.82,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,50261.66,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Aetna,Commerical,,,3191.24,,3191.24,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Aetna,Middlesex Employees,,,3060.13,,3060.13,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Commerical,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Indemnity,,,3098.18,,3098.18,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Individual Exchange,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,State Preferred,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Cigna,Cigna,,62.69,,,62.69,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Connecticare,Commerical,,85.23,,,85.23,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Connecticare,Exchange,,85.23,,,85.23,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,Multiplan,Multiplan,,,3515.49,,3515.49,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0676-01,NDC,both,0.4,mL,4135.87,2481.52,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Aetna,Commerical,,,3191.24,,3191.24,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Aetna,Middlesex Employees,,,3060.13,,3060.13,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Commerical,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Indemnity,,,3098.18,,3098.18,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,Individual Exchange,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Anthem,State Preferred,,,,,,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Cigna,Cigna,,62.69,,,62.69,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Connecticare,Commerical,,85.23,,,85.23,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Connecticare,Exchange,,85.23,,,85.23,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,Multiplan,Multiplan,,,3515.49,,3515.49,62.69,3515.49,percent of total billed charges,,
TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-102-01,NDC,both,0.4,mL,4135.87,2481.52,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,3515.49,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Commerical,,,6382.41,,6382.41,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Middlesex Employees,,,6120.2,,6120.2,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Commerical,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Indemnity,,,6196.3,,6196.3,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Individual Exchange,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Anthem,State Preferred,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Cigna,Cigna,,62.69,,,62.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Commerical,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Exchange,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,Multiplan,Multiplan,,,7030.91,,7030.91,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0703-0686-01,NDC,both,0.2,mL,8271.66,4963,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Aetna,Commerical,,,6382.41,,6382.41,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Aetna,Middlesex Employees,,,6120.2,,6120.2,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Anthem,Commerical,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Anthem,Indemnity,,,6196.3,,6196.3,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Anthem,Individual Exchange,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Anthem,State Preferred,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Cigna,Cigna,,62.69,,,62.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Connecticare,Commerical,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Connecticare,Exchange,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,Multiplan,Multiplan,,,7030.91,,7030.91,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,0781-3427-80,NDC,both,0.2,mL,8271.66,4963,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Commerical,,,6382.41,,6382.41,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Middlesex Employees,,,6120.2,,6120.2,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Commerical,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Indemnity,,,6196.3,,6196.3,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Individual Exchange,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Anthem,State Preferred,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Cigna,Cigna,,62.69,,,62.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Commerical,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Exchange,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,Multiplan,Multiplan,,,7030.91,,7030.91,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,42023-208-01,NDC,both,0.2,mL,8271.66,4963,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Commerical,,,6382.41,,6382.41,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Aetna,Middlesex Employees,,,6120.2,,6120.2,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Commerical,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Indemnity,,,6196.3,,6196.3,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Anthem,Individual Exchange,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Anthem,State Preferred,,,,,,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Cigna,Cigna,,62.69,,,62.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Commerical,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Connecticare,Exchange,,85.23,,,85.23,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,Multiplan,Multiplan,,,7030.91,,7030.91,62.69,7030.91,percent of total billed charges,,
TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,J3285,HCPCS,66302-105-01,NDC,both,0.2,mL,8271.66,4963,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,7030.91,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Aetna,Commerical,,,10.27,,10.27,9.85,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Aetna,Middlesex Employees,,,9.85,,9.85,9.85,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Anthem,Commerical,,,,,,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Anthem,Indemnity,,,9.97,,9.97,9.85,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Anthem,Individual Exchange,,,,,,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Anthem,State Preferred,,,,,,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Cigna,Cigna,,62.69,,,62.69,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Connecticare,Commerical,,85.23,,,85.23,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Connecticare,Exchange,,85.23,,,85.23,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,Multiplan,Multiplan,,,11.31,,11.31,9.85,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.005 MG/ML,J3285,HCPCS,40810-0203-37,NDC,both,1,mL,13.31,7.99,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,9.85,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Aetna,Commerical,,,20.54,,20.54,19.7,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Aetna,Middlesex Employees,,,19.7,,19.7,19.7,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Anthem,Commerical,,,,,,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Anthem,Indemnity,,,19.94,,19.94,19.7,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Anthem,Individual Exchange,,,,,,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Anthem,State Preferred,,,,,,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Cigna,Cigna,,62.69,,,62.69,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Connecticare,Commerical,,85.23,,,85.23,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Connecticare,Exchange,,85.23,,,85.23,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,Multiplan,Multiplan,,,22.63,,22.63,19.7,85.23,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 0.01 MG/ML,J3285,HCPCS,40810-0203-38,NDC,both,1,mL,26.62,15.97,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,19.7,85.23,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Aetna,Commerical,,,684.39,,684.39,62.69,753.93,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Aetna,Middlesex Employees,,,656.28,,656.28,62.69,753.93,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Anthem,Commerical,,,,,,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Anthem,Indemnity,,,664.44,,664.44,62.69,753.93,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Anthem,Individual Exchange,,,,,,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Anthem,State Preferred,,,,,,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Cigna,Cigna,,62.69,,,62.69,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Connecticare,Commerical,,85.23,,,85.23,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Connecticare,Exchange,,85.23,,,85.23,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,Multiplan,Multiplan,,,753.93,,753.93,62.69,753.93,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 1 MG/ML,J3285,HCPCS,40810-0203-39,NDC,both,1,mL,886.98,532.19,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,753.93,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Aetna,Commerical,,,6843.87,,6843.87,62.69,7539.25,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Aetna,Middlesex Employees,,,6562.7,,6562.7,62.69,7539.25,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Anthem,Commerical,,,,,,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Anthem,Indemnity,,,6644.3,,6644.3,62.69,7539.25,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Anthem,Individual Exchange,,,,,,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Anthem,State Preferred,,,,,,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Cigna,Cigna,,62.69,,,62.69,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Connecticare,Commerical,,85.23,,,85.23,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Connecticare,Exchange,,85.23,,,85.23,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,Multiplan,Multiplan,,,7539.25,,7539.25,62.69,7539.25,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 10 MG/ML,J3285,HCPCS,40810-0203-43,NDC,both,1,mL,8869.71,5321.83,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,7539.25,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Aetna,Commerical,,,1825.04,,1825.04,62.69,2010.48,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Aetna,Middlesex Employees,,,1750.06,,1750.06,62.69,2010.48,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Anthem,Commerical,,,,,,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Anthem,Indemnity,,,1771.82,,1771.82,62.69,2010.48,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Anthem,Individual Exchange,,,,,,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Anthem,State Preferred,,,,,,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Cigna,Cigna,,62.69,,,62.69,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Connecticare,Commerical,,85.23,,,85.23,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Connecticare,Exchange,,85.23,,,85.23,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,Multiplan,Multiplan,,,2010.48,,2010.48,62.69,2010.48,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 2.5 MG/ML,J3285,HCPCS,40810-0203-40,NDC,both,0.4,mL,2365.27,1419.16,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,2010.48,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Aetna,Commerical,,,3421.94,,3421.94,62.69,3769.63,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Aetna,Middlesex Employees,,,3281.35,,3281.35,62.69,3769.63,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Anthem,Commerical,,,,,,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Anthem,Indemnity,,,3322.15,,3322.15,62.69,3769.63,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Anthem,Individual Exchange,,,,,,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Anthem,State Preferred,,,,,,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Cigna,Cigna,,62.69,,,62.69,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Connecticare,Commerical,,85.23,,,85.23,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Connecticare,Exchange,,85.23,,,85.23,62.69,3769.63,Other,Could be inpatient or outpatient,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,Multiplan,Multiplan,,,3769.63,,3769.63,62.69,3769.63,percent of total billed charges,,
TREPROSTINIL SUBCUTANEOUS INFUSION 5 MG/ML,J3285,HCPCS,40810-0203-42,NDC,both,1,mL,4434.86,2660.92,United Healthcare/Oxford,United Healthcare/Oxford,,67.69,,,67.69,62.69,3769.63,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Aetna,Commerical,,,75.51,,75.51,72.41,83.18,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Aetna,Middlesex Employees,,,72.41,,72.41,72.41,83.18,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Indemnity,,,73.31,,73.31,72.41,83.18,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Individual Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,State Preferred,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Cigna,Cigna,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Connecticare,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Connecticare,Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Multiplan,Multiplan,,,83.18,,83.18,72.41,83.18,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Aetna,Commerical,,,63.59,,63.59,60.98,70.05,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Aetna,Middlesex Employees,,,60.98,,60.98,60.98,70.05,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Commerical,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Indemnity,,,61.73,,61.73,60.98,70.05,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Individual Exchange,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,State Preferred,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Cigna,Cigna,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Connecticare,Commerical,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Connecticare,Exchange,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Multiplan,Multiplan,,,70.05,,70.05,60.98,70.05,percent of total billed charges,,
TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Aetna,Commerical,,,74.06,,74.06,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Aetna,Middlesex Employees,,,71.02,,71.02,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Anthem,Commerical,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Anthem,Indemnity,,,71.9,,71.9,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Anthem,Individual Exchange,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Anthem,State Preferred,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Cigna,Cigna,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Connecticare,Commerical,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Connecticare,Exchange,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,Multiplan,Multiplan,,,81.58,,81.58,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,0574-2205-20,NDC,both,1,gm,95.98,57.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Aetna,Commerical,,,74.06,,74.06,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Aetna,Middlesex Employees,,,71.02,,71.02,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Anthem,Commerical,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Anthem,Indemnity,,,71.9,,71.9,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Anthem,Individual Exchange,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Anthem,State Preferred,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Cigna,Cigna,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Connecticare,Commerical,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Connecticare,Exchange,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,Multiplan,Multiplan,,,81.58,,81.58,71.02,81.58,percent of total billed charges,,
TRETINOIN 0.05 % TOPICAL CREAM,J8999,HCPCS,51672-1394-0,NDC,both,1,gm,95.98,57.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,71.02,81.58,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Aetna,Commerical,,,75.51,,75.51,72.41,83.18,percent of total billed charges,,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Aetna,Middlesex Employees,,,72.41,,72.41,72.41,83.18,percent of total billed charges,,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Anthem,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Anthem,Indemnity,,,73.31,,73.31,72.41,83.18,percent of total billed charges,,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Anthem,Individual Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Anthem,State Preferred,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Cigna,Cigna,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Connecticare,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Connecticare,Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,Multiplan,Multiplan,,,83.18,,83.18,72.41,83.18,percent of total billed charges,,
TRETINOIN 1 MG/ML DISSOLVED CAPSULE CHEMO,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,99.14,59.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Aetna,Commerical,,,75.51,,75.51,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Aetna,Middlesex Employees,,,72.41,,72.41,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Indemnity,,,73.31,,73.31,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,Individual Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Anthem,State Preferred,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Cigna,Cigna,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Connecticare,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Connecticare,Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,Multiplan,Multiplan,,,83.18,,83.18,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,0555-0808-02,NDC,both,1,ea,97.86,58.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Aetna,Commerical,,,63.59,,63.59,60.98,70.05,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Aetna,Middlesex Employees,,,60.98,,60.98,60.98,70.05,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Commerical,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Indemnity,,,61.73,,61.73,60.98,70.05,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,Individual Exchange,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Anthem,State Preferred,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Cigna,Cigna,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Connecticare,Commerical,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Connecticare,Exchange,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,Multiplan,Multiplan,,,70.05,,70.05,60.98,70.05,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,10370-268-01,NDC,both,1,ea,82.41,49.45,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.98,70.05,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Aetna,Commerical,,,75.51,,75.51,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Aetna,Middlesex Employees,,,72.41,,72.41,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Anthem,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Anthem,Indemnity,,,73.31,,73.31,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Anthem,Individual Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Anthem,State Preferred,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Cigna,Cigna,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Connecticare,Commerical,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Connecticare,Exchange,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,Multiplan,Multiplan,,,83.18,,83.18,72.41,83.18,percent of total billed charges,,
TRETINOIN 10 MG CAPSULE NO CO-SIGN,J8999,HCPCS,68462-792-01,NDC,both,1,ea,97.86,58.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,72.41,83.18,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Aetna,Commerical,,,458.21,,458.21,6.52,504.77,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Aetna,Middlesex Employees,,,439.39,,439.39,6.52,504.77,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Anthem,Commerical,,,,,,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Anthem,Indemnity,,,444.85,,444.85,6.52,504.77,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Anthem,Individual Exchange,,,,,,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Anthem,State Preferred,,,,,,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Cigna,Cigna,,27.2,,,27.2,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Connecticare,Commerical,,6.52,,,6.52,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Connecticare,Exchange,,6.52,,,6.52,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,Multiplan,Multiplan,,,504.77,,504.77,6.52,504.77,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,J3300,HCPCS,0065-0543-01,NDC,both,0.025,mL,593.85,356.31,United Healthcare/Oxford,United Healthcare/Oxford,,34.55,,,34.55,6.52,504.77,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Anthem,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Anthem,Individual Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Anthem,State Preferred,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Cigna,Cigna,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Connecticare,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Connecticare,Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-15,NDC,both,1,gm,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Aetna,Commerical,,,32.86,,32.86,31.51,36.2,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Aetna,Middlesex Employees,,,31.51,,31.51,31.51,36.2,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Anthem,Commerical,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Anthem,Indemnity,,,31.9,,31.9,31.51,36.2,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Anthem,Individual Exchange,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Anthem,State Preferred,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Cigna,Cigna,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Connecticare,Commerical,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Connecticare,Exchange,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,Multiplan,Multiplan,,,36.2,,36.2,31.51,36.2,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,0168-0003-80,NDC,both,1,gm,42.59,25.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.51,36.2,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Aetna,Commerical,,,6.17,,6.17,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Aetna,Middlesex Employees,,,5.91,,5.91,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Anthem,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Anthem,Indemnity,,,5.99,,5.99,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Anthem,Individual Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Anthem,State Preferred,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Cigna,Cigna,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Connecticare,Commerical,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Connecticare,Exchange,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,Multiplan,Multiplan,,,6.79,,6.79,5.91,6.79,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,33342-327-15,NDC,both,1,gm,7.99,4.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.91,6.79,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Aetna,Commerical,,,10.64,,10.64,10.2,11.72,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Aetna,Middlesex Employees,,,10.2,,10.2,10.2,11.72,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Anthem,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Anthem,Indemnity,,,10.33,,10.33,10.2,11.72,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Anthem,Individual Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Anthem,State Preferred,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Cigna,Cigna,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Connecticare,Commerical,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Connecticare,Exchange,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,Multiplan,Multiplan,,,11.72,,11.72,10.2,11.72,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,J3490,HCPCS,45802-063-35,NDC,both,1,gm,13.79,8.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.2,11.72,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Aetna,Commerical,,,8.47,,8.47,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Aetna,Middlesex Employees,,,8.12,,8.12,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Anthem,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Anthem,Indemnity,,,8.23,,8.23,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Anthem,Individual Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Anthem,State Preferred,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Cigna,Cigna,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Connecticare,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Connecticare,Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,Multiplan,Multiplan,,,9.33,,9.33,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,0713-0229-15,NDC,both,1,gm,10.98,6.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Aetna,Commerical,,,8.47,,8.47,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Aetna,Middlesex Employees,,,8.12,,8.12,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Anthem,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Anthem,Indemnity,,,8.23,,8.23,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Anthem,Individual Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Anthem,State Preferred,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Cigna,Cigna,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Connecticare,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Connecticare,Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,Multiplan,Multiplan,,,9.33,,9.33,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,33342-331-15,NDC,both,1,gm,10.98,6.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Aetna,Commerical,,,8.47,,8.47,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Aetna,Middlesex Employees,,,8.12,,8.12,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Anthem,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Anthem,Indemnity,,,8.23,,8.23,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Anthem,Individual Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Anthem,State Preferred,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Cigna,Cigna,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Connecticare,Commerical,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Connecticare,Exchange,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,Multiplan,Multiplan,,,9.33,,9.33,8.12,9.33,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,J3490,HCPCS,45802-054-35,NDC,both,1,gm,10.98,6.59,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.12,9.33,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Aetna,Commerical,,,183.38,,183.38,175.84,202.01,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Aetna,Middlesex Employees,,,175.84,,175.84,175.84,202.01,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Anthem,Commerical,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Anthem,Indemnity,,,178.03,,178.03,175.84,202.01,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Anthem,Individual Exchange,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Anthem,State Preferred,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Cigna,Cigna,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Connecticare,Commerical,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Connecticare,Exchange,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,Multiplan,Multiplan,,,202.01,,202.01,175.84,202.01,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,J3490,HCPCS,0713-0655-40,NDC,both,1,gm,237.66,142.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,175.84,202.01,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Aetna,Commerical,,,8.25,,8.25,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Aetna,Middlesex Employees,,,7.91,,7.91,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Anthem,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Anthem,Indemnity,,,8.01,,8.01,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Anthem,Individual Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Anthem,State Preferred,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Cigna,Cigna,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Connecticare,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Connecticare,Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,Multiplan,Multiplan,,,9.09,,9.09,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-15,NDC,both,1,gm,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Aetna,Commerical,,,249.56,,249.56,239.31,274.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Aetna,Middlesex Employees,,,239.31,,239.31,239.31,274.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Anthem,Commerical,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Anthem,Indemnity,,,242.28,,242.28,239.31,274.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Anthem,Individual Exchange,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Anthem,State Preferred,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Cigna,Cigna,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Connecticare,Commerical,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Connecticare,Exchange,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,Multiplan,Multiplan,,,274.92,,274.92,239.31,274.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,0168-0004-16,NDC,both,1,gm,323.43,194.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,239.31,274.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Aetna,Commerical,,,8.25,,8.25,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Aetna,Middlesex Employees,,,7.91,,7.91,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Anthem,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Anthem,Indemnity,,,8.01,,8.01,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Anthem,Individual Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Anthem,State Preferred,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Cigna,Cigna,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Connecticare,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Connecticare,Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,Multiplan,Multiplan,,,9.09,,9.09,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,45802-064-35,NDC,both,1,gm,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Aetna,Commerical,,,8.25,,8.25,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Aetna,Middlesex Employees,,,7.91,,7.91,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Anthem,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Anthem,Indemnity,,,8.01,,8.01,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Anthem,Individual Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Anthem,State Preferred,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Cigna,Cigna,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Connecticare,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Connecticare,Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,Multiplan,Multiplan,,,9.09,,9.09,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-1,NDC,both,1,gm,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Aetna,Commerical,,,16.5,,16.5,15.82,18.17,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Aetna,Middlesex Employees,,,15.82,,15.82,15.82,18.17,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Anthem,Commerical,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Anthem,Indemnity,,,16.02,,16.02,15.82,18.17,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Anthem,Individual Exchange,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Anthem,State Preferred,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Cigna,Cigna,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Connecticare,Commerical,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Connecticare,Exchange,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,Multiplan,Multiplan,,,18.17,,18.17,15.82,18.17,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,51672-1282-2,NDC,both,1,gm,21.38,12.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.82,18.17,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Aetna,Commerical,,,8.25,,8.25,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Aetna,Middlesex Employees,,,7.91,,7.91,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Anthem,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Anthem,Indemnity,,,8.01,,8.01,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Anthem,Individual Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Anthem,State Preferred,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Cigna,Cigna,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Connecticare,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Connecticare,Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,Multiplan,Multiplan,,,9.09,,9.09,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,52565-056-15,NDC,both,1,gm,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Aetna,Commerical,,,8.25,,8.25,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Aetna,Middlesex Employees,,,7.91,,7.91,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Anthem,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Anthem,Indemnity,,,8.01,,8.01,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Anthem,Individual Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Anthem,State Preferred,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Cigna,Cigna,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Connecticare,Commerical,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Connecticare,Exchange,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,Multiplan,Multiplan,,,9.09,,9.09,7.91,9.09,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,J3490,HCPCS,67877-251-15,NDC,both,1,gm,10.69,6.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.91,9.09,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,0168-0006-15,NDC,both,1,gm,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,33342-333-15,NDC,both,1,gm,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,45802-055-35,NDC,both,1,gm,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Aetna,Commerical,,,12.64,,12.64,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Aetna,Middlesex Employees,,,12.12,,12.12,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Anthem,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Anthem,Indemnity,,,12.27,,12.27,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Anthem,Individual Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Anthem,State Preferred,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Cigna,Cigna,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Connecticare,Commerical,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Connecticare,Exchange,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,Multiplan,Multiplan,,,13.92,,13.92,12.12,13.92,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,J3490,HCPCS,51672-1284-1,NDC,both,1,gm,16.38,9.83,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.12,13.92,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Aetna,Commerical,,,12.19,,12.19,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Aetna,Middlesex Employees,,,11.69,,11.69,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Anthem,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Anthem,Indemnity,,,11.84,,11.84,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Anthem,Individual Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Anthem,State Preferred,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Cigna,Cigna,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Connecticare,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Connecticare,Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,Multiplan,Multiplan,,,13.43,,13.43,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,0168-0002-15,NDC,both,1,gm,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Aetna,Commerical,,,12.19,,12.19,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Aetna,Middlesex Employees,,,11.69,,11.69,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Anthem,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Anthem,Indemnity,,,11.84,,11.84,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Anthem,Individual Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Anthem,State Preferred,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Cigna,Cigna,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Connecticare,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Connecticare,Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,Multiplan,Multiplan,,,13.43,,13.43,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,33342-328-15,NDC,both,1,gm,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Aetna,Commerical,,,12.19,,12.19,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Aetna,Middlesex Employees,,,11.69,,11.69,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Anthem,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Anthem,Indemnity,,,11.84,,11.84,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Anthem,Individual Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Anthem,State Preferred,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Cigna,Cigna,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Connecticare,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Connecticare,Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,Multiplan,Multiplan,,,13.43,,13.43,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,45802-065-35,NDC,both,1,gm,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Aetna,Commerical,,,12.19,,12.19,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Aetna,Middlesex Employees,,,11.69,,11.69,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Anthem,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Anthem,Indemnity,,,11.84,,11.84,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Anthem,Individual Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Anthem,State Preferred,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Cigna,Cigna,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Connecticare,Commerical,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Connecticare,Exchange,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,Multiplan,Multiplan,,,13.43,,13.43,11.69,13.43,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,J3490,HCPCS,67877-318-15,NDC,both,1,gm,15.8,9.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.69,13.43,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Aetna,Commerical,,,12.06,,12.06,11.56,13.29,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Aetna,Middlesex Employees,,,11.56,,11.56,11.56,13.29,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Anthem,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Anthem,Indemnity,,,11.71,,11.71,11.56,13.29,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Anthem,Individual Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Anthem,State Preferred,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Cigna,Cigna,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Connecticare,Commerical,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Connecticare,Exchange,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,Multiplan,Multiplan,,,13.29,,13.29,11.56,13.29,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,J3490,HCPCS,45802-049-35,NDC,both,1,gm,15.63,9.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.56,13.29,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Aetna,Commerical,,,31.71,,31.71,1.16,34.94,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Aetna,Middlesex Employees,,,30.41,,30.41,1.16,34.94,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Anthem,Commerical,,,,,,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Anthem,Indemnity,,,30.79,,30.79,1.16,34.94,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Anthem,Individual Exchange,,,,,,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Anthem,State Preferred,,,,,,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Cigna,Cigna,,1.16,,,1.16,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Connecticare,Commerical,,1.38,,,1.38,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Connecticare,Exchange,,1.38,,,1.38,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,Multiplan,Multiplan,,,34.94,,34.94,1.16,34.94,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0494-20,NDC,both,1,mL,41.1,24.66,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,34.94,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Aetna,Commerical,,,10.92,,10.92,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Aetna,Middlesex Employees,,,10.47,,10.47,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Anthem,Commerical,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Anthem,Indemnity,,,10.6,,10.6,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Anthem,Individual Exchange,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Anthem,State Preferred,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Cigna,Cigna,,1.16,,,1.16,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Connecticare,Commerical,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Connecticare,Exchange,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,Multiplan,Multiplan,,,12.03,,12.03,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-05,NDC,both,0.25,mL,14.15,8.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Aetna,Commerical,,,54.59,,54.59,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Aetna,Middlesex Employees,,,52.35,,52.35,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Anthem,Commerical,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Anthem,Indemnity,,,53,,53,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Anthem,Individual Exchange,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Anthem,State Preferred,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Cigna,Cigna,,1.16,,,1.16,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Connecticare,Commerical,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Connecticare,Exchange,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,Multiplan,Multiplan,,,60.14,,60.14,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-20,NDC,both,0.25,mL,70.75,42.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Aetna,Commerical,,,109.17,,109.17,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Aetna,Middlesex Employees,,,104.69,,104.69,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Anthem,Commerical,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Anthem,Indemnity,,,105.99,,105.99,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Anthem,Individual Exchange,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Anthem,State Preferred,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Cigna,Cigna,,1.16,,,1.16,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Connecticare,Commerical,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Connecticare,Exchange,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,Multiplan,Multiplan,,,120.27,,120.27,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0003-0293-28,NDC,both,0.25,mL,141.49,84.89,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Aetna,Commerical,,,10.92,,10.92,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Aetna,Middlesex Employees,,,10.47,,10.47,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Anthem,Commerical,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Anthem,Indemnity,,,10.6,,10.6,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Anthem,Individual Exchange,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Anthem,State Preferred,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Cigna,Cigna,,1.16,,,1.16,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Connecticare,Commerical,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Connecticare,Exchange,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,Multiplan,Multiplan,,,12.03,,12.03,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0241-01,NDC,both,0.25,mL,14.15,8.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Aetna,Commerical,,,54.59,,54.59,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Aetna,Middlesex Employees,,,52.35,,52.35,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Anthem,Commerical,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Anthem,Indemnity,,,53,,53,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Anthem,Individual Exchange,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Anthem,State Preferred,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Cigna,Cigna,,1.16,,,1.16,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Connecticare,Commerical,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Connecticare,Exchange,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,Multiplan,Multiplan,,,60.14,,60.14,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,0703-0243-01,NDC,both,0.25,mL,70.75,42.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Aetna,Commerical,,,10.92,,10.92,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Aetna,Middlesex Employees,,,10.47,,10.47,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Anthem,Commerical,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Anthem,Indemnity,,,10.6,,10.6,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Anthem,Individual Exchange,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Anthem,State Preferred,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Cigna,Cigna,,1.16,,,1.16,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Connecticare,Commerical,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Connecticare,Exchange,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,Multiplan,Multiplan,,,12.03,,12.03,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-1,NDC,both,0.25,mL,14.15,8.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Aetna,Commerical,,,10.92,,10.92,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Aetna,Middlesex Employees,,,10.47,,10.47,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Anthem,Commerical,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Anthem,Indemnity,,,10.6,,10.6,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Anthem,Individual Exchange,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Anthem,State Preferred,,,,,,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Cigna,Cigna,,1.16,,,1.16,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Connecticare,Commerical,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Connecticare,Exchange,,1.38,,,1.38,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,Multiplan,Multiplan,,,12.03,,12.03,1.16,12.03,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1049-2,NDC,both,0.25,mL,14.15,8.49,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,12.03,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Aetna,Commerical,,,54.59,,54.59,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Aetna,Middlesex Employees,,,52.35,,52.35,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Commerical,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Indemnity,,,53,,53,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Individual Exchange,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Anthem,State Preferred,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Cigna,Cigna,,1.16,,,1.16,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Connecticare,Commerical,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Connecticare,Exchange,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,Multiplan,Multiplan,,,60.14,,60.14,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1168-1,NDC,both,0.25,mL,70.75,42.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Aetna,Commerical,,,109.17,,109.17,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Aetna,Middlesex Employees,,,104.69,,104.69,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Commerical,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Indemnity,,,105.99,,105.99,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Individual Exchange,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Anthem,State Preferred,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Cigna,Cigna,,1.16,,,1.16,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Connecticare,Commerical,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Connecticare,Exchange,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,Multiplan,Multiplan,,,120.27,,120.27,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1169-1,NDC,both,0.25,mL,141.49,84.89,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Aetna,Commerical,,,54.59,,54.59,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Aetna,Middlesex Employees,,,52.35,,52.35,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Commerical,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Indemnity,,,53,,53,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Anthem,Individual Exchange,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Anthem,State Preferred,,,,,,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Cigna,Cigna,,1.16,,,1.16,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Connecticare,Commerical,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Connecticare,Exchange,,1.38,,,1.38,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,Multiplan,Multiplan,,,60.14,,60.14,1.16,60.14,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1652-1,NDC,both,0.25,mL,70.75,42.45,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,60.14,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Aetna,Commerical,,,109.17,,109.17,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Aetna,Middlesex Employees,,,104.69,,104.69,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Commerical,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Indemnity,,,105.99,,105.99,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Anthem,Individual Exchange,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Anthem,State Preferred,,,,,,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Cigna,Cigna,,1.16,,,1.16,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Connecticare,Commerical,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Connecticare,Exchange,,1.38,,,1.38,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,Multiplan,Multiplan,,,120.27,,120.27,1.16,120.27,percent of total billed charges,,
TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,J3301,HCPCS,70121-1653-1,NDC,both,0.25,mL,141.49,84.89,United Healthcare/Oxford,United Healthcare/Oxford,,1.26,,,1.26,1.16,120.27,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Aetna,Commerical,,,192.09,,192.09,2.77,211.61,percent of total billed charges,,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Aetna,Middlesex Employees,,,184.2,,184.2,2.77,211.61,percent of total billed charges,,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Anthem,Commerical,,,,,,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Anthem,Indemnity,,,186.49,,186.49,2.77,211.61,percent of total billed charges,,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Anthem,Individual Exchange,,,,,,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Anthem,State Preferred,,,,,,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Cigna,Cigna,,9.37,,,9.37,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Connecticare,Commerical,,2.77,,,2.77,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Connecticare,Exchange,,2.77,,,2.77,2.77,211.61,Other,Could be inpatient or outpatient,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,Multiplan,Multiplan,,,211.61,,211.61,2.77,211.61,percent of total billed charges,,
TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION,J3303,HCPCS,59137-570-01,NDC,both,0.25,mL,248.95,149.37,United Healthcare/Oxford,United Healthcare/Oxford,,11.9,,,11.9,2.77,211.61,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Aetna,Commerical,,,137.24,,137.24,131.61,151.19,percent of total billed charges,,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Aetna,Middlesex Employees,,,131.61,,131.61,131.61,151.19,percent of total billed charges,,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Anthem,Commerical,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Anthem,Indemnity,,,133.24,,133.24,131.61,151.19,percent of total billed charges,,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Anthem,Individual Exchange,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Anthem,State Preferred,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Cigna,Cigna,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Connecticare,Commerical,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Connecticare,Exchange,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,Multiplan,Multiplan,,,151.19,,151.19,131.61,151.19,percent of total billed charges,,
TRICHLOROACETIC ACID 80 % TOPICAL SOLUTION,J3490,HCPCS,10481-3008-1,NDC,both,1,mL,177.87,106.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,131.61,151.19,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Aetna,Commerical,,,3.19,,3.19,3.06,3.51,percent of total billed charges,,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Aetna,Middlesex Employees,,,3.06,,3.06,3.06,3.51,percent of total billed charges,,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Anthem,Commerical,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Anthem,Indemnity,,,3.09,,3.09,3.06,3.51,percent of total billed charges,,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Anthem,Individual Exchange,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Anthem,State Preferred,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Cigna,Cigna,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Connecticare,Commerical,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Connecticare,Exchange,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,Multiplan,Multiplan,,,3.51,,3.51,3.06,3.51,percent of total billed charges,,
TRIFLUOPERAZINE 1 MG TABLET,J3490,HCPCS,51079-572-20,NDC,both,1,ea,4.13,2.48,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.06,3.51,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Aetna,Commerical,,,458.87,,458.87,440.02,505.5,percent of total billed charges,,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Aetna,Middlesex Employees,,,440.02,,440.02,440.02,505.5,percent of total billed charges,,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Anthem,Commerical,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Anthem,Indemnity,,,445.49,,445.49,440.02,505.5,percent of total billed charges,,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Anthem,Individual Exchange,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Anthem,State Preferred,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Cigna,Cigna,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Connecticare,Commerical,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Connecticare,Exchange,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,Multiplan,Multiplan,,,505.5,,505.5,440.02,505.5,percent of total billed charges,,
TRIFLURIDINE 1 % EYE DROPS,J3490,HCPCS,61314-044-75,NDC,both,1,mL,594.7,356.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,440.02,505.5,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Aetna,Commerical,,,62.91,,62.91,60.32,69.3,percent of total billed charges,,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Aetna,Middlesex Employees,,,60.32,,60.32,60.32,69.3,percent of total billed charges,,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Anthem,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Anthem,Indemnity,,,61.07,,61.07,60.32,69.3,percent of total billed charges,,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Anthem,Individual Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Anthem,State Preferred,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Cigna,Cigna,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Connecticare,Commerical,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Connecticare,Exchange,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,Multiplan,Multiplan,,,69.3,,69.3,60.32,69.3,percent of total billed charges,,
TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,J3490,HCPCS,0121-0658-16,NDC,both,1,mL,81.53,48.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,60.32,69.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Aetna,Commerical,,,0.53,,0.53,0.51,0.59,percent of total billed charges,,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Aetna,Middlesex Employees,,,0.51,,0.51,0.51,0.59,percent of total billed charges,,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Anthem,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Anthem,Indemnity,,,0.52,,0.52,0.51,0.59,percent of total billed charges,,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Anthem,Individual Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Anthem,State Preferred,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Cigna,Cigna,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Connecticare,Commerical,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Connecticare,Exchange,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,Multiplan,Multiplan,,,0.59,,0.59,0.51,0.59,percent of total billed charges,,
TRIHEXYPHENIDYL 1 MG ORAL TAB,J3490,HCPCS,40810-0003-08,NDC,both,1,ea,0.69,0.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.51,0.59,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,0591-5335-01,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Aetna,Commerical,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Anthem,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Anthem,Indemnity,,,0.13,,0.13,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Anthem,Individual Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Anthem,State Preferred,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Cigna,Cigna,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Connecticare,Commerical,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Connecticare,Exchange,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,Multiplan,Multiplan,,,0.14,,0.14,0.13,0.14,percent of total billed charges,,
TRIHEXYPHENIDYL 2 MG TABLET,J3490,HCPCS,70954-212-10,NDC,both,1,ea,0.17,0.1,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.14,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Aetna,Commerical,,,0.86,,0.86,0.83,0.95,percent of total billed charges,,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Aetna,Middlesex Employees,,,0.83,,0.83,0.83,0.95,percent of total billed charges,,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Anthem,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Anthem,Indemnity,,,0.84,,0.84,0.83,0.95,percent of total billed charges,,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Anthem,Individual Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Anthem,State Preferred,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Cigna,Cigna,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Connecticare,Commerical,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Connecticare,Exchange,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,Multiplan,Multiplan,,,0.95,,0.95,0.83,0.95,percent of total billed charges,,
TRIHEXYPHENIDYL 2.5 MG TABLET,J3490,HCPCS,40810-0018-24,NDC,both,1,ea,1.12,0.67,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.83,0.95,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,0591-5337-01,NDC,both,0.078,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,16571-161-10,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
TRIHEXYPHENIDYL 5 MG TABLET,J3490,HCPCS,70954-211-10,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Aetna,Commerical,,,0.91,,0.91,0.87,1,percent of total billed charges,,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Aetna,Middlesex Employees,,,0.87,,0.87,0.87,1,percent of total billed charges,,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Anthem,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Anthem,Indemnity,,,0.88,,0.88,0.87,1,percent of total billed charges,,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Anthem,Individual Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Anthem,State Preferred,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Cigna,Cigna,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Connecticare,Commerical,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Connecticare,Exchange,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,Multiplan,Multiplan,,,1,,1,0.87,1,percent of total billed charges,,
TRIMETHOPRIM 100 MG TABLET,J3490,HCPCS,43386-330-01,NDC,both,1,ea,1.18,0.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.87,1,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Aetna,Commerical,,,0.61,,0.61,0.58,0.67,percent of total billed charges,,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Aetna,Middlesex Employees,,,0.58,,0.58,0.58,0.67,percent of total billed charges,,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Anthem,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Anthem,Indemnity,,,0.59,,0.59,0.58,0.67,percent of total billed charges,,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Anthem,Individual Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Anthem,State Preferred,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Cigna,Cigna,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Connecticare,Commerical,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Connecticare,Exchange,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,Multiplan,Multiplan,,,0.67,,0.67,0.58,0.67,percent of total billed charges,,
TRIMETHOPRIM 50 MG ORAL TAB,J3490,HCPCS,40810-0003-09,NDC,both,1,ea,0.79,0.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.58,0.67,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Aetna,Commerical,,,1064.9,,1064.9,1021.15,1173.1,percent of total billed charges,,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Aetna,Middlesex Employees,,,1021.15,,1021.15,1021.15,1173.1,percent of total billed charges,,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Anthem,Commerical,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Anthem,Indemnity,,,1033.85,,1033.85,1021.15,1173.1,percent of total billed charges,,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Anthem,Individual Exchange,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Anthem,State Preferred,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Cigna,Cigna,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Connecticare,Commerical,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Connecticare,Exchange,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,Multiplan,Multiplan,,,1173.1,,1173.1,1021.15,1173.1,percent of total billed charges,,
TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1593-04,NDC,both,1,mL,1380.12,828.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1021.15,1173.1,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Aetna,Commerical,,,60.86,,60.86,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Aetna,Middlesex Employees,,,58.36,,58.36,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Anthem,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Anthem,Indemnity,,,59.09,,59.09,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Anthem,Individual Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Anthem,State Preferred,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Cigna,Cigna,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Connecticare,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Connecticare,Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,Multiplan,Multiplan,,,67.05,,67.05,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,17478-101-12,NDC,both,1,mL,78.88,47.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Aetna,Commerical,,,60.86,,60.86,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Aetna,Middlesex Employees,,,58.36,,58.36,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Anthem,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Anthem,Indemnity,,,59.09,,59.09,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Anthem,Individual Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Anthem,State Preferred,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Cigna,Cigna,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Connecticare,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Connecticare,Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,Multiplan,Multiplan,,,67.05,,67.05,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,24208-590-64,NDC,both,1,mL,78.88,47.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Aetna,Commerical,,,60.86,,60.86,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Aetna,Middlesex Employees,,,58.36,,58.36,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Anthem,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Anthem,Indemnity,,,59.09,,59.09,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Anthem,Individual Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Anthem,State Preferred,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Cigna,Cigna,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Connecticare,Commerical,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Connecticare,Exchange,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,Multiplan,Multiplan,,,67.05,,67.05,58.36,67.05,percent of total billed charges,,
TROPICAMIDE 0.5 % EYE DROPS,J3490,HCPCS,61314-354-01,NDC,both,1,mL,78.88,47.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,58.36,67.05,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Aetna,Commerical,,,144.84,,144.84,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Aetna,Middlesex Employees,,,138.89,,138.89,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Anthem,Commerical,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Anthem,Indemnity,,,140.61,,140.61,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Anthem,Individual Exchange,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Anthem,State Preferred,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Cigna,Cigna,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Connecticare,Commerical,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Connecticare,Exchange,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,Multiplan,Multiplan,,,159.55,,159.55,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,17478-102-12,NDC,both,2,mL,187.71,112.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Aetna,Commerical,,,18.11,,18.11,17.37,19.95,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Aetna,Middlesex Employees,,,17.37,,17.37,17.37,19.95,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Anthem,Commerical,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Anthem,Indemnity,,,17.58,,17.58,17.37,19.95,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Anthem,Individual Exchange,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Anthem,State Preferred,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Cigna,Cigna,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Connecticare,Commerical,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Connecticare,Exchange,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,Multiplan,Multiplan,,,19.95,,19.95,17.37,19.95,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-59,NDC,both,2,mL,23.47,14.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.37,19.95,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Aetna,Commerical,,,94.57,,94.57,90.68,104.18,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Aetna,Middlesex Employees,,,90.68,,90.68,90.68,104.18,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Anthem,Commerical,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Anthem,Indemnity,,,91.81,,91.81,90.68,104.18,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Anthem,Individual Exchange,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Anthem,State Preferred,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Cigna,Cigna,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Connecticare,Commerical,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Connecticare,Exchange,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,Multiplan,Multiplan,,,104.18,,104.18,90.68,104.18,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,24208-585-64,NDC,both,2,mL,122.56,73.54,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,90.68,104.18,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Aetna,Commerical,,,36.21,,36.21,34.72,39.89,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Aetna,Middlesex Employees,,,34.72,,34.72,34.72,39.89,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Anthem,Commerical,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Anthem,Indemnity,,,35.16,,35.16,34.72,39.89,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Anthem,Individual Exchange,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Anthem,State Preferred,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Cigna,Cigna,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Connecticare,Commerical,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Connecticare,Exchange,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,Multiplan,Multiplan,,,39.89,,39.89,34.72,39.89,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,61314-355-01,NDC,both,2,mL,46.93,28.16,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.72,39.89,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Aetna,Commerical,,,144.84,,144.84,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Aetna,Middlesex Employees,,,138.89,,138.89,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Anthem,Commerical,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Anthem,Indemnity,,,140.61,,140.61,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Anthem,Individual Exchange,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Anthem,State Preferred,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Cigna,Cigna,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Connecticare,Commerical,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Connecticare,Exchange,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,Multiplan,Multiplan,,,159.55,,159.55,138.89,159.55,percent of total billed charges,,
TROPICAMIDE 1 % EYE DROPS,J3490,HCPCS,70069-121-01,NDC,both,2,mL,187.71,112.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.89,159.55,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Aetna,Commerical,,,174.95,,174.95,167.76,192.73,percent of total billed charges,,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Aetna,Middlesex Employees,,,167.76,,167.76,167.76,192.73,percent of total billed charges,,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Anthem,Commerical,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Anthem,Indemnity,,,169.85,,169.85,167.76,192.73,percent of total billed charges,,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Anthem,Individual Exchange,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Anthem,State Preferred,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Cigna,Cigna,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Connecticare,Commerical,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Connecticare,Exchange,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,Multiplan,Multiplan,,,192.73,,192.73,167.76,192.73,percent of total billed charges,,
TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,J3490,HCPCS,68803-612-10,NDC,both,0.5,mL,226.74,136.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,167.76,192.73,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Aetna,Commerical,,,263.08,,263.08,252.28,289.82,percent of total billed charges,,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Aetna,Middlesex Employees,,,252.28,,252.28,252.28,289.82,percent of total billed charges,,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Anthem,Commerical,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Anthem,Indemnity,,,255.41,,255.41,252.28,289.82,percent of total billed charges,,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Anthem,Individual Exchange,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Anthem,State Preferred,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Cigna,Cigna,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Connecticare,Commerical,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Connecticare,Exchange,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,Multiplan,Multiplan,,,289.82,,289.82,252.28,289.82,percent of total billed charges,,
TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86580,HCPCS,42023-104-01,NDC,both,1,mL,340.96,204.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,252.28,289.82,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Aetna,Commerical,,,4787,,4787,170.48,5273.39,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Aetna,Middlesex Employees,,,4590.33,,4590.33,170.48,5273.39,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Anthem,Commerical,,213.1,,,213.1,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Anthem,Indemnity,,,4647.41,,4647.41,170.48,5273.39,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Anthem,Individual Exchange,,170.48,,,170.48,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Anthem,State Preferred,,213.1,,,213.1,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Cigna,Cigna,,,,,,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Connecticare,Commerical,,,,,,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Connecticare,Exchange,,,,,,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,Multiplan,Multiplan,,,5273.39,,5273.39,170.48,5273.39,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,90691,HCPCS,49281-790-20,NDC,both,0.5,mL,6203.99,3722.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.48,5273.39,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Aetna,Commerical,,,346.89,,346.89,170.48,382.13,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Aetna,Middlesex Employees,,,332.64,,332.64,170.48,382.13,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Anthem,Commerical,,213.1,,,213.1,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Anthem,Indemnity,,,336.77,,336.77,170.48,382.13,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Anthem,Individual Exchange,,170.48,,,170.48,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Anthem,State Preferred,,213.1,,,213.1,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Cigna,Cigna,,,,,,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Connecticare,Commerical,,,,,,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Connecticare,Exchange,,,,,,170.48,382.13,Other,Could be inpatient or outpatient,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,Multiplan,Multiplan,,,382.13,,382.13,170.48,382.13,percent of total billed charges,,
TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,90691,HCPCS,49281-790-51,NDC,both,0.5,mL,449.57,269.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,170.48,382.13,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Aetna,Commerical,,,110.23,,110.23,105.7,121.43,percent of total billed charges,,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Aetna,Middlesex Employees,,,105.7,,105.7,105.7,121.43,percent of total billed charges,,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Anthem,Commerical,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Anthem,Indemnity,,,107.02,,107.02,105.7,121.43,percent of total billed charges,,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Anthem,Individual Exchange,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Anthem,State Preferred,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Cigna,Cigna,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Connecticare,Commerical,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Connecticare,Exchange,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,Multiplan,Multiplan,,,121.43,,121.43,105.7,121.43,percent of total billed charges,,
ULIPRISTAL 30 MG TABLET,J3490,HCPCS,73302-456-01,NDC,both,1,ea,142.86,85.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,105.7,121.43,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Aetna,Commerical,,,9122.79,,9122.79,8747.99,10049.73,percent of total billed charges,,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Aetna,Middlesex Employees,,,8747.99,,8747.99,8747.99,10049.73,percent of total billed charges,,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Anthem,Commerical,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Anthem,Indemnity,,,8856.77,,8856.77,8747.99,10049.73,percent of total billed charges,,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Anthem,Individual Exchange,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Anthem,State Preferred,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Cigna,Cigna,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Connecticare,Commerical,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Connecticare,Exchange,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,Multiplan,Multiplan,,,10049.73,,10049.73,8747.99,10049.73,percent of total billed charges,,
UPADACITINIB 1 MG/ML ORAL SOLUTION,J3490,HCPCS,0074-2320-01,NDC,both,1,mL,11823.21,7093.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8747.99,10049.73,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Aetna,Commerical,,,580.73,,580.73,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Aetna,Middlesex Employees,,,556.87,,556.87,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Anthem,Commerical,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Anthem,Indemnity,,,563.8,,563.8,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Anthem,Individual Exchange,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Anthem,State Preferred,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Cigna,Cigna,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Connecticare,Commerical,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Connecticare,Exchange,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,Multiplan,Multiplan,,,639.74,,639.74,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 15 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2306-30,NDC,both,1,ea,752.63,451.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Aetna,Commerical,,,580.73,,580.73,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Aetna,Middlesex Employees,,,556.87,,556.87,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Anthem,Commerical,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Anthem,Indemnity,,,563.8,,563.8,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Anthem,Individual Exchange,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Anthem,State Preferred,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Cigna,Cigna,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Connecticare,Commerical,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Connecticare,Exchange,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,Multiplan,Multiplan,,,639.74,,639.74,556.87,639.74,percent of total billed charges,,
"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",J7599,HCPCS,0074-2310-30,NDC,both,1,ea,752.63,451.58,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,556.87,639.74,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Aetna,Commerical,,,79.79,,79.79,76.51,87.9,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Aetna,Middlesex Employees,,,76.51,,76.51,76.51,87.9,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Anthem,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Anthem,Indemnity,,,77.46,,77.46,76.51,87.9,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Anthem,Individual Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Anthem,State Preferred,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Cigna,Cigna,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Connecticare,Commerical,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Connecticare,Exchange,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,Multiplan,Multiplan,,,87.9,,87.9,76.51,87.9,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-10,NDC,both,1,mL,103.41,62.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,76.51,87.9,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Aetna,Commerical,,,39.9,,39.9,38.26,43.95,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Aetna,Middlesex Employees,,,38.26,,38.26,38.26,43.95,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Anthem,Commerical,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Anthem,Indemnity,,,38.74,,38.74,38.26,43.95,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Anthem,Individual Exchange,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Anthem,State Preferred,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Cigna,Cigna,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Connecticare,Commerical,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Connecticare,Exchange,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,Multiplan,Multiplan,,,43.95,,43.95,38.26,43.95,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-73,NDC,both,1,mL,51.71,31.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,38.26,43.95,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Aetna,Commerical,,,159.58,,159.58,153.03,175.8,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Aetna,Middlesex Employees,,,153.03,,153.03,153.03,175.8,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Anthem,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Anthem,Indemnity,,,154.93,,154.93,153.03,175.8,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Anthem,Individual Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Anthem,State Preferred,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Cigna,Cigna,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Connecticare,Commerical,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Connecticare,Exchange,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,Multiplan,Multiplan,,,175.8,,175.8,153.03,175.8,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-74,NDC,both,1,mL,206.82,124.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,153.03,175.8,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Aetna,Commerical,,,239.37,,239.37,229.54,263.7,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Aetna,Middlesex Employees,,,229.54,,229.54,229.54,263.7,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Anthem,Commerical,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Anthem,Indemnity,,,232.39,,232.39,229.54,263.7,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Anthem,Individual Exchange,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Anthem,State Preferred,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Cigna,Cigna,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Connecticare,Commerical,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Connecticare,Exchange,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,Multiplan,Multiplan,,,263.7,,263.7,229.54,263.7,percent of total billed charges,,
URSODIOL 25 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-75,NDC,both,1,mL,310.23,186.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,229.54,263.7,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-6221-06,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,0904-7168-06,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,42806-503-01,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,51224-151-50,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,59651-421-01,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Aetna,Commerical,,,1.18,,1.18,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Aetna,Middlesex Employees,,,1.13,,1.13,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Anthem,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Anthem,Indemnity,,,1.15,,1.15,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Anthem,Individual Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Anthem,State Preferred,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Cigna,Cigna,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Connecticare,Commerical,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Connecticare,Exchange,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,Multiplan,Multiplan,,,1.3,,1.3,1.13,1.3,percent of total billed charges,,
URSODIOL 300 MG CAPSULE,J3490,HCPCS,69238-1540-1,NDC,both,1,ea,1.53,0.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.13,1.3,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Aetna,Commerical,,,4728.33,,4728.33,14.55,5208.77,percent of total billed charges,,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Aetna,Middlesex Employees,,,4534.08,,4534.08,14.55,5208.77,percent of total billed charges,,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Anthem,Commerical,,,,,,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Anthem,Indemnity,,,4590.45,,4590.45,14.55,5208.77,percent of total billed charges,,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Anthem,Individual Exchange,,,,,,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Anthem,State Preferred,,,,,,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Cigna,Cigna,,14.55,,,14.55,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Connecticare,Commerical,,19.8,,,19.8,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Connecticare,Exchange,,19.8,,,19.8,14.55,5208.77,Other,Could be inpatient or outpatient,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,Multiplan,Multiplan,,,5208.77,,5208.77,14.55,5208.77,percent of total billed charges,,
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,J3358,HCPCS,57894-054-27,NDC,both,0.2,mL,6127.96,3676.78,United Healthcare/Oxford,United Healthcare/Oxford,,15.71,,,15.71,14.55,5208.77,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Aetna,Commerical,,,1.37,,1.37,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Anthem,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Anthem,Indemnity,,,1.33,,1.33,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Anthem,Individual Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Anthem,State Preferred,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Cigna,Cigna,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Connecticare,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Connecticare,Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,Multiplan,Multiplan,,,1.51,,1.51,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,0378-4276-93,NDC,both,1,ea,1.78,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Aetna,Commerical,,,3.83,,3.83,3.68,4.22,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.22,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Anthem,Commerical,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Anthem,Indemnity,,,3.72,,3.72,3.68,4.22,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Anthem,Individual Exchange,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Anthem,State Preferred,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Cigna,Cigna,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Connecticare,Commerical,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Connecticare,Exchange,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,Multiplan,Multiplan,,,4.22,,4.22,3.68,4.22,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,57237-043-30,NDC,both,1,ea,4.97,2.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.22,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Aetna,Commerical,,,1.37,,1.37,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Aetna,Middlesex Employees,,,1.32,,1.32,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Anthem,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Anthem,Indemnity,,,1.33,,1.33,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Anthem,Individual Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Anthem,State Preferred,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Cigna,Cigna,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Connecticare,Commerical,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Connecticare,Exchange,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,Multiplan,Multiplan,,,1.51,,1.51,1.32,1.51,percent of total billed charges,,
VALACYCLOVIR 1 GRAM TABLET,J3490,HCPCS,59746-325-30,NDC,both,1,ea,1.78,1.07,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.32,1.51,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Aetna,Commerical,,,2.39,,2.39,2.29,2.64,percent of total billed charges,,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Aetna,Middlesex Employees,,,2.29,,2.29,2.29,2.64,percent of total billed charges,,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Anthem,Commerical,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Anthem,Indemnity,,,2.32,,2.32,2.29,2.64,percent of total billed charges,,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Anthem,Individual Exchange,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Anthem,State Preferred,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Cigna,Cigna,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Connecticare,Commerical,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Connecticare,Exchange,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,Multiplan,Multiplan,,,2.64,,2.64,2.29,2.64,percent of total billed charges,,
VALACYCLOVIR 250 MG ORAL TAB,J3490,HCPCS,40810-0003-11,NDC,both,1,ea,3.1,1.86,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.29,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Aetna,Commerical,,,429.28,,429.28,411.64,472.9,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Aetna,Middlesex Employees,,,411.64,,411.64,411.64,472.9,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Anthem,Commerical,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Anthem,Indemnity,,,416.76,,416.76,411.64,472.9,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Anthem,Individual Exchange,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Anthem,State Preferred,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Cigna,Cigna,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Connecticare,Commerical,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Connecticare,Exchange,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,Multiplan,Multiplan,,,472.9,,472.9,411.64,472.9,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0003-12,NDC,both,1,mL,556.35,333.81,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,411.64,472.9,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Aetna,Commerical,,,858.56,,858.56,823.29,945.8,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Aetna,Middlesex Employees,,,823.29,,823.29,823.29,945.8,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Anthem,Commerical,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Anthem,Indemnity,,,833.52,,833.52,823.29,945.8,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Anthem,Individual Exchange,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Anthem,State Preferred,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Cigna,Cigna,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Connecticare,Commerical,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Connecticare,Exchange,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,Multiplan,Multiplan,,,945.8,,945.8,823.29,945.8,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-76,NDC,both,1,mL,1112.7,667.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,823.29,945.8,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Aetna,Commerical,,,214.64,,214.64,205.83,236.45,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Aetna,Middlesex Employees,,,205.83,,205.83,205.83,236.45,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Anthem,Commerical,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Anthem,Indemnity,,,208.38,,208.38,205.83,236.45,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Anthem,Individual Exchange,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Anthem,State Preferred,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Cigna,Cigna,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Connecticare,Commerical,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Connecticare,Exchange,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,Multiplan,Multiplan,,,236.45,,236.45,205.83,236.45,percent of total billed charges,,
VALACYCLOVIR 50 MG /ML ORAL SUSP,J3490,HCPCS,40810-0012-77,NDC,both,1,mL,278.18,166.91,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,205.83,236.45,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,0378-4275-77,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Aetna,Commerical,,,0.89,,0.89,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Aetna,Middlesex Employees,,,0.85,,0.85,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Anthem,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Anthem,Indemnity,,,0.86,,0.86,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Anthem,Individual Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Anthem,State Preferred,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Cigna,Cigna,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Connecticare,Commerical,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Connecticare,Exchange,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,Multiplan,Multiplan,,,0.98,,0.98,0.85,0.98,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,40810-0009-01,NDC,both,1,ea,1.15,0.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.85,0.98,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Aetna,Commerical,,,2.4,,2.4,2.3,2.64,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Aetna,Middlesex Employees,,,2.3,,2.3,2.3,2.64,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Anthem,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Anthem,Indemnity,,,2.33,,2.33,2.3,2.64,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Anthem,Individual Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Anthem,State Preferred,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Cigna,Cigna,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Connecticare,Commerical,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Connecticare,Exchange,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,Multiplan,Multiplan,,,2.64,,2.64,2.3,2.64,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,57237-042-90,NDC,both,1,ea,3.11,1.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.3,2.64,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Aetna,Commerical,,,7.7,,7.7,7.38,8.48,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Aetna,Middlesex Employees,,,7.38,,7.38,7.38,8.48,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Anthem,Commerical,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Anthem,Indemnity,,,7.48,,7.48,7.38,8.48,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Anthem,Individual Exchange,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Anthem,State Preferred,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Cigna,Cigna,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Connecticare,Commerical,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Connecticare,Exchange,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,Multiplan,Multiplan,,,8.48,,8.48,7.38,8.48,percent of total billed charges,,
VALACYCLOVIR 500 MG TABLET,J3490,HCPCS,65862-448-90,NDC,both,1,ea,9.98,5.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.38,8.48,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Aetna,Commerical,,,69.24,,69.24,66.39,76.27,percent of total billed charges,,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Aetna,Middlesex Employees,,,66.39,,66.39,66.39,76.27,percent of total billed charges,,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Anthem,Commerical,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Anthem,Indemnity,,,67.22,,67.22,66.39,76.27,percent of total billed charges,,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Anthem,Individual Exchange,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Anthem,State Preferred,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Cigna,Cigna,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Connecticare,Commerical,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Connecticare,Exchange,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,Multiplan,Multiplan,,,76.27,,76.27,66.39,76.27,percent of total billed charges,,
VALGANCICLOVIR 225 MG TABLET,J3490,HCPCS,40810-0104-43,NDC,both,1,ea,89.73,53.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,66.39,76.27,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Aetna,Commerical,,,6.47,,6.47,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Aetna,Middlesex Employees,,,6.2,,6.2,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Anthem,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Anthem,Indemnity,,,6.28,,6.28,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Anthem,Individual Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Anthem,State Preferred,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Cigna,Cigna,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Connecticare,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Connecticare,Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,Multiplan,Multiplan,,,7.12,,7.12,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0004-0038-22,NDC,both,1,ea,8.38,5.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Aetna,Commerical,,,149.02,,149.02,142.9,164.16,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Aetna,Middlesex Employees,,,142.9,,142.9,142.9,164.16,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Anthem,Commerical,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Anthem,Indemnity,,,144.67,,144.67,142.9,164.16,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Anthem,Individual Exchange,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Anthem,State Preferred,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Cigna,Cigna,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Connecticare,Commerical,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Connecticare,Exchange,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,Multiplan,Multiplan,,,164.16,,164.16,142.9,164.16,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,0603-6330-20,NDC,both,1,ea,193.13,115.88,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,142.9,164.16,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Aetna,Commerical,,,6.47,,6.47,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Aetna,Middlesex Employees,,,6.2,,6.2,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Anthem,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Anthem,Indemnity,,,6.28,,6.28,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Anthem,Individual Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Anthem,State Preferred,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Cigna,Cigna,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Connecticare,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Connecticare,Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,Multiplan,Multiplan,,,7.12,,7.12,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,31722-832-60,NDC,both,1,ea,8.38,5.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Aetna,Commerical,,,6.47,,6.47,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Aetna,Middlesex Employees,,,6.2,,6.2,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Anthem,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Anthem,Indemnity,,,6.28,,6.28,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Anthem,Individual Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Anthem,State Preferred,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Cigna,Cigna,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Connecticare,Commerical,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Connecticare,Exchange,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,Multiplan,Multiplan,,,7.12,,7.12,6.2,7.12,percent of total billed charges,,
VALGANCICLOVIR 450 MG TABLET,J3490,HCPCS,40810-0009-79,NDC,both,1,ea,8.38,5.03,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.2,7.12,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Aetna,Commerical,,,2013.13,,2013.13,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Aetna,Middlesex Employees,,,1930.42,,1930.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Anthem,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Anthem,Indemnity,,,1954.42,,1954.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Anthem,Individual Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Anthem,State Preferred,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Cigna,Cigna,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Connecticare,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Connecticare,Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,Multiplan,Multiplan,,,2217.68,,2217.68,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,0004-0039-09,NDC,both,1,mL,2609.03,1565.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Aetna,Commerical,,,2287.65,,2287.65,2193.66,2520.09,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Aetna,Middlesex Employees,,,2193.66,,2193.66,2193.66,2520.09,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Anthem,Commerical,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Anthem,Indemnity,,,2220.94,,2220.94,2193.66,2520.09,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Anthem,Individual Exchange,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Anthem,State Preferred,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Cigna,Cigna,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Connecticare,Commerical,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Connecticare,Exchange,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,Multiplan,Multiplan,,,2520.09,,2520.09,2193.66,2520.09,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,40810-0015-80,NDC,both,1,mL,2964.81,1778.89,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2193.66,2520.09,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Aetna,Commerical,,,2013.13,,2013.13,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Aetna,Middlesex Employees,,,1930.42,,1930.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Anthem,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Anthem,Indemnity,,,1954.42,,1954.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Anthem,Individual Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Anthem,State Preferred,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Cigna,Cigna,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Connecticare,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Connecticare,Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,Multiplan,Multiplan,,,2217.68,,2217.68,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70010-051-40,NDC,both,1,mL,2609.03,1565.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Aetna,Commerical,,,2013.13,,2013.13,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Aetna,Middlesex Employees,,,1930.42,,1930.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Indemnity,,,1954.42,,1954.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Individual Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Anthem,State Preferred,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Cigna,Cigna,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Connecticare,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Connecticare,Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,Multiplan,Multiplan,,,2217.68,,2217.68,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,70069-810-01,NDC,both,1,mL,2609.03,1565.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Aetna,Commerical,,,2013.13,,2013.13,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Aetna,Middlesex Employees,,,1930.42,,1930.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Indemnity,,,1954.42,,1954.42,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Anthem,Individual Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Anthem,State Preferred,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Cigna,Cigna,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Connecticare,Commerical,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Connecticare,Exchange,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,Multiplan,Multiplan,,,2217.68,,2217.68,1930.42,2217.68,percent of total billed charges,,
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,J8499,HCPCS,72205-019-01,NDC,both,1,mL,2609.03,1565.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1930.42,2217.68,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE 100 MG/ML ORAL SOLUTION FOR KETOGENIC DIET,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9637-01,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-01,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9785-10,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,55390-007-10,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-01,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Aetna,Commerical,,,6.83,,6.83,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Aetna,Middlesex Employees,,,6.55,,6.55,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Indemnity,,,6.63,,6.63,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,Individual Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Anthem,State Preferred,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Cigna,Cigna,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Connecticare,Commerical,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Connecticare,Exchange,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,Multiplan,Multiplan,,,7.52,,7.52,6.55,7.52,percent of total billed charges,,
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,J3490,HCPCS,63323-494-05,NDC,both,1,mL,8.85,5.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.55,7.52,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Aetna,Commerical,,,1.22,,1.22,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Aetna,Middlesex Employees,,,1.17,,1.17,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Anthem,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Anthem,Indemnity,,,1.18,,1.18,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Anthem,Individual Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Anthem,State Preferred,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Cigna,Cigna,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Connecticare,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Connecticare,Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,Multiplan,Multiplan,,,1.34,,1.34,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,0121-4675-05,NDC,both,1,mL,1.58,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Aetna,Commerical,,,1.22,,1.22,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Aetna,Middlesex Employees,,,1.17,,1.17,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Anthem,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Anthem,Indemnity,,,1.18,,1.18,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Anthem,Individual Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Anthem,State Preferred,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Cigna,Cigna,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Connecticare,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Connecticare,Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,Multiplan,Multiplan,,,1.34,,1.34,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-59,NDC,both,5,mL,1.58,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Aetna,Commerical,,,1.22,,1.22,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Aetna,Middlesex Employees,,,1.17,,1.17,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Anthem,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Anthem,Indemnity,,,1.18,,1.18,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Anthem,Individual Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Anthem,State Preferred,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Cigna,Cigna,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Connecticare,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Connecticare,Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,Multiplan,Multiplan,,,1.34,,1.34,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-61,NDC,both,1,mL,1.58,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Aetna,Commerical,,,1.22,,1.22,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Aetna,Middlesex Employees,,,1.17,,1.17,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Anthem,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Anthem,Indemnity,,,1.18,,1.18,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Anthem,Individual Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Anthem,State Preferred,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Cigna,Cigna,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Connecticare,Commerical,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Connecticare,Exchange,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,Multiplan,Multiplan,,,1.34,,1.34,1.17,1.34,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,J3490,HCPCS,68094-193-62,NDC,both,1,mL,1.58,0.95,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.17,1.34,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Aetna,Commerical,,,215.27,,215.27,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Aetna,Middlesex Employees,,,206.42,,206.42,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Anthem,Commerical,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Anthem,Indemnity,,,208.99,,208.99,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Anthem,Individual Exchange,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Anthem,State Preferred,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Cigna,Cigna,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Connecticare,Commerical,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Connecticare,Exchange,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,Multiplan,Multiplan,,,237.14,,237.14,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,0121-0675-85,NDC,both,1,mL,278.99,167.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Aetna,Commerical,,,215.27,,215.27,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Aetna,Middlesex Employees,,,206.42,,206.42,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Anthem,Commerical,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Anthem,Indemnity,,,208.99,,208.99,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Anthem,Individual Exchange,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Anthem,State Preferred,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Cigna,Cigna,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Connecticare,Commerical,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Connecticare,Exchange,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,Multiplan,Multiplan,,,237.14,,237.14,206.42,237.14,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,J3490,HCPCS,60432-621-16,NDC,both,1,mL,278.99,167.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,206.42,237.14,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Aetna,Commerical,,,213.87,,213.87,205.09,235.6,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Aetna,Middlesex Employees,,,205.09,,205.09,205.09,235.6,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Anthem,Commerical,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Anthem,Indemnity,,,207.64,,207.64,205.09,235.6,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Anthem,Individual Exchange,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Anthem,State Preferred,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Cigna,Cigna,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Connecticare,Commerical,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Connecticare,Exchange,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,Multiplan,Multiplan,,,235.6,,235.6,205.09,235.6,percent of total billed charges,,
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML RECTAL SYRP,J3490,HCPCS,0121-0675-16,NDC,both,1,mL,277.18,166.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,205.09,235.6,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Aetna,Commerical,,,34.73,,34.73,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Aetna,Middlesex Employees,,,33.3,,33.3,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Anthem,Commerical,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Anthem,Indemnity,,,33.72,,33.72,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Anthem,Individual Exchange,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Anthem,State Preferred,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Cigna,Cigna,,2.26,,,2.26,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Connecticare,Commerical,,3.3,,,3.3,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Connecticare,Exchange,,3.3,,,3.3,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,Multiplan,Multiplan,,,38.26,,38.26,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 10 MG/ML DILUTION,J3370,HCPCS,40810-0201-16,NDC,both,50,mL,45.01,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Aetna,Commerical,,,34.73,,34.73,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Aetna,Middlesex Employees,,,33.3,,33.3,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Anthem,Commerical,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Anthem,Indemnity,,,33.72,,33.72,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Anthem,Individual Exchange,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Anthem,State Preferred,,,,,,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Cigna,Cigna,,2.26,,,2.26,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Connecticare,Commerical,,3.3,,,3.3,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Connecticare,Exchange,,3.3,,,3.3,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,Multiplan,Multiplan,,,38.26,,38.26,2.26,38.26,percent of total billed charges,,
VANCOMYCIN (VANCOCIN) 2 MG/ML DILUTION,J3370,HCPCS,40810-0201-25,NDC,both,250,mL,45.01,27.01,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,38.26,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Aetna,Commerical,,,3841.8,,3841.8,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Aetna,Middlesex Employees,,,3683.96,,3683.96,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Anthem,Commerical,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Anthem,Indemnity,,,3729.77,,3729.77,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Anthem,Individual Exchange,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Anthem,State Preferred,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Cigna,Cigna,,7.32,,,7.32,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Connecticare,Commerical,,9.8,,,9.8,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Connecticare,Exchange,,9.8,,,9.8,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,Multiplan,Multiplan,,,4232.15,,4232.15,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-01,NDC,both,100,mL,4979,2987.4,United Healthcare/Oxford,United Healthcare/Oxford,,7.91,,,7.91,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Aetna,Commerical,,,3841.8,,3841.8,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Aetna,Middlesex Employees,,,3683.96,,3683.96,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Anthem,Commerical,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Anthem,Indemnity,,,3729.77,,3729.77,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Anthem,Individual Exchange,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Anthem,State Preferred,,,,,,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Cigna,Cigna,,7.32,,,7.32,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Connecticare,Commerical,,9.8,,,9.8,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Connecticare,Exchange,,9.8,,,9.8,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,Multiplan,Multiplan,,,4232.15,,4232.15,7.32,4232.15,percent of total billed charges,,
VANCOMYCIN 1 GRAM/200 ML PREMIX BAG (5 MG/ML),J3372,HCPCS,70594-042-03,NDC,both,100,mL,4979,2987.4,United Healthcare/Oxford,United Healthcare/Oxford,,7.91,,,7.91,7.32,4232.15,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Aetna,Commerical,,,347.24,,347.24,0.93,382.53,percent of total billed charges,,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Aetna,Middlesex Employees,,,332.98,,332.98,0.93,382.53,percent of total billed charges,,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Anthem,Commerical,,,,,,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Anthem,Indemnity,,,337.12,,337.12,0.93,382.53,percent of total billed charges,,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Anthem,Individual Exchange,,,,,,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Anthem,State Preferred,,,,,,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Cigna,Cigna,,0.93,,,0.93,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Connecticare,Commerical,,1.23,,,1.23,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Connecticare,Exchange,,1.23,,,1.23,0.93,382.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,Multiplan,Multiplan,,,382.53,,382.53,0.93,382.53,percent of total billed charges,,
VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL PF,J0690,HCPCS,40810-0204-34,NDC,both,50,mL,450.03,270.02,United Healthcare/Oxford,United Healthcare/Oxford,,1,,,1,0.93,382.53,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Aetna,Commerical,,,19.95,,19.95,2.26,21.98,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Aetna,Middlesex Employees,,,19.13,,19.13,2.26,21.98,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Anthem,Commerical,,,,,,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Anthem,Indemnity,,,19.37,,19.37,2.26,21.98,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Anthem,Individual Exchange,,,,,,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Anthem,State Preferred,,,,,,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Cigna,Cigna,,2.26,,,2.26,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Connecticare,Commerical,,3.3,,,3.3,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Connecticare,Exchange,,3.3,,,3.3,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,Multiplan,Multiplan,,,21.98,,21.98,2.26,21.98,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-01,NDC,both,0.5,ea,25.86,15.52,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,21.98,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,0409-6535-11,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,25021-151-20,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,47781-597-91,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Aetna,Commerical,,,8.76,,8.76,2.26,9.65,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Aetna,Middlesex Employees,,,8.4,,8.4,2.26,9.65,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Anthem,Commerical,,,,,,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Anthem,Indemnity,,,8.5,,8.5,2.26,9.65,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Anthem,Individual Exchange,,,,,,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Anthem,State Preferred,,,,,,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Cigna,Cigna,,2.26,,,2.26,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Connecticare,Commerical,,3.3,,,3.3,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Connecticare,Exchange,,3.3,,,3.3,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,Multiplan,Multiplan,,,9.65,,9.65,2.26,9.65,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,63323-284-20,NDC,both,0.5,ea,11.35,6.81,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,9.65,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70436-021-82,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3370,HCPCS,70594-123-01,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Aetna,Commerical,,,7.92,,7.92,6.71,8.72,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Aetna,Middlesex Employees,,,7.59,,7.59,6.71,8.72,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Anthem,Commerical,,,,,,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Anthem,Indemnity,,,7.69,,7.69,6.71,8.72,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Anthem,Individual Exchange,,,,,,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Anthem,State Preferred,,,,,,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Cigna,Cigna,,6.71,,,6.71,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Connecticare,Commerical,,8.66,,,8.66,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Connecticare,Exchange,,8.66,,,8.66,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,Multiplan,Multiplan,,,8.72,,8.72,6.71,8.72,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",J3371,HCPCS,67457-612-20,NDC,both,0.5,ea,10.26,6.16,United Healthcare/Oxford,United Healthcare/Oxford,,7.25,,,7.25,6.71,8.72,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-01,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0143-9357-10,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,2.26,7.68,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,2.26,7.68,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Anthem,Commerical,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,2.26,7.68,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Anthem,Individual Exchange,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Anthem,State Preferred,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Cigna,Cigna,,2.26,,,2.26,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Connecticare,Commerical,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Connecticare,Exchange,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,2.26,7.68,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-01,NDC,both,0.5,ea,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.68,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-11,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-21,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-31,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Aetna,Commerical,,,7.2,,7.2,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Aetna,Middlesex Employees,,,6.9,,6.9,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Commerical,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Indemnity,,,6.99,,6.99,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,Individual Exchange,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Anthem,State Preferred,,,,,,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Cigna,Cigna,,2.26,,,2.26,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Connecticare,Commerical,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Connecticare,Exchange,,3.3,,,3.3,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,Multiplan,Multiplan,,,7.93,,7.93,2.26,7.93,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,0409-6533-59,NDC,both,0.5,ea,9.33,5.6,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.93,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Aetna,Commerical,,,7.38,,7.38,2.26,8.13,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Aetna,Middlesex Employees,,,7.07,,7.07,2.26,8.13,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Anthem,Commerical,,,,,,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Anthem,Indemnity,,,7.16,,7.16,2.26,8.13,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Anthem,Individual Exchange,,,,,,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Anthem,State Preferred,,,,,,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Cigna,Cigna,,2.26,,,2.26,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Connecticare,Commerical,,3.3,,,3.3,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Connecticare,Exchange,,3.3,,,3.3,2.26,8.13,Other,Could be inpatient or outpatient,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,Multiplan,Multiplan,,,8.13,,8.13,2.26,8.13,percent of total billed charges,,
"VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION TOPICAL OSM",J3370,HCPCS,67457-340-01,NDC,both,0.5,ea,9.56,5.74,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,8.13,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Aetna,Commerical,,,79.68,,79.68,2.26,87.77,percent of total billed charges,,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Aetna,Middlesex Employees,,,76.4,,76.4,2.26,87.77,percent of total billed charges,,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Anthem,Commerical,,,,,,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Anthem,Indemnity,,,77.35,,77.35,2.26,87.77,percent of total billed charges,,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Anthem,Individual Exchange,,,,,,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Anthem,State Preferred,,,,,,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Cigna,Cigna,,2.26,,,2.26,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Connecticare,Commerical,,3.3,,,3.3,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Connecticare,Exchange,,3.3,,,3.3,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,Multiplan,Multiplan,,,87.77,,87.77,2.26,87.77,percent of total billed charges,,
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-314-61,NDC,both,0.5,ea,103.26,61.96,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,87.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Aetna,Commerical,,,2.79,,2.79,2.26,3.3,percent of total billed charges,,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Aetna,Middlesex Employees,,,2.67,,2.67,2.26,3.3,percent of total billed charges,,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Anthem,Commerical,,,,,,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Anthem,Indemnity,,,2.7,,2.7,2.26,3.3,percent of total billed charges,,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Anthem,Individual Exchange,,,,,,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Anthem,State Preferred,,,,,,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Cigna,Cigna,,2.26,,,2.26,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Connecticare,Commerical,,3.3,,,3.3,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Connecticare,Exchange,,3.3,,,3.3,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,Multiplan,Multiplan,,,3.07,,3.07,2.26,3.3,percent of total billed charges,,
VANCOMYCIN 25 MG/ML OPHTHALMIC SOLN,J3370,HCPCS,40810-0204-58,NDC,both,20,mL,3.61,2.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,3.3,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Aetna,Commerical,,,422.72,,422.72,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Aetna,Middlesex Employees,,,405.35,,405.35,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Anthem,Commerical,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Anthem,Indemnity,,,410.39,,410.39,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Anthem,Individual Exchange,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Anthem,State Preferred,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Cigna,Cigna,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Connecticare,Commerical,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Connecticare,Exchange,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,Multiplan,Multiplan,,,465.67,,465.67,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLN,J3490,HCPCS,65628-205-10,NDC,both,40,mL,547.85,328.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Aetna,Commerical,,,396.3,,396.3,380.02,436.57,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Aetna,Middlesex Employees,,,380.02,,380.02,380.02,436.57,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Anthem,Commerical,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Anthem,Indemnity,,,384.75,,384.75,380.02,436.57,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Anthem,Individual Exchange,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Anthem,State Preferred,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Cigna,Cigna,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Connecticare,Commerical,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Connecticare,Exchange,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,Multiplan,Multiplan,,,436.57,,436.57,380.02,436.57,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,52536-107-10,NDC,both,1,mL,513.61,308.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,380.02,436.57,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Aetna,Commerical,,,198.15,,198.15,190.01,218.29,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Aetna,Middlesex Employees,,,190.01,,190.01,190.01,218.29,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Anthem,Commerical,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Anthem,Indemnity,,,192.38,,192.38,190.01,218.29,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Anthem,Individual Exchange,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Anthem,State Preferred,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Cigna,Cigna,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Connecticare,Commerical,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Connecticare,Exchange,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,Multiplan,Multiplan,,,218.29,,218.29,190.01,218.29,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-204-05,NDC,both,1,mL,256.81,154.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,190.01,218.29,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Aetna,Commerical,,,422.72,,422.72,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Aetna,Middlesex Employees,,,405.35,,405.35,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Anthem,Commerical,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Anthem,Indemnity,,,410.39,,410.39,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Anthem,Individual Exchange,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Anthem,State Preferred,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Cigna,Cigna,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Connecticare,Commerical,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Connecticare,Exchange,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,Multiplan,Multiplan,,,465.67,,465.67,405.35,465.67,percent of total billed charges,,
VANCOMYCIN 25 MG/ML ORAL SOLUTION,J3490,HCPCS,65628-205-10,NDC,both,40,mL,513.61,308.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,405.35,465.67,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Aetna,Commerical,,,33.04,,33.04,31.68,36.4,percent of total billed charges,,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Aetna,Middlesex Employees,,,31.68,,31.68,31.68,36.4,percent of total billed charges,,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Anthem,Commerical,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Anthem,Indemnity,,,32.08,,32.08,31.68,36.4,percent of total billed charges,,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Anthem,Individual Exchange,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Anthem,State Preferred,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Cigna,Cigna,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Connecticare,Commerical,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Connecticare,Exchange,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,Multiplan,Multiplan,,,36.4,,36.4,31.68,36.4,percent of total billed charges,,
VANCOMYCIN 250 MG CAPSULE,J3490,HCPCS,63323-339-20,NDC,both,1,ea,42.82,25.69,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.68,36.4,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Aetna,Commerical,,,204.89,,204.89,2.26,225.71,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Aetna,Middlesex Employees,,,196.47,,196.47,2.26,225.71,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Anthem,Commerical,,,,,,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Anthem,Indemnity,,,198.92,,198.92,2.26,225.71,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Anthem,Individual Exchange,,,,,,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Anthem,State Preferred,,,,,,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Cigna,Cigna,,2.26,,,2.26,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Connecticare,Commerical,,3.3,,,3.3,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Connecticare,Exchange,,3.3,,,3.3,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,Multiplan,Multiplan,,,225.71,,225.71,2.26,225.71,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,63323-295-61,NDC,both,0.1,ea,265.54,159.32,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,225.71,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Aetna,Commerical,,,46.52,,46.52,2.26,51.25,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Aetna,Middlesex Employees,,,44.61,,44.61,2.26,51.25,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Anthem,Commerical,,,,,,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Anthem,Indemnity,,,45.16,,45.16,2.26,51.25,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Anthem,Individual Exchange,,,,,,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Anthem,State Preferred,,,,,,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Cigna,Cigna,,2.26,,,2.26,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Connecticare,Commerical,,3.3,,,3.3,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Connecticare,Exchange,,3.3,,,3.3,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,Multiplan,Multiplan,,,51.25,,51.25,2.26,51.25,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,67457-341-05,NDC,both,0.1,ea,60.29,36.17,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,51.25,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Aetna,Commerical,,,226.14,,226.14,2.26,249.12,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Aetna,Middlesex Employees,,,216.85,,216.85,2.26,249.12,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Anthem,Commerical,,,,,,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Anthem,Indemnity,,,219.55,,219.55,2.26,249.12,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Anthem,Individual Exchange,,,,,,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Anthem,State Preferred,,,,,,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Cigna,Cigna,,2.26,,,2.26,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Connecticare,Commerical,,3.3,,,3.3,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Connecticare,Exchange,,3.3,,,3.3,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,Multiplan,Multiplan,,,249.12,,249.12,2.26,249.12,percent of total billed charges,,
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,J3370,HCPCS,70436-022-82,NDC,both,0.1,ea,293.08,175.85,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,249.12,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,2.26,19.53,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,2.26,19.53,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Anthem,Commerical,,,,,,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,2.26,19.53,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Anthem,Individual Exchange,,,,,,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Anthem,State Preferred,,,,,,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Cigna,Cigna,,2.26,,,2.26,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Connecticare,Commerical,,3.3,,,3.3,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Connecticare,Exchange,,3.3,,,3.3,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,2.26,19.53,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-07,NDC,both,100,mL,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,19.53,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Aetna,Commerical,,,13.3,,13.3,2.26,14.65,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Aetna,Middlesex Employees,,,12.76,,12.76,2.26,14.65,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Anthem,Commerical,,,,,,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Anthem,Indemnity,,,12.91,,12.91,2.26,14.65,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Anthem,Individual Exchange,,,,,,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Anthem,State Preferred,,,,,,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Cigna,Cigna,,2.26,,,2.26,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Connecticare,Commerical,,3.3,,,3.3,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Connecticare,Exchange,,3.3,,,3.3,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,Multiplan,Multiplan,,,14.65,,14.65,2.26,14.65,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-08,NDC,both,75,mL,17.24,10.34,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,14.65,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Aetna,Commerical,,,8.87,,8.87,2.26,9.77,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Aetna,Middlesex Employees,,,8.5,,8.5,2.26,9.77,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Anthem,Commerical,,,,,,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Anthem,Indemnity,,,8.61,,8.61,2.26,9.77,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Anthem,Individual Exchange,,,,,,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Anthem,State Preferred,,,,,,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Cigna,Cigna,,2.26,,,2.26,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Connecticare,Commerical,,3.3,,,3.3,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Connecticare,Exchange,,3.3,,,3.3,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,Multiplan,Multiplan,,,9.77,,9.77,2.26,9.77,percent of total billed charges,,
VANCOMYCIN 5 MG/ML RETENTION ENEMA,J3370,HCPCS,40810-0018-09,NDC,both,50,mL,11.49,6.89,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,9.77,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,2.26,7.68,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,2.26,7.68,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Commerical,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,2.26,7.68,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Individual Exchange,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,State Preferred,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Cigna,Cigna,,2.26,,,2.26,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Connecticare,Commerical,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Connecticare,Exchange,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,2.26,7.68,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Aetna,Commerical,,,6.69,,6.69,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Aetna,Middlesex Employees,,,6.41,,6.41,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Anthem,Commerical,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Anthem,Indemnity,,,6.49,,6.49,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Anthem,Individual Exchange,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Anthem,State Preferred,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Cigna,Cigna,,2.26,,,2.26,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Connecticare,Commerical,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Connecticare,Exchange,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,Multiplan,Multiplan,,,7.37,,7.37,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,0409-4332-11,NDC,both,1,ea,8.67,5.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Aetna,Commerical,,,6.61,,6.61,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Aetna,Middlesex Employees,,,6.34,,6.34,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Anthem,Commerical,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Anthem,Indemnity,,,6.42,,6.42,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Anthem,Individual Exchange,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Anthem,State Preferred,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Cigna,Cigna,,2.26,,,2.26,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Connecticare,Commerical,,3.3,,,3.3,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Connecticare,Exchange,,3.3,,,3.3,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,Multiplan,Multiplan,,,7.28,,7.28,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-07,NDC,both,1,ea,8.57,5.14,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Aetna,Commerical,,,6.61,,6.61,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Aetna,Middlesex Employees,,,6.34,,6.34,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Anthem,Commerical,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Anthem,Indemnity,,,6.42,,6.42,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Anthem,Individual Exchange,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Anthem,State Preferred,,,,,,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Cigna,Cigna,,2.26,,,2.26,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Connecticare,Commerical,,3.3,,,3.3,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Connecticare,Exchange,,3.3,,,3.3,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,Multiplan,Multiplan,,,7.28,,7.28,2.26,7.28,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,47781-598-91,NDC,both,1,ea,8.57,5.14,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.28,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Aetna,Commerical,,,6.69,,6.69,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Aetna,Middlesex Employees,,,6.41,,6.41,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Anthem,Commerical,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Anthem,Indemnity,,,6.49,,6.49,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Anthem,Individual Exchange,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Anthem,State Preferred,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Cigna,Cigna,,2.26,,,2.26,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Connecticare,Commerical,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Connecticare,Exchange,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,Multiplan,Multiplan,,,7.37,,7.37,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70436-020-82,NDC,both,1,ea,8.67,5.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Aetna,Commerical,,,20.07,,20.07,2.26,22.11,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Aetna,Middlesex Employees,,,19.24,,19.24,2.26,22.11,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Anthem,Commerical,,,,,,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Anthem,Indemnity,,,19.48,,19.48,2.26,22.11,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Anthem,Individual Exchange,,,,,,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Anthem,State Preferred,,,,,,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Cigna,Cigna,,2.26,,,2.26,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Connecticare,Commerical,,3.3,,,3.3,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Connecticare,Exchange,,3.3,,,3.3,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,Multiplan,Multiplan,,,22.11,,22.11,2.26,22.11,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,70860-104-10,NDC,both,1,ea,26.01,15.61,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,22.11,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Aetna,Commerical,,,6.69,,6.69,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Aetna,Middlesex Employees,,,6.41,,6.41,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Anthem,Commerical,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Anthem,Indemnity,,,6.49,,6.49,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Anthem,Individual Exchange,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Anthem,State Preferred,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Cigna,Cigna,,2.26,,,2.26,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Connecticare,Commerical,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Connecticare,Exchange,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,Multiplan,Multiplan,,,7.37,,7.37,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-01,NDC,both,1,ea,8.67,5.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Aetna,Commerical,,,6.69,,6.69,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Aetna,Middlesex Employees,,,6.41,,6.41,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Anthem,Commerical,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Anthem,Indemnity,,,6.49,,6.49,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Anthem,Individual Exchange,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Anthem,State Preferred,,,,,,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Cigna,Cigna,,2.26,,,2.26,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Connecticare,Commerical,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Connecticare,Exchange,,3.3,,,3.3,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,Multiplan,Multiplan,,,7.37,,7.37,2.26,7.37,percent of total billed charges,,
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,J3370,HCPCS,72611-761-10,NDC,both,1,ea,8.67,5.2,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.37,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Aetna,Commerical,,,6.98,,6.98,2.26,7.68,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Aetna,Middlesex Employees,,,6.69,,6.69,2.26,7.68,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Commerical,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Indemnity,,,6.77,,6.77,2.26,7.68,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,Individual Exchange,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Anthem,State Preferred,,,,,,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Cigna,Cigna,,2.26,,,2.26,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Connecticare,Commerical,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Connecticare,Exchange,,3.3,,,3.3,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,Multiplan,Multiplan,,,7.68,,7.68,2.26,7.68,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,0409-4332-01,NDC,both,1,ea,9.04,5.42,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,7.68,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Aetna,Commerical,,,10.26,,10.26,2.26,11.31,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Aetna,Middlesex Employees,,,9.84,,9.84,2.26,11.31,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Anthem,Commerical,,,,,,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Anthem,Indemnity,,,9.96,,9.96,2.26,11.31,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Anthem,Individual Exchange,,,,,,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Anthem,State Preferred,,,,,,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Cigna,Cigna,,2.26,,,2.26,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Connecticare,Commerical,,3.3,,,3.3,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Connecticare,Exchange,,3.3,,,3.3,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,Multiplan,Multiplan,,,11.31,,11.31,2.26,11.31,percent of total billed charges,,
VANCOMYCIN FOR INHALATION,J3370,HCPCS,67457-339-50,NDC,both,1,ea,13.3,7.98,United Healthcare/Oxford,United Healthcare/Oxford,,2.44,,,2.44,2.26,11.31,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Aetna,Commerical,,,134,,134,128.5,147.62,percent of total billed charges,,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Aetna,Middlesex Employees,,,128.5,,128.5,128.5,147.62,percent of total billed charges,,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Anthem,Commerical,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Anthem,Indemnity,,,130.1,,130.1,128.5,147.62,percent of total billed charges,,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Anthem,Individual Exchange,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Anthem,State Preferred,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Cigna,Cigna,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Connecticare,Commerical,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Connecticare,Exchange,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,Multiplan,Multiplan,,,147.62,,147.62,128.5,147.62,percent of total billed charges,,
VANCOMYCIN LOCK 5 MG/ML IN NS,J3490,HCPCS,40810-0017-81,NDC,both,1,mL,173.67,104.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,128.5,147.62,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Aetna,Commerical,,,489.52,,489.52,223.49,539.26,percent of total billed charges,,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Aetna,Middlesex Employees,,,469.41,,469.41,223.49,539.26,percent of total billed charges,,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Anthem,Commerical,,279.37,,,279.37,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Anthem,Indemnity,,,475.24,,475.24,223.49,539.26,percent of total billed charges,,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Anthem,Individual Exchange,,223.49,,,223.49,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Anthem,State Preferred,,279.37,,,279.37,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Cigna,Cigna,,,,,,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Connecticare,Commerical,,,,,,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Connecticare,Exchange,,,,,,223.49,539.26,Other,Could be inpatient or outpatient,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,Multiplan,Multiplan,,,539.26,,539.26,223.49,539.26,percent of total billed charges,,
"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",90716,HCPCS,0006-4827-00,NDC,both,1,ea,634.42,380.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,223.49,539.26,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,0548-9701-00,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,42023-164-25,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-11,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,43598-085-25,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-00,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-01,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-24,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Commerical,,,44,,44,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Aetna,Middlesex Employees,,,42.2,,42.2,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Commerical,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Indemnity,,,42.72,,42.72,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Anthem,Individual Exchange,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Anthem,State Preferred,,,,,,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Cigna,Cigna,,2.18,,,2.18,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Commerical,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Connecticare,Exchange,,2.47,,,2.47,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,Multiplan,Multiplan,,,48.48,,48.48,2.18,48.48,percent of total billed charges,,
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,J2598,HCPCS,55150-370-25,NDC,both,0.05,mL,57.03,34.22,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,48.48,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Aetna,Commerical,,,438.86,,438.86,2.18,483.45,percent of total billed charges,,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Aetna,Middlesex Employees,,,420.83,,420.83,2.18,483.45,percent of total billed charges,,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Anthem,Commerical,,,,,,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Anthem,Indemnity,,,426.06,,426.06,2.18,483.45,percent of total billed charges,,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Anthem,Individual Exchange,,,,,,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Anthem,State Preferred,,,,,,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Cigna,Cigna,,2.18,,,2.18,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Connecticare,Commerical,,2.47,,,2.47,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Connecticare,Exchange,,2.47,,,2.47,2.18,483.45,Other,Could be inpatient or outpatient,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,Multiplan,Multiplan,,,483.45,,483.45,2.18,483.45,percent of total billed charges,,
VASOPRESSIN FOR DIABETES INSIPIDUS 5 UNITS/ML DILUTION,J2598,HCPCS,40810-0204-84,NDC,both,0.2,mL,568.76,341.26,United Healthcare/Oxford,United Healthcare/Oxford,,2.35,,,2.35,2.18,483.45,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-01,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0143-9234-10,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Aetna,Commerical,,,15.31,,15.31,14.68,16.86,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Aetna,Middlesex Employees,,,14.68,,14.68,14.68,16.86,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Anthem,Commerical,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Anthem,Indemnity,,,14.86,,14.86,14.68,16.86,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Anthem,Individual Exchange,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Anthem,State Preferred,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Cigna,Cigna,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Connecticare,Commerical,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Connecticare,Exchange,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,Multiplan,Multiplan,,,16.86,,16.86,14.68,16.86,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-01,NDC,both,1,ea,19.84,11.9,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.68,16.86,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-21,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1632-49,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,0703-2914-03,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-40,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-931-44,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,47335-931-44,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Aetna,Commerical,,,10.28,,10.28,9.86,11.32,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.32,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Anthem,Commerical,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Anthem,Indemnity,,,9.98,,9.98,9.86,11.32,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Anthem,Individual Exchange,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Anthem,State Preferred,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Cigna,Cigna,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Connecticare,Commerical,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Connecticare,Exchange,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,Multiplan,Multiplan,,,11.32,,11.32,9.86,11.32,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-01,NDC,both,1,ea,13.32,7.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.32,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-02,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-10,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-235-11,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-037-10,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-10,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-781-21,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Aetna,Commerical,,,6.9,,6.9,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Anthem,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Anthem,Indemnity,,,6.7,,6.7,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Anthem,Individual Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Anthem,State Preferred,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Cigna,Cigna,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Connecticare,Commerical,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Connecticare,Exchange,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,Multiplan,Multiplan,,,7.6,,7.6,6.61,7.6,percent of total billed charges,,
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,J3490,HCPCS,67457-438-10,NDC,both,1,ea,8.94,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.6,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,25021-686-20,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,41616-932-44,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-01,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-02,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-20,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55150-236-21,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,55390-039-10,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-20,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Aetna,Commerical,,,13.8,,13.8,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Aetna,Middlesex Employees,,,13.23,,13.23,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Anthem,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Anthem,Indemnity,,,13.39,,13.39,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Anthem,Individual Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Anthem,State Preferred,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Cigna,Cigna,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Connecticare,Commerical,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Connecticare,Exchange,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,Multiplan,Multiplan,,,15.2,,15.2,13.23,15.2,percent of total billed charges,,
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,J3490,HCPCS,63323-782-23,NDC,both,1,ea,17.88,10.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.23,15.2,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-28,NDC,both,50,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Aetna,Commerical,,,102.85,,102.85,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Aetna,Middlesex Employees,,,98.62,,98.62,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Anthem,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Anthem,Indemnity,,,99.85,,99.85,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Anthem,Individual Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Anthem,State Preferred,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Cigna,Cigna,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Connecticare,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Connecticare,Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,Multiplan,Multiplan,,,113.3,,113.3,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0014-29,NDC,both,10,mL,133.29,79.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Aetna,Commerical,,,154.27,,154.27,147.93,169.94,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Aetna,Middlesex Employees,,,147.93,,147.93,147.93,169.94,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Anthem,Commerical,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Anthem,Indemnity,,,149.77,,149.77,147.93,169.94,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Anthem,Individual Exchange,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Anthem,State Preferred,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Cigna,Cigna,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Connecticare,Commerical,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Connecticare,Exchange,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,Multiplan,Multiplan,,,169.94,,169.94,147.93,169.94,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-15,NDC,both,10,mL,199.93,119.96,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,147.93,169.94,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Aetna,Commerical,,,257.1,,257.1,246.54,283.23,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Aetna,Middlesex Employees,,,246.54,,246.54,246.54,283.23,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Anthem,Commerical,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Anthem,Indemnity,,,249.61,,249.61,246.54,283.23,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Anthem,Individual Exchange,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Anthem,State Preferred,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Cigna,Cigna,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Connecticare,Commerical,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Connecticare,Exchange,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,Multiplan,Multiplan,,,283.23,,283.23,246.54,283.23,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN 0.9% SODIUM CHLORIDE,J3490,HCPCS,40810-0018-16,NDC,both,10,mL,333.21,199.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,246.54,283.23,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Aetna,Commerical,,,51.43,,51.43,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Aetna,Middlesex Employees,,,49.31,,49.31,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Anthem,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Anthem,Indemnity,,,49.93,,49.93,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Anthem,Individual Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Anthem,State Preferred,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Cigna,Cigna,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Connecticare,Commerical,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Connecticare,Exchange,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,Multiplan,Multiplan,,,56.65,,56.65,49.31,56.65,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-26,NDC,both,50,mL,66.65,39.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,49.31,56.65,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Aetna,Commerical,,,102.85,,102.85,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Aetna,Middlesex Employees,,,98.62,,98.62,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Anthem,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Anthem,Indemnity,,,99.85,,99.85,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Anthem,Individual Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Anthem,State Preferred,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Cigna,Cigna,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Connecticare,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Connecticare,Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,Multiplan,Multiplan,,,113.3,,113.3,98.62,113.3,percent of total billed charges,,
VECURONIUM IV INFUSION 1 MG/ML IN DEXTROSE 5%,J3490,HCPCS,40810-0014-27,NDC,both,10,mL,133.29,79.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Aetna,Commerical,,,36.43,,36.43,34.94,40.14,percent of total billed charges,,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Aetna,Middlesex Employees,,,34.94,,34.94,34.94,40.14,percent of total billed charges,,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Anthem,Commerical,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Anthem,Indemnity,,,35.37,,35.37,34.94,40.14,percent of total billed charges,,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Anthem,Individual Exchange,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Anthem,State Preferred,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Cigna,Cigna,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Connecticare,Commerical,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Connecticare,Exchange,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,Multiplan,Multiplan,,,40.14,,40.14,34.94,40.14,percent of total billed charges,,
VENETOCLAX 10 MG TABLET,J3490,HCPCS,0074-0561-14,NDC,both,1,ea,47.22,28.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.94,40.14,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Aetna,Commerical,,,364.31,,364.31,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Aetna,Middlesex Employees,,,349.34,,349.34,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Anthem,Commerical,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Anthem,Indemnity,,,353.69,,353.69,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Anthem,Individual Exchange,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Anthem,State Preferred,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Cigna,Cigna,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Connecticare,Commerical,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Connecticare,Exchange,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,Multiplan,Multiplan,,,401.33,,401.33,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,0074-0576-30,NDC,both,1,ea,472.15,283.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Aetna,Commerical,,,364.31,,364.31,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Aetna,Middlesex Employees,,,349.34,,349.34,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Anthem,Commerical,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Anthem,Indemnity,,,353.69,,353.69,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Anthem,Individual Exchange,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Anthem,State Preferred,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Cigna,Cigna,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Connecticare,Commerical,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Connecticare,Exchange,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,Multiplan,Multiplan,,,401.33,,401.33,349.34,401.33,percent of total billed charges,,
VENETOCLAX 100 MG TABLET,J3490,HCPCS,40810-0208-41,NDC,both,1,ea,472.15,283.29,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,349.34,401.33,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Aetna,Commerical,,,364.34,,364.34,349.37,401.36,percent of total billed charges,,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Aetna,Middlesex Employees,,,349.37,,349.37,349.37,401.36,percent of total billed charges,,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Anthem,Commerical,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Anthem,Indemnity,,,353.72,,353.72,349.37,401.36,percent of total billed charges,,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Anthem,Individual Exchange,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Anthem,State Preferred,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Cigna,Cigna,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Connecticare,Commerical,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Connecticare,Exchange,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,Multiplan,Multiplan,,,401.36,,401.36,349.37,401.36,percent of total billed charges,,
VENETOCLAX 25 MG SPLIT TABLET,J3490,HCPCS,40810-208-75,NDC,both,2,ea,472.19,283.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,349.37,401.36,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Aetna,Commerical,,,182.17,,182.17,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Aetna,Middlesex Employees,,,174.68,,174.68,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Anthem,Commerical,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Anthem,Indemnity,,,176.86,,176.86,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Anthem,Individual Exchange,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Anthem,State Preferred,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Cigna,Cigna,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Connecticare,Commerical,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Connecticare,Exchange,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,Multiplan,Multiplan,,,200.68,,200.68,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,0074-0566-11,NDC,both,1,ea,236.09,141.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Aetna,Commerical,,,182.17,,182.17,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Aetna,Middlesex Employees,,,174.68,,174.68,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Anthem,Commerical,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Anthem,Indemnity,,,176.86,,176.86,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Anthem,Individual Exchange,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Anthem,State Preferred,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Cigna,Cigna,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Connecticare,Commerical,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Connecticare,Exchange,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,Multiplan,Multiplan,,,200.68,,200.68,174.68,200.68,percent of total billed charges,,
VENETOCLAX 50 MG TABLET,J3490,HCPCS,40810-208-76,NDC,both,1,UN,236.09,141.65,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,174.68,200.68,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,40810-0017-74,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57237-173-01,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Aetna,Commerical,,,0.32,,0.32,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Aetna,Middlesex Employees,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Anthem,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Anthem,Indemnity,,,0.31,,0.31,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Anthem,Individual Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Anthem,State Preferred,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Cigna,Cigna,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Connecticare,Commerical,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Connecticare,Exchange,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,Multiplan,Multiplan,,,0.36,,0.36,0.31,0.36,percent of total billed charges,,
VENLAFAXINE 37.5 MG TABLET,J3490,HCPCS,57664-393-88,NDC,both,1,ea,0.42,0.25,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.31,0.36,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,40810-0008-98,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57237-174-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,57664-394-88,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
VENLAFAXINE 50 MG TABLET,J3490,HCPCS,68382-020-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-01,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,51079-482-20,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,57237-175-01,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Aetna,Commerical,,,2.23,,2.23,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Aetna,Middlesex Employees,,,2.14,,2.14,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Anthem,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Anthem,Indemnity,,,2.16,,2.16,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Anthem,Individual Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Anthem,State Preferred,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Cigna,Cigna,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Connecticare,Commerical,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Connecticare,Exchange,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,Multiplan,Multiplan,,,2.46,,2.46,2.14,2.46,percent of total billed charges,,
VENLAFAXINE 75 MG TABLET,J3490,HCPCS,68084-856-01,NDC,both,1,ea,2.89,1.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.14,2.46,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,0904-7076-61,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,40810-0006-14,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Aetna,Commerical,,,0.35,,0.35,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Aetna,Middlesex Employees,,,0.33,,0.33,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Anthem,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Anthem,Indemnity,,,0.34,,0.34,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Anthem,Individual Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Anthem,State Preferred,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Cigna,Cigna,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Connecticare,Commerical,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Connecticare,Exchange,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,Multiplan,Multiplan,,,0.38,,0.38,0.33,0.38,percent of total billed charges,,
"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",J8499,HCPCS,65862-697-30,NDC,both,1,ea,0.45,0.27,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.33,0.38,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0008-0837-20,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,0093-7384-56,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,40810-0006-12,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Aetna,Commerical,,,0.27,,0.27,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Aetna,Middlesex Employees,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Anthem,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Anthem,Indemnity,,,0.26,,0.26,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Anthem,Individual Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Anthem,State Preferred,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Cigna,Cigna,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Connecticare,Commerical,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Connecticare,Exchange,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,Multiplan,Multiplan,,,0.3,,0.3,0.26,0.3,percent of total billed charges,,
"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",J3490,HCPCS,65862-527-30,NDC,both,1,ea,0.35,0.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.26,0.3,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,23155-059-01,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VERAPAMIL 10 MG ORAL TAB,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-1144-05,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4011-01,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-01,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,70069-271-05,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-01,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Aetna,Commerical,,,13.09,,13.09,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Aetna,Middlesex Employees,,,12.55,,12.55,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Anthem,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Anthem,Indemnity,,,12.7,,12.7,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Anthem,Individual Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Anthem,State Preferred,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Cigna,Cigna,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Connecticare,Commerical,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Connecticare,Exchange,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,Multiplan,Multiplan,,,14.42,,14.42,12.55,14.42,percent of total billed charges,,
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,72485-108-05,NDC,both,1,mL,16.96,10.18,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.55,14.42,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
VERAPAMIL 20 MG ORAL TAB,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.44,,0.44,0.42,0.48,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.42,,0.42,0.42,0.48,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.43,,0.43,0.42,0.48,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.48,,0.48,0.42,0.48,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,0591-0404-01,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.42,0.48,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0204-90,NDC,both,1,ea,0.57,0.34,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Aetna,Commerical,,,0.42,,0.42,0.4,0.46,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Aetna,Middlesex Employees,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Indemnity,,,0.4,,0.4,0.4,0.46,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,Individual Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Anthem,State Preferred,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Cigna,Cigna,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Connecticare,Commerical,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Connecticare,Exchange,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,Multiplan,Multiplan,,,0.46,,0.46,0.4,0.46,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-65,NDC,both,1,ea,0.54,0.32,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.4,0.46,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Aetna,Commerical,,,0.83,,0.83,0.79,0.91,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Aetna,Middlesex Employees,,,0.79,,0.79,0.79,0.91,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Anthem,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Anthem,Indemnity,,,0.8,,0.8,0.79,0.91,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Anthem,Individual Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Anthem,State Preferred,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Cigna,Cigna,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Connecticare,Commerical,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Connecticare,Exchange,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,Multiplan,Multiplan,,,0.91,,0.91,0.79,0.91,percent of total billed charges,,
VERAPAMIL 40 MG TABLET,J3490,HCPCS,40810-0207-66,NDC,both,1,ea,1.07,0.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.79,0.91,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Aetna,Commerical,,,15.96,,15.96,15.31,17.59,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Aetna,Middlesex Employees,,,15.31,,15.31,15.31,17.59,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Anthem,Commerical,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Anthem,Indemnity,,,15.5,,15.5,15.31,17.59,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Anthem,Individual Exchange,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Anthem,State Preferred,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Cigna,Cigna,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Connecticare,Commerical,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Connecticare,Exchange,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,Multiplan,Multiplan,,,17.59,,17.59,15.31,17.59,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0003-18,NDC,both,1,mL,20.69,12.41,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.31,17.59,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Aetna,Commerical,,,7.99,,7.99,7.66,8.8,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Aetna,Middlesex Employees,,,7.66,,7.66,7.66,8.8,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Anthem,Commerical,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Anthem,Indemnity,,,7.75,,7.75,7.66,8.8,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Anthem,Individual Exchange,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Anthem,State Preferred,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Cigna,Cigna,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Connecticare,Commerical,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Connecticare,Exchange,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,Multiplan,Multiplan,,,8.8,,8.8,7.66,8.8,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-78,NDC,both,1,mL,10.35,6.21,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.66,8.8,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Aetna,Commerical,,,31.92,,31.92,30.61,35.16,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Aetna,Middlesex Employees,,,30.61,,30.61,30.61,35.16,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Anthem,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Anthem,Indemnity,,,30.99,,30.99,30.61,35.16,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Anthem,Individual Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Anthem,State Preferred,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Cigna,Cigna,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Connecticare,Commerical,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Connecticare,Exchange,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,Multiplan,Multiplan,,,35.16,,35.16,30.61,35.16,percent of total billed charges,,
VERAPAMIL 50 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-79,NDC,both,1,mL,41.37,24.82,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.61,35.16,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,0591-0343-01,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Aetna,Commerical,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Aetna,Middlesex Employees,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Anthem,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Anthem,Indemnity,,,0.15,,0.15,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Anthem,Individual Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Anthem,State Preferred,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Cigna,Cigna,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Connecticare,Commerical,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Connecticare,Exchange,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,Multiplan,Multiplan,,,0.17,,0.17,0.15,0.17,percent of total billed charges,,
VERAPAMIL 80 MG TABLET,J3490,HCPCS,40810-0008-02,NDC,both,1,ea,0.2,0.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.15,0.17,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Aetna,Commerical,,,0.39,,0.39,0.38,0.43,percent of total billed charges,,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Aetna,Middlesex Employees,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Anthem,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Anthem,Indemnity,,,0.38,,0.38,0.38,0.43,percent of total billed charges,,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Anthem,Individual Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Anthem,State Preferred,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Cigna,Cigna,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Connecticare,Commerical,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Connecticare,Exchange,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,Multiplan,Multiplan,,,0.43,,0.43,0.38,0.43,percent of total billed charges,,
"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",J3490,HCPCS,68462-260-01,NDC,both,1,ea,0.51,0.31,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.38,0.43,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67386-211-65,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,67877-674-63,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Aetna,Commerical,,,17.73,,17.73,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Aetna,Middlesex Employees,,,17,,17,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Anthem,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Anthem,Indemnity,,,17.21,,17.21,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Anthem,Individual Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Anthem,State Preferred,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Cigna,Cigna,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Connecticare,Commerical,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Connecticare,Exchange,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,Multiplan,Multiplan,,,19.53,,19.53,17,19.53,percent of total billed charges,,
VIGABATRIN 500 MG ORAL POWDER PACKET,J8499,HCPCS,69097-964-53,NDC,both,1,ea,22.98,13.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17,19.53,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Aetna,Commerical,,,4166.87,,4166.87,65.01,4590.26,percent of total billed charges,,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Aetna,Middlesex Employees,,,3995.68,,3995.68,65.01,4590.26,percent of total billed charges,,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Anthem,Commerical,,,,,,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Anthem,Indemnity,,,4045.36,,4045.36,65.01,4590.26,percent of total billed charges,,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Anthem,Individual Exchange,,,,,,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Anthem,State Preferred,,,,,,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Cigna,Cigna,,65.01,,,65.01,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Connecticare,Commerical,,,,,,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Connecticare,Exchange,,,,,,65.01,4590.26,Other,Could be inpatient or outpatient,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,Multiplan,Multiplan,,,4590.26,,4590.26,65.01,4590.26,percent of total billed charges,,
VILTOLARSEN 50 MG/ML INTRAVENOUS SOLUTION,J1427,HCPCS,73292-011-01,NDC,both,0.2,mL,5400.3,3240.18,United Healthcare/Oxford,United Healthcare/Oxford,,71.75,,,71.75,65.01,4590.26,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Aetna,Commerical,,,151.37,,151.37,4.73,166.75,percent of total billed charges,,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Aetna,Middlesex Employees,,,145.15,,145.15,4.73,166.75,percent of total billed charges,,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Anthem,Commerical,,,,,,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Anthem,Indemnity,,,146.96,,146.96,4.73,166.75,percent of total billed charges,,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Anthem,Individual Exchange,,,,,,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Anthem,State Preferred,,,,,,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Cigna,Cigna,,5.47,,,5.47,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Connecticare,Commerical,,6.77,,,6.77,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Connecticare,Exchange,,6.77,,,6.77,4.73,166.75,Other,Could be inpatient or outpatient,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,Multiplan,Multiplan,,,166.75,,166.75,4.73,166.75,percent of total billed charges,,
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,J9360,HCPCS,63323-278-10,NDC,both,1,mL,196.18,117.71,United Healthcare/Oxford,United Healthcare/Oxford,,4.73,,,4.73,4.73,166.75,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Aetna,Commerical,,,15.31,,15.31,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Aetna,Middlesex Employees,,,14.68,,14.68,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Anthem,Commerical,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Anthem,Indemnity,,,14.86,,14.86,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Anthem,Individual Exchange,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Anthem,State Preferred,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Cigna,Cigna,,11.97,,,11.97,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Connecticare,Commerical,,12.54,,,12.54,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Connecticare,Exchange,,12.54,,,12.54,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,Multiplan,Multiplan,,,16.86,,16.86,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,0703-4402-11,NDC,both,1,mL,19.84,11.9,United Healthcare/Oxford,United Healthcare/Oxford,,10.36,,,10.36,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Aetna,Commerical,,,13.91,,13.91,10.36,15.33,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Aetna,Middlesex Employees,,,13.34,,13.34,10.36,15.33,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Anthem,Commerical,,,,,,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Anthem,Indemnity,,,13.51,,13.51,10.36,15.33,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Anthem,Individual Exchange,,,,,,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Anthem,State Preferred,,,,,,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Cigna,Cigna,,11.97,,,11.97,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Connecticare,Commerical,,12.54,,,12.54,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Connecticare,Exchange,,12.54,,,12.54,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,Multiplan,Multiplan,,,15.33,,15.33,10.36,15.33,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-06,NDC,both,1,mL,18.03,10.82,United Healthcare/Oxford,United Healthcare/Oxford,,10.36,,,10.36,10.36,15.33,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Aetna,Commerical,,,15.31,,15.31,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Aetna,Middlesex Employees,,,14.68,,14.68,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Anthem,Commerical,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Anthem,Indemnity,,,14.86,,14.86,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Anthem,Individual Exchange,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Anthem,State Preferred,,,,,,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Cigna,Cigna,,11.97,,,11.97,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Connecticare,Commerical,,12.54,,,12.54,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Connecticare,Exchange,,12.54,,,12.54,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,Multiplan,Multiplan,,,16.86,,16.86,10.36,16.86,percent of total billed charges,,
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-26,NDC,both,1,mL,19.84,11.9,United Healthcare/Oxford,United Healthcare/Oxford,,10.36,,,10.36,10.36,16.86,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Aetna,Commerical,,,28.46,,28.46,10.36,31.36,percent of total billed charges,,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Aetna,Middlesex Employees,,,27.29,,27.29,10.36,31.36,percent of total billed charges,,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Anthem,Commerical,,,,,,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Anthem,Indemnity,,,27.63,,27.63,10.36,31.36,percent of total billed charges,,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Anthem,Individual Exchange,,,,,,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Anthem,State Preferred,,,,,,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Cigna,Cigna,,11.97,,,11.97,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Connecticare,Commerical,,12.54,,,12.54,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Connecticare,Exchange,,12.54,,,12.54,10.36,31.36,Other,Could be inpatient or outpatient,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,Multiplan,Multiplan,,,31.36,,31.36,10.36,31.36,percent of total billed charges,,
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,J9370,HCPCS,61703-309-16,NDC,both,1,mL,36.89,22.13,United Healthcare/Oxford,United Healthcare/Oxford,,10.36,,,10.36,10.36,31.36,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Aetna,Commerical,,,73.88,,73.88,10,81.39,percent of total billed charges,,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Aetna,Middlesex Employees,,,70.85,,70.85,10,81.39,percent of total billed charges,,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Anthem,Commerical,,,,,,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Anthem,Indemnity,,,71.73,,71.73,10,81.39,percent of total billed charges,,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Anthem,Individual Exchange,,,,,,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Anthem,State Preferred,,,,,,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Cigna,Cigna,,11.56,,,11.56,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Connecticare,Commerical,,11.59,,,11.59,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Connecticare,Exchange,,11.59,,,11.59,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,Multiplan,Multiplan,,,81.39,,81.39,10,81.39,percent of total billed charges,,
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-01,NDC,both,1,mL,95.75,57.45,United Healthcare/Oxford,United Healthcare/Oxford,,10,,,10,10,81.39,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Aetna,Commerical,,,98.15,,98.15,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Aetna,Middlesex Employees,,,94.12,,94.12,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Anthem,Commerical,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Anthem,Indemnity,,,95.29,,95.29,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Anthem,Individual Exchange,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Anthem,State Preferred,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Cigna,Cigna,,11.56,,,11.56,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Connecticare,Commerical,,11.59,,,11.59,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Connecticare,Exchange,,11.59,,,11.59,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,Multiplan,Multiplan,,,108.12,,108.12,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,0703-4183-01,NDC,both,1,mL,127.2,76.32,United Healthcare/Oxford,United Healthcare/Oxford,,10,,,10,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Aetna,Commerical,,,98.15,,98.15,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Aetna,Middlesex Employees,,,94.12,,94.12,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Anthem,Commerical,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Anthem,Indemnity,,,95.29,,95.29,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Anthem,Individual Exchange,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Anthem,State Preferred,,,,,,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Cigna,Cigna,,11.56,,,11.56,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Connecticare,Commerical,,11.59,,,11.59,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Connecticare,Exchange,,11.59,,,11.59,10,108.12,Other,Could be inpatient or outpatient,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,Multiplan,Multiplan,,,108.12,,108.12,10,108.12,percent of total billed charges,,
VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,J9390,HCPCS,25021-204-05,NDC,both,1,mL,127.2,76.32,United Healthcare/Oxford,United Healthcare/Oxford,,10,,,10,10,108.12,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,40810-0203-31,NDC,both,1,ea,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Aetna,Commerical,,,10.29,,10.29,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Aetna,Middlesex Employees,,,9.86,,9.86,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Indemnity,,,9.99,,9.99,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,Individual Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Anthem,State Preferred,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Cigna,Cigna,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Connecticare,Commerical,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Connecticare,Exchange,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,Multiplan,Multiplan,,,11.33,,11.33,9.86,11.33,percent of total billed charges,,
"VIOKACE 10,440 UNITS VIA ENTERAL TUBE",J3490,HCPCS,73562-104-10,NDC,both,1,ea,13.33,8,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,9.86,11.33,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Aetna,Commerical,,,0.08,,0.08,0.07,0.09,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Anthem,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Anthem,Indemnity,,,0.07,,0.07,0.07,0.09,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Anthem,Individual Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Anthem,State Preferred,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Cigna,Cigna,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Connecticare,Commerical,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Connecticare,Exchange,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,Multiplan,Multiplan,,,0.09,,0.09,0.07,0.09,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,761043310,NDC,both,1,ea,0.1,0.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.09,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",J3490,HCPCS,904208560,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Aetna,Commerical,,,5.53,,5.53,5.31,6.09,percent of total billed charges,,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Aetna,Middlesex Employees,,,5.31,,5.31,5.31,6.09,percent of total billed charges,,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Anthem,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Anthem,Indemnity,,,5.37,,5.37,5.31,6.09,percent of total billed charges,,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Anthem,Individual Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Anthem,State Preferred,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Cigna,Cigna,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Connecticare,Commerical,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Connecticare,Exchange,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,Multiplan,Multiplan,,,6.09,,6.09,5.31,6.09,percent of total billed charges,,
VITAMIN A AND D TOPICAL CREAM,J3490,HCPCS,1170100216,NDC,both,85,gm,7.17,4.3,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.31,6.09,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Aetna,Commerical,,,8.97,,8.97,8.61,9.89,percent of total billed charges,,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Aetna,Middlesex Employees,,,8.61,,8.61,8.61,9.89,percent of total billed charges,,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Anthem,Commerical,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Anthem,Indemnity,,,8.71,,8.71,8.61,9.89,percent of total billed charges,,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Anthem,Individual Exchange,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Anthem,State Preferred,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Cigna,Cigna,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Connecticare,Commerical,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Connecticare,Exchange,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,Multiplan,Multiplan,,,9.89,,9.89,8.61,9.89,percent of total billed charges,,
"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",J3490,HCPCS,61703-418-07,NDC,both,1,mL,11.63,6.98,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.61,9.89,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Aetna,Commerical,,,53.93,,53.93,51.72,59.42,percent of total billed charges,,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Aetna,Middlesex Employees,,,51.72,,51.72,51.72,59.42,percent of total billed charges,,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Anthem,Commerical,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Anthem,Indemnity,,,52.36,,52.36,51.72,59.42,percent of total billed charges,,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Anthem,Individual Exchange,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Anthem,State Preferred,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Cigna,Cigna,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Connecticare,Commerical,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Connecticare,Exchange,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,Multiplan,Multiplan,,,59.42,,59.42,51.72,59.42,percent of total billed charges,,
VITAMIN B COMPLEX WITH C NO.10-FOLIC ACID 900 MCG/5 ML ORAL LIQUID,A9153,HCPCS,5485951608,NDC,both,1,mL,69.9,41.94,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,51.72,59.42,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Aetna,Commerical,,,0.62,,0.62,0.6,0.69,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Aetna,Middlesex Employees,,,0.6,,0.6,0.6,0.69,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Anthem,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Anthem,Indemnity,,,0.61,,0.61,0.6,0.69,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Anthem,Individual Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Anthem,State Preferred,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Cigna,Cigna,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Connecticare,Commerical,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Connecticare,Exchange,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,Multiplan,Multiplan,,,0.69,,0.69,0.6,0.69,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885711,NDC,both,1,ea,0.81,0.49,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.6,0.69,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Aetna,Commerical,,,0.79,,0.79,0.76,0.88,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Aetna,Middlesex Employees,,,0.76,,0.76,0.76,0.88,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Anthem,Commerical,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Anthem,Indemnity,,,0.77,,0.77,0.76,0.88,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Anthem,Individual Exchange,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Anthem,State Preferred,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Cigna,Cigna,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Connecticare,Commerical,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Connecticare,Exchange,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,Multiplan,Multiplan,,,0.88,,0.88,0.76,0.88,percent of total billed charges,,
VITAMIN B COMPLEX-FOLIC ACID 0.4 MG TABLET,J3490,HCPCS,5026885715,NDC,both,1,ea,1.03,0.62,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.76,0.88,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.4 MG SPLIT TABLET,J3490,HCPCS,40810-0206-09,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Aetna,Commerical,,,0.35,,0.35,0.34,0.39,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Aetna,Middlesex Employees,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Anthem,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Anthem,Indemnity,,,0.34,,0.34,0.34,0.39,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Anthem,Individual Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Anthem,State Preferred,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Cigna,Cigna,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Connecticare,Commerical,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Connecticare,Exchange,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,Multiplan,Multiplan,,,0.39,,0.39,0.34,0.39,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,536730001,NDC,both,1,ea,0.46,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.34,0.39,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,6025816001,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,7985401269,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Aetna,Commerical,,,0.14,,0.14,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Aetna,Middlesex Employees,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Anthem,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Anthem,Indemnity,,,0.13,,0.13,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Anthem,Individual Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Anthem,State Preferred,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Cigna,Cigna,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Connecticare,Commerical,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Connecticare,Exchange,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,Multiplan,Multiplan,,,0.15,,0.15,0.13,0.15,percent of total billed charges,,
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,J3490,HCPCS,40810-0009-78,NDC,both,1,ea,0.18,0.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.13,0.15,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,536135201,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Aetna,Commerical,,,0.19,,0.19,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Anthem,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Anthem,Indemnity,,,0.18,,0.18,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Anthem,Individual Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Anthem,State Preferred,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Cigna,Cigna,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Connecticare,Commerical,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Connecticare,Exchange,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.18,0.2,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",J3490,HCPCS,8068100800,NDC,both,1,ea,0.24,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.2,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Aetna,Commerical,,,59.58,,59.58,57.14,65.64,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Aetna,Middlesex Employees,,,57.14,,57.14,57.14,65.64,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Anthem,Commerical,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Anthem,Indemnity,,,57.85,,57.85,57.14,65.64,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Anthem,Individual Exchange,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Anthem,State Preferred,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Cigna,Cigna,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Connecticare,Commerical,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Connecticare,Exchange,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,Multiplan,Multiplan,,,65.64,,65.64,57.14,65.64,percent of total billed charges,,
"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",J3490,HCPCS,7132180230,NDC,both,1,mL,77.22,46.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,57.14,65.64,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,7985490010,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Aetna,Commerical,,,0.18,,0.18,0.17,0.2,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Aetna,Middlesex Employees,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Anthem,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Anthem,Indemnity,,,0.17,,0.17,0.17,0.2,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Anthem,Individual Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Anthem,State Preferred,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Cigna,Cigna,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Connecticare,Commerical,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Connecticare,Exchange,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,Multiplan,Multiplan,,,0.2,,0.2,0.17,0.2,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,40810-0011-16,NDC,both,1,ea,0.23,0.14,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.17,0.2,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Aetna,Commerical,,,0.12,,0.12,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Aetna,Middlesex Employees,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Anthem,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Anthem,Indemnity,,,0.11,,0.11,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Anthem,Individual Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Anthem,State Preferred,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Cigna,Cigna,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Connecticare,Commerical,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Connecticare,Exchange,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,Multiplan,Multiplan,,,0.13,,0.13,0.11,0.13,percent of total billed charges,,
VITAMIN E 200 UNIT CAPSULE,J3490,HCPCS,54629-0200-01,NDC,both,1,ea,0.15,0.09,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.11,0.13,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Aetna,Commerical,,,3784.17,,3784.17,2.07,4168.67,percent of total billed charges,,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Aetna,Middlesex Employees,,,3628.71,,3628.71,2.07,4168.67,percent of total billed charges,,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Anthem,Commerical,,,,,,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Anthem,Indemnity,,,3673.83,,3673.83,2.07,4168.67,percent of total billed charges,,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Anthem,Individual Exchange,,,,,,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Anthem,State Preferred,,,,,,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Cigna,Cigna,,2.07,,,2.07,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Connecticare,Commerical,,2.86,,,2.86,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Connecticare,Exchange,,2.86,,,2.86,2.07,4168.67,Other,Could be inpatient or outpatient,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,Multiplan,Multiplan,,,4168.67,,4168.67,2.07,4168.67,percent of total billed charges,,
VON WILLEBRAND FACTOR (RECOMB) 650 (+/-) UNIT RANGE INTRAVENOUS SOLN,J7179,HCPCS,0944-7551-02,NDC,both,0.002,ea,4904.32,2942.59,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,2.07,4168.67,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Aetna,Commerical,,,7568.34,,7568.34,2.07,8337.34,percent of total billed charges,,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Aetna,Middlesex Employees,,,7257.41,,7257.41,2.07,8337.34,percent of total billed charges,,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Anthem,Commerical,,,,,,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Anthem,Indemnity,,,7347.64,,7347.64,2.07,8337.34,percent of total billed charges,,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Anthem,Individual Exchange,,,,,,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Anthem,State Preferred,,,,,,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Cigna,Cigna,,2.07,,,2.07,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Connecticare,Commerical,,2.86,,,2.86,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Connecticare,Exchange,,2.86,,,2.86,2.07,8337.34,Other,Could be inpatient or outpatient,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,Multiplan,Multiplan,,,8337.34,,8337.34,2.07,8337.34,percent of total billed charges,,
"VON WILLEBRAND FACTOR(RECOMB) 1,300 (+/-) UNIT RANGE INTRAVENOUS SOLN",J7179,HCPCS,0944-7553-02,NDC,both,0.001,ea,9808.63,5885.18,United Healthcare/Oxford,United Healthcare/Oxford,,2.23,,,2.23,2.07,8337.34,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Aetna,Commerical,,,35.63,,35.63,34.17,39.25,percent of total billed charges,,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Aetna,Middlesex Employees,,,34.17,,34.17,34.17,39.25,percent of total billed charges,,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Anthem,Commerical,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Anthem,Indemnity,,,34.59,,34.59,34.17,39.25,percent of total billed charges,,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Anthem,Individual Exchange,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Anthem,State Preferred,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Cigna,Cigna,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Connecticare,Commerical,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Connecticare,Exchange,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,Multiplan,Multiplan,,,39.25,,39.25,34.17,39.25,percent of total billed charges,,
VORICONAZOLE 100 MG ORAL TAB,J3490,HCPCS,40810-0003-19,NDC,both,1,ea,46.18,27.71,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,34.17,39.25,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Aetna,Commerical,,,69.37,,69.37,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Aetna,Middlesex Employees,,,66.52,,66.52,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Anthem,Commerical,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Anthem,Indemnity,,,67.35,,67.35,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Anthem,Individual Exchange,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Anthem,State Preferred,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Cigna,Cigna,,0.79,,,0.79,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Connecticare,Commerical,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Connecticare,Exchange,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,Multiplan,Multiplan,,,76.42,,76.42,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,0049-3190-28,NDC,both,0.05,ea,89.91,53.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.85,,,0.85,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Aetna,Commerical,,,69.37,,69.37,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Aetna,Middlesex Employees,,,66.52,,66.52,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Anthem,Commerical,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Anthem,Indemnity,,,67.35,,67.35,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Anthem,Individual Exchange,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Anthem,State Preferred,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Cigna,Cigna,,0.79,,,0.79,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Connecticare,Commerical,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Connecticare,Exchange,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,Multiplan,Multiplan,,,76.42,,76.42,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,71288-027-30,NDC,both,0.05,ea,89.91,53.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.85,,,0.85,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Aetna,Commerical,,,69.37,,69.37,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Aetna,Middlesex Employees,,,66.52,,66.52,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Anthem,Commerical,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Anthem,Indemnity,,,67.35,,67.35,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Anthem,Individual Exchange,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Anthem,State Preferred,,,,,,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Cigna,Cigna,,0.79,,,0.79,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Connecticare,Commerical,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Connecticare,Exchange,,1.18,,,1.18,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,Multiplan,Multiplan,,,76.42,,76.42,0.79,76.42,percent of total billed charges,,
VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,J3465,HCPCS,72266-131-01,NDC,both,0.05,ea,89.91,53.95,United Healthcare/Oxford,United Healthcare/Oxford,,0.85,,,0.85,0.79,76.42,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0378-1640-93,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-6471-04,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,0904-7024-04,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,27241-063-03,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Aetna,Commerical,,,3.84,,3.84,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Aetna,Middlesex Employees,,,3.68,,3.68,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Anthem,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Anthem,Indemnity,,,3.73,,3.73,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Anthem,Individual Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Anthem,State Preferred,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Cigna,Cigna,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Connecticare,Commerical,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Connecticare,Exchange,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,Multiplan,Multiplan,,,4.23,,4.23,3.68,4.23,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,40810-0009-85,NDC,both,1,ea,4.98,2.99,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.68,4.23,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Aetna,Commerical,,,138.62,,138.62,132.92,152.7,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Aetna,Middlesex Employees,,,132.92,,132.92,132.92,152.7,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Anthem,Commerical,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Anthem,Indemnity,,,134.58,,134.58,132.92,152.7,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Anthem,Individual Exchange,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Anthem,State Preferred,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Cigna,Cigna,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Connecticare,Commerical,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Connecticare,Exchange,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,Multiplan,Multiplan,,,152.7,,152.7,132.92,152.7,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-01,NDC,both,1,ea,179.65,107.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,132.92,152.7,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Aetna,Commerical,,,110.9,,110.9,106.35,122.17,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Aetna,Middlesex Employees,,,106.35,,106.35,106.35,122.17,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Anthem,Commerical,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Anthem,Indemnity,,,107.67,,107.67,106.35,122.17,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Anthem,Individual Exchange,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Anthem,State Preferred,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Cigna,Cigna,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Connecticare,Commerical,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Connecticare,Exchange,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,Multiplan,Multiplan,,,122.17,,122.17,106.35,122.17,percent of total billed charges,,
VORICONAZOLE 200 MG TABLET,J3490,HCPCS,51079-165-03,NDC,both,1,ea,143.73,86.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,106.35,122.17,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Aetna,Commerical,,,1938.71,,1938.71,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Aetna,Middlesex Employees,,,1859.06,,1859.06,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Indemnity,,,1882.17,,1882.17,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Individual Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,State Preferred,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Cigna,Cigna,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Connecticare,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Connecticare,Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Multiplan,Multiplan,,,2135.69,,2135.69,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Aetna,Commerical,,,1938.71,,1938.71,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Aetna,Middlesex Employees,,,1859.06,,1859.06,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Indemnity,,,1882.17,,1882.17,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Individual Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,State Preferred,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Cigna,Cigna,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Connecticare,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Connecticare,Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Multiplan,Multiplan,,,2135.69,,2135.69,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Aetna,Commerical,,,2495.03,,2495.03,2392.53,2748.54,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Aetna,Middlesex Employees,,,2392.53,,2392.53,2392.53,2748.54,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Anthem,Commerical,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Anthem,Indemnity,,,2422.27,,2422.27,2392.53,2748.54,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Anthem,Individual Exchange,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Anthem,State Preferred,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Cigna,Cigna,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Connecticare,Commerical,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Connecticare,Exchange,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,Multiplan,Multiplan,,,2748.54,,2748.54,2392.53,2748.54,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,59762-0935-3,NDC,both,1,mL,3233.58,1940.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2392.53,2748.54,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Aetna,Commerical,,,1938.71,,1938.71,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Aetna,Middlesex Employees,,,1859.06,,1859.06,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Anthem,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Anthem,Indemnity,,,1882.17,,1882.17,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Anthem,Individual Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Anthem,State Preferred,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Cigna,Cigna,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Connecticare,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Connecticare,Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,Multiplan,Multiplan,,,2135.69,,2135.69,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,J3490,HCPCS,65162-913-22,NDC,both,1,mL,2512.58,1507.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Aetna,Commerical,,,1938.71,,1938.71,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Aetna,Middlesex Employees,,,1859.06,,1859.06,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Indemnity,,,1882.17,,1882.17,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,Individual Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Anthem,State Preferred,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Cigna,Cigna,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Connecticare,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Connecticare,Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,Multiplan,Multiplan,,,2135.69,,2135.69,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,0049-3160-44,NDC,both,1,mL,2512.58,1507.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Aetna,Commerical,,,1938.71,,1938.71,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Aetna,Middlesex Employees,,,1859.06,,1859.06,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Indemnity,,,1882.17,,1882.17,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,Individual Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Anthem,State Preferred,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Cigna,Cigna,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Connecticare,Commerical,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Connecticare,Exchange,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,Multiplan,Multiplan,,,2135.69,,2135.69,1859.06,2135.69,percent of total billed charges,,
VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION FOR PROPHYLAXIS USE,J3490,HCPCS,43386-038-60,NDC,both,1,mL,2512.58,1507.55,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1859.06,2135.69,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,24.38,14.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,27241-062-03,NDC,both,1,ea,24.38,14.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Aetna,Commerical,,,27.83,,27.83,26.69,30.66,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Aetna,Middlesex Employees,,,26.69,,26.69,26.69,30.66,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Anthem,Commerical,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Anthem,Indemnity,,,27.02,,27.02,26.69,30.66,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Anthem,Individual Exchange,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Anthem,State Preferred,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Cigna,Cigna,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Connecticare,Commerical,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Connecticare,Exchange,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,Multiplan,Multiplan,,,30.66,,30.66,26.69,30.66,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-11,NDC,both,1,ea,36.07,21.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.69,30.66,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET,J3490,HCPCS,60687-294-21,NDC,both,1,ea,24.38,14.63,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,0904-6596-04,NDC,both,1,ea,25.6,15.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,27241-062-03,NDC,both,1,ea,25.6,15.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Aetna,Commerical,,,18.81,,18.81,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Aetna,Middlesex Employees,,,18.04,,18.04,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Anthem,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Anthem,Indemnity,,,18.26,,18.26,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Anthem,Individual Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Anthem,State Preferred,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Cigna,Cigna,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Connecticare,Commerical,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Connecticare,Exchange,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,Multiplan,Multiplan,,,20.72,,20.72,18.04,20.72,percent of total billed charges,,
VORICONAZOLE 50 MG TABLET FOR PROPHYLAXIS USE,J3490,HCPCS,60687-294-21,NDC,both,1,ea,25.6,15.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,18.04,20.72,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Aetna,Commerical,,,369.64,,369.64,354.46,407.2,percent of total billed charges,,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Aetna,Middlesex Employees,,,354.46,,354.46,354.46,407.2,percent of total billed charges,,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Anthem,Commerical,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Anthem,Indemnity,,,358.86,,358.86,354.46,407.2,percent of total billed charges,,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Anthem,Individual Exchange,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Anthem,State Preferred,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Cigna,Cigna,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Connecticare,Commerical,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Connecticare,Exchange,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,Multiplan,Multiplan,,,407.2,,407.2,354.46,407.2,percent of total billed charges,,
VORINOSTAT 100 MG CAPSULE,J3490,HCPCS,0006-0568-40,NDC,both,1,ea,479.06,287.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,354.46,407.2,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Aetna,Commerical,,,144.34,,144.34,138.41,159,percent of total billed charges,,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Aetna,Middlesex Employees,,,138.41,,138.41,138.41,159,percent of total billed charges,,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Anthem,Commerical,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Anthem,Indemnity,,,140.13,,140.13,138.41,159,percent of total billed charges,,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Anthem,Individual Exchange,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Anthem,State Preferred,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Cigna,Cigna,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Connecticare,Commerical,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Connecticare,Exchange,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,Multiplan,Multiplan,,,159,,159,138.41,159,percent of total billed charges,,
VORINOSTAT 50 MG/ML ORAL SUSPENSION CHEMO,J8999,HCPCS,40810-0018-47,NDC,both,1,mL,187.06,112.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,138.41,159,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Aetna,Commerical,,,44.22,,44.22,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Aetna,Middlesex Employees,,,42.4,,42.4,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Anthem,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Anthem,Indemnity,,,42.93,,42.93,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Anthem,Individual Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Anthem,State Preferred,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Cigna,Cigna,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Connecticare,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Connecticare,Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,Multiplan,Multiplan,,,48.71,,48.71,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 10 MG TABLET,J3490,HCPCS,64764-730-30,NDC,both,1,ea,57.31,34.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Aetna,Commerical,,,44.22,,44.22,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Aetna,Middlesex Employees,,,42.4,,42.4,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Anthem,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Anthem,Indemnity,,,42.93,,42.93,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Anthem,Individual Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Anthem,State Preferred,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Cigna,Cigna,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Connecticare,Commerical,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Connecticare,Exchange,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,Multiplan,Multiplan,,,48.71,,48.71,42.4,48.71,percent of total billed charges,,
VORTIOXETINE 20 MG TABLET,J3490,HCPCS,64764-750-30,NDC,both,1,ea,57.31,34.39,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,42.4,48.71,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Aetna,Commerical,,,1.6,,1.6,1.53,1.76,percent of total billed charges,,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Aetna,Middlesex Employees,,,1.53,,1.53,1.53,1.76,percent of total billed charges,,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Anthem,Commerical,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Anthem,Indemnity,,,1.55,,1.55,1.53,1.76,percent of total billed charges,,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Anthem,Individual Exchange,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Anthem,State Preferred,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Cigna,Cigna,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Connecticare,Commerical,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Connecticare,Exchange,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,Multiplan,Multiplan,,,1.76,,1.76,1.53,1.76,percent of total billed charges,,
WARFARIN 0.25 MG ORAL TAB,J3490,HCPCS,40810-0013-78,NDC,both,1,ea,2.07,1.24,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.53,1.76,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Aetna,Commerical,,,0.11,,0.11,0.1,0.12,percent of total billed charges,,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Aetna,Middlesex Employees,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Anthem,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Anthem,Indemnity,,,0.1,,0.1,0.1,0.12,percent of total billed charges,,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Anthem,Individual Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Anthem,State Preferred,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Cigna,Cigna,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Connecticare,Commerical,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Connecticare,Exchange,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,Multiplan,Multiplan,,,0.12,,0.12,0.1,0.12,percent of total billed charges,,
WARFARIN 0.5 MG ORAL TAB,J3490,HCPCS,40810-0003-20,NDC,both,1,ea,0.14,0.08,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.1,0.12,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Aetna,Commerical,,,0.88,,0.88,0.84,0.97,percent of total billed charges,,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Aetna,Middlesex Employees,,,0.84,,0.84,0.84,0.97,percent of total billed charges,,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Anthem,Commerical,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Anthem,Indemnity,,,0.85,,0.85,0.84,0.97,percent of total billed charges,,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Anthem,Individual Exchange,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Anthem,State Preferred,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Cigna,Cigna,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Connecticare,Commerical,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Connecticare,Exchange,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,Multiplan,Multiplan,,,0.97,,0.97,0.84,0.97,percent of total billed charges,,
WARFARIN 1 MG TABLET,J3490,HCPCS,0832-1211-01,NDC,both,1,ea,1.14,0.68,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.84,0.97,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Aetna,Commerical,,,0.42,,0.42,0.41,0.47,percent of total billed charges,,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Aetna,Middlesex Employees,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Anthem,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Anthem,Indemnity,,,0.41,,0.41,0.41,0.47,percent of total billed charges,,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Anthem,Individual Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Anthem,State Preferred,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Cigna,Cigna,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Connecticare,Commerical,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Connecticare,Exchange,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,Multiplan,Multiplan,,,0.47,,0.47,0.41,0.47,percent of total billed charges,,
WARFARIN 1.25 MG ORAL TAB,J3490,HCPCS,40810-0003-22,NDC,both,1,ea,0.55,0.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.41,0.47,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Anthem,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Cigna,Cigna,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Connecticare,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Connecticare,Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,0832-1212-01,NDC,both,1,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Aetna,Commerical,,,0.48,,0.48,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Aetna,Middlesex Employees,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Anthem,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Anthem,Indemnity,,,0.46,,0.46,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Anthem,Individual Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Anthem,State Preferred,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Cigna,Cigna,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Connecticare,Commerical,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Connecticare,Exchange,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,Multiplan,Multiplan,,,0.53,,0.53,0.46,0.53,percent of total billed charges,,
WARFARIN 2 MG TABLET,J3490,HCPCS,62584-984-01,NDC,both,1,ea,0.62,0.37,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.46,0.53,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Aetna,Commerical,,,0.93,,0.93,0.89,1.02,percent of total billed charges,,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Aetna,Middlesex Employees,,,0.89,,0.89,0.89,1.02,percent of total billed charges,,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Anthem,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Anthem,Indemnity,,,0.9,,0.9,0.89,1.02,percent of total billed charges,,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Anthem,Individual Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Anthem,State Preferred,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Cigna,Cigna,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Connecticare,Commerical,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Connecticare,Exchange,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,Multiplan,Multiplan,,,1.02,,1.02,0.89,1.02,percent of total billed charges,,
WARFARIN 2.5 MG TABLET,J3490,HCPCS,0832-1213-01,NDC,both,1,ea,1.2,0.72,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.89,1.02,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Aetna,Commerical,,,0.94,,0.94,0.9,1.04,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Aetna,Middlesex Employees,,,0.9,,0.9,0.9,1.04,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Anthem,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Anthem,Indemnity,,,0.91,,0.91,0.9,1.04,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Anthem,Individual Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Anthem,State Preferred,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Cigna,Cigna,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Connecticare,Commerical,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Connecticare,Exchange,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,Multiplan,Multiplan,,,1.04,,1.04,0.9,1.04,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-01,NDC,both,1,ea,1.22,0.73,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.9,1.04,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Aetna,Commerical,,,0.95,,0.95,0.91,1.05,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Aetna,Middlesex Employees,,,0.91,,0.91,0.91,1.05,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Anthem,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Anthem,Indemnity,,,0.92,,0.92,0.91,1.05,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Anthem,Individual Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Anthem,State Preferred,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Cigna,Cigna,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Connecticare,Commerical,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Connecticare,Exchange,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,Multiplan,Multiplan,,,1.05,,1.05,0.91,1.05,percent of total billed charges,,
WARFARIN 3 MG TABLET,J3490,HCPCS,0832-1214-89,NDC,both,1,ea,1.23,0.74,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.91,1.05,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Aetna,Commerical,,,0.96,,0.96,0.92,1.06,percent of total billed charges,,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Aetna,Middlesex Employees,,,0.92,,0.92,0.92,1.06,percent of total billed charges,,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Anthem,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Anthem,Indemnity,,,0.94,,0.94,0.92,1.06,percent of total billed charges,,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Anthem,Individual Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Anthem,State Preferred,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Cigna,Cigna,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Connecticare,Commerical,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Connecticare,Exchange,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,Multiplan,Multiplan,,,1.06,,1.06,0.92,1.06,percent of total billed charges,,
WARFARIN 5 MG TABLET,J3490,HCPCS,0832-1216-01,NDC,both,1,ea,1.25,0.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.92,1.06,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Aetna,Commerical,,,4.52,,4.52,4.34,4.98,percent of total billed charges,,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Aetna,Middlesex Employees,,,4.34,,4.34,4.34,4.98,percent of total billed charges,,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Anthem,Commerical,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Anthem,Indemnity,,,4.39,,4.39,4.34,4.98,percent of total billed charges,,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Anthem,Individual Exchange,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Anthem,State Preferred,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Cigna,Cigna,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Connecticare,Commerical,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Connecticare,Exchange,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,Multiplan,Multiplan,,,4.98,,4.98,4.34,4.98,percent of total billed charges,,
"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",J3490,HCPCS,0409-3977-03,NDC,both,30,mL,5.86,3.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.34,4.98,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Aetna,Commerical,,,11.82,,11.82,11.34,13.02,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Aetna,Middlesex Employees,,,11.34,,11.34,11.34,13.02,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Anthem,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Anthem,Indemnity,,,11.48,,11.48,11.34,13.02,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Anthem,Individual Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Anthem,State Preferred,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Cigna,Cigna,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Connecticare,Commerical,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Connecticare,Exchange,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,Multiplan,Multiplan,,,13.02,,13.02,11.34,13.02,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0264-7850-10,NDC,both,500,mL,15.32,9.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.34,13.02,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Aetna,Commerical,,,23.64,,23.64,22.67,26.04,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Aetna,Middlesex Employees,,,22.67,,22.67,22.67,26.04,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Anthem,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Anthem,Indemnity,,,22.95,,22.95,22.67,26.04,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Anthem,Individual Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Anthem,State Preferred,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Cigna,Cigna,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Connecticare,Commerical,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Connecticare,Exchange,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,Multiplan,Multiplan,,,26.04,,26.04,22.67,26.04,percent of total billed charges,,
"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",J3490,HCPCS,0990-7990-09,NDC,both,1,mL,30.64,18.38,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,22.67,26.04,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Anthem,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Anthem,State Preferred,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Cigna,Cigna,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Connecticare,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Connecticare,Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,5042100878,NDC,both,1,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Aetna,Commerical,,,5.91,,5.91,5.67,6.51,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Aetna,Middlesex Employees,,,5.67,,5.67,5.67,6.51,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Anthem,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Anthem,Indemnity,,,5.74,,5.74,5.67,6.51,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Anthem,Individual Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Anthem,State Preferred,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Cigna,Cigna,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Connecticare,Commerical,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Connecticare,Exchange,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,Multiplan,Multiplan,,,6.51,,6.51,5.67,6.51,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0338-0004-04,NDC,both,1,mL,7.66,4.6,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.67,6.51,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Aetna,Commerical,,,16.26,,16.26,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Aetna,Middlesex Employees,,,15.59,,15.59,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Anthem,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Anthem,Indemnity,,,15.78,,15.78,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Anthem,Individual Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Anthem,State Preferred,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Cigna,Cigna,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Connecticare,Commerical,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Connecticare,Exchange,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,Multiplan,Multiplan,,,17.91,,17.91,15.59,17.91,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-6139-03,NDC,both,1,mL,21.07,12.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.59,17.91,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Aetna,Commerical,,,32.51,,32.51,31.17,35.81,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Aetna,Middlesex Employees,,,31.17,,31.17,31.17,35.81,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Anthem,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Anthem,Indemnity,,,31.56,,31.56,31.17,35.81,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Anthem,Individual Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Anthem,State Preferred,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Cigna,Cigna,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Connecticare,Commerical,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Connecticare,Exchange,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,Multiplan,Multiplan,,,35.81,,35.81,31.17,35.81,percent of total billed charges,,
"WATER FOR IRRIGATION, STERILE SOLUTION",J3490,HCPCS,0990-7973-05,NDC,both,1,mL,42.13,25.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,31.17,35.81,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Aetna,Commerical,,,18.47,,18.47,17.71,20.35,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Aetna,Middlesex Employees,,,17.71,,17.71,17.71,20.35,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Anthem,Commerical,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Anthem,Indemnity,,,17.93,,17.93,17.71,20.35,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Anthem,Individual Exchange,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Anthem,State Preferred,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Cigna,Cigna,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Connecticare,Commerical,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Connecticare,Exchange,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,Multiplan,Multiplan,,,20.35,,20.35,17.71,20.35,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214045231,NDC,both,50,gm,23.94,14.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,17.71,20.35,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Aetna,Commerical,,,15.32,,15.32,14.69,16.88,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Aetna,Middlesex Employees,,,14.69,,14.69,14.69,16.88,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Anthem,Commerical,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Anthem,Indemnity,,,14.88,,14.88,14.69,16.88,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Anthem,Individual Exchange,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Anthem,State Preferred,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Cigna,Cigna,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Connecticare,Commerical,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Connecticare,Exchange,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,Multiplan,Multiplan,,,16.88,,16.88,14.69,16.88,percent of total billed charges,,
WHITE PETROLATUM 41 % TOPICAL OINTMENT,J3490,HCPCS,7214063377,NDC,both,1,gm,19.86,11.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.69,16.88,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Aetna,Commerical,,,13.01,,13.01,12.47,14.33,percent of total billed charges,,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Aetna,Middlesex Employees,,,12.47,,12.47,12.47,14.33,percent of total billed charges,,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Anthem,Commerical,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Anthem,Indemnity,,,12.63,,12.63,12.47,14.33,percent of total billed charges,,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Anthem,Individual Exchange,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Anthem,State Preferred,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Cigna,Cigna,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Connecticare,Commerical,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Connecticare,Exchange,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,Multiplan,Multiplan,,,14.33,,14.33,12.47,14.33,percent of total billed charges,,
WHITE PETROLATUM 42 % TOPICAL OINTMENT,J3490,HCPCS,0536-1143-97,NDC,both,1,gm,16.86,10.12,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,12.47,14.33,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Aetna,Commerical,,,7.62,,7.62,7.3,8.39,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Aetna,Middlesex Employees,,,7.3,,7.3,7.3,8.39,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Anthem,Commerical,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Anthem,Indemnity,,,7.39,,7.39,7.3,8.39,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Anthem,Individual Exchange,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Anthem,State Preferred,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Cigna,Cigna,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Connecticare,Commerical,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Connecticare,Exchange,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,Multiplan,Multiplan,,,8.39,,8.39,7.3,8.39,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,0904-5731-82,NDC,both,1,gm,9.87,5.92,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.3,8.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Aetna,Commerical,,,2.58,,2.58,2.47,2.84,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Aetna,Middlesex Employees,,,2.47,,2.47,2.47,2.84,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Anthem,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Anthem,Indemnity,,,2.5,,2.5,2.47,2.84,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Anthem,Individual Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Anthem,State Preferred,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Cigna,Cigna,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Connecticare,Commerical,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Connecticare,Exchange,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,Multiplan,Multiplan,,,2.84,,2.84,2.47,2.84,percent of total billed charges,,
WHITE PETROLATUM TOPICAL JELLY,J3490,HCPCS,53329-068-01,NDC,both,1,gm,3.34,2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,2.47,2.84,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Aetna,Commerical,,,58.99,,58.99,56.57,64.98,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Aetna,Middlesex Employees,,,56.57,,56.57,56.57,64.98,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Anthem,Commerical,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Anthem,Indemnity,,,57.27,,57.27,56.57,64.98,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Anthem,Individual Exchange,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Anthem,State Preferred,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Cigna,Cigna,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Connecticare,Commerical,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Connecticare,Exchange,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,Multiplan,Multiplan,,,64.98,,64.98,56.57,64.98,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-16,NDC,both,453.6,gm,76.45,45.87,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,56.57,64.98,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Aetna,Commerical,,,3.77,,3.77,3.62,4.16,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Aetna,Middlesex Employees,,,3.62,,3.62,3.62,4.16,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Anthem,Commerical,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Anthem,Indemnity,,,3.66,,3.66,3.62,4.16,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Anthem,Individual Exchange,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Anthem,State Preferred,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Cigna,Cigna,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Connecticare,Commerical,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Connecticare,Exchange,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,Multiplan,Multiplan,,,4.16,,4.16,3.62,4.16,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT,J3490,HCPCS,0168-0053-21,NDC,both,1,gm,4.89,2.93,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3.62,4.16,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Aetna,Commerical,,,0.66,,0.66,0.63,0.72,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Aetna,Middlesex Employees,,,0.63,,0.63,0.63,0.72,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Anthem,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Anthem,Indemnity,,,0.64,,0.64,0.63,0.72,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Anthem,Individual Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Anthem,State Preferred,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Cigna,Cigna,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Connecticare,Commerical,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Connecticare,Exchange,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,Multiplan,Multiplan,,,0.72,,0.72,0.63,0.72,percent of total billed charges,,
WHITE PETROLATUM TOPICAL OINTMENT IN PACKET,J3490,HCPCS,0168-0053-45,NDC,both,5,gm,0.85,0.51,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.63,0.72,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Aetna,Commerical,,,26.68,,26.68,25.59,29.39,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Aetna,Middlesex Employees,,,25.59,,25.59,25.59,29.39,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Anthem,Commerical,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Anthem,Indemnity,,,25.9,,25.9,25.59,29.39,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Anthem,Individual Exchange,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Anthem,State Preferred,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Cigna,Cigna,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Connecticare,Commerical,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Connecticare,Exchange,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,Multiplan,Multiplan,,,29.39,,29.39,25.59,29.39,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,0023-0240-04,NDC,both,1,gm,34.58,20.75,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,25.59,29.39,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Aetna,Commerical,,,27.9,,27.9,26.75,30.74,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Aetna,Middlesex Employees,,,26.75,,26.75,26.75,30.74,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Anthem,Commerical,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Anthem,Indemnity,,,27.09,,27.09,26.75,30.74,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Anthem,Individual Exchange,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Anthem,State Preferred,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Cigna,Cigna,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Connecticare,Commerical,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Connecticare,Exchange,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,Multiplan,Multiplan,,,30.74,,30.74,26.75,30.74,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT,J3490,HCPCS,70000-0513-1,NDC,both,1,gm,36.16,21.7,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,26.75,30.74,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Aetna,Commerical,,,32.23,,32.23,30.91,35.5,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Aetna,Middlesex Employees,,,30.91,,30.91,30.91,35.5,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Anthem,Commerical,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Anthem,Indemnity,,,31.29,,31.29,30.91,35.5,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Anthem,Individual Exchange,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Anthem,State Preferred,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Cigna,Cigna,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Connecticare,Commerical,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Connecticare,Exchange,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,Multiplan,Multiplan,,,35.5,,35.5,30.91,35.5,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,J3490,HCPCS,1011902239,NDC,both,1,gm,41.77,25.06,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,30.91,35.5,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,8.19,9.41,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,8.19,9.41,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Anthem,Commerical,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,8.19,9.41,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Anthem,Individual Exchange,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Anthem,State Preferred,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Cigna,Cigna,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Connecticare,Commerical,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Connecticare,Exchange,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,8.19,9.41,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,6192417804,NDC,both,1,gm,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Aetna,Commerical,,,11.91,,11.91,11.42,13.12,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Aetna,Middlesex Employees,,,11.42,,11.42,11.42,13.12,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Anthem,Commerical,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Anthem,Indemnity,,,11.56,,11.56,11.42,13.12,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Anthem,Individual Exchange,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Anthem,State Preferred,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Cigna,Cigna,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Connecticare,Commerical,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Connecticare,Exchange,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,Multiplan,Multiplan,,,13.12,,13.12,11.42,13.12,percent of total billed charges,,
WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM,J3490,HCPCS,61924-174-04,NDC,both,1,gm,15.43,9.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,11.42,13.12,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Aetna,Commerical,,,1.95,,1.95,1.87,2.15,percent of total billed charges,,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Aetna,Middlesex Employees,,,1.87,,1.87,1.87,2.15,percent of total billed charges,,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Anthem,Commerical,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Anthem,Indemnity,,,1.9,,1.9,1.87,2.15,percent of total billed charges,,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Anthem,Individual Exchange,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Anthem,State Preferred,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Cigna,Cigna,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Connecticare,Commerical,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Connecticare,Exchange,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,Multiplan,Multiplan,,,2.15,,2.15,1.87,2.15,percent of total billed charges,,
WHITE PETROLATUM-ZINC TOPICAL PASTE,J3490,HCPCS,8212427181,NDC,both,60,gm,2.53,1.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.87,2.15,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Aetna,Commerical,,,30.18,,30.18,28.94,313.67,percent of total billed charges,,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Aetna,Middlesex Employees,,,28.94,,28.94,28.94,313.67,percent of total billed charges,,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Anthem,Commerical,,313.67,,,313.67,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Anthem,Indemnity,,,29.3,,29.3,28.94,313.67,percent of total billed charges,,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Anthem,Individual Exchange,,250.94,,,250.94,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Anthem,State Preferred,,313.67,,,313.67,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Cigna,Cigna,,,,,,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Connecticare,Commerical,,,,,,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Connecticare,Exchange,,,,,,28.94,313.67,Other,Could be inpatient or outpatient,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,Multiplan,Multiplan,,,33.25,,33.25,28.94,313.67,percent of total billed charges,,
YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP,90717,HCPCS,49281-915-01,NDC,both,0.5,mL,39.12,23.47,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,28.94,313.67,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Aetna,Commerical,,,10.72,,10.72,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Aetna,Middlesex Employees,,,10.28,,10.28,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Commerical,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Indemnity,,,10.4,,10.4,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Individual Exchange,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,State Preferred,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Cigna,Cigna,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Connecticare,Commerical,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Connecticare,Exchange,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Multiplan,Multiplan,,,11.81,,11.81,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000 UNITS FOR FEEDS",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Aetna,Commerical,,,8.29,,8.29,7.95,9.13,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Aetna,Middlesex Employees,,,7.95,,7.95,7.95,9.13,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Anthem,Commerical,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Anthem,Indemnity,,,8.05,,8.05,7.95,9.13,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Anthem,Individual Exchange,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Anthem,State Preferred,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Cigna,Cigna,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Connecticare,Commerical,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Connecticare,Exchange,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,Multiplan,Multiplan,,,9.13,,9.13,7.95,9.13,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0201-86,NDC,both,1,ea,10.74,6.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,7.95,9.13,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Aetna,Commerical,,,10.72,,10.72,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Aetna,Middlesex Employees,,,10.28,,10.28,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Commerical,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Indemnity,,,10.4,,10.4,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,Individual Exchange,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Anthem,State Preferred,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Cigna,Cigna,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Connecticare,Commerical,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Connecticare,Exchange,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,Multiplan,Multiplan,,,11.81,,11.81,10.28,11.81,percent of total billed charges,,
"ZENPEP 10,000-32,000-42,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-110-01,NDC,both,1,ea,13.89,8.33,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,10.28,11.81,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Aetna,Commerical,,,15.48,,15.48,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Aetna,Middlesex Employees,,,14.84,,14.84,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Commerical,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Indemnity,,,15.03,,15.03,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Individual Exchange,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,State Preferred,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Cigna,Cigna,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Connecticare,Commerical,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Connecticare,Exchange,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Multiplan,Multiplan,,,17.05,,17.05,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000 UNITS FOR FEEDS",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Aetna,Commerical,,,6.89,,6.89,6.61,7.59,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Aetna,Middlesex Employees,,,6.61,,6.61,6.61,7.59,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Anthem,Commerical,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Anthem,Indemnity,,,6.69,,6.69,6.61,7.59,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Anthem,Individual Exchange,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Anthem,State Preferred,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Cigna,Cigna,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Connecticare,Commerical,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Connecticare,Exchange,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,Multiplan,Multiplan,,,7.59,,7.59,6.61,7.59,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0006-11,NDC,both,1,ea,8.93,5.36,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,6.61,7.59,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Aetna,Commerical,,,15.48,,15.48,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Aetna,Middlesex Employees,,,14.84,,14.84,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Commerical,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Indemnity,,,15.03,,15.03,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,Individual Exchange,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Anthem,State Preferred,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Cigna,Cigna,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Connecticare,Commerical,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Connecticare,Exchange,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,Multiplan,Multiplan,,,17.05,,17.05,14.84,17.05,percent of total billed charges,,
"ZENPEP 15,000-47,000-63,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-111-01,NDC,both,1,ea,20.06,12.04,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.84,17.05,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Aetna,Commerical,,,21.03,,21.03,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Aetna,Middlesex Employees,,,20.16,,20.16,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Commerical,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Indemnity,,,20.41,,20.41,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Individual Exchange,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,State Preferred,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Cigna,Cigna,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Connecticare,Commerical,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Connecticare,Exchange,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Multiplan,Multiplan,,,23.16,,23.16,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000 UNITS FOR FEEDS",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Aetna,Commerical,,,16.22,,16.22,15.55,17.87,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Aetna,Middlesex Employees,,,15.55,,15.55,15.55,17.87,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Anthem,Commerical,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Anthem,Indemnity,,,15.75,,15.75,15.55,17.87,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Anthem,Individual Exchange,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Anthem,State Preferred,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Cigna,Cigna,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Connecticare,Commerical,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Connecticare,Exchange,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,Multiplan,Multiplan,,,17.87,,17.87,15.55,17.87,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0202-17,NDC,both,1,ea,21.02,12.61,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.55,17.87,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Aetna,Commerical,,,21.03,,21.03,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Aetna,Middlesex Employees,,,20.16,,20.16,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Commerical,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Indemnity,,,20.41,,20.41,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,Individual Exchange,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Anthem,State Preferred,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Cigna,Cigna,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Connecticare,Commerical,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Connecticare,Exchange,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,Multiplan,Multiplan,,,23.16,,23.16,20.16,23.16,percent of total billed charges,,
"ZENPEP 20,000-63,000-84,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-112-01,NDC,both,1,ea,27.25,16.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,20.16,23.16,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Aetna,Commerical,,,4.4,,4.4,4.22,4.85,percent of total billed charges,,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Aetna,Middlesex Employees,,,4.22,,4.22,4.22,4.85,percent of total billed charges,,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Anthem,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Anthem,Indemnity,,,4.27,,4.27,4.22,4.85,percent of total billed charges,,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Anthem,Individual Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Anthem,State Preferred,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Cigna,Cigna,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Connecticare,Commerical,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Connecticare,Exchange,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,Multiplan,Multiplan,,,4.85,,4.85,4.22,4.85,percent of total billed charges,,
"ZENPEP 3,000 UNITS FOR FEEDS",J8499,HCPCS,0023-6113-01,NDC,both,1,ea,5.7,3.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.22,4.85,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Aetna,Commerical,,,3.13,,3.13,3,3.45,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Aetna,Middlesex Employees,,,3,,3,3,3.45,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Anthem,Commerical,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Anthem,Indemnity,,,3.04,,3.04,3,3.45,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Anthem,Individual Exchange,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Anthem,State Preferred,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Cigna,Cigna,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Connecticare,Commerical,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Connecticare,Exchange,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,Multiplan,Multiplan,,,3.45,,3.45,3,3.45,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0017-29,NDC,both,1,ea,4.06,2.44,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,3,3.45,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Aetna,Commerical,,,5.69,,5.69,5.45,6.26,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Aetna,Middlesex Employees,,,5.45,,5.45,5.45,6.26,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Anthem,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Anthem,Indemnity,,,5.52,,5.52,5.45,6.26,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Anthem,Individual Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Anthem,State Preferred,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Cigna,Cigna,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Connecticare,Commerical,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Connecticare,Exchange,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,Multiplan,Multiplan,,,6.26,,6.26,5.45,6.26,percent of total billed charges,,
"ZENPEP 3,000-10,000-14,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-113-01,NDC,both,1,ea,7.37,4.42,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.45,6.26,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Aetna,Commerical,,,4.2,,4.2,4.03,4.62,percent of total billed charges,,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Aetna,Middlesex Employees,,,4.03,,4.03,4.03,4.62,percent of total billed charges,,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Anthem,Commerical,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Anthem,Indemnity,,,4.08,,4.08,4.03,4.62,percent of total billed charges,,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Anthem,Individual Exchange,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Anthem,State Preferred,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Cigna,Cigna,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Connecticare,Commerical,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Connecticare,Exchange,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,Multiplan,Multiplan,,,4.62,,4.62,4.03,4.62,percent of total billed charges,,
"ZENPEP 5,000 UNITS FOR FEEDS ",J8499,HCPCS,0023-6115-01,NDC,both,1,ea,5.44,3.26,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,4.03,4.62,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Aetna,Commerical,,,1.64,,1.64,1.58,1.81,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Aetna,Middlesex Employees,,,1.58,,1.58,1.58,1.81,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Anthem,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Anthem,Indemnity,,,1.6,,1.6,1.58,1.81,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Anthem,Individual Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Anthem,State Preferred,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Cigna,Cigna,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Connecticare,Commerical,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Connecticare,Exchange,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,Multiplan,Multiplan,,,1.81,,1.81,1.58,1.81,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,40810-0015-11,NDC,both,1,UN,2.13,1.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.58,1.81,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Aetna,Commerical,,,5.42,,5.42,5.2,5.98,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Aetna,Middlesex Employees,,,5.2,,5.2,5.2,5.98,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Anthem,Commerical,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Anthem,Indemnity,,,5.27,,5.27,5.2,5.98,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Anthem,Individual Exchange,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Anthem,State Preferred,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Cigna,Cigna,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Connecticare,Commerical,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Connecticare,Exchange,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,Multiplan,Multiplan,,,5.98,,5.98,5.2,5.98,percent of total billed charges,,
"ZENPEP 5,000-17,000-24,000 UNIT CAPSULE, DELAYED RELEASE",J8499,HCPCS,73562-115-01,NDC,both,1,ea,7.03,4.22,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.2,5.98,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Aetna,Commerical,,,83.05,,83.05,1.71,91.49,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Aetna,Middlesex Employees,,,79.64,,79.64,1.71,91.49,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Anthem,Commerical,,,,,,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Anthem,Indemnity,,,80.63,,80.63,1.71,91.49,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Anthem,Individual Exchange,,,,,,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Anthem,State Preferred,,,,,,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Cigna,Cigna,,1.71,,,1.71,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Connecticare,Commerical,,2.31,,,2.31,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Connecticare,Exchange,,2.31,,,2.31,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,Multiplan,Multiplan,,,91.49,,91.49,1.71,91.49,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,J3485,HCPCS,49702-213-26,NDC,both,1,mL,107.63,64.58,United Healthcare/Oxford,United Healthcare/Oxford,,1.84,,,1.84,1.71,91.49,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Aetna,Commerical,,,102.85,,102.85,98.62,113.3,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Aetna,Middlesex Employees,,,98.62,,98.62,98.62,113.3,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Anthem,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Anthem,Indemnity,,,99.85,,99.85,98.62,113.3,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Anthem,Individual Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Anthem,State Preferred,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Cigna,Cigna,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Connecticare,Commerical,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Connecticare,Exchange,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,Multiplan,Multiplan,,,113.3,,113.3,98.62,113.3,percent of total billed charges,,
ZIDOVUDINE 10 MG/ML ORAL SYRUP,J3490,HCPCS,65862-048-24,NDC,both,1,mL,133.29,79.97,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,98.62,113.3,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Aetna,Commerical,,,8.54,,8.54,8.19,9.41,percent of total billed charges,,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Aetna,Middlesex Employees,,,8.19,,8.19,8.19,9.41,percent of total billed charges,,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Anthem,Commerical,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Anthem,Indemnity,,,8.29,,8.29,8.19,9.41,percent of total billed charges,,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Anthem,Individual Exchange,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Anthem,State Preferred,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Cigna,Cigna,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Connecticare,Commerical,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Connecticare,Exchange,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,Multiplan,Multiplan,,,9.41,,9.41,8.19,9.41,percent of total billed charges,,
ZIDOVUDINE 100 MG CAPSULE,J8499,HCPCS,65862-107-01,NDC,both,0.991,ea,11.07,6.64,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,8.19,9.41,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Aetna,Commerical,,,33.26,,33.26,1.71,36.64,percent of total billed charges,,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Aetna,Middlesex Employees,,,31.9,,31.9,1.71,36.64,percent of total billed charges,,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Anthem,Commerical,,,,,,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Anthem,Indemnity,,,32.29,,32.29,1.71,36.64,percent of total billed charges,,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Anthem,Individual Exchange,,,,,,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Anthem,State Preferred,,,,,,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Cigna,Cigna,,1.71,,,1.71,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Connecticare,Commerical,,2.31,,,2.31,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Connecticare,Exchange,,2.31,,,2.31,1.71,36.64,Other,Could be inpatient or outpatient,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,Multiplan,Multiplan,,,36.64,,36.64,1.71,36.64,percent of total billed charges,,
ZIDOVUDINE 2 MG/ML IN D5W NICU,J3485,HCPCS,40810-0004-77,NDC,both,5,mL,43.11,25.87,United Healthcare/Oxford,United Healthcare/Oxford,,1.84,,,1.84,1.71,36.64,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Aetna,Commerical,,,41.82,,41.82,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Aetna,Middlesex Employees,,,40.1,,40.1,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Indemnity,,,40.6,,40.6,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Individual Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,State Preferred,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Cigna,Cigna,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Connecticare,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Connecticare,Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Multiplan,Multiplan,,,46.07,,46.07,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Aetna,Commerical,,,41.82,,41.82,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Aetna,Middlesex Employees,,,40.1,,40.1,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Anthem,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Anthem,Indemnity,,,40.6,,40.6,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Anthem,Individual Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Anthem,State Preferred,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Cigna,Cigna,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Connecticare,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Connecticare,Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,Multiplan,Multiplan,,,46.07,,46.07,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-1,NDC,both,1,mL,54.2,32.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Aetna,Commerical,,,41.82,,41.82,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Aetna,Middlesex Employees,,,40.1,,40.1,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Anthem,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Anthem,Indemnity,,,40.6,,40.6,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Anthem,Individual Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Anthem,State Preferred,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Cigna,Cigna,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Connecticare,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Connecticare,Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,Multiplan,Multiplan,,,46.07,,46.07,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,51754-0102-4,NDC,both,1,mL,54.2,32.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Aetna,Commerical,,,41.82,,41.82,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Aetna,Middlesex Employees,,,40.1,,40.1,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Indemnity,,,40.6,,40.6,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,Individual Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Anthem,State Preferred,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Cigna,Cigna,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Connecticare,Commerical,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Connecticare,Exchange,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,Multiplan,Multiplan,,,46.07,,46.07,40.1,46.07,percent of total billed charges,,
ZINC CHLORIDE 1 MG/ML ORAL SOLN,J8499,HCPCS,0409-4090-01,NDC,both,1,mL,54.2,32.52,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,40.1,46.07,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Aetna,Commerical,,,15.67,,15.67,15.03,17.26,percent of total billed charges,,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Aetna,Middlesex Employees,,,15.03,,15.03,15.03,17.26,percent of total billed charges,,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Anthem,Commerical,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Anthem,Indemnity,,,15.21,,15.21,15.03,17.26,percent of total billed charges,,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Anthem,Individual Exchange,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Anthem,State Preferred,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Cigna,Cigna,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Connecticare,Commerical,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Connecticare,Exchange,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,Multiplan,Multiplan,,,17.26,,17.26,15.03,17.26,percent of total billed charges,,
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,J3490,HCPCS,7430000070,NDC,both,57,gm,20.31,12.19,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,15.03,17.26,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Aetna,Commerical,,,15.58,,15.58,14.94,17.16,percent of total billed charges,,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Aetna,Middlesex Employees,,,14.94,,14.94,14.94,17.16,percent of total billed charges,,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Anthem,Commerical,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Anthem,Indemnity,,,15.12,,15.12,14.94,17.16,percent of total billed charges,,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Anthem,Individual Exchange,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Anthem,State Preferred,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Cigna,Cigna,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Connecticare,Commerical,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Connecticare,Exchange,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,Multiplan,Multiplan,,,17.16,,17.16,14.94,17.16,percent of total billed charges,,
ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,J3490,HCPCS,11701-050-32,NDC,both,1,gm,20.19,12.11,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,14.94,17.16,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Aetna,Commerical,,,52.52,,52.52,50.36,57.85,percent of total billed charges,,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Aetna,Middlesex Employees,,,50.36,,50.36,50.36,57.85,percent of total billed charges,,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Anthem,Commerical,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Anthem,Indemnity,,,50.98,,50.98,50.36,57.85,percent of total billed charges,,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Anthem,Individual Exchange,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Anthem,State Preferred,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Cigna,Cigna,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Connecticare,Commerical,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Connecticare,Exchange,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,Multiplan,Multiplan,,,57.85,,57.85,50.36,57.85,percent of total billed charges,,
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,J3490,HCPCS,0517-6101-25,NDC,both,1,mL,68.06,40.84,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,50.36,57.85,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Aetna,Commerical,,,0.36,,0.36,0.35,0.4,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Aetna,Middlesex Employees,,,0.35,,0.35,0.35,0.4,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Anthem,Commerical,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Anthem,Indemnity,,,0.35,,0.35,0.35,0.4,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Anthem,Individual Exchange,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Anthem,State Preferred,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Cigna,Cigna,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Connecticare,Commerical,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Connecticare,Exchange,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,Multiplan,Multiplan,,,0.4,,0.4,0.35,0.4,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,73140106,NDC,both,1,ea,0.47,0.28,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.35,0.4,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Aetna,Commerical,,,0.45,,0.45,0.43,0.49,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Aetna,Middlesex Employees,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Anthem,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Anthem,Indemnity,,,0.43,,0.43,0.43,0.49,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Anthem,Individual Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Anthem,State Preferred,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Cigna,Cigna,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Connecticare,Commerical,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Connecticare,Exchange,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,Multiplan,Multiplan,,,0.49,,0.49,0.43,0.49,percent of total billed charges,,
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,J3490,HCPCS,2055504000,NDC,both,1,ea,0.58,0.35,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.43,0.49,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Aetna,Commerical,,,5.86,,5.86,5.62,6.46,percent of total billed charges,,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Aetna,Middlesex Employees,,,5.62,,5.62,5.62,6.46,percent of total billed charges,,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Anthem,Commerical,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Anthem,Indemnity,,,5.69,,5.69,5.62,6.46,percent of total billed charges,,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Anthem,Individual Exchange,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Anthem,State Preferred,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Cigna,Cigna,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Connecticare,Commerical,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Connecticare,Exchange,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,Multiplan,Multiplan,,,6.46,,6.46,5.62,6.46,percent of total billed charges,,
ZIPRASIDONE 20 MG CAPSULE,J3490,HCPCS,0904-6269-08,NDC,both,1,ea,7.6,4.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,5.62,6.46,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,40810-0005-77,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,55111-257-60,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,59762-2002-1,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Aetna,Commerical,,,0.85,,0.85,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Aetna,Middlesex Employees,,,0.81,,0.81,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Anthem,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Anthem,Indemnity,,,0.82,,0.82,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Anthem,Individual Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Anthem,State Preferred,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Cigna,Cigna,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Connecticare,Commerical,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Connecticare,Exchange,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,Multiplan,Multiplan,,,0.94,,0.94,0.81,0.94,percent of total billed charges,,
ZIPRASIDONE 40 MG CAPSULE,J3490,HCPCS,65862-703-60,NDC,both,1,ea,1.1,0.66,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.81,0.94,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Aetna,Commerical,,,99.57,,99.57,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Aetna,Middlesex Employees,,,95.48,,95.48,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Anthem,Commerical,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Anthem,Indemnity,,,96.66,,96.66,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Anthem,Individual Exchange,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Anthem,State Preferred,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Cigna,Cigna,,8.08,,,8.08,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Connecticare,Commerical,,9.88,,,9.88,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Connecticare,Exchange,,9.88,,,9.88,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,Multiplan,Multiplan,,,109.68,,109.68,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,16729-242-31,NDC,both,1.25,mL,129.04,77.42,United Healthcare/Oxford,United Healthcare/Oxford,,6.99,,,6.99,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Aetna,Commerical,,,99.57,,99.57,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Aetna,Middlesex Employees,,,95.48,,95.48,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Anthem,Commerical,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Anthem,Indemnity,,,96.66,,96.66,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Anthem,Individual Exchange,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Anthem,State Preferred,,,,,,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Cigna,Cigna,,8.08,,,8.08,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Connecticare,Commerical,,9.88,,,9.88,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Connecticare,Exchange,,9.88,,,9.88,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,Multiplan,Multiplan,,,109.68,,109.68,6.99,109.68,percent of total billed charges,,
ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,J3489,HCPCS,67457-390-54,NDC,both,1.25,mL,129.04,77.42,United Healthcare/Oxford,United Healthcare/Oxford,,6.99,,,6.99,6.99,109.68,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Aetna,Commerical,,,3388.17,,3388.17,6.99,3732.44,percent of total billed charges,,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Aetna,Middlesex Employees,,,3248.97,,3248.97,6.99,3732.44,percent of total billed charges,,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Anthem,Commerical,,,,,,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Anthem,Indemnity,,,3289.37,,3289.37,6.99,3732.44,percent of total billed charges,,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Anthem,Individual Exchange,,,,,,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Anthem,State Preferred,,,,,,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Cigna,Cigna,,8.08,,,8.08,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Connecticare,Commerical,,9.88,,,9.88,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Connecticare,Exchange,,9.88,,,9.88,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,Multiplan,Multiplan,,,3732.44,,3732.44,6.99,3732.44,percent of total billed charges,,
ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,J3489,HCPCS,0078-0435-61,NDC,both,20,mL,4391.1,2634.66,United Healthcare/Oxford,United Healthcare/Oxford,,6.99,,,6.99,6.99,3732.44,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Aetna,Commerical,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Aetna,Middlesex Employees,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Anthem,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Anthem,Indemnity,,,0.07,,0.07,0.07,0.08,percent of total billed charges,,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Anthem,Individual Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Anthem,State Preferred,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Cigna,Cigna,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Connecticare,Commerical,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Connecticare,Exchange,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,Multiplan,Multiplan,,,0.08,,0.08,0.07,0.08,percent of total billed charges,,
ZOLPIDEM 2.5 MG ORAL TAB,J3490,HCPCS,40810-0003-24,NDC,both,1,ea,0.09,0.05,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.07,0.08,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Aetna,Commerical,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Aetna,Middlesex Employees,,,0.18,,0.18,0.18,0.21,percent of total billed charges,,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Anthem,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Anthem,Indemnity,,,0.19,,0.19,0.18,0.21,percent of total billed charges,,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Anthem,Individual Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Anthem,State Preferred,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Cigna,Cigna,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Connecticare,Commerical,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Connecticare,Exchange,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,Multiplan,Multiplan,,,0.21,,0.21,0.18,0.21,percent of total billed charges,,
ZOLPIDEM 5 MG TABLET,J3490,HCPCS,0904-6082-61,NDC,both,1,ea,0.25,0.15,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.18,0.21,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Aetna,Commerical,,,0.72,,0.72,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Aetna,Middlesex Employees,,,0.69,,0.69,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Anthem,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Anthem,Indemnity,,,0.7,,0.7,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Anthem,Individual Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Anthem,State Preferred,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Cigna,Cigna,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Connecticare,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Connecticare,Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,Multiplan,Multiplan,,,0.79,,0.79,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,0024-5521-31,NDC,both,1,ea,0.93,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Aetna,Commerical,,,0.72,,0.72,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Aetna,Middlesex Employees,,,0.69,,0.69,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Anthem,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Anthem,Indemnity,,,0.7,,0.7,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Anthem,Individual Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Anthem,State Preferred,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Cigna,Cigna,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Connecticare,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Connecticare,Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,Multiplan,Multiplan,,,0.79,,0.79,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,10370-116-10,NDC,both,1,ea,0.93,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Aetna,Commerical,,,0.72,,0.72,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Aetna,Middlesex Employees,,,0.69,,0.69,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Anthem,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Anthem,Indemnity,,,0.7,,0.7,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Anthem,Individual Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Anthem,State Preferred,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Cigna,Cigna,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Connecticare,Commerical,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Connecticare,Exchange,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,Multiplan,Multiplan,,,0.79,,0.79,0.69,0.79,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,47335-308-88,NDC,both,1,ea,0.93,0.56,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.69,0.79,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Aetna,Commerical,,,13.87,,13.87,13.3,15.27,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Aetna,Middlesex Employees,,,13.3,,13.3,13.3,15.27,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Anthem,Commerical,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Anthem,Indemnity,,,13.46,,13.46,13.3,15.27,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Anthem,Individual Exchange,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Anthem,State Preferred,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Cigna,Cigna,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Connecticare,Commerical,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Connecticare,Exchange,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,Multiplan,Multiplan,,,15.27,,15.27,13.3,15.27,percent of total billed charges,,
"ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE",J8499,HCPCS,68180-780-01,NDC,both,1,ea,17.97,10.78,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,13.3,15.27,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Aetna,Commerical,,,45.75,,45.75,43.87,50.4,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Aetna,Middlesex Employees,,,43.87,,43.87,43.87,50.4,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Anthem,Commerical,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Anthem,Indemnity,,,44.41,,44.41,43.87,50.4,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Anthem,Individual Exchange,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Anthem,State Preferred,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Cigna,Cigna,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Connecticare,Commerical,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Connecticare,Exchange,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,Multiplan,Multiplan,,,50.4,,50.4,43.87,50.4,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-80,NDC,both,1,mL,59.29,35.57,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,43.87,50.4,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Aetna,Commerical,,,22.88,,22.88,21.94,25.2,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Aetna,Middlesex Employees,,,21.94,,21.94,21.94,25.2,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Anthem,Commerical,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Anthem,Indemnity,,,22.21,,22.21,21.94,25.2,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Anthem,Individual Exchange,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Anthem,State Preferred,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Cigna,Cigna,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Connecticare,Commerical,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Connecticare,Exchange,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,Multiplan,Multiplan,,,25.2,,25.2,21.94,25.2,percent of total billed charges,,
ZONISAMIDE 10 MG/ML ORAL SUSP,J3490,HCPCS,40810-0012-81,NDC,both,1,mL,29.65,17.79,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,21.94,25.2,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Anthem,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Anthem,Individual Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Anthem,State Preferred,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Cigna,Cigna,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Connecticare,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Connecticare,Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-11,NDC,both,1,ea,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Anthem,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Anthem,Individual Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Anthem,State Preferred,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Cigna,Cigna,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Connecticare,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Connecticare,Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,50268-816-15,NDC,both,1,ea,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Anthem,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Anthem,Individual Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Anthem,State Preferred,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Cigna,Cigna,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Connecticare,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Connecticare,Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,60687-230-01,NDC,both,1,ea,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Aetna,Commerical,,,1.31,,1.31,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Aetna,Middlesex Employees,,,1.26,,1.26,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Anthem,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Anthem,Indemnity,,,1.27,,1.27,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Anthem,Individual Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Anthem,State Preferred,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Cigna,Cigna,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Connecticare,Commerical,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Connecticare,Exchange,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,Multiplan,Multiplan,,,1.45,,1.45,1.26,1.45,percent of total billed charges,,
ZONISAMIDE 100 MG CAPSULE,J3490,HCPCS,69097-861-07,NDC,both,1,ea,1.7,1.02,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,1.26,1.45,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Aetna,Commerical,,,995.62,,995.62,954.72,1096.78,percent of total billed charges,,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Aetna,Middlesex Employees,,,954.72,,954.72,954.72,1096.78,percent of total billed charges,,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Anthem,Commerical,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Anthem,Indemnity,,,966.59,,966.59,954.72,1096.78,percent of total billed charges,,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Anthem,Individual Exchange,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Anthem,State Preferred,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Cigna,Cigna,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Connecticare,Commerical,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Connecticare,Exchange,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,Multiplan,Multiplan,,,1096.78,,1096.78,954.72,1096.78,percent of total billed charges,,
ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,J3490,HCPCS,52652-8001-1,NDC,both,1,mL,1290.33,774.2,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,954.72,1096.78,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,40810-0005-88,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,59651-378-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,68462-128-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Aetna,Commerical,,,0.22,,0.22,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Aetna,Middlesex Employees,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Anthem,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Anthem,Indemnity,,,0.21,,0.21,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Anthem,Individual Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Anthem,State Preferred,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Cigna,Cigna,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Connecticare,Commerical,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Connecticare,Exchange,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,Multiplan,Multiplan,,,0.24,,0.24,0.21,0.24,percent of total billed charges,,
ZONISAMIDE 25 MG CAPSULE,J3490,HCPCS,72578-040-01,NDC,both,1,ea,0.28,0.17,United Healthcare/Oxford,United Healthcare/Oxford,,,,,,0.21,0.24,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Aetna,Commerical,,,40.33,,40.33,1.33,44.43,percent of total billed charges,,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Aetna,Middlesex Employees,,,38.67,,38.67,1.33,44.43,percent of total billed charges,,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Anthem,Commerical,,,,,,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Anthem,Indemnity,,,39.16,,39.16,1.33,44.43,percent of total billed charges,,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Anthem,Individual Exchange,,,,,,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Anthem,State Preferred,,,,,,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Cigna,Cigna,,1.33,,,1.33,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Connecticare,Commerical,,1.68,,,1.68,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Connecticare,Exchange,,1.68,,,1.68,1.33,44.43,Other,Could be inpatient or outpatient,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,Multiplan,Multiplan,,,44.43,,44.43,1.33,44.43,percent of total billed charges,,
ZOSYN 50 MG/ML IN D5W NICU,J2543,HCPCS,40810-0004-78,NDC,both,22.5,mL,52.27,31.36,United Healthcare/Oxford,United Healthcare/Oxford,,1.44,,,1.44,1.33,44.43,Other,Could be inpatient or outpatient,